Do SSRIs impact on the antidepressant efficacy of psilocybin? Researchers performed an open-label trial of single-dose psilocybin in patients with TRD who were taking SSRIs. CASE VIGNETTE “Mr Blythe” is a 29-year-old AfricanAmerican male with a history of recurrent, sever major depressive disorder (MDD) without psychosis. The onset of his depression was around age 20 years. He has some features of atypical depression, including hypersomnia, weight gain, and anxiety. Mr Blythe previously failed trials of fluoxetine, bupropion, venlafaxine, and nortriptyline.He declines neurostimulation due to a family member having significant adverse cognitive effects from electroconvulsive therapy. He is currently taking sertraline 200 mg daily and sees a psychotherapist weekly for cognitive-behavioral therapy. At his most recent outpatient clinic visit, he asks whether he is a candidate for treatment with adjunctive psychedelics and specifically asks about psilocybin. As his psychiatrist, how would you respond? Psilocybin has demonstrated antidepressant properties in patients with MDD and treatment-resistant depression (TRD).1-3 Although the mechanism(s) of this association is unclear, there is some evidence that the acute psychedelic experience may play an important role.4 However, there is also evidence that the acute subjective psychedelic effects of psilocybin are diminished by the use of antidepressant drugs prior to exposure.5,6 There is evidence that psilocybin also weakly inhibits the serotonin transporter site that is the target of selective serotonin reuptake inhibitors (SSRIs).7 However, a recent double-blind randomized controlled trial in healthy participants found that SSRI administration for 2 weeks did not significantly alter the acute subjective effects of 25 mg psilocybin. Given interest in psilocybin for TRD, it is important to test the impact of chronic antidepressant treatment on the antidepressant effects of psilocybin. The Current Study Goodwin and colleagues8 conducted an exploratory phase 2, fixed-dose, open-label study to investigate the safety and efficacy of a synthetic form of psilocybin (COMP360) with psychological support, in adjunct to SSRI, in patients with TRD. The investigators recruited adult outpatients aged 18 years or older with TRD, defined as a depressive episode without psychotic features, a Hamilton Depression Rating Scale (HAM-D) ≥ 18, and failure to respond to an adequate dose and duration (≥ 8 weeks) of 2 to 4 pharmacological treatments for the current episode, including their current SSRI. Participants were taking an approved therapeutic dose of a single SSRI with at least 75% adherence for a minimum of 6 weeks. Participants with a major comorbid psychiatric disorder or suicide risk were excluded. Participants underwent a 3-week screening period prior to psilocybin administration (day 1), including repeated safety measures. Preparation for the psilocybin experience was conducted by a trained therapist. Participants received a single administration of psilocybin 25 mg and were accompanied by a lead therapist for the 6- to 8-hour session. Blood pressure was continuously monitored. Participants wore eyeshades and headphones with a specifically designed music playlist. Participants were followed up for 3 weeks to monitor safety and efficacy, and completed an integration session with their lead therapist on day 2 and week 1. Safety outcomes included electrocardiogram (ECG), vital signs, clinical laboratory tests, adverse events, and change from baseline in the Columbia Suicide Severity Rating Scale (C-SSRS). The primary efficacy end point was the change in Montgomery-Asberg Rating Scale (MADRS) from baseline (day 1) to week 3. Secondary end points were the proportion of responders (≥ 50% improvement in MADRS total score) and remitters (MADRS total score ≤ 10) at week 3, and change in the Clinical Global Impression-Severity (CGI-S) score at week 3. The acute subjective psychedelic experience was assessed by the Five-Dimensional Altered States of Consciousness questionnaire (5D-ASC). Approximately 19 out of 24 enrolled participants received psilocybin and completed the study, with no post-treatment withdrawals. The mean duration of prior SSRI treatment was 15 months. The mean participant age was 42 years, 68% of participants were female, and 79% were Caucasian. The mean baseline CGI-S score was 4.3 (moderately ill). Approximately 17 treatment-emergent adverse events were reported for 12 participants (63%), the most commonly reported of which was headache (32%). None of the reported adverse events were severe. There were no reports of suicidal ideation with plan or intent, suicide attempts, or self-injurious behavior throughout the study. There were no clinically significant changes in laboratory tests or ECG. The mean MADRS total score at endpoint was 16.8, with a mean change from baseline of -14.9, apparent at day 2 and maintained throughout the study. Eight (42%) participants were responders at week 3. The same 42% of responders at week 3 also met criteria for remission. The mean CGI-S score was week 3 was 2.9, with a mean change from baseline of -1.3. There was also clinically meaningful improvement in anxiety, evidenced by a mean 4.1 decrease in the GAD-7 total score. Study Conclusions The investigators concluded that a single administration of psilocybin 25 mg with psychological support adjunctive to SSRI demonstrated a favorable safety and therapeutic efficacy profile in subjects with TRD. Findings do not support the hypothesis that adjunctive SSRIs diminish the antidepressant effects of psilocybin, the investigation of which is a primary study strength. Study limitations include the small sample size, open-label design, and absence of a comparator, and the exclusion of patients at increased risk of suicide or psychiatric hospitalization. The Bottom Line Larger, comparator-controlled trials of psilocybin in adjunct to antidepressants would be valuable, especially in cases where antidepressant drug withdrawal would be problematic. Dr Miller is a professor in the Department of Psychiatry and Health Behavior at Augusta University in Augusta, Georgia. He is on the Editorial Board and serves as the schizophrenia section chief for Psychiatric Times®. The author reports that he receives research support from Augusta University, the National Institute of Mental Health, and the Stanley Medical Research Institute. Related Articles: Single Psilocybin Dose Again Shows Major Depression Benefit Psilocybin Reduces Symptoms, Disability in Major Depression

National Suicide Prevention Month is upon us again. This month represents hope: hope as we create more awareness around suicide; hope found in the resources available; and hope as we see the stigma around addressing suicide decrease. This month also can represent pain for those who have been touched by suicide. Whatever you are feeling this September, there are things you can do to create hope in your family and your community. Learn the warning signs and risk factors for suicide, or attend a training (many trainings are now offered online) to learn how to intervene and refer if someone is considering suicide, and help spread the word about the 988 Suicide & Crisis Lifeline. SAMHSA is committed to suicide prevention year-round. Our commitment is evident in our leadership, our funding opportunities, and our partnerships. Many of our funding opportunities help address groups that are disproportionately affected by suicide. American Indian and Tribal Communities: American Indian and Alaska Natives (AI/AN) experience disproportionately high rates of suicide. According to the Centers for Disease Control and Prevention (CDC) 2022 Morbidity and Mortality Weekly Report (MMWR), from 2015-2020, suicide rates among AI/AN individuals increased almost 20 percent. While provisional estimates of suicide rates among this population decreased in 2022, their suicide rates are still much higher than the national average. Incorporating culture as a protective factor has been shown to help AI/AN individuals, especially youth, have an increased sense of purpose and belonging and can reduce suicidal ideation. At SAMHSA, we have developed a program called Native Connections that supports a model of increasing community readiness to address suicide. Black Youth: Black youth have been experiencing rapidly increasing rates of suicide deaths and attempts. According to CDC data, suicide deaths of Black youth and young adults between the ages of 10-24 increased significantly from 2018-2021. Connecting Black youth with culturally supportive suicide prevention and mental health supports can help reduce suicidal ideation and attempts among Black youth. At SAMHSA, we’ve created a Black Youth Suicide Prevention Initiative to help develop strategies to support Black youth. To learn more about supporting this population, check out the HHS Report to Congress on African American Youth Suicide (PDF | 1.3 MB). LGBTQ+ Youth: Youth who identify as lesbian, gay, bisexual, transgender, or queer/questioning are more than four times as likely to attempt suicide than their peers because of the stigma and mistreatment they experience in society.. LGBTQ+ youth who have even one supportive adult in their life (e.g., a parent, a coach, a teacher, mentor, friend’s parent, etc.) are 40% less likely to report a suicide attempt. You can check out the Suicide Prevention Resource Center’s (SPRC) newly released Mental Health and Suicide Prevention for LGBTQIA2S+ Youth Resource Guide as well as SAMHSA’s Family Counseling and Support for Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex+ Youth and their Families grant for more information. Older Adults: Data released by the CDC indicated a significant increase in suicide deaths among older adults aged 64 and over in 2022. Understanding challenges that older adults face — such as increased chances of developing a chronic illness, which can be connected to a sense of burdensomeness and perhaps suicidal thoughts and behaviors — can help create meaningful supports for this population. Screening for suicide risk among older adults is another strategy to identify older adults at risk for suicide. To learn more about supporting the mental health of older adults, SAMHSA’s E4 Center of Excellence for Behavioral Health Disparities in Aging can be helpful. Persons with Lived Experience: Whether you have had thoughts of suicide yourself, have loved or supported someone who has survived a suicide attempt, or lost someone to suicide, it is important to take extra care of yourself and to be mindful of your needs for support and self-care. Some of the ways you can do this are learning how to support someone considering suicide, browsing resources for suicide attempt survivors or suicide loss survivors, and taking care of your own mental health and well-being. The SPRC’s Lived Experience Advisory Committee is working to engage the field around integrating lived experience in suicide prevention activities. Persons with Substance Use Disorders: Substance use disorders (SUDs) are associated with significantly increased risk of suicide in the United States, especially among individuals experiencing multiple SUDs. Share facts on substance use and misuse and connect people in your social and professional communities to evidence-based prevention information and tools, such as: SAMHSA’s “Talk. They Hear You.” campaign, including its new mobile app, which helps parents and caregivers start conversations about substance misuse prevention; SAMHSA’s Student Assistance Program which provides schools and educator resources to help teachers, administrators and other school professionals play a role in preventing underage substance use and abuse; harm reduction; and other SAMHSA resources on substance misuse and opioid overdose. We all play a role in suicide prevention. When you start a conversation with a loved one who may be struggling with thoughts of suicide and offer support and model self-care, you are providing hope to those who may need it most. If you are a part of one of the groups highlighted above or have a loved one who is, we encourage you to build from the momentum this month to incorporate additional support and learning opportunities in your community. Related Articles: - Suicide Prevention

The US Food and Drug Administration (FDA) has approved Gepirone hydrochloride extended-release tablets (Exxua) as the first oral selective 5HT1A receptor agonist for treating major depressive disorder in adults. Exxua, a novel mechanism of action, has been approved without warnings or adverse reactions related to sexual dysfunction or weight gain. The FDA approval marks a unique accomplishment, as Exxua overcame several obstacles, having been rejected three times before finally receiving the green light. The drug displayed an overall acceptable safety profile in clinical trials, with rates of sexual side effects comparable to that with placebo. There were no significant adverse effects on blood pressure, heart rate, and liver function. Dizziness and nausea were the most commonly reported adverse events in clinical trials, and they were mild, of short duration, related to dose escalations and did not require discontinuation of treatment. The FDA did not grant approval when the drug was originally submitted, but it was backed by two well-designed randomized controlled trials. The FDA decision is being applauded by many in the field, with patient advocacy groups celebrating the new entry. Exxua should be available to patients in early 2024.

The overdose crisis in the US has seen a significant increase in drug overdose deaths, with fentanyl-laced stimulants fueling the fourth wave. This surge in overdose deaths, which accounted for 32% of fatal overdoses in 2021, is attributed to the use of fentanyl combined with stimulants. The rise in fentanyl stimulant fatalities is the fourth wave in the opioid overdose crisis, which began with an increase in deaths from prescription opioids in the early 2000s and heroin in 2010. The study, published in the journal Addiction, found that the percentage of overdose deaths in that 12-year span involving both fentanyl and stimulants jumped from 0.6% (235 deaths) in 2010 to 32.3% (34,429 deaths) in 2021. This reflects intentional co-use and unintentional use of fentanyl and stimulants. The study also found that fentanyl/stimulant overdose deaths disproportionately affect racial/ethnic minority communities in the US, including Black and African American people and Native American people. Geographic patterns to fentanyl/stimulant use are also evident, with fentanyl often combined with cocaine in the Northeast US and methamphetamine in the southern and western US. The landscape of polysubstance overdose has been evolving rapidly, and the current results may represent snapshots of shifting dynamics that will soon change. Related Article: - Missouri's fentanyl epidemic is getting worse, with a record number of overdoses - Study Shows That Anti-Fentanyl Antibody Reverses Signs of Carfentanil Overdose

A retrospective cohort study published in Regional Anesthesia and Pain Medicine found that off-label gabapentin prescriptions did not reduce opioid dosage in patients with chronic opioid use. The study assessed 172,602 commercially insured patients with chronic opioid use who received a new off-label gabapentin prescription between January 1, 2010, and June 30, 2019. The majority of patients had arthritis (82.3%) or back pain (68.5%), with 28.7% having an anxiety diagnosis and 19.4% having an alcohol or substance use disorder. Opioid dosages were measured using oral morphine equivalents (OME) per day after adding the new off-label gabapentin prescription. The new off-label gabapentin prescription was associated with a decrease in opioid dosage in 38.8% of patients 6 months after initiating the prescription, while an increase in opioid dosage was reported in 47.0% of patients. No change in opioid dosage was reported in 14.2% of patients. The study's limitations include the retrospective nature of the study, the fact that gabapentin and opioid prescriptions reflect fill rates but may not reflect actual consumption, and the study of employer-sponsored health insurance claims may not be generalizable to Medicare and Medicaid recipients or the uninsured.

"Talk. They Hear You."® is a national prevention campaign by SAMHSA that aims to increase parents' awareness of underage substance use and equip them with the knowledge, skills, and confidence to prevent it. The campaign offers resources such as a mobile app, Screen4Success, podcasts, educational session toolkits, discussion starter videos, Public Service Announcements (PSAs), e-newsletters, and other resources for parents, caregivers, schools, and communities. Launched in 2013, the campaign initially focused on alcohol with children but expanded to include other drugs and youth under age 21. The campaign has registered over 1,500 licensed campaign partners across the country, garnered over 22.4 billion impressions of PSAs on television, radio, and print publications, and won 58 awards since 2018. The campaign has also received recognition from the National Parent Teacher Association's School of Excellence Program and has won 58 awards since 2018. To celebrate "Talk. They Hear You."®, communities and schools can join SAMHSA's 20th Prevention Day, plan local events, participate in National Prevention Week and MyPreventionStory, and download SAMHSA's Prevention Month toolkit each October. Everyone has a role to play in prevention, and the campaign encourages everyone to take action to advance prevention in their community. Drug addiction treatment should be tailored to each individual's unique situation, addressing not just drug abuse but also the broader life issues such as relationships, career, health, and psychological well-being. Successful treatment requires a new way of living and addressing the reasons for drug use. Long-term follow-up care is crucial for recovery. Treatment options vary based on factors like age, drug-use history, and medical conditions. It's also essential to seek treatment for mental health problems simultaneously, combining mental health and addiction treatment from the same provider or team.

National Suicide Prevention Month is a time to remember the lives lost to suicide, support those experiencing suicidal thoughts, and raise awareness about suicide prevention. Lethal means safety is an evidence-based suicide prevention practice that involves making a suicide attempt method less available or more difficult to access immediately, reducing the risk of harm and saving lives. In the United States, firearms are the most common and lethal method of attempting, with nearly 90% of suicide attempts involving firearms being fatal. The mechanics of lethal means safety involve making a firearm less available or inaccessible during a crisis, allowing for someone to intervene or reach out for help. Research has consistently found that if someone's preferred suicide attempt method is unavailable, they will generally not attempt using a different method. If a person does attempt suicide using a different method, a far less lethal method is likely to be used, and subsequently the person is more likely to survive. Surviving a suicide attempt allows the person to get the help they need and allows them to thrive and live a fruitful life. Key strategies to promote lethal means safety include practicing safe storage initiatives, ensuring that firearms are stored unloaded, with ammunition stored separately, in a gun safe or tamper-proof storage box, or with external locking devices. Reducing access to lethal means of self-harm is crucial for a comprehensive approach to suicide prevention. Firearms and high-dose medications are the most lethal methods, and reducing access is essential for preventing suicide attempts during short-term crises. Families, organizations, healthcare providers, and policymakers can take various actions to reduce access to lethal means, including limiting access to medications and storing firearms safely. In cases of a person experiencing a crisis, it is safe to remove lethal means from the household until the situation improves. Communities can also focus means restriction efforts on local suicide "hotspots" like bridges. To take action, individuals should obtain and share knowledge about the issue, educate family members, train mental health professionals, and educate the community about temporary firearm storage options. Implementing lethal means counseling policies in health and behavioral health care settings, working with gun retailers and owner groups, and ensuring protective barriers in bridges and high buildings are also essential steps.

The Nurses Health Study II (NHS II) has found that a diet high in ultraprocessed food (UPF), particularly artificial sweeteners, has been linked to increased depression risk. Nurses who consumed more than eight servings daily had about a 50% higher risk of developing depression than those who consumed four or fewer servings daily. However, only artificial sweeteners and artificially sweetened beverages were associated with an increased risk of depression. Animal studies have shown that artificial sweeteners may trigger the transmission of particular signaling molecules in the brain that are important for mood. Given this potential association between ultraprocessed food and multiple adverse health conditions, wherever possible individuals may wish to limit their intake of such foods. This may be a lifestyle change that could have important benefits, particularly for those who struggle with mental health. The findings are based on 31,712 mostly non-Hispanic White women who were free of depression at baseline. As part of the NHS II, the women provided information on diet every 4 years using validated food frequency questionnaires. Compared to women with low UPF intake, those with high UPF intake had greater body mass index (BMI), were apt to smoke, have diabetes, hypertension, and dyslipidemia, and were less apt to exercise regularly. A study has found that a combination of a healthy diet and physical activity can reduce the risk of depression and its impact on quality of life. However, the study has limitations, including the potential for factors like obesity, smoking habits, and less-active lifestyles to influence the results. It is unclear if low mood increases the risk of weight gain or vice versa, and the body mass index (BMI) does not distinguish between excess weight and lean muscle versus fat. The study also relied on participants accurately recalling their eating habits and mental health diagnoses, making it difficult to determine if the findings would apply to other groups.

A systematic legal analysis using the Alcohol Policy Information System identified 18 states with AELs, 15 with explicitly prohibited AE provisions, and 17 with no clear laws on AE. The study argues that these laws perpetuate the outdated notion that adverse consequences of alcohol use should be viewed as evidence of a lack of willpower and immorality, preventing individuals from receiving treatment for alcohol use disorder. Alcohol exclusion laws (AELs) in 18 states remain in place, despite evidence showing they prevent treatment for alcohol use disorder. Alcohol laws in 18 states remain unchanged from 2004, with 15 explicitly prohibiting AE provisions and 17 lacking clear laws, perpetuating the outdated notion of adverse consequences as evidence of willpower and immorality. Clinical presentation of alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include: Being unable to limit the amount of alcohol you drink. Wanting to cut down on how much you drink or making unsuccessful attempts to do so. To address a problem related to excessive alcohol consumption, seek help from a doctor, mental health professional, or support group like Alcoholics Anonymous. Recognize your drinking habits and seek help from loved ones or professionals experienced in alcohol treatment. Denial can lead to denial and hinder recovery. Seek help from a doctor, mental health professional, or a support group to address your drinking habits and problem.

A new study published in the Journal of the American Medical Association (JAMA) found that recreational marijuana use among teenagers is 2 to 3 times more likely to lead to depression and suicidal thoughts than non-users. The National Survey on Drug Use and Health revealed that teens with cannabis use disorder are 4 times more likely to experience these thoughts and feelings. The study also found that marijuana use was linked to other issues such as school failure, skipping school, and police involvement. A new study from Columbia University has found that teens who recreationally use cannabis are two to four times more likely to develop psychiatric disorders and engage in problem behaviors, such as poor academic performance and trouble with the law. Even casual use of cannabis is associated with long-term negative outcomes, affecting the mental health, behavior, and potential development of adolescents. The research, published in the journal JAMA Network Open, suggests that teenagers engaging in recreational cannabis use are two to four times more prone to developing mental health issues like depression and suicidality compared to their peers who refrain from cannabis use entirely. The study also revealed that even infrequent usage of cannabis can put teens at risk for problematic behaviors, such as poor academic results, school absenteeism, and legal issues, which may potentially hinder their long-term development and prevent them from realizing their full potential as adults. The study is the first to identify that subclinical, or non-disordered, cannabis use—symptoms and behaviors that do meet the criteria for a clinical disorder—has clear adverse and impairing associations for adolescents. In conclusion, the study highlights the importance of addressing the negative impacts of cannabis use on the mental health and potential development of adolescents. Parents who are experiencing, clinical psychiatry, emphasized the importance of discussing marijuana use, depression, and anxiety with parents to prevent further negative impacts on their children's mental health. A child psychiatrist discovered a higher risk of mental health issues among recreational users, highlighting the negative impact of cannabis use on thinking and potentially increasing depression and suicidal thoughts, a concern for child psychiatrists. Related Articles: - Cannabis and Bipolar - Is a Drug to Treat Cannabis Addiction Finally Within Reach? - Physicians Aren't Asking Enough Questions About Cannabis Use

Ketogenic supplements have been used for centuries to treat various conditions, including seizures and diabetes. The ketogenic diet, which consists of low-carbohydrate, high-fat meals, has been shown to be effective in controlling seizures and treating diabetes and metabolic syndrome. However, the effectiveness of ketogenic supplements in treating conditions like heart disease and dementia remains unknown. The National Institutes of Health has awarded a $3.5 million federal grant for a double-blind, randomized, placebo-controlled clinical trial to understand the effects of long-term use of ketone ester supplementation on frailty. Ketone bodies, precursor molecules that the body breaks down into ketone bodies when carbohydrates aren't available, could have helpful applications in various aging conditions. The TAKEOFF trial aims to recruit 180 people across three sites and assess how ketones might affect frailty in the elderly. The main hypothesis of the TAKEOFF study is that targeting these fundamental mechanisms of aging could impact various diseases of aging across different organ systems. Understanding how ketogenic diets influence brain function could lead to new treatments to prevent cognitive decline in mental health conditions, which are increasingly recognized as neuro-progressive disorders. Treatment-resistant conditions often result from the damage to the brain's structure and function. Some of the mechanisms through which ketogenic diets may affect brain function include: Reducing inflammation Improving oxygen utilisation Regulating key neurotransmitters Changing gut bacteria in the microbiome The latest research on ketogenic diets has shown promising results, but understanding the reasons behind their effectiveness is complex. While not all patients experience improvement, the latest research suggests that ketogenic diets should be used under medical supervision due to potential risks and individual responses.

There's no escaping mental health challenges—everyone has them. So, if you struggle with anxiety, depression, or substance abuse you've got lots of company. Mental health Battles Here we spotlight some accounts of brave singers, actors—even royalty—battling big emotions and in some cases mental illness, as the whole world watches. Ryan Reynolds, Meghan Markle, Britney Spears, Amanda Bynes along with 11 others, prove that no amount of money, glamour, physical health, or privilege can fend off the heartbreak and devastation of despair. But when the glitterati shares their struggles by speaking out, it normalizes the problem and helps the rest of us feel less alone. Actor Ryan Reynolds Although Canadian-born actor Ryan Reynolds is often cast as a savage superhero, he admits to struggling with stress and anxiety both on and off the screen. Growing up Reynolds says he was shy and often used humor to deflect attention away from himself—and to keep him safe. "I have three older brothers. So I was less a brother and more of a moving target in our house," Reynolds told NPR in March (2022). "And I developed a bit of a silver tongue as a kid." On Instagram, Reynolds once referred to his anxiety as his "lifelong pal" and told SELF that his parents didn't model the best mental health coping skills. "They were part of a generation that didn't really discuss mental health." Today, the father of three young daughters encourages conversation at home around difficult feelings and shares his personal struggles in an effort to destigmatize common issues like anxiety. Reynolds seems to be living proof that tough guys can—and should—have a soft side, too! Child Actor Amanda Bynes Britney Spears may have put the word "conservatorship" on the map but she isn't the only star who wants out. What is a conservatorship? A conservatorship (aka guardianship) is an unusual legal arrangement intended to protect someone—often an elderly person—from potentially harming themselves. The court appoints a conservator, or guardian, to make financial and medical decisions until the protected individual is able. It's meant to be a temporary solution. Thanks in part to the FreeBritney movement, conservatorships have come under increasing scrutiny for being largely unregulated nationwide. Now 35, actor Amanda Bynes, who starred in her own show as a child, has been under her parents' guardianship since 2013, according to multiple media outlets, after legal and substance abuse issues plagued her. But nearly a decade has passed and Bynes is ready to be rid of their rule. In a short video on Instagram (in March 2022), Bynes thanked her followers for their "love and support" and let them know her day in court was fast approaching. (Conservatorship can only be granted and lifted by the courts.) NBC News reported that Amanda's mother, Lynn Bynes, supports her daughter's intention. Stay tuned to find out if the courts return control of her finances to Amanda Bynes. Singer Britney Spears In November 2021 Britney Spears' 13-year conservatorship was finally ended by a Los Angeles County judge. During this time the singer and actress had no control over her finances or aspects of her personal life, such as getting married or having more children. After fans in April 2019 suspected Spears was forced to check into a mental health facility, her private court battles became more public, and she spoke out about her situation for the first time in June that year. This inspired an explosion of support led by the FreeBritney movement. In June 2021 Spears testified to conservatorship abuses by her father, including being forced to wear an IUD and being medicated without her knowledge. It became more clear to the world that while tabloids reveled in her "erratic" behavior in the late 2000s and 2010s, the superstar was surrounded by people who did not have her best mental health interests at heart. On Instagram shortly after the judge's decision, Spears said: “I'm not here to be a victim. I lived with victims my whole life as a child. That's why I got out of my house, and I worked for 20 years and worked my ass off. ... I'm here to be an advocate for people with real disabilities and real illnesses. I'm a very strong woman, so I can only imagine what the system has done to those people. So hopefully, my story will make an impact and make some changes in the corrupt system.” Actor and Royal Meghan Markle Conversations around race, estrangement, and mental health continue to plague the royal family now that the series Harry & Meghan has been released on Netflix (December 2022). The six-part series, which was produced in collaboration with the couple, airs less than two years after the now-infamous interview with Oprah Winfrey. In that March 2021 interview (seen by 17 million people), Meghan Markle, the Duchess of Sussex and former actress of the television series Suits, revealed to Oprah that she suffered from a culture of isolation and silencing when she was part of the royal family. Being told "no" by senior human resources staff at Buckingham Palace when she asked for help, triggered thoughts of suicide. "I just didn’t want to be alive anymore. And that was very clear and real and frightening,” Meghan said during the interview. Says psychologist Doreen Marshall, PhD, vice president of mission engagement for the American Foundation for Suicide Prevention, "Seeing her speak about it helps people understand that suicide is not a forgone conclusion for anyone having suicidal thoughts. It doesn't mean that you will die by suicide or even attempt suicide. But it is an indicator that your mental health may need attention." Singer Bruce Springsteen In his 2017 book, Born to Run, Bruce Springsteen writes about his personal struggles with depression and mental health in his family. “As a child, it was simply mysterious, embarrassing, and ordinary,” he writes In a later interview aired on the New Yorker Radio Hour podcast (in January 2021) he explained his energetic concert performances as a form of catharsis: “I had had enough of myself by that time to want to lose myself. So I went onstage every night to do exactly that.” He also described other ways he coped in Esquire magazine (2018). “I have come close enough to [mental illness] where I know I am not completely well myself. I’ve had to deal with a lot of it over the years, and I’m on a variety of medications that keep me on an even keel; otherwise, I can swing rather dramatically and . . . just . . . the wheels can come off a little bit. So we have to watch, in our family. I have to watch my kids, and I’ve been lucky there. It ran in my family going way before my dad". Image courtesy of Simon & Schuster. Actor Angelina Jolie Actress Angelina Jolie opened up about her battle with depression in an interview with the Wall Street Journal Magazine in November 2015. In her teens, Jolie Pitt suffered from depression, which she attributes in part to her “unhealthy” hometown. “I grew up in L.A., where focus is very inward. I didn’t know why I was so destructive and miserable. I didn’t appreciate or understand my life.” Her unhappiness was further compounded by guilt. “I was raised in a place where if you have fame and money and you’re decent-looking and have the ability to work in this industry, you have everything in the world. Then you attain those things and realize you still couldn’t be more empty. I didn’t know where to put myself.” Actor Cara Delevingne At just 15-years-old, model turned actress Cara Delevingne hit “a massive wave of depression, anxiety, and self-hatred,” she told Vogue in June 2015. She took numerous psychotropic medications, saw an armada of therapists, and found herself contemplating suicide in her New York apartment. “I was packing my bags, and suddenly I just wanted to end it. I had a way, and it was right there in front of me. And I was like, I need to decide whether I love myself as much as I love the idea of death,” she told Vogue. Actor Brad Pitt Brad Pitt spoke candidly about his battle with depression in the 1990s. "I used to deal with depression, but I don't know, not this decade—maybe last decade. But that's also figuring out who you are. I see it as a great education, as one of the seasons or a semester: 'This semester I was majoring in depression,’ he told the Hollywood Reporter in January 2012. "I was doing the same thing every night and numbing myself to sleep, the same routine. Couldn't wait to get home and hideout. But that feeling of unease was growing and one night I just said, 'This is a waste.'" In 2011 actress Catherine Zeta-Jones revealed that she has bipolar II disorder, which causes severe depression. Speaking to Good Housekeeping about battling the illness, she said, “Finding out that it was called something was the best thing to ever happen to me…the fact that there was a name for my emotions and that a professional could talk me through my symptoms was very liberating. There are amazing highs and very low lows.” “There is no need to suffer silently and there is no shame in seeking help,” she told People magazine in April 2011. Actor Winona Ryder Following the breakdown of her high-profile relationship with actor Johnny Depp, Winona Ryder, then 19, began abusing alcohol, having anxiety attacks, and spiraling into depression, she told The San Francisco Chronicle in January 2000. “There was a time when I was 19 that I really, really, really thought I was going crazy. I was exhausted and going through a terrible depression.” After falling asleep with a lit cigarette and setting herself on fire, Ryder sought treatment, briefly, in a mental institution herself, and finally with a private therapist. Actor Kerry Washington Kerry Washington spoke out in May 2015 about de-stigmatizing mental illness and mental health. She also opened up about seeing a therapist in the magazine, noting that keeping tabs on mental health is just as important as monitoring our physical wellbeing. “My brain and my heart are really important to me. I don’t know why I wouldn’t seek help to have those things as healthy as my teeth,” she told Glamour magazine. “I go to the dentist. So why wouldn’t I go to the shrink?” Actor Dwayne Johnson Dwayne Johnson experienced depression during his early 20s when his football career stalled. Speaking to Men's Health magazine in 2022, Johnson told other men who may be dealing with depression: “I think one of the defining, seminal moments in my life was when I really realized the power and the value of asking for help. You know, really kind of checking your ego at the door. As guys, we have a tendency to not ask for help. Ego gets in the way, and we start stuffing things deep down in our guts, which is not a good thing. ... You gotta ask for help. There’s no shame in that.” Actor Gwyneth Paltrow Gwyneth Paltrow opened up about her experience with postpartum depression in an interview with Good Housekeeping in February 2011. “I felt like a zombie. I couldn’t access my emotions,” she revealed. “I thought postpartum depression meant you were sobbing every single day and incapable of looking after a child. But there are different shades and depths to it.” Actor Jon Hamm "Mad Men" actor John Hamm experienced chronic depression at just 20-years-old following his father’s death. He looked to therapy and antidepressants to recover, as well as the structured environment of college and work. "You can change your brain chemistry enough to think: 'I want to get up in the morning; I don't want to sleep until four in the afternoon," Hamm told The Observer in September 2010. Actor Amanda Seyfried Actress Amanda Seyfried opened up about her use of antidepressants as part of her ongoing treatment for obsessive-compulsive disorder (OCD), a common side effect of which is depression. “I’m on Lexapro, and I’ll never get off it. I’ve been on it since I was 19, so 11 years. I’m on the lowest dose. I don’t see the point of getting off it. Whether it’s a placebo or not, I don’t want to risk it. And what are you fighting against? Just the stigma of using a tool?” she told Allure magazine in October 2016. “A mental illness is a thing that people cast in a different category, but I don’t think it is,” she continued. “It should be taken as seriously as anything else. You don’t see the mental illness: It’s not a mass; it’s not a cyst. But it’s there.” Related Articles: 300 Famous Individuals with Mental Health issues, illnesses, and disorders Celebrities with Mental Health