Two former depression sufferers launch service to help others

A free online mentoring service has been launched by two women; both of who share a history of depression, reported the Daily Mail recently.

Jayne Hardy (30) and Samantha Hadadi (25) wanted to provide a safe and welcoming place for others affected by depression to share their feelings openly.

One in four

Depression is extremely common and will affect one in four of us at some point in our lives. For most who visit their doctor for help, the answer is likely to be anti depressants or a lengthy wait for therapy.

Some who have been prescribed drugs for depression will find that they either don’t work or that the side effects make their lives even more miserable.

 

“Doctors often didn’t have time to help, and the antidepressants they prescribed made me worse” Jayne told the Daily Mail.

Ashamed of being depressed

Others may feel isolated and alone, reluctant to talk about it to anyone. This is the tragedy of depression. Despite massive awareness campaigns, there is still stigma attached to mental health problems.

“Because I’d become withdrawn and isolated, I’d have felt too intimidated to walk into a selfhelp group of strangers. I felt ashamed of being depressed” said Jayne.

Samantha’s first experience of depression came whilst she was studying at university and for her the drugs did work.

“My mum urged me to seek help. I was lucky. My doctor was understanding, antidepressants did help, as did the counselling my doctor lined up” says Samantha.

“But I know I would never have considered joining a group, even if I’d known they were there. I think many young people would be similarly reluctant, which is why I think our online mentoring could prove especially helpful”.

You can find Jayne and Samantha’s mentoring service at blurtitout.org.

Other ways to help beat depression include:

Diet

Many people with busy lives live on processed foods and takeaways. Eat plenty of fresh fruit and vegetables, cut down on red meats and eat more fish.

Fish contains important Omega 3 fatty acids that are known to be essential for healthy brain function and studies have shown they can help alleviate the symptoms of depression. If you don’t want to eat more fish try fish oils.

Exercise

Exercise releases ‘feel-good’ hormones and allows more oxygen to reach the brain. If you’re not a fitness fanatic, don’t worry, studies have shown that taking a walk, particularly in a “green space” has proved to be helpful for depression.

Relaxation

We all need time to recharge our batteries and allow our bodies and brains some time to recover from the stresses and strains of life. Prolonged stress releases Cortisol, the stress hormone, which over time can be harmful to health. Spend some time each day doing something that you enjoy whether it’s reading, taking a bath, or listening to music.

Don’t suffer in silence

The most important thing to remember is that depression is treatable, too many people are afraid to seek help and suffer unnecessarily either because they don’t want to admit they are depressed to themselves or to others or because they are afraid. Don’t suffer in silence.

Omega 3 reduces stroke damage says new study

According to a brand new study by researchers Jasna Kriz and Frederic Calon from the Universite Laval’s Faculty of Medicine in Canada and published in the journal ‘Stroke’ eating a diet that is rich in Omega 3 fatty acids could reduce the amount of brain damage incurred after a stroke.

The neuro-protective benefit appears to come from the anti-inflammatory properties of Omega 3. “It prevents an acute inflammatory response that, if not controlled, is harmful to brain tissue” said Kriz

According to the Stroke Association, around 150,000 people have a stroke in the UK each year resulting in around 53,000 deaths. So what exactly is a stroke and can we do anything to prevent one?

Blood supply to the brain

A stroke occurs when the blood supply to the brain is cut off which can result in damage to brain cells or death of the brain cells causing loss of function in the body.

Causes

There are 3 main things which can cause a stroke and these are atherosclerosis (hardening of the arteries and thickening of the artery walls), a ruptured Aneurysm (an aneurysm is a weak spot on the artery wall), or a blood clot which forms in the heart caused by arrhythmia (irregular heart beat) which then travels to the brain.

Risk Factors

High blood pressure can increase the risk of both heart disease and stroke and so can high triglyceride levels and high cholesterol levels (the bad cholesterol). Medical conditions such as existing heart disease and diabetes can also increase the risk as well as a sedentary lifestyle, poor diet, and smoking and drinking. If you have already suffered a stroke then you are at risk of suffering another one.

Reducing the risk

The obvious things would be to stop smoking, reduce alcohol intake, exercise regularly and eat a healthy diet.

Diet plays a massive role in how healthy or unhealthy we are in general and should not be underestimated. Modern diets are not ideal for promoting good health as they tend to contain high levels of Omega 6, which is found in meat and dairy products, processed foods, confectionery and vegetable oils. There is nothing wrong with this in theory as Omega 6 fatty acids are just as important to our health as Omega 3 fatty acids.

Unfortunately, Omega 3 is not in such plentiful supply with the most abundant sources of it found only in cold water oily fish and fish oil supplements but nowadays we just don’t eat the same amount of fish that we used to in the past and at the same time we have increased our consumption of processed foods.

The Omega 3 Omega 6 imbalance

The implications on health of an imbalance between Omega 6 and Omega 3 fatty acids becomes startlingly clear when we look at how these fatty acids behave in the body.

Amongst other things, too much Omega 6 and not enough Omega 3 can increase inflammation in the body, promote weight gain, thicken the blood, increase triglyceride levels and the levels of bad cholesterol, increase blood pressure, increase the risk of heart disease, stroke, inflammatory conditions, cancer, and even depression and other mental health problems.

It’s no coincidence that previous studies have found that a diet rich in Omega 3 can reduce the risk of heart disease, some types of cancer and depression as well as numerous other health problems.

Omega 3 helps to:

  • Reduce inflammation
  • Reduce Triglyceride levels
  • Reduce Cholesterol levels
  • Lower high blood pressure
  • Thin the blood
  • Regulate irregular heartbeats (arrhythmias)
  • Alleviate symptoms of depression
  • Keep artery walls clear of debris
  • Improve memory and mental processing
  • Boost the immune system

It is now clear from countless studies that Omega 3 can reduce the risk of cardiovascular disease, that’s why we are told it’s so important to continue to eat fish, just not too much due to the toxins they can contain. However, many of the risk factors that apply to heart disease also apply to strokes. By reducing these risk factors then it goes without saying that you also reduce the risk of suffering from a stroke.

Risk of Hemorrhagic Stroke

There has been some concern that due to the blood thinning effect of Omega 3, bleeding times can be increased and that this could maybe increase the risk of a hemorrhagic stroke (bleeding in the brain), however, a study by Skerrett P J, and Hennekens C H published in 2003 entitled “Consumption of fish and fish oils and decreased risk of stroke” no such association was found.

“No association was observed between consumption of fish or fish oil and hemorrhagic stroke. These data support the hypothesis that consumption of fish several times per week reduces the risk of thrombotic stroke but does not increase the risk of hemorrhagic stroke” the researchers concluded.

If you are concerned about your health for any reason, or if you have an existing health problem, it’s always advisable to speak to your doctor before making major changes to your diet or before taking fish oil supplements.

Climate change affects our mental health too

Most of us have probably heard or even used the expression “feeling under the weather” before, but can the weather, or to be more precise, severe weather, have an impact on our moods and mental health?

According to a recent report, climate change is leading to an increase in the rates of depression, anxiety, and post traumatic stress as well as substance abuse.

Loss of social cohesion

Australian Scientists from the Brain and Mind Research Institute have come to the conclusion that more people are suffering from mental health problems because of “loss of social cohesion in the wake of severe weather events related to climate change”.

“The damage caused by a changing climate is not just physical” they said in the report

“Recent experience shows extreme weather events also pose a serious risk to public health, including mental health and wellbeing, with serious flow-on consequences for the economy and wider society.”

Clear Evidence

According to the paper, one in 10 primary school children reported symptoms associated with post traumatic stress after Cyclone Larry in 2006.

The report also states that one in five people suffer from “emotional injury, stress and despair” after severe weather events.

“There’s really clear evidence around severe weather events” said Professor Ian Hickie, director of the Brain and Mind Research Institute.

The Future

Hickie reckons that climate change and severe weather will play a major part in influencing our mental health in the future.

“When we talk about the next 50 years and what are going to be the big drivers at the community level of mental health costs, one we need to factor in are severe weather events, catastrophic weather events” he said.

 

“What we have seriously underestimated is the effects of climate change on social cohesion… that is very hard to rebuild and they are critical to the mental health of an individual.”

Hurricane Irene

Over in the US, Jeffrey Katz, a Clinical Psychologist and American Red Cross Disaster Mental Health Chairman for South Eastern Virginia, has some advice for those suffering in the wake of hurricane Irene.

In the Daily Press Katz recommends eating well, keeping hydrated, maintaining normal routines, talking to those around you, and not getting ahead of yourself if there’s a lot to do.

If after a few months you are still feeling depressed, are not interested in things you used to do, and have difficulty eating or sleeping, then you may benefit from seeking professional help.

 

Music can reduce depression says Finnish Study

An interesting study by researchers from the University of Jyväskylä in Finland, has found that music therapy can be beneficial in the treatment of depression. The results of the study revealed that in the short term at least, those who received music therapy alongside standard therapy, showed a greater improvement in symptoms of depression than those receiving standard therapy alone.

The Study

The study, which was led by Professor Jaakko Erkkilä and Professor Christian Gold, involved 79 people aged between 18 and 50, each of whom had been diagnosed with depression. Of the 79 participants, 33 were given individual music therapy sessions twice a week as well as their standard treatment, and the rest of the participants just received the standard treatment alone. Standard treatment included anti depressant medication and counselling/psychotherapy sessions.

After a follow up at 3 months, those who had received music therapy showed a greater improvement than the others and had fewer symptoms of depression. There was no statistical difference after six months.

Specific qualities

“Our trial has shown that music therapy, when added to standard care including medication, psychotherapy and counselling, helps people to improve their levels of depression and anxiety” said Professor Gold.

“Music therapy has specific qualities that allow people to express themselves and interact in a non-verbal way – even in situations when they cannot find the words to describe their inner experiences.”

Cathartic experience

According to Professor Erkkilä people were able to express their inner pressure and feelings by drumming and that some described it as “cathartic”.

“Our findings now need to be repeated with a larger sample of people, and further research is needed to assess the cost-effectiveness of such therapy” said professor Erkkilä

Improve mood and general functioning

The findings of the Finnish study have been published in the British Journal of Psychiatry. Dr Mike Crawford, a specialist in Mental Health Services Research, Imperial College, London, wrote in an editorial in the same journal:

“This is a high-quality randomised trial of music therapy specifically for depression, and the results suggest that it can improve the mood and general functioning of people with depression. Music-making is social, pleasurable and meaningful. It has been argued that music making engages people in ways that words may simply not be able to.”

Can bipolar mood swings sometimes be a good thing?

All of us experience mood swings to some extent, you know, one minute you’re feeling quite happy and the next you’re down in the dumps. However, bipolar disorder is diagnosed when mood swings are significant and severe enough to interfere with an individual’s ability to function effectively on a day to day basis.

 

Treatment of bipolar disorder (sometimes referred to as manic depression) will usually involve some sort of anti depressant or anti psychotic medication.

 

Now a new report from the British Psychological Society authored by Professor Steven Jones of Lancaster University and a number of other leading psychologists who worked in partnership with service users, has suggested that mood swings are not always a bad thing and medication may not be the only answer.

 

According to the review, extreme mood swings can have their problems but they often bring significant benefits too, for example, many people who experience wide variations in mood are often creative and highly successful individuals – think of actor Stephen Fry, actress Carrie Fisher, television presenters Gail Porter and Bill Oddie, government press adviser Alistair Campbell and comedian Paul Merton as just a few examples.

 

The report also suggests that the  mood swings associated with bipolar are more extreme forms of the variations we all experience and can result from life events rather than just brain chemistry and it’s not always helpful to think of extreme mood swings as an illness.

 

It’s true that during ‘highs’ there can be a tendency for people with bipolar to believe they are capable of extraordinary things and all too often they are encouraged by health professionals to lower their expectations of what they can realistically achieve.

 

The report suggests that although medication may be helpful in some cases, it may not be the answer for everyone and that some people are able to manage their moods by changing their lifestyle and perhaps undergoing some form of psychotherapy.

 

One of the authors, Joanne Hemmingfield, a service user herself, said the report offered a “message of hope” to people with bipolar disorder “which is in stark contrast to the messages most people have received in the past”.

 

According to Clare Dolman, Chair of MDF the Bipolar Organisation, the report highlights the positive aspects of living with bipolar as well as the negative and “paints a more hopeful picture of the path to recovery by combining psychological approaches with medication where necessary”.

 

 

Benefits of Omega 3 during pregnancy and beyond

Omega 3 supplements taken during pregnancy may help protect the child against future bouts of illness says a recent study from Mexico. The study has been published online in the journal “Pediatrics”.

The researchers from an Emory University found that the babies born to mothers who had been given Omega 3 in the latter half of pregnancy (from 18 to 22 weeks until childbirth) had fewer colds at one month, three months, and six months of age, and if the infants did get ill, the duration of the illness was shorter than the illnesses suffered by other babies whose mothers had received a placebo.

Altogether, over 1100 pregnant women and 900 babies were involved in the study. Some were given 400 mg of Omega 3 supplements daily whereas the remainder of the women received a placebo.

Healthier babies

The findings of the Mexico study showed that women who were given Omega 3 supplements delivered healthier babies when compared with the control group.

  • At the age of one month, the babies whose mothers had taken Omega 3 had a 25 percent reduction in cold symptoms and had fewer problems with phlegm and wheezing.
  • At 3 months of age they spent 14 percent less time being ill.
  • At 6 months of age the babies had shorter bouts of sickness and symptoms such as fever, runny nose, breathing difficulties and rashes, although they had longer bouts of vomiting.

“This is a large scale, robust study that underscores the importance of good nutrition during pregnancy” said Usha Ramakrishnan, PhD, associate professor, Hubert Department of Global Health at Emory’s Rollins School of Public Health.

Previous studies by the same researchers have shown that women who had taken Omega 3 supplements during pregnancy gave birth to heavier and taller babies.

Reduced risk of postnatal depression

It’s not just the babies who benefit when the mother takes Omega 3, the women themselves do to. Over the past few years a number of research studies have shown that women who consume higher levels of Omega 3 fatty acids during pregnancy appear to have a reduced risk of post natal depression after the birth of their baby.

Anyone who has ever suffered from post natal depression will know the devastating effect it can have, not just on the women suffering, but on the rest of the family too.

Dr Joseph Hibbeln of the US National Institutes of Health analysed data from over 40 studies involving more than 14,000 women in 23 countries and found a clear correlation between fish consumption and post natal depression.

Basically he found that the higher the amount of fish consumed the lower the incidence of post partum depression.

Many women unaware

Interestingly, a survey carried out a few years ago by the Society for Women’s Health Research (SWHR) involving 500 women revealed that over half of them (59 percent) were unaware of the importance of Omega 3 during pregnancy and in the first few years of life. However, most were aware of the importance of other nutrients such as folic acid, Calcium and vitamin D.

Although the benefits of Omega 3 are more widely portrayed now, the message may still not be getting through. If more people were aware of the need for an adequate amount of Omega 3 fatty acids in the diet, not just during pregnancy and in the first few years of life, but right throughout life, then perhaps our overall health and quality of life would improve. Most of us are familiar with the importance of vitamins and minerals for good health, not so much the benefits of Omega 3 essential fatty acids. Why?

Health benefits only recently discovered

Omega 3 fatty acids are relative newcomers to the good nutrition arena, they were originally discovered in the early part of the 20th century and were called Omega 3 because of their chemical structure as they have at least 3 double bonds with the first one appearing on the third carbon bond from the methyl end of the fatty acid chain.

The amazing health benefits of Omega 3 fatty acids were only really discovered a few decades ago in the 1980’s when Danish researchers discovered that Inuit Eskimos had lower rates of heart disease than other populations despite eating a diet very high in fat as they consumed large amounts of oily fish.

Fats have received a lot of bad press in the past but what we know now is that we need the right kinds of fats in our diet. Now we have learned that Omega 3 fatty acids, which are polyunsaturated fatty acids, are important for the development of the brain and vision, they can reduce the risk of heart disease, lower inflammation in the body, lower triglyceride levels and bad cholesterol, reduce the risk of depression and other mental illnesses as well as alleviate depression symptoms, and can even improve brain function.

3 main players

There are 3 main players in the Omega 3 chain and they are ALA (alpha linolenic acid), EPA (Eicosapentaenoic acid) and DHA (Docosahexaenoic acid). ALA can be found in plant and vegetable sources whereas significant amounts of EPA and DHA are only found in oily fish and some algae.

Concerns

One of the concerns about eating large amounts of fish in this day and age is that fish is contaminated with industrial pollutants, particularly mercury, however, high grade fish oil supplements have had the pollutants removed leaving only concentrated Omega 3.

If you are pregnant or thinking about becoming pregnant, or if you have an existing health problem, it’s advisable to speak to your doctor before taking Omega 3 supplements just in case there are any contraindications that might apply to you. For example, Omega 3 has a blood thinning effect so caution is advised if you are already taking blood thinning medication such as Warfarin or Aspirin.

 

New study on treatment of separation anxiety disorder

Professor Silvia Schneider, Director of Clinical Psychology of Children and Adolescents at the University of Basel, Switzerland has just published in the current issue ‘Psychotherapy and Psychosomatics’ a groundbreaking new study on treatment of separation anxiety disorder

This is the first study to show that cognitive behaviour therapy is effective on young children. Until now, there has been no randomised controlled trial involving a disorder specific treatment program for children suffering from separation anxiety disorder.

The study

Forty three children between the ages of 5 and 7, all diagnosed with separation anxiety disorder, were assigned to one of two groups. The children’s parents were also involved.

One group received a 16 session disorder-specific separation anxiety disorder treatment program which included parent training and classical cognitive behaviour therapy. The other group were assigned to a 12 week waiting list.

Data on anxiety, impairment/distress and quality of life was collected at the start of the trial, after treatment or spending time on the waiting list, and at a 4 week follow up.

Results

Significantly, over 91 percent of the children had improved immediately after treatment. The children were rated either by themselves, their parents or their therapist.

At the follow up, over 76 percent of the children in the treatment group no longer satisfied the criteria for a diagnosis of separation anxiety disorder compared to just under 14 percent in the waiting list group.

The researchers concluded that the results indicate the short term efficacy of a disorder specific treatment approach for separation anxiety disorder.

Symptoms of separation anxiety disorder

The main symptom of separation anxiety disorder is severe distress when separated from the attachment figure i.e. mother, father, significant other or home etc. or when separation is anticipated.

This can manifest itself as persistent fretting, crying, worrying, fear and anxiety, and a reluctance to let go of the subject of attachment. A child may not want to go to sleep or go out or go to school and may suffer from nightmares where the recurrent theme is separation or being lost. Other symptoms that may be present can include stomach pains, headaches, and feeling nauseous.

Separation anxiety disorder may also be a symptom of another underlying condition such as ADHD, Pervasive Developmental Disorder, Panic disorder or other mental health problem and so a proper assessment by a qualified practitioner is necessary for an accurate diagnosis.

Mental health support a priority for those with mental illness

Mental illness often ignored by many churches

A new study by Baylor University has found that some church communities are sadly lacking when it comes to support for families in their congregation who are affected by mental illness and this can destroy a family’s connection with their church.

Almost 6,000 people from 24 churches from four Protestant denominations were surveyed as part of the research and asked about family stresses, strengths, faith practices and desires for assistance from the congregation.

Mental health support a priority for those with mental illness

Out of those who took part, 27 percent of families were found to be affected by mental illness. They reported more problems and requested more assistance than the others, and for them, support with issues surrounding mental health was a priority.

The researchers found that those who had a member of the family with mental illness ranked help with issues like depression and mental illness as second on the list of desires for assistance from the congregation.

Difference in response “staggering”

Support for mental health issues wasn’t considered as important for those who weren’t affected by mental illness as they ranked mental health assistance from the church as 42nd on the list of priorities.

“The difference in response is staggering, especially given the picture of distress painted by the data: families with mental illness reported twice as many problems and tended to ask for assistance with more immediate or crisis needs compared to other families” said study co-author Dr. Matthew Stanford, professor of psychology and neuroscience at Baylor.

“The data give the impression that mental illness, while prevalent within a congregation, is also nearly invisible.”

Lack of awareness and understanding

Dr Diana Garland, Dean of Baylor’s School of Social Work and a co-author of the study says the findings suggest that it amounts to lack of awareness and understanding.

“Families with mental illness stand to benefit from their involvement within a congregation, but our findings suggest that faith communities fail to adequately engage these families because they lack awareness of the issues and understanding of the important ways that they can help” said Dr Garland.

“Mental illness is not only prevalent in church communities, but is accompanied by significant distress that often goes unnoticed. Partnerships between mental health providers and congregations may help to raise awareness in the church community and simultaneously offer assistance to struggling families.”

The study is the first study to look at how mental illness of a family member influences an individual’s relationship with the church and appears on-line in the journal Mental Health, Religion and Culture.

Alzheimer’s screening In Ten Minuets On Laptop

According to leading psychiatrist Barbara Sahakian, (Professor Sahakian has developed her own test which can be done on a laptop in ten minutes and this could be available in doctor’s surgeries within the next couple of years)   professor of neuropsychology at the University of Cambridge, everyone over the age of 60 should be offered screening for Alzheimer’s disease at their local doctor’s surgery.

Professor Sahakian says that the NHS and private health services should be making more effort to detect mental disorders earlier and that stigma surrounding mental health has resulted in symptoms of mental health problems being ignored until the patient hits a crisis point. She adds that one of the top challenges is to integrate screening into routine healthcare.

Numbers affected

Alzheimer’s Disease currently affects around 465,000 people in the UK and over 35 million people globally. It is a progressive disease which means that the brain continues to deteriorate over a period of time and will ultimately end in death.

At the moment a third of cases aren’t diagnosed and are left untreated and in some areas this could be as high as 74 percent.

“I am shocked some people are allowed to deteriorate so much and then finally someone figures out that they probably have Alzheimer’s disease and takes them to the GP and psychiatrist. By that time the drugs don’t work as effectively. It is tragic” said Professor Sahakian.

Hope on the horizon

Once someone has been diagnosed with Alzheimer’s disease, neurological function has already declined and early screening would give patients access to treatment that could help preserve attention and concentration for longer.

Professor Sahakian also said that neuroprotective drugs that could slow down or even stop the progress of Alzheimer’s disease could be available within the next ten years and possibly within five years if side effects aren’t a problem.

“If they don’t have many side-effects, they’ll be available within five years. But if they have to do more work on reducing side-effects, it will be ten years. If there is a neuroprotective agent and it stops the disease process, then presumably you would die of something else, it wouldn’t be Alzheimer’s disease.”

The professor’s comments came at the launch of an international campaign to improve treatment of mental health disorders.

New tests

Blood tests are currently being developed around the world that could spot the early signs of the disease. Other tests are able to spot changes in memory that are not linked with normal forgetfulness.

Professor Sahakian has developed her own test which can be done on a laptop in ten minutes and this could be available in doctor’s surgeries within the next couple of years.

Antidepressants , Depression , Pregnacy and Autism Link

A recent report in the Archives of General Psychiatry highlighted a slight increase in the risk of a child developing an autism spectrum disorder (ASD) if the mother takes a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI) during pregnancy, particularly in the first trimester, reports Science Daily.

The connection

According to the authors of the report, the number of autistic spectrum disorders has increased over recent years along with a rise in the number of women using anti depressant medication during pregnancy.

Naturally, this prompted concerns that exposure to antidepressants during pregnancy could increase the risk of an autistic spectrum disorder.

Medical records examined

Professor Lisa Croen of Kaiser Permanente Northern California and her colleagues studied the medical records of almost 300 children with ASD and over 1500 ‘control’ children who were involved in the Childhood Autism Perinatal Study. They also examined the medical records of the mothers.

Out of the 300 children with ASD, twenty mothers had been prescribed antidepressants, 13 of whom had received SSRIs only, 2 who had received a combination of SSRIs and another antidepressant and 5 who had received a non SSRI only.

Of the 1500 control group 50 mothers had been prescribed at least one antidepressant, half of these had received an SSRI only, 9 had been prescribed a combination of SSRIs and another antidepressant, and 16 had received a non SSRI only.

More than twice as likely

After making adjustments for maternal and birth factors, the researchers found that mothers of children with an autistic spectrum disorder were twice as likely to have been prescribed at least one anti depressant in the year before the child’s birth.

When the researchers compared this with women who had no anti depressants prescribed during the twelve month period up to the child’s birth, they found that women who had received a Selective Serotonin Reuptake Inhibitor (SSRI) were more than twice as likely to have a child diagnosed with an autistic spectrum disorder later on.

The same association was not seen for women who had a received an antidepressant but not an SSRI.

“Although the number of children exposed prenatally to selective serotonin reuptake inhibitors in this population was low, results suggest that exposure, especially during the first trimester, may modestly increase the risk of ASD,” the authors conclude.

More studies needed

The researchers recommend that their findings be treated with caution pending results from more studies designed to “address the very complex question of whether prenatal exposure to SSRIs may be etiologically linked to later diagnoses of ASDs in offspring.”