The Behavioral Corner 
Hi, and welcome. I'm Steve Martorano. And this is the Behavioral Corner; you're invited to hang with us, as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and wellbeing. So you're on the corner, the Behavioral Corner, please hang around a while.

Steve Martorano 
Hey, everybody, how are you, and welcome to the Behavioral Corner. It's me hanging where you last saw me on the Corner. You know what we do here, we're lucky, we run into all kinds of people that are coming and going, and they hang with us and sit on the stoop and they always have great stories. It's funny how it works out. The Behavioral Corner, of course, is underwritten by our good, good friends from Retreat Behavioral Health. So today, you know what, it's sort of like, you know, if you stand in one place long enough, you're going to run into everybody ever new in your life. And that's what happened to us on the Corner, coming out of the bodega across the street. He's an old pal, Reed Alexander is a, as I said, a former colleague, we worked together briefly back in the day. He's also a journalist and author and an actor, aka for those of you young enough to remember, he is Nevel Papperman from the Nickelodeon program iCarly. Now, though, our charging reporter, a great asset for our program, and for everybody else who wants information about a wide range of things. Reed, welcome to the Corner.

Reed Alexander
Steve, it's such a pleasure to be here with you, thank you for the invitation to come and hang out with you today and talk about some very interesting topics. You're a friend and a former colleague and someone whom I greatly admire on this broadcast. So it's really a delight to get to be part of your show today.

Steve Martorano 
Well, thanks. It's great to see you too. So let me frame it by saying that no one within the sound or sight of us will be surprised to hear that the COVID virus in the pandemic has had a profound, profound impact not only on the United States but all over the world. The horrible results of this virus are apparent -- they run the gamut, physically, everything from you know, hospitalization, sickness, serious, serious consequences, often in long-term recovery for survivors. And then, of course, the toll and death, 4 million worldwide now and counting because now we're in the second wave of that. So we know that what we do not know and I'm sorry to have to tell you this, there's more unfortunate news, and that is that this virus has had profound effects collaterally on our mental health. We've touched upon a couple of these things on the Corner, the effects of isolation and lockdown, and all that on our mental health. But Reed has spent some time in his role now as a reporter for the Business Insider took a look at what the scientists in the data and the researchers are telling us about the collateral damage from COVID-19. And I'm really grateful for him taking the time to talk to us about it. Read, I know you looked at a couple of these --- a bunch of different studies, one of which from the University of Michigan, which took a broad view of the entire spectrum of mental health impact. So tell us about that study. I know it was it looked at four particular groups of people affected? Who were those people?

Reed Alexander 
Yeah, no, it's a great question. So I recently reported for Business Insider on a study that was done by researchers at the University of Michigan. And what they determined was, as you say, there are four groups or four core constituencies and people in the US who have been disproportionately impacted by the effects of the pandemic from a mental health perspective. So one is just women, generally, right women across the board. Another is people ages 50 to 60 for both men and women. The third group was people who reported that they were either in fair or poor physical health, so fair to say people sort of in weakened physical condition, right. And we know that the pandemic has, you know, really negatively affected people who were dealing with overweight or immunocompromised if they were to contract the virus. And then the fourth group, and I found this especially interesting because I hadn't heard this was people with higher levels of education. Now, what the researchers did not do since they base their findings on a poll of 2000 people they conducted was they didn't necessarily spell out why. So there are some clues out there. And there is some research that helps us to understand why each of these groups was affected the way they were. But the researchers at the University of Michigan did not answer that question for us. But of course, you and I can delve into some of those answers and try and figure out what's going on with these different populations.

Steve Martorano 
Yeah. First, let's define our terms. When you say that the study measured the impact, it doesn't mean just solely the negative impact. Did any of these groups have an impact that was not as severe to their mental houses as another group, for instance? I mean, I certainly understand an individual's poor health, having a more negative mental health impact from this, but how about higher education people were they more likely to understand and feel a little safer about it? How did that break down?

Reed Alexander 
Yeah, excellent question. Um, so in regards to the four groups that I say were impacted here, so these were the groups that reported feeling heightened levels of anxiety, depression, or other mental health symptoms. Now in regards to groups that did a little bit better or fared better, because the poll looked at people really across the spectrum of age demographics. And I should say, your demographics. One thing that we saw that I thought was really interesting was that people who were a little bit older people over the age of 80, in this survey, said that they had fared the best and that some constituencies had put in some protocols like trying to improve their physical exercise, eat better get healthier, that had a positive impact on their mental health. So not everybody in this study said that they were suffering. But in regard to the groups that we talked about, I think you asked me, Why is it people with higher education? So here's my take on that, as I've tried to think about this. And just to be clear, I mean, this is my two cents here. from people I've interviewed and people, I've talked to. Frontline workers, many of whom have not had the opportunity to work from home, if you look empirically at the data tend to be people who don't have the same levels of education as workers who have the flexibility of working remotely. So that would make you think, right that the frontline workers, therefore are the ones who are really suffering from a mental health perspective. That's not exactly what we saw on this, right, we saw that people with higher levels of education said that they were really suffering, I think, if you're someone who has the flexibility of working from home, you might be taking advantage of it. And holding off going back to the office, which we're seeing a lot of companies start to think about a return to Office returned to work, particularly in the world that I cover, which is banking. You might be holding off because you might be thinking, it's not safe. And because you have higher levels of education, perhaps you're scrutinizing epidemiological data more or your news reports more than people on the front lines of this, who realize it's very stressful, but I have to go to work, I have no choice, right? I'm facing other issues that are non-pandemic related or tied to the pandemic, but not necessarily public health-related, like economic issues, which are related to the pandemic losing a job, or facing the expiration of unemployment benefits that are pandemic related, but not public health-related, you see the distinction. And that could be driving more anxiety for those populations. Now, again, it's really important with these kinds of things, not to paint with broad strokes, because mental health is so malleable, and it's so personal for everybody and what upset someone on one day, could not bother them the next but upset an entirely different person, right? So a lot of this when you catch people who are self-reporting, and I'm sure there are many people with lesser levels of education, who are feeling extraordinary stress as a result of this pandemic, I do think there's something to be said, for this idea of privilege and luxury in our country. If you have higher levels of education, and you can work remotely, maybe you have more time to take in more information and feel your anxieties around the dangers and detriments of this pandemic from a public health perspective. Whereas, you know, if you're somebody working at a gas station, or a drugstore, grocery store, and all year long, you've had to go to work, you've had no choice. Maybe you had to come up with coping mechanisms to push aside some degree of anxiety from the public health crisis. And just focus on keeping your jobs you can put food on the table.

Steve Martorano 
Yeah, that's a great point and plainly obvious. Even without the pandemic as a backdrop. Yes, people who are working to feed their family and keep the electricity and water on, don't have the luxury of feeling sorry for themselves, they just get up and do it. That's a phenomenon that's always there. And I agree with you, higher educated people have more opportunity to digest more information, and then ponder it. And when you know, and sometimes it's true ignorance is bliss. If you can cut down some of the information flow, I know I am my equilibrium constraint now when I don't like getting bombarded. So if we look at all these groups together, and factor in all the things you said about what contributes to a mental health crisis, associated with COVID, is it safe and scary to assume that this is already obvious, this mental health crisis, but this is a ticking time bomb, it's going to get bigger down the road, right?

Reed Alexander 
Absolutely. You know, the World Health Organization has been warning since last May. So this is now more than a year ago, going to be soon, a year and a half ago, a few weeks into the pandemic, that there was a looming mental health crisis. People have been warning about what happened to the frontline workers and people who were in lockdown in the Chinese city of Wuhan last January, and have that impacted their mental health for a very long time. This is a global issue. It's not retreating right. Like it's clear that the pandemic refuses to wane and it won't even bow to the medical solutions that we've tried to put into place. You know, we have a vaccination. campaign underway in the country. And in states like mine in Florida, which significantly lags other parts of the country in terms of vaccinations. Just about one in two adults here that's eligible for a vaccine has gotten the vaccine, you have high levels of spread worse than ever with the Coronavirus among people who are not vaccinated. Now we're hearing that people who are vaccinated may need a booster. So the point is, you know, the pandemic is not disappearing anytime soon, the longer it lasts, the more damage it can do to everyone's mental health. And it's not just stressed about what you see on the news. A lot of this pertains to job loss or substance use behaviors and substance use disorders that we saw forming last year, which are very difficult to shake. And we're going to see I think, more and more people require residential care or long-term care to counteract the effects of substance use that they might have developed a dependency for. And in regards to women, I mean, this can be a generational problem, women have really borne the brunt of the pandemic, through mental health perspective. And one thing the World Health Organization warned about last year, which predated the University of Michigan survey that you and I have been talking about was they did say women are in a very difficult position with this because they're having to pick up most of the workaround childcare and homeschooling, and they're also giving up leisurely activities are important activities that are good for their mental health exercise, you know, their jobs, no less.

Steve Martorano 
And again, even before the outbreak of the pandemic, with regard to young women, we were approaching high watermarks for a general anxiety crisis, particularly young women, already anxious about a multitude of things, and then boom, this lands in their lap -- and it's not making it any easier by a longshot. I don't know how much data came out of the Michigan study with regard to suicide rates and see, we talk about collateral damage from this virus in the mental health field. There's really no way unless someone reads a definitive note behind who've taken their lives. They did so because of anxiety or fear of the virus. But what do we know about suicide rates during this pandemic?

Reed Alexander 
Yeah, I'm pulling up the report specifically. So we did see that there were heightened levels of suicidal ideation among certain groups. And we've seen it really skyrocket for months. And when it comes to suicidal ideation, I think it's fair to say that, okay, I want to back up a little, you mentioned a really excellent point, which is young women. Before the pandemic, there was data coming out showing that young women have been contemplating suicide for a very long time, I had dug into this heavily during my time covering the mental health beat, where I was taking a look at adolescent trauma. And I think we had seen record levels of suicidal ideation among young people, largely stemming from social media use, etc. In the absence of psycho-social interactions that we would call anhedonia, which are things that people do essentially to enjoy themselves, right. So seeing friends, being able to have access to classmates, suicidal ideation has absolutely increased in this country. And the numbers have to I don't have the data right in front of me. But the University of Michigan study warned about it. And I have seen a preponderance of data that I think makes it very clear.

Steve Martorano 
You know, what else was fascinating here? You know, there are so many events of unintended consequences. You know, the butterfly flaps, its wings here, and the storm occurs someplace else, these young people who are suffering epidemic levels of anxiety, to begin with, find themselves isolated and cut off. But look, we've got social media, this pandemic has sort of taken the lure out of that, I think we're seeing higher levels of a sense of isolation. No matter what social media, his promises are about bringing people together, I think it isolates people.

Reed Alexander 
150%. You and I are in total agreement on this. You're absolutely right. You know, social media has some great applications. Like for me as a reporter, finding sources, you know, your people, day to day kind of user perspective, I think social media has unleashed some really terrible consequences for young people, as far as comparing themselves to other people, and making them feel that maybe they're the only ones who are isolated if someone they know living somewhere else with lower rates of case transmission or traveling or living their lives, making them feel left out of certain groups when all you have to communicate with people is through, you know, a six-inch phone screen, and an app where it's really easy to delude other people about what actually is happening in your life. That's not a really healthy place to be starting from and forming a relationship. Social media also creates the possibility for a lot of remote bullying to go on. And I think we've known about online bullying for some time, but it might be scarier for the bully to try and bully knowing that the student who they're bullying could come into school the next day and see them that hasn't had to happen, right? There's been no accountability. Yeah, throws them under the bus and sandbag them and say terrible things online and not worry during the pandemic, that you're going to run into them in person. So it makes it easier for people to target people. And I absolutely think it's contributed to this problem, and probably has trained some very impressionable young people, I would think, 8, 9, 10, 11, 12 years old, in some unusual and perhaps deleterious friendship related behaviors since they've spent the last 18 months largely conducting friendships over social media.

Steve Martorano 
Oh yeah, over social media, I mean --- there's going to be a period of adjustment, it may not be smooth when they're back in the same physical environment together. Again, hate to be you know, the doomsayers here, but it's a big, big problem, this virus has impact has been profound. And as we said at the beginning, spread out all kinds of areas. So let's, let's pivot to the other stuff, he took a look at through a couple of other studies, not least of which from Yale University, which has to do with alcohol consumption and abuse in the context of COVID. Now, I gotta stop you right now, when I see the Yale looked at, you know, alcohol consumption under young people, particularly in New York, and I went really, I can tell you in five minutes, what happened, they drank a lot of alcohol. Probably wasn't good. You know, having said that, it's still interesting to ask questions about how this happened. So what did the Yale study actually say about the team drinking during this?

Reed Alexander 
Listen, I agree with you sometimes, you know, quantifying things that are so obvious there's definitely value to have empirical data and clinical data and the application of that can be used to make better kinds of decisions from a policy perspective. But sometimes you read about these things, and it's really obvious and it's not exactly eye-opening information. But the Yale School of Public Health did do some research. Now, back at the beginning of the pandemic, I was in New York City. And I remember those early days of pandemonium, right? It was really pandemonium, where people were, you know, tearing everything off of supermarket shelves. I would see, you know, in the first few days, there was no water, there was no toilet paper, there was very little food, you know. Rice was sold out, pasta was gone. It was true, you know, pandemonium in New York City back in that time. What this particular study looked at was in the early days of COVID. And in the lockdowns that we saw what people were doing as far as consuming high levels of alcohol, and what it was doing to them. So they took a look at survey data from 600 young people. And I have more to add on this, by the way in a second about generally, other research about young people and alcohol consumption that I think might be a bit more eye-opening. But this Yale School of Public Health Study that's recently been reported in the journal alcoholism, treatment quarterly, took a look at data from 600 young people. And what they found was increased alcohol use shared a connection, it's unclear if it's just a correlation or causation with anxiety, sleep disturbances, and this was perhaps the most interesting finding positive COVID-19 diagnoses. So they found increased alcohol among people who had been diagnosed with COVID, which I think is very, very interesting. And what they found was that you know, there were warnings about consuming alcohol if you were infected with the virus, but seems like a lot of people didn't heed those warnings. Go figure, right? They found that quote, "The stress of the diagnosis led many to crave alcohol and drink more as a result." Because if you are threatened by a life-threatening disease, like COVID-19, which is not a chronic disease, you know, it's a disease that is an infectious you know, respiratory disease. You'd be really nervous in those first few weeks. And I think it shows a lot of people, unfortunately, see substances as a way to alleviate anxiety, even when they know they shouldn't be drinking, not just because excessive alcohol is unhealthy, but excessive alcohol, while you're fighting the Coronavirus, is particularly unhealthy, you know?

Steve Martorano 
Yeah, you see alcohol falls into a special category with regard to people who seek self-medication. Because it's so accessible. And because it's, you know, part of the social fabric you have a drink. I mean, even people who didn't anesthetize themselves during this thing, at least in my experience, obviously, you're drinking more at home, there was no other place to drink. I mean, people who were social drinkers before the pandemic, probably many of them rarely thought about having a drink at home. You know, "let's have a martini before dinner, honey, and that went on in the movies, but not where I grew up. But I bet you a lot of people, you know, the past two years now, let's have a drink. Let's have another bottle of wine.

Reed Alexander 
I do think there's an element of what's cost-prohibitive. You know, in past people would go out and meet friends for happy hour, last two hours, get a couple of drinks on discount. Go to a big dinner, maybe you don't drink three, four glasses of wine because you know that could be $80 in wine alone in New York in your house. A bottle of wine could cost $15, $20 bucks. So why not buy two or three? More bang for the buck? Seriously, what I can do with it goes way further for a lot of people who realize we didn't have anywhere to go. And it's cheaper to drink at home anyway.

Steve Martorano 
Yeah, yeah, yeah. A lot of people have been given education about how to be getting ripped off at these restaurants on the price of a bottle of wine. You know, the other thing that went on, and this is another sad fact of life is that you know, the beverage industry is clever. They know that you know, there are people who drink hard liquor, they like their bourbon. And there are other wider consumers who like something a little, you know, less obvious. What do you find out about hard seltzers? First of all, what are hard seltzers?

Reed Alexander 
It's an excellent question. So hard seltzers are drinks like White Claw, or there's another brand called Four Loko. There are these canned beverages that look like a soda can and you pop them open, and they're carbonated fizzy drinks. And part of their allure for a lot of younger folks is one, I think they're easy to transport. Two, they're very sugary. So their tastes tend to appeal to younger consumers. And they don't really have pronounced alcohol, like the taste. You know how sometimes you drink strong alcohol and you get that, taste? You know, this just tastes like soda. So they say I mean, I will admit, I've tasted White Claw -- really not my thing. I'm not a big you know, hard seltzer consumer myself. So I think a lot of other younger people are. And one interesting piece of research that was done was a very interesting piece of research that I reported on back in June, there was a study that found that $17 billion worth of alcohol was consumed by us underage adults during the year 2016. So it's during the year 2016. So this is, you know, four years before the pandemic even started.

Steve Martorano 
Billion? Billion with a "B?"

Reed Alexander 
Billion with a "B." Not millions, with an "M." Seventeen billion with a "B" dollars worth of alcohol that was sold in the United States, that year, was consumed by people under the age of 21 -- who shouldn't be drinking at all. And a lot of that was in the hard seltzer category. So what we decided to do at Business Insider, we saw this research and we thought, gosh, this is a really concerning study. And the reason why this study came out in 2021, was that was the most recently available sort of comprehensive consumer data that the researchers were able to get their hands on from 2016. You know, I'm sure it has probably only accelerated since then. So we spoke to some behavioral health experts who said, "Oh, yeah, this has been a huge problem during COVID." The rise of a lot of these products like white claw, which, by the way, went on sale in 2016. So not to blame them necessarily for this problem but just interesting to note that they went on sale that year and they've widely available on shelves since then. The rise of drinks like this.

Steve Martorano 
And let me...let me interrupt you there. I know, you'll get around these available in supermarkets. So you know, the stigma of having to go into a packaged goods store. So I've been alleviated. But it also explains why young underage kids can probably get served a lot easier if they're buying it from supermarkets, right?

Reed Alexander 
Yeah, I mean, I think you do have to present an ID at the grocery store. But I think it's much easier if you can grab somebody's older brother or sibling who's over the age of 21. Or you have a fake ID and say, "Hey, toss a couple of those in the cart." I mean, it's absolutely, I'm sure contributes to the issue in many ways, when these things are available

Steve Martorano 
Reed, how many times you think youngsters said to their parents, I'm talking about teenagers going? "Hey, Mom, let me go to store you."

Reed Alexander 
Oh, totally!

Steve Martorano 
So Mom is shopping and they're going "Hey, Mom, for a couple of these in there." What's mom know. It looks like a can drink.

Reed Alexander 
You know what Steve, it's such a good point. I'm sure people said this is a really cool new soda or everybody drinks it at school. And you know, there were probably parents who were none the wiser, and just throw it right in the cart. So what this study looked at, and by the way, this was done by researchers at the University of North Carolina was that level of alcohol consumption accounted for about 8.6. So under 10% of all of the alcohol sold in the US in 2016. That went to young people. They looked at beverages from multiple brands, and they found that AB InBev, Miller, Coors, and Diageo were the brands that really represented the lion's share more than half of all the alcohol that was consumed by young people. And I thought this was really interesting. You know, the lead researcher on the study, Pamela Trangenstein, at the University of North Carolina told me in an interview, quote, "The research shows time and time again, that young people if they haven't started to drink, or if they're exposed to alcohol advertising over time— they're more likely to start drinking. If they've already started drinking, they're more likely to progress to heavier drinking." And one element of what she found was that advertising plays a huge part in selling young people that it's cool and it's enticing and alluring to shark drink. Early. I mean, we've seen that with cigarettes and nicotine, right. And we've seen huge lawsuits in which companies have had to roll back advertising campaigns around smoking cigarettes and nicotine. You know, it raises a question, should there be some sort of legal consequences for companies that are found to be engaging in marketing efforts that appeal to these younger consumers? And then I will tell you if we can pause there, Steve, if you have any follow up questions, but there are some other really interesting data points, I think we should look at just about more recent alcohol consumption in the past year because we're talking about things from 2016.

Steve Martorano 
I do want you to get to that but just make this additional point. Because you're correct. You're absolutely correct. One of the brilliance of the advertising campaigns, from those big beverage companies, and this goes back 20, 30 years. beer in particular. Now, I'm not a teetotaler, I'm not a beer drinker, but I'm not a teetotaler. Beer Can be consumed responsibly, for sure. But what Madison Avenue has done over the years, is turn beer drinking into a lifestyle choice that appears to signal health and vitality. Right? They're always on the beach, and they're always thin, and they're always attractive. Anyway, that being said, I'm off my soapbox. Now, tell us what's going on now with regard to consumption.

Reed Alexander 
You know, by the way, I just want to say that's a really excellent point that I have not thought of before, that a lot of like physically fit people are represented in the media, as you know, cracking open and beer. And one would think that that's an aspirational thing for you to do. If you attain that level of physical fitness, or, you know, you have a lot of really great friends and you're outside join the open air. I think you're absolutely right. So the National Center for Drug Abuse statistics was taking a look at this. In the past year, throughout 21. They found that more than half of 12th graders so 55% -- more than one into 12th graders in America had abused alcohol, not just drank alcohol had abused alcohol. That's how common it is at the high school level, at at least one point, potentially multiple points. They were followed by 10th graders, so about 40% -- four in ten 10th graders had abused alcohol, according to this research, at least one point last year. And 1/5 of 8th graders. So you know, think about it, even freshman in high school is ninth grade. So kids in middle school have been found to be doing this. So this is how widespread this situation is. I interviewed a psychiatrist in New York, Scott Krakower, who's with the Zucker Hillside Hospital in New York. And he told me that one big issue is that a lot of people were having house parties when they should not have been during the pandemic. And it was really easy to drink alcohol from home if you're having a house party during the pandemic, he said this, and I thought this was very interesting. "Usually, drinking ends when you have a place to go to end it. When the keg party was over, it would be over. In this situation, you're kind of trapped."

Steve Martorano 
And listen, it's a big topic. And we could spend, you know, hours in the weeds on this thing. The ripples from the pandemic effect are so widespread, but thanks so much for bringing us up to speed on a couple of items. We've painted, you know, let's face it, not a terrific picture about the mental health aspects of this disease. There is another side to this. And that is there are lots of places to get help, both residential and outpatient. The other side of the internet story is there's plenty of stuff online. Good stuff online. Telemedicine is a big, big deal and it can help as well. And so can people like our guest Reed Alexander, whose job it is to inform us about this stuff. And we appreciate that --your work and your time. And any news you can give your fans on the showbiz front? Where's Nevel? Is he coming back?

Reed Alexander 
Wow! Well, thank you so much team for this really terrific conversation. I think we covered a lot of ground here. In regards to iCarly, which is very exciting, the revival of the show has been met with tremendous success -- which is amazing to see on Paramount plus, and it's on now. And Nevel -- my character there that I played for many years is up to some nefarious tricks. So I suggest everyone check out our special which was called iRobot Wedding. And good news, the show has been renewed for season two. So all I can say is and I've you know talked about this, I can't go into detail on what is being planned, mostly because I don't know, I don't think any of us know, I think the writers are soon to start fleshing out what thinks looked like but I wouldn't put it past Nevel to always hold a grudge and be out to plan some evil schemes. So if anyone watched iCarly, I would say tune back into Season Two for a lot of good times, Nevel or otherwise. I truly don't know what the future holds for the show. But I know that it's going to be a pretty remarkable season because we've got great writers working on it.

Steve Martorano 
Good luck, break a leg. And again, thanks so much. And we'll cross paths many more times here on the Behavioural Corner. You guys, don't forget to follow us. Look for us like us. Do the whole thing wherever podcasts are had these days. It's the Behavioral Corner. Reed, take care. Thanks again.

Reed Alexander 
Thanks a lot, Steve. All the best.

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