Posts Tagged ‘Mental Health’

Eva Redei, the David Lawrence Stein Professor of Psychiatry at Northwestern’s Feinberg School has published new research which explains why antidepressants don’t work for so many people.

There are two prevailing theories about the causes of depression. One is that depression can be caused by stressful life events and the second is that depression results from an imbalance in neurotransmitters. However, medications based on those theories are treating effects, not causes.

Most animal models that are used by scientists to test antidepressants are based on the hypothesis that stress causes depression. “They stress the animals and look at their behavior,” she said. “Then they manipulate the animals’ behavior with drugs and say, ‘OK, these are going to be good anti-depressants.’ But they are not treating depression; they are treating stress.”

That is one key reason why current antidepressants aren’t doing a great job, Redei noted. She is now looking at the genes that differ in the depressed rat to narrow down targets for drug development.

She said another reason current antidepressants are often ineffective is that they aim to boost neurotransmitters based on the popular molecular explanation of depression, which is that it’s the result of decreased levels of the neurotransmitters serotonin, norepinephrine and dopamine. But that’s wrong, Redei said.

Redei examined the genes involved in both stress and depression. Of the 254 genes related to stress and the 1275 genes related to depression there is an overlap of only 5 genes.

“This overlap is insignificant, a very small percentage,” Redei said. “This finding is clear evidence that at least in an animal model, chronic stress does not cause the same molecular changes as depression does.”

If current medications are only treating effects then research should be focused on finding and treating the causes.

In the second part of the study, Redei found strong indications that depression actually begins further up in the chain of events in the brain. The biochemical events that ultimately result in depression actually start in the development and functioning of neurons.

“The medications have been focusing on the effect, not the cause,” she said. “That’s why it takes so long for them to work and why they aren’t effective for so many people.”

Her animal model of depression did not show dramatic differences in the levels of genes controlling neurotransmitters functions. “If depression was related to neurotransmitter activity, we would have seen that,” she said.

Unfortunately, although we now know those theories are wrong, we still do not have a theory that is right.

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UPDATE: Welcome Instapundit readers. Have look around, enjoy the show.

Since the lifetime prevalence of mental disorders is lower in Mediterranean countries than in Northern European countries, a study was conducted to see if diet plays a role as a protective factor.

We have covered the Mediterranean diet previously, in the article Take It Or Leave It? The Truth About 8 Mediterranean Diet Staples, which we recommend reading to get up to speed about the particulars of this diet.

The report was published in the October issue of Archives of General Psychiatry. Over 10,000 Spanish people participated in this study. Participants had to fill out a survey detailing their dietary intake. Researchers then translated those details into a level of adherence to the Mediterranean diet using a system of nine components. For example, one such component is maintaining a high ratio of monounsaturated fatty acids to saturated fatty acids in the diet.

After a median (midpoint) of 4.4 years of follow-up, 480 new cases of depression were identified, including 156 in men and 324 in women. Individuals who followed the Mediterranean diet most closely had a greater than 30 percent reduction in the risk of depression than whose who had the lowest Mediterranean diet scores. The association did not change when the results were adjusted for other markers of a healthy lifestyle, including marital status and use of seatbelts.

The scale of the study seems to clearly show some correlation between following the Mediterranean diet and better mental health. However, as long time readers are undoubtedly aware, correlation is not causation.

“The specific mechanisms by which a better adherence to the Mediterranean dietary pattern could help to prevent the occurrence of depression are not well known,” the authors write. Components of the diet may improve blood vessel function, fight inflammation, reduce risk for heart disease and repair oxygen-related cell damage, all of which may decrease the chances of developing depression.

“However, the role of the overall dietary pattern may be more important than the effect of single components. It is plausible that the synergistic combination of a sufficient provision of omega-three fatty acids together with other natural unsaturated fatty acids and antioxidants from olive oil and nuts, flavonoids and other phytochemicals from fruit and other plant foods and large amounts of natural folates and other B vitamins in the overall Mediterranean dietary pattern may exert a fair degree of protection against depression,” the authors write.

There may be a combination of factors at play here. Perhaps living in Spain is less depressing than living in Northern Europe regardless of diet. We need scientists to unravel the specific mechanisms which are responsible for these results. Until then, we can only speculate.

Vitamin D is called the “sunshine vitamin” for a reason, and people in Northern Europe may simply not be getting enough.

Dairy is a good source of Vitamin D, but most people do not eat enough dairy to meet their daily requirements without sun exposure. Aside from the fact that eating so much dairy may be unhealthy and counterproductive, 60% of adults cannot digest lactose.

An important component of the Mediterranean diet is fish, and fish are rich in Docosahexaenoic acid (DHA). A recent study determined that feeding infants formula enriched with DHA is worth the cost premium because it can enhance IQ.

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Before we light this gasoline soaked issue on fire, please understand that we are exempting people who have abstained voluntarily as part of religious obligations. They are nutty for entirely different reasons.

From a study published in Addiction:

It has long been recognised that excessive alcohol consumption can lead to poor physical and mental health.  However, there has been mounting evidence that low levels of alcohol consumption may also be associated with poor mental health possibly due to abstainers having other health problems or being reformed heavy drinkers.

Drinking alcohol is like many other enjoyable facets of life – don’t overdo it. Whatever the underlying reason, whether genetic susceptibility or purely psychological, it is clear that being unable to moderate consumption is an indicator of some kind of problem.

The authors conclude that in societies where some use of alcohol is the norm, abstinence may be associated with being socially marginalised or particular personality traits that may also be associated with mental illness.

One of the things we do which truly makes the sun shine brighter, the air taste sweeter, and life more enjoyable is exposing quacks and hustlers. For that reason, it is our duty to inform you that Alcoholics Anonymous, a group dedicated to helping alcoholics through a 12 step program of abstinence, may not be as helpful and benevolent as they first appear.

  • The Alcoholics Anonymous 12 step treatment plan may cause more harm than good, and is not based on science.
  • Alcoholics Anonymous is a religious organization, which may not be suitable for many people. They offer religion as a cure for a disease.
  • Alcoholics Anonymous represses information about alternative programs, which offer treatment in a secular environment.
  • Alcoholics Anonymous represses information about the fact that abstinence, as opposed to moderation, may be a poor choice for many.
  • A good portion of the Alcoholics Anonymous clientele are coerced by the courts to join, thus making their “attraction rather than promotion” marketing spiel complete baloney.

We recommend reading Alcoholics Anonymous: Cult or Cure by Charles Bufe to get a detailed look at all the sordid details. Obviously, a Mormon who chooses not to drink is different from an underhanded, cult-like organization promoting its religious message as the only possible solution to a medical problem.

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Two of our favorite people, Dr. Helen and Barbara Oakley (of Evil Genes fame) discuss the politicization of the American Psychological Association in this video Diagnosis Liberal: Most Psychologists Suffer From Acute Liberal Derangement Syndrome from PJTV.

Many people do not trust psychologists and with good reason. They exclude half of the population or more due to their leftist politics.

Barbara Oakley, Ph.D., P.E.,  was previously featured in an earlier post, Kiss My APA!

Is the APA a non-partisan 501(c)(3) or an organization of partisan hacks? Listen to the show and decide for yourself.

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Use It Or Lose It

Putting your brain to use through years of formal education can serve as a protector against the effects of Alzheimer’s disease. The remarkable effect discovered was not that years of education lower the odds of getting the disease. Instead, researchers discovered that those individuals with more formal education were not showing clinical symptoms of brain deficits compared to other people with Alzheimer’s and without the educational background.

These phenomena are often ascribed to the theoretical concept of cognitive reserve. A high level of cognitive reserve results in a strong individual resilience against symptoms of brain damage; cognitive reserve can therefore be seen as protective against brain damage.

The amount of brain tissue lost was assessed through MRI (Magnetic Resonance Imaging) scans. Somehow, those with the benefit of a formal education showed an equal amount of brain volume lost, yet they were able to function normally.

Human brains are flexible organs, and it’s never too late to give them a workout. Although this study, published in the current issue of the Journal of Alzheimer’s Disease (“Education attenuates the effect of medial temporal lobe atrophy on cognitive function in Alzheimer’s disease: The MIRAGE Study,” Journal of Alzheimer’s Disease, August 2009), used formal education as a convenient guideline, you can get similar benefits by exercising your brain regularly with mentally challenging activities.

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Speaking at APA’s 117th Annual Convention, Steven Blair, PED, called Americans’ physical inactivity “the biggest public health problem of the 21st century.”

Quick, raise your hand if you snickered when you read the word biggest because you were picturing just how big and fat Americans are. Now take your raised hand and slap yourself across the face for being so insensitive.

We kid.

Really though, there are surely much bigger global problems relating to health, especially in regards to disease control, access to clean water, nutritional deficiencies, etc.

Research has shown approximately 25 percent to 35 percent of American adults are inactive, Blair said, meaning that they have sedentary jobs, no regular physical activity program and are generally inactive around the house or yard. “This amounts to 40 million to 50 million people exposed to the hazard of inactivity,” Blair said in an interview.

Putting the hyperbole aside, it is an often accepted and mistaken bit of common knowledge that weight can determine a person’s health. Many young men and women diet and exercise with the goal of changing their weight to a particular amount, and are occasionally briefly successful. Others do not exercise, or do so rarely, but are not considered overweight so it is assumed that they are healthy.

One follow-up study of 40,842 longitudinal study participants showed poor fitness level accounted for about 16 percent of all deaths in both men and women. The percentage was calculated by estimating the number of deaths that would have been avoided if people had spent 30 minutes a day walking.

The reality is that everyone should make it a goal to be physically active to at least a moderate level. Cardiovascular exercises in particular seem to be strongly correlated with longevity and better health, physical and mental,  well into old age. Most people should stay away from exercise extremes such as marathon running because the damage incurred (to the joints, for example) and risk of injury are not worth the health benefits.

Blair also highlighted the benefits of exercise on the mind, referring to recent emerging evidence that activity delays the mind’s decline and is good for brain health overall.

Diet alone cannot make a person healthy. Appetite control is regulated in a complex way by the body, and is very difficult to fight against for any reasonable period of time. Should you be one of those people with a slow metabolism and a hearty appetite, make sure you put extra time and effort into exercising.

Obviously, since this was presented at an APA function there was a role in all this for psychologists.

“I believe psychologists can help develop better lifestyle change interventions to help people be more active via the Internet and other technological methods.”

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Why the Imp in Your Brain Gets Out

At a fundamental level, functioning socially means mastering one’s impulses. The adult brain expends at least as much energy on inhibition as on action, some studies suggest, and mental health relies on abiding strategies to ignore or suppress deeply disturbing thoughts — of one’s own inevitable death, for example. These strategies are general, subconscious or semiconscious psychological programs that usually run on automatic pilot.

In order to suppress a particular (perhaps nasty or politically incorrect) thought, one must consider it in the first place. In doing so, it is more likely to come to fruition. Stress plays an important role in determining whether something remains a thought or actually gets blurted out.

Concentrating intensely on not staring at a prominent mole on a new acquaintance’s face, while also texting and trying to follow a conversation, heightens the risk of saying: “We went to the mole — I mean, mall. Mall!”

Paging Austin Powers…

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Is there really such a thing as unconditional maternal love? A recent study says “no”.

Women are more likely than men to reject unattractive-looking babies, according to a study by researchers at Harvard-affiliated McLean Hospital, possibly reflecting an evolutionary-derived need for diverting limited resources towards the nurturing of healthy offspring. The findings also challenge the idea of unconditional maternal love.

“Our study shows how beauty can affect parental attitudes,” said Igor Elman, senior author of the research, director of the Clinical Psychopathology Laboratory at McLean Hospital, and associate professor of psychiatry at Harvard Medical School. “It shows women are more invested in raising healthy babies and that they are more prone to reject unattractive kids.”

The full study is available online at PLoS ONE if you would like to get involved in the full detailed methodology.

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Cognitive declines are an unfortunate side effect of aging. For scientists to better understand how to prevent it from happening they look to those lucky few who age and remain mentally sharp. One particular group being studied are people over the age of 90 who live in a retirement community.

Laguna Woods Village, a sprawling retirement community of 20,000 south of Los Angeles, is at the center of the world’s largest decades-long study of health and mental acuity in the elderly. Begun by University of Southern California researchers in 1981 and called the 90+ Study, it has included more than 14,000 people aged 65 and older, and more than 1,000 aged 90 or older.

A favorite game requiring a sharp memory is contract bridge. Since forming new memories is one of the first things to be impaired with the onset of dementia, routine players can easily tell when another member begins to have problems.

“When a partner starts to slip, you can’t trust them,” said Julie Davis, 89, a regular player living in Laguna Woods. “That’s what it comes down to. It’s terrible to say it that way, and worse to watch it happen. But other players get very annoyed. You can’t help yourself.”

The real question researchers are trying to answer is whether people who stay involved in mentally engaging activities, such as playing bridge, doing crossword puzzles, or socializing keep themselves sharp as a result of their activities or if they participate in those things because they are already mentally fit. In some cases there appears to be a genetic component.

In studies of the very old, researchers in California, New York, Boston and elsewhere have found clues to that good fortune. For instance, Dr. Kawas’s group has found that some people who are lucid until the end of a very long life have brains that appear riddled with Alzheimer’s disease. In a study released last month, the researchers report that many of them carry a gene variant called APOE2, which may help them maintain mental sharpness.

Dr. Nir Barzilai of the Albert Einstein College of Medicine has found that lucid Ashkenazi Jewish centenarians are three times more likely to carry a gene called CETP, which appears to increase the size and amount of so-called good cholesterol particles, than peers who succumbed to dementia.

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