Urban Moms at Greater Risk for Postpartum Depression

2013-08-12

By Alexandra Sifferlin

Researchers are narrowing in on the host of factors that can contribute to postpartum depression, from genes to social connections. The latest work focuses on where a new mother lives.

The new study, published in the journal Canadian Medical Association Journal (CMAJ), looked at whether urban or rural locales played a role in postpartum depression rates.

More than 6,400 women who lived in a variety of different geographical areas, including urban, rural, semi-urban and semi-rural areas, participated in the 2006 Canadian Maternity Experiences Survey. (Rural living was defined as settlements with fewer than 1,000 people but more than 400 people per square kilometer. Semirural settings included up to 30,000 people, while semi-urban was defined as including 30,000 to 499,999 residents and urban areas included 500,000 people or more.) They also accounted for whether a woman commuted for work to urban places.

Overall, 7.5% of the women who had recently given birth in the weeks prior to the survey developed postpartum depression, but women from urban areas were at a greater risk, with a 10% rate, compared to 6% of women in rural areas, nearly 7% in semi-rural areas and 5% in semi-urban areas who developed the condition. The discrepancy is likely due to the disproportionate distribution of known risk factors such as social support and a prior history of depression that have been previously associated with postpartum depression. In the current study, for example, many of the city-dwelling mothers who developed postpartum were members of immigrant populations, which typically have weaker social support networks.

That could explain the counterintuitive result that a woman living among thousands of people in an urban setting, where post natal care and support may be more accessible than in less populated rural areas, can still experience social isolation that can contribute to feelings of helplessness and despondence. Paula Caplan, a clinical and research psychologist at Harvard University and author of “Don’t Blame Mother: Mending the Mother-Daughter Relationship,” who was not affiliated with the study, says that women living in urban environments are also likely to be working multiple jobs, and to be living in poverty. These stressors, on top of raising children, can test the limits of a new mother’s coping skills.

“People say poor mothers suffer from depression. Why is this a surprise? If you’re trying to be a good mother, it is very hard if you are poor and if you are isolated without having a sense of helplessness,” says Caplan.

Changes in the family dynamic also play a role; women are more likely to live further away from home than they have in the past, which means they are forced to manage without help from family members. While social networks may be more extensive thanks to social media, those connections still can’t replace the support and reassurance provided by the physical presence of a friend or loved one — especially for a new mother. “There are mommy blogs and social media, but there is no substitute for having someone right there who can break down our isolation and tell you you’re doing fine and your kids are okay,” says Caplan.

While hormones as well as possible genetic markers have also been connected to postpartum depression, Caplan believes that classifying the condition as a mental or physiological problem could take the focus away from social changes that could be made to support mothers. As the study results suggest, isolation and lack of social support can intensify feelings of discouragement, being overwhelmed, and loneliness that any new mother naturally experiences.

“We have completely unreasonable expectations for mothers,” says Caplan. “We live in a mother-blaming society where mothers get blamed for almost anything that goes wrong with their child. Mothers can feel isolated or scared to death. There are social changes that need to be made. These women do not need to be treated for alleged mental illness.” The study authors say better daycare options and more supportive services for women who have recently given birth could alleviate some of the burden that mothers feel. And as the results show, these services are needed not just in sparsely populated areas but in densely packed urban ones as well, since it’s possible to feel lonely even when you’re surrounded by people.

Chocolate craving comes from total sensory pleasure

2013-08-07

By Philippa Roxby Health reporter, BBC News

A chocolate lover’s dream? Overflowing molten chocolate

For most of us, chocolate is a guilty pleasure. We crave it because it tastes wonderful and sweet – although we know we should really be stretching for the fruit bowl.

The British are particularly fond of chocolate. Research shows that, on average, Britons enjoy about 11kg (24lb) of chocolate a year, making the UK one of the biggest consumers of chocolate in the world. Only the Swiss and Germans eat more.

But a recent study suggests that chocolate cravings are not a modern phenomenon. In fact, chocoholism may date back to the 18th Century and beyond.

Cacao beans, which are the basic component of chocolate, were roasted, ground and drunk with water by the Mayans from around 2,000 years ago.

In the 14th Century, the Aztecs concocted chocolate drinks with flavourings and used the beans to treat a number of common ailments.

Then in the late 1700s in Mexico, a young doctor started seeing chocolate as harmful, rather than medicinal. He blamed an increase in hysteria among women and nuns in several cities on their excessive consumption of chocolate.

Was this actually an extreme form of chocolate craving?

According to a paper presented at the International Congress on the History of Science, Technology and Medicine at the University of Manchester this weekend, cacao was very popular at the time and could be served hot or cold for medicinal or pleasure purposes.

Nuns were particularly privileged, says author Dr Mauricio Sanchez Menchero, and they “were able to have as much chocolate as they wished for regardless of costs”.

Even a sharp rise in the price of chocolate did not affect consumption levels in convents, he says.

So when new laws were brought in which forced nuns to do away with personal servants and make their own food and drinks, their intake of cacao was “greatly diminished” and they were afflicted by hysterical attacks.

Dr Jose Bartolache was convinced that the cacao plant played a major role in ill health, although very tight clothes and going to bed late were other supposed causes.

The bitter, dark chocolate eaten by the nuns is nothing like the sugary, flavoured milk chocolate which is popular today – but the reaction is understandable.

Many people would claim to crave chocolate and enjoy the feeling that eating it induces.

The key to this may be a chemical called anandamide, which is similar to the compounds released when cannabis is taken.

It is released in small quantities when we eat chocolate and it creates a relaxing feeling.

Prof Philip K. Wilson, joint author of Chocolate as Medicine – A Quest over the Centuries with Jeffrey Hurst, says what lies behind the aphrodisiac qualities of chocolate is still to be answered.

“It’s difficult to tease apart which chemicals may be contributing to which psychological functions. There are over 500 chemicals in consumer chocolate products, so there’s a lifetime of chemical analysis still to be done,” says Prof Wilson.

His hunch is that the “almost seductive” texture of chocolate is as important as its ingredients.

Dr Barry Smith, director of the Centre for the Study of the Senses at Birkbeck University of London, agrees.

He says the combination of the smoothness and creaminess of chocolate in the mouth, the sweetness of the taste – boosted by vanilla flavouring – and the smell of it before it even hits the taste buds make chocolate-eating a hugely pleasurable experience.

And this contrasts with other foods.

“Cheese might smell stinky but it can taste great. Brewed coffee always smells fantastic but it’s not the same taste when you drink it – and that’s disappointing.

“But with chocolate, the pleasure of anticipation and the reward in eating it match up. The aroma and the taste are the same.

“And that matters because there are two sorts of pleasure involved,” says Dr Smith.

He recommends taking time to savour a piece of chocolate, then comparing that experience with eating it quickly.

“When you start eating it, turn it around in your mouth to get the melting quality which strokes the tongue.

“Receptors in the tongue then respond to this stroking and it’s a different feeling from touch.

“That’s why we love a velvety wine or double cream – it’s the feeling on our tongues.”

Both men and women can experience the pleasure of chocolate but women’s superior sense of smell means that they may be more likely to enjoy the ride.

And yet not all countries and cultures show cravings for chocolate.

There is a theory that because chocolate is perceived as “bad food” – because of its sugar and fat content – we try to avoid eating it, and this leads us to crave it, because it is forbidden.

However in recent years, chocolate’s press has improved to the extent that it is now known to have some health benefits.

The type of polyphenols present in cacao beans, known as flavanoids, are antioxidants and there is some evidence that this action may help protect our hearts – but only as part of a healthy and balanced diet.

As for whether chocolate can actually improve our mood, there is limited evidence according to neuroscientists.

But millions of women (and nuns) can’t be wrong, can they?

Hotter World Means Hotter Tempers, More Violence

2013-08-05

By Maia Szalavitz

Climate change may be one of the factors contributing to violence within and among societies, according to the latest study.

Whether it’s a drought in India, a heat wave in the U.S. or an extreme change in rainfall in Africa, Asia or South America, the outcomes tend to be the same: more wars, more murder, more riots and more domestic violence.

The intimate connection between climate and human interaction has long been documented, and could have contributed to the downfall of Chinese and Mayan empires, say the study’s authors. Reporting in the journal Science,  lead author Solomon Hsiang, assistant professor of public policy at the University of California in Berkeley. and his colleagues analyzed 60 studies of climate change and human conflict at several levels, from domestic violence to the collapse of entire civilizations. “All around the world across different societies in the modern world as well as throughout history, we find that human conflict seems to be linked to changes in climate,” says Hsiang.

Rising temperatures have the greatest effect on human conflict; the equivalent of a five degree Fahrenheit increase in an average U.S. county over a month, for example, could raise the odds of personal violence such as assault, murder and domestic violence by 4%, and the risk of civil war, riots or ethnic violence by 14%.

Rainfall and drought can also contribute to conflict; the researchers found spikes in domestic violence in India, as well as higher murder rates in the U.S. and in Tanzania and civil wars in tropical regions tied to relatively small changes in rain or temperature.

The findings reinforce previous studies that linked climate change to human affairs, and raise concerns about the potential impact that changing environmental conditions will have on the stability of societies in coming decades. Most climate change estimates predict a rise of two to four standard deviations in temperature, rainfall or drought by 2050, which suggests a 30% greater risk of intergroup conflicts, says Hsiang.

“It’s a very, very impressive review of the literature,” says Dr. Mark Shapiro, chief of acute care surgery at Duke University Medical Center, who has published research on the link between heat and assaults, but was not associated with the latest study.

Heat could provide fertile ground for interpersonal violence by bringing people into closer contact indoors to seek relief. Assault, rape— even the number of baseball pitchers who retaliate against batters by hitting them with pitches — all rise with temperature, studies show. Even noise can become a more anger-inducing irritant, according to Dutch researchers.

On a population level, climate change may have more indirect effects on social stability; as crops fail due to drought or flood, for instance, migration may provoke conflicts as communities compete for more limited resources.

However, Shapiro says it’s not clear that rising global temperatures will necessary lead to ever-escalating conflict. His own work found a direct, linear relationship between assault and temperature, but other studies suggested there may be a threshold at which violence starts to decline.

Still, says Hsiang, his data show that man is historically ill-equipped to cope with changing climate, and may continue to fall prey to the influence that higher temperatures and more rainfall can have on the stability of both personal and society relationships. “We need to understand why climate changes cause conflict so we can help societies to adapt to these events and avoid the violence,” he said in a statement.

Your happiness type matters

2013-08-01

By Jen Christensen,

You feel happiness all the way down to your genes, scientists say. But the kind of happiness you’re feeling matters, as different kinds can have wildly different effects on your physical well-being.

In fact, the happiness you get from instant gratification — eating that giant cupcake or buying that fabulous pair of shoes — may have the same physical impact on your genes as depression or stress, according to a groundbreaking study published in the Proceedings of the National Academy of Sciences.

“I’ve been studying the physical and psychological impact of positive emotion for 20 years, (and) the pattern of results we found with this study completely surprised me,” said the lead author, Barbara Fredrickson.

Fredrickson is a professor of psychology and the principal investigator of the Positive Emotions and Psychophysiology Lab at the University of North Carolina.

“I’ve known anecdotally that positive emotions impact us on a cellular level, but seeing these results have given us proof that there is a real difference in the kinds of happiness we feel and its potential long-term consequences.”

The experts divide well-being into two different types: hedonic and eudaimonic. These are fancy words to describe happiness that comes from two different sources.

Hedonic well-being comes from an experience a person seeks out that gives them pleasure. As study co-author Steve Cole describes it, it’s “having lots of positive experiences that come from, say, eating great food or smelling beautiful flowers.”

Eudaimonic well-being is a kind of happiness that comes not from consuming something but from a sustained effort at working toward something bigger than you. In other words, it’s working toward a sense of meaning in your life or contributing to some kind of cause. Think of the happiness you see on the Dalai Lama or Mother Teresa’s face.

While the two kinds of happiness are conceptually different, they can and do influence each other, so it has been hard for scientists to measure which kind has had a greater positive influence on someone’s physical or psychological well-being.

Cole, a professor of medicine, psychiatry and biobehavioral sciences at UCLA, studies the biological pathways by which social environments influence gene expression.

“I know what misery looks like on a genetic level,” Cole said. “I can look at white blood cells and see a physical response to stress and misery, but we knew very little about how — if at all — positive psychology gets disseminated to the body. That’s what this study does.”

If you experience misery and stress, your genes react to it. Essentially, there is an increased expression of genes involved in inflammation and a decreased antiviral response. People who are subjected to long periods of stress have white blood cells that make slightly more pro-inflammatory proteins on a constant basis.

Inflammation is the first line of defense against infection, so that would be a very useful kind of protein to have; however, something that causes your body to create inflammation over a sustained amount of time can cause collateral damage to healthy tissue.

Colorado College microbiologist Phoebe Lostroh, who is not affiliated with the study but is familiar with its contents, explains it this way: “The immune system of someone stressed out is not at the normal level of green on the terrorism alert scale. Instead, it’s on yellow or orange, if not all the way on red. So there’s this low level of constant inflammation, which is not healthy.”

Low levels of inflammation can cause exhaustion. They also increase a person’s risk for cancer, heart disease and Alzheimer’s and can damage various tissues wherever the white blood cells are causing inflammation where they shouldn’t be, Lostroh said.

With this understanding in mind, the scientists in the new study took blood from 80 healthy adults who were screened for the two types of happiness. None of them reported being depressed or stressed.

Scientists extracted the RNA from their blood and took a closer look at the inflammatory and antiviral responses.

The study found that people who experienced the well-being that comes from self-gratification had high inflammation and low antiviral and antibody gene expression, a result similar to what people who are depressed or experience great stress have.

Bottom line? Happiness that comes from working for the greater good has a much more positive genetic impact.

“Keep in mind positives go with both kinds of well-being,” Fredrickson said. “But emotions you feel today … really will effect who you are at a cellular level.”

The study didn’t get at why the two kinds of well-being have different genetic impacts, but Cole has a theory.

“Hedonic well-being is dependent on your taking self-involved action to constantly feed this positive emotion machine,” he said. “If something threatens your ability to seek out this kind of personal happiness — if you get injured, for instance, or you experience a loss — your entire source of well-being is threatened. You are living closer to the edge of that kind of stress.

“But if you find well-being in the connections you have to others and in pursuing something that involves collaborating with other people, if in that circumstance you get sick or injured or suffer a personal loss, that community you’ve worked so hard to connect to, they will help you get through.”