Yoga and the Mind: Can Yoga Reduce Symptoms of Major Psychiatric Disorders?

2013-01-29

By Alexandra Sifferlin

Yoga does the body good, and according to a new study, it may ease the mind as well.

“Yoga has also become such a cultural phenomenon that it has become difficult for physicians and consumers to differentiate legitimate claims from hype,” researchers from Duke University Medical Center write in their study, published in the journal Frontiers in Psychiatry. In order to explore the widely held belief that practicing yoga can relieve mental stress, the team reviewed more than 100 studies on the effect of yoga and mental health.

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Revisions to Mental Health Manual May Turn Binge Drinkers into ‘Mild’ Alcoholics

Are you an alcoholic— or just a problem drinker? It may not matter, according to the latest version of the DSM, psychiatry’s diagnostic manual.

And now, in a new study of the different levels of alcohol misuse, scientists say the changes made to the DSM-5 may not even represent a significant improvement in the diagnosis of alcoholism. In fact, the revised definition collapses the medical distinction between problem drinking and alcoholism, potentially leading college binge drinkers to be mislabeled as possible lifelong alcoholics. The changes take effect in May, when the DSM-5 will be released.

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Child Abuse: Why It’s So Hard to Determine Who’s at Risk

By Bonnie Rochman

Prevention is nearly always preferable to treatment when it comes to our health, and the stakes are even higher in cases of child abuse. But is it even possible to identify children at risk of abuse before it’s too late? That’s the question the U.S. Preventive Services Task Force (USPSTF) addressed, in a comprehensive review of the available data on ways to detect maltreatment of children.

The task force is a government-funded group of independent experts that considers all the available evidence on a range of health topics, then grades studies on their reliability and validity before making recommendations based on the quality of those results. In recent years, its review of the benefits of mammography in preventing breast cancer and prostate specific antigen (PSA) testing in detecting prostate tumors caused controversy when it recommended that men skip regular PSA screening altogether, and that women wait until they reach 50 to begin routine mammogram testing — a full 10 years later than previous advice.

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When the holidays turn depressing By Dr. Charles Raison

2013-01-21

When the holidays bring heartache instead of joy, I think they do so because they stand as an unforgiving yardstick against which we measure our losses and troubles.

If no one reminds us, we can sometimes overlook the fact that loved ones are gone, or that our lives are filled with painful conflict in exactly the intimate areas that should be sources of strength and comfort for us. But then along come the holidays, imposing upon us once again a template for what happiness and interpersonal success is expected to look like.

It can be hard to measure up. It is far easier to overlook the death of loved ones when you don’t have to stare across the holiday table at their empty places. It is far easier to pretend that family trauma or conflict don’t exist when you are far away and on your own.

But the holidays force us to either return to painful family interactions or to fully own our isolation and spend the season alone.

It is a terrible choice. I’ve treated many patients over the years who reliably became depressed during the holidays out of dread of having to interact with their families. On the other hand, the silence of Christmas morning on one’s own carries its own unique pain.

I never cease to be amazed at how often both emotional well-being and mental illness hinge on how we negotiate these types of impossible choices. Because the choices really are often insoluble and the losses are often so actual, we in the mental health professions frequently try to find “a third way” to help people cope. In the end, these “third way” approaches usually come down to helping people reframe their issues so they that seem less hopeless and painful. Or we provide people with medications such as antidepressants to make their brains and bodies less reactive to stress. Or we do both.

Reframing

I’ve given many interviews over the years regarding strategies for helping people cope emotionally with the holidays. For people truly overwhelmed, I often recommend exploring ways to neutralize Christmas negativity by changing how they approach the holidays. For example, if someone develops a major depression every year before or after going home to see her family, I encourage her to explore what would happen if she abandoned this painful pattern and instead proactively planned a Christmas vacation somewhere beyond the reach of her memories and holiday associations that generate symptoms of depression.

Sometimes this type of strategy works beautifully. Often other family members are equally miserable and join the exodus, providing strength in numbers. Sometimes the person’s absence leads the family to re-evaluate itself and change in positive ways. But sometimes, the attempt to flee Christmas is met with such anger and guilt production from the family that the patient actually ends up doing worse. Everyone’s holiday situation is unique.

This type of approach toward reframing Christmas follows what I sometimes call the “who says” rule. Many times we torture ourselves with ideas of how things should be, or would be if we were somehow smarter, richer, different. To which I often ask, “Who says?” “Who says things have to be the way you think they should be?” “Who says you have to suffer over a painful fantasy of what you think Christmas ought to be?”

We cling tightly to our fantasies — good and bad. But sometimes when we can loosen their grip on us, we can see new possibilities for how to be at peace with our lives and find a little joy.

Medications

This holiday season I’ve been thinking a lot about Christmas 1987, because it was four days later, on December 29, that fluoxetine, better known by its brand name Prozac, received FDA approval for use in the United States. The approval of Prozac launched one of history’s greatest run of “third way” approaches to trauma and loss.

With Prozac came a growing belief that medicines might hold promise as the ultimate solution, not just to clinical depression, but perhaps to heartache more generally.

Having once believed this myself, I find that now, 25 years later, I am far more cautious in my appraisal of what the coming of Prozac actually meant for the world’s emotional well-being. I’ve seen repeatedly with my own eyes how modern antidepressants like Prozac can help depressed people get their lives back. And I’ve seen people who had struggled with negative thoughts and feelings for years find that they were different — and more successful — with the addition of an antidepressant in their lives.
Dr. Charles Raison
Dr. Charles Raison

But in the last several years it has become increasingly clear that antidepressants are not, and probably will never be, a cure-all for heartache, in any of its forms clinical or mundane. For one thing, our best current data suggest that antidepressants only work adequately for 40% to 60% of depressed people, with the percentages varying depending on what one thinks of as “adequate.”

More recent evidence suggests that antidepressants can actually worsen depressive symptoms in a sizable minority of people who take them. Perhaps this shouldn’t surprise us. Chemotherapeutic agents that increase the probability of surviving cancer also increase the risk of developing a second cancer in the future. And yet despite this fact, and despite the dread we feel at the mere mention of the word “chemotherapy,” most of us embrace chemotherapeutic treatment when diagnosed with cancer, understanding that despite the manifold limitations and horrendous side effects, it’s the best that we’ve got.

Perhaps the most concerning recent debate in the antidepressant literature revolves around the question of whether taking these medications increases the risk of having a depression relapse when the antidepressant is discontinued. This issue is complex and hotly debated. But if the weight of the evidence eventually suggests that antidepressants carry this risk it will further complicate the clinician’s task. Still, as with chemotherapy, they’re the best that we’ve got.

Finding more solutions

This year, with Christmas upon us, I am more convinced than ever that we who work clinically or conduct research in the realm of mental health must redouble our efforts to find new and better “third ways” to help deal, not just with clinical depression, but also with the ubiquitous heartache and anxiety that are so prevalent in the modern world.

Although I personally research biological approaches to treating depression, I suspect that part of our movement forward will come from better integrating older ways of wisdom into our treatment protocols. Many wisdom traditions point toward the same thing — that full healing requires not just reframing or biology, but an inner transformation that embraces suffering itself as a means of escape from our suffering.

Childhood Trauma Leaves Legacy of Brain Changes

2013-01-18

Painful experiences early in life can alter the brain in lasting ways.

A difficult reality for psychiatrists and counselors of child abuse is that young victims are at high risk of becoming offenders themselves one day, although it’s unclear why. But now a team of behavioral geneticists in Switzerland report a possible reason: early psychological trauma may actually cause lasting changes in the brain that promote aggressive behavior in adulthood.

Writing this week Translational Psychiatry, the researchers describe a series or experiments conducted in rats that led them to that conclusion. Animals placed in traumatic, fear-inducing situations around the time of puberty show high and sustained levels of aggression later in life. And while rats cannot substitute for humans, the scared rats also showed changes in hormone levels, brain activity, and genetic expression that appear very similar to traits observed among troubled and unusually violent people.

The main implication of the research, says study co-author Carmen Sandi, is that it links two previously observed phenomena: the higher rate of aggression among those experiencing early-life stress, and the blunted activation of a brain region known as the orbitofrontal cortex among people with pathological aggression. Social learning, it seems, may not be the only thing that makes abused kids more likely to grow up aggressive.

“This is a key finding which highlights the importance of not only developing social programs and politics, but also of reinforcing research that could offer valid [medical] treatments for individuals that have been victimized early in life,” says Sandi, the director of the Brain Mind Institute at Ecole Polytechnique Fédérale de Lausanne, in an email discussing the study. “We need to understand the neurobiological mechanisms to offer better solutions to break ‘the cycle of violence.’”

In the study, Sandi and colleagues tested the rats for changes in specific regions of the brain following long periods of fear, and then tested a potential treatment to determine if it was possible to undo those brain changes.

They began by exposing about 40 pubescent male rats for a few minutes at a time over several days, to severe stress — which, for the rats was either the scent of a fox or being stranded on a brightly lit platform. Those rats immediately showed higher levels of stress hormones and later puberty onset than similar animals not exposed to those experiences.

As adults, the stressed rats showed greater aggression toward other males they met — even ones that were clearly not a threat because they were much smaller or even anesthetized. And the once-stressed animals also showed more signs of depression and anxiety, including a reduced interest in food, lower sociability, and a tendency to give up quickly when faced with a challenge.

Those behavioral changes were accompanied by neurobiological changes in the brain as well. Compared to normal rats, the once-fearful ones had higher levels of the hormone testosterone, which is linked to aggression. They also showed more activity in the amygdala, the part of the brain responsible for emotions such as fear and anxiety, and altered connectivity between the amygdala and a region of the brain involved in decision-making. These brain alterations were also correlated with enhanced expression of the gene for an enzyme known as monoamine oxidase A, or MAOA, providing the scientists with a potential way to reverse the effects of the early traumas. Indeed, treating the rats with an MAOA inhibitor helped to restore normal social behavior and reduce aggression in the formerly stressed animals.

It turns out that the MAOA gene is also related to aggressive behavior in people, and certain inherited variants of the gene have also been linked to aggressive tendencies. Because the new study showed that MAOA inhibitors were effective in treating pathological aggression in rats, Sandi says the findings might suggest a similar drug treatment for humans, too, to complement behavioral therapy.

“What we show in our study is that, regardless of the genetic background, exposure to early life trauma can on its own affect the expression levels of this molecule in the brain,” Sandi says. “Our work is novel in many ways, particularly because it provides concrete neurobiological pathways that link early trauma with pathological aggression.”

Why would early traumatic experiences crave permanent changes in the brain? Evolutionarily, such brain changes may have helped us to survive a harsh and cruel environment, by keeping us on edge and ready to confront any possible threats, Sandi says. Today, however, those same changes may do more harm than good, leading some victims of abuse to slip into a vicious cycle, seeing threats where none exist, and overreacting to situations, often with violence. It’s possible that some people may be genetically more sensitive to the changes triggered by painful experiences, and therefore more likely to benefit from treatments that can address those genetic differences. Better understanding of why vicious cycles of violence exist may help researchers to find ways to break them.

Why You’re More Likely to Remember A Facebook Status Than a Face

Remember a year ago, when the cousin of your college roommate posted a Facebook status that she got engaged? Sure you do. In fact, according to a recent study, you remember that Facebook status more than a line from a book or a stranger’s face.

Even if the quips are from complete strangers, new research published in the journal Memory & Cognition found these Facebook posts are about one and a half times more memorable than sentences in books and two and a half times more memorable than faces.

To understand how we process information absorbed from social media, researchers from the University of California San Diego (UCSD) and the University of Scranton asked 280 undergraduates to read 100 sentences pulled from Facebook pages, 100 sentences extracted from books — none of which were more than 25 words long — and a series of pictures of human faces. The participants were then prompted with the same phrases and pictures and asked to recall which ones they had seen previously. Which were more memorable? The students remembered more of the Facebook posts than either the reading passages or the faces.

And because the scientists removed extraneous punctuation, leaving only words, the sharper recall wasn’t due to smiley emoticons, writing in all caps or those ubiquitous multiple explanation points to “I’m having the BEST day EVER!!!!!” that pepper Facebook writings.

Instead, the researchers speculate that Facebook posts’ unforgetableness could be related to their coherency and “gossipy” tone. It’s easier to recall a chatty or witty post about the antics of someone’s cat, for example, than it is to remember a line from Great Expectations. To test this, the research team repeated the experiment using news headlines from CNN, lines from CNN stories about either breaking news or entertainment, and reader comments. The headlines were recalled better than random sentences from the stories, and entertainment headlines were more memorable than those from news stories.

But of all the bits of text, what the participants remembered the most were the readers’ comments, suggesting that our brains are more likely to recall patterns of speech that fall in line with our spontaneous thought processes.

“Not only is the Facebook memory effect strong, but we replicated the effect each time,” says study author Laura Mickes, a visiting scholar at UCSD and senior research fellow at the University of Warwick. “One would not expect posts written casually to be remembered better than words penned by professional authors and edited by professional editors, but that is exactly what we found, repeatedly.”

The authors suggest that causally written and unedited posts are more “mind-ready,” meaning that natural wording sticks in our mind because it’s how we speak day-to-day. The authors write:

It seems that, with the growth of blogging, text messaging, and the like, written language has moved closer to natural speech, with less editing and contemplation than was needed not only when writing was done by monks with goose-feather quills or by Gutenberg with moveable type, but even when it is done by authors sitting patiently at their own keyboards.

“This is surprising, and gives us a glimpse into how memory works and has implications for how we learn, advertise and generally communicate,” says Mickes.

Does that mean the written word is becoming more colloquial? The research wasn’t designed to answer that question, but the findings hint that some shift in how we write is certainly occurring in our online communications. And the results certainly show that everything we post on social media may live longer in the memory banks of our “friends” than we’d like.

Emotional Eating: The Toughest Part of Weight Loss

2013-01-16

Diet and exercise — sure, they can help you lose weight. But most people need to consider a third component to keep unwanted pounds from coming back: emotional eating. While we’ve all reached for the carton of ice cream or box of chocolate cookies when we’re blue, we don’t always know what emotional undercurrents are driving the urge to stand in front of the fridge, make poor food choices, or eat when we’re not hungry.

“From the time we’re little, we’re placated with food. If we’re upset about something that happened at school, we get a treat. If we trip and fall, we get a treat. We get into the mode of eating more food than we need to placate ourselves emotionally,” says Tracy Olgeaty Gensler, MS, RD, a nutritionist for The Best Life Diet. “Many times, people will say, ‘I feel empty inside and can’t explain it.’”

What’s Eating You?
Overeating may be a sign that something is missing in your life. When you discover what that is, you can start to make the changes that will help you lose weight and make positive, long-lasting improvements in your life. Here are some ideas for getting to that place.

Spell out happiness. Write down everything you consider part of a fulfilled life, such as family, good health, spirituality, watching sports, a job you love and financial security. Think about your childhood, the early days of your marriage, and present day as you draw up your list of things that you consider important to happiness and fulfillment. In The Best Life Diet, author Bob Greene calls this exercise the Circle of Life. Don’t try to write down everything in one sitting. Take time to reflect and really give the list some thought, says Olgeaty Gensler.

Look at the equation. When you’re all done, place a plus or minus sign next to everything on your list. A plus sign means you’re generally satisfied with this item, while a minus sign means you’re dissatisfied or it’s missing from your life. For example, you may be satisfied with your marriage but unhappy with the amount of sleep you get or with how little time you have for friends.

Focus on the minuses. Pay close attention to these areas — they are places in your life where something important is missing, according to Olgeaty Gensler. “These are areas where you may be looking to fulfill yourself emotionally with food,” she says. Identifying the minuses helps you get to the bottom of your emotional eating and allows you to be freer to focus on finding nonfood solutions.

Reap the benefits. Writing this list also helps you get organized and gives you permission to put yourself first for a change. It’s easy to come up with excuses for why we don’t have time for ourselves, and it’s more difficult to confront the things that are missing from our busy lives. But the payoff is huge.

“When you put yourself first, you become a better person, a better spouse, a better parent. You feel more energy and less deprived. You can be so much more productive when you take care of your needs,” says Olgeaty Gensler.

Your smartphone may be powering down your relationship

2013-01-11

an Kerner, a sexuality counselor and New York Times best-selling author, writes about sex and relationships for CNN Health. Read more from him on his website, GoodInBed.

Are you spending more time with your smartphone than with your partner — even during romantic dates?

Technology allows us to be constantly connected to the world, but it can also make us even more disconnected from each other.

In fact, two recent studies show that cell phones can have a negative impact on close relationships.

Researchers from the University of Essex found that people who engaged in personal discussions when a cell phone was nearby — even if neither was actually using it — reported lower relationship quality and less trust for their partner. They also felt their partner was less empathetic to their concerns.

Other studies suggest that cell phones can distract our attention from the present moment. And that’s a problem, considering the results of the Mobile Mindset Study, a recent survey that found three out of five U.S. smartphone users don’t go more than hour without checking their gadgets.

Taken a few steps further, smartphones, tablets, and laptops — and the social media they often support — have the potential to tear couples apart.

Internet infidelity: Is it time to snoop?

I’ve talked before in this column about the capability of Facebook and other social media to threaten relationships: They provide a sense of instant gratification that stimulates our brain’s reward centers, offering quick hits of novelty that can be downright addictive.

Plus, they allow us to connect with friends, co-workers, and even former flames, fostering an immediate and intense sense of intimacy that can lead us to romanticize these connections. At best, you’re giving your energy to these digital distractions, not your partner. At worst, you could be setting the stage for emotional infidelity.

Of course, it’s unrealistic to ditch your smartphone altogether, especially if you also need it for work. But there are things you can do to use it wisely — and even help improve your relationship. Here are three tips for making technology work for you and your partner:
Ian Kerner
Ian Kerner

Set it aside. It should go without saying that cell phones are best kept out of sight and out of mind when you’re on a date. Turn it off and place it in your bag or pocket for the duration — the world won’t end if you can’t check your e-mail for an hour or two.

I also recommend shutting down phones, tablets and laptops at night, or at least charging them in a room other than your bedroom. Not only can they interfere with your ability to relax and unwind, but their distracting presence can also put a real crimp in intimacy.

Rethink social media. We’ve talked about the possible perils of connecting with your exes online. But I typically advise that you don’t “friend” your partner, either. As Facebook friends, you have access to the most mundane parts of your significant other’s day, from what he ate for lunch, to what new movies she wants to see. Talk about removing any sense of mystery!

If you do want to connect online as well as off, consider joining a digital service that helps foster togetherness. Best described as intimate online spaces for just you and your partner, programs like Between or TwoCup offer a place to share private memories, messages, and photos — away from the prying eyes of others.

Make a sexy connection. Technology isn’t all bad: It can actually bring you closer together — and even add some spice to foreplay.

Use your smartphone to send your partner a sexy e-mail, voicemail message, or “sext” describing a fantasy or your plans with him or her for the evening. Engage in a little Skype or FaceTime flirtation, especially if one of you is out of town. Just a word of caution: Be sure to use personal, not company accounts.

Smartphones and other gadgets can clearly have a negative impact on your relationship — but they don’t have to. By learning to use them wisely, you can start to feel more connected to your partner than ever.

Diet drinks’ ‘link to depression’ questioned

2013-01-09

Experts are questioning whether diet drinks could raise depression risk, after a large study has found a link.

The US research in more than 250,000 people found depression was more common among frequent consumers of artificially sweetened beverages.

The work, which will be presented at the American Academy of Neurology’s annual meeting, did not look at the cause for this link.

Drinking coffee was linked with a lower risk of depression.

People who drank four cups a day were 10% less likely to be diagnosed with depression during the 10-year study period than those who drank no coffee.
Continue reading the main story
“Start Quote

Sweeteners have been very widely tested and reviewed for safety and the ones on the market have an excellent safety track record”

Gaynor Bussell British Dietetic Association

But those who drank four cans or glasses of diet fizzy drinks or artificially sweetened juice a day increased their risk of depression by about a third.

Lead researcher Dr Honglei Chen, of the National Institutes of Health in North Carolina, said: “Our research suggests that cutting out or down on sweetened diet drinks or replacing them with unsweetened coffee may naturally help lower your depression risk.”

But he said more studies were needed to explore this.
No proof

There are many other factors that may be involved.

And the findings – in people in their 50s, 60s, 70s and 80s and living in the US – might not apply to other populations.

The safety of sweeteners, like aspartame, has been extensively tested by scientists and is assured by regulators.

Gaynor Bussell, of the British Dietetic Association, said: “Sweeteners used to be called ‘artificial’ sweeteners and unfortunately the term ‘artificial’ has evoked suspicion. As a result, sweeteners have been very widely tested and reviewed for safety and the ones on the market have an excellent safety track record.

Sweeteners

Sweeteners are used in a wide range of manufactured sugar-free, reduced sugar and low calorie foods and drinks
These include aspartame, saccharin, acesulfame potassium (K), cyclamate and sucralose
They are virtually free of calories and do not affect blood glucose levels
There are regulations about how much sweetener can be used in foods and “Acceptable Daily Limits”

“However, the studies on them continue and this one has thrown up a possibly link – not a cause and effect – with depression.”

She said the study was a “one-off” and did not mean that sweeteners caused depression.

“For a start, people who suffer from depression may latch on to the idea that it is their sweetened beverages that caused it and so add a bias to their reporting of past intake, especially as ‘soda’ in the US is demonised even more than in the UK. Also, it may be that drinking ‘diet’ drinks is a marker for obesity or diabetes which in themselves can cause depression.

“Non-calorific sweeteners can play a useful role in the diets of those trying to lose weight and diabetics and it is certainly not advocated that people should replace their diet sodas with more coffee.”

Beth Murphy, at the mental health charity Mind, said: “We would urge anyone who is affected by depression to follow the advice of their GP or other medical professional in regards to their treatment.”