Articles on Mental Health Topics


When Exercise Boosts Mood, How Long Do The Effects Last?

posted Aug 20, 2013, 2:21 AM by Barb Cornblath   [ updated Aug 20, 2013, 2:32 AM ]

By Gretchen Reynolds

Originally Printed In The New York Times: Well Blogs

It is well established that exercise bolsters the structure and function of the brain. Multiple animal and human studies have shown that a few months of moderate exercise can create new neurons, lift mood and hone memory and thinking.

But few studies have gone on to examine what happens next. Are these desirable brain changes permanent? Or, if someone begins exercising but then stops, does the brain revert to its former state, much like unused muscles slacken?

The question may be particularly relevant ... when so many people start new exercise programs. Helpfully, two recent animal studies that were presented at the 2012 annual meeting of the Society for Neuroscience in New Orleans have taken on the issue and may have relevance for people, though the results are disquieting.

Of the two experiments, the more dramatic looked at what happens to the brain’s memory center when exercise is stopped.

Researchers from the University of Sao Paulo in Brazil began by allowing half of a group of healthy, adult rats to run at will on running wheels. Rats enjoy that activity and, for a week, they enthusiastically skittered on their wheels. The animals were also injected with a substance that marks newborn neurons in the hippocampus, or memory center of the brain, so that the scientists would be able to track how many cells had been created. Inactive animals, including people, create new brain cells, but exercise is known to spark the creation of two or three times as many new hippocampal neurons.

A separate control group was housed in cages with locked wheels, so that they remained sedentary. They were also monitored for new brain cell growth.

After a week, the runners’ wheels were locked and they, too, became inactive.

A week later, some of the exercised and control rats completed memory testing that required them to find, then remember, the location of a platform placed along the wall of a small swimming pool. (Rats aren’t fond of being in the water, and the platform allowed them to clamber out.) Those with better memories remembered and paddled to the platform more quickly.

The remaining animals completed the same memory test after either three weeks or six weeks of inactivity.

Afterward, the researchers compared the animals’ performance on the memory test, as well as the number of new brain cells in the hippocampus of each group of rats.

They found that, after only a week of inactivity, the rats that had run were much faster on the water maze test than the control animals. They also had at least twice as many newborn neurons in the hippocampus.

But those advantages faded after several more weeks of not running. The brains of the animals that had been inactive for three weeks contained far fewer newborn neurons than the brains of the animals that had rested for only one week. The brains of the animals that had been inactive for six weeks had fewer still.

The animals inactive for three or six weeks also performed far worse on the water maze test than the animals that had been inactive for only a single week. In fact, their memories were about as porous of those of the control animals, “indicating,” the authors write, “that the exercise-induced benefits may be transient.”

The other new study of exercise-induced brain changes found that they were similarly fragile, although this study explored the impacts of exercise on mood.

In earlier experiments by the same group of scientists, from McMaster University in Hamilton, Ontario, rats given access to a running wheel, toys and other types of environmental enrichment were able to use serotonin, a neurotransmitter involved in anxiety and other moods, more efficiently. After several months of exercise, the exercised animals became noticeably less anxious and more resilient to stress during behavioral testing. But that savoir-faire dissipated rapidly if they were removed from the cages with running wheels and toys.

In their latest experiment, also presented at the Society for Neuroscience meeting, the researchers reported that after 10 weeks of running, followed by three weeks of inactivity, the running rats’ brains were almost indistinguishable from those of animals that had never exercised. They had almost comparable levels of an enzyme in the brain that affects the synthesis and uptake of serotonin. It was as if they had never run.

In other words, the brain benefits “wear off quickly,” said Dr. Michael Mazurek, a professor of neurology at McMaster, who oversaw the study. “This is analogous to what happens to muscle bulk or heart rate following exercise withdrawal.”

Gilberto Xavier, a professor of psychology at the University of Sao Paulo and senior author of the study of hippocampal neurons, agrees. “Brain changes are not maintained when regular physical exercise is interrupted,” he said, adding that, “though our observations are restricted to rats, indirect evidence suggests that the same phenomenon occurs in human beings.”

Meaning that the lessons of both studies point in the same direction. For the ongoing health of our minds, as well as for the plentiful other health benefits of exercise, it might be wise to stick to those New Year’s exercise resolutions.

Responses To Sad Movies Provide Clues To Depression Relapse

posted Aug 29, 2011, 4:36 PM by Barb Cornblath   [ updated Aug 29, 2011, 4:48 PM ]

By Joseph Brownstein
Re-printed from MSNBC Health News and MyHealthNewsDaily
updated 8/26/2011 2:42:42 PM ET

    The brains of people who relapse into depression differ from those of people who maintain a recovery, a new study shows.The results may provide insight into why some people relapse and why certain therapies may help, the researchers said.

    Researchers at the University of Toronto used functional magnetic resonance imaging (fMRI) to study the brains of 16 people who had successfully completed treatment for major depression, along with 16 people who hadn't been depressed,and followed them for 18 months.They found that the areas of the brain that lit up when the formerly depressed people watched a sad movie corresponded with whether the patients ultimately needed more treatment.

    "Some of the people who felt sad [while watching the movies] had a pattern of activity in the front and medial areas— areas that have been associated with continued thinking and ruminating," said study researcher Zindel Segal, chairman of depression studies in the university's department of psychiatry.  "People who had those reactions were more likely to become depressed again over an 18-month period."

    Patients who were less likely to relapse had activation in lateral areas of the brain instead. Those patients were about 35 percent less likely to suffer a relapse, Segal said. The patients' brains were scanned while they watch two neutral film scenes, and then two sad scenes (from the films "The Champ" and "Terms of Endearment").

    The different brain activity patterns, Segal explained, might show that the patients who were more likely to relapse were internalizing sadness, while those likely to maintain their recoveries were observing the films more as sensory experiences.

    "Even though people have recovered from depression, they can still be vulnerable, or a little bit at risk, if they experience sadness or sad states of mind. How they handle those brief sad moods has a lot to do with whether they relapse," he said.  "Cognitive training in how to handle brief dysphoric moods can be helpful in teaching people skills to regulate emotion and prevent relapse," Segal added.

    However, before the results can be considered a full explanation of how cognitive therapy works to treat depression, they need to be replicated, said Scott Langenecker, a clinical neuropsychologist at the University of Michigan, who was not involved with the research.

    Because the study included relatively few patients, and few films were used in observing their brains, Langenecker said a larger study, perhaps one that began during patients' initial depression, would provide better data for drawing the conclusions. Still, the study is "really interesting" and has potential for real clinical implications, Langenecker said. "It's pushing a line of research that's very near and dear to my heart."

    He said he is optimistic that the field will provide better tools for psychologists and psychiatrists to treat depression, which would benefit not only patients but society, through lower health care costs.
"The basic treatment strategy that we have right now is trial and error," he said. And as a result, perhaps only 40 percent of people improve in the first round of treatment – an improvement that takes at least three months to become apparent.

"That's a long time for people to suffer," he said.

Basing treatments on observations of what is going on in patients' brains might raise the success rate of a first treatment to more along the lines of 70 percent, Langenecker said. "That doesn't mean everybody is going to get well, but it means 30 percent more will get better in three months rather than six months or a year," he said. "We can't continue to have a 60 percent failure rate in that first three months."

Mood Influences Ability To Problem Solve

posted Jan 14, 2011, 9:09 AM by Barb Cornblath   [ updated Jan 14, 2011, 9:21 AM ]

Better Mood, Better Performance: Happiness Helps Us Make Good Decisions...Sometimes


By: Sian Beilock, Ph.D.

Jan. 5, 2011

Re-printed from Psychology Today (http://www.psychologytoday.com

We've all experienced positive and negative moods - whether it's feeling happy after just seeing a really funny movie or feeling sad after receiving some bad news. These moods affect how we feel so it's not so hard to imagine that they might also impact how we think. Indeed, it's a fairly well-established finding that mood can impact our cognitive functioning (i.e., how we think, reason, problem solve). But, how exactly this works is still somewhat of a mystery.

In a study published recently in the journal Psychological Science, researchers from the University of Western Ontario in Canada set out to solve the mood-cognition puzzle - or at least shed some new light on it. They brought people into their laboratory and asked them to watch funny or depressing videos to put them in particular mood states.

People fortunate enough to be assigned to the positive mood condition got to watch segments from the popular comedy show "who's line is it anyway." Folks in the negative mood condition watched news reports about natural disasters or scenes from a movie about a person with terminal cancer.

After the videos, everyone performed one of two tasks. The goal in both tasks was the same: To determine whether a circle presented on a computer screen belonged to Category A or Category B. The circle was filled in with a repeated number of fuzzy dark and light bars and people had to determine which category it belonged to simply by its visual features.

Even though the goal of the two tasks was the same, they were solved in very different ways. One task, the Rule Task, was solvable by finding a single rule that separated the circles into categories - such as the orientation of the bars in the circle (some circles had bars oriented to the left, some to the right). The second task couldn't be solved in this way. More than one visual feature differed between the circles so it was impossible to get a handle - at least a handle you could verbalize - on what really made some circles different from others. Instead, people could only solve this task by going through a number of circles, seeing which circle belonged to which category, and then going with their gut hunch about what separated new circles they saw into the two separate categories.

Why would the researchers use these odd circle tasks to explore the impact of mood on cognition? The reason is that different parts of the brain are thought to support how people learn each of the tasks. Showing that say, a positive mood, has an impact on one task and not the other might tell us something interesting about the types of activities that are enhanced by a happy state of mind.

Sure enough, the researchers found that positive mood enhanced performance, but only on the Rule Task where flexibly testing one hypothesis after another produces the best performance. On the other task, where people were better off going with their gut, mood had no impact on performance.

The prefrontal cortex, the area of the brain that sits just above the eyes and houses our working memory - that mental scratchpad that allows us to "work" with whatever information is held in consciousness - is thought to play a big role in performing the Rule-Task. What this suggests is that only activities that require a heavy dose of the prefrontal cortex will be enhanced by a positive mood.

The take home point? Mood can impact how we function, but a better mood doesn't equal better performance across the board. For situations where you have to flexibly shift between goals or exhaust many different hypotheses - say when solving a difficult logistics issue at work or juggling several different tasks at once - being in a good mood is beneficial. But for activities where you need to just go with your gut, there may be no performance benefit to a positive mood. Indeed, it might even hurt.

Our mood impacts how we think. By knowing a bit of the science behind the relation between cognition and emotion, we can pick the right activity for our mood and optimize our performance.

--Nadler, et al. (2010). Better Mood and Better Performance : Learning Rule-Described Categories Is Enhanced by Positive Mood. Psychological Science.

--Check out Dr. Beilock's interesting book Choke on coping with performance anxiety and test anxiety


Are Anxiety Disorders Among Women On The Rise?

posted Oct 31, 2010, 4:53 PM by Barb Cornblath   [ updated Oct 31, 2010, 5:07 PM ]

By Shaun Dreisbach --
Reprinted from MSNBC and Glamour Magazine 
October 15, 2010

    Anxiety. It’s a term that’s often tossed around in conversation—as a casual synonym for stress, or worry, or that feeling you get when you look at your to-do list. But for 40 million Americans, anxiety disorders are debilitating and omnipresent, and women are twice as likely to suffer as men, according to the Anxiety Disorders Association of America. 
    “There is an intense, constant fear that is hard to describe,” says Laura Rowe, 34, of Denver. “It’s a sinking feeling in your stomach—almost as if someone is stalking you and you never know when those arms are going to wrap around you and drag you away.” And more and more of us are being diagnosed: A recent study of about 63,700 college students found that five times as many young adults are dealing with high levels of anxiety as in the late 1930s (itself a stressful time!). 
    The signs of anxiety’s prevalence among women are everywhere: Ads for anti-anxiety drugs run frequently on TV shows often aimed at women; young female stars, like the actress Amanda Seyfried, confide their own experiences in the press; websites like findthelight.net attract thousands of users. 
    And though no national data of rates in women exist, many experts believe the surge is not just media hype—it’s real. “I think there’s little question that there’s more anxiety today, and that women, in particular, are feeling it,” says JoAnn E. Manson, M.D., chief of the division of preventive medicine at Boston’s Brigham and Women’s Hospital. “I see it not only among patients but with friends, colleagues and people I interact with daily.” 

Diagnosis and help are late to come 
    One general practitioner—not a psychiatrist—estimates that one in five of the patients she sees now is there for anxiety issues, making it one of the most common reasons young women show up in her exam room. Megan Catalano, 34, of Berkeley Heights, New Jersey, is living proof of all the statistics. “In my M.F.A. program last year, Xanax was everywhere,” she says. “I always thought my anxiety was a quirk particular to me. It was shocking to realize how many of my girlfriends and classmates felt the same way.” 
    Ironically, despite the condition’s seeming ubiquity, mental health experts agree that anxiety is actually under diagnosed among women. 
    “The average length of time between the onset of symptoms—the time a woman starts feeling bad—and when she gets actual diagnosis is between nine and 12 years,” says Robert Leahy, Ph.D., a clinical professor of psychology and psychiatry at Weill Cornell Medical College in New York. “And of those who are diagnosed, only a very small percentage get adequate help.” 
    Part of the problem, say doctors, is that a woman with anxiety may fail to seek help quickly, even if she’s seriously on edge. “To her, that is normal,” says Richard A. Friedman, M.D., a professor of clinical psychiatry at Weill Cornell Medical College. “If you’re a healthy woman and you come down with the flu, you know you’re sick. You know what it’s like to feel good, and you know you feel worse now. But if you have this sickness that’s been hanging on since you were 5, that’s your baseline. You believe it’s normal, and that everyone else must feel this way too.” 
    It took Bassey Ikpi, 34, a writer and performer in Washington, D.C., nine years of panic attacks and stress headaches before she finally realized that what she had was a real medical condition. “Anxiety is a very real and serious—yet treatable—disorder. I didn’t know that until I took a college-prep psych class,” she says. “All of a sudden I was like, This is me. This is what I have.” 
    And when women do seek help, doctors often confuse their symptoms with those of other mental-health conditions. Kristen Nilsen, 27, of Arlington, Va., remembers having her first panic attack as a child. When she finally found the courage to see a doctor at age 17, she was told she had depression and was prescribed meds that didn’t ease her attacks. She wasn’t correctly diagnosed with generalized anxiety disorder and panic disorder until she was 23, and didn’t find a medication that worked for her until four years after that. “Anxiety can be just as debilitating as a physical injury, but it’s often not given the same immediate attention that, say, a broken leg would receive,” says Nilsen. “If I could shout it from the tallest building, I would: Seek help. You deserve to live an unafraid life.” 

Stressful news taking a toll? 
    So what is anxiety? And why are so many young women grappling with it now? “Anxiety is a normal emotion which helps us recognize real problems and solve them. In its healthy form, anxiety helps you perform at your top form when you’re adjusting to, say, a new job or a new baby,” says Terrie Moffitt, Ph.D., a professor of psychology and neuroscience at Duke University in North Carolina. “That said, in some people anxiety grows out of proportion and becomes disabling. Generally, we say anxiety is not normal when it lasts days beyond a specific stressful event, or when it interferes with a person’s life.” 
    There are multiple, distinct types of anxiety disorder: The most common is social phobia, which is an extreme fear of being judged by others. There’s also panic disorder (with its trademark panic attacks), and generalized anxiety disorder, defined as persistent and unrealistic worry. But all anxiety disorders share common denominators: Unlike depression, which is marked by unshakable sadness, they feel physically more like fear, with symptoms like insomnia, heart palpitations and headaches. And they happen young: Nearly three quarters of afflicted adults develop symptoms by age 22. 
    As for the rise in anxiety, experts point to a range of factors. “There is a sense that the world is not as safe as it used to be, and that creates a lot of anxiety,” says Leahy. In any given day, he argues, women worry about environmental hazards, their job security, the odds of their boyfriend cheating (see: Tiger and Jesse James). “There’s so much stressful news that it starts to take a toll on you,” says Susan Nolen-Hoeksema, Ph.D., a professor of psychology at Yale University who specializes in stress and women's health and a former Ann Arbor resident and professor at the University of Michigan. “If I watch CNN for an hour, I [get] fidgety.” 

Could a shift in cultural values be to blame? 
    Fine—and all true. But wasn’t the Great Depression stressful too? And why should we get more worked up about Tiger than, say, our grandmothers did over a social system that kept many of them from working outside the home or dating whomever they wished? Are our modern lives really that much more stressful? “The answer appears to be yes,” says anxiety researcher Jean Twenge, Ph.D., a professor at San Diego State University and author of "Generation Me." “Anxiety rates have risen steadily over the past seven decades, during good economic times and bad.” 
    She believes the rise is related to a cultural shift, over the last 70 years, away from “intrinsic” values—appreciating things like close relationships and having a real love for your work—toward more “extrinsic” ones, like money and status. 
    In fact, her research found that anxiety rates rose at the same pace with this change in mind-set. “Recent generations have been told over and over again, ‘You can be anything you want to be. You can have the big job title. You can have the big bank account.’ And in the case of women, ‘You can have this perfect body.’ That puts a lot on a person’s shoulders—and it’s also not really true. These are things that aren’t always under your control, but that disconnect creates a lot of anxiety about how hard you need to work to achieve them—and a deep fear of failure,” she explains. “And although these extrinsic values—the latest iPad, the cutest shoes—seem important, all the evidence shows that at the end of the day they don’t leave us very happy or satisfied.” 
    The argument, in other words, is that our grandmothers and great-grandmothers were able to tune out their stresses in part because they had more satisfying personal values to fall back on. They also probably had more quiet time to contemplate their worries in a productive way— something in short supply now. 
    “Everyone works all the time, and there are no boundaries between work and personal life anymore,” says a 29-year-old woman from Jersey City, N.J., who recently began struggling with panic attacks. “Your to-do list is enormous, and then you have to go home, cook dinner, work out, check in with friends, spend time with your boyfriend or family. There’s just a lot of pressure.” 
    Nolen-Hoeksema agrees: “People feel they should always be on, and that they could be called upon at any moment to do something. Our e-mail and iPhones are constantly pinging, which keeps anxiety heightened all the time.” That’s exactly what exacerbated Ikpi’s panic attacks a few years ago. “Every time my cell phone rang, or I heard an e-mail or text come through, I’d get this overwhelming feeling of dread,” she says. “My heart raced. I got nauseous and dizzy and couldn’t breathe. It was so intense at times that I truly believed I was going to die.” At that time, she was experiencing two to three panic attacks each day. 
    Social networking, experts say, is also problematic, since connecting virtually with a friend is not the same as seeing them, hugging them or hearing the tone of their voice. “Having a Twitter- or Facebook-only friend,” says Twenge, “is like having a junk food relationship." You may be keeping in touch, but without face-to-face interaction, you miss out on the true bonding that studies show can help protect against mental health problems. 
    All of these factors hit women harder than men because, experts are learning, we may be wired to worry. Just-released research from the Children’s Hospital of Philadelphia suggests that the female brain may be more sensitive to stress hormones and less able to adapt to high levels of them. We also have a well-known propensity to ruminate and let problems roll around and around in our heads, says Nolen-Hoeksema: 
    “We’re more aware about our feelings, and we get more hung up on them than men do.” And yet another emerging theory is that our diets are having a biological impact on our anxiety levels: “A diet high in sugar and saturated fat can disrupt brain functioning,” says Fernando Gómez- Pinilla, Ph.D., a professor of neurosurgery and physiological science at UCLA, who researches the effects of diet on mood disorders. “That contributes to mental disorders, particularly anxiety.” 

Thankfully, experts say there are several proven ways to soothe those feelings of panic and fear. 

Here, strategies to calm anxieties both extreme and everyday: 

• Exercise three to four days a week 
The link between exercise and improved mental health is almost irrefutable. “I’m a therapist—a ‘head guy’—and I was shocked at how effective our research showed exercise to be. It can work as well as medication,” says Michael Otto, Ph.D., a professor of psychology at Boston University.
Beyond alleviating pent-up angst, physical activity can actually teach your brain to be anxiety-resistant. “The physical stress that working out has on the body engages a lot of the same responses that mental stress does,” says Michael Hopkins, a researcher at the Neurobiology of Learning and Memory Laboratory at Dartmouth College. “Your heart beats faster; your blood pressure goes up. Over time, exercise appears to train the body to handle those changes, so when anxiety strikes, your body says, ‘Oh, OK, this is like when we go jogging. I know how to deal with this.’” 
    Exactly how much exercise do you need to feel better? Roughly 30 minutes of cardio—any kind—three or more days a week. What matters most is that you simply do something on a regular basis. 

• More whole foods, less junk 
    “The vitamins, minerals and other compounds in food act almost like medications on the brain,” says Gómez-Pinilla. Australian research recently found that women who ate a whole-foods diet, with lots of fruits, vegetables, whole grains, lean meat and fish, were 32 percent less likely to experience anxiety. (By comparison, women on a diet high in refined, processed foods and saturated fats were 50 percent more prone to depression.) “Eating too much of the wrong kind of foods produces an inflammation effect that can cause disease in our brains,” says David Heber, M.D., Ph.D., director of the Center for Human Nutrition at UCLA. Fruits and vegetables, on the other hand, have the opposite effect and fight inflammation. And foods rich in omega-3 fats (like salmon and walnuts) and those containing tryptophan (like skim milk and turkey) can be like natural Xanax when eaten on a regular basis, says Gómez-Pinilla. 
    Caffeine can also increase anxiety—and even trigger panic attacks, according to research. “Most of us sip our morning coffee and don’t notice if it makes our heart rate and blood pressure go up,” says Jonathan Abramowitz, Ph.D., director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill. “But women with panic disorder are really tuned in to their body channel, and they’ve got the volume turned way up. They sense those internal changes, which feel so similar to the onset of a panic attack, and become so stressed that they actually bring one on.” 


• Mind-body therapies 
    “Relaxation techniques are effective in so many aspects of your life, but they’re particularly good for generalized anxiety disorders,” says Otto. “They should be taught as a requirement in school, as the fourth R: reading, ‘riting, ‘rithmetic and relaxation!” Yoga, meditation and hypnotherapy have all been shown to help, as can deep breathing, relaxing to soothing music, and massage. “When we’re stressed, most of us breathe shallowly from our chest, which triggers the sympathetic nervous system—that’s the classic ‘fight or flight’ reaction,” says Lizabeth Roemer, Ph.D., a professor of psychology at the University of Massachusetts, Boston. 
    “If you inhale and exhale more deeply, that activates the opposite, parasympathetic response. Your body physically settles down.” Also, “this type of relaxation prompts the release of feel-good endorphins,” which can buffer against the biological response to stress, says London-based clinical hypnotherapist Georgia Foster. 

• The right treatment 
    You should be able to tell after one to two months whether the lifestyle changes above will make a difference. If they don’t, you might need therapy or medication intervention. It’s fine to turn to your GP; you don’t need to start with a psychiatrist. She may refer you to a therapist, or prescribe medication. But tell her all of your symptoms in detail. More and more women are doing so, and their assertiveness is paying off. “Emergency rooms used to be flooded with people thinking they were having a heart attack when really it was a panic attack,” says Edna B. Foa, Ph.D., director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. “Now a lot of women with anxiety problems diagnose themselves because they’re more educated. It’s become part of the culture we’re in to be able to talk about anxiety without feeling you’re going to be judged.” No judgment, just help. That’s what every woman deserves.

Study: Exercise Can Boost Mood Similar To Antidepressants

posted Jun 22, 2010, 11:58 AM by Barb Cornblath   [ updated Jun 22, 2010, 12:40 PM ]

By LAURA BLUE – Originally Printed in 

Time 

Magazine, June, 19, 2010

At his research clinic in Dallas, psychologist Jasper Smits is working on an unorthodox treatment for anxiety and mood disorders, including depression. It is not yet widely accepted, but his treatment is free and has no side effects. Compare that with antidepressant drugs, which cost Americans $10 billion each year and have many common side effects: sleep disturbances, nausea, tremors, changes in body weight.

This intriguing new treatment? It's nothing more than exercise. 

That physical activity is crucial to good health - both mental and physical - is nothing new. As early as the 1970s and '80s, observational studies showed that Americans who exercised were not only less likely to be depressed than those who did not but also less likely to become depressed in the future. 

In 1999, Duke University researchers demonstrated in a randomized controlled trial that depressed adults who participated in an aerobic-exercise plan improved as much as those treated with sertraline, the drug that, marketed as Zoloft, was earning Pfizer more than $3 billion annually before its patent expired in 2006.

Subsequent trials have repeated these results, showing again and again that patients who follow aerobic-exercise regimens see improvement in their depression comparable to that of those treated with medication, and that both groups do better than patients given only a placebo. But exercise trials on the whole have been small, and most have run for only a few weeks; some are plagued by methodological problems. Still, despite limited data, the trials all seem to point in the same direction: exercise boosts mood. It not only relievesdepressive symptoms but also appears to prevent them from recurring. 

"I was really surprised that more people weren't working in this area when I got into it," says Smits, an associate professor of psychology at Southern Methodist University.

Molecular biologists and neurologists have begun to show that exercise may alter brain chemistry in much the same way that antidepressant drugs do - regulating the key neurotransmitters serotonin andnorepinephrine. At the University of Georgia, neuroscience professor Philip Holmes and his colleagues have shown that over the course of several weeks, exercise can switch on certain genes that increase the brain's level of galanin, a peptide neurotransmitter that appears to tone down the body's stress response by regulating another brain chemical, norepinephrine.

The result is that exercise primes the brain to show less stress in response to new stimuli. In the case of lab rats and mice, those stimuli include being plunged into very cold water or being suspended by the tail. And while those are not exactly problems most people face, the thinking is that the human neurochemical response may well react similarly, with exercise leaving our brain less susceptible to stress in the face of harmless but unexpected events, like missing an appointment or getting a parking ticket. A little bit of mental strain and excess stimulation from exercise, in other words, may help us to keep day-to-day problems in perspective.

Researchers wonder whether this interaction between body and brain may, evolutionarily speaking, be hardwired. "It occurs to us that exercise is the more normal or natural condition and that being sedentary is really the abnormal situation," Holmes says.

Humans (and lab rats) never evolved to be cooped up, still, all day long. Our brains simply may not be built for an environment without physical activity. Research has also suggested that exercise may be an effective treatment for not just depression but also related anxiety disorders and even substance dependence.

Other scientists have found that in mammals, exercise also boosts the production of brain-derived neurotrophic factor (BDNF), a substance that supports the growth and maintenance of brain cells. In depressed patients, BDNF has been shown to help repair brain atrophy, which can lift symptoms of the disease. 

Smits says his exercise treatment appeals to patients for two main reasons. First, exercise doesn't carry the same stigma among patients (and some providers) that depression medication and psychotherapy do. Second, the mood-enhancing benefits of exercise can kick in fast - a lot faster than, say, its impact on weight loss or cardiovascular health. "By and large, for most people, when they exercise 30 minutes - particularly when it's a little bit more demanding and they get their heart rate up - they feel better," Smits says. "You get an immediate mood lift." 

That effect doesn't reflect the longer-term changes in the brain that Holmes studies. But Smits uses the immediate mood boost as a way to motivate patients with depression (which, of course, manifests in a chronic lack of motivation) to get moving. Instead of a barrier to exercise, Smits suggests, depression can become a reason to exercise. "You feel crappy, so you get on the treadmill, and you look back and you say, 'Wow, I feel much better,' " he says.

Yet for all the potential clinical benefits, the big questions about exercise treatment remain unanswered: How much? How long? In which patients? In their recent book for therapists, Exercise for Mood and Anxiety Disorders (Oxford University Press, 2009), Smits and co-author Michael Otto at Boston University suggest precise exercise doses that they hope will aid psychologists and primary-care doctors in prescribing exercise as treatment - which can be administered in combination with other treatments, of course. 

Smits and Otto recommend the familiar 30 minutes of moderate-intensity aerobic exercise, like walking, five times per week, or 30 minutes of high-intensity aerobic exercise three times a week. These doses, which are regularly recommended for physical fitness, are the only ones that have been well tested for depression. "But we can't say at this point that more wouldn't be better," Smits says. "Or maybe less would be better. We really don't know." Too few tests have been run. It is also unclear whether anaerobic exercise, like weight lifting, would have the same mood-lifting effects, or whether exercise works as well in severely depressed patients as it does in sufferers of mild to moderate depression.

For now, then, data on exercise are only suggestive. The clinical literature on antidepressant drugs is massive, since large-scale, rigorous studies are required for market approval from the FDA. The trials on exercise have all been smaller, perhaps in part because they need no government approval. "If you look at FDA standards [for evidence], it's not clear that exercise would meet that standard," says James Blumenthal, the Duke University professor of medical psychology who ran Duke's 1999 exercise study as well as a 2007 follow-up with more than 200 patients, which Blumenthal believes is the largest such trial to date.

But the evidence is mounting, and it's hard to argue with a free treatment that is exempt from side effects for a pervasive and debilitating mental-health scourge - especially when so many other health benefits of exercise are incontrovertible. "I think that we have reason to be optimistic," Blumenthal says. "For people who at least want to consider exercise as a possible treatment, and for whom exercise is safe, it's definitely worth a shot."

 

How To Preserve Friendships Post Divorce

posted Mar 5, 2010, 1:37 PM by Barb Cornblath   [ updated Mar 5, 2010, 1:44 PM ]

By Barton Goldsmith, Ph.D.
Published on Psychology Today (http://www.psychologytoday.com)

When a couple breaks up, there may be a division of property and money, and if there are children (or pets), there will be a custody arrangement as well. The final thing to be divvied up will be your mutual friends. This process can be unsettling for everyone involved.

Most of the time, true friends try to remain neutral, and make no mistake, being in this position is tough and it can be burdensome on the friendship. The good ones won't want to take sides, and they can find it hard to listen to the breaking-up friend vent. It's simply uncomfortable to hear that kind of negativity about somebody you like.

Look, when we go through something as painful as a breakup, we need to rally our forces around us. It is natural and it makes sense. Problems occur when a person tries to hijack mutual friendships and turn them against the other partner. If you have ever been close to someone who's done this, you know how difficult it can be. Choosing between two people you love is really hard. I believe that it's emotional blackmail to tell someone that the only way he or she can still be your friend is to dislike your ex.

What some people don't realize is that after things calm down and everyone starts to (hopefully) get along again, the divisiveness can come back to bite you. Friends who did not want to choose may have moved on, and those who did so may find it uncomfortable being around your ex because you've convinced them not to like him or her.

Breakups are at best a difficult thing, and most of the time both people feel hurt on various levels. Sometimes that pain comes out as anger and a need to win (or make the other person lose). When your friends become pawns in this game, they can actually end up getting hurt as well, so it is wise to be considerate of their feelings too.

As gut wrenching as a divorce or breakup can be, it will help if you do your best to avoid creating any additional drama. Because anger and sadness are part of the process, make sure to check in with yourself before you attempt to enlist your mutual friends to go to war with you. Truth be told, couples who can end their relationship like adults usually have an easier time moving on, co-parenting, and having appropriate relationships with the people who care for them.

Rather than trying to suck the life out of each other, put the effort into working together and separating with as little animosity as possible. The more thoughtful you can be during this very difficult time, the better you will feel about yourself and the less damage you will do to those who are close to you. That fact will help you live a full life once again.

Lack of Sleep Linked to Weight Gain and Depression

posted Feb 4, 2010, 3:14 PM by Barb Cornblath   [ updated Feb 5, 2010, 9:26 AM ]


Published in Psychology Today

By Dennis Rosen, M.D.

A study published in the February 2010 issue of SLEEP* found that short sleep duration (less than 6 hours/night), as well long sleep duration (more than 9 hours/night) were associated with increased weight gain in men.

More than 35,000 workers at an electric power company in Japan (of whom 31,000 were men) were followed over the course of a year, with weight, height, and self reported sleep duration obtained at annual health checkups in 2006 and 2007. Out of those men who were not overweight at the beginning of the study, 5.8% became so during the study period.

What was interesting was that men who slept fewer than 5 hours/night were almost twice (1.91 times) as likely to have become overweight during that time than those who were considered normal, and who slept between 7-8 hours/night. Those men sleeping between 5-6 hours/night were one and a half times more likely to have become overweight relative to the 7-8 hour/night group. Men sleeping more than 9 hours/night were 1.42 times more likely to have become overweight as compared with the 7-8 hour/night group. While no similar, statistically significant finding was found amongst the women, it is important to point out that the numbers of women sleeping 5-6 hours/night (14) and fewer than 5 hours/night (1) were very small.

How can one explain the connection between short sleeping and weight gain? One reason is that insufficient sleep is well known to affect the secretion of certain hormones called ghrelin and leptin, which govern both the sensation of hunger and of feeling full. When this is disrupted, we tend to eat more, and feel less full when we do.

Another reason for the connection may be co-existing depression, which very often causes loss of sleep (though in some cases it can lead to oversleeping), and its treatment with certain medications which may cause weight gain. Whereas 2.3% of those sleeping 7-8 hours/night had depressive symptoms, 6.7% of those sleeping fewer than 5 hours/night, 3.8% of those sleeping 5-6 hours/night and 4.9% of those sleeping greater than 9 hours/night had depressive symptoms. That being said, insufficient sleep itself can lead to depressive symptoms, so it is not clear which is cause and which is effect.

In summary: this study provides one more piece of evidence demonstrating just how important sleep is to staying healthy. It also shows why one should make a conscious effort to getting a good night's sleep, and not just treat it like something to be left for when one has run out of other, more "important" things to do.

* Watanabe M; Kikuchi H; Tanaka T; Takahashi M. Association of short sleep duration with weight gain and obesity at 1-year follow-up: a large-scale prospective study. SLEEP 2010;33(2):161-167.

 

Managing Conflicts With Email: Why It's So Tempting.

posted Jan 15, 2010, 5:47 AM by Barb Cornblath   [ updated Mar 5, 2010, 1:45 PM ]

By David F. Swink
Published on Psychology Today (http://www.psychologytoday.com)

Email, text, chat, and IM are fantastic innovations. They keep us connected, allow us to communicate quickly, and even type, eat lunch, and read the newspaper all at the same time!

It is very tempting to use electronic media in dealing with the inevitable conflicts and time crunches in life and work. Conflict just doesn't feel good, and people generally avoid it. It may seem easier to deal with conflicts with email, because you don't have to see the recipient's angry facial expressions or hear their seething voice tone. Because of email's asynchronous nature, someone can study what was said and craft their response before they hit the "send" key. They are isolated from the physical intensity of the conflict.

While the splendid isolation from strong emotion may be a comfort for some, it cuts us off from the most valuable information in the conversation. We rely heavily on non-verbal information like facial expression, body posture, gestures, and voice tone during interactions to interpret and predict other people's behavior. In fact, research now indicates that we do this even more than we thought, through our use of "mirror neurons." A Society for Neuroscience paper, adapted from Marco Iacoboni, describes mirror neurons as "a special class of brain cells that fire not only when an individual performs an action, but also when the individual observes someone else make the same movement."

Dr. Iacoboni at the UCLA School of Medicine, observes that before the discovery of mirror neurons, scientists generally believed that our brains use logical thought processes to interpret and predict other people's actions. Now, however, many scientists have come to believe that we understand others not by thinking, but by feeling.

Mirror neurons appear to let us "simulate" not just other people's actions, but the intentions and emotions behind those actions. When you see someone smile, for example, your mirror neurons for smiling also fire up, creating a sensation of the feeling associated with smiling. You don't have to think about what the other person intends by smiling. You experience the meaning immediately and effortlessly. Daniel Goleman explores this concept and the neuroscience of social interactions in his book, Social Intelligence.

Our mirror neurons are not at work, and other communication cues are not present when we are emailing and texting; therefore, we miss a lot of information about what the other person is feeling and experiencing. When we read an email, we automatically try to figure out the "tone," or the emotional undercurrent. We fill in the gaps with what we think the person is feeling or what their intention is. Most people fill in the gaps with the worst-case scenario, especially if they don't know much about the person.

What do you think when a person doesn't return your email or when they answer your well-thought out question with a short reply and no greeting? These "gap fillers" can influence your response and unintentionally escalate the conflict.

Email can play a role in how we deal with conflicts. We just need to know when and how to use it wisely. Here are some tips for using email in dealing with conflicts.

Use emails in conflicts:

  • When there needs to be a record of the interaction.
  • When dealing with conflicts where the emotional level is fairly low.
  • To have an initial conversation that sets up a phone call, or a meeting to deal with the conflict. 

Do not use emails in conflicts:                        

  • When you've never met the other person face-to-face.
  • When the emotional level is high.
  • When the email has gone back and forth with a person more than 3 times. This could mean that the issue is too complex to deal with using only email.   

Here are some things to consider when dealing with conflicts through email:

  • Don't assume why a person didn't respond to an email or answered your email in a certain manner. Intentions are invisible. Get more information.
  • Monitor your emotions. If you feel triggered by what you read, don't write an immediate reply back and hit "send." You may regret it once you calm down, and by then, it's too late.
  • Save a draft of your reply. Have someone review your draft, or you read it later after you have cooled off, and then send it.
  • Do not rely on emoticons :) or text speak (btw), to convey emotions.
  • Be careful with sarcasm and humor because voice tone is absent and your message could be misinterpreted.
  • If the email fills the screen...pick up the phone. The message is probably too complex to not speak with someone about it.
  • Be careful with "cc's" and the message they send. This may imply that you are ratting a person out to their boss or colleagues.

Are You A Cyberchondriac?

posted Jan 7, 2010, 9:06 AM by Barb Cornblath

Don't Be a Cyberchondriac: Use the Internet to Self-Screen, Not Self-Diagnose

By Joni E. Johnston, Psy.D.
Created Jan 6 2010 - 6:14am

If you’ve never taken a psychology class, you may not be familiar with Psychology Student Syndrome, a common (and often frightening) “condition” whereby an intro to psych student begins to think s/he and others has the mental conditions they are learning about. 

A bad day?  Self-diagnosis - major depression.  PMS?  Oh, no!  Maybe it’s bipolar disorder. Medical students catch their own version although, of course, their “symptoms” tend to center around life-threatening physical illnesses.

Now, thanks to the internet, you don’t have to be a psych major or first year medical student to develop the internet version of hypochondria – cyberchondria.  With all that health advice just a click away, it’s all to easy to consult Dr Google when we're feeling under the weather – and all too easy to give ourselves a serious case of the heebie-jeebies.  This is especially true if we already have health anxieties.

Why Health Information on the Internet Can Lead Us Astray

While cyberchondria has been around for almost a decade, Microsoft scientists Eric Horvitz and Ryen White were the first to systemically investigate it.  After analyzing the internet behavior of a million surfers around the world and surveying more than 500 Microsoft employees, they found:

  • In contrast to the actual prevalence of life-threatening illnesses, the proportion of websites listing them as primary causes is significantly higher.   For example, while brain tumors occur in less than one if 50,000 people, 25% of the documents showing up in a web search for “headache” point to a brain tumor as a possible cause. 
  • About 75 percent of internet health information seekers fail to check either the date or the source of their health information. 
  • People frequently confuse search rankings with the actual likelihood that a serious disease exists.  For example, if a search for “muscle twitching” produces three results near the top of the page about ALS, then, it’s 'Oh my God, I've got a terminal disease."

The solution isn’t to stay clear of the internet; it’s a great resource.  However, it’s unfiltered.  This is especially true when it comes to mental illnesses, which often have overlapping symptoms and differ from normal emotions only by their frequency and severity.  So the next time you scour the internet when you’re feeling emotionally out-of-whack:

Self-screen – but don’t self-diagnose.  There are lots of mental health screening tools available on the internet.  These can be useful both as a starting place in evaluating troubling emotional symptoms and as an ongoing reality check in terms of how much progress is being made.  For instance, the instrument that has been reported to be most helpful in screening for bipolar disorder is the Mood Disorder Questionnaire, which is widely available for free on the Internet.  

Don’t forget, though:  screening tools cast a wide net.  By design, they over-recognize symptoms so that the person will be encouraged to follow up with a professional.  Take advantage of these free resources, print out your answers, and bring them with you to your clinician. 

Check your sources.  Not all health sites are created equally and it’s hard to know which one to trust.  Start with the Health on the Net Foundation (HON), which requires the 6,500 sites that have signed up to it to display information responsibly and inform readers about its purpose and source. It also runs Medhunt, a search engine that pools results from trusted sites. 

Consider the context.  It is normal for people who’ve just lost a loved one to suffer many of the symptoms of major depression; in this context, they’re the typical manifestations of grief.  Unfortunately, current Diagnostic and Statistical Manual (DSM - IV) criteria doesn’t recognize the intense normal sadness that can arise after the end of a love affair, marital separation, diagnosis of serious illness in oneself or a loved one, or the loss of a valued job.  A recent study, however, if DSM-IV guidelines for bereavement were extended to reactions triggered by other losses, about 25% of persons who are currently diagnosed with depressive disorders might, in fact, be experiencing an intense, but normal, grief reaction that will reside on its own within a couple of months..  

When it comes to using the internet to research health information, it’s important to find a balance between taking charge of your mental health and catastrophizing every normal emotion.  Be your own advocate - but not your own doctor.

 Published on Psychology Today (http://www.psychologytoday.com)

Coping with Holiday Stress

posted Oct 14, 2009, 11:16 PM by Barb Cornblath   [ updated Dec 22, 2009, 4:02 AM ]


How to stay calm during the holidays.

The holidays can be fun, but they also can be a source of great stress - and no wonder. The holidays are often depicted as a magical time when people reconcile and dreams come true.

How Can You Deal With Continuing Family Problems During The Holidays?

Being realistic is the first step. If you have bad feelings about someone, try and avoid him or her and not make an issue of it but don't pretend that all is well. This will enable you to feel true to yourself and less stressed out.

Do Financial Pressures Stress People Out to the Point of Ruining the Holiday Spirit?

Knowing your spending limit is also a way to relieve holiday stress. People believe that they have to go out and buy gifts because it's the holidays, even if they can't afford to do so. Not only is it stressful to feel that you have to buy everyone an expensive gift, but you'll be stressed for the rest of the year trying to pay off your bills. You can show love and caring by getting something that you know is meaningful and personal for that person that doesn't have to cost a lot.

How Do Time Pressures Affect People Around the Holidays?

People shouldn't have to put their lives on pause or totally rearrange their schedules either because of the holidays. Learn to prioritize the invitations you accept and don't feel that you have to go to every holiday gathering.

How Does a Person Deal With the Holidays When He or She Has Just Experienced A Recent Tragedy, Death or Romantic Break-up?

If you're feeling really out of sorts because of any chronic or current stressors, like a death or recent romantic break-up, you may want to avoid some of the festivities because they are so out of sync with how you're feeling. Try to tell those around you what you really need, since they may not know how to help you, and ask for their understanding if you decline an activity.

How Do You Cope With Kids Who Want Everything For The Holidays and Have No Sense of What Things Cost?

Parents need to tell their children to be realistic. It is OK to say to your child that a certain toy is too expensive. And even Santa Claus has limited funds and has to choose what to give because he has a very long list. You can also tell your children that Mom and Dad and Santa Claus will try to choose the most suitable present for the child. Children have to learn that their wish is not someone's command and to curb their desires for instant gratification.

What Are Some Good Coping Strategies?

Take stock of your expectations and make sure they're realistic. Don't expect more of this time of year than of any other. Take a break from holiday music and television specials if you find that they're turning you into "Scrooge."

Most people dread the holidays because their inner experience is so different from what is being hyped. You should trust your own instincts and don't try to be what you're not. Keep up your normal routine and know that this day will pass too.

If, however, you are unable to shake what you think are "holiday blues" your feelings may not be about the holidays, but about other things in your life. If you need help in sorting out or dealing with this issue, a psychologist is a person with the training to help you do so. Call 1-800-964-2000 to get information about referrals.

Thanks to Dorothy Cantor, Psy.D., a private practitioner in Westfield, N.J., and a former president of the American Psychological Association.

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