Showing posts with label stress. Show all posts
Showing posts with label stress. Show all posts

Sunday, March 13, 2011

Chapter 39: The Constant Chatter In My Mind Is Not Me


I know my mind is not me.  I know the constant chatter in my head is not me.  If I do not become the watcher of my mind, my ego and pain-body analyze the past over and over and make up outrageous scenarios for the future.  They judge, criticize, compare, complain, lament, whine, degrade and take a position.

If I am present and watching what my mind is saying, I can question what is being said.  If it is not true and I recognize it, I will save myself from experiencing the emotions that go with the thoughts.  I do not want to waste time and energy trying to solve problems that have been made up by my ego or pain-body.  Staying in the present, living in the moment, has reduced the stress in my life.  For me, this has been an important part of the healing process from the disease depression. 

I learned how to change my thinking from Eckhart Tolle and his books.  I have talked about these books in many chapters of my blog.  "The Power of Now", Chapter 6, Chapter 14, Chapter 16, Chapter 18, and Chapter 19"A New Earth", Chapter 5, Chapter 6, and Chapter 19.  I don't agree with all of the concepts Eckhart Tolle teaches, but most of them I do.  Some of his beliefs do not correspond to the religious teachings I believe. I have written quite a bit about the things he taught me that have changed my life for the better.  I would also like to write about my religious beliefs that are different than his.  I will do that. =)       

There have been times in the past when a thought has come into my head that I didn't like, or wasn't consistent with what I believe.  It was awesome to learn that this type of thought came from my ego or pain-body.  The present part of me, or what I like to call my higher self, would not have a thought like that and I can dismiss it without feeling guilty about thinking it.  Being present, or in my higher self, brings more peace into my life.  I have to make a conscious effort every day to have my higher self be in charge of my life.

How Stress, Anxiety, and Depression Affect Your Health

WebMD

Reviewed by Amal Chakraburtty, MD on March 01, 2010
© 2010 WebMD, LLC. All rights reserved. 

How Does Stress Affect Health?

Controlling stress is important to our health. Unrelenting stress can turn to distress. Stress is the body's reaction to any change that requires a physical, mental, or emotional adjustment or response. Stress is a normal part of life. Many events that happen to you and around you -- and many things that you do to yourself -- put stress on your body. Some stress can be good. It keeps us alert, motivated, and ready to avoid danger. But too much stress can make us sick.

Stress that continues without relief can lead to a condition called distress -- a negative stress reaction. Distress can disturb the body's internal balance or equilibrium, leading to physical symptoms such as headaches, an upset stomach, elevated blood pressure, chest pain, sexual dysfunction, and problems sleeping. Emotional problems can also result from distress. These problems include depression, panic attacks, or other forms of anxiety and worry. Research suggests that stress also can bring on or worsen certain symptoms or diseases. Stress is linked to six of the leading causes of death: heart disease, cancer, lung ailments, accidents, cirrhosis of the liver, and even suicide.

Stress also becomes harmful when people engage in the compulsive use of substances or behaviors to try to relieve their stress. These substances or behaviors may include food, alcohol, tobacco, drugs, gambling, sex, shopping, and the Internet. Rather than relieving the stress and returning the body to a relaxed state, these substances and compulsive behaviors tend to keep the body in a stressed state causing more problems. The distressed person becomes trapped in a vicious circle. 


By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on April 12, 2010  


Researchers have discovered a biological link between stress, anxiety and depression. 

Lead researcher Stephen Ferguson believes that the connecting mechanism in the brain explains how stress and anxiety could lead to depression. The study also reveals a small molecule inhibitor, developed by Ferguson, which may provide a new and better way to treat anxiety, depression and other related disorders.

The findings are published online in the journal Nature Neuroscience.

Ferguson, Ana Magalhaes and their colleagues used a behavioral mouse model and a series of molecular experiments to reveal the connection pathway and to test the new inhibitor. 

“We’ve gone from mechanism to mouse, and the next step is to see whether or not we can take the inhibitor we developed, and turn it into a pharmaceutical agent.”

The research was conducted in collaboration with Hymie Anisman at Carleton University, and funded through the Canadian Institutes of Health Research (CIHR).

“According to the World Health Organization, depression, anxiety and other related mood disorders now share the dubious distinction of being the most prevalent causes of chronic illness,” says Anthony Phillips, the scientific director of the CIHR Institute of Neurosciences, Mental Health and Addiction.

“Using the power of molecular biology, Stephen Ferguson and colleagues provide novel insights that may be the key to improving the lives of so many individuals coping with these forms of mental ill health.”

The linking mechanism in the study involves the interaction between corticotropin releasing factor receptor 1 (CRFR1) and specific types of serotonin receptors (5-HTRs).

While no one has been able to connect these two receptors on a molecular level, the study reveals that CRFR1 works to increase the number of 5-HTRs on cell surfaces in the brain, which can cause abnormal brain signaling.

Since CRFR1 activation leads to anxiety in response to stress, and 5-HTRs lead to depression, the research shows how stress, anxiety and depression pathways connect through distinct 
processes in the brain.

Most importantly, the inhibitor developed by the Ferguson lab blocks 5-HTRs in the pathway to combat anxious behavior, and potentially depression, in mice.

While major depressive disorder often occurs together with anxiety disorder in patients, the causes for both are strongly linked to stressful experiences. Stressful experiences can also make the symptoms of anxiety and depression more severe.

By discovering and then blocking a pathway responsible for the link between stress, anxiety and depression, Ferguson not only provides the first biological evidence for a connection, but he also pioneers the development of a potential drug for more effective treatment.

Genetic Link Between Stress and Depression

Study Shows People With a Genetic Mutation May Be More Likely to Develop Depression

By Jennifer Warner
WebMD Health News

Feb. 7, 2011 -- A gene that influences how the brain responds to stress may also play a key role in depression.

A new study shows people with a certain genetic mutation that causes them to produce less of the brain chemical neuropeptide Y (NPY) have a more intense negative emotional response to stress and may be more likely to develop depression than others.

Researchers found low levels of neuropeptide Y caused a stronger emotional response to negative stimuli and physiological response to pain in the brain, which may make people less resilient in the face of stress and more prone to depression.

"We've identified a biomarker -- in this case genetic variation -- that is linked with increased risk of major depression," says researcher Jon-Kar Zubieta, MD, PhD, professor of psychiatry and radiology at the University of Michigan, in a news release. "This appears to be another mechanism, independent of previous targets in depression research, such as serotonin, dopamine and norepinephrine." 

Genetic Link to Depression

In three separate tests, researchers looked at the link between this genetic mutation and depression in 39 adults with depression and 113 healthy adults. The results are published in the Archives of General Psychiatry.

First, researchers measured the amount of NPY expression in each of the participants and used functional magnetic resonance imaging (fMRI) to measure the brain's response to positive, neutral, or negative words like "hopeful," "material," or "murderer."

The results showed people with low levels of this brain molecule had much more activity in an area of the brain associated with regulating emotions, the prefrontal cortex, than those with high levels. 

Response to Stress

In a second experiment, researchers measured the response to a stressful event involving injecting saline solution into a jaw muscle, which produces moderate pain for about 20 minutes, but no lasting harm.

The study showed those with low neuropeptide Y rated their emotional response as more negative while anticipating the event before and immediately after the event while reflecting on their experience.

"This tells us that individuals with the risk-associated NPY gene variant tend to activate this key brain region more than other people, even in the absence of stress and before psychiatric symptoms are present," says researcher Brian Mickey, MD, PhD, assistant professor in the department of psychiatry at the University of Michigan Medical School, in the news release.
Finally, researchers found participants with this genetic variation were much more likely to have been diagnosed with depression than those without it.

"These are genetic features that can be measured in any person. We hope they can guide us toward assessing an individual's risk for developing depression and anxiety," Mickey says.

SOURCES: Mickey, B. Archives of General Psychiatry, February 2011; vol 68: pp 158-166.News release, University of Michigan Health System.

©2011 WebMD, LLC. All Rights Reserved.



I am excited about the research that may lead to new treatment options for depression.  Below is a summary of the two research articles above. 

1.  CRFR1 (corticotropin releasing factor receptor 1) works to increase the number of 5-HTRs (specific types of serotonin receptors) on cell surfaces in the brain, which can cause abnormal brain signaling.  CRFR1 activation leads to anxiety in response to stress, and 5-HTRs lead to depression.  The research shows how stress, anxiety, and depression pathways connect through distinct processes in the brain.  This is the first biological evidence for a connection between stress, anxiety, and depression.  

The small molecule inhibitor developed by the Ferguson lab blocks 5-HTRs in the pathway to combat anxious behavior, and potentially depression, in mice.  The researchers are hoping to take the inhibitor they developed, and turn it into a pharmaceutical agent.

2.  People with a genetic mutation that causes them to produce less of the brain chemical neuropeptide Y (NPY), have a more intense negative emotional response to stress and may be more likely to develop depression than others.  People with low levels of this brain molecule had much more activity in an area of the brain associated with regulating emotions, the prefrontal cortex, than those with high levels. 

Individuals with the risk-associated NPY gene variant tend to activate this key brain region more than other people, and participants with this genetic variation were much more likely to have been diagnosed with depression than those without it.  This information will help in assessing an individual's risk for developing depression and anxiety, and may lead to a way to manipulate NPY to improve depression and anxiety symptoms.

Lowering my stress levels help me manage the depression symptoms.  Regular aerobic exercise and weight training help me reduce stress.  I feel the best when I use our Cross Trainer (eliptical) every day, but that doesn't always happen.  

Changing my thinking patterns have also been a great help in lowering stress.  Eckhart Tolle teaches, "Wherever you are, be there totally.  If you find your here and now intolerable and it makes you unhappy, you have three options:  remove yourself from the situation, change it, or accept it totally.  If you want to take responsibility for your life, you must choose one of those three options, and you must choose now."  "The Power of Now", page 82.

What do you do to reduce your stress levels?  Does it help manage your depression symptoms?  Please share.



Monday, February 21, 2011

Chapter 38: Depression & Inflammation ARE Linked

 Another excellent article explaining why inflammation can cause depression.

Strong link seen between depression, inflammation

SAN JUAN, P.R. -- Growing evidence points to an association between inflammation and depression, according to a presentation at the annual meeting of the American College of Psychiatrists.

For example, depressed patients have elevated inflammatory markers--such as interleukin-6 and C-reactive protein. In fact, the levels of proinflammatory cytokines correlate with the severity of depressive symptoms in studies. In addition, administration of cytokine antagonists can effectively reverse depressive symptoms in patients, Dr. Andrew H. Miller said.

"We really stand at a point that is very exciting in terms of novel therapies and translation of research," Dr. Miller said. "The notion quite simply is that stress or depression affects the HPA [hypothalamic-pituitary-adrenal] axis, [affects] the endocrine system, alters the immune system, and leaves patients open to diseases."

Physicians from many specialties already recognize that inflammation plays a key role in cardiovascular disease, diabetes, metabolic syndrome, and cancer, said Dr. Miller, professor in the department of psychiatry and behavioral sciences at Emory University, Atlanta.

"We did not want to be left out in terms of psychiatry," said Dr. Miller, who also is director of the psychiatric oncology program at the Winship Cancer Institute at Emory.

There are multiple possible mechanisms whereby inflammation could cause depression. Inflammatory cytokines released peripherally might reach the brain through active transport, passage through leaky regions in the blood-brain barrier, or transmission through afferent nerve fibers (vagus nerve), Dr. Miller said. There is a cytokine network in the central nervous system, and glia and microglia are the richest source of cytokines in the brain. Neurons also produce and express cytokines.

"We've learned these cytokines have access to the brain and ... ultimately can change behavior," Dr. Miller said. Inflammatory cytokines cause anhedonia (an inability to experience pleasure), fatigue, cognitive dysfunction, and other flu-like symptoms in sick patients. In addition, researchers induced behavioral changes that resemble major depression in human and animal studies with administration of proinflammatory cytokines.

Some therapeutic cytokines cause depression. For example, interferon-[alpha] (IFN-[alpha]) is used to treat viral infections and cancer because it is a potent inducer of the inflammatory cytokine network, especially interleukin-6, Dr. Miller said. "Oncologists told us early on this drug causes a lot of depression."

A total of 60% of patients treated with IFN-[alpha] reported depressed mood in one study (Neuropsychopharmacology 2002;26:643-52). Dr. Miller and his associates also found a 45% incidence of major depression among patients with malignant melanoma treated with IFN-[alpha] (N. Engl. J. Med. 2001;344:961-6).

The good news is that paroxetine (Paxil) aggressively blocked development of depression. "Just 11% developed depression, so there was a fourfold reduction with this pretreatment.

"There is a caveat. If you give a drug that causes release of dopamine--for example, paroxetine--that dopamine becomes oxidized and in the long term can damage basal ganglia," Dr. Miller said in response to a question from a person attending the meeting. "So we're using dopamine antagonists to block this until we get more information about what we are doing to patients."

Physician reaction to his study varied, Dr. Miller said. "The people who got on us the most for that study with paroxetine were the ones who were treating hepatitis C. They said we'd expose a lot of people to antidepressants who don't really need them." However, "with melanoma, many patients will not go back on interferon therapy, and giving antidepressant prophylaxis might help."

In another study, patients with psoriasis treated with the cytokine antagonist etanercept experienced reversal of their depressive symptoms (Lancet 2006;367:29-35). Improvement in depression was independent of the drug's effect on disease progress.

The wider picture may be a link between stress, depression, and illness, Dr. Miller said. In one study in review, patients with major depressive disorder exhibited an exaggerated inflammatory response to stress.

"There is an interesting possible link between depression and a wide variety of medical disorders where inflammation plays a role," Dr. Miller said. It "may explain high comorbidity of some medical conditions with depression.

"Psychiatry is now catching up to other medical specialties in recognizing the adverse effects of inflammation," Dr. Miller added. "Psychiatrists need to keep an eye on this. The idea that the immune system might affect the brain and vice versa presents a lot of novel targets for treating psychiatric disorders."

BY DAMIAN MCNAMARA
Miami Bureau
COPYRIGHT 2006 International Medical News Group
COPYRIGHT 2008 Gale, Cengage Learning


My Summary of the Article:  Strong link seen between depression, inflammation

1.  Patients with depression have elevated inflammatory markers in their blood such as interleukin-6 and C-reactive protein.  
 2.  The levels of elevated inflammatory markers in the blood of depressed patients, called proinflammatory cytokines, correlate with the severity of depressive symptoms
 3.  Administration of cytokine antagonist drugs can effectively reverse depressive symptoms in patients.
 4.  Stress or depression affects the HPA [hypothalamic-pituitary-adrenal] axis, affects the endocrine system, alters the immune system, and leaves people open to diseases.
 5.  Inflammatory cytokines may reach the brain by transport through the blood, giving them passage through leaky regions in the blood-brain barrier, or transmission through nerve fibers to the central nervous system.
 6.  Inflammatory cytokines in the brain cause the inability to experience pleasure (anhedonia), fatigue, cognitive dysfunction, and flu-like symptoms in sick patients.
 7.  When researchers administered proinflammatory cytokine drugs in human and animal studies it induced behavioral changes that resembled major depression.
 8.  Interferon is a drug called a therapeutic cytokine used to treat viral infections and cancer.  It induces the inflammatory cytokine network, especially interleukin-6, and causes depression in patients taking the drug.
 9.  Dr. Andrew H. Miller and his associates found a 45% incidence of major depression among patients with malignant melanoma treated with IFN-[alpha], another therapeutic cytokine.
10.  Patients taking Paxil while using a therapeutic cytokine were relieved of depression symptoms.  This may help patients stay on a therapeutic cytokine drug that is causing depression.
11.  Patients with psoriasis were treated with the cytokine antagonist drug etanercept (Enbral). They experienced reversal of their depressive symptoms even if the drug wasn't effective on the psoriasis.
12.  Patients with major depressive disorder showed an exaggerated inflammatory response to stress.
13.  There is a possible link between depression and a wide variety of medical disorders where inflammation plays a role.
14.  Psychiatry is now catching up to other medical specialties in recognizing the adverse effects of inflammation.
15.  The immune system affecting the brain, and the brain affecting the immune system presents a lot of new ways to treat psychiatric disorders.


Cytokines were talked about so much in the above article, I wanted to learn more about them.  The following article is from BioPortal / Cytokines. 

  What are Cytokines? 

Cytokines, also known as immune factors, are protein produced naturally by the cells and organs of the human immune system. They act on other immune system cells modulating the body's response to disease and infection. Cytokines can also regulate the growth of new blood cells in the bone marrow.

Cytokines play a crucial role in the immune system response to all kinds of disease. They interact with organs and cells, alone and in combination with each other. The diverse role that cytokines serve in the immune system make them an ideal target for intervening or bolstering immune responses. Using recombinant DNA technology cytokines can be created in a laboratory. They have many treatment applications including cancer, multiple sclerosis, anaemia, and rheumatoid arthritis.



  Types of Cytokines

There are several types of cytokines with different varieties within each type. The following are the cytokines naturally produced by the body and the immune cells that produce them: 

Interferons (IFNs) have three main varieties. Produced by a number of immune system cells. Eg: White blood cells.  

Interleukins (ILs) have more than ten varieties. Produced by the white blood cells (leukocytes). 

Tumour Necrosis Factors (TNFs) have two main varieties. Produced by a number of immune system cells. Eg: T-Cells, white blood cells.  

Colony Stimulating Factors (CSFs) have many varieties and names. Produced by T-Cells and macrophages. 

Erythropoietin (Epoetin/EPO) has several varieties. Mainly produced by the kidney (10-15 percent originating in the liver). 

Thymopoietin has three main varieties. Produced by the thymus.

The Science - How do Cytokines Work?

Cytokines work in ways very similar to hormones. They are released by immune cells into the circulation or locally in a tissue. Cytokines interact with receptors on target immune system cells. This interaction triggers a cascade of biochemical reactions such as the release of other cytokines, cell division, or cell differentiation, that leads to a given event. Each type and variety of cytokine has distinct effects on specific targets: 

Interleukin 2 (IL-2) - This is the only variety of IL that is currently used therapeutically. It Interacts with T-cells that have been activated by an infection and triggers T-cell division increasing the number in circulation. IL-2 also stimulates the division of B-Cells and works in the bone marrow to promote the differentiation of stem cells into immune cells.

Interferon - Has numerous therapeutic applications including:
  Stimulating activity in other immune system cells,
  Inhibiting growth in some types of cancer cells,
  Increasing immune cell capacity to bind foreign particles,
  Modulating the production of antibodies, and 
  Inhibiting viral protein synthesis, through a system of interactions.

Erythropoietin - Stimulates stem cells in the bone marrow to differentiate into mature red blood cells. 

Colony Simulating Factors - Stimulate stem cells in the bone marrow to differentiate into immune cells called "neutrophils." Neutrophils are an important component of the body's inflammatory response to infection. CSF's can also stimulate activity in other immune system cells.

Cytokines can also work in combination to produce different effects in the body. Some therapies combine more than one cytokine to achieve their results.

  Biotechnology and Cytokines

Therapeutic cytokines are produced through recombinant DNA techniques. The human gene that codes for the desired cytokine is inserted into a host cell, such as the bacteria species E-coli, yeast, or the cells of mammals or insects. The cells then act as factories, producing the desired human protein.

Proteins produced by non-human cells (like those produced through yeast or E-coli) will vary slightly from the those produced naturally in the body. Small variations in structure can cause therapeutic cytokines to behave differently from their natural counterparts. Therefore, recombinant cytokines are studied further to determine if they will behave differently due to the variations.


I want to ask my psychiatrist if anti-inflammatory drugs may help my depression symptoms, or if there are other cytokine antagonist drugs that would be more effective.  This short abstract of an article talks about cytokine-based therapies.  An Overview of Cytokines and Cytokine Antagonists as Therapeutic Agents

Donnelly, R. P., Young, H. A. and Rosenberg, A. S. (2009), An Overview of Cytokines and Cytokine Antagonists as Therapeutic Agents. Annals of the New York Academy of Sciences, 1182: 1–13. doi: 10.1111/j.1749-6632.2009.05382.x

Keywords:
  • cytokines;
  • inflammation;
  • interferons;
  • interleukins;
  • receptors
Cytokine-based therapies have the potential to provide novel treatments for cancer, autoimmune diseases, and many types of infectious disease. However, to date, the full clinical potential of cytokines as drugs has been limited by a number of factors. To discuss these limitations and explore ways to overcome them, the FDA partnered with the New York Academy of Sciences in March 2009 to host a two-day forum to discuss more effective ways to harness the clinical potential of cytokines and cytokine antagonists as therapeutic agents. The first day was focused primarily on the use of recombinant cytokines as therapeutic agents for treatment of human diseases. The second day focused largely on the use of cytokine antagonists as therapeutic agents for treatment of human diseases. This issue of the Annals includes more than a dozen papers that summarize much of the information that was presented during this very informative two-day conference.

I hope research in the link between inflammation and depression will lead to new, effective treatment options for depression!