“This is a pivotal, and exciting, time for mental health. As we saw in chancellor George Osborne’s spending review, and in repeated statements by party leaders, it is higher up the political agenda than it’s ever been. Also, more employers are actively encouraging greater openness and understanding, and that’s a good thing too. And more people are talking more openly about at least some aspects of mental wellbeing.
But in other ways, we are failing people with mental health problems every day, and destroying lives as a result. Political commitment and promises of funding are fine. But ask anyone at the frontline and they will tell you that NHS mental health services are struggling. Ask anyone working with mental health charities and they will tell you of people being shunted up and down the country because of bed shortages; long waiting times for therapy; too many people, including children, being put in police cells while in crisis; a rise in rough sleeping; a rise in suicides to the point where it is now the biggest killer of young men; and squeezed community teams dealing with more cases with fewer resources.”
“When the last major wave of “blockbuster” psychiatric drugs such as Prozac arrived on the market in the late 1980s and 90s, they ushered in a new era in the treatment of depression. With fewer serious side effects than their predecessors and aggressively marketed as a new class of “wonder drug”, they were prescribed very quickly to tens of millions of people living with depression and other debilitating conditions worldwide while pharmaceutical companies made a fortune.
A quarter of a century later, questions are being asked about what, if anything, will be the next significant leap forward in psychiatric pharmacology, be it for depression or other diagnoses such as schizophrenia or anxiety. With a quarter of the population likely to experience some kind of mental health difficulty in their lifetime, it is a pretty important question.
Since the heyday of SSRIs (selective serotonin reuptake inhibitors) such as Prozac, “big pharma” has withdrawn from psychiatric drugs research and development, and industry experts are warning the pipeline is running dry.
According to Harry Tracy, whose newsletter NeuroPerspective tracks developments in drug treatments for psychiatric problems as well as neurological conditions such as Alzheimer’s and Parkinson’s disease, the number of psychopharmacological drugs research programmes in larger drug firms has shrunk by 70% in the past decade.”
“A commonly prescribed antidepressant exerts epigenetic effects that may provide a useful biomarker of whether the drug works in patients. A team led by researchers at the Max Planck Institute of Psychiatry in Germany identified a molecular pathway that results in altered DNA methylation in the presence of the selective serotonin reuptake inhibitor paroxetine. In an in vitro study published this week (November 24) in Science Signaling, the team presented a link between molecular stress signals and epigenetic activity, both of which have been previously implicated in depressive disorders.
“The authors identified one interesting mechanism of the effects of an antidepressant and really defined this pathway biochemically in an impressive way,” said Ted Abel, director of the Training Program in Behavioral and Cognitive Neuroscience at the University of Pennsylvania who was not involved in the new study.”
“Even though people with mental health problems tend to die at least 10 years earlier than their peers and are far less likely to seek healthcare for illnesses such as HIV and Aids, tuberculosis, diabetes or heart disease, their plight tends to be less acknowledged.
“From a public health perspective, it’s one of these invisible crises, since people are not measuring it or looking at it,” she says.
“I think it’s more visible in humanitarian crises. But when it comes to the development side – planning for development, health system strengthening, better social systems and long-term nutrition – I think it’s often overlooked.”
Part of the reason, Weissbecker argues, is that people tend to focus on the trauma that comes in the immediate aftermath of natural disasters and conflicts rather than the underlying problems that can predate them, or the long tails of depression that can follow them.”
“Brain damage is caused by persistent depression rather than being a predisposing factor for it, researchers have finally concluded after decades of unconfirmed hypothesising.
A study published in Molecular Psychiatry today has proved once and for all that recurrent depression shrinks the hippocampus – an area of the brain responsible for forming new memories – leading to a loss of emotional and behavioural function.
Hippocampal shrinkage has long been linked to depression but previous studies haven’t been conclusive. Small sample sizes, varying types of depression and treatment levels, as well as variance in methods for collecting and interpreting results, have together led to inconsistent and often conflicting findings.”
“As a psychiatrist, I see this as the biggest challenge facing psychiatry today. A large part of the population – perhaps even the majority – might benefit from some form of mental health care, but too many fear that modern psychiatry is on a mission to pathologise normal individuals with some dystopian plan fuelled by the greed of the pharmaceutical industry, all in order to put the populace on mind-numbing medications. Debates about psychiatric overdiagnosis have amplified in the wake of last year’s release of the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the so-called ‘bible of psychiatry’, with some particularly vocal critics coming from within the profession.
It’s true that the scope of psychiatry has greatly expanded over the past century. A hundred years ago, the profession had a near-exclusive focus on the custodial care of severely ill asylum patients. Now, psychiatric practice includes the office-based management of the ‘worried well’. The advent of psychotherapy, starting with the arrival of Sigmund Freud’s psychoanalysis at the turn of the 20th century, drove the shift. The ability to treat less severe forms of psychopathology – such as anxiety and so-called adjustment disorders related to life stressors – with the talking cure has had profound effects on mental health care in the United States.”
“What is depression? Depression is mind-energy’s succumbing to an overwhelming load of discouraging attacks. This happens to all of us from time to time, however for young people this can literally mean life or death because their minds are not yet humanly and spiritually experienced and matured to consider alternate possibilities or approaches.
When a mind reaches its breaking point under the weight of accumulated criticisms, deceptions, sarcasms, slights, hurts, humiliations, disappointments, pains, and other forms of human abuse, this will cause it to crash much more easily.”
“A recent study that I coauthored with Wen Li and Jennifer O’Brien, doctoral students at the University of North Carolina at Chapel Hill, and UNC professor Matthew O. Howard examines this new behavioral addiction.
Perhaps unsurprisingly, people with PIU have been found to experience several negative mental health problems which could include depression, attention deficit/hyperactivity disorder (ADHD), hostility, social phobias, problematic alcohol use, self-injurious behavior, and trouble sleeping (including sleep apnea, nightmares, insomnia, and struggling to stay awake during the daytime).”
“There are important connections between compulsive Internet use and mental illness, psychologists from the University of Illinois at Urbana-Champlain suggest in a study that will be published in the May issue of the journal Computers in Human Behavior.
“It appears that people who use cell phones to avoid stress and negative events in their real life also tend to have mental health problems,” Dr. Alejandro Lleras, a psychologist at the university and the study’s lead author, told The Huffington Post in an email. “Mental health providers may want to assess cellphone use patterns in their patients and include that in their treatment.”
For the study, Lleras and his colleagues asked over 300 university undergraduates about their mental health, smartphone and Internet habits, and motivations for using digital devices. Questions included: “Do you think that your academic or work performance has been negatively affected by your cellphone use?” and “Do you think that life without the Internet is boring, empty and sad?”
“Our understanding and treatment of mental disorders is primitive. Why is that? The burden on our society is huge. A quarter of women will have an episode of depression at some stage in their lives (it’s about half that for men). Most will never reach a doctor or be diagnosed. About 40 per cent of those who do won’t respond to the first antidepressant they are prescribed, and about 60 per cent of those won’t respond to the second. About half of schizophrenics will get better or manage to live reasonable lives: the other half will relapse or never recover in the first place. Anorexia nervosa claims the lives of more patients proportionately than any other mental disorder. But mental disorders are only one category – a rather artificial one – of brain disorders.”
“Psychedelic drugs like LSD have the power to radically alter consciousness, giving rise to a number of psychological effects that are positive, negative, mystical and just plain weird.
Research in recent decades has shown that LSD-assisted psychotherapy can potentially treat a range of mental illnesses, including depression, addiction and end-of-life anxiety. On the other hand, scientists have also used LSD to mimic the effects of psychosis.
But if LSD replicates the features of mental illness — namely, early-stage psychosis — how can it improve mental health in the long run?”
“Psychedelic research is back from underground laboratories to university hospitals. When LSD, mescaline and psilocybin were prohibited in 1970, all academic research on humans was abandoned for two decades. Now the return of psychedelic drugs to highly regarded research facilities, which began in the 1990s, is on the verge of reaching its goal. Two large clinical trials of psilocybin and MDMA (Ecstasy) are in the making. Should they show medical applications of these drugs to be effective, psychedelics would become part of our medicine cabinet. But there is a problem ahead. These odd substances might escape the current paradigm of pharmacology.
The resurgence of psychedelic research became possible thanks to a strategic decision of the two main organisations responsible for making these drugs presentable again. Both the Multidisciplinary Association for Psychedelic Studies (MAPS) in California and the Heffter Research Institute in New Mexico broke with the philosophy of the counterculture best summed up by Timothy Leary’s advice to ‘Turn on, tune in, and drop out.’ Instead, the proponents of the revival have made every effort to integrate psychedelic drugs into mainstream society. When the US President George H W Bush declared the 1990s to be the Decade of the Brain and neuroimaging popularised the belief that the human mind was little more than grey matter, what better mainstreaming vehicle could there have been than neuropsychopharmacology?”
“Cannabidiol (CBD), one of the chemical components found in marijuana, may have fast-acting antidepressant effects, according to a study published in Neuropharmacology.
Marijuana has long been valued in many cultures for its mood-altering effects. Neuroscientists have identified several ways CBD influences neurochemical processes, especially by affecting production of the neurotransmitters serotonin and glutamate. Because the same brain systems are known to be related to depression, it has been suggested that CBD has the potential to impact depression through these pathways.”
“Psychotherapy remains the cornerstone of treatment. Cognitive behavioural therapy (CBT) is the most studied of the therapies, but other forms are effective too. CBT works by addressing the thoughts and behaviours that act to entrench depression.
When people are depressed they tend to withdraw from their social networks. They no longer enjoy social interactions and think they’re unappealing company. By spending more time alone, and less time around people whose company they would usually enjoy, the depression gets worse, leading to even more time spent alone, and so on.
CBT and most other therapies act to break this feedback loop by challenging the thoughts and behaviours that reinforce social isolation, and getting people engaged again.”
“Is it healthy to dwell in the past? Up until about 15 years ago most psychologists would have suggested probably not. The habit of living in memory rather than the present, of comparing how things once were with how things are now, was for several centuries thought at best a trait to avoid and at worst a root cause of depressive illness. Nostalgia was the soldiers’ malady – a state of mind that made life in the here and now a debilitating process of yearning for that which had been lost: rose-tinted peace, happiness, loved ones. It had been considered a psychological disorder ever since the term was coined by a 17th-century Swiss army physician who attributed the fragile mental and physical health of some troops to their longing to return home — nostos in Greek, and algos, the pain that attended thoughts of it.
Since the turn of this century, however, things have been looking up for nostalgia.
That shift began, to a considerable degree, in the mind of an émigré academic called Constantine Sedikides. Greek by birth, he worked for many years at the University of North Carolina in the States, but in 1999 he found himself transplanted to the University of Southampton, where he had taken up the role of professor of social and personality psychology.”
“Vinte e dois suicídios por dia. Esta é a estatística sombria que persegue os quase 300 mil veteranos de guerra nos Estado Unidos. A maioria destas pessoas vive em um estado de sofrimento profundo e crônico conhecido na psiquiatria como Transtorno de Estresse Pós-Traumático (TEPT). Pacientes com TEPT sofrem de medo constante, ansiedade generalizada, têm pesadelos quase todas as noites, dificuldades para dormir, incapacidade de se relacionar afetuosamente e enfrentam as chamadas “revivências traumáticas”: quando encontram situações que os fazem lembram do trauma, revivem todo o ciclo de medo e pânico avassalador produzido pela experiência traumática original.
No Brasil, estudo da UNIFESP mostrou que 90% da população de cidades como Rio de Janeiro e São Paulo já foi exposta a situações de violência impactante, como assaltos, roubos, violência sexual, abuso infantil, conflitos urbanos e guerras. E cerca de 10% destes desenvolvem TEPT. São, portanto, milhões de pessoas vítimas da violência e milhares de pacientes com Estresse Pós-Traumático, uma situação gravíssima (para mais informações sobre essa pesquisa, acesse aqui artigo científico de Wagner Silva Ribeiro e outros autores).”
“Your mood is the product of chemicals in the brain called “neurochemicals”. This includes “neurotransmitters”, which are small molecules nerve cells (neurons) use to communicate with each other. One important neurotransmitter involved in mood is serotonin.
Many drugs that target the brain’s systems are designed to increase or decrease the levels of neurotransmitters. For example, many antidepressant medications such as fluoxetine or escitalopram are designed to block the disposal of serotonin and consequently increase its levels in the brain.
I realized today that in all my posts regarding the brain and how to sculpt it with mindfulness, I’ve never actually explained how and why meditation works. Specifically, the science behind how your brain changes the longer you meditate. I think this is important for many reasons, but one of the most salient is that this information serves as a great motivator to keep up a daily practice (or start one).
I’m sure you’ve heard people extol the virtues of meditation. You may be skeptical of the claims that it helps with all aspects of life. But, the truth is, it does. Sitting every day, for at least 15-30 minutes, makes a huge difference in how you approach life, how personally you take things and how you interact with others. It enhances compassion, allows you to see things more clearly (including yourself) and creates a sense of calm and centeredness that is indescribable. There really is no substitute.
A regular meditation practice brings with it many benefits, such as increased brain density, a boost in connections between neurons, decreased symptoms of depression and anxiety, improved clarity of thought, and an increase in endorphins that affect mood. Surprisingly to many, the advantages of meditation extend beyond the brain, and published studies have shown it can improve physical functioning and vitality, decrease chronic disease risks, and enhance overall quality of life.
Similar to physical exercise, there are different methods that you can try as you build up your meditation practice and find a style that best fits you. Below is an image that explains four types of meditation that you can consider.
But for many of us, finding a quiet space where we can close the eyes, practice some breathing exercises, or repeat a mantra in our head, is an ideal place to start. As you become more practiced at meditation, you will likely notice significant improvements in your energy, health and mental/emotional balance. Enjoy!
“Emotional stress in adult life affects us on a physical level in quantifiable, life-altering ways. We all know that when we are stressed, chemicals and hormones can flush our body and increase levels of inflammation. That’s why stressful events in adult life are correlated with the likelihood of getting a cold or having a heart attack.
But when children or teens face adversity and especially unpredictable stressors, they are left with deeper, longer‑lasting scars. When the young brain is thrust into stressful situations over and over again without warning, and stress hormones are repeatedly ramped up, small chemical markers, known as methyl groups, adhere to specific genes that regulate the activity of stress‑hormone receptors in the brain. These epigenetic changes hamper the body’s ability to turn off the stress response. In ideal circumstances, a child learns to respond to stress, and recover from it, learning resilience. But kids who’ve faced chronic, unpredictable stress undergo biological changes that cause their inflammatory stress response to stay activated.
Joan Kaufman, director of the Child and Adolescent Research and Education (CARE) programme at the Yale School of Medicine, recently analysed DNA in the saliva of happy, healthy children, and of children who had been taken from abusive or neglectful parents. The children who’d experienced chronic childhood stress showed epigenetic changes in almost 3,000 sites on their DNA, and on all 23 chromosomes – altering how appropriately they would be able to respond to and rebound from future stressors.”