Rock-a-bye Baby

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A Lullaby As Effective Stress Management

The repetitive soothing sounds and rhythm of the lullaby have been used for millennia as a natural tranquilizer. Globally, children are gently rocked, lullabies are hummed, nursery rhymes are recited, affectionate sounds are spoken in a lilting fashion—all with the intended purpose of inducing relaxation. Without formal training or explanation, human caregivers are acting out of an intuitive awareness of the soothing effects of such rhythmic activities on the children’s psychophysical state. It works. But what makes it work? What is the basic science behind lullabies and can it be put to use in inducing relaxation in adults?

The rhythmic component of the lullaby may be the most important factor in inducing calm, as its rhythmicity is the single common factor among the vastly different types of lullabies sung or spoken in hundreds of languages and dialects around the world. It is not coincidental that rhythmicity is also the key component of mantra meditation.

What Is Mantra Meditation?

There are two basic types of meditation: concentrative or non-concentrative. Concentrative meditation is based on limiting stimulation by focusing on a single unchanging or repetitive stimulus, such as a word mantra or a candle flame. Non-concentrative meditation techniques, e.g. mindfulness or yoga meditation, seek to expand awareness to include as much mental activity as possible. Of the two approaches, mantra meditation is the easiest to learn and use, the most natural technique, and one of the most effective forms of stress relief capable of producing lasting results.

Mantra meditation, much like a lullaby and acting on the same principle, can rapidly induce a deeply restful state. During mantra meditation, body and mind are beneficially affected. During 20–30 minutes of meditation, oxygen consumption is lowered to a level equivalent to that of 6–7 hours of sleep, and both heart and respiration rates generally show a significant decrease. Psychologically, mantra meditation appears to induce a fluid state of consciousness, with shared characteristics of sleep and wakefulness, and comes closest to the sleep-inducing state than any other meditation technique.

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Don’t let a good crisis go to waste!

hangingonWhen adversity strikes and when it lingers on in our lives, it is easy to think that all of it is just a bad experience and that nothing good can possibly come of it. In fairness, there are situations that look just like that: hopelessly bad. Take for example an important relationship that won’t heal on its own, an otherwise bright child who doesn’t seem to follow the right path, a career that is going nowhere, an income that is simply not enough, or a personal problem that does not seem to get any better. All these are crises, mostly crises of growth whose resolution requires deep changes to be identified and implemented.

Nothing can focus attention more than a crisis staring at us in the face, except that… sometimes we are very good at denying, avoiding, numbing and otherwise doing our best to ignore the problem.  We muddle through, hoping and praying for a magic fix.

Not letting one of these crises fester, linger, and possibly get worse requires courage and faith that a better outcome is possible, even if such positive outcome cannot be discerned right now. Not letting a painful crisis go unattended means having the courage and the resolve to take full advantage of the opportunity (yes, opportunity) that the crisis is presenting to us.

How to turn a crisis into a win

We can do turn a hopeless crisis into a growth opportunity (and thus a win) thanks to several tools that are available to us:

  1. The pain and hurt of the crisis can provide a unique motivation toward change, the type of motivation that is just not there when things are going relatively well. Welcoming the hurt as a means to an end is the first tool.
  2. Discerning the emotional and the rational components of the crisis is the second tool. All crises have a rational side (the facts, the figures, the objective reality of what is happening or not happening) and an emotional side (the mixed feelings, the contradictory emotions, the confusing desires, the fears and hopes we might have). Knowing what is rational and what is irrational is a key to good decision-making.
  3. Identifying what IS must come before deciding what SHOULD BE. A good handle of the situation is the third tool. It is only by knowing what is actually happening, and verifying the accuracy of our information, that we can hope to ascertain what we would like to change. This is a step that cannot be bypassed.
  4. A fourth tool is managing our emotions in situations where the crisis is at its peak: during an argument, when trying to communicate our point of view or understand another’s, when resisting the temptation to shoot from the hip or doing more of what doesn’t work, by controlling anger and despair. Sometime the best course of action is doing less, not more, while working on an effective and perhaps difficult solution.
  5. Switching off the autopilot and taking the controls in our hands is the fifth tool. So many of the daily decisions we make are automatic, out of immediate consciousness. This is not necessarily bad, however when applied to a crisis situation the autopilot can take us but to one pre-programmed destination, i.e. to the pain, the emotion, the helplessness that we’ve felt all along.
  6. Working up options for change is the sixth tool. Here we might want to take advantage of any help that may be available to us: family resources, internet information, the advice of trusted and knowledgeable people, our own experience, the power of prayer. All these can help us work up a set of options from which to choose the best possible course of action.

The moment of truth

When the best option finally materializes in front of us, we may not recognize it right away but it is definitely there. Being open to the possibilities, being flexible in considering all alternatives, being aware of our strengths and weaknesses are key factors that permit us to discern the truth. Additionally, we must have a clearer idea of what is RIGHT in the situation, and not just consider what is easiest, least painful, cheapest, or feels good.

This is when a crisis becomes a win, when it is utilized for growth to its fullest potential: when we finally arrive at the solution, the truth, the change that makes all the difference. There is no greater feeling than to feel the personal power that comes from having considered all options and having made the right decision.

Stress Software: You Survived Monday Morning?

vanGogh_1889_StarryNight_MOMANY Is There a Better Time of Day to Have a Heart Attack? This question was asked by Dr. David J. Lefer of the Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine in Atlanta in a study published this February. (1)

According to Dr. Lefer, it is widely accepted that the time of the day, the day of the week, and the season of the year influence the risk of a cardiovascular episode.

For example, heart attacks occur more frequently early on Monday mornings, especially during the fall and winter months. Recent research confirms that there is also “a significant contribution of intrinsic mechanisms mediating temporal dependence of cardiovascular physiology and pathophysiology,” medspeak for “the time of day and day of the week matters a lot, no matter where you are.”

Dr. Lefer cites the example of travelers who appear to retain time-of-day oscillations if they have a sudden cardiac episode, in such a way that the peak incidence is equivalent to the early hours of the morning in their time zone of origin.

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Successful Leadership: What Does It Take?

David_NapoleonSt-Bernard In reporting the results of a global survey, Michael Haid discusses the factors that contribute most to exceptional leadership performance. It turns out that it is not what leaders know, i.e. their skill set, but it is how they fit in their company’s culture, how they are motivated by opportunities within the organization, and how they interact with those around them that result in high performance. Read more

Of Washington, Stress, and the Mind

b_800_600_16777215_0_stories_immagini_Inverno_Alba_sul_primo_piazzaleThe way we perceive a situation, and decide whether it is positive or negative, is an active, continuing process of appraisal of the risks, costs, and likely gains of our
possible responses. Three individuals may be stuck in traffic at the same time and each may perceive and appraise the situation quite differently. “OMG,” one may say, “late again, my boss will be furious!” The second may think, “I’m going to be late, but my boss will understand how unpredictable this traffic really is.” The third may settle in, turn on the radio and say, “It’s a good thing I left a little early, I can’t speed this up so I’ll just catch up on the news.”

Depending on this cognitive appraisal of a situation, the stress reaction will mobilize the body to action. The greater the anxiety generated by the situation, the higher the level of physical and psychological arousal. Sometimes, overt behavior will be produced directly by the mobilization of impulses, drives, or wishes. One specific and frequent set of behaviors is likely to occur most frequently, as a behavioral inclination to act in a certain way due to our background, beliefs and available resources. Depending on the content of our thoughts about the situation, the behavioral inclination may be a desire to withdraw (flight), attack (fight), approach, or avoid (freeze). The emotions corresponding to these inclinations are anxiety, anger, affection, and sadness, respectively. The ultimate response to a stressor can be conceptualized as a structure of the mind, where a set of beliefs about one’s self, the world, and the outcome activates and controls the behavioral inclination and the emotional response.

Life’s stressors, especially if significant to our physical, psychological and social well-being can disrupt the normal activity of the mind. In addition to almost immediate loss of the ability to concentrate, recall, reason and control impulses, a severe and unexpected stressor produces a relative increase in instinctive, more primitive, and less rational processes. Instinctive reactions are usually paired to specific stimuli. These almost mandatory reactions are characteristic to the specific sensitivity of each individual. They can give way to inappropriate or excessive behavioral reactions. For example, the need for a stiff drink, reaching for a cigarette, crying, or being unable to breathe or move can be automatic, with little insight and thus virtually unstoppable.

The wide differences between people in their specific sensitivities explains why an event that is an almost unbearable stressor for one person may be an annoying or even benign situation for another. The seasoned public speaker may still get butterflies in the stomach, but is able to carry on and deliver an excellent presentation, whereas another may be terrified at the very idea of speaking before an audience.

Core differences in one’s personality also account for the wide variations in individual
sensitivities to stressors. The independent and somewhat misanthropic personality will not be sensitive to the same stressor as the individual who craves human connection and feels dependent on it for validation. Excessive or ineffective reactions to stressors, such as hostility, anxiety, and depression, also result from specific behavioral inclinations, personality structure, and specific sensitivities.

Finally, reactions to stressors may be dictated primarily by one’s internal motivations, with no apparent connection to the events or circumstances of the outside world. For example, the belief that the only road to happiness is through total success is characteristic of achievement-oriented individuals who are therefore extremely vulnerable to excessive and ineffective reactions at the slightest doubt of failure—regardless of evidence to the contrary.

Obama & Boehner at Stresshacker.comStressful interactions with other people who may be equally as stressed, albeit for different reasons, produce a mutually reinforcing cycle of excessive and ineffective reactions. Specific psychological mechanisms, such as an egocentric approach, negative framing, and polarization, increase the level of arousal experienced by each individual and, consequently, to higher and higher levels of collectively shared stress. This cycle seems to be in evidence at this time in Washington, as the executive and legislative powers appear to be locked in a mutually reinforcing cycle of excessive and ineffective reactions to each other.

Get Away From the Maddening City—Now!

Blackwell at Stresshacker.com Incidence of schizophrenia and other psychoses is greater in urban than rural areas, but the reason remains unclear. Various studies have found the link between living in the city and severe mental illness, and none have determined a specific cause. A new study claims to have the explanation. The study examined a group of over 200,000 people born between 1972 and 1977 whose medical history was cross-referenced with demographic, school, municipality, and county information.

The study, published this month in the Archives of General Psychiatry examined whether individual, school, or area characteristics could be associated with psychosis and whether the effects of individual characteristics on risk of psychosis varied according to location.

The incidence of psychosis was significantly higher among people living in urban settings as compared to those living in the country.  Further data analysis showed that psychosis appears to be a reflection of the increased social fragmentation that has become a feature of city living.

The principal researcher, Dr. Stanley Zammit of the Center for Neuropsychiatric Genetics and Genomics of Cardiff University, said that previous studies had found that the severity of schizophrenia risk depends on the context of the living situation, with increased risk found for those living in an area with few people of their own ethnicity.

Of this study, Dr Zammit says that "it was somewhat surprising that we found this sort of context-dependent effect across a range of characteristics: ethnicity, social fragmentation, and deprivation. Although it makes sense that such an effect would not be restricted to ethnicity but to potentially any characteristic that might define someone as being different from their peers as they grow up."

With the caution that is characteristic of studies that avoid the presumption of absolute revelation, the researchers point out that much more investigation is needed before it could be said (if ever) that living in the city causes schizophrenia. What can be said from this and other similar studies, however, is that there is a greater risk of developing a severe mental illness such as psychotic disorder for people who live in a predominantly urban setting. Is this enough to make you want to live in the boonies? Maybe not. But this may be another consideration for a move to the more distant ‘burbs.

Forced to Lie About Stress

aaDelacroix_1852_LaMerADieppeA full 36% say it’s stomach upset, 13% that it’s a cold; 12% claim to have a headache, 6% a medical appointment; 5% blame it on a bad back. The rest cite a variety of reasons, from housing problems to the illness of a loved one or the death of a beloved relative, for not showing up for work. None of it is true. What’s going on? In most cases, nothing more than an intense stress reaction forces 19% of workers to call in sick, yet as many as 93% feel compelled to lie to their boss and coworkers about the real reason for missing work.

Although employees are willing to go to great lengths to cover up their dangerously high stress levels, the vast majority do not like having to lie: 70% say that they long to be able to discuss stress with their employers. While some try, most can’t seem to find the courage to bring it up and remain hopeful that their boss will make the first move and approach them directly when they show signs of strain. Few employers do.

Millions of people experience unmanageable stress at work, and the fact that so many people feel forced to lie about it rather than finding a solution should be a major concern for our businesses. If employees don’t feel they can be honest about the pressures on them, problems that aren’t addressed can quickly snowball into low morale, low productivity and high sick leave. We’d urge employers to encourage a culture of openness at work so they can solve problems now, rather than storing up problems for the future.–Paul Farmer, Mind Research

These sobering statistics were published in a study released by the British mental health research group Mind, an organization which campaigns vigorously to promote and protect good mental health and advocates that people with experience of mental distress are treated fairly, positively and with respect.

Not being able to come clean clean on workplace stress claims its toll: 62% of employees feel their bosses aren’t doing enough to look after the well-being of their staff and resent this apparent neglect. One in five becomes physically ill from stress, but only 10% seek help from their doctor or from a counselor on specific issues of stress. Doctors and therapists are often told a different reason, at least initially, for the symptoms the individual may be experiencing.

Stress-related symptoms still appear to carry a stigma in the workplace, as stress may be associated, at least in Western cultures, with a negative perception of one’s ability to manage a heavy workload. In this day and age, the fear of being perceived as a stressed out (and therefore unproductive) worker may have the power to trump honesty and reasonable self-care.

Why Can’t I Just Fall Asleep!

Aaah, to sleep. Peacefully. Like a baby, a puppy, a kitty… Is that possible anymore? I haven’t slept well in so long. Every night is a struggle. I futz and futz and go to bed later and later—it doesn’t do the trick. Tell me doc, what do I gotta do?

Villefrance at Stresshacker.com Sleep deprivation is literally a form of torture, and a very effective one at that. You don’t have to be a fiendish Capulet spy to find out how true that can be. US statistics from the Department of Transportation estimate that 20% of drivers doze off regularly at the wheel, while the National Highway Traffic Safety Administration estimates conservatively that, during an average year, “drowsy driving” causes 100,000 automobile wrecks, 71,000 injuries and 1,550 fatalities. These staggering stats are supplemented by data from the US military, children studies, surveys of truck drivers, shift workers, couples, medical students—all pointing to one simple fact: we can’t sleep. Let’s see what is happening, why, and look at some possible remedies.

What’s Happening to Sleep?

Sleep is under attack from many sources. First and foremost, especially in the westerly and northerly parts of the planet, our schedules simply allow much less time for sleep. While this may seem like a no-brainer and suggest that there is a simple remedy (just allocate more time to sleep!), the problem of sleep scheduling is actually very complex and with no easy solution. The reason for this is below the surface and can be uncovered only by identifying that our fundamental belief about sleep has changed. To put it simply, many of us no longer believe in the necessity of sleep, while continuing to proclaim its virtues and benefits, at least out loud. Secretly, don’t we wish we could simply do away with sleep altogether?

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When Stress Hurts: Central Nervous System

In establishing the connection between the onset of psychogenic pain and stress, it is important to notice that pain and stress share the same central nervous system (CNS) pathways and structures. In this second post in the series on the close association between psychological stress and psychogenic pain, we’ll take a look at these shared structures.

CNS Structures Mobilized by Pain and Stress

PendulumThe body’s response to pain engages a large number of CNS structures that are often the same as the ones activated by the stress reaction. The afferent pathways that carry pain signals connect to the thalamic nuclei and from there to the somatosensory, insular and anterior cingulate (ACC) portions of the brain cortex. A recent functional MRI (fMRI) study (Keltner et al., 2006) on the effects of pain expectation on pain transmission provides the best evidence for the activation of the rostral ACC (rACC), periaqueductal gray (PAG), and medial prefrontal cortex. This and other imaging studies provide evidence of a bidirectional pain pathway receiving input from the limbic system and the amygdala, converging on the PAG, traveling through the pontomedullar nuclei, and controlling spinal pain transmission neurons (Fields, 2000; Fields & Martin, 2001). As the authors of this study point out, “expectation for a higher intensity noxious stimulus increases subjectively experienced pain intensity in part through the action of a descending pathway that facilitates nociceptive transmission at and/or caudal to the region of the contralateral nucleus cuneiformis (nCF)” (p. 4442). The nCF, in humans and other primates, has a composition similar to the PAG and its neurons project directly into the rostroventral medulla, the hypothalamus and the amygdala, all structures directly involved in modulation of the stress reaction.

PMR_muscle-crampsLikewise, the body’s stress response engages a large number of the same CNS structures, specifically certain subregions of the hypothalamus such as the paraventricular nucleus (PVN), the amygdala, and the periaqueductal grey; and certain cortical brain structures, such as the medial prefrontal cortex and subregions of the anterior cingulate and insular cortices (Maier, 2003). These structures provide output to the pituitary and pontomedullar nuclei, which in their turn stimulate the body’s neuroendocrine secretions, as well as to the hypothalamic-pituitary-adrenal (HPA) axis, the endogenous pain modulation system, and the ascending aminergic pathways. The feedback controlling the stress response is provided by the serotonergic (raphe) and noradrenergic (locus ceruleus) structures and by the levels of glucocorticoids in the blood stream, which provide inhibitory impulses to the medial prefrontal cortex and to the hippocampus. Corticotrophin releasing hormone (CRH) is the fundamental chemical substances mediating the stress response, which is secreted by PVN, amygdala, and locus ceruleus neurons. Acute or chronic stress can temporarily or permanently modify the level of responsiveness and output of the CNS to stress (Bennett et al., 1998).

Sharing Pathways, Sharing Outcomes

With this significant convergence of pathways, neurochemical activity and CNS structure activation, it should come as no surprise that acute stress can provoke physical pain, often in the head, the muscles, and the abdominal region. Equally unsurprising is that pain, especially when sharp and unexpected, is in itself a cause of stress that mobilizes the body into immediate action (think of the hand that immediately goes to cover the cut or the burn). Continuous pain, of any origin, is inherently stressful. Continuous stress can be, and often is, manifested by otherwise unexplained (thus psychogenic) physical pain.

Previously in this series: When Stress Hurts: Psychogenic Pain

Next:

  • The Neurochemistry of Psychogenic Pain and Stress
  • Psychological Stressors and the Sudden Appearance of Psychogenic Pain
  • Fibromyalgia, Severe Headaches and Other Stress-Related Misery
  • Medical and Non-Medical Treatments for Stress and Psychogenic Pain

9 Ways to Beat Procrastination…Tomorrow.

Langisjor_EN-US2321196967Procrastination is three times as stressful as getting things done right away. First, because tasks that need doing aren’t getting done; second, because it is stressful to think about all that needs to be done…and remains undone. Third, procrastination in itself is a source of stress due to its impact on self-esteem and psychological well-being.

Procrastination is a delay in deciding to start a task or in completing it. Men and women in roughly equal percentage suffer from this debilitating condition. Situational procrastination happens to everyone and simply describes an occasional delay that does not indicate a habitual pattern. Dispositional procrastination applies to people who delay many tasks on a regular basis, including tasks that are important and sometimes even critical to optimal functioning. Among dispositional procrastinators, two major types can be discerned based on their presumed motivation: arousal procrastinators, who (often subconsciously) need to be motivated to act by the adrenaline rush that comes from cutting it close to the deadline, and avoidant procrastinators, who are de-motivated to act by their fear of failure or success and/or by task aversion.

Here are nine ways to beat procrastination that have been proven to work with many people. (Try one or two, if you have some time…perhaps tomorrow?)

1. Learn to Tell Time

lastminuteHabitual procrastinators, even when faced with simple tasks, don’t seem as capable to estimate the time necessary to perform the task as non-procrastinators. They overestimate how much time it will take to finish the task, and are therefore reluctant to begin it; or they underestimate how long it will take to complete it, and are afraid of not being able to finish it. Learning to better estimate time to task completion is a skill that needs to be developed by procrastinators who, for whatever reason, seem to fall short of its mastery.

GTD-cover2. Banish Disorganization

Not being able to plan a task, misplacing some of the things needed to perform a task effectively, or losing track of what has already been done are areas that cause people to delay starting a task or its completion.

Getting rid of the very idea of disorganization is the start of a better strategy for getting things done. The enormously popular book Getting Things Done: The Art of Stress-Free Productivity may help…

3. Post-It and Read It

Sometimes the simplest things carry the most value. Any procrastinator can benefit from the little yellow notes strategically posted in visible locations that act as silent reminders of tasks that need to be done. If the notes are read and acted upon, procrastination can become a less frequent problem.

4. Make It Easy to Concentrate

Not having a specific, designated place in which to concentrate and focus exclusively on a task introduces the scourge of distraction to the misery of indecision. Being in a place where there are too many other stimuli competing for attention is not a winning strategy. Getting in the zone and achieving flow is key to task completion.

LeoMarvin5. Take Baby Steps

Sometimes even a relatively simple task can appear complex, until it is broken down into smaller chunks. Behavioral psychologists recommend chaining, which is a series of responses needed to perform a particular target end-behavior or, in simpler terms, baby steps. Getting things done one small chunk at a time. Simple. It works.

6. Take Small Time Bites

Complexity of the task can be compounded by the (often incorrect) estimation of the total  time needed to complete it. To take care of this aspect of the problem, it helps to break down the task into small bites of time—say, 5-minute segments—instead of staring at the total time needed and freezing in place.

7. Put the 80-20 Rule to Work

Even the best laid out strategy of eliminating procrastination cannot be accomplished in one day. We simply can’t go from “total procrastination” to “total completion” in one fell swoop. A more realistic and achievable plan may be to apply the 80-20 rule, where success means completing at least 80% of the tasks, instead of aiming for 100%.

8. Seek Role Models

Go with a procrastinator and you’ll learn to procrastinate more. Seek non-procrastinators as role models, get past the negative comparisons, and you will learn useful techniques and approaches that may come natural to them, but can be a godsend on the way to getting things done.

9. Take Responsibility

Everyone knows that there are consequences for delays and for failing to get things done. Procrastinators know that, too. Unfortunately, the habit of making excuses that can be accepted by others simply sharpens the skills for coming up with “reasons” that just sound plausible. A procrastinator who is willing to take responsibility is only a few short steps away from kicking the habit.

Something Needs to Be Done About Hostility!

Ginetto at Stresshacker.com Hostility is stressful, both ways. To giver and receiver alike, hostility metes out its toxic charge of badness. Far from being a true relief for frustration, pent-up anger, or unexpressed emotion, a sudden explosion of hostility merely releases a burst of energy and briefly discharges some muscle tension. Beyond these ephemeral effects, it is hard to find a good justification for hostility in everyday situations. So why is it so prevalent?

Two reasons account for hostility’s “popularity.” The first is the genetically programmed aggression instinct, which, in its proper setting and situation, can be useful (in a competitive physical sport like football), or downright vital (in combat situations, to fight off an aggressor, or in other situations of danger when a calm and relaxed demeanor would be clearly out of place). We can be aggressive and hostile by design, but we are also given a brain that helps mitigate the limbic system’s rage of emotions, and the amygdala’s watchfulness against aggressors, real or perceived as they may be.

The second reason for the pervasive presence of hostility is a misfiring of the very structures of the brain that are supposed to help us regulate it. Poor regulation of negative emotions can unleash hostility. Notoriously so, antisocial personalities have little to no self-regulation of hostility and most of the times this lands them in jail. Many more individuals, though, fall short of law-breaking hostility but still exhibit plenty of it in everyday situations (behind the wheel of their car, while waiting in line, with customer service people, with their spouses, children, friends) to make life more stressful for themselves and for anyone they come in contact with.

Steve Slater on Stresshacker.com At the other end of the spectrum, hostility, while present as a natural emotion, can be sublimated into a more productive and less threatening display of displeasure with someone or a situation.  Well-regulated hostility and aggressive instinct become assertiveness, standing up for one’s right, engaging in an passionate discussion. It can also sublimate into artistic pursuit, an all-out workout at the gym, or humor. A recent example of the latter was portrayed by JetBlue flight attendant Jeff Slater. Justifiably enraged by an unjustifiably aggressive passenger, Mr. Slater regulated down his hostility, expressed himself aloud on the plane’s PA system, grabbed a couple of beers, activated the emergency slide, slid down to the tarmac, ran for his car and drove home.

Hostility and (Bad) Health

Negative emotional states, such as anger and hostility, when they persist over time and become chronic, can negatively impact health. The risk to health comes through a number of mechanisms, including engaging in high-risk behavior (verbally provoking, physically attacking others), loss of social support (no one wants to be with a chronically hostile individual), and social isolation.

Chronic negative emotions also induce a semi-permanent activation of the stress reaction and cause sustained systemic inflammation, both of which increase the risk of disease. Research on hostility and aggressive personality has clearly established a link between these emotional states and heart disease, heart attacks, and cardiac-related mortality. Hostility not only contributes to a higher incidence and increased severity of heart disease, but is also related to symptoms of metabolic syndrome, including insulin resistance.

What Can Be Done?

Taking a page from Mr. Slater’s playbook, humor is one of the highest levels of sublimation that can be achieved in down-regulating aggression and hostility. Other forms of self-regulation of hostility (which incidentally are also ways of dealing with stressful situations in general) can be listed as follows:

  • Anticipation (the ability to anticipate the consequences of hostility and evaluate alternative responses)
  • Affiliation (turning to others for help and support, initiating a dialogue instead of a confrontation)
  • Altruism (taking into account the needs of others, and being able to contain rather than meet their aggression head on)
  • Humor (finding the amusing and the ironic in the situation)
  • Self-assertion (expressing feelings and thoughts directly and openly, but without resorting to verbal or physical violence)
  • Self-observation (reflecting on one’s own reactions and regulating them appropriately, before the explosion occurs)
  • Sublimation (channeling negative feelings into positive behaviors, i.e. taking it out on gym equipment, a good run, a distracting activity)
  • Suppression (intentionally avoiding catastrophic, negative and pessimistic thoughts that can lead to aggression).

Optogenetics Discovers Brain Anxiety Circuit

AmygdCingGyrusThe state of heightened apprehension and high arousal in the absence of immediate threat—commonly labeled as acute stress or anxiety—can be a severely debilitating condition. Over 28% of the population suffers from anxiety disorders that contribute to the development of major depressive disorder and substance abuse. Of all the structures of the limbic system, the seat of emotion processing, the amygdala plays a key role in anxiety, although by what exact mechanism still remains unclear. Newly published research carried out by a group of neuroscientists at Stanford University using the novel technique of optogenetics with two-photon microscopy has permitted a much closer exploration of the neural circuits underlying anxiety than ever before. The optogenetics approach facilitates the identification not only of cell types but also the specific connections between cells. The researchers noticed that timed optogenetic stimulation of the basolateral amygdala (BLA) terminals in the central nucleus of the amygdala (CeA) produced a significant, acute, and reversible anxiety-reducing effect. Conversely, selective optogenetic inhibition of the same projection resulted in increased anxiety-related behaviors. These results indicate that specific BLA–CeA projections are the critical circuit elements for acute anxiety control in the brain. The results were published in the March 17 issue of the scientific journal Nature.

A Closer Look at the Amygdala’s BLA and CeA Regions

BasolateralAmygdalaThe amygdalae (amygdaloid nucleus) are two identical almond-shaped brain structures located in each temporal lobe. Each amygdala receives input from the olfactory system, as well as from visceral structures. The amygdala in humans has been confirmed by functional MRI imaging to be the area of the brain that is best correlated with emotional reactions and plays a key role in the brain’s integration of emotional meaning with perception and experience. The emotional aspect of the response of the individual is passed on to the frontal cortex, where “decisions” are made regarding possible responses. In this way, the response of the individual can take into account the emotional aspect of the situation.

Additionally, the amygdala coordinates the actions of the autonomic and endocrine systems and prompts release of adrenaline and other excitatory hormones into the bloodstream. The amygdala is involved in producing and responding to nonverbal signs of anger, avoidance, defensiveness, and fear. The amygdala has been implicated in emotional dysregulation, aggressive behavior, and psychiatric illnesses such as depression. It has also been shown to play an important role in the formation of emotional memory and in temporal lobe epilepsy.

The basolateral amygdala, one of the two structures studied in the recent Stanford research, receives extensive projections from areas of the brain cortex that are specialized for recognizing objects such as faces in central vision. Extensive intrinsic connections within the amygdala
promote further coordination of sensory information.

Biological effects initiated by amygdala include increases or decreases in arterial pressure and heart rate, gastrointestinal motility and secretion, evacuation, pupillary dilation, piloerection, and secretion of various anterior pituitary hormones, especially the gonadotropins and
adrenocorticotropic hormone, which are key agents in the stress reaction. Interestingly, amygdala stimulation can also cause several types of involuntary movement, such as raising the head or bending the body, circling movements, occasionally rhythmical movements, and movements
associated with taste and eating, such as licking, chewing, and swallowing.

LimbicSystemGeographyThe findings also show the involvement of the amygdala’s CeA region in mediating threat-related anxiety and acute fear-related behavioral and hormonal responses. Earlier studies had shown that stimulation of this same area reduces snake fear and pituitary-adrenal activity and that CeA lesions resulted in decreased expression of threat-induced freezing. Additionally, the CeA region of the amygdala was reported as being significantly involved in the consolidation of contextual fear memory, i.e., what permits us to remember so vividly and persistently objects or situations that have caused fear in us in the past.

The Ineffable Madness of War

guernica-picasso
Over 2.2 million American service members have served in Iraq or Afghanistan since September 11, 2001.

Detailed statistics have been recently released that reveal the enormous cost in lives and health of these two ongoing American wars:

  • The US Veteran’s Administration (VA) has diagnosed 167,000 new cases of post-traumatic stress disorder (PTSD), 195,000 cases of depressive conditions and affective psychoses, and 103,000 cases of anxiety disorders among these troops.
  • The suicide rate in the Army and Marine Corps has, for the first time, equaled that of the US civilian population.
  • An estimated 18 US veterans are dying by suicide each day, according to the VA.
  • In 2009 throughout the Army, 160 soldiers died by suicide, at the same time as 160 soldiers died while serving in Iraq, i.e. one suicide for each combat casualty.
  • In 2009 worldwide another 146 Army soldiers died from unintentional drug overdoses, murders, or from other causes that the Army labels as risky behaviors.
  • The Army reported over 1700 known suicide attempts in 2009.
  • The suicide rate in 2009 for the US Marines was 24 suicides per 100,000 marines, which was even higher than the 22 suicides per 100,000 rate of the US Army.

Stress Hardware Review: Anterior Cingulate

Dolomites_EN-US3033597177The anterior cingulate cortex is a region of the brain that is activated by sensation, cognition, and emotion. It appears to play an important role in autonomic, affective, and cognitive behavior. Because of its position, the anterior cingulate is anatomically and functionally well positioned to integrate information across the physical, intellectual and emotional domains. Important in the stress reaction, the anterior cingulate region is activated during self-regulation of arousal through its connections with the cholinergic basal forebrain. The whole structure, but especially area 32, produces inhibitory inputs that decrease amygdala responsiveness and are helpful in mitigating the effects of fear and in preventing or at least delaying “amygdala hijacks.”

The normal functioning of the anterior cingulate area leads to a normal response to stressful events, which is a psychophysiological arousal or increased emotionality. The normality of the brain response to traumatic stimuli also serves to inhibit feelings of fear when there is no true threat.  Any chemical or structural failure of activation in this area and/or decreased blood flow in the adjacent subcallosal gyrus can lead to an exaggerated response to stress, resulting in significantly higher emotionality and the inability to properly regulate fear. The latter condition provides the inducing cues in anxiety disorders, i.e. increased and persistent fearfulness that is not appropriate for the context.

What the Anterior Cingulate Does

BrodmanBrainAreasPhysically, stimulation of the anterior cingulate (especially in area 24) induces changes in blood pressure, heart rate, respiratory rate, pupillary dilation, skin conductance, thermoregulation, gastrointestinal motility, and changes in adrenal cortical hormone secretion (ACTH). Cognitively, the anterior cingulate cortex plays a leading role in learning new behaviors, whether as a conditioned response to predictors of painful stimuli, as an instrumental response to avoid such stimuli, or in response to reduced reward. Emotionally, the anterior cingulate (along with other structures in the limbic system) mediates emotional responses including fear, agitation, and euphoria, and verbal expression with affective content, such as sighs, cries, and screams.

Neuroimaging studies with powerful fMRI instruments show electrical activation in the rostral–ventral anterior cingulate cortex when individuals under study are asked to recall sad memories or view faces with sad expressions, when they are told to anticipate an upcoming painful electric shock, and when exposed to scenes or words with emotional content. It should come as no surprise that stress-induced activations in the amygdala and orbitofrontal cortex occur simultaneously with those in the anterior cingulate cortex.

Genes, Stress and the Anterior Cingulate

Genetic studies have conclusively demonstrated that the anterior cingulate cortex is highly sensitive to environmental stressors, either physical, psychological, or behavioral. Anoxia (lack of oxygen), maternal separation, amyloid protein expression, and drug abuse all induce hypometabolism, gliosis, and programmed cell death in the anterior cingulate cortex. After prolonged and continued exposure to stress, nerve cells in the anterior cingulate cortex are damaged and killed by excessive stimulation, a process called excitotoxicity.

When the Anterior Cingulate Malfunctions

Several psychiatric disorders are linked with abnormalities in the function of the anterior cingulate cortex. Significantly elevated neurochemical activity in this region of the brain has been observed in obsessive–compulsive disorder, tic disorder, and depression. A normal range of activity is restored with behavioral and pharmacological treatment of these disorders. Other psychiatric disorders that have been associated with abnormal functioning of the anterior cingulate cortex include attention deficit hyperactivity disorder (ADHD) and schizophrenia.

Heart Attack or Stress?

Warsaw_EN-US2451207088Emergency room or a chill pill? What is that sudden stabbing pain that lasts only a few seconds? Or that pressure on the chest that won’t go away and feels like it’s getting worse? A heart attack, heartburn or something else? Dramatic questions like these bring people to emergency rooms or doctors’ offices by the thousands every year. The stress caused by chest pains and severe discomfort in the area around the heart can be acute, and fear of the worst in fact augments the symptoms and brings on additional ones, such as sweating, dizziness, racing heart beat, and more.

But how can we tell when to seek emergency treatment and when to simply lay down and relax? Pain or severe discomfort centered around the heart can be caused by literally dozens of conditions, from pancreatitis, to pneumonia, to an anxiety attack. Given the variety of causes, some of which carry a lethal risk, it is not surprising that most people choose to consult a doctor. In fact, it may be the wisest thing to do, unless pain and discomfort subside in just a few minutes.

The most accurate (but slow) way to determine whether a person has experienced a heart attack is a blood test that identifies creatine kinase and cardiac troponin, chemical markers that appear in the blood stream when the heart muscle has sustained some damage. A faster (but less accurate) method is an electrocardiogram (ECG). The third method (the most immediately available but least accurate) is the person’s own description of the chest pain and any other symptoms to an emergency room physician.

The Harvard Medical Letter describes the following symptoms as generally indicating a condition other than a heart attack, including anxiety or stress:

  • sharp or knifelike pain brought on by breathing or coughing
  • sudden stabbing pain that lasts only a few seconds
  • pain clearly on one side or another
  • pain confined to one small spot
  • pain that lasts for many hours or days without any other symptoms
  • pain produced by pressing on the chest or with body movements.

These symptoms may not require a visit to the emergency room, especially if they resolve within a few minutes. When they persist longer, a doctor’s visit would be necessary to identify their exact cause and take the appropriate remedies.

On the other hand, the following symptoms may indicate a stronger likelihood that a heart attack is in progress and should be taken much more seriously:

  • sensation of pain, or of pressure, tightness, squeezing, or burning
  • the gradual onset of pain over the course of a few minutes over a diffuse area, including the middle of the chest, and its persistence
  • pain that extends to the left arm, neck, jaw, or back
  • pain or pressure accompanied by other signs, such as difficulty breathing, a cold sweat, or sudden nausea
  • pain or pressure that appears during or after physical exertion, or emotional stress, or while at rest.

The appearance of these symptoms would more clearly warrant a 911 call.