The Overwhelming Stress of Paranoia

My spouse and I have been married for several years and we have beautiful children. Beginning some time ago, and following some life events and difficult circumstances that have occurred to us and between us, my spouse has begun suspecting me (and accusing me) of having an affair, trying to hide financial assets, threatening physical harm, wanting to hurt the children, tapping the phone, bugging the house with cameras and listening devices, not loving, planning on leaving for someone else.  I haven’t done any of these things.  I love my spouse with all of my heart, but this is definitely taking a toll on me.  I am now locked out of the house and there is a restraining order preventing me from contacting my spouse or my kids.  I remember that when we first met I noticed a slightly paranoia, which now has gone off the deep end (at least with respect to me, while still being fairly rational and normal with everything else.)  My spouse will not talk to me at all, throws away my letters, deletes my emails and accuses the counselor we were seeing of lying and now won’t go to a counselor either.  What should I do?

paranoiaIt is likely that your spouse may be suffering from a paranoid disorder. This is a condition that tends to get worse over time, since in many cases its underlying cause affects the brain much like a degenerative neurological disorder.

Some people exhibit signs of paranoid thinking at an early age, which may indicate an early psychological trauma. In one typical case, a patient seen for the first time at the age of 16 had a serious head injury when she was 6. She is now 38 and on certain occasion manifests some paranoid symptoms, but is married with three children and has steadily improved throughout her lifetime. It’s a relatively rare but encouraging example of how paranoia can remit almost completely in a supportive and caring environment.

Many patients with serious paranoid disorders eventually divorce their spouses, despite efforts by everyone who cares for them, including their loving spouses, in trying to stop them. The patient’s therapist, minister, friends, relatives and spouse may go to truly extraordinary lengths to try to prove that the paranoid fears are unfounded, but “proof” very rarely has any lasting effect.

Certain medications can help control paranoid thinking, particularly when the person is experiencing schizophrenic or manic symptoms along with being paranoid. In a pure state of paranoid thinking, without any psychotic or manic symptoms, however, medication has been shown to propduce only minimal improvement. Talk therapy is also somewhat unsuccessful, although there may be instances of nearly full recovery.

People who suffer from paranoid thinking don’t give their spouses too many chances to regain trust. It is possible that paranoid patients may let tjheir spouse back into their world again. If they do, it is important to spend as much time together as possible and be completely transparent about one’s activities and whereabouts. The more time spent with paranoid spouses, the less chances they have to imagine what one could be doing behind their back. Also, stress clearly increases paranoid thinking, and when the couple is together there is generally less wondering and therefore less anxiety.

For a while, the healthy spouse may experience singificant stress from all the accusations, and these may even cause significant anger and resentment. But it is useless to argue. Often, what works best is to reassure the spouse of love, and promise to never leave. This may calm the situation, at least temporarily. Also, it is important to call regularly throughout the day. The more of your time given, especially when it is in the form of undivided attention, the fewer symptoms you are likely to occur.

People with a paranoid disorder imagine all sorts of plots designed to do psychological, financial, social or even physical harm to them. Some are dangerous to live with because they are convinced their spouses are planning to kill them. There are documented cases of paranoid patients who have tried to kill their spouses in what they think is “self defense.” Whenever a patient who threatens to kill their spouse, a separation is a must, until there is clear evidence of remission.

If there does not seem to be any danger, the healthy spouse should make every effort to reunite with the spouse. In many case there is a positive response within a few weeks, or at the most, a few months.

It is advisable to make repeated efforts to talk, and when possible, reaffirm love. It is important to always stick to the truth, refusing to go along with any paranoiod fantasies just to try to get along. If the paranoid spouse demands a confession of having done some imaginary transgression, gently state that you would never do anything to inflict intentional hurt. Give regular reassurance that you care and don’t let yourself become so frustrated that you end up saying something that would would contribute to hurt feelings.

Anxiety: Fear Turned Inward

Joanne Weidman, MS, MFTLet’s say on more days than not you feel pretty good about yourself and how you do in most areas of your life. Then one day, you struggle, perhaps at work, perhaps under pressure from a boss who expects more of you at times than you feel capable of achieving. The stress can be overwhelming. On the way home that day the elevator feels particularly confining and the freeway traffic is more irritating than usual, in part because when it stops you feel trapped too far from the next exit. You can’t sleep that night because your heart races and your thoughts are dominated by efforts to figure our out how to solve the problem that came down earlier in the day.

Each of these symptoms can be understood within the broad category of what we call “anxiety.” We throw the word around a lot, but what does it really mean in a psychological sense? Anxiety means more than just the symptoms you feel, though that list is long, including phobias (ex: afraid of flying, elevators, or leaving the house), obsessive-compulsive thoughts and behaviors (ex: counting steps, hand washing), physiological reactions (ex: feeling flushed, racing heart, sweating, dizziness, difficulty sleeping), generic fears (of losing control or going crazy), performance, social and separation anxieties, and the granddaddy of them all, post-traumatic stress disorder or PTSD. Different people are inclined to express their anxiety in different ways and to vastly different degrees.

Some understand anxiety symptoms as fear turned inward. But your anxiety thinks it’s being your friend by trying to keep you safe — anxiety issues are all about feeling in control. Some anxieties are what we would call situational, such as a mandatory performance or project, the evaluation of which is out of your control. Some anxiety we would consider chronic. This is common for those who have had neglect or abuse in their lives, and some of this may be unconscious, meaning that sometimes you’re not even sure what you’re frightened about that’s causing the anxiety symptoms. This is especially distressful, because how can you take control of a situation when you aren’t even sure what it’s about?

Your distress means that you are struggling alone, but you don’t have to. Therapy can help you identify your anxiety triggers and acknowledge anxiety’s good intentions to protect you. You and your therapist can identify real solutions for managing or eliminating it.

Guest post by Joanne Weidman, M.S., M.F.T.

When Stress Hits You On the Nose

Stress-induced upper respiratory symptoms are not unusual. Stress has a powerful effect on the immune system, as the circulation of high levels of the excitatory hormones that accompany stress undermines its defense mechanisms, often producing symptoms such as those of the common cold.

How Does It Work?

sneeze.article Stress suppresses the activity of the immune system, principally due to the effects of the stress hormone cortisol. When under the impact of a significant stressor, the immune system is “flooded” by cortisol and other hormones and its functioning is, at least temporarily, greatly reduced. Thus, pathogens, such as those producing the common cold, have a relatively easier time entering and proliferating in the upper respiratory system.

This is the most prevalent theory of why people get sick while under stress. It does not affect everyone in the same way, however. For some people, it is not until the stressor is removed that adverse symptoms begin to manifest. In this case, it is almost as if the relaxation produced by the removal of the stressor had the effect of making the individual more vulnerable.

What Can Be Done?

A doctor once was asked how long it would take to cure a cold. His answer was, “Oh, about seven days if you take this prescription, or about a week if you decide not to take anything.”  Beside the joke, there is truth in the fact that there is no cure for the common cold, either stress-induced or otherwise. It will generally resolve itself, with or without medication, in about a week or so.

Something can be done however to reduce the effects of stress on the immune system. Some people find help in ingesting large quantities of vitamin C at the onset of their respiratory symptoms. Others find that remedies such as hot baths, hot drinks with honey, breathing exercises, yoga or meditation all have beneficial effects on the effects of stress, and thereby, on the immune system.

When Stress Becomes Trauma

aaHiroshige_TakanawaThere have been considerable advances in the last few years of our understanding of stress, its origin, its antecedents and the course of its manifestations. Significant progress has also been made in understanding what can help reduce its effects on functioning and mood. In spite of the barrage of advertising that promotes such “remedies” as prescription opioids and “benzos” and the ever-present allure of alcohol or marijuana, many people now know that exercise can work just the same, if not better, in reducing stress and anxiety.

There are certain stressors, however, that produce effects that go beyond and cross into a different domain, that of traumatic stress. Recent research places posttraumatic stress disorder (PTSD) within a theory of pathological anxiety, whereby the individual becomes vulnerable in two very important ways.

The first vulnerability precedes the traumatic stressor and is an innate, and therefore genetic, biological predisposition of the individual toward experiencing intense, negative emotions that can easily escalate into panic or degenerate into depression. This biological vulnerability can have many effects, chief among which is the inability to correctly assess the difference between true and false alarms and the subsequent inability to correctly decide on the most appropriate response between fight, flight or freeze. A true state of alarm arousal is the normal and most appropriate reaction to a truly threatening event or situation, i.e. what most people would find dangerous or risky. A falsely perceived state of alarm is one that causes a sudden and involuntary mobilization of the body and the mind’s defenses, in the presence of a situation or event that is objectively non threatening but is assessed as such by the individual who is genetically predisposed to an intense alarm reaction.

The second vulnerability is psychological in nature. Individuals who develop this sensitivity report a greatly reduced sense of control over events and situations. They tend to approach the present and imagine the future with anxious apprehension. Their mood is often characterized by an anxious state of exaggerated vigilance, whereby it is inherently hard to relax and enjoy life. Cognitively, they expect and anticipate the appearance of various threats, external and internal, with an attending constellation of negative emotions (fear, obsession, panic). This complex system of cognitive and emotional arousal usually promotes avoidance and triggers a near-constant state of worry.

When applied to traumatic stress, these vulnerabilities magnify the experience of a traumatic event and trigger a significantly more severe state of alarm at the time of the trauma. It is well known fact that some individuals appear able to remain relatively calm in the face of traumatic events, while others (who are more likely to have bio-psychological vulnerabilities to intense stressors) seem to quickly “fall apart” and be seemingly “destroyed” by the circumstance.

When the intense trauma passes, these individuals remain in a state of arousal that continues to trigger alarms in response to internal and external stimuli associated with the trauma, and their
initial response to it. For example, a sudden noise may trigger the stimulus associated with a bomb blast, or a burst of anger by another may trigger a stimulus associated with physical abuse. These learned responses to real or perceived threats produce a state of anxious apprehension which, in PTSD, includes the re-experiencing of emotions. This near-continuous state of alarm may, in time, be mitigated by coping mechanisms which generally consist of an individual’s efforts at avoiding the triggers of the learned alarms and the strong emotions associated with them. Intense avoidance of any stimulation that may results in a re-experience of the traumatic events and its associated emotions can eventually developed into a state of emotional numbing, where even those stimuli that should provoke a reaction do not.

“Rich” Nutrition Linked to Poor Mental Health

killer-fast-foodPsychological stress is known to increase the production of pro-inflammatory cytokines. The deriving inflammation is accompanied by an accumulation of highly reactive oxygen species, also known as oxidative stress, which is a contributing factor in the development of severe depression. A diet rich in antioxidants, vitamins, minerals and fiber is associated with reduced systemic inflammation. Conversely, diets that are low in essential nutrients, such as magnesium and sugar- and fat-rich western diets are associated with increased systemic inflammation.

A new study of 3040 Australian adolescents 11 to 18 years of age collected information on diet and mental health by self-report and anthropometric data by trained researchers. Improvements in diet quality were mirrored by improvements in mental health over the follow-up period, while deteriorating diet quality was associated with poorer psychological functioning. Researchers concluded that the quality of one’s nutrition is associated with adolescent mental health both cross-sectionally and prospectively. Moreover, improvements in diet quality were mirrored by improvements in mental health, while reductions in diet quality were associated with declining psychological functioning over the follow-up period.

There are many ways in which an insufficiency of healthy foods and/or an excessive intake of unhealthy and processed foods may increase the risk for mental health problems in adolescents. Fruits and vegetables, as well as other components of a healthy diet such as whole grains, fish, lean red meats and olive oils, are rich in important nutrients such as folate, magnesium, b-group vitamins, selenium, zinc, mono- and polyunsaturated fatty acids, polyphenols and fiber. Many of these nutrients have already been reported as of importance in depressive illnesses, however the critical importance of these food components as modulators of reactive oxygen species (inflammation) and immune system functioning, both pathophysiological substrates of depressive illness is increasingly appreciated.

stressed-dessertsA new meta-analysis, reporting on data collected at many time points and thus more reliable, has reported large generational increases in self-reported mental health problems among American high school and college students between the 1930s and 2007. Paralleling this increase in the rates of psychological illness among young people are data indicating a reduction in the quality of adolescents’ diets over recent decades. A report based on trends in adolescent food consumption in the US identified a reduction in the consumption of raw fruits, high-nutrient vegetables and dairy foods, which are important sources of fiber and essential nutrients, between 1965 and 1996, with an associated increase in the consumption of fast food, snacks and sweetened beverages.

Concurrently, population surveys demonstrate a substantial increase in overweight and obesity among children and adolescents over recent decades. Obesity does not necessarily indicate nutritional deficiency: paradoxically, high-energy foods typically have poor nutrient content.

Fast Food, Depression and Anxiety

Another study of 5731 men and women 46 to 49 and 70 to 74 years of age found that those with better quality diets were less likely to be depressed, whereas a higher intake of processed and unhealthy foods was associated with increased anxiety.

USA-Obesity-RateA third study examined the extent to which the high-prevalence mental disorders are related to habitual diet in 1,046 women 20–93 years of age. Results showed that a “traditional” dietary pattern characterized by vegetables, fruit, meat, fish, and whole grains was associated with lower odds for major depression or log-term depression (dysthymia) and anxiety disorders. A western diet of processed or fried foods, refined grains, sugary products, and beer was associated with a higher prevalence of mental disorders. These results demonstrate an association between habitual diet quality and a higher prevalence of mental disorders.

In a fourth study (1999–2010) of 12,059 Spanish university graduates discovered a detrimental relationship between a diet rich in trans unsaturated fatty acids (TFA) and depression risk, whereas weak inverse associations were found for monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA) and olive oil. These findings suggest that cardiovascular disease and depression may share some common nutritional determinants related to fat intake.

Most notably, results of a 2010 randomized placebo controlled trial showed that fish oil supplements prevented conversion from a subthreshold psychotic state to full-blown schizophrenia. Another recent randomized controlled trial study suggested that omega-3 supplements may help reduce anxiety.

Lower DHA Intake Linked to Higher Suicidality

ChileVolcanoEruption_EN-US1005377464Low levels of docosahexaenoic acid (DHA), the major omega-3 fatty acid concentrated in the brain, may increase suicide risk. A retrospective case-control study published in the most recent issue of the Journal of Clinical Psychiatry of 1600 United States military personnel, including 800 who had committed suicide and 800 healthy counterparts, showed that all participants had low omega-3 levels. However, the suicide risk was 62% greatest in those with the lowest levels of DHA.

Our findings add to an extensive body of research that points to a fundamental role for DHA and other omega-3 fatty acids in protecting against mental health problems and suicide risks. —  Joseph R. Hibbeln, MD, acting chief, Section on Nutritional Neurosciences at the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland

DHA is found in naturally in fish and nuts and is also available in fish oil supplements. Fish oil supplements can help lower inflammation by decreasing the synthesis of proinflammatory molecules and have been proven beneficial in treating inflammatory diseases, such as rheumatoid arthritis and Crohn’s disease. Although fish oil has been shown to be less effective in treating other stress-related illnesses such as ulcerative colitis and asthma, some patients do benefit from its intake.

The omega-3 fatty acids EPA and DHA contained in fish oil are effective in treating both cardiovascular disease and depression, often in combination with other specific medications. Higher levels of EPA and DHA are also associated with increased stress resilience.

Cellphone Use & Cancer: Risks and Opinions

cellphone_brainOn May 31, 2011 the World Health Organization (WHO) announced their classification of radiofrequency (RF) electromagnetic fields emitted from cell phones, used globally by more than 4.6 billion people, as "possibly carcinogenic to humans.”  Given the serious health risk that this implies, WHO has pledged to conduct a formal risk assessment of all studied health outcomes from radiofrequency fields exposure by 2012.

The Current Evidence of Cancer Risk

  1. A study conducted in Denmark from 1982 to 1995 (with a follow-up in 2002) analyzed cancer rates among 420,095 cell phone users and found no increased risk for brain tumors, salivary gland tumors, eye tumors, or leukemia.
  2. A number of earlier and smaller case–control studies as well as more than 40 experimental studies also found no direct association between cell phone use and cancer.
  3. The INTERPHONE study, the largest of its kind to date, examined 2,708 glioma and 2,409
    meningioma cases in 13 countries using a common protocol. This study found that using a cell phone appeared to slightly lower the risk of developing a glioma, compared with never using one. But, when the highest 10% of cell phone users in terms of call time were analyzed, this subgroup had a 40% increased risk for glioma, compared with those who had never used a cell phone. Thus, according to Interphone, there is a higher risk for tumors occurring on the same side of the brain as cell phone exposure, and especially for tumors located in the temporal lobe, where RF exposure is highest.
  4. A meeting of 31 scientists organized by the International Agency for Research on Cancer (IARC) in Lyon, France, whose results have been just published in the latest issue of the medical journal The Lancet, considered the potential carcinogenic hazards from exposure to RF electromagnetic fields emitted by cell phones. The IARC group concluded that fields emitted by cell phones should be considered as "possibly carcinogenic" to humans. 
  5. A pooled analysis of Swedish studies examined the association between cell and cordless phone use and glioma, acoustic neuroma, and meningioma in 1,251 (85%) cases and 2,438 (84%) controls. For people who had used a cell phone for more than 1 year, the risk for brain tumors was 1.3 times higher (30%) than in people who had never used a cell phone. This risk increased with time since first use and with total call time. After more than 2000 hours of use, the risk was 3.2 times as high. Similar results were observed among cordless phone users.

In addition to the comprehensive review planned by WHO, the Cohort Study on Mobile Communications (COSMOS) is attempting to do a similarly all-inclusive study. It will become the largest study ever conducted and examine the effects of cell phone use on long-term health. COSMOS plans to track at least 250,000 people in 5 European countries for up to 30 years and it will not rely on users’ self-report, but will follow cell phone use in real time.

The Opinions On Cell Phone Use and Cancer Risk

aaKandinsky_YellowRedBlueDr. Jonathan Samet, Chair of the IARC working group and the Flora L. Thornton Chair of the Department of Preventive Medicine at the Keck School of Medicine, University of Southern California, Los Angeles, , explains that "possibly carcinogenic" means is that cell phone use is not completely safe, although it needs to be more clearly defined through better investigation. If users want to do something about the risk, says Dr. Samet, “there are easy steps to take to lower exposure, such as using hands-free devices and reducing use of the phone."

Other researchers point out that exposure to RF fields is not limited to cell phones but can be caused by other personal devices. Moreover, the specific absorption rate varies from one phone model to another and it can be affected by many factors, including the design, the position of the phone and its antenna in relation to the head, how the phone is held, the anatomy of the head, and the quality of the link between the base station and the phone.

Children are more at risk than adults, since the average RF energy deposition in a child’s brain is generally at least twice as high as in adults. In the most sensitive area of the head, the bone marrow of the skull, exposure in children can be up to 10 times as high as in adults.

Researchers also point out that the INTERPHONE study and the Swedish pooled analysis may not be entirely accurate due to the possibility of "recall error and selection for participation," although the results of these studies cannot be dismissed as reflecting bias alone, since a cause-effect relationship between cell phone-caused exposure to RF fields and brain cancer remains a distinct possibility.

More, Better Research Needed

Where does this leave cell phone users, all 4.6 billion of them? More studies are certainly needed and, perhaps most importantly, the studies need to be better designed. Studies which rely on interviews and on the participants ability to recall the details of their phone use do not produce the most reliable results. Prospective studies that track phone use and health records in real time, that are large enough to include significant segments of the population will produce far more accurate results. They are being planned and, in the case of the COSMOS study, they are underway. Until then, Bluetooth earpieces would seem the way to go.

Sugary Drinks Linked to Higher Blood Pressure

aaMatisse_1948_PlumBlossomsSoft drinks, sweetened fruit juices, and sugar-loaded sports drinks raise blood pressure, according to a International Study of Macro/Micronutrients and Blood Pressure (INTERMAP). The researchers measured the consumption of sugar-sweetened drinks, sugars, and diet beverages (which contain high quantities of glucose and fructose) over the course of four days, administered two 24-hour urine collections and eight blood-pressure recordings, and asked questions about the patients’ lifestyle and medical history. Results show that there is a direct correlation between fructose and glucose intake and increases in blood pressure and that sugar-sweetened beverages are associated with a 1.1-mm-Hg increase in systolic and 0.4-mm-Hg increase in diastolic blood pressure after adjustment for weight and height.

Sugar-sweetened beverages have been linked to high blood pressure, obesity, type 2 diabetes, and heart-disease risk, and this is one more piece of evidence showing that if individuals want to drink these drinks, they should do so in moderation. Also, one of our interesting findings was that the association between sugar-sweetened beverage consumption and blood pressure was stronger in people who are consuming more sodium. We already know that salt is bad for blood pressure, but what we’re finding is that if you’re consuming more sodium, you appear to be, at least in this study, exacerbating the effects of these sugar-sweetened beverages.—Lead investigator Dr. Ian Brown (Imperial College London, UK)

Female Soldiers At Greater Risk for PTSD

US_Flag_Flying_1Results of a 3-year longitudinal study of 2665 female National Guard soldiers began in 2008 of their mental health status before and after their deployment to Iraq provides new evidence that women have more than twice the risk of developing combat-related posttraumatic stress disorder (PTSD) than their male counterparts, 18.7% vs. 8.7%. Women soldiers, with the same level of combat exposure, are also much less likely than men to feel prepared for combat (14.3% vs. 32.2%) or to take advantage of unit cohesion, which are the two most important protective factors against PTSD.

When we investigated the reasons for this we found men felt much more prepared for combat than women, and they were also much more likely to feel they had the support of their unit than women.—Anna Kline, Ph.D. Principal Investigator, Department of Veterans Affairs–New Jersey Health Care System, East Orange

The results of this study, presented May 17 at the American Psychiatric Association 2011 Annual Meeting, confirm previous studies among the general population, which have shown a higher prevalence of PTSD from all causes among women compared with men. What made this study among servicewomen possible was the higher percentage of female soldiers in combat zones, which in Operation Iraqi Freedom and Operation Enduring Freedom reached a high of 14% of total deployed forces.

According to the researchers, these findings may be more accurate because the study was conducted in anonymity. This factor alone may have improved the reliability of findings, as asking sensitive questions about mental health and substance use among identifiable servicemen and women has been shown to produce less that candid responses.

"The military now has integrated gender-based basic training so men and women do prepare together. However, it is possible that even if they get exactly the same training, their perceptions [of training] could be very different. It is also possible that training is geared more towards the strengths of men, so they feel more prepared to handle the rigors of combat. These are areas that need further investigation," said Dr. Kline.

Stress in Pregnancy a Health Risk for the Child

aavanEyck_1434_ArnolfiniMarriageAn anxious expectant father can make a pregnant woman more anxious, and their combined higher level of stress can have a negative influence on the health of their newborn child. While it is a well-known fact that significant mental distress in pregnant women due to anxiety, lack of social support or low self-esteem can result in higher health risks for the infant child, the impact of fathers’ anxiety heretofore had not been examined.

A new study shows that the stress related to pregnancy uniquely affects the mental health of expectant fathers, and that this in turn also has an effect on the health of expectant mothers and their infants. A University of Missouri researcher arrived at these conclusions by examining the underlying factors of the Prenatal Psychosocial Profile as a composite measure of stress, support from partner, support from others and self-esteem; and compared factor structures between pregnant women and expectant fathers.

The study, recently published in the Journal of Advanced Nursing was conducted on 132 expectant mothers and fathers in a sample of 66 low-income couples living in rural Missouri between 2006 and 2008.

Similarities and unique differences between expectant fathers and mothers were found. Among the stress factors, ‘problems related to family’, ‘the current pregnancy’ and ‘feeling generally overloaded’ were perceived as financial stressors by men but as emotional stressors by women. In terms of perceived partner support, women believed they were receiving more tangible support from their partners through actions such as help with tasks or care, while men felt that they were receiving more emotional support.

Among study participants, women had higher self-esteem than men during pregnancy. The assessment of psychosocial well-being in both women and men during pregnancy, especially careful assessment of stressors of pregnancy is deemed useful not only in establishing stress levels and providing adequate stress management tools to both men and women, but most especially in ensuring that reduced levels of stress and anxiety are less likely to impact the health of their infant child.

Stress of Cell Phone Use Disturbs Sleep, Mood

WestminsterAbby_EN-US1401418381Evidence of a direct link between cell phone use and mental health problems just keeps on coming. A major prospective study over a period of one year of young adults who used their cell phones frequently reveals significant disturbances to sleep patterns, increased stress symptoms, and an increased incidence of clinical depression. Researchers at the University of Gothenburg, Sweden investigated possible negative health effects of mobile phone exposure. The study, published this month in BioMed Public Health, focused on the psychosocial variables of mobile phone use and their possible effects on the mental health symptoms in a group of over 4,000 young adults.

Cell phone exposure variables in the study included the frequency of cell phone use, the demands on availability put on the individual, the perceived stressfulness of accessibility, the effects of being awakened at night by the phone, and instances of personal overuse of the cell phone. The mental health outcomes included in the study were current stress levels, symptoms of sleep disorders, and symptoms of depression. Prevalence ratios were calculated first as a baseline at the beginning of the study, and one year later. Mental health outcomes for men and women were studied separately. Any participant who reported mental health symptoms at baseline was excluded from the study.

cellphone_brainA detailed analysis of results showed a cross-sectional association between high cell phone use and elevated stress levels, increased sleep disturbances, and more frequent symptoms of depression for both men and women. High cell phone use was associated with sleep disturbances and symptoms of depression among men and symptoms of depression among women at 1-year follow-up. All exposure variables showed a correlation with mental health outcomes. In particular, cell phone overuse appeared to increase stress and sleep disturbances among women, and high accessibility appeared to produce elevated stress, sleep disturbances, and symptoms of depression among both men and women.

The researchers concluded that a high frequency of cell phone use over a period of one year is a risk factor for stress, sleep and mood disorders among young adults. The frequency of mental health symptoms was greatest among those who had perceived their near-constant accessibility via cell phones to be stressful.

A New Stressor: FOMO

Sm-bandwagonThe power of communication has been unleashed on the Internet as never before. It is now possible to know almost instantly what is happening around the world, to broadcast one’s ever-changing “status” to real or virtual friends and acquaintances, to express oneself endlessly in 160-character increments, to blog multiple times a day one’s erudite or inane musings to an audience that can number in the tens of thousands. Everyone has the power to become a “brand” and many have done so to great lengths, baring their life and its inspiring or sordid details without regard for privacy, confidentiality or simple reserve. With this phenomenon, new stressors are born, old ones are better overcome, and still others morph into more or less ominous sources of anxiety.

Take for example the ability to know, via Facebook, Twitter, Foursquare and Instagram, the whereabouts and activities of our immediate and extended social network. It is possible to know, just by virtue of swiping the screen of a smartphone, who’s out, who’s dining with whom and where, who’s at the club or the sports arena—often with photos and videos of the event as it unfolds in some sort of electronic play by play. Truly fascinating glimpses of reality in some cases, not so interesting and even banal in many others.

One of the newest stressors originated by this type of instant access is “fear of missing out,” or FOMO. It is a bizarre reversal of social anxiety, the particularly debilitating condition which causes people to reluctantly withdraw from interpersonal contact due to stress overload. In FOMO, the stress comes from the anxiety provoked in recipients of instant messages by the awareness that others are socially involved at that very minute, while they are supposedly missing out on something fun and interesting. In other words, being at home, at work, or otherwise “not there,” not doing the things others are doing and that are being portrayed in the photo or video or described in the message, is sufficient to produce anxiety, which perhaps could be referred to as non-social in nature.

texting-while-drivingFOMO is a close cognate of that other need to be connected at all times, for which there may already be an acronym of which I am not aware, yet. Being “out of touch” means not having 24×7 access to email, IM, social media—and that’s simply too horrible to contemplate. Voice calls are becoming an endangered species, as people seem to prefer, in increasingly greater numbers, to text or post. The stress of not having access, no rhyme intended, can be fiercely acute. Its excesses bear on the ridiculous, and increasingly more often, on the tragic—as in the train operator in the San Fernando Valley who wrecked his passenger train while texting to his friends. For the growing number of car accidents caused by this technological distraction there is already an acronym, TWD or texting while driving.

Occasional Sex, Greater Risk of Heart Attack

Italy_BergamoThe sudden stress load placed on the cardiovascular system by sexual activity is more likely to cause a heart attack on people who have sex only occasionally, as compared to those who have sex frequently or routinely exercise. The results of a research published in the Journal of the American Medical Association on March 23 are unequivocal in stating that, “Acute cardiac events (are) significantly associated with episodic physical and sexual activity; this association (is) attenuated among persons with high levels of habitual physical activity.” Conducted at the Center for Clinical Evidence Synthesis within the Institute for Clinical Research and Health Policy Studies of Tufts Medical Center in Boston, the study provides convincing new evidence that physical and sexual activity might trigger critical and even fatal cardiac events when the body is not conditioned to handle the sudden increase in cardiovascular demand.

The detailed analysis of case-crossover studies investigating the relationship between occasional physical or sexual activity and myocardial infarction (MI) or sudden cardiac death (SCD) was conducted by calculating relative risk rates using random-effects meta-analysis and absolute event rates. The analysis was based on a statistically valid sample of US data for the incidence of MI and SCD. The researchers sought to test whether habitual physical activity levels reduced the triggering effect and to what extent.

Results showed that occasional sexual activity (among individuals who did not regularly exercise nor have frequent sex) was more likely to produce an increase in the risk of MI by a risk rate of 3.45. Occasional physical activity in individuals who did not habitually exercise produced an increase in the risk of SCD by a risk rate of 4.98. However, even just 1 hour of additional physical or sexual activity per week was estimated to reduce the risk of a heart attack to a risk rate of 2 to 3 per 10,000 person-years for MI, and to 1 per 10,000 person-years for SCD.

Among people who frequently enjoy physical or sexual activity, risk levels of MI or SCD caused by occasional physical activity were dramatically reduced to the almost negligible rate of .001. The study points out that, for every additional time per week an individual is habitually exposed to physical activity, the risk rate from sudden and infrequent sexual activity for MI decreases by approximately 45%, and the risk rate for SCD decreases by 30%.

A New Stressor: Cell Phone Waves Affect Brain

cellphone_brainLess than one hour on the cellphone has been shown to significantly increase brain activity, especially in the area closest to the phone’s antenna. Is this good or bad? In a study just published in the Journal of the American Medical Association, researchers from the National Institutes of Health in Bethesda, MD and Brookhaven National Laboratories in Upton, NY presented convincing evidence of this localized increase, but could not say whether the findings may have any clinical significance. At issue was whether exposure to cell phone radiofrequency signals has any noticeable and, most importantly, any dangerous effects on the human brain.

One of the measures that best indicates brain activity levels is brain glucose metabolism. In a randomized crossover study conducted between January 1 and December 31, 2009, at Brookhaven National Laboratory, 47 healthy individuals were asked to use their cell phone during a period of 50 minutes. Using positron emission tomography (a PET scan) to detect levels of the biological marker 18F-fluorodeoxyglucose, brain glucose metabolism was measured with the cell phone activated (sound muted) for 50 minutes (switch in the “on” position) and with the cell phone deactivated (“off” position). Statistical tools were used to compare brain glucose metabolism between on and off conditions, and to verify the association of brain glucose metabolism and the estimated amplitude of radiofrequency-modulated electromagnetic waves emitted by the cell phones.

The results of the tests indicate that glucose metabolism throughout the whole brain did not differ between on and off conditions. However, glucose metabolism in the region of the brain closest to the cell phone antenna (corresponding to the orbitofrontal cortex and the temporal area) was significantly higher when the phone was on (35.7 vs. 33.3 μmol/100g per minute). The increase in brain activity appeared to be directly correlated with the estimated electromagnetic field amplitudes.

The researchers conclude that, compared with no exposure at all, a 50-minute cell phone conversation is associated with increased brain glucose metabolism in the region closest to the antenna. Short of any evidence that this increase is harmful, the study authors concluded that this finding “is of unknown clinical significance.”

What Is Brain Glucose Metabolism?

Brain glucose metabolism is the use of glucose (sugars) to create energy for neural activation, as the brain requires a continuous supply of glucose carried to it by blood circulation to meet its metabolic requirements. The central nervous system is dependent upon a continuous supply of blood and the viability of brain cells depends upon the immediate and constant availability of oxygen and glucose.

Although there is inconsistent evidence that increased brain glucose metabolism is pathogenic, the consensus is that it may be a contributing factor in causing a higher than normal concentration of extracellular potassium (ionic disequilibrium), that it may produce fluctuating levels of extracellular excitatory amino acids, and that it may be responsible for localized brain seizure activity.

Similar to the detrimental effects of too little glucose (hypoglycemia), periods of too high glucose (hyperglycemia) have been shown to worsen neurologic outcomes, i.e., to aggravate any existing brain disorder. More specifically, high glucose can cause isolated seizures and situation-related syndromes, such as fever seizures and seizures due to alcohol, drugs, or complications of pregnancy. In fact, longitudinal neuroimaging studies of alcohol-dependent individuals have revealed increased brain glucose metabolism in the frontal cortex and other studies have revealed that cocaine at doses typically used by drug abusers also significantly increased brain glucose metabolism.

Scans of amphetamine users have shown a 14% increase in whole brain metabolism in abusers as compared to non-abusers. Differences were most accentuated in the parietal cortex, ­ an area of the brain that regulates sensation and coordinates information on space and spatial relations. "This finding was a complete surprise," study author Dr. Volkow says. "Most drug studies have shown decreased metabolism. The increased metabolism we saw is consistent with an inflammatory response. This result, taken together with our other findings, indicates that this is a very toxic drug." The presence of inflammation signals that there is a physical injury to the brain.

tn_reach-outWhile it is premature to conclude that cell phone use is harmful to the human brain, the concern has been around for a while and the possible correlation between electromagnetic waves and brain injuries continues to be studied. That a direct correlation of higher than normal brain activity and cell phone use has been so clearly established may however be sufficient to give many of us a reason for using text messaging and a plain old landline to reach out and touch someone.

Can Food Be Stressful? The Evidence

aaRenoir_NiniAuJardinScientific investigators in the 1970s began to ask if a correlation existed between food and behavior. They have discovered quite a few coincidences. New and increasingly more sophisticated studies have revealed the effective existence of a food-behavior correlation in children and older adults. In a review of 10 years of studies conducted between 1985 and 1995, Breakey found evidence of a relationship between what children eat and the way in which they behave. “The most important discovery,” he concluded, “has been the presence—in nearly all studies—of one statistically meaningful variation of behavior as a result of a dietary change” (p. 193). Moreover, these studies have revealed a consistency of response to dietary variations which is also statistically significant. Although other studies have established a correlation between changes in the diet and improvements in hyperactivity and insomnia, Breakey’s unexpected discovery was that the parameter primarily influenced by the intake of certain foods is mood, most of all stress and irritability. According to a recently published study by noted psychoneuroimmunologist Janice Kiecolt-Glaser, diets that promote inflammation (i.e., stress) are high in refined starches, sugar, saturated and transfats, and are low in omega-3 fatty acids, natural antioxidants, and fiber from fruits, vegetables, and whole grains.

A study by Christensen & Christensen investigated the correlation between the course of schizophrenia and national statistics relative to fat consumption. They have found that countries with better prognosis for schizophrenia were those in which the national diet included a higher proportion of fat from fish and from vegetables. In essence, the patients who consumed greater amounts of omega-3 fatty acids showed less severe symptoms, a finding supported by a variety of other studies. If anti-oxidant agents can help in blocking the damage caused by free radicals, the treatment with these food supplements could restore cellular structure. Such a therapy, along with counseling on dietetic factors and lifestyle, could beneficially influence the prognosis of schizophrenia.

New research is also focusing attention on the role that anti-oxidants in the diet may play in the treatment of mood disorders. It is hypothesized that fatty acids may have stabilizing effects on mood with a mechanism similar to that of lithium and of valproic acid, by modifying the pathways of transmission of neuronal signals. In their action on bipolar disorder, they appear to mimic lamotrigine’s mood stabilizing and antidepressant properties. The mechanisms of action must be further clarified, as it is still unclear whether fatty acids show a specific pharmacological effect or a mere compensation of nutritional deficits. The concomitant intake of anti-oxidants vitamins (vitamins C and E) may optimize the effect of fatty acids, further preventing oxidation. A double-blind 4-month clinical study of 30 patients with bipolar disorder has shown the effectiveness of fatty acid supplements in comparison to a placebo (olive oil), added to the usual therapies. The experiment group of patients had a significantly longer period of remission as compared to the control group. Kiecolt-Glaser also cites epidemiological studies that demonstrate significant inverse relationships between annual fish consumption and major depression—the more fish eaten, the lower the prevalence of serious clinical depression.

Adjuvant nutritional therapies have also been studied in patients who showed a relapse despite continuing antidepressant treatment. A double-blind study that added omega-3 or a placebo to the conventional treatment has shown statistically significant improvements in the experiment group in as little as three weeks. Also, melatonin seems to perform as a scavenger of free radicals, beyond its well-known properties of regulation of gonadal function and of biological rhythms (e.g., as a sleep aid). Research data suggest that melatonin may positively influence neurodegenerative processes that are involved in the formation of free radicals and the release of excitatory aminoacids.