Stress News: The Good, the Bad, the Ugly

Stress and the Unborn

Overexposure to stress hormones in the womb can program the potential for adverse health effects in those children and the next generation, but effects vary depending on whether the mother or father transmits them, a new animal study suggests. The results were presented this past Saturday at The Endocrine Society’s 93rd Annual Meeting in Boston.

Posttraumatic Stress Disorder

Depressed-Soldier-02A new study from the Journal of Traumatic Stress finds that for active-duty male soldiers in the U.S. Army who are happily married, communicating frequently with one’s spouse through letters and emails during deployment may protect against the development of posttraumatic stress disorder (PTSD) symptoms after returning home.

Veterans of the Iraq/Afghanistan wars showed a 50 percent reduction in their symptoms of post-traumatic stress disorder (PTSD) after just eight weeks of practicing the stress-reducing Transcendental Meditation technique, according to a pilot study published in the June 2011 issue of Military Medicine.

Individuals with post-traumatic stress disorder (PTSD) are likely to have a higher chance of developing heart disease and to die prematurely, US researchers reported in the American Journal of Cardiology. They found that those with PTSD were more likely to have coronary artery disease, an accumulation of plaque in the arteries that lead to the heart disease.

Stress and Multiple Sclerosis

Contrary to earlier reports, a new study finds that stress does not appear to increase a person’s risk of developing multiple sclerosis (MS). The research is published in the May 31, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology.

Stress and Alzheimer’s Disease

Stress promotes neuropathological changes that are also seen in Alzheimer’s disease. Scientists from the Max Planck Institute of Psychiatry in Munich have discovered that the increased release of stress hormones in rats leads to generation of abnormally phosphorylated tau protein in the brain and ultimately, memory loss and dementia.

The Bipolar Hippocampus

aavanGogh_1888_PontLAngloisA Vanderbilt University study just published in the Archives of General Psychiatry reveals that hippocampal interneurons are modified by bipolar depression. The hippocampus is an important component of the limbic system that acts as the switching center through which incoming sensory signals are retransmitted and initiate behavioral reactions for different purposes. Its importance has been demonstrated empirically: experimental artificial stimulation of the hippocampus can induce a wide variety of behavioral patterns such as pleasure, rage, passivity, or excessive sexual drive. Because of its central function in the modulation of emotions, the hippocampus is believed to have a role in mood disorders such as depression. Numerous postmortem studies conducted on the brain of individuals who were affected by bipolar disorder have shown a decreased density and decreased gene expression of hippocampal interneurons. These findings, however, had not been confirmed by neuroimaging studies of hippocampal volume and function in live subjects—until now.

hippocampal_anatomyTo assess hippocampal volume, neuron number, and interneurons the Vanderbilt study examined sample brain specimens of hippocampi from 14 individuals with bipolar disorder and compared them to those taken from 18 healthy control subjects. The specimens, provided by the Harvard Brain Tissue Resource Center at McLean Hospital, were cut at 2.5-mm intervals and sections from each tissue slice were either Nissl-stained or stained with antibodies against somatostatin or parvalbumin. Messenger RNA was extracted from fixed tissue and real-time quantitative polymerase chain reaction was performed.

The researchers analyzed each sample by measuring the volume of pyramidal and nonpyramidal cell layers, overall neuron number and size, number of somatostatin- and parvalbumin-positive interneurons, and messenger RNA levels of somatostatin, parvalbumin, and glutamic acid decarboxylase 1.

After comparing healthy and unhealthy hippocampal samples, the study showed that the 2 groups did not differ in the total number of hippocampal neurons, but the bipolar disorder group showed reduced volume of the nonpyramidal cell layers, reduced somal volume in cornu ammonis sector 2/3, reduced number of somatostatin- and parvalbumin-positive neurons, and reduced messenger RNA levels for somatostatin, parvalbumin, and glutamic acid decarboxylase 1.

According to the researchers, these results indicate a specific alteration of hippocampal interneurons in bipolar disorder, which is likely to produce a hippocampal dysfunction that can have, among other manifestations, an effect on the onset and severity of bipolar depression.

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.

Songs of Self-focus, Social Alienation, Misery

aaKandinsky_YellowRedBlueListening to the lyrics of the most popular songs being played on the radio or downloaded from the web provides an increased understanding of important psychological characteristics of the U.S. population—and of how these characteristics may change in the future. Words used in popular song lyrics are a cultural product that changes along with cultural changes in the individual psychological traits of the population for which the songs are written and by which they are consumed. A new study conducted on U.S. song lyrics published between 1980 and 2007 shows the influence of this heretofore understudied cultural product in ways that reflect psychological transformations in their authors and listeners. The results show that, over a time span of 27 years, changes have occurred in the frequency of words related to self-focus, social disconnection, anger, antisocial behavior, and misery vs. the frequency of words related to other-focus, social interactions, and positive emotion.

black-eyed-peas-2The results of the study, conducted by researchers from the universities of Kentucky, Georgia, and San Diego State provide consistent evidence in support of the hypothesis that popular U.S. music lyrics now include more words related to a focus on the self with an increase in the use of first-person singular pronouns and fewer first-person plural pronouns over the last 27 years. Popular song lyrics now include fewer words related to social interactions and positive emotions, which parallels evidence in other studies showing increases in U.S. loneliness and psychopathology over time. Words related to anger and antisocial behavior have also increased significantly, which appears to reflect increases in narcissism and social rejection that are conducive to heightened anger and antisocial behavior. To arrive at these results, the researchers analyzed song lyrics for the 10 most popular U.S. songs (according to the Billboard Hot 100 year-end chart) for each year between 1980 through 2007, for a total of 88,621 words.

RihannaChanges in popular music lyrics appear to closely mirror increases in narcissism and self-focus. Just as people report more frequent instances of loneliness and social isolation over time (feelings of loneliness and social isolation in the United States rose 250% between 1985 and 2004), popular song lyrics have progressively included fewer words related to social interactions. Correspondingly, the use of angry and antisocial song lyrics has increased over the same time span, to such an extent that the tone and content of popular songs has become increasingly more angry and antisocial over time.

Other longitudinal data appear to support the findings in the song lyrics. For example, scores on the widely-administered Minnesota Multiphasic Personality Inventory (MMPI) clinical scales, which measure mental health, have increased approximately one full standard deviation between 1938 and 2007. In particular, scores on the depression scale have risen by 0.66 standard deviation units between 1938 and 2007. This would indicate that more people meet diagnostic criteria for major depressive disorder in recent generations as compared to their predecessors.

Lady-GagaU.S. culture is continuously inundated with cultural products which are delivered through a wide variety of media and are increasingly consumed in isolation. Americans listen to popular music, view billboards, and watch TV programs and movies—in increasing numbers, they do these activities alone. The evidence that changes in cultural products reflect generational changes in psychological characteristics is not surprising. Given the ubiquity of cultural products, in spite of the ongoing controversy over whether the media induce or reflect cultural changes, we need a better understanding of how cultural changes over time influence personality traits, goals, and emotions. It appears that, at least on the basis of song lyrics, things aren’t looking up at all for social connection, altruism, and positive emotions.

Discovery: A New Brain Pathway for Stress


In many individuals, a major stressor activates a critical and previously unknown pathway in the brain that regulates anxiety in response to traumatic events. The amygdala, which is the emotional center of the brain, reacts to the stressor by increasing production of the protein neuropsin. The release of neuropsin activates a series of chemical events  that further stimulate amygdala activity, which in turn activates a gene that determines the stress response at a cellular level. Due to this gene activation, these individuals develop long-term anxiety and a typical anxious response to real or perceived stressors.

A study just published in the journal Nature for the first time clarifies the mechanism whereby, in certain individuals and not in others, the extracellular proteolysis triggered by fear-associated responses facilitates neuronal plasticity at the neuron–matrix interface. This process centers around the activity of the serine protease neuropsin, which is critical for stress-related plasticity in the amygdala. Neuropsin determines the dynamics of the EphB2–NMDA-receptor interaction, the expression of the “anxiety gene” Fkbp5 and the triggering of anxiety-like behavior. When faced with a stressor, individuals who are neuropsin-deficient show a much less frequent expression of the Fkbp5 gene and low anxiety. On the other hand, the behavioral response to stress in individuals who are rich in neuropsin shows a more frequent expression of the Fkbp5 gene and much more significant anxiety-related behavior. The researchers, consisting of a team of neuroscientists at the University of Leicester, UK, in collaboration with researchers from Poland and Japan, conclude that their findings establish a novel neuronal pathway linking stress-induced proteolysis of EphB2 in the amygdala to the development of an anxiety-driven response to stress.

Stress-related disorders affect a large percentage of the population and generate an enormous personal, social and economic impact. It was previously known that certain individuals are more susceptible to detrimental effects of stress than others. Although the majority of us experience traumatic events, only some develop stress-associated psychiatric disorders such as depression, anxiety or posttraumatic stress disorder… We asked: What is the molecular basis of anxiety in response to noxious stimuli? How are stress-related environmental signals translated into proper behavioral responses? To investigate these problems we used a combination of genetic, molecular, electrophysiological and behavioral approaches. This resulted in the discovery of a critical, previously unknown pathway. –Dr. Robert Pawlak, University of Leicester.

The study took four years to complete and it sought to examine the behavioral consequences of a series of cellular events caused by stress in the amygdala. They discovered that when certain proteins produced by the amygdala were blocked, either via medication or by gene therapy, the study subjects did not exhibit the highly anxious traits.

This is a significant discovery for the study and treatment of maladaptive stress responses that result in anxiety. By knowing which chemicals along the neuropsin pathway are present in the human brain at the moment of traumatic events, the researchers believe that it will be possible to design intervention therapies for controlling stress-induced behaviors and for the prevention and treatment of stress-related psychiatric disorders such as depression and posttraumatic stress disorder.

Stress and the Female Brain Advantage

drlouannbrizendineIn 1994, Louann Brizendine, a neuropsychiatrist at the University of California, established the Women’s Mood and Hormone Clinic in San Francisco—one of very few such institutions in the world—and focused her attention on the etiology and functioning of the female nervous system.

In 2007, she published The Female Brain as the culmination of her 20 years of research and a compendium of the latest findings from a range of disciplines. It is a fascinating and, in some ways, startling revelation of the most noteworthy particularities that characterize the human female brain.

Size Does Matter… and So Does Density

Women and men have very nearly the same number of brain cells, even though the female brain is about 9% smaller than men’s. This fact had been known for some time and had been, more or less jokingly, interpreted as meaning that women were not as smart. Dr. Brizendine reveals a much simpler explanation: women’s brain cells are more tightly packed into the skull.

To further dispel any notion of masculine brain superiority, she says, women have 11% more language and hearing neurons than men and a larger hippocampus, the area of the brain that is most closely associated with memory. Much more developed in female brains than male’s is also the circuitry for observing emotion on other people’s faces. Dr. Brizendine concludes that, when it comes to speech, emotional intelligence, and the ability to store richer and more detailed memories, women appear to possess a richer brain endowment and thus a natural advantage.

The amygdala in males, on the other hand, has far more processors than in females, which could explain men’s greater intensity in perceiving danger and their higher proneness to aggression. The male body is much quicker to mobilize to anger and take violent action in reaction to an immediate physical danger.

Are women not as capable of reacting to danger? Dr. Brizendine says that a woman’s brain is as capable to perceive danger or deal with life-threatening situations, but that it mobilizes the body’s resources in quite a different way. The female brain appears to be wired to perceive greater stress over the same event than a man’s. This greater arousal and more forceful stress reaction appears to be a natural way to ensure adequate protection against all possible risks to her children or family unit. Brizendine suggests that this ancestral reason may account for the way a modern woman may view unpaid bills as catastrophic and naturally perceive them more intensely threating to the family’s very survival.

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MRI scans have pushed knowledge much higher by allowing the observation of the workings of the brain in real time. The brain lights up in different places depending on whether it is stimulated by love, looking at faces, solving a problem, speaking, or experiencing anxiety. What lights up, where and when, is different between men’s and women’s brains. Women use different parts of the brain and different circuits to accomplish the same tasks, including solving problems, processing language, and generally experiencing the world.

This is a fascinating book for the scientist and the novice alike, well worth reading. It is the Stresshacker Recommended selection for this month.

How to Get a Larger Brain

aaMonet_WaterLiliesHow do you increase the volume of gray matter in your brain? Mindfulness-Based Stress Reduction (MBSR), one of the most widely used mindfulness training programs, may be the answer. MBSR is receiving increasing attention for the significant morphological changes that it appears to produce on brain structures. The most recent results come from a controlled longitudinal study completed at Massachusetts General Hospital and published in the January 2011 edition of Psychiatry Research. Researchers at MGH investigated pre–post changes in brain gray matter concentration in individuals who participated in an 8-week MBSR program. Changes in gray matter concentration, measured using voxel-based morphometry, showed increases in gray matter concentration within the left hippocampus, as compared with a control group of individuals who did not meditate and showed no such increase. Whole brain analysis also confirmed gray matter increases in the MBSR group only, which were located in regions of the brain involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking, such as the posterior cingulate cortex, the temporo-parietal junction, and the cerebellum.

Earlier studies conducted in the last five years at Yale and Harvard have shown that mindfulness meditation increases the thickness of gray matter between .004 and .008  inches (in proportion to the frequency of meditation) in parts of the brain that are responsible for attention and processing of sensory input. It also appears to slow down the brain deterioration which is a part of the natural aging process.

Yoga and tantric meditation, mantra or transcendental meditation, and mindfulness meditation are increasingly popular forms of stress management. The therapeutic value of meditation in producing positive effects on psychological well-being and ameliorating symptoms of a number of disorders has become widely accepted. Research on the neural mechanisms that underlie these beneficial effects and actual morphological changes produced by these practices offers encouraging new avenues of study that further validate their effectiveness.

Abuse in Childhood May Mean Shorter Life

aavanGogh_1885_AutumnLandscapeAccording to an analysis by the Centers for Disease Control and Prevention (CDC), the experience of verbal, physical, sexual abuse, or severe family dysfunction, such as an incarcerated, mentally ill, or substance-abusing family member, domestic violence, or absence of a parent because of divorce or separation, is directly linked to serious problems in adulthood, which may include substance abuse, depression, cardiovascular disease, diabetes, cancer, and premature death.

The combination of risky behaviors such as substance abuse, the effects of severe depression on variables such as suicide, and the incidence of deadly diseases such as diabetes and cancer contribute to an elevated risk of early death in adults who experienced abuse and dysfunctional family environments. More specific studies have confirmed that individuals with six or more adverse childhood experiences were almost twice as likely (1.7  times) to die before age 75 and 2.4 times more likely to die before age 65 years, i.e. below to well below normal life expectancies.

The CDC analyzed information from 26,229 adults in five US states (Arkansas, Louisiana, New Mexico, Tennessee, and Washington) using the 2009 ACE (Adverse Childhood Experience) module of the Behavioral Risk Factor Surveillance System (BRFSS), which is operated by state health departments in cooperation with the CDC. The results of the analysis show that 59.4% of the interviewed reported having at least one adverse childhood experience, and 8.7% reported five or more.

The prevalence of each adverse childhood experience ranged from a high of 29.1% for household substance abuse to a low of 7.2% for having an incarcerated family member. Over one quarter (25.9%) of respondents reported having experienced verbal abuse, 14.8% reported physical abuse, and 12.2% reported sexual abuse. In measures of severe family dysfunction, 26.6% reported separated or divorced parents, 19.4% reported that they had lived with someone who was depressed, mentally ill, or suicidal, and 16.3% reported witnessing domestic violence.

The analysis reiterates the risk for long-term impact on health and mortality of childhood abuse, stress and trauma. Numerous studies (Sansone & Poole, Ozer, Best, et al., Heim, Newport, et al., Bremner et al., to cite only a few of the most recent) have confirmed the positive and significant correlations between childhood physical abuse, emotional abuse, and witnessing violence and the number of psychophysiological and pain disorders in adulthood.

Freshmen Stress, Debt Worries Grow Higher

JeffersonMemorial_EN-US2610056053Results of the 2009 survey of over 200,000 first-year students at 4-year American colleges, administered by the Cooperative Institute Research Program of the Higher Education Research Institute at UCLA, show that at least 67% of freshmen are concerned about financing their college cost, the highest percentage since 1971. Moreover, 53% of first-year students have taken out loans to finance college, 4% more than in 2008 and the highest percentage in the last ten years. 

The global economic downturn is having an impact on the characteristics, attitudes, and beliefs of incoming first-time students at four-year institutions. They are more concerned about finances, more likely to take out loans and need grants in higher amounts. They will likely be graduating with higher debts and have shifted majors and career aspirations away from business fields. Although the values of these students coming into college show a slight retrenching towards financial security and less towards social agency, there is hope that their increased desire for volunteering and community service will foster an increase in such attitudes during their college careers. — Pryor, J.H., Hurtado, S., DeAngelo, L., Palucki Blake, L., & Tran, S. (2009). The American Freshman: National Norms Fall 2009. Los Angeles: Higher Education Research Institute, UCLA.

The students are describing themselves as being “below average” in their emotional health in higher numbers than ever before. The percentage of students who described their emotional health as above average fell from 64% in 1985 to 52%. Female students have a less positive view of their emotional health than male students, by a wider than ever margin: 18% of the men compared with 39% of the women. Female students also accounted for 60% of the number of students who reported having sought mental health services during their first year of college.

Among the principal causes of the increase in stress, the economy appears to play the major role, due to much greater financial pressures on parents and the students’ own worries about college debt and job prospects after graduation. 29% of the students surveyed reported that they had been frequently overwhelmed by stress during their senior year of high school, up from 27% last year.

Gene Found to Mediate Stress and Depression

PearlHarbor_EN-US3308869662The serotonin transporter promoter polymorphism 5-HTTLPR region of gene SLC6A4, one of the over 1,000 genes located on human chromosome 17, has been positively identified as the moderator of the relationship between stress and depression. A new, extensive analysis of 54 studies of more than 40,000 individuals was recently completed at the University of Wurzburg, Germany, finding “strong evidence that 5-HTTLPR moderates the relationship between stress and depression, with the s [short] allele associated with an increased risk of developing depression under stress.”

The meta-analysis of the 54 studies looked at 40,749 individuals stratified into subgroups according to specific types of stressors. They found a statistically significant relationship between the presence of the short allele of 5-HTTLPR in the individual’s gene and increased stress sensitivity in two of the subgroups: the subgroup of individuals who had suffered childhood maltreatment and the subgroup of individuals who developed a specific stress-related medical condition.

Despite some analytical limitations due to the variety of sources and methods within the 54 original studies, the authors of the meta-analysis conclude that, “the present study suggests that there is cumulative and replicable evidence that 5-HTTLPR moderates the relationship between stress and depression. Our evidence, particularly the identification of important study characteristics that influence study outcome (stressor type and stress assessment method), can provide guidance for the design of future gene x environment interaction studies.”

This new study, already published online and scheduled to appear in the January 2011 edition of the Archives of General Psychiatry, disconfirms the findings of 2 earlier and much less extensive studies, which had found no evidence of the interaction. The authors of the new study speculate that the earlier negative findings may have been due to the small number of cases analyzed, the authors’ inability to obtain primary data for many of the studies, and the inclusion only of studies that looked at stressful life events (SLEs), and not other stressors such as childhood maltreatment.

More On 5-HTTLPR and Serotonin

5HTTLPR-Chromosome_17_svgSince its discovery in the 1990s, polymorphic region 5-HTTLPR located on SLC6A4, the gene that codes for the serotonin transporter, has received intense investigation for its possible role in stress and other mental health issues, especially mood disorders. A 2000 study uncovered evidence that 5-HTTLPR may be involved in the appearance of certain anxiety-related personality traits, and a 2003 study presented evidence that 5-HTTLPR may also be involved in the development of childhood anxiety and shyness.

Serotonin is a small-molecule indoleamine neurotransmitter that plays an important role in mood, depression and anxiety, and is also implicated in the sleep/wake cycle. Serotonin, after being released in the raphe nuclei of the brain stem and other parts of the body and having its effect on mood, is routinely removed from the synaptic cleft by the reuptake of the transmitter with the serotonin transporter. It is the blocking of this reuptake that results in the therapeutic effect of SSRI (selective serotonin reuptake inhibitor) antidepressant medications, such as Lexapro, Paxil, Zoloft, and Prozac.

The History of Stress in Very Small Bites: 2

descartesIn the 17th century, French philosopher Rene Descartes, without addressing the concept of stress reaction in his writings, nonetheless had a profound impact on psychology, the new scientific pursuit of many of his contemporaries who were beginning to understand the impact of psychological stress on human functioning.

Descartes’ thoughts also touched on the relationship between mind and body. In his view, mind and body were clearly separated, although he recognized that the body could somehow influence the mind, or vice versa. In particular, as Descartes put it, 

…as regards the soul and the body together, we have only the notion of their union, on which depends our notion of the soul’s power to move the body, and the body’s power to act on the soul and cause its sensations and passions (Descartes, R., Oeuvres de Descartes, 11 vols., eds. Charles Adam and Paul Tannery, Paris: Vrin, 1974-1989.)

georgebeardAn important contributor to the understanding of psychological stress was the noted American physician George Beard (1839–1883), a specialist in diseases of the nervous system. Beard hypothesized that the newly imposed demands of the Industrial Revolution on 19th century life may cause an overload of the nervous system.

He variously labeled this overload as neurasthenia, a weakness of the nervous system, or nervous exhaustion. This condition, very much equivalent to our modern understanding of chronic stress, was characterized by Beard has exhibiting symptoms of severe anxiety, unexplained fatigue, and irrational fears—a state of affairs that caused an inability of the individual’s nervous system to meet the demands of daily life.

The History of Stress in Very Small Bites: 1

I did consent,
And often did beguile her of her tears
When I did speak of some distressful stroke
That my youth suffer’d.

Here can I sit alone, unseen of any,
And to the nightingale’s complaining notes
Tune my distresses and record my woes.
William Shakespeare (1595) THE TWO GENTLEMEN OF VERONA

william-shakespeare-portraitFrom the vulgar Latin districtia (being torn asunder), through Middle French destrece,  Middle English distresses, modern English distress and, by aphesis, stress. Used in the 15th century to mean applied pressure or physical strain, in the 17th century the word stress began to be used to mean hardship or adversity.

In the 20th century, stress took on its current meaning of psychological disturbance, ill health and mental disease. Using the physiological concepts of stimulus and reflex arc, freudSigmund Freud enlarged the concept of stressors to include internal “stimuli of the mind” which he called instincts. As opposed to an external stressor, an instinct “never acts as a momentary impact but always as a constant force. As it makes its attack not from without but from within the organism, it follows that no flight can avail against it.” "Instincts and Their Vicissitudes," in Collected Papers of Sigmund Freud, ed. Joan Rivière, Vol. IV (New York: Basic Books, 1959), p. 69.

Can Psychological Stress Increase Cancer Risk?

FaggioBurcinaThe continuous circulation of white immune cells throughout the body is our defense against disease caused by bacteria, viruses, harmful chemicals, as well as our built-in, 24×7 surveillance system against the development of cancer. A healthy body sees between 4,000 and 11,000 white cells per microliter of circulating blood, but this concentration increases in response to a threat. Psychological stress has an immuno-suppressive effect by reducing the white cell count and thus the body’s ability to fight diseases ranging from the common cold to cancer.

How Stress Affects the Immune System

The direct communication between the sympathetic nervous system (SNS) and the immune system consists of adrenergic projections and sympathetic nerve terminals that are found in many organs of the body, such as the spleen. An acute SNS activation by a stressor causes the immediate release of catecholamines from nerve endings, initiating the automatic arousal that takes place during the stress reaction. This neuroendocrine response to stressors also increases the levels of glucocorticoids (primarily cortisol) in circulation, which are steroid hormones that in addition to rapidly mobilizing the body against the threat also have an effect on the immune system.

Acute vs. Chronic Stress

Stressors, depending on their nature and duration, modulate the functions of the immune system by influencing the number of white cells circulating in the bloodstream. The effects of a brief, acute stressor (e.g., a sudden noise) on white cell circulation are short-lived and subside when the stressor passes. There are longer lasting effects on white cell circulation when the stressor is prolonged and severe (e.g., a relationship problem), as in chronic stress.

Regardless of its origin, psychological stress always leads to a change in white cell count at varying degrees depending on the type and duration of the stressor. Current research shows that longer-lasting stressors cause a reduction of immune function and increase our vulnerability to disease. Numerous studies document the immune system suppression caused by severe stressors such as marital strife, bereavement, long-term caregiving, living in unfavorable conditions, and by the psychological reaction to environmental disasters such as floods, earthquakes, fires, and hurricanes.

Stress, Immune System and Cancer

According to the National Cancer Institute’s current information on the possible association between stress and cancer, at least three areas of investigation are being explored: stress effects on virus-related cancer, stress effects on cell processes, and stress effects on tumor growth and spread.

Virus-related Tumors. An indirect relationship between certain types of virus-related tumors (Kaposi sarcoma, Burkitt lymphoma, cancer of the liver) and stress has been established. The indirectness results from the fact that some cancers are triggered by a process that involves certain precursor infections (such as herpes and hepatitis) that are known to be exacerbated by stress and a weakened immune system.

Cell Processes. The body’s natural neuroendocrine response has been shown to alter important cell processes that protect against the formation of cancer, such as DNA repair and the regulation of cell growth. Age-related deficits in protein synthesis and the responsiveness of cells to stress, decreased cell-cell communication, and inefficient signal transduction may render old cells less able to withstand stress (genotoxic stress).

Tumor Growth and Spread. The precise biological mechanisms underlying the influence of stress on the growth and spread of cancer are not yet well understood, but a link between the effects of stress on the immune system and the growth of some tumors has been documented. A recent study at the University of Texas Anderson Cancer Center in Houston indicates that stress hormones, especially norepinephrine and epinephrine, can contribute to tumor progression in patients with ovarian cancer.

Other Factors in the Effects of Stress on the Immune System

There are many factors that can exacerbate the negative influence of stress on the immune system. Age, nutrition, gender, ethnicity, and psychosocial characteristics of the individual can affect white cell circulation in response to stressors. Depression, lack of social support, or a hostile personality can cause altered immune cell responses to acute stress. Among the protective factors, physical fitness appears to be a very important positive mediator of white cell activity in the presence of psychological stressors.

Making Your Marriage Last and Thrive

SH_Rcmds_smWhat makes a good marriage last? According to the best evidence provided by thousands of studies and experimental research (most prominent that of Dr. John Gottman), marriages where the spouses provide a safe haven for each other and a secure base from which to face the world together provide the best chances of success. A key skill that all good partners acquire is that of arguing in a fair manner, which respects the other’s point of view (without necessarily agreeing with it), seeks to understand the reasons underneath each respective position, and negotiates a fair compromise.

If you are a couple, you most likely have arguments. Big or small, they can ruin a day and, even worse, a relationship. Dr. Sharon Morris May says, "It’s not how similar you are or even your level of conflict that determines your marital success but how you deal with your emotions, vulnerabilities, and dragons when you argue." In her book, How To Argue So Your Spouse Will Listen: 6 Principles for Turning Arguments into Conversations, Dr. Morris May presents conflict through the lens of attachment theory, helping couples understand why they argue, how they argue, and how to unravel arguments. The book also helps spouses identify what’s really going on in their brains and in their bodies when they argue, the cycle they get stuck in, the emotions fueling the cycle, and what can help them argue in more considerate and connecting ways.

[amtap book:isbn=0849918685]

How To Argue offers six practical principles that can help turn arguments into real conversations: Establish a Safe Haven, Comfort Each Other’s Dragons, Get Inside Each Other’s Emotions, Learn How to Complain, Learn How to Apologize, and Bookend It With Good Times.

Learning how to argue so your spouse will listen and in ways which will not lead to irreparable breaches is a fundamental skill that perhaps you did not learn in your prior relationships or from our own parents. The good news is that it is a skill that can be learned at any age and virtually at any point of your marriage: this book, the Stresshacker Recommended book for this week, can teach you how.

Mental Health USA: An Inconvenient Truth

aaWyeth_1946_WinterIn 2009, almost 20% of the adult population in the United States (19.9% or 45.1 million people) had a mental illness of some kind during the prior twelve months. Those with a serious mental illness were 4.8% of the adult population, or 11 million people.

These are the sobering results of the latest National Survey on Drug Use and Health (NSDUH), a report presenting estimates on the prevalence of mental disorders and mental health services utilization among adult Americans.

The results showed that adult women were more likely than men to have a mental illness of any kind (23.8 vs. 15.6%) or a serious mental illness (6.4 vs. 3.2%). An estimated 8.4 million adults, or 3.7%, had serious thoughts of suicide, 2.2 million (1%) had made suicide plans, and 1 million (0.5%) had attempted suicide within the past year.

The survey results estimate that among the over 45 million adults with any mental illness in the past year, almost 9 million had substance dependence or abuse. Among the 11 million adults with a serious mental illness, almost 26% also had substance dependence or abuse.

Only 17 million people with any mental illness received mental health services, whereas 28 million neither sought or received any treatment. Six in ten adults with a serious mental illness received mental health services, while almost 4.5 million received no treatment at all.

aaWyeth_1948_ChristinasWorldThe survey is conducted each year by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services using computerized interviewing. The 2009 results were extrapolated from screening completed at 143,565 addresses, and 68,700 completed interviews. In this survey, the category any mental illness includes the presence of a diagnosable mental, behavioral, or emotional disorder in the past year (excluding developmental and substance use disorders) of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The category serious mental illness includes a diagnosable mental, behavioral, or emotional disorder resulting in substantial impairment in carrying out major life activities.

You can see the complete results of the 2009 survey, published a few days ago, on the OAS-SAMHSA web site by following this link.