Mental Health

Daniel Pendick

PET scans peer into the heart of dementia

What’s bad for the heart is often bad for the brain. High cholesterol, high blood pressure, diabetes, and unhealthy “hardening” of the arteries increase the risk of mental decline or dementia later in life. A study published online today in Neurology shows that older people with the stiffest arteries are more likely to show the kinds of damage to brain tissue often seen in people with dementia. The study adds support to the “two hit” theory of dementia. It suggests that the accumulation of Alzheimer’s-linked amyloid protein in the brain may not pose problems until damage to small blood vessels that nourish the brain nudges them over into dementia. There may be a silver lining to this line of research: Efforts to improve cardiovascular health can also protect the brain.

Michael Craig Miller, M.D.

Nighttime overeating can throw weight and health out of sync

For many people, a late-night “snack” is a daily habit. There are two types of nighttime eating disorders. Sleep-related eating disorder is a highly-publicized though uncommon malady. People with this problem eat while sleepwalking or while in a twilight state between sleep and wakefulness. A better-documented problem is night eating syndrome, in which people do the majority of their eating late at night. It may affect 1 or 2 out of 100 people in the general population. Sleeping and eating are almost certainly connected, given the link between lack of sleep and weight gain. So getting plenty of sleep may be a helpful substitute for nighttime trips to the refrigerator. Being mindful of the problem and trying to identify its triggers, or stress-reduction techniques, may help avert trips to the refrigerator. Some people benefit from talk therapy.

Edward Phillips, M.D.

Go with the flow: engagement and concentration are key

Have you ever been so immersed in what you were doing that all distractions and background chatter just fell away? Nothing existed except the brush and your painting, your skis and the slope, your car and the road. Mihaly Csikszentmihalyi, a renowned professor of psychology at Claremont Graduate University in Claremont, Calif., calls that state of intense absorption “flow.” Flow experiences lead to positive emotions in the short term, and over the long term people who more frequently experience flow are generally happier. Flow experiences have several common characteristics. These include losing awareness of time, not thinking about yourself, working effortlessly, and wanting to repeat the experience. They are more likely to occur when there is a balance between the challenge of an activity and the skill you have in performing it.

Patrick J. Skerrett

Infection, autoimmune disease linked to depression

Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. A new study from Denmark suggests that a serious infection or autoimmune disease could trigger a mood disorder. How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.

Michael Craig Miller, M.D.

Healing from emotional trauma after the Marathon bombing

The bombs that exploded on Monday near the finish line of the Boston Marathon killed three people, physically injured nearly 200 others, and traumatized thousands more. Recovery and healing are beginning for the families of those who died, for the injured and their families, and for others touched by this tragedy. For some, healing will be swift. For others it will be measured in small steps over months, and possibly years. The Marathon explosions will leave a legacy of emotional scars along with the physical ones, even among those who weren’t anywhere near the blasts. Some people who were at the scene of the explosions will undoubtedly develop post-traumatic stress disorder (PTSD). But PTSD is not the only response to frightening events. In fact, most people exposed to a trauma do not develop this condition. They may develop an anxiety disorder, for example, or become depressed. Most people do have some emotional response, but the majority develop no illness at all.

Heidi Godman

Which is better for keeping your mind fit: physical or mental activity?

Physical and mental activities are both important for protecting your thinking skills and warding off dementia. But does one trump the other? A study published yesterday in JAMA Internal Medicine tried to tease out if one was better than the other for brain health. Researchers recruited 126 older adults who felt that their memory or thinking skills had recently gotten worse, and divided them into four groups. All were asked to do an hour of mental activity three times a week and an hour of physical activity three times a week. What differed were the intensities of these activities. After 12 weeks, scores on thinking tests improved across the board. The big surprise was that there weren’t any real differences in improvement between the groups. The researchers concluded that the amount of activity is more important for stimulating the brain than the type of activity, because all of the participants both exercised and engaged in mental activities each week.

Patrick J. Skerrett

New concussion guidelines say “When in doubt, sit it out”

New guidelines for recognizing and managing sports-related concussions could help protect the brains of millions of athletes at all levels of play, from professional football to youth soccer. The guidelines, released today by the American Academy of Neurology (AAN), replace a now-outdated set published in 1997. The guidelines step away from trying to “grade” concussions or diagnose them on the field or sidelines. Instead, they focus on immediately removing from play athletes who are suspected of having a concussion until they can be evaluated. “When in doubt, sit it out.” The AAN estimates that concussions cause between 1.6 million and 3.8 million mild brain injuries each year. Many athletes don’t get medical attention for these injuries, often because they or their coaches don’t recognize the warning signs or take them seriously. The new guidelines should help better identify athletes who have suffered concussions and improve how concussions are managed and treated.

Heidi Godman

Your well-being: more than just a state of mind

Americans are a diverse lot, so it’s no surprise they give different answers when asked about their well-being. But it seems that well-being differs from state to state, too. In the latest Gallup-Healthways Well-Being Index, which gauges the physical and emotional health of people in all 50 states, residents of Hawaii reported the best sense of overall well-being while West Virginia residents reported the worst. The index calculates overall well-being based on six quality of life categories, each of which is made up of several components. Poll respondents in Hawaii had the highest scores in the emotional health and work environment indexes, and were most likely to say they were thriving. People in West Virginia were most likely to say they were not thriving, and had the worst emotional health, the worst health habits, the most diagnoses of depression, and high rates of obesity. People in the other 50 states fell in between. It’s possible to change both emotional and physical well-being, and improve happiness.

Howard LeWine, M.D.

Shared genes link depression, schizophrenia, and three other mental illnesses

Five seemingly different mental health disorders—major depression, bipolar disorder, schizophrenia, autism, and attention-deficit hyperactivity disorder—may be more alike than we think. A ground-breaking new study has identified four regions of the genetic code that carry same variations in people with these disorders. Two of the affected genes help control the movement of calcium in and out of brain cells. That might not sound like much, but this movement provides a key way that brain cells communicate. Subtle differences in calcium flow could cause problems that, depending on other genes or environmental factors, could eventually lead to a full-blown mental illness. But this work offers tantalizing hints that bipolar disorder, major depression, and schizophrenia—and possibly autism and attention-deficit hyperactivity disorder—may not be so distinct after all, but could be different manifestations of the same underlying disorder. This could change the way we view mental illness and open the door to more effective therapies.

Patrick J. Skerrett

Mini-relaxations to ease holiday stress

With Black Friday upon us, the holiday season is now officially underway. Although the next month or so provides many opportunities to see family and friends, be generous, and spread good cheer, it can also be a difficult time. In a stressed-out heartbeat, the holiday season can morph into the hell-iday season. Deep breathing, meditation, progressive muscle relaxation, and visualization can evoke a state of rest and release. Doing them can slow your heartbeat, calm your breathing, lower your blood pressure, and help you chill out. You can’t necessarily eliminate the seasonal stressors. But you can counter them using mini-relaxation exercises, whether you have 10 minutes to spare or just one minute.