A Gene for Anxiety, Depression, and PTSD?

I’ve often wondered why some people are tormented by anxiety and depression while others are not, and how having parents with similar afflictions seems to translate into higher incidence among family members.

Phillip M. Newton, Ph.D., writing in Psychology Today, takes a look at the science behind FK506 binding protein number 5, which might hold the genetic explanation that’s long been assumed.

FKBP5 is part of the body’s stress-sensing system, and this system responds to stress by releasing the hormone cortisol which drives the biological response to stress stimulus. If the FKBP5 gene is slightly altered from person to person, that might explain the hyper-reactive response common to anxiety and PTSD sufferers.

Certainly, slight variations in the FKBP5 gene could account for part of our problem, but what about environmental factors – the other half of the nature vs. nuture formula?

Research around FKBP5 specifically has shown that history of child abuse shows correlation to later development of PTSD. From the article:

Researchers at Emory University, led by Kerry Ressler M.D. Ph.D, have identified four variants of the FKBP5 gene that are more commonly found in people who suffer from posttraumatic stress disorder. Many unfortunate factors contribute toward the development of posttraumatic stress disorder, with a history of child abuse being one of the most significant. Importantly, the genetic variants of FKBP5 are found in PTSD patients with a history of child abuse, but not PTSD patients who do not have a history of child abuse, suggesting a gene- environment interaction during childhood that can predict the development of posttraumatic stress disorder.

As more research develops on the genetic make-up of anxiety disorders, perhaps we’ll see the resulting data used as part of a gene-therapy approach to treatment in the coming years.

Childhood Anxiety Can Start Early

As an adult with anxiety challenges, I’ve often wondered at what point in my life I climbed aboard the anxiety train.

A new study published in the Journal of Child Psychology and Psychiatry posits that up to 15% of preschool children may have “atypically high depression and anxiety levels”, a number that I find statistically significant and somewhat surprising.

What wasn’t surprising was the genetic aspect of childhood anxiety documented. Children with high levels of anxiety and depression are more likely to have mothers who suffer from depression.

The study revealed that children as young as a year old demonstrate indications of higher risk. Given how quickly kids develop in that first year, it makes sense to think that the genetic similarities might come into play, but for me, it raises questions around environmental factors too.

The concept of preventative intervention in very young children with significant risk factors might be a good way to address core issues before they have a chance to lead to atypical behaviors and suffering. It will be interesting to see where the research eventually leads.

Anxiety Insights link

Evolution and Depression

Scientific American takes a look at depression from a different perspective in asking if perhaps it’s the result of an evolutionary process that’s more helpful than harmful.

The authors posit that our brains play an important role in survival and reproduction, and therefore they should be resistant to high rates of malfunction. Most mental illness is rare, except for depression. Why is that?

One possible answer is that depression isn’t a disorder at all, but rather an adaptation that brings both costs and benefits.

Here’s an example:

So what could be so useful about depression? Depressed people often think intensely about their problems. These thoughts are called ruminations; they are persistent and depressed people have difficulty thinking about anything else. Numerous studies have also shown that this thinking style is often highly analytical. They dwell on a complex problem, breaking it down into smaller components, which are considered one at a time.

Without completing restating the entire article here, the main point being articulated is that depression is nature’s way of letting you know that you have some complex social problems to solve, and that your brain is actively engaged in seeking those solutions. And rather than attempting to stop depressive ruminations, therapists would be wise to encourage them in an attempt to find the answers to the problems causing the bouts of depression in the first place.

If you’ve suffered from depressive episodes, I’d like your thoughts on this concept. Does this ring true for you?

Link , via Scientific American

Can Yoga Help Workplace Stress & Anxiety?

With the often relentless pace at work, it’s sometimes difficult to carve out even a half-hour for lunch. Stepping away for 20-30 minutes to have a bite to eat, stretch my legs, and just get away from the workplace energy for a little while can be helpful in reducing those feelings of stress and anxiety that slowly surround me like a misty fog.

So when I read about this study that included guided workplace yoga and meditation to help with stress relief, my first thought was, “Where do I sign up?”, although I’m unsure that anyone wants to see me in full downward facing dog while wearing my Dockers.

I’ve written before about the benefits of mindfulness-based stress reduction therapy, most notably here and here. Conceptually, being able to recognize and be aware of your stressful, anxious state is the first step toward doing something about it. Over time, I learned breathing and relaxation techniques that can be put into use in just about any situation, at any time, the result being a more relaxed, unstressed version of me.

The study, conducted at the Ohio State University here in Columbus, was specifically designed for office worker types wearing business apparel, and involved an hour meeting once a week during lunch, plus 20 minutes per day of yoga and meditation performed at the subject’s desks. The results were impressive:

Mindful attention awareness increased significantly and perceived stress decreased significantly among the intervention group when compared to the control group’s responses. Overall sleep quality increased in both groups, but three of seven components of sleep were more affected in the intervention group.

On average, mindfulness increased by about 9.7 percent and perceived stress decreased by about 11 percent among the group that experienced the intervention. These participants also reported that it took them less time to fall asleep, they had fewer sleep disturbances and they experienced less daytime dysfunction than did members of the non-intervention group.

Two things jump out at me from this study – one, that simply being exposed to the concept of mindfulness, becoming aware of what you are feeling and why, is enormously beneficial. Secondly, there is an amazing sense of empowerment that comes from having effective tools, like yoga and meditation, to help address the stress and anxiety, and feeling better even a little bit can help spur you on, which can lead to even more effective results.

If you would like to know more about the study, you can read the full details at Anxiety Insights. Go forth and unwind those tight muscles and loosen that tense mind!

NY Times: Taking Anxiety to a New Level

The New York Times has a posting in their Fashion and Style section on anxiety. Who knew that my psychological disorder was either stylish, fashionable, or both?

The author experiences some knee-knocking while looking over a cliff at Big Sur and notices that as she gets older, she’s much less inclined to engage in activities that involve elevation. She claims to never have been afraid of heights before, but now, at 47, altitude causes her anxiousness.

From a clinical perspective, as one gets older, we lose some of our mobility, and our confidence in being able to handle some of the physical demands as well as we did in our youth can wane. But is that anxiety?

From the article:

There is a difference between a fear and a phobia, of course. The people at the Anxiety Disorders Association of America will tell you that we all have things that scare us, after all. It’s when fears start limiting our behavior that they become the kind of full-fledged anxiety-producing phobias that afflict more than 19 million people nationwide. That’s more than 8 percent of the adult population, and the only reason I agreed to hike on the headlands trail in the first place was to keep myself from joining them.

So she takes to nature so she doesn’t have to join our ever-growing group of anxiety sufferers? Really?

I think there’s a big difference between fear and anxiety. Standing on the edge of a craggy cliff that juts out over the ocean is the kind of thing humans learned to stay away from, because experience reminded us of the time when Urg the caveman did that and plunged to his death. Our self-survival mechanisms kicked in, and over time it became ingrained in us to avoid doing silly things like that. It reminds me of a cat that sits on a hot stove. He never sits on a hot stove again – but he never sits on a cold one, either.

I’m guessing that the writer was trying to be cute and draw comparisons between loafing at Big Sur and having a panic attack for no discernible reason, but I’m not buying it. We don’t have the choice to avoid our everyday lives like she can avoid Big Sur, or an expensive dinner at a rotating restaurant at the top of some tall building.

Please don’t use anxiety for alliteration purposes, especially if you don’t understand what it is. A couple of quotes tossed in from authoritative anxiety sources doesn’t help explain how crippling anxiety disorders can be, and equating them to being afraid of falling into the ocean do nothing to educate the general public about a very real, very serious illness.

Image via Wikimedia Commons – Dysepsion

It Is What It Is

This may sound completely idiotic coming from an anxiety sufferer, but Murphy’s Law is generally correct. More often than not, things don’t go exactly as planned.

For the anxious control freaks among us, that’s like crack. What better way to get revved up and knee-deep in the drama surrounding something unanticipated than to slap a label on it? If things didn’t turn out like we thought they should, that’s bad. Right?

Or is it?

One of the big challenges I’ve faced over the years has been the struggle to accept things as they are, without assigning a value or judgment to them. Admittedly, that’s a difficult habit to break after 40 years. My natural response to something like stripping a bolt thread or dropping the eggs on the floor has been, “well, that sucks, dammit.” which obviously removes the need for a mind-reader to ascertain what I’m thinking at that moment.

Similarly, whining about how I wished this hadn’t happened, or feeling put upon (this always happens to me at the worst possible time) did nothing to change my situation or act to prevent something from going wrong in the future. The universe doesn’t work that way!

The world is an imperfect place. Screws fall out all the time. Why are we so surprised by this?

If anything, when something goes awry, I should take comfort in the realization that the universe is working exactly as designed. Things are supposed to break down, not work, or turn out poorly now and then. It’s my unrealistic expectation of perfection that’s the problem, not the egg yolks staining my socks.

When I moved into a new job about 18 months ago, it came with a different level of interaction with senior management, one that didn’t always make it easy to be heard or advocate for my programs. After a couple of frustrating weeks of trying to prepare and anticipate where the obstacles would pop up next, I decided to post a handy reminder on the cork board by my Cisco IP phone.

It is what it is.

Sounding like a phrase oft-uttered at the Bada-Bing club by Tony Soprano, it was the perfect cue to draw my focus away from getting caught up in making judgment calls about what was happening, or more importantly, who was causing it to happen. Rather, I began to deal with just the facts of the situation, without worrying if they were good or bad, happy or sad, positive or negative. It all depended on perspective after all – what seemed good to me was bad for someone else, and when we got caught up in trying to convince someone to change their position or outlook, we were missing the main point. It just was – so what do we do next?

Success has been mixed, but it’s important for me to stay engaged and focused, and when events occur, to not lament or wish things are different. They aren’t different. Everything is as it should be.

Image by KaroliK via flickr

Does Life’s Stress Lead to Weight Gain

We’ve all read that stress and anxiety can lead to a host of health issues, like increased blood pressure, poor sleep habits, headaches, and other maladies. But does it lead to weight gain, and if so, why?

MedicineNet has an article positing that life’s stress can lead to overeating and weight gain, but I’m a bit confused by their explanation – that heavier men and women gain weight when stressed, but their skinnier counterparts do not.

From the article:

A study in the July 15 issue of the American Journal of Epidemiology suggests that when heavier men and women are stressed, they gain weight.

And:

Block and colleagues found that men were more likely to gain weight due to job demands, lack of decision-making authority, difficulty paying bills, and lack of skill discretion — the ability to learn new skills and perform interesting new duties.

The researchers use the term “psychological stress” to describe the factors that caused the weight gain; they say study participants were more likely to gain weight if they already had a higher body mass index (BMI).

Couldn’t it be more likely that people with a high BMI tend to overeat as a matter of course, and their lack of control of food has little to do with stress, but rather with their behavioral activity in general?

I’ve struggled with my weight for years, and yes, I occasionally overeat when feeling anxious or stressed. But I also have periods where I don’t overeat when stressed, and I have longer stretches where I am feeling very relaxed and unstressed, yet I eat too much.

I’m not sure that I agree with the study results that stress is the driving factor in weight gain, especially among high-BMI subjects. More likely, a high BMI could be just another symptom of how people deal with life in general, stressed or not.

Image by Christian Cable via flickr

Welcoming and Releasing Emotions

Urban Monk has a powerful piece on the practice of dealing with our emotions rather than living a life of avoidance. As noted in the article, we tend to avoid people and situations that cause us pain and discomfort, because why put yourself in those situations if you don’t have to?

In our internal world, however, that does us more harm than good. It isn’t until we’re willing to face our pain and troubling thoughts that we begin to understand them and work through them to obtain a measure of peace.

The three steps outlined in the posting – awareness, relax into the raw emotion, and bypassing the mind, are pretty familiar to anyone who has ever experienced exposure therapy or engaged in any sort of meditation. From my perspective, it can be boiled down into one word – feel.

When we choose to feel, rather than think, rationalize, intellectualize – insert your favorite -ize here – we’re getting down to our raw base. Some people call it inviting the emotion in, and they facilitate it by naming what they are feeling out loud.

Pain, come in and walk around – I won’t push you away or hide from you. I’ll let myself be awash in you. All creatures feel pain. It’s okay.

Sadness, my old friend, good to see you again. Come sit with me and get soggy from my tears as I allow myself to acknowledge your presence and understand that it’s normal to feel you. You don’t last forever.

Fear, you’re intruding into my life, as you often do, so rather than wrestling with you, fighting and grappling in an intellectual cage match, I’m going to let you swirl around a bit, knowing that you have no stamina, and that you will soon pass and allow me to focus on more meaningful things.

It can be difficult to embrace and understand your emotions if you’ve been avoiding them for a time. In addition to how you react in your brain, what physical symptoms do various emotions cause?

Muscle tension is a good one for fear or panic, along with rapid pulse, increased rate of breathing, perhaps some dizziness or disorientation. Recognizing them, calling them out, is a good way to label them for what they are – physical manifestations of emotional reaction, temporary in nature, and not indicative of anything else. No pending heart attack or stroke, just your body physically reacting to emotions that you haven’t spent much time with lately.

My experience has been that once I welcomed these emotions, embraced them, named them, understood them, and let them flow through me, two distinct patterns emerged. First, the racing mind and physical symptoms tended to be less severe and the amount of time they lasted became less and less. Secondly, I found myself  with less apprehension about them when there was a possibility that they would occur. Since I knew what they are, what they did, and that I was able to acknowledge and embrace them, they lost all mystery and negative connotation. In the words of our friends from The Sopranos, it is what it is.

So I encourage you to stop avoiding your emotional side and send it an invitation to sit down for a chat. Buy it a cup of coffee or an herbal tea. Know that viewing your emotions as a necessary part of yourself that’s needed to make you a whole being should make it easier to make friends with your emotions, and learn to benefit from the lessons they hold.

We don’t always need to think and analyze and dissect. Sometimes, it’s best to just sit back and feel.

Core Practice: Welcoming and Releasing Emotions, via Urban Monk

Take Responsibility for Your Happiness

In previous postings, I’ve alluded to The Art of Happiness, a tome of collaboration between the Dalai Lama and psychologist Howard C. Cutler, M.D.

The most revealing passage from the book was something Dr. Cutler noted – that in canvassing his colleagues in the psychiatry field, none had ever noted “being happy” as a therapy goal. That seemed telling to me, because once you move away from the tactical treatment of various conditions and issues, shouldn’t being happy be the ultimate goal?

So, if doctors and therapists aren’t putting happiness on your To-Do list, how do you get there? The short answer is to take responsibility for your own happiness. But that seems like a daunting task. How does one go about charting a course to happiness?

Urban Monk has an enlightening piece (pun intended) by guest blogger John J. Patton that examines this very topic. In a section titled A Light Unto Yourself, Patton lays out some very simple and easily managed rules of the road for taking charge of your own happiness. As in most things of a Buddha nature, everything revolves around being accountable and responsible on your own, instead of looking toward outside forces to provide what you are seeking.

Here are a couple that resonated with me:

I value my inner peace more than I do winning, defending my identity, proving my point, or reactively expressing momentary emotions.

I understand that my feelings are natural, and so make no apologies for them.

I make plans for the future, but remain open in order to respond to each moment directly.

I learn from the past, but do not allow it to interfere with the present.

Though I cannot always control my thoughts, I can control which ones I pursue and give energy.

Patton’s list is a must-read for anyone who is ready to take advantage of the massive power that lies within the self. If you haven’t added being happy to your list of goals and objectives, perhaps now is the perfect time. If so, Patton’s piece is an excellent way to kick off your journey.

A Light Unto Yourself / In Case of Emergency , via Urban Monk

Germany Building a Better Anxiety Drug

Via Reuters, German scientists believe they have found a new drug for panic disorders that works effectively without many of the effects of current compounds such as Valium (drowsiness, forgetfulness) and that work much more quickly than SSRIs that can can weeks to build up effective blood levels.

The new drug, termed XBD173, appears to work by targeting a much different “panic button” in the brain than other medicines. It also appears to be both safe and fast-acting. Studies showed XBD173 began to work as quickly as one hour after being administered, which would be ideal for people having acute panic attacks.

Also promising is the discovery that there are no withdrawal symptoms once patients discontinue use of the drug. Valium and other similar compounds are well-known to present dependency challenges and unpleasant withdrawal.

Let’s hope research continues on XBD173 and we see it on the market sometime in the near future.

German research points way to better anxiety drug , via Reuters