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

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!

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

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

Repressing Trauma Not Harmful?

Anxiety Insights has the details of a Geisinger Health Center study that suggests certain people exposed to traumatic events may not suffer harm when they repress memories of those events.

“Going back to the days of Sigmund Freud, psychiatrists and mental health experts have suggested that repression of traumatic memories could lead to health problems,” Dr Boscarino said. “Yet we have found little evidence that repression had an adverse health impact on combat veterans exposed to psychological trauma many years later.”

One thing that leaps out in the article is the view that the use of exposure therapy – where people are asked to relive painful or traumatic events – may actually serve to trigger PTSD symptoms and psychological distress in those who had otherwise been doing just fine, thank you very much.

“While the dominant therapy model for PTSD should not be abandoned at this point, emerging research suggests that it might need to be seriously re-evaluated, at least for some PTSD patients,” Dr Boscarino said. “More research is clearly needed.”

Repressing traumatic memories may not be harmful to some , via Anxiety Insights

Anxiety and Insomnia – Thanks, Mom

US News and World Report has posted an abstract that details the findings of researchers in the U.S. that there might be a genetic link between anxiety, depression and insomnia.

As a result, researchers advise that adolescents who suffer from anxiety and depression should also be screened for insomnia. That seems like an excellent idea.

I’ve often wondered if my occasional (but more frequent as I get older) insomnia and my anxiety are somehow connected, and if so, if my lack of sleep problems in my youth were in any way a signal of impending emotional struggles that didn’t start until later in life.

From the article:

The researchers’ analysis of data from 749 monozygotic twin pairs and 687 dizygotic twin pairs, aged 8 to 17, and their parents revealed that 19.5 percent of the children had insomnia.

The results indicate that, as has been seen in previous studies of insomnia in adults, diagnosable insomnia in children aged 8 to 16 years is moderately likely to be inherited, according to a news release about the study. The shared genetic effects between insomnia, depression and anxiety suggest that these disorders are linked.

Since genetics plays such a key role in so many disorders, it’s not surprising that insomnia might fall into that category, and 19.5% doesn’t seem to be outside of expectations. It’s also not shocking that there’s a link between insomnia and anxiety, but I wonder if this might not qualify as a “which came first – the chicken or the egg?” scenario. Are the teens more prone to anxiety and depression because they are so worn down due to insomnia, or is one of the symptoms of anxiety the inability to exhibit normal sleep patterngens? Or both?

Not much detail in the online article, but it’s an interesting topic nonetheless.

Insomnia and Anxiety May Be Genetically Linked, via US News and World Report

Napping and Anxiety

There’s an old saying that “if you snooze, you lose.” When it comes to anxiety and depression, that might not necessarily be true.

A study conducted on children between the ages of 4-5 (what, 4 1/4, 4 7/8 – that’s how kids count it) found that kids who stopped daytime napping between these ages had parent-reported higher incidence of anxiety, depression, and hyperactivity than kids who continued to take happy naps.

Reported during SLEEP 2009, an annual meeting of sleep professionals (sure wish I qualified for that), the results shed some new light on the benefits of daytime napping. The connection between poor sleep patterns and anxiety or depression are well-documented, but many believed that children could make up for the lack of daytime napping via nighttime sleep.

The quoted study demonstrated the potential for napping to be significantly more beneficial to children’s daytime functioning compared to nighttime sleep only. Any parent can provide anecdotal evidence that kids who nap tend to be less moody and more easily entertained than children who don’t nap.

Not mentioned in the article was any connection or bias on the part of parents whose children stay awake all day. If the study relied on parental reporting of the child’s anxiety or depression, I could easily see a situation where a parents’ own emotional state could impact on the reporting, as parents of kids who don’t nap can be every bit as frazzled as the children.

The article further points out that there’s still no data to suggest an optimal age to stop napping. I’d like to recommend that we never stop napping. In fact, if I had a cot in my office, and support from management, I’d nap every day. But that’s just me.

Napping, hyperactivity, anxiety and depression linked in preschoolers, via Anxiety Insights

Nature-nurture debate continues

It’s long been held that for folks suffering from emotional and behavioral conditions such as panic, anxiety, OCD, and so on, the genesis of their disorder could be traced to heredity, or via shaping by their environment, or both. Certain people were deemed to be more genetically vulnerable than others.

Anxiety Insights reports that new studies in the area of gene-by-environment interaction (GXE) surrounding the so-called “genetic vulnerability to adversity” is causing scientists to take another look.

The new thinking is that those with the “vulnerability” gene are not only more likely to be adversely impacted by negative experiences, but also more prone to benefit from positive environments, and they are noted as being more “malleable or plastic”, not just vulnerable.

Long story short – it’s not just vulnerability, it’s that these kinds of folks are more affected by all environmental conditions, both negative and positive.

“Our analysis of many published findings suggests that one potential solution to the nature-nurture controversy is to appreciate the role played by environmental experience and the role played by heredity in shaping who we are may actually differ across people,” said Prof Belsky.

Is it just me, or does it seem like this concept isn’t really breaking any new ground?

If there is a breakthrough here, it would be using this information to expand genetic research and gnome mapping to be able to someday identify the specific hereditary factors at work, which would allow a more tailored therapy approach based on the unique DNA of each individual.

From the article: “This could mirror the trend we are now seeing towards personalized medicine, where an understanding of the genetic make-up of an individual determines the type of drugs used to treat the patient based on their DNA,” said Prof Belsky.

Reframing the Nature-Nurture Debate , via Anxiety Insights

Fear On / Off Switch?

This would be very good news for those of us who have issues with having fear, panic, and anxiety responses that don’t work as well as they should.

Researchers at Harvard Medical School’s affiliate McLean Hospital have identified a protein in the brain that serves as a trigger for how we respond to fear, real or imagined. This finding increases the chances that scientists may be able to develop medications that could help regulate this faulty fear switch in people suffering from certain types of anxiety disorders.

In the study, the researchers looked at the neurons in the amygdala of mice lacking the TRPC5 gene and discovered that they did not fire as well as those in the brains of normal mice. At the same time, neurons in the same region of the brain of the mice missing the TRPC5 gene were not as sensitive to the neuropeptide cholecystokinine, commonly released in the brain during situations of innate fear or anxiety…

Let’s hope that this research continues and that we see some pharmaceutical trials of new medications as a result.

Researchers identify a fear on-off switch , via Anxiety Insights