Immune to Stress?

Following on from last Friday’s post on the beneficial effects of stress hormones, we bring you news of study that helps us to better understand the stress process at a cellular level and how stress can lead to mood disorders.

The new research from Ohio State University, published in The Journal of Neuroscience, shows that certain cells from the immune system are recruited to the brain during stress, causing symptoms of anxiety.

Researchers discovered the dynamic mind-body interaction – a two-way communication from the central nervous system to the rest of the body – and back to the central nervous system that ultimately influences behavior during prolonged stress.

Under prolonged stress, the brain sends signals out to the bone marrow, calling up monocytes. The cells travel to specific regions of the brain and generate inflammation that causes anxiety-like behavior.

In experiments conducted in mice, researchers showed that repeated stress exposure caused the highest concentration of monocytes migrating to the brain. The cells surrounded blood vessels and penetrated brain tissue in several areas linked to fear and anxiety, including the prefrontal cortex, amygdala and hippocampus, and their presence led to anxiety-like behavior in the mice.

“In the absence of tissue damage, we have cells migrating to the brain in response to the region of the brain that is activated by the stressor,” said John Sheridan, senior author of the study. “In this case, the cells are recruited to the brain by signals generated by the animal’s interpretation of social defeat as stressful.”

The mice in this study were subjected to stress that might resemble a person’s response to persistent life stressors. In this model male mice were given time to establish a hierarchy, and then an aggressive male was added to the group for two hours. This elicits a “fight or flight” response in the resident mice as they are repeatedly defeated. The experience of social defeat leads to submissive behaviors and the development of anxiety-like behavior.

Mice subjected to zero, one, three or six cycles of this social defeat were then tested for anxiety symptoms. The more cycles of social defeat, the higher the anxiety symptoms. For example, the mice took longer to enter an open space and opted for darkness rather than light when given the choice. Anxiety symptoms corresponded to higher levels of monocytes that had traveled to the animals’ brains from the blood. Additional experiments showed that these cells did not originate in the brain, but traveled there from the bone marrow.

Exactly what happens at this point in the brain remains unknown, but the research offers clues. The monocytes that travel to the brain don’t respond to natural anti-inflammatory steroids in the body and have characteristics signifying they are in a more inflammatory state.

These results indicate that inflammatory gene expression occurs in the brain in response to the stressor.

These findings do not apply to all forms of anxiety, the scientists noted, but they are a game-changer in research on stress-related mood disorders.

“Our data alter the idea of the neurobiology of mood disorders,” said Eric Wohleb, a pre-doctoral fellow in Ohio State’s Neuroscience Graduate Studies Program. “We’re saying something outside the central nervous system – something from the immune system – is having a profound effect on behavior.”

Stress and Distress at Work

Here’s a classic Catch-22 conundrum for co-workers to consider. Psychological distress, such as feelings of  worthlessness, hopelessness, nervousness, and/or restlessness)  can be predictors  of early stage anxiety and depression. It can also lead to decreased job productivity and absenteeism. But, it may actually be the job that’s creating the mental distress in the first place. Norwegian researchers have identified that perceived role conflicts and emotional demands are the most important and most consistent risk factors for psychological distress. While other psychosocial working conditions have been linked to distress, this study is the first to highlight the importance of these two issues. Håkon A. Johannessen, PhD, and colleagues from the Norwegian National Institute of Occupational Health, looked at how the work environment affected employees’ levels of psychological distress. Sixteen percent of workers said they were at least slightly bothered by psychological distress over the past month. The study focused on two main risk factors: role conflict, such as being given work tasks without enough resources to complete them and receiving contradictory requests from different people; and emotional demands, defined as “dealing with strong feelings such as sorrow, anger, desperation and frustration” at work. Problematic levels of distress were 53% more likely for workers reporting role conflict and 38% more likely for those facing high emotional demands. Other risk factors were low job control, bullying/harassment, and job insecurity. The researchers conclude that employers should focus on the identified risk factors to improve the psychosocial work environment and thus promote good mental health and productivity among employees. Is your job getting you down? Have you any tips for beating work-related stress?  We’d love to hear from you.

Honoring Our Military

Today, Veterans Day, our nation honors the men and women who have served our country. Cities host parades, department stores have sales, schools and the Federal Government close. Most of us are thankful for a day off. But how many of us will stop and think about the tremendous sacrifices made by those in the military community – the risks they take and the burdens they carry? And how many of us will take the time to reflect on how families and lives are forever changed as a result of war?

Since September 11, 2001, over 2 million men and women have deployed to fight the wars in Iraq and Afghanistan – many of these have deployed multiple times.  During this time, countless family members have suffered through multiple separations. And let’s not forget the 5,798 American men and women who have died during these wars or the 40,000 who have come home with significant physical injuries. In addition, many of our troops come home with invisible injuries of war including post traumatic stress, traumatic brain injury, depression and anxiety.

Sadly, a large number of those who suffer these invisible injuries fail to seek the care that they so need and deserve. The stigma associated with seeking mental health care and our cultural reluctance to admit mental health concerns prevents many of the brave men and women in our armed forces from obtaining proper treatment.

Families are suffering. A recent study in the journal, Pediatrics, found that young children in military families are about 10% more likely to see a doctor for a mental health difficulty when a parent is deployed than when the parent is home. Social scientists have long known that the cycle of deployment and reintegration puts a significant strain on the families of those who serve, particularly spouses. Given that the conflict in Iraq has been underway for over seven long years, tens of thousands of military children have only known the experience of war.

While most civilians are familiar with the terms “post traumatic stress” and “traumatic brain injury” it is striking how little the average person knows about these very understandable, yet potentially devastating, consequences of war.  Movies and television programs often portray veterans suffering with post traumatic stress as out-of-control and hyper-aggressive. While difficulties with impulse control and rage are indeed possible manifestations there is a range of other symptoms and reactions that are less well known. Some withdraw and become disengaged from those around.  Others have difficulty finding meaning in life, while others may experience anxiety, flashbacks and severe sleep disturbance. Sometimes the painful mental health symptoms that result from the experience of war lead to self-medication and substance abuse and suicide. Then there is the dramatic increase in the number of suicides reported by active duty personnel as well as those who have separated from the military.

Some members of our military community come home to families that cannot possibly understand what they have seen or done. Unable to bridge the gap between who they were when they deployed and who they are upon return, our service members find themselves in relationships that falter and marriages that fail.

But there is reason to hope. Many within government and Veterans Affairs, the academic community, the nonprofit sector, the entertainment industry, and caring individuals in communities across the country are stepping up to assist those who serve our country and their families.

The rest of us can help by recognizing and accepting psychological injuries of war and encouraging our veterans to receive proper care and treatment in a timely manner.  Together, we can stem the tide of suicides and save hundreds of thousands of service members who have come home from war with injuries that they alone cannot heal. In order to be successful in this mission, however, we must harness the goodwill, the knowledge, the resources and the commitment of a thankful nation that recognizes the sacrifices made by so few for so many.

SRxA’s Word on Health would like to honor and thank all of our Veterans.

Goodnight, sleep tight, don’t let the bedbugs…make you paranoid!

SRxA’s Word on Health bloggers have been keeping a watchful eye on the impact of the recent bedbug outbreak on North Americans’ health.  Although bedbugs present only a mild threat to physical health, their impact on psychological well-being can be more serious.

Anxiety, paranoia and stress are common results of the social rejection some bedbug victims face.  Bedbugs not only consume a person’s blood, but also a person’s social interactions:  Can a victim hug her family?  Can she have guests over?  Is it okay for her to sleep at a friend’s place?  Even the decision to tell friends and colleagues about a bedbug infestation can cause distress.

The Toronto Globe and Mail reports that social rejection can occur in the workplace as well.  After a sleepless night in her condo, one victim showed up to work groggy and on edge. When her co-workers asked if she was okay, she broke down into tears and confessed she might have bed bugs.  They responded, ‘We’re going to support you, but we’re not going to touch you or go near you,’ the victim recalls.

People whose homes are infested with bedbugs face social stigmas.  Although even top-tier luxury hotels have fallen victim of bedbug infestations, the stereotype still exists that infestations are caused by a person’s dirtiness or poor hygiene.

SRxA’s Word on Health is pleased to learn that online support forums are available.  While some sites provide tips on how to prevent bedbugs, others such as BedBugger.com, specifically address the anxiety, paranoia and stress they cause.

Sweet Dreams!

Mood Monitoring

Word on Health was interested to hear about a simple, free online diagnostic tool that helps patients and primary care doctors screen for four common psychiatric illnesses: depression, bipolar disorder, anxiety disorders and post-traumatic stress disorder.

Developed by M-3 Information and validated by researchers at the University of North Carolina at Chapel Hill, the 27-item questionnaire can detect a mood disorder with approximately 80% accuracy.

This is good news for the 1 in 10 Americans who suffer from depression and other mental-health disorders but never receive treatment because they don’t understand what’s wrong.

Bradley Gaynes, M.D., M.P.H, lead author of the study and an associate professor of psychiatry in the University of North Carolina at Chapel Hill School of Medicine said “For millions of people, a single tool that can screen for multiple disorders would be very helpful.”

M-3 has also developed a mobile phone version of the checklist that will be released shortly.  In the meantime, Word on Health readers can take their mental health pulse at http://www.mymoodmonitor.com/