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New Support for a Serotonin Deficit in Depression

Source link: https://www.sciencedaily.com/releases/2022/12/221215120730.htm

Since the 1960s, researchers have postulated that major depression stems from disruptions in the serotonin neurotransmitter system, but the evidence for that idea, though plentiful, was indirect. In fact, a recent comprehensive analysis of existing studies concluded that there was not strong evidence to support the “serotonin hypothesis.” In its wake, some in the field have called for a reexamination of the hypothesis. Not so fast, says a new study that provides direct evidence of disrupted serotonin release in the brains of individuals with depression.

The study appears in Biological Psychiatry, published by Elsevier.

Depression is among the most common mental illnesses and causes of disability worldwide. Despite the lack of direct evidence for disrupted serotonin signaling in the depressed brain, medications used to treat depression overwhelmingly target the serotonin signaling system to increase extracellular serotonin, also known as 5-hydroxytryptamine (5-HT). Only about half of patients respond to antidepressants, and fewer than 30% experience total remission. A better understanding of 5-HT dynamics in depression could help guide more effective therapies.

“Our thinking about the role of serotonin in depression has evolved significantly over the past decade. We once thought that serotonin changes could account for the entirety of depression. When this simple hypothesis could no longer be supported, some were inclined to dismiss any role for serotonin in depression,” said John Krystal, MD, editor-in-chief of Biological Psychiatry. “The current study provides important new support for further exploration of the role of serotonin in depression. This is particularly timely, as drugs targeting serotonin receptors, such as psychedelics, are being explored as potential new treatments for mood disorders.”

The study, conducted by Invicro, a global, imaging contract research organization, in collaboration with researchers from Imperial College London, King’s College London, Copenhagen University, and the University of Oxford, used a novel imaging technique to look directly at the magnitude of serotonin released from neurons in response to a pharmacological challenge. In previous work, these researchers pioneered the use of positron emission tomography (PET) with the radioligand [11C] Cimbi-36 to detect serotonin release. In the current study, the researchers applied this methodology to compare serotonin release in 17 patients with depression and 20 healthy individuals.

David Erritzoe, MRCPsych, PhD, lead author of the paper, said, “This study used a new and more direct method to measure serotonin in the living human brain, and the results suggest reduced serotonin (release) functioning in depression. This imaging method, in combination with similar methods for other brain systems, has the potential to help us to better understand the varying — sometimes limited or even lacking — treatment responses that people with depression have to antidepressant medication.”

Participants with depression and healthy controls underwent PET scanning with [11C] Cimbi-36 to measure 5-HT2A receptor availability in the frontal cortex; the two groups did not differ significantly at baseline. Both groups then received a dose of d-amphetamine, a stimulant drug that works to increase 5-HT concentration outside of neurons, where it interacts with 5-HT2A receptors and reduces the binding of [11C] Cimbi-36. In a second scanning session three hours after drug administration, healthy control participants had significantly reduced 5-HT2A receptor availability, indicating an increase in serotonin levels. Participants with depression, however, did not show a significant decrease in binding potential, suggesting they had a blunted serotonin release capacity in key brain regions.

The study found no relationship between the severity of depression and the extent of serotonin release capacity deficits. Of note, all patients were free of antidepressant medication, and 11 out of the 17 had never received antidepressant treatment, indicating that low serotonin release capacity is a feature of depression rather than a result of antidepressant treatment.

This first direct evaluation of serotonin levels in the brain of individuals with depression is a major step forward in laying to rest the speculations questioning the involvement of serotonergic neurotransmission in the pathology of depression. Depression is a multifaceted disorder that may have multiple causes, and different subtypes may involve multiple neurotransmitter systems. Serotonergic dysfunction is unlikely to explain all the clinical features encountered in this disorder. Nevertheless, this study demonstrates that serotonergic deficits are present in unmedicated depressed individuals.

Eugenii Rabiner, MBBCh, FCPsych SA, at Invicro and senior author of the paper said, “It has taken our field over 20 years to develop a method that enables the measurement of serotonin release in the living human brain. I am very pleased that we managed to develop this method and apply it to clarify this important aspect of the pathophysiology of depression. I hope that we can use this technique in future to explore the different symptoms of depression, as well as serotonergic deficits found in other conditions, such as Parkinson’s disease.”

Journal Reference:

1. David Erritzoe, Beata R. Godlewska, Gaia Rizzo, Graham E. Searle, Claudio Agnorelli, Yvonne Lewis, Abhishekh H. Ashok, Alessandro Colasanti, Iro Boura, Chloe Farrell, Hollie Parfit, Oliver Howes, Jan Passchier, Roger N. Gunn, David J. Nutt, Philip J. Cowen, Gitte Knudsen, Eugenii A. Rabiner. BRAIN SEROTONIN RELEASE IS REDUCED IN PATIENTS WITH DEPRESSION: A [11C]Cimbi-36 PET STUDY WITH A D-AMPHETAMINE CHALLENGE.. Biological Psychiatry, 2022; DOI: 10.1016/j.biopsych.2022.10.012

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What Gives Meaning to Our Lives?

Source link: https://www.psychologytoday.com/intl/blog/longing-nostalgia/202003/what-gives-meaning-our-lives?collection=1137432

New research finds a sense of “mattering” may matter more than other factors.

When we think of a crisis, we imagine a situation that is serious and urgent, imperative to address without delay. It can also be considered a turning point, such that life will never be the same again. The decisions made during a crisis will likely affect the nature and quality of life for the future. Some crises, like natural disasters or traumatic accidents, are dramatic upheavals accompanied by intense emotions. Others may be more insidious, arriving and intensifying more gradually.

In sudden events, the realization that life will change dramatically comes soon after urgent needs are met and the imminent threats have resolved. But the impact of crises that develop more gradually is often not obvious and, in some cases, is only fully appreciated with time. During either type of crisis, threats to health or safety awaken and clarify what is most important and what gives meaning to our lives.

Unfortunately, a pronounced sense of meaninglessness seems to exist among young people. In a recent survey of a representative national sample of 1,700 Americans, a majority (59%) of adults 65 years and older strongly agreed that their life has meaning, in contrast to only 36% of those 18 to 29 years old.

Are an increasing number of young adults experiencing lives empty of essential meaning? Research suggests that a sense that one’s life is meaningful is correlated with healthier behaviors, such as exercise and better diet, greater life satisfaction, and a lower incidence of depression. Conversely, a sense of emptiness of purpose or value in life has been associated with unfavorable indicators such as depression, anxiety, and suicide. The association of depression and suicidal ideation with weak assurance of meaning in life suggests that many people are experiencing a crisis of meaning. 

In The Rebel, Albert Camus argued: “If we believe in nothing, if nothing has any meaning and if we can affirm no values whatsoever, then everything is possible and nothing has any importance.”

Recent research has shed light on what constitutes a person’s sense of meaning in life (Costin & Vignoles, 2020). One prominent theory views meaning in life as comprised of three facets: coherence, purpose, and mattering.

  • Coherence refers to making sense of one’s experiences or the world at large. A high sense of coherence is the feeling that there is order to the world or that what happens to us makes sense.
  • Purpose refers to the belief that one’s life is justified by a life aim that can be pursued and a vision of how life ought to be.
  • Mattering refers to the experiences of value and worth that transcend superficial passing situations and events. Mattering means feeling that one’s behaviors make a difference and that life is worth living. More importantly, mattering refers to a person’s feeling that they matter.

The research suggests that of the three dimensions, a sense of mattering is most predictive of overall meaningfulness in life. Although further research is needed, preliminary work suggests that mattering is enhanced by rising above petty things and exclusive self-interest. Understanding our role in the broader social landscape can yield insight into the significance of our life and of our self.

Appreciating the impact we have on others, especially on those to whom we will one day pass the torch, strengthens our recognition that we and our lives matter. Most parents understand what matters most when they see their child’s spontaneous expressions of joy, need, fear, and love. What matters is even more evident in their child’s rapid growth toward independence.

The significance of one’s life is affirmed when we ponder the legacy we will leave behind in those who have been affected by us—by how we have interacted with them, by who we are, and by how we have lived and loved. The anguish we once felt over pricey purchases or fashion choices fades in the face of a loved one’s life-threatening illness or life-changing injury. Arguments over homework or practicing for music lessons become trivial when a child’s life or wellbeing is threatened.

We don’t need to wait for a crisis to know what really matters. We can remind ourselves of what really counts before we ever find ourselves in the midst of one.

The most valuable gift we can give to one another is the conviction that they matter. As noted nearly 2,000 years ago, faith, hope, and love endure, but the greatest of these is love. Faith in the coherence of life even when we can’t understand it and hope in fulfilling our purpose in life are important to our psychological wellbeing. But ultimately, feeling that one’s life is worth living flows from having been loved and from loving another. During the most difficult times, the most life-sustaining resource we can extend to another is the affirmation that they are loved.

References

Costin, V., & Vignoles, V. L.  (2020).  Meaning is about mattering:  Evaluating coherence, purpose, and existential meaning as precursors of meaning in life judgments.  Journal of Personality and Social Psychology, 118, 864-884.

Ekins, E.  (2019).  Poll:  Who finds the most meaning in their lives?  Cato Institute.

Kleiman, E. M., & Beaver, J. K.  (2013).  A meaningful life is worth living:  Meaning in life as a suicide resiliency factor.  Psychiatry Research, 210, 934-939.

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Same Mental Illness, Different Perception Of Reality — DSM (Defeating Stigma Mindfully)

The subjectivity related to the field of mental health has a lot to do with the many different versions of a particular mental illness. Someone with MDD may by suffering from a decreased appetite and sleep, while another person with atypical depression may be experiencing an increased appetite and sleep. Mental illness may affect everyone differently even if the diagnosis is the same. That’s why we cannot assume that we understand what everyone is going through. . .

via Same Mental Illness, Different Perception Of Reality — DSM (Defeating Stigma Mindfully)

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Socially Depressed — DSM (Defeating Stigma Mindfully)

For children and adolescents, staying at home may not be so bad; they get to play more video games, read more books or indulge in whatever activity they always craved when they used to be in school. But I’m sure some adolescents are also feeling depressed as they cannot gather in their social cliques as frequently as they used to. There’s no doubt that social distancing is increasing the rate of depression worldwide.

via Socially Depressed — DSM (Defeating Stigma Mindfully)

Post-lockdown
HeartyPsych PsychWELLNESS

Life after Lockdown: Don’t Let Your Guard Down Just Yet

As countries begin easing out lockdown, we are entering a world of new normal. If you think your life is going to be just like it used to be before the COVID-19 pandemic hit the country, you are probably mistaken. The researchers are trying hard to develop a safe and effective coronavirus vaccine as quickly as possible. But meanwhile, we need to be extra careful and be mentally, emotionally, and physically prepared to manage life amid coronavirus scare. This definitely entails drastic changes in our daily routines and habits, and at the same it requires some constant and continued efforts on our part as well. Here are a few things that we have to keep in mind as we now enter the post-lockdown phase. But before that let’s first remind ourselves that the purpose of lockdown, among other things, was to raise public-awareness about how grave the COVID-19 situation is. Therefore, even after the lockdown gets over, we cannot let our guard down just yet because the virus is still around.

hand-disinfectionFrequent reminders: As the lockdown ends, we are going back to our jobs and businesses. So we are now bound to spend more time outside our house, working, commuting, etc. As the activities become regular and part of our daily routine, complacency may set in leading to carelessness in following the health guidelines in all seriousness. We may no longer wash our hands as frequently as before or may overlook wearing mask or observing personal distancing while talking to our co-worker. This could increase our chances of exposure to the virus. Therefore, what we need is constant reminders. Placing sticky notes on your computer at work-place for reminding you of staying safe by wearing face-mask, gloves, or using sanitizer, can be of great help in this regard. Make sure that these reminders are conspicuous enough to grab your attention.

The office-management should place such reminders at various places in the office, such as on every table of the office canteen, inside and outside common restroom, at the entry and at each employee’s desk. You can also set wallpaper on your phone and computer to remind you of following the preventive measures set by the health department.

Herd-Behavior: Once you go out to work after lockdown, you are at risk of falling prey to a behavioural pitfall called herd-behavior, which could be more dangerous if you are surrounded by people who are a bit easy-going. Herd behaviour is a phenomenon where an individual’s thoughts and behaviors get aligned to what majority of the group thinks or behaves. Being aware of this phenomenon will help you stick to your beliefs and actions and maintain healthy behavior. Challenging herd behavior will require recognition of the phenomenon and being ready to stand out.

A new normal: Post-lockdown, you are going to enter a world of new normal where you have to greet your colleagues and seniors at work-place from a distance and without a handshake; you have to stop touching your face to avoid infection; and you have to limit socializing with your family and friends. All of these are easier said than done because these are habits that we have acquired over a long period of time and making a change in them requires a constant effort. However, until there is any cure for corona, we have no other way but to accustom ourselves to this new normal. During this phase, we might also have to add an activity or two, to our daily routine, such as taking a second bath as we come back home from office, before joining our family members. Remember all this will take time to become part of our daily repertoire, so a few slip-ups are bound to happen, which could add embarrassment to the self or bring quick judgement from others. Don’t let it affect you and cause anxiety. Remember! a habit takes on an average two months to form. So don’t let a few goof-ups derail you or demoralize you.

Don’t get offended: We also need to be more accepting of our friends and relatives who turn down our offer of a quick meet-up in order to maintain social distance. Don’t criticize them for being overly cautious. Remember! when your friend or a family member chooses to maintain distance from you, it is not just for his or her own safety, rather it shows the concern for your safety as much. So, next time when your office colleague wishes to sit on a table at some distance from yours for lunch, don’t get offended; rather appreciate and respect his wish to maintain social distancing. Don’t let this temporary phase affect your permanent and long-term relationships with your colleagues, friends, and family members.

Beware of the Health-Belief Model of Perceived Susceptibility: You also need to be aware of the health-belief model that prevents people from following a healthy lifestyle or giving up a risky health behavior (smoking, drinking, etc) even though a competing evidence is present, as they believe that they somehow are not at risk or it cannot happen to them. The same goes for coronavirus situation too. Therefore, don’t let this belief set in that you probably will not get COVID-19. You will have to constantly challenge this belief and remind yourself of this belief model.

Follow the Health-Belief Model of Perceived Severity: There is another health-belief model of perceived severity which suggests that individuals who perceive a given health problem as serious are more likely to engage in behaviors that prevent health problems from taking place. Accordingly, if you keep considering coronavirus a serious health condition, you will probably engage in behaviors that prevent it from occurring.

Don’t panic, take responsibility instead: Now that the lockdown is gradually being lifted in various parts of the world, the responsibility of fighting this pandemic lies with you. At present, you are the controller of the behavioral choices you make and it is up to you whether you choose to follow the government advisories or not. This is the time to show your real self. Take this responsibility with full determination and don’t panic. Believe that you have every control over the situation as long as you follow the guidelines. Having a sense of control will prevent undue worry, stress, and anxiety. Remember! post-lockdown, the control lies with you.

mental healthDon’t neglect: As we fight this deadly pandemic, we might be neglecting some other health conditions that warrant our equal attention. Psychological impact of COVID 19 alone requires a great deal of attention and need to be addressed as soon as possible. Anxiety, panic attacks, depression, risk of self-harm, and even post-traumatic stress disorder (PTSD) are some of the common outcomes of any natural disaster, COVID-19 being no exception. Some of you might have postponed your regular visit to your physician at the cost of your physical well-being. Whatever may be the case, it is imperative that you seek professional help to deal with your psychological or physical issues in order to ensure that your mental and physical health doesn’t suffer amid this COVID -19 crisis.

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Pseudobulbar Affect

Arthur Fleck's uncontrollable laughterThose of you who have watched Joaquin Phoenix’s Oscar-winning performance in Joker, would agree that one of the most striking traits of Arthur Fleck’s character is his uncontrollable laughter. Although the movie never names the specific conditions Fleck is diagnosed with, his fits of laughter are likely based on a real disorder called pseudobulbar affect.

Pseudobulbar affect (PBA) or emotional incontinence is a condition characterized by episodes of uncontrollable laughing or crying or some other emotional displays. PBA may occur in people with neurologic disorder such as multiple sclerosis or brain injuries, or stroke. As the involuntary outbursts can last from seconds to several minutes at a time, PBA can feel extremely alienating for the person living with it. Patients may find themselves crying or laughing uncontrollably at something that is only moderately sad or funny, respectively. These laughing or crying periods not only land the patients up in uncomfortable situations, but are also exhausting and painful too. Severe symptoms of PBA can lead to embarrassment, social isolation, anxiety, and depression. The condition can be quite disruptive to the patient’s life but fortunately, it is treatable. As with any sharp shift in mood, the most important thing to do is consult a professional as soon as possible.

 

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Being Open About Depression — DSM (Defeating Stigma Mindfully)

You’d be surprised how many people suffer from depression. People who you would never expect to experience depressive symptoms, may have been suffering for years. Depression is not always how we envision: someone who appears sad, disheveled, does not talk much and appears tearful all the time. Being open about depression is something that we should all be doing.

via Being Open About Depression — DSM (Defeating Stigma Mindfully)

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The Invisibility Of Depression — DSM (Defeating Stigma Mindfully)

 

Sadness In The Shadows

Depression is like an invisible dark cloud that hovers in the stratosphere, looming all around us and ready to attack when in our weakest states of mind. The invisibility of depression can be observed through the actions of those affected: avolition, abulia, apathy, anhedonia and more. Sadness in the shadows is much more common than you would think.

via The Invisibility Of Depression — DSM (Defeating Stigma Mindfully)

sad man
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8 Ways to Overcome Sadness

We all experience sadness at some point or other in our lives. Pondering on the sad thoughts and feelings again and again, can keep people from overcoming sadness. For those who are suffering from depression or are going through an emotionally tough phase, it becomes all the more difficult to stop feeling the way they are. Sometimes, such individuals feel frustrated at why they can’t just stop feeling sad or why can’t they just snap out of their sadness. Another difficulty they face is that other people around them believe the former have control over such emotions, not realizing that a depressed or sad person doesn’t enjoy being sad or unhappy and that he himself too wants to feel good but is somehow unable to do so. It is, therefore, important for all of us to understand that emotions don’t work as simply as we expect them to; and so, you can’t just put a stop to the emotion of sadness altogether. However, what you can surely do is to pause the feelings of sadness, anxiety, guilt, anger, or feelings of being worthless for some time. Here are a few ways that can help you overcome sadness and make you feel better; these may be considered components of your first-aid kit:

1. Distract: A significant characteristic of depression is rumination. A person who is feeling sad or depressed often ruminates on negative thoughts which, in turn, increases the feelings of sadness. To get rid of the habit of ruminating, you should try to distract yourself by watching TV, reading, listening to music or anything that you find enjoyable. The idea is to keep your mind occupied.

2. Use mantra: You can design your mantra which you can recite whenever negative thoughts come to your mind. This can be a serenity prayer, an inspiring quote, or you can just simply repeat saying OM or one.

3. Physical exercise: There is ample research to prove that exercising helps uplift mood. Exercise makes your body release feel-good hormones called endorphins which help lower feelings of sadness and depression. So when you feel sad or down, go out for a walk or hit the gym.

4. Practice gratitude: Research has shown that being grateful helps increase happiness. So whenever you encounter negative thoughts, focus on the things you are grateful for. Concentrate on what you have rather than what you don’t.

5. Write down your feelings: You can make a pact with yourself that every time a negative thought comes to your mind, instead of ruminating over it you will write them down in a journal and close the book. Give outlet to your feelings without overthinking.

6. Let things take their own course: Sometimes, when you try to control things, they take control over you. So rather than trying to control each and everything, free yourself and let things take their own course. Take things as they come and as they are.

7. Read biographies: Reading biographies of inspiring people will help you learn better coping skills and will help you realize that hardships and difficulties are part of life. What matters is how you perceive and approach them. Taking hardships and difficulties as challenges will definitely change your outlook towards them and will help you deal with your situation properly.

8. Challenge your thoughts: Whenever negative thoughts creep in to your mind, challenge them. Don’t surrender to negative feelings; confront such feelings instead. You will find that most of your thoughts don’t even have any base and are just creation of your mind and imagination.

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Depression Without the Depressed Part? — Mental Health @ Home

Chances are the first thing that comes to most people’s minds when they think about depression is depressed mood, right? But while depressed mood is often a major part of depressive illnesses, sometimes it plays a minor role and other times it’s not present at all. The symptoms of depression are (must have one of […]

via Depression Without the Depressed Part? — Mental Health @ Home

Man smoking in the dark
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Smoking may Increase Risk of Depression and Schizophrenia: Study

A new study, published in the journal Psychological Medicine, has revealed that smokers may be at greater risk of developing depression and schizophrenia. The study conducted by a team of scientists from the UK’s University of Bristol has re-emphasized that smoking can adversely affect mental health.

Instead of focusing on whether the smokers had a genetic predisposition to depression or schizophrenia, the scientists used genetic data to observe cause-and-effect relationships with smoking. Robyn Wootton, the study’s lead author, said in a statement, “Individuals with mental illness are often overlooked in our efforts to reduce smoking prevalence, leading to health inequalities. Our work shows that we should be making every effort to prevent smoking initiation and encourage smoking cessation because of the consequences to mental health as well as physical health.”

Data from 462,690 people of European ancestry was examined for this study using an approach known as Mendelian randomization. The latter involves identifying genetic variations associated with a trait, such as depression or schizophrenia, and then testing for those variations against an exposure, such as smoking, in a group of subjects. This enables scientists to examine whether this relationship is causal or not.

The scientists concluded that whereas smoking increased the risk of depression and schizophrenia, individuals with depression and schizophrenia are also more liable to smoke. The authors, however, noted that the association was weaker in those with schizophrenia. The team further found that smoking also increases the risk of bipolar disorder, in another Mendelian randomization study published in September 2019. The scientists recommended that psychiatric hospitals be made smoke-free to prevent harmful effects on mental health.

On the other hand, a retired consultant psychiatrist and honorary professor at University College London and Queen Mary University of London, David Curtis, although not involved in the study, interprets its results differently to the authors.

Curtis says he doesn’t think it’s plausible that smoking acts directly on the brain to increase schizophrenia risk, and the results likely show the effect of mothers’ smoking when they were pregnant—a risk factor for schizophrenia. “So what we are likely seeing is that the mothers of people with schizophrenia were at a higher genetic risk of smoking, smoked during pregnancy and thereby increased the risk of schizophrenia developing in their children,” Curtis said in a statement. “And of course they would then also pass on an increased genetic risk of smoking to those children, which is what this study is picking up,” he added.

According to a Lancet Psychiatry Commission report published in July 2019, people with mental illness die up to 20 years earlier than the general population. Another study published in the journal JAMA Psychiatry in January 2018 found that the use of either marijuana or cigarettes is related to a greater risk of psychotic-like experiences in teenagers. Psychosis  is a mental condition characterized by a disconnection from reality causing hallucinations or delusions.

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Ten Different Types of Depression and the Things to Look for — Top 10 of Anything and Everything – The Fun Top Ten Blog

You might be thinking it is easy to spot signs of depression in people, but that is not the case at all. In fact, there are lots of different types of depression…

via Ten Different Types of Depression and the Things to Look for — Top 10 of Anything and Everything – The Fun Top Ten Blog

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Vitamins for Depression — Psych Central

In trying to cope with the debilitating symptoms of depression, people often turn to vitamins, supplements, herbs, or home remedies first. And it’s no wonder — such efforts to alleviate symptoms are often far less expensive and easier to obtain. For some, it may be a part of their rationalization that their depression “isn’t all […]

via Vitamins for Depression — Psych Central

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Positive Psychology – The Secret to Optimal Well-being — Damon Ashworth Psychology

 

For many years, Psychology, following in the footsteps of Medicine, was preoccupied with the alleviation of suffering. A worthy objective, but the treatments were focused on how to reduce depression or anxiety, not how to increase happiness. Does not feeling bad equate to the same thing as feeling good? If someone is no longer feeling […]

via Positive Psychology – The Secret to Optimal Well-being — Damon Ashworth Psychology