Early life pain alters neural circuits in the brain that regulate stress, suggesting pain experienced by infants who often do not receive analgesics while undergoing tests and treatment in neonatal intensive care may permanently alter future responses to anxiety, stress and pain in adulthood, a research team led by Dr. Anne Murphy, associate director of the Neuroscience Institute at Georgia State University, has discovered.
n estimated 12 percent of live births in the U.S. are considered premature, researchers said. These infants often spend an average of 25 days in neonatal intensive care, where they endure 10-to-18 painful and inflammatory procedures each day, including insertion of feeding tubes and intravenous lines, intubation and repeated heel lance. Despite evidence that pain and stress circuitry in the brain are established and functional in preterm infants, about 65 percent of these procedures are performed without benefit of analgesia. Some clinical studies suggest early life pain has an immediate and long-term impact on responses to stress- and anxiety-provoking events.
The Georgia State study examined whether a single painful inflammatory procedure performed on male and female rat pups on the day of birth alters specific brain receptors that affect behavioral sensitivity to stress, anxiety and pain in adulthood. The findings demonstrated that such an experience is associated with site-specific changes in the brain that regulate how the pups responded to stressful situations. Alterations in how these receptors function have also been associated with mood disorders.
The study findings mirror what is now being reported clinically. Children who experienced unresolved pain following birth show reduced responsiveness to pain and stress.
- Research finds pain in infancy alters response to stress, anxiety later in life (eurekalert.org)
- Research finds pain in infancy alters response to stress, anxiety later in life (medicalxpress.com)
“Give sorrow words.” – Malcolm in Shakespeare’s “Macbeth”
Can simply describing your feelings at stressful times make you less afraid and less anxious?
A new UCLA psychology study suggests that labeling your emotions at the precise moment you are confronting what you fear can indeed have that effect.
The psychologists asked 88 people with a fear of spiders to approach a large, live tarantula in an open container outdoors. The participants were told to walk closer and closer to the spider and eventually touch it if they could.
The subjects were then divided into four groups and sat in front of another tarantula in a container in an indoor setting. In the first group, the subjects were asked to describe the emotions they were experiencing and to label their reactions to the tarantula – saying, for example, “I’m anxious and frightened by the ugly, terrifying spider.”
“This is unique because it differs from typical procedures in which the goal is to have people think differently about the experience – to change their emotional experience or change the way they think about it so that it doesn’t make them anxious,” said Michelle Craske, a professor of psychology at UCLA and the senior author of the study. “Here, there was no attempt to change their experience, just to state what they were experiencing.” …
- That giant tarantula is terrifying, but I’ll touch it: Expressing your emotions can reduce fear (sciencedaily.com)
- That Giant Tarantula Is Terrifying, but I’ll Touch It (zen-haven.dk)
- Expressing Your Emotions Can Reduce Fear (sott.net)
- ‘That Giant Tarantula Is Terrifying, but I’ll Touch It’ – Expressing Your Emotions Can Reduce Fear (psychologicalscience.org)
- That giant tarantula is terrifying, but I’ll touch it (universityofcalifornia.edu)
- That giant tarantula is terrifying, but I’ll touch it (eurekalert.org)
- Speaking Out Your Fears Helps You Face Them (techie-buzz.com)
- How To Live Fearlessly (psychologicalscience.org)
- Fear, Spiders and the Perception of Threat (psmag.com)
And if so, is the workplace still drug free??? And if an employee would prefer not to follow advice on using a drug??
A top executive I know recently decided to takeInderal before making high-pressure/high-anxiety presentations. The impact was immediate. She felt more relaxed, confident and effective. Her people agreed.
Would she encourage a comparably anxious subordinate to take the drug? No. But if that employee’s anxiety really undermined his or her effectiveness, she’d share her story and make them aware of the Inderal option. She certainly wouldn’t disapprove of an employee seeking prescription help to become more productive.
No one in America thinks twice anymore if a colleague takes Prozac. (Roughly 10% of workers in Europe and the U.K. use antidepressants, as well). Caffeine has clearly become the (legal) stimulant of business choice and Starbucks its most profitable global pusher (two shots of espresso, please).
Increasingly, prescription ADHD drugs like Adderall, dedicated to improving attention deficits, are finding their way into gray market use by students looking for a cognitive edge. When one looks at existing and in-the-pipeline drugs for Alzheimer’s and other neurophysiological therapies for aging OECD populations with retirements delayed, the odds are that far more employees are going to be taking more drugs to get more work done better….
- Should Your Boss Encourage You to Take Drugs? (thehealthcareblog.com)
- Should Your Boss Encourage You to Take Drugs? (blogs.hbr.org)
- FDA Warns of Counterfeit Adderall Sales (whnt.com)
- FDA Warns of Fake Version of ADHD Drug Adderall (news.health.com)
- FDA Warns Over Fake Adderall Drugs (myfoxphilly.com)
From a 17 May 2011 Medical News Today article
For the first time, researchers at McMaster University have conclusive evidence that bacteria residing in the gut influence brain chemistry and behaviour.
The findings are important because several common types of gastrointestinal disease, including irritable bowel syndrome, are frequently associated withanxiety or depression. In addition there has been speculation that some psychiatric disorders, such as late onset autism, may be associated with an abnormal bacterial content in the gut.
“The exciting results provide stimulus for further investigating a microbial component to the causation of behavioural illnesses,” said Stephen Collins, professor of medicine and associate dean research, Michael G. DeGroote School of Medicine. Collins and Premysl Bercik, assistant professor of medicine, undertook the research in the Farncombe Family Digestive Health Research Institute.
The research appears in the online edition of the journal Gastroenterology. ….
- When a Loved One Has PTSD (everydayhealth.com)
- How Trauma Leads to Depression (everydayhealth.com)
- Depression and Anxiety After a Natural Disaster (everydayhealth.com)
- Post Traumatic Stress Disorder: Diagnostic Criteria (brighthub.com)
- Help for Post-Traumatic Stress Disorder (everydayhealth.com)
- Child soldier trauma in Uganda shares similarities with Northern Ireland (eurekalert.org)
- Psychological Scarring to Palestinian and Israeli Children when Exposed to War (hellerbrittani.wordpress.com)
- Teachers-based intervention provides stress resistance in war-exposed children (eurekalert.org)
- How to Help Children Cope With a Dangerous World (health.usnews.com)
University Park, Pa. — Just as the constant pressure soldiers face on the battlefield can follow them home in the form of debilitating stress, African-Americans who face chronic exposure to racial discrimination may have an increased likelihood of suffering a race-based battle fatigue, according to Penn State researchers.
African-Americans who reported in a survey that they experienced more instances of racial discrimination had significantly higher odds of suffering generalized anxiety disorder (GAD) some time during their lives, according to Jose Soto, assistant professor, psychology.
Generalized anxiety disorder has both psychological and physical symptoms that are so severe that they can significantly affect everyday tasks and job performance. People with the disorder may have chronic worrying, intrusive thoughts and difficulty concentrating. Physically, the disorder may manifest such symptoms as tension headaches, extreme fatigue and ulcers. Some of these symptoms are associated with “racial battle fatigue,” a term coined by William A. Smith, associate professor, University of Utah….
Broader psychological impact of 2010 BP oil spill
Spill caused significant psychological impact even to nearby communities not directly touched by oil
Baltimore, MD – Feb. 17, 2011. The explosion and fire on a BP-licensed oil platform in the Gulf of Mexico in April 2010 had huge environmental and economic effects, with millions of gallons of oil leaking into the water for more than five months. It also had significant psychological impact on people living in coastal communities, even in those areas that did not have direct oil exposure, according to researchers at the University of Maryland School of Medicine who worked in collaboration with the University of Florida, Gainesville. Study results will be published in the February 17 online edition of Environmental Health Perspectives, a publication of the National Institutes of Health.
“We found that people living in communities with and without direct oil exposure had similar levels of psychological distress. People in both groups showed clinically significant levels of depression and anxiety. Also, where compared to people whose income was unaffected by the disaster, people with spill-related income loss in both groups had higher rates of depression, were less resilient and were more likely to cope using ‘behavioral disengagement,’ which involves just ‘giving up’ trying to deal the problem,” explains Lynn Grattan, Ph.D., associate professor of neurology at the University of Maryland School of Medicine.
The Maryland investigators, who traveled to the region soon after the spill, worked with Gulf Coast community leaders to get “real-time” assessments of the acute impacts of the spill. Their goal was to measure the acute psychological distress, coping resilience and perceived risk (concerns about the environmental impact and potential health consequences) of people living along the Gulf Coast. By doing this, they could help identify the potential mental health needs of the Northwest Gulf Coast communities. They examined the psychological impact in two fishing communities: Baldwin County, Alabama, and Franklin County, Florida. Baldwin County had direct oil exposure; Franklin County did not. The researchers defined indirect impact as a place where oil did not physically reach the coastline, but where anticipation of the oil spread significantly affected the community’s recreation, tourism and fishing industries.
“The findings of these University of Maryland researchers may have important implications for planning public health response in similar situations, suggesting that a broader approach may needed,” adds E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine.
The people in Florida, where oil had not reached shore, showed similar elevated levels of anxiety and depression as those living in Alabama who had direct oil exposure. Both groups had similar high levels of worry about the impact of the spill on the environment, health and seafood safety.
However, the levels of psychological distress were higher in both communities among people who had suffered income loss because of the spill. They had significantly more tension, anger, fatigue and overall mood disturbance than those whose income was not adversely affected. These people also had lower scores on resilience and may have fewer psychological resources to bounce back from adversity.
“From a public health standpoint, we need to understand that when there is a significant environmental crisis, we need to extend public health outreach and education, psychological monitoring and mental health services beyond the immediately affected areas, paying particular attention to people at risk for income loss. There are things that can be done to help people manage their stress and anxiety, and cope in these situations, so these interventions need to be available immediately in the communities where the impacted individuals live,” adds Dr. Grattan, who is also a neuropsychologist at the University of Maryland Medical Center.
The study on psychological impact built on a research program by University of Florida investigators who were already in the area to study the acute environmental and health impact of the spill. Through contacts with local community and religious leaders, trade associations, the University of Florida extension office and other agencies, the Maryland researchers recruited 71 residents in Florida and 23 from Alabama for the psychological assessment.
The team evaluated the participants through interviews and standardized assessments of psychological distress, resilience and coping. The team also looked at whether the participants had cognitive symptoms of neurotoxicity as a result of exposure to oil and chemical dispersants. These included assessments of attention, memory, and dexterity and speed (through a pegboard puzzle task). The researchers also asked the participants about what they were doing to cope with the situation, which could range from prayer and meditation to increased use of alcohol and other drugs.
Related news item
CHICAGO, ILLINOIS (Reuters Health) – Uncertainty about a diagnosis causes more anxiety and can be more stressful than actually knowing that you have a serious illness, researchers reported here at the 2010 annual meeting of the Radiological Society of North America.
“Once people have the diagnosis, they gain some understanding and control, but without it, all they have is anxiety, and they do not know how to handle it,” Dr. Elvira V. Lang, from Harvard Medical School, Boston, told Reuters Health. “It is important for physicians and others who work in the health care field to realize this and find ways to alleviate this anxiety and stress. Not only will they help patients, they will also be helping their institutions to provide more cost effective care.”…
We were very surprised to see that the women having breast biopsy were significantly more anxious than the women who came for treatment for malignant cancer and those who came for fibroids,” Lang said in an interview.
Health care professionals tend not to be aware that diagnostic tests can be stressful, she added.
The researchers recognize that for a woman awaiting breast biopsy, the fear of being diagnosed with cancer and uncertainty about what the outcome will be can create higher anxiety levels than even those experienced by patients undergoing a “much riskier and invasive treatment of a known cancer.”
“People in health care and also family members may judge what is minor or major by how much risk is involved. But that is not what the patient is experiencing. That is why we want to alert them,” Lang said.
There are simple ways to diffuse this anxiety prior to procedures, she added. “People want to make patients feel better but they use language that is not helpful. For instance, they will say ‘oh, it’s not going to be that bad’, or ‘it’s just going to be a little sting’, but using such vocabulary only increases anxiety and pain.”
Training health care providers to use the right language with patients about to undergo diagnostic procedures will not only reduce their anxiety levels, it will also save the health care system money, Lang added.
“Sometimes patients are so anxious they can’t complete a test….
Study found they needed more doctor visits to handle issues from parent‘s absence
From a November 8, 2010 Health Day news item
MONDAY, Nov. 8 (HealthDay News) — Mental and behavioral problems cause children of U.S. soldiers deployed to Iraq, Afghanistan and other war zones to need considerably more outpatient medical visits than those with non-deployed parents, a new study suggests.
Researchers examined the medical records of more than 640,000 military children between the ages of 3 and 8, and found that those separated from deployed parents sought treatment 11 percent more often for cases of mood, anxiety and adjustment disorders. Visits for conditions such as autism and attention-deficit disorder, whose causes are not linked to deployment, also increased.
The study, reported online Nov. 8 and in the December issue of the journal Pediatrics [article is free through this link], also revealed larger increases in mental and behavioral visits among older children, children with military fathers and children of married military parents.
“It’s statistically significant, but I also think it’s clinically significant,” said lead researcher Dr. Gregory Gorman, an assistant professor of pediatrics at Uniformed Services University of the Health Sciences in Bethesda, Md. “These are also probably the worst cases.”
Gorman said he was surprised to find that while these types of medical visits went up, the rates of visits for all other medical conditions dropped.
“I have no direct evidence, but we hypothesize that when a parent is deployed . . . and the other parent has to do all of the duties, they may want to handle other problems at home,” Gorman said. “These parents who remain at home need to multi-task even more.”…
…In Gorman’s study, the most frequent primary diagnosis during mental and behavioral health visits was attention-deficit disorder (ADD). Adjustment and autistic disorders came next, while farther down the list were mood and anxiety disorders, oppositional defiant disorder, developmental delays, post-traumatic stress disorder, bedwetting and separation anxiety.
SOURCES: Gregory Gorman, M.D., assistant professor, pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Md.; Rick Olson, retired Army general, director, strategic communications, Child, Adolescent and Family Behavioral Health Proponency, Fort Lewis, Wash.; December 2010 Pediatrics
Anxiety disorders are generally treated with medication, specific types of psychotherapy such as “talk therapy,” or both. Treatment depends on the problem and the person’s preference. Before any treatment, a doctor must do a careful evaluation to see whether a person’s symptoms are from an anxiety disorder or a physical problem. The doctor must also check for coexisting conditions, such as depression or substance abuse. Sometimes, treatment for the anxiety disorder must wait until after treatment for the other conditions.
How Medications Can Help
Doctors may prescribe medication, along with talk therapy, to help relieve anxiety disorders. Some medicines may take a few weeks to work. Your family doctor or psychiatrist may prescribe:
- Antidepressants. These medications take up to four to six weeks to begin relieving anxiety. The most widely prescribed antidepressants for anxiety are the SSRIs (selective serotonin reuptake inhibitors). Commonly prescribed: Prozac, Zoloft, Paxil, Lexapro, and Celexa.
- Anti-anxiety medicines (or “tranquilizers”). These medications produce feelings of calm and relaxation. Side effects may include feeling sleepy, foggy, and uncoordinated. The higher the dose, the greater the chance of side effects. Benzodiazepines are the most common class of anti-anxiety drugs.Commonly prescribed: Xanax, Klonopin, Valium, and Ativan.
- Beta blockers. These drugs block norepinephrine, the body’s “fight-or-flight” stress hormone. This helps control the physical symptoms of anxiety, such as rapid heart rate, a trembling voice, sweating, dizziness, and shaky hands. Because beta blockers don’t affect the emotional symptoms of anxiety, such as worry, they’re most helpful for phobias, particularly social phobia and performance anxiety. Commonly prescribed: Tenormin and Inderal.
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