Recovery Michigan

Rejected by a person you like? Just "shake it off" and move on, as music star Taylor Swift says.

But while that might work for many people, it may not be so easy for those with untreated depression, a new brain study finds.

The pain of social rejection lasts longer for them -- and their brain cells release less of a natural pain and stress-reducing chemical called natural opioids, researchers report in the journal Molecular Psychiatry.

The findings were made in depressed and non-depressed people using specialized brain-scanning technology and a simulated online dating scenario. The research sheds new light on how the brain's pain-response mechanism, called the opioid system, differs in people with depression.

"Although the right to daily time outdoors may seem trivial" when compared with other fundamental rights, stated the press release, "to those who have experienced life inside a psychiatric unit of a hospital or other inpatient facility, the promise of even temporary reprieve from their confines can have important implications for those persons' mental health and recovery prospects."

To find out, Mehta’s team studied blood cells from 169 people in Atlanta who were participating in the Grady Trauma Project.  Most were in their late 30s to mid 40s and were African American; some had been abused as children but all had suffered at least two other significant traumatic events, such as being held at gun- or knife point, having a major car accident or being raped. On average, the participants experienced seven major traumas. Despite these events, however, the majority were resilient: 108 participants never developed PTSD.

Among the 61 that did, 32 had been abused as children and 29 had not.  The authors examined their blood cells, looking for genetic changes that distinguished people with the disorder who had been abused from those who had not. To focus on changes associated with PTSD diagnosis rather than trauma exposure alone, they looked for differences not seen in the resilient group.

These genetic alterations are known as epigenetic changes: chemical differences that don’t mutate the DNA itself but affect how actively and efficiently the genes are made into proteins. By either silencing or activating genes, epigenetic changes can influence everything from brain development and functioning to the risk for certain diseases. While not necessarily permanent, some of these changes can last a lifetime and some can even be passed on to the next generation.

“In PTSD with a history of child abuse, we found a 12-fold higher [level] of epigenetic changes,” says Mehta.  In contrast, people who experienced trauma later in life showed genetic effects that tended to be short-lived, and did not permanently alter the function of the genes.

The study, carried out by the Washington-based group Disability Rights International, found that 42% of the women interviewed had been pressured by their families and health professionals into being sterilised, with some subjected to operations without their knowledge. The women’s disabilities include depression, schizophrenia and bipolar disorder.

It also revealed that 43% of the sample reported suffering some form of emotional or physical abuse during visits to gynaecologists, ranging from hurtful comments to rape.

“These are egregious human rights violations perpetrated against women with disabilities,” said Priscila Rodríguez, who headed the study. “They are violations of sexual and reproductive rights that have long been ignored.”

"Given the elevated risk for diabetes among individuals with symptoms of psychological distress, even greater numbers of clinicians in the study sample should have been providing lifestyle counseling," Xiang said. "However, the increase in the rates of diabetes and diabetes risk factors seems to have outpaced the increase in the rates of provider advice for this population."

Because people with mental illness tend to utilize outpatient, inpatient and emergency services at much higher rates than the general population, clinicians have increased opportunities to educate patients about the benefits of a healthy diet and physical activity, Xiang said.

Fortunately, there are steps you can take to help ensure you'll actually pass out once your head hits the pillow.

1. Do a 60-minute wind-down.
If you're moving at full-speed all day, it can be tough to suddenly switch yourself "off" at night. "We are assaulted by information all the time and it's really up to us to create routines that help separate the buzzing of the brain from our sleep routines," says Janet Kennedy, Ph.D., clinical psychologist, founder of NYC Sleep Doctor and author of The Good Sleeper: The Essential Guide to Sleep for Your Baby (and You). She recommends giving your mind and body a full hour to wind down from work (or happy hour) before you try to fall asleep.

2. Take a warm bath or shower.
Spending time in a steamy shower could be beneficial even if you don't need to rinse off. Kennedy points out that your body temperature drops rapidly once you exit the shower. Research shows that this decrease in temperature can trigger a sleepy feeling because your heart rate, digestion and other metabolic processes slow down. This can make it easier for your brain and body to power down, too.

3. Put on socks.

More than 1 in 4 females have experienced cyberbullying in college, increasing their risk for depression. Female college students who acted as cyberbullies were also more likely to report problem alcohol use, according to a new study published in Cyberpsychology, Behavior, and Social Networking, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available free on the Cyberpsychology, Behavior, and Social Networkingwebsite until March 19, 2015.

In the article "Cyberbullying, Depression, and Problem Alcohol Use in Female College Students: A Multisite Study," authors Ellen Selkie, MD, MPH and Ya-Fen Chan, PhD University of Washington, Seattle, Rajitha Kota, MPH, University of Wisconsin School of Medicine and Public Health, and Megan Morena, MD, MSEd, MPH, Seattle Children's Research Institute, explored the relationship between involvement in cyberbullying-as either the person doing the bullying or being bullied-and depression or problem alcohol use.

"When counseling college students, inquiring about cyberbullying during intake assessments may help clinicians uncover stressors to be targeted during treatment,"

The majority of the clients I treat have been exposed to repeated traumatic episodes and threats during childhood. For many of these men and women, their heinous histories of emotional, psychological, and sexual abuse at the hands of trusted caregivers, have led to their suffering from complex PTSD (known as C-PTSD).

C-PTSD is more complicated than simple PTSD as it pertains to chronic assaults on one’s personal integrity and sense of safety, as opposed to a single acute traumatic episode. This chronic tyranny of abuse results in a constellation of symptoms, which impact personality structure and development.

The symptom clusters for C-PTSD are:

• Alterations in regulation of affect and impulses
• Changes in relationship with others
• Somatic symptoms
• Changes in meaning
• Changes in the perception of self
• Changes in attention and consciousness

This is not the first study to find a link between air pollution and increased risk of suicide. A 2010 studypublished in The American Journal of Psychiatry found people from over seven cities in South Korea were 9% more likely to commit suicide within 2 days of a rise in air pollution.

And last year, Bakian and colleagues conducted a study that found residents of Salt Lake County were more likely to commit suicide within 3 days of being exposed to increased levels of nitrogen oxide or high concentrations of fine particulate matter (PM 2.5) - particles in smoke and haze that are 2.5 micrometers in diameter or less.

They build on these findings with their latest study, which found middle-aged individuals and men are most at risk of suicide through exposure to air pollution.

The results of this study showed that depression seems to be the most common affective prodrome of medical disorders and is consistently reported in Cushing's syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson's disease, and AIDS.

Mania, anxiety and irritability Anxiety and irritability may occur in conjunction with depression, but are less frequent on their own. Mania was not found to be consistently associated with specific medical disorders other than Wilson's disease.

Physicians may not pursue medical workup of cases that appear to be psychiatric in nature. They should be alerted that disturbances in mood, anxiety and irritability may antedate the appearance of a medical disorder.