In 2013, there were an estimated 43.8 million adults aged 18 or older in the U.S. with any sort of mental illness in the past year. This represented 18.5 percent of all U.S. adults. And mental disorders are common among children in the United States. Just over 20 percent (or 1 in 5) children, either currently or at some point during their life, have had a seriously debilitating mental disorder. 

So we will be reviewing some select research about mental health issues that should be a helpful adjunct to more traditional mental health interventions like group psychotherapy, individual therapy, counseling, medications, stress management and the like. This material should be especially helpful to those with any sort of addiction and to athletes who experience a full spectrum of challenges during training as well as competitive events. 

Stress: Psychological stress--both perceived stress and chronicity of stress--is significantly associated with higher oxidative stress, lower telomerase activity, and shorter telomere length, which are known determinants of cellular aging and shortened longevity, in peripheral blood mononuclear cells from healthy premenopausal women. A telomere is a region of repetitive DNA, a cap, at the end of a chromosome, which protects the end of the chromosome from deterioration. Telomere length, is a reliable predictor of disease and can be affected by genetics, chronic stress, healthy behavior and  is an indicator of cellular aging. Women with the highest levels of perceived stress have telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low stress women. These findings have implications for understanding how, at the cellular level, stress may promote earlier onset of age-related diseases. 

In another more recent study those who meditated for just 12 minutes a day for 8 weeks experienced significant benefit, including better mental and psychological function accompanied by an increase in telomerase activity, suggesting an improvement in stress-induced cellular aging. Subjects in this study were caregivers for patients with Alzheimer’s Disease. Again, telomerase is an enzyme that protects the tips of chromosomes. 

Ref:  1) Epel ES et al. ‘Accelerated telomere shortening in response to life stress’  , Proc Natl Acad Sci U S A. 2004. 2)  Lavretsky H, Et Al.  ‘A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity.’  Int J Geriatr Psychiatry. 2013. 

 

Inflammation: A recent study compared people with major depressive disorder (MDD) with people without mood disorder and have found convincing evidence that brain inflammation plays a significant role in depressed individuals. Inflammation levels rose with the severity of depressive symptoms. This research raises hopes that anti-inflammatory therapies may be of help to those 50% of people with MDD who do not respond to standard treatments. The finding that inflammation affects the brain directly helps to explain the tendency of patients with MDD to experience fatigue, loss of appetite, sleep disturbances, and other symptoms often associated with other inflammatory conditions. It would follow that patients with MDD may want to adopt healthy lifestyle behaviors that can minimize inflammation: getting regular exercise, an optimal diet, quitting smoking, achieving an ideal weight, relaxation techniques and minimizing stress, managing medical conditions that promote inflammation, and perhaps, consuming dietary supplements that help reduce inflammation such as curcumin, green tea, and ginger. 

Ref: Elaine Setiawan et al.  ‘Role of Translocator Protein Density, a Marker of Neuroinflammation, in the Brain During Major 

Depressive Episodes,’ JAMA Psychiatry. March 2015. 

 

Mercury in Fish: Depression is a serious and common mental disorder responsible for the majority of suicides and worldwide, a million people kill themselves every year. 100,000 Japanese men and women were followed for up to 10 years, and they didn’t find evidence of a protective role of higher fish consumption or the long chain omega 3’s EPA and DHA against suicide. In fact, they found a significantly increased risk of suicide among male nondrinkers with high seafood omega 3 intake. One possible explanation could be the mercury content of fish. An accumulation of mercury compounds could increase the risk of depression. We know that mercury in fish can cause neurological damage, such as negative effects on Alzheimer disease, memory loss, and autism as well as depression. 

Ref: A C Tsai et al. ‘Suicide mortality in relation to dietary intake of n-3 and n-6 polyunsaturated fatty acids and fish: equivocal findings from 3 large US cohort studies,’ Am J Epidemiol. 2014. 

 

Hydration: Water is by far the #1 nutrient in our diet. Although it is well known that water is essential for human survival, only recently have we begun to understand its role in the maintenance of brain function. Makes sense, our brain is 75% water, and so when we get dehydrated our brain actually shrinks. Even mild dehydration, caused by  exercising on a hot day has been shown to change brain function. The most important effects of fluid deprivation were increased sleepiness and fatigue, lower levels of vigor and alertness, and increased confusion. But as soon as they gave them some water the deleterious effects on alertness, happiness and confusion were immediately reversed. Water absorption actually happens very rapidly, within 5 minutes from mouth to bloodstream, peaking around minute 20. And, cold water is absorbed about 20% more rapidly than warm, body temperature water. So, you empty your bladder and drink about three cups of water, and then an hour later see how much you urinate; if you urinate out less than 1 cup there’s a good chance that you were dehydrated.  

Ref: N A Masento etal.  ‘Effects of hydration status on cognitive performance and mood,’ Br J Nutr. 2014. 

 

Essential Oils & Anxiety Disorders:  Anxiety disorders are the most prevalent class of psychiatric disorders in the general population; these conditions are often treated with antianxiety drugs that have significant addiction potential and undesirable side effects. Lavender oil is distilled from lavender flowers and is most often used in aromatherapy and massage. Despite its popularity, only recently have scientifically-based investigations been undertaken into its biological activity. Since lavender oil has no potential for drug abuse and causes no hangover effects it appears to be an effective and well-tolerated alternative to benzodiazepine drugs for amelioration of generalized anxiety; but the research findings are tentative. Orange Aromatherapy has been found to have an anxiety reducing effect, create a sense of increased energy, and improved mood. Orange essential oil has even been used with patients in the intensive care unit the day after open-heart surgery, getting foot massages with orange-scented oil; patients  felt restful, peaceful, and calm but the positive effects may have been due to the massage alone. More recently the ambient odor of orange was tested in a dental office to see if it reduces anxiety and improves mood; it did have these effects but the design of the study didn’t allow definitive conclusions. Aromatherapy can pose some adverse effects.  

REF: 1) W. Sayorwan et al. ‘ The effects of lavender oil inhalation on emotional states, autonomic nervous system and brain electrical activity.’ J Med Assoc Thai 2012. 2) Y.-L. Lee et al.  ‘A systematic review on the anxiolytic effects of aromatherapy in people with anxiety symptoms,’ J Altern Complement Med 2011. 

 

Dietary Issues: If you measure the levels of carotenoid phytonutrients (in fruits and vegetables) in nearly 2,000 people across the country, a higher total blood carotenoid level was associated with a lower likelihood of elevated depressive symptoms, and there appeared to be a dose-response relationship, meaning the higher the levels, the better people felt. In a study of about a thousand older men and women, those who ate the most tomato products had about half the odds of depression. In these studies only food sources of antioxidants were protectively associated with depression, not antioxidants from dietary supplements. Low dietary intake of folate may indeed be a risk factor for severe depression, as much as a threefold higher risk. Note this is dietary folate intake from foods like dark green leafy vegetables, not folic acid supplements.  

Another study of 620 vegans, vegetarians, and omnivores demonstrated that increased fruit and vegetable intake resulted in lower anxiety scores for male vegan participants, compared with nonvegans. Female vegan participants experienced reduced stress levels as a result of their animal-free diets as well as their lower intakes of sweets. 

REF:  1) A L Sharpley, R Hockney. L McPeake, J R Gedes, P J Cowen. ‘Folic acid supplementation for prevention of mood disorders in young people at familial risk: a randomised, double blind, placebo controlled trial.’ J Affect Disord. 2014. 2) M A Beydoun, H A Beydoun, A Boueiz, M R Shroff, A B Zonderman. ‘Antioxidant status and its association with elevated depressive symptoms among US adults: National Health and Nutrition Examination Surveys.’ Br J Nutr. 2013. 3) Beezhold B, Radnitz C, Rinnie A, DiMatteo J. ‘Vegans report less stress and anxiety than omnivores. ‘ Nutr Neuroscir. Published online on November 21, 2014. 

 

Medication: The pharmaceutical industry is considered the most profitable and politically influential industry in the United States, and mental illness can be thought of as the drug industry’s golden goose: incurable, common, long term, and involving multiple medications. Antidepressant medications are prescribed to 8.7% of the US population. It’s a multi-billion dollar market. Recent analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits of antidepressant medications are due to the placebo effect. And what’s even worse, Freedom of Information Act documents show the FDA knew about it but made an explicit decision to keep this information from the public and from prescribing physicians. So,  there is a strong therapeutic response to antidepressant medication; it’s just that the response to placebo is almost as strong. For very severe depression, the drugs do beat out sugar pills. 

REF: 1)  I Kirsch. ‘Antidepressants and the Placebo Effect.’ Z Psychol. 2014. 2) E Penn, D K Tracy. ‘The drugs don’t work? antidepressants and the current and future pharmacological management of depression.’ Ther Adv Psychopharmacol. 2012. 

Exercise:  In the largest exercise trial of patients with major depression conducted to date, and not just including older folks but other adults as well and three different treatment groups: a home exercise group in addition to a supervised group exercise and drug group. And they all worked about just as well in terms of forcing the depression into remission. Putting all the best studies together, they indicate that exercise, at least has a moderate antidepressant effect, and at best, exercise has a large effect on reductions in depression symptoms and could be categorized as a very useful and powerful intervention. Unfortunately, while studies support the use of exercise as a treatment for depression, exercise is rarely prescribed as a treatment for this common and debilitating problem. 

REF: T Josefsson, M Lindwall, T Archer. ‘Physical exercise intervention in depressive disorders: meta-analysis and systematic review.’  Scand J Med Sci Sports. 2014. 

 

Autism Spectrum Disorder (ASD: ASD encompassing impaired communication and social interaction, and repetitive stereotypic behavior and language, affects 1–2% of predominantly male individuals and is an enormous medical and economic problem for which there is no documented, mechanism-based treatment. In a placebo-controlled, randomized, double-blind clinical trial, daily oral administration for 18 weeks of the phytochemical sulforaphane (derived from broccoli sprouts)  

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to 29 young men with ASD substantially (and reversibly) improved behavior compared with 15 placebo recipients. Behavior was quantified by both parents/caregivers and physicians by three widely accepted measures. Sulforaphane, which showed negligible toxicity, was selected because it upregulates genes that protect aerobic cells against oxidative stress, inflammation, and DNAdamage, all of which are prominent and possibly mechanistic characteristics of ASD.  

REF: Kanwaljit Singh et  al. ‘Sulforaphane treatment of autism spectrum disorder,’ Proc Natl Acad Sci U S A. 2014. Oct 28. 

 

Lifestyle Habits: If you are having recurrent depressed moods, one way to start taking control is to address three basic issues. Eat properly a predominantly whole food, plant-based diet. Exercise regularly every day, if possible. Exercise helps to improve your brain chemistry, and helps you to sleep more effectively. Finally, get enough sleep. It is during sleep that many important moodregulating circuits of the brain restore their neurochemical firepower. 

The natural brain-healthy properties of a high-nutrient (plant-based) diet, regular exercise, adequate vitamin D and omega-3 stores, and light exposure combine to promote a positive mood, even in the cold, gray days of winter, thereby helping to prevent Seasonal Affective Disorder. 

REF: 1) Douglas Lisle, ‘How To Feel Better Fast,’  TrueNorth  Health Center, 2010. 2)  Joel Fuhrman, ‘Counteract the Winter Blues Naturally,’  Published Online, 2013. 

 

Fasting: Clinicians have found that fasting was frequently accompanied by an increased level of vigilance and mood improvement, Therapeutic fasting, following an established protocol, is safe and well tolerated. Many neurobiological mechanisms have been proposed to explain fasting effects on mood, such as changes in neurotransmitters, quality of sleep, and synthesis of neurotrophic factors. Many clinical observations relate an early (between day 2 and day 7) effect of fasting on depressive symptoms with an improvement in mood, alertness and a sense of tranquility reported by patients. 

REF: Fond G et al. ‘Fasting in mood disorders: neurobiology and effectiveness. A review of the literature.’ Psychiatry Res. 2013. 

 

Bill Zahler 

August 2015