tag:theconversation.com,2011:/us/topics/chronic-stress-17743/articles
Chronic stress – The Conversation
2024-03-19T12:26:43Z
tag:theconversation.com,2011:article/222245
2024-03-19T12:26:43Z
2024-03-19T12:26:43Z
How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help
<figure><img src="https://images.theconversation.com/files/579438/original/file-20240303-22-dk7t8p.jpg?ixlib=rb-1.1.0&rect=0%2C12%2C8348%2C5957&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Toxic stress increases the risks for obesity, diabetes, depression and other illnesses.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/depressed-man-covering-face-amidst-orange-rays-royalty-free-image/1227304528?phrase=stress+&adppopup=true">Klaus Vedfelt/Digital Vision via Getty Images</a></span></figcaption></figure><p>COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others. </p>
<p>So how much stress is too much, and what can you do about it?</p>
<p>I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues.</p>
<p>I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.” </p>
<p>A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</span></figcaption>
</figure>
<h2>The difference between good stress and the toxic kind</h2>
<p>Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit. </p>
<p>Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.” </p>
<p>The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface. </p>
<p>When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions.</p>
<p>For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors. </p>
<h2>‘Treating’ stress</h2>
<p>Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan. </p>
<p>Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure. </p>
<p>Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>. </p>
<p>Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress. </p>
<p>Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses. </p>
<h2>Suffering from toxic stress</h2>
<p>Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood.</p>
<p>Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be. </p>
<p>And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all. </p>
<p>Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Exercise, meditation and a healthy diet help fight toxic stress.</span></figcaption>
</figure>
<h2>Recognizing and managing stress and its associated conditions</h2>
<p>The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>. </p>
<p>The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate.</p>
<p>Adopting these lifestyle changes is not quick or easy, but it works. </p>
<p>The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits.</p>
<p>There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.</p><img src="https://counter.theconversation.com/content/222245/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lawson R. Wulsin received funding in 2010 from the Veterans Administration support a secondary analysis of data from the Framingham Heart Study, which was published and contributed in part to the substance of this article. </span></em></p>
No one can escape stress, but sometimes it takes a physical and emotional toll that translates to disease and other health effects. The good news is that there are new approaches to treating it.
Lawson R. Wulsin, Professor of Psychiatry and Family Medicine, University of Cincinnati
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/221684
2024-01-28T13:55:15Z
2024-01-28T13:55:15Z
The contraceptive pill also affects the brain and the regulation of emotions
<figure><img src="https://images.theconversation.com/files/570657/original/file-20231221-19-oxth15.jpg?ixlib=rb-1.1.0&rect=2%2C0%2C988%2C667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Like natural hormones, known as endogenous hormones, the artificial hormones contained in the pill, known as exogenous hormones, can have effects on the brain.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Oral contraceptives, also known as birth control pills, are <a href="https://doi.org/10.18356/1bd58a10-en">used by more than 150 million women worldwide</a>. Approximately one-third of teenagers in <a href="https://www150.statcan.gc.ca/n1/en/pub/82-003-x/2015010/article/14222-eng.pdf">North America</a> and <a href="https://doi.org/10.1001/jamapsychiatry.2016.2387">Europe</a> use them, making them the most prescribed drug for teenagers.</p>
<p>It is well known that oral contraceptives have the power to alter a woman’s menstrual cycle. What’s less well known is that they can also have an effect on the brain, particularly in the regions that are important for regulating emotions.</p>
<p>As a doctoral student and professor of psychology at UQAM, we were interested in the impact of oral contraceptives on the brain regions involved in emotional processes. We published our <a href="https://doi.org/10.3389/fendo.2023.1228504">results in the scientific journal Frontiers in Endocrinology</a>.</p>
<h2>How does the pill work?</h2>
<p>There are several methods of hormonal contraception, but the most common type in North America is the contraceptive pill, more specifically, <a href="https://doi.org/10.1016/j.yfrne.2022.101040">combined oral contraceptives</a> (COCs). These are made up of two artificial hormones that simulate one of the types of estrogen (generally ethinyl estradiol) and progesterone.</p>
<p>Like natural hormones, known as endogenous hormones, the artificial hormones contained in the pill, known as exogenous hormones, <a href="https://doi.org/10.1016/j.yfrne.2022.101040">have an effect on the brain</a>. They bind to receptors in different areas and signal the brain to reduce the production of endogenous sex hormones. It is this phenomenon that leads to the cessation of menstrual cycles, preventing ovulation.</p>
<p>In other words, while using COCs, users’ bodies and brains are not exposed to the fluctuations in sex hormones typically seen in women with a natural cycle.</p>
<h2>The pill’s effects on the brain: neuroscience to the rescue!</h2>
<p>When they start taking COCs, teenage girls and women are informed of their different side effects, mainly physical (nausea, headaches, weight changes, breast tenderness). However, the fact that sex hormones affect the brain, particularly in areas important for regulating emotions, is not generally discussed.</p>
<p>Studies have associated the use of COCs with <a href="https://doi.org/10.1016/j.psyneuen.2018.02.019">poorer ability to regulate emotions</a> and a <a href="https://doi.org/10.1001/jamapsychiatry.2016.2387">higher risk of developing psychopathologies</a>.</p>
<p>In addition, women are more likely than men to suffer from <a href="https://doi.org/10.1016/j.jpsychires.2011.03.006">anxiety and chronic stress disorders</a>. Given the widespread use of COCs, it is important to gain a better understanding of their effects on the anatomy of the brain regions that are responsible for emotional regulation.</p>
<p>We therefore conducted a study to examine the effects of COCs on the anatomy of brain regions involved in emotional processes. We were interested in the effects associated with their current use, but also in the possibility of lasting effects, i.e. whether COCs could affect brain anatomy even after women stopped taking them.</p>
<p>To do this, we recruited four profiles of healthy individuals: women currently using COCs, women who had used COCs in the past, women who had never used any method of hormonal contraception, and men.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/567191/original/file-20231221-24-r2t5pd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="magnetic resonance imaging" src="https://images.theconversation.com/files/567191/original/file-20231221-24-r2t5pd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567191/original/file-20231221-24-r2t5pd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567191/original/file-20231221-24-r2t5pd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567191/original/file-20231221-24-r2t5pd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567191/original/file-20231221-24-r2t5pd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567191/original/file-20231221-24-r2t5pd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567191/original/file-20231221-24-r2t5pd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Magnetic resonance imaging (MRI) is used to analyze the morphology of certain regions of the brain.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Using brain imaging, we found that only women currently using COCs had a slightly thinner ventromedial prefrontal cortex than men. This part of the brain is known to be essential for regulating emotions such as fear. The scientific literature shows that <a href="https://doi.org/10.1073/pnas.0502441102">the thicker this region is, the better the emotional regulation will be</a>.</p>
<p>COCs could therefore alter emotional regulation in women. Although we have not directly tested the link between brain morphology and mental health, our team is currently investigating other aspects of the brain and mental health, which will allow us to better understand our anatomical findings.</p>
<h2>An effect associated with the dose, but that doesn’t last</h2>
<p>We tried to better understand what could explain the effect using COCs on this region of the brain. We discovered that it was associated with the dose of ethinyl estradiol. In fact, among COC users, only those using a low-dose COC (10-25 micrograms) – not a higher dose (30-35 micrograms) – were associated with a thinner ventromedial prefrontal cortex.</p>
<p>It may seem surprising that a lower dose was associated with a cerebral effect…</p>
<p>Given that all COCs reduce concentrations of endogenous sex hormones, we propose that estrogen receptors in this brain region may be insufficiently activated when low levels of endogenous estrogen are combined with a low intake of exogenous estrogen (ethinyl estradiol).</p>
<p>Conversely, higher doses of ethinyl estradiol could help to achieve adequate binding to estrogen receptors in the prefrontal cortex, simulating moderate to high activity similar to that of women with a natural menstrual cycle.</p>
<p>It is important to note that this lower grey matter thickness was specific to current COC use: women who had used COCs in the past showed no thinning compared to men. Our study therefore supports the reversibility of the impact of COCs on cerebral anatomy, in particular on the thickness of the ventromedial prefrontal cortex.</p>
<p>In other words, the use of COCs could affect brain anatomy, but in a reversible way.</p>
<h2>And now?</h2>
<p>Although our research has no direct clinical orientation, it is helping to advance our understanding of the anatomical effects associated with the use of COCs.</p>
<p>We are not calling for women to stop using their COCs: adopting such discourse would be both too hasty and alarming.</p>
<p>It’s also important to remember that the effects reported in our study appear to be reversible.</p>
<p>Our aim is to promote basic and clinical research, but also to increase scientific interest in women’s health, an area that is still understudied.</p><img src="https://counter.theconversation.com/content/221684/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alexandra Brouillard is a student member of the Research Centre of the Institut universitaire en santé mentale de Montréal. She holds a doctoral scholarship from the Canadian Institutes of Health Research.</span></em></p><p class="fine-print"><em><span>Marie-France Marin is a regular researcher at the Centre de recherche de l'Institut universitaire en santé mentale de Montréal, a professor in the Department of Psychology at the Université du Québec à Montréal and an associate professor in the Department of Psychiatry and Addictology at the Université de Montréal. She was supported by a salary grant from the Fonds de recherche du Québec - Santé (2018-2022) and currently holds a Canada Research Chair in Hormonal Modulation of Cognitive and Emotional Functions (2022-2027). The project discussed in the article is funded by the Canadian Institutes of Health Research and has received support from pilot project funds from the Research Centre of the Institut universitaire en santé mentale de Montréal and the Quebec Bioimaging Network.</span></em></p>
Oral contraceptives modify the menstrual cycle. What’s less well known is that they also reach the brain, particularly the regions important for regulating emotions.
Alexandra Brouillard, Doctorante en psychologie, Université du Québec à Montréal (UQAM)
Marie-France Marin, Professor, Department of Psychology, Université du Québec à Montréal (UQAM)
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/203307
2023-05-03T12:15:54Z
2023-05-03T12:15:54Z
Black mothers trapped in unsafe neighborhoods signal the stressful health toll of gun violence in the U.S.
<figure><img src="https://images.theconversation.com/files/523312/original/file-20230427-18-2ufwkh.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The stress of experiencing high levels of community violence harms entire families.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/african-american-mother-consoling-her-sad-girl-at-royalty-free-image/1077179266">skynesher/E+ via Getty Images</a></span></figcaption></figure><p>Black mothers are the canaries in the coal mine when it comes to the mental and physical harms of stress from living with gun violence in America.</p>
<p>In the U.S., Black people are likelier than white people to reside in impoverished, <a href="https://doi.org/10.1007/s12552-019-09280-1">racially segregated communities</a> with high levels of gun violence. Research has suggested that <a href="https://doi.org/10.1176/appi.ajp.2021.21060558">living in</a> <a href="https://doi.org/10.1590/S1413-81232006000200007">violent and unsafe</a> environments can result in <a href="https://doi.org/10.1037/a0032484">continuous traumatic stress</a>, a constant form of PTSD. Researchers have also linked experiences of violence and poverty to an increased risk of <a href="https://doi.org/10.1016/j.healthplace.2022.102746">chronic disease</a> such as cancer and cardiovascular, respiratory and neurodegenerative diseases.</p>
<p>We are Black women and <a href="https://scholar.google.com/citations?user=mrM-LJsAAAAJ&hl=en">public policy</a> and <a href="https://scholar.google.com/citations?user=xIwwuN4AAAAJ&hl=en">sociology professors</a> who study health inequities and sustainable policy solutions. Our research has found that Black mothers who feel trapped in neighborhoods they perceived as unsafe because of high levels of community violence are more likely to report <a href="https://doi.org/10.1007/s40615-022-01432-1">elevated PTSD and depression symptoms</a>, as well as elevated stress hormone levels.</p>
<p>The trauma of gun violence and systemic racism isn’t simply a Black mother’s story – it’s an American story. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/n1JpnLJBB98?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Gun violence is an epidemic in the U.S.</span></figcaption>
</figure>
<h2>Health effects of feeling trapped</h2>
<p>Our research team sought to understand <a href="https://doi.org/10.1007/s40615-022-01432-1">how stress from structural violence affects the body</a>, specifically the immune system. We talked to 68 low-income single Black mothers living on the South Side of Chicago about how they deal with gun violence in their communities and how it affects their health. </p>
<p>We asked these Black mothers to complete surveys that measured depression and PTSD symptoms. We also asked them to provide blood samples to examine the effects of stress at the cellular level, measuring the activity of genes that code for the receptors for the <a href="https://doi.org/10.1016/j.ejphar.2007.11.071">stress hormone cortisol</a>. Looking at cortisol receptors offers a more cumulative measure of cortisol levels over time.</p>
<p>We found that about 65% of the mothers wanted to move out of their neighborhoods but could not afford to do so. These mothers felt trapped in areas with high levels of gun violence that fostered a sense of not feeling safe for adults and children. One mother in our study, whom we will call Ellan, described her neighborhood as dangerous and wanted to leave as soon as she could. “I’m very terrified of my kids going out to the park, playing in front of the house,” she said. “And I’m afraid that a car might come past shootin’ and one of my kids get hurt.” </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/523308/original/file-20230427-2243-r895dy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Mother cradling child against chest" src="https://images.theconversation.com/files/523308/original/file-20230427-2243-r895dy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/523308/original/file-20230427-2243-r895dy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/523308/original/file-20230427-2243-r895dy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/523308/original/file-20230427-2243-r895dy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/523308/original/file-20230427-2243-r895dy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/523308/original/file-20230427-2243-r895dy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/523308/original/file-20230427-2243-r895dy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Black mothers who feel trapped in their neighborhoods feel terrified for their children.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mother-holding-sleeping-son-royalty-free-image/84910809">Jose Luis Pelaez/The Image Bank via Getty Images</a></span>
</figcaption>
</figure>
<p>Another mother in our study, whom we will call Skylar, felt she couldn’t escape to a safer community. “I don’t really want to raise my kids there, but I don’t have a choice. You know, cause it’s what I can afford. But it’s real violent.”</p>
<p>Mothers who felt trapped reported more symptoms of PTSD, like disturbing memories and dreams and reliving stressful experiences, than mothers who did not feel trapped. They also reported more depressive symptoms, such as feeling down and hopeless, taking little pleasure in doing things and having trouble sleeping. </p>
<p>Mothers unable to afford the move to safer neighborhoods had lower levels of glucocorticoid receptors. Having fewer glucocorticoid receptors helped protect their bodies from being overwhelmed by high cortisol levels caused by stress. Nevertheless, high cortisol levels from chronic stress are linked to a number of <a href="https://www.pbs.org/wgbh/nova/article/racism-stress-covid-allostatic-load/">negative mental and physical health outcomes</a>.</p>
<h2>Environment determines health</h2>
<p>Where someone lives, learns, works, plays and worships can <a href="https://pubmed.ncbi.nlm.nih.gov/28845341">determine their health</a> and has the power to make them sick and cause premature death.</p>
<p>Researchers have estimated that around <a href="https://doi.org/10.1377/hlthaff.24.2.459">83,570 Black people die prematurely</a> each year in the U.S. because of health disparities, using 2002 data. Some scholars have previously described this as equivalent to a <a href="https://unnaturalcauses.org/amazing_facts.php">plane full of Black passengers</a> falling out the sky every day every year.</p>
<p>It is important to note that it is not the racial makeup of where a person lives that shapes the significant disparities they face, but exposure to violence, poverty and lack of resources as a result of <a href="https://doi.org/10.1146/annurev-soc-073014-112305">structural racism</a>. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497358/">Redlining</a>, <a href="https://doi.org/10.1089/env.2020.0019">environmental contamination</a>, <a href="https://doi.org/10.1111/soc4.12846">food deserts</a> and gun violence are a part of the <a href="https://doi.org/10.1177%2F1090198120922942">racial capitalism</a>, or exploitation of marginalized communities, that affect the health of Black women.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/9WIv2oO2Vxs?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Black people face systemic economic and health disparities in the U.S.</span></figcaption>
</figure>
<p>What we are learning about the constant threats to the safety of Black mothers and their families also applies to the general American public. </p>
<p>The <a href="https://www.pewresearch.org/short-reads/2023/04/26/what-the-data-says-about-gun-deaths-in-the-u-s/">rate of mass shootings</a> is increasing. Firearm fatalities are a <a href="https://doi.org/10.1056/NEJMc2201761">leading cause of death among children</a> ages 1 to 19 in the U.S. Gun violence has harmed people while they are <a href="https://theconversation.com/scapegoating-rap-hits-new-low-after-july-fourth-mass-shooting-186443">watching a parade</a>, <a href="https://theconversation.com/rampage-at-virginia-walmart-follows-upward-trend-in-supermarket-gun-attacks-heres-what-we-know-about-retail-mass-shooters-195241">shopping at a store</a>, <a href="https://theconversation.com/fueled-by-virtually-unrestricted-social-media-access-white-nationalism-is-on-the-rise-and-attracting-violent-young-white-men-186896">worshipping</a>, <a href="https://theconversation.com/five-years-after-parkland-school-shootings-havent-stopped-and-kill-more-people-198224">attending school</a> and <a href="https://theconversation.com/hate-crimes-against-lgbtq-people-are-a-public-health-issue-61186">other</a> <a href="https://theconversation.com/stand-your-ground-laws-empower-armed-citizens-to-defend-property-with-violence-a-simple-mistake-can-get-you-shot-or-killed-204012">ordinary</a> <a href="https://theconversation.com/monterey-park-a-pioneering-asian-american-suburb-shaken-by-the-tragedy-of-a-mass-shooting-198373">events</a>.</p>
<h2>Increasing access to wellness</h2>
<p>Understanding the <a href="https://doi.org/10.1021/acs.estlett.1c00648">complexity of the exposome</a> – the word researchers use for environmental factors like gun violence that affect an individual’s health and well-being – can help extend the <a href="https://theconversation.com/are-you-a-rapid-ager-biological-age-is-a-better-health-indicator-than-the-number-of-years-youve-lived-but-its-tricky-to-measure-198849">years of healthy life</a> of groups who typically experience premature death. Building this knowledge requires input from people of color and others who have traditionally been pushed to the margins of society.</p>
<p>We are currently creating a “<a href="https://www.youthwellnessproject.com/wellness-store">wellness store</a>” that places wellness tools and health knowledge at the fingertips of individuals, especially for those experiencing interlocking traumas such as racism, sexism, classism, incarceration, racial segregation and rural geographic isolation. These tools, co-created with community health workers and citizen scientists, range from phone apps to public policy designed to get stress “out from under the skin.” Our goal is to work with clinics, hospitals and community organizations to provide accessible tools to prevent illness.</p>
<p>Black communities are filled with resilient and vulnerable individuals who deserve urgent policy solutions that lead to societal change. We believe that more investment in disease prevention and health equity can help the U.S. use the knowledge, technology and finances that it already has to help people access its most precious resource: a healthy life and the ability to pursue wellness.</p><img src="https://counter.theconversation.com/content/203307/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Loren Henderson is affiliated with Association of Black Sociologists. I am the Executive Officer of the Association of Black Sociologists.
</span></em></p><p class="fine-print"><em><span>Ruby Mendenhall receives funding from the National Science Foundation, the MacArthur Foundation and the University of Illinois at Urbana-Champaign.</span></em></p>
Chronic stress from living with systemic racism and gun violence can lead to increased symptoms of PTSD and depression as well as elevated cortisol levels.
Loren Henderson, Associate Professor of Public Policy, University of Maryland, Baltimore County
Ruby Mendenhall, Associate Professor in Sociology, African American Studies, Urban and Regional Planning and Social Work, University of Illinois at Urbana-Champaign
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/184905
2022-06-15T12:27:46Z
2022-06-15T12:27:46Z
Social stress can speed up immune system aging – new research
<figure><img src="https://images.theconversation.com/files/468840/original/file-20220614-26-b250v0.jpg?ixlib=rb-1.1.0&rect=6%2C202%2C2133%2C1451&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Immunosenescence, or immune aging, can lead to less effective responses to vaccines and greater vulnerability to invading pathogens.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/man-with-weak-immune-system-not-protected-royalty-free-illustration/1302827254">Kudryavtsev Pavel/iStock via Getty Images Plus</a></span></figcaption></figure><p>As people age, their immune systems naturally begin to decline. This aging of the immune system, called <a href="https://doi.org/10.1016/j.exger.2017.10.024">immunosenescence</a>, may be an important part of such <a href="https://doi.org/10.1038/s41586-021-03547-7">age-related</a> health problems as <a href="https://doi.org/10.3390/ijms20112810">cancer</a> and <a href="https://doi.org/10.3389/fimmu.2017.00195">cardiovascular disease</a>, as well as older people’s <a href="https://doi.org/10.1016/j.exger.2020.110887">less effective response to vaccines</a>.</p>
<p>But not all immune systems age at the same rate. In our <a href="https://doi.org/10.1073/pnas.2202780119">recently published study</a>, my colleagues <a href="https://scholar.google.com/citations?user=iLr8LkEAAAAJ&hl=en">and I</a> found that social stress is associated with signs of accelerated immune system aging.</p>
<h2>Stress and immunosenescence</h2>
<p>To better understand why people with the same chronological age can have different immunological ages, my colleagues and I looked at data from the <a href="https://hrs.isr.umich.edu/">Health and Retirement Study</a>, a large, nationally representative survey of U.S. adults over age 50. HRS researchers ask participants about different kinds of stressors they have experienced, including stressful life events, such as job loss; discrimination, such as being treated unfairly or being denied care; major lifetime trauma, such as a family member’s having a life-threatening illness; and chronic stress, such as financial strain.</p>
<p>Recently, HRS researchers have also started collecting blood from a sample of participants, counting the number of different types of immune cells present, including <a href="https://my.clevelandclinic.org/health/body/21871-white-blood-cells">white blood cells</a>. These cells play a central role in immune responses to viruses, bacteria and other invaders. This is the first time such detailed information about immune cells has been collected in a large national survey.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/468828/original/file-20220614-15-k597vz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Scanning electron microscope image of a human T cell" src="https://images.theconversation.com/files/468828/original/file-20220614-15-k597vz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/468828/original/file-20220614-15-k597vz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/468828/original/file-20220614-15-k597vz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/468828/original/file-20220614-15-k597vz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/468828/original/file-20220614-15-k597vz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/468828/original/file-20220614-15-k597vz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/468828/original/file-20220614-15-k597vz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">As people age, the T cells in the immune systems become less effective at fighting pathogens.</span>
<span class="attribution"><a class="source" href="https://flic.kr/p/ni2rkv">National Institute of Allergy and Infectious Diseases/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>By analyzing the data from 5,744 HRS participants who both provided blood and answered survey questions about stress, my research team and I found that people who experienced more stress had a lower proportion of <a href="https://doi.org/10.1016/j.exger.2020.110887">“naive” T cells</a> – fresh cells needed to take on new invaders the immune system hasn’t encountered before. They also have a larger proportion of <a href="https://doi.org/10.1111/acel.13272">“late differentiated” T cells</a> – older cells that have exhausted their ability to fight invaders and instead produce proteins that can increase harmful inflammation. People with low proportions of newer T cells and high proportions of older T cells have a <a href="https://doi.org/10.3389/fimmu.2019.02247">more aged immune system</a>.</p>
<p>After we controlled for poor diet and low exercise, however, the connection between stress and accelerated immune aging wasn’t as strong. This suggests that improving these health behaviors might help offset the hazards associated with stress. </p>
<p>Similarly, after we accounted for potential exposure to <a href="https://www.cdc.gov/cmv/overview.html">cytomegalovirus</a> – a common, usually asymptomatic virus known to <a href="https://doi.org/10.1186/1742-4933-9-23">accelerate immune aging</a> – the link between stress and immune cell aging was reduced. While CMV normally stays dormant in the body, researchers have found that <a href="https://doi.org/10.1016/j.bbi.2014.01.012">stress can cause CMV to flare up</a> and force the immune system to commit more resources to control the reactivated virus. Sustained infection control can use up naive T cell supplies and result in more exhausted T cells that circulate throughout the body and cause <a href="https://doi.org/10.1093/gerona/glu057">chronic inflammation</a>, an important contributor to age-related disease.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/468826/original/file-20220614-13-4y37mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Electron microscope image of cytomegalovirus visions" src="https://images.theconversation.com/files/468826/original/file-20220614-13-4y37mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/468826/original/file-20220614-13-4y37mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=395&fit=crop&dpr=1 600w, https://images.theconversation.com/files/468826/original/file-20220614-13-4y37mx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=395&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/468826/original/file-20220614-13-4y37mx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=395&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/468826/original/file-20220614-13-4y37mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=497&fit=crop&dpr=1 754w, https://images.theconversation.com/files/468826/original/file-20220614-13-4y37mx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=497&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/468826/original/file-20220614-13-4y37mx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=497&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">After an initial infection, cytomegalovirus stays in the body for life.</span>
<span class="attribution"><a class="source" href="https://phil.cdc.gov/Details.aspx?pid=14429">Centers for Disease Control and Prevention</a></span>
</figcaption>
</figure>
<h2>Understanding immune aging</h2>
<p>Our study helps clarify the association between social stress and faster immune aging. It also highlights potential ways to slow down immune aging, such as changing how people cope with stress and improving lifestyle behaviors like diet, smoking and exercise. Developing effective <a href="https://doi.org/10.1016%2Fj.vaccine.2018.02.089">cytomegalovirus vaccines</a> may also help alleviate immune system aging.</p>
<p>It is important to note, however, that epidemiological studies cannot completely establish cause and effect. More research is needed to confirm whether stress reduction or lifestyle changes will lead to improvements in immune aging, and to better understand how stress and latent pathogens like cytomegalovirus interact to cause illness and death. We are currently using additional data from the Health and Retirement Study to examine how these and other factors like childhood adversity affect immune aging over time.</p>
<p>Less aged immune systems are <a href="https://doi.org/10.1038/ni.2588">better able to fight infections and generate protective immunity from vaccines</a>. Immunosenescence may help explain why people are likely to have more severe cases of COVID-19 and a weaker response to vaccines as they age. Understanding what influences immune aging may help researchers better address age-related disparities in health and illness.</p><img src="https://counter.theconversation.com/content/184905/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Eric Klopack receives funding from the USC/UCLA Center on Biodemography and Population Health through a grant from NIA (P30AG017265).
The HRS (Health and Retirement Study) is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan.</span></em></p>
While the immune system naturally gets weaker with age, social stressors like trauma and discrimination can hasten immunosenescence.
Eric Klopack, Postdoctoral Researcher in Gerontology, University of Southern California
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/175287
2022-01-25T22:31:47Z
2022-01-25T22:31:47Z
Screaming into the void? Us too. Coping tips for stressed-out families in the COVID-19 pandemic
<figure><img src="https://images.theconversation.com/files/442352/original/file-20220124-17-tfk519.jpeg?ixlib=rb-1.1.0&rect=915%2C735%2C4789%2C3070&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many parents are struggling with burnout, loneliness and mental health problems during the pandemic.</span> <span class="attribution"><span class="source">(Pexels/Alexander Dummer)</span></span></figcaption></figure><iframe style="width: 100%; height: 175px; border: none; position: relative; z-index: 1;" allowtransparency="" src="https://narrations.ad-auris.com/widget/the-conversation-canada/screaming-into-the-void-us-too--coping-tips-for-stressed-out-families-in-the-covid-19-pandemic" width="100%" height="400"></iframe>
<p>Talk to any parent during these dark winter days and you’re likely to hear a mix of fear, <a href="https://www.nytimes.com/2022/01/23/us/mom-scream-massachusetts-pandemic.html">anger</a>, exhaustion and <a href="https://www.romper.com/parenting/here-we-go-again-omicron-edition">defeat</a>. These are tough months when many politicians have moved to a living-with-the-virus model despite millions of our youngest citizens being <a href="https://globalnews.ca/news/8492083/covid-omicron-kids-fear/">ineligible for vaccines</a>. </p>
<p>There seem to be endless immediate stressors of unpredictable child care, school closures and isolation requirements. What can you do when there are truly no good choices? Here, we offer coping tips to help push back on parenting-during-the-pandemic despair. </p>
<p>As psychologists (and parents), we’ve focused on understanding families’ experiences since the onset of the pandemic. We know that so many parents are struggling with <a href="https://doi.org/10.1371/journal.pone.0251720">burnout, loneliness</a> and <a href="https://doi.org/10.1016/j.jad.2020.07.081">mental health problems</a>. Based on the science of stress, we describe why this should feel hard and strategies for taking back control when you dread the challenging day ahead. </p>
<h2>Why is this so hard?</h2>
<p>There are three core components that make up the concept of “<a href="https://doi.org/10.1037/0033-2909.130.3.355">stress</a>,” and the pandemic has served parents up a textbook example of each: </p>
<p><strong>Unpredictability</strong>: When you’re faced with something unfamiliar or the future feels uncertain. </p>
<p><strong>Uncontrollability</strong>: When it feels like you can’t change your circumstances or protect your loved ones.</p>
<p><strong>Social-evaluative threat</strong>: When you fear being judged. For example, “Am I a bad parent for giving them so much screen time?” </p>
<p>Stress takes a toll on our bodies through activation of our stress response system, the hypothalamic-pituitary-adrenal axis (HPAA). The <a href="https://doi.org/10.1146/annurev.psych.58.110405.085605">HPAA is designed</a> to help regulate our energy and metabolism. </p>
<p>Shared with our evolutionary ancestors, the HPAA is great for helping us respond to urgent threats to family safety or tricky social settings by mobilizing our attention to respond effectively. However, the adrenaline surge is less helpful when it persists long-term or results in late-night anxiety about decisions like keeping your kid home. </p>
<p>Chronic stress has downstream effects on health, including altered sleep, appetite and mood dysregulation (like <a href="https://doi.org/10.1016/j.tins.2008.06.006">anxiety, depression and anger</a>). However, you can also push back to bring your stress system in check and reduce the mental health burdens of the pandemic. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/442342/original/file-20220124-23298-1ktk7vu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Infographic with strategies for coping with stress" src="https://images.theconversation.com/files/442342/original/file-20220124-23298-1ktk7vu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/442342/original/file-20220124-23298-1ktk7vu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/442342/original/file-20220124-23298-1ktk7vu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/442342/original/file-20220124-23298-1ktk7vu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/442342/original/file-20220124-23298-1ktk7vu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/442342/original/file-20220124-23298-1ktk7vu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/442342/original/file-20220124-23298-1ktk7vu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Coping strategies parents can use during the pandemic and beyond.</span>
<span class="attribution"><span class="source">(Leslie E. Roos)</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>What you can do:</h2>
<p><strong>1. Say “Help!” out loud</strong>. You probably know that being able to see friends helps your mental health. This is aligned with research highlighting the “<a href="https://doi.org/10.1007/bf00918169">stress-buffering</a>” effects of <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003044307-10/social-support-stress-buffering-hypothesis-theoretical-analysis-sheldon-cohen-garth-mckay">social support</a>. </p>
<p>The trick in the pandemic is that you need to <em>tell</em> your people that you’re struggling. Before 2020, allowing people to see your tears, rage or nervousness would signal a need for help (a key function of emotions), but now they probably won’t know that you’re struggling unless you tell them because we’re interacting less in-person. </p>
<p>It is helpful to be direct about asking for what you need:</p>
<blockquote>
<p><em>I’m feeling crappy and sad, do you have a minute to talk? My kids are driving me bonkers, any chance you take them for an outside play? I really need a hot shower to unwind, could you Facetime read a few books with Devin?</em></p>
</blockquote>
<p>We know it’s not the warm hug or shared meal you are craving. <a href="https://doi.org/10.1016/j.jpsychores.2021.110433">It can still be helpful</a>, especially when you’re managing pent-up inner chaos.</p>
<p><strong>2. Do something (anything).</strong> Taking 10 minutes to move your body (stretch or walk, keep it easy) and purposely seeking out good news can help shift gloom and doom thinking. <a href="https://doi.org/10.1017/S0033291721002142">Behavioural activation</a>, an evidenced-based treatment for low mood and stress, emphasizes that in the midst of lifestyle disruption, finding pleasurable daily activities — ones that are really important to you — significantly impacts health and well-being. </p>
<p>Choosing to engage in any sort of activity can provide <a href="https://doi.org/10.1371/journal.pone.0100100">positive reinforcement</a>, which <a href="https://doi-org.uml.idm.oclc.org/10.1002/cpp.2430">decreases stress and improves mood</a>. The activity may not be the gym class you used to love, <em>but</em> substituting an online class (even better if it’s with friends) or a 10-minute walk can be helpful. </p>
<p><strong>3. Be kind</strong>. When things are hard it can be tough, but incredibly important, to offer yourself compassion. What do you say to your friends when they are feeling defeated? Likely, you meet them with warmth and kindness:</p>
<blockquote>
<p><em>This is so hard. You are doing your best in an impossible situation. I totally lost my cool yesterday too. Being a great parent includes having bad days.</em> </p>
</blockquote>
<p>Most of us are less generous to ourselves than we are to others. Take a moment to reflect on supportive words that you can offer yourself next time those tough thoughts creep in. Evidence shows that re-framing self-critical thoughts and working on self-compassion can <a href="https://doi.org/10.1016/j.cpr.2012.06.003">improve mood</a> and facilitate positive coping <a href="https://doi.org/10.3390/ijerph18042017">during these challenging times</a>. </p>
<h2>How you can support your child’s mental health:</h2>
<p><strong>1. Lower expectations.</strong> Children have a tough time with unpredictability and can sense parent stress. Keep things simple and familiar to help them know what to expect. For online learning, this could look like setting a short period for engaging (do 20 minutes, then take a break). Offering praise or small rewards for their efforts not abilities promotes a growth mindset, which helps children take on challenges. If you have the energy, try a <a href="https://teachingmama.org/visual-schedule-for-toddlers/">visual schedule</a> to let children help plan their day. </p>
<p><strong>2. Sit on the floor.</strong> Getting down to your child’s level and giving them your focused attention for five to 10 minutes a day can offer an emotional reset, strengthen your relationship, and prevent challenging behaviours. You can even try lying down and see what your child wants to do. (Read? Pretend your belly is a racecar track?) Your presence and connection, even through short bursts, can help kids <a href="https://doi.org/10.1080/17470919.2015.1070747">manage stress</a> and feel confident to do things independently later in the day. </p>
<p><strong>3. Say what you see.</strong> Big emotions and behaviours are normal ways children react to unpredictability. Pointing out what you notice and naming emotions helps children make sense of their own experience and develop <a href="https://doi.org/10.1111/j.1532-7078.2012.00125.x">socio-emotional competence</a>. </p>
<blockquote>
<p><em>Your fists are balled up and your voice is loud, are you angry your tower broke?</em> </p>
</blockquote>
<p>If your child is safe, all you need to do is sit with them calmly (even if you’re not feeling your calmest) and let them know you’re here. If they are actively doing something dangerous, feel free to move their body first. The saying, “That’s not what you wanted to happen, is it?” can apply in most situations. </p>
<p>When it comes down to managing stress as a parent right now, there are no easy solutions. Sometimes a good cry in the car is a necessary release but try not to keep these feelings to yourself. Occasional team screams (or pack howls) as a family can offer a surprising mood boost at the collective challenge of it all. It has been a difficult two years, and acknowledging the challenges of parenting during the pandemic is part of coping.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/442343/original/file-20220124-23-1ug4vdk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Infographic with suggestions for child-friendly acitivities" src="https://images.theconversation.com/files/442343/original/file-20220124-23-1ug4vdk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/442343/original/file-20220124-23-1ug4vdk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/442343/original/file-20220124-23-1ug4vdk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/442343/original/file-20220124-23-1ug4vdk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/442343/original/file-20220124-23-1ug4vdk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/442343/original/file-20220124-23-1ug4vdk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/442343/original/file-20220124-23-1ug4vdk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A parent’s presence and connection, even through short bursts or simple activities, can help kids manage stress.</span>
<span class="attribution"><span class="source">(Leslie E. Roos)</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure><img src="https://counter.theconversation.com/content/175287/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Leslie E. Roos receives funding from the Children's Hospital Research Institute of Manitoba, the Canadian Institute of Health Research, the Social Sciences and Humanities Research Council of Canada, the Natural Sciences and Engineering Research Council of Canada, and Brain Canada.</span></em></p><p class="fine-print"><em><span>Anna MacKinnon receives funding from SSHRC. </span></em></p><p class="fine-print"><em><span>Lianne Tomfohr-Madsen receives funding from the Alberta Children's Hospital Research Institute, the Owerko Centre, the Canadian Child Health Clinician Scientist Program, the Canadian Institute of Health Research, Social Sciences and Humanities Research Council, Brain Canada and the Calgary Health Trust. </span></em></p><p class="fine-print"><em><span>Elisabeth Bailin Xie, Kaeley Simpson, and Marlee R. Salisbury do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
The science of stress explains why parenting during the pandemic feels so hard. Here are strategies from psychologists for taking back control when you dread yet another challenging day ahead.
Leslie E. Roos, Assistant Professor, Department of Psychology, University of Manitoba
Anna MacKinnon, Postdoctoral Scholar, Department of Psychology, University of Calgary
Elisabeth Bailin Xie, Doctoral Student, Department of Psychology, University of Calgary
Kaeley Simpson, MA School Psychology Student, University of Manitoba
Lianne Tomfohr-Madsen, Associate Professor, Department of Psychology, University of Calgary
Marlee R. Salisbury, Doctoral Student, Department of Psychology, York University, Canada
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/171607
2021-11-22T01:51:46Z
2021-11-22T01:51:46Z
Stress is a health hazard. But a supportive circle of friends can help undo the damaging effects on your DNA
<figure><img src="https://images.theconversation.com/files/432764/original/file-20211118-27-1rf4yck.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5991%2C3997&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Stress affects <a href="https://www.therecoveryvillage.com/mental-health/stress/related/stress-statistics/">up to 90% of people</a>, and we know it harms our mental and physical well-being. </p>
<p>Stress can impact the activity and function of our genes. It does this via “epigenetic” changes, which turn on and off certain genes, though it doesn’t change the DNA code.</p>
<p>But why do some people respond worse to stress, while others seem to cope under pressure?</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729718/">Previous</a> <a href="https://www.sciencedirect.com/science/article/pii/088394179290028H?via%3Dihub">research</a> has identified having strong social support and a sense of belonging are robust indicators of physical and mental health.</p>
<p>Social support means having a network you can turn to in times of need. This can come from natural sources such as family, friends, partners, pets, co-workers and community groups. Or from formal sources such as mental health specialists.</p>
<p>My new study, <a href="https://doi.org/10.1016/j.jpsychires.2021.11.026">published today in the Journal of Psychiatric Research</a>, shows for the first time that these positive effects are also observed on human genes.</p>
<p>Having supportive social structures buffers and even reverses some of the harmful effects of stress on our genes and health, via the process of epigenetics. </p>
<p>The findings suggest the DNA we are born with is not necessarily our destiny.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-chronic-stress-changes-the-brain-and-what-you-can-do-to-reverse-the-damage-133194">How chronic stress changes the brain – and what you can do to reverse the damage</a>
</strong>
</em>
</p>
<hr>
<h2>What is epigenetics?</h2>
<p>Our genes and our environment contribute to our health.</p>
<p>We inherit our DNA code from our parents, and this doesn’t change during our life. Genetics is the study of how the DNA code acts as a risk or protective factor for a particular trait or disease.</p>
<p><a href="https://www.science.org.au/curious/epigenetics">Epigenetics</a> is an additional layer of instructions on top of DNA that determines how they affect the body. This layer can chemically modify the DNA, without changing DNA code.</p>
<p>The term epigenetics is derived from the Greek word “epi” which means “over, on top of”.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-epigenetics-13877">Explainer: what is epigenetics?</a>
</strong>
</em>
</p>
<hr>
<p>This extra layer of information lies on top of the genes and surrounding DNA. It acts like a switch, turning genes on or off, which can also impact our health.</p>
<p>Epigenetic changes occur throughout our lives due to different environmental factors such as stress, exercise, diet, alcohol, and drugs.</p>
<p>For instance, chronic stress can impact our genes via epigenetic changes that in turn can <a href="https://onlinelibrary.wiley.com/doi/10.1111/acps.12778">increase the rate of mental health disorders</a> such as post-traumatic stress disorder (PTSD), depression and anxiety.</p>
<p>New technologies now allow researchers to collect a biological sample from a person (such as blood or saliva) and measure epigenetics to better understand how our genes respond to different environments.</p>
<p>Measuring epigenetics at different times allows us to gain insight into which genes are altered because of a particular environment.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/extreme-stress-in-childhood-is-toxic-to-your-dna-99009">Extreme stress in childhood is toxic to your DNA</a>
</strong>
</em>
</p>
<hr>
<h2>What did we study?</h2>
<p><a href="https://doi.org/10.1016/j.jpsychires.2021.11.026">My study</a> investigated both positive and negative factors that drive a person’s response to stress and how this changes the epigenetic profiles of genes.</p>
<p>Certain groups of people are more likely to face stress as a part of their routine work, such as emergency responders, medical workers and police officers. </p>
<p>So, my research team and I recruited 40 Australian first year paramedical students at two points in time – before and after exposure to a potentially stressful event. The students provided saliva samples for DNA and filled out questionnaires detailing their lifestyle and health at both points in time.</p>
<p>We investigated epigenetic changes before and after exposure to stress, to better understand: </p>
<ul>
<li><p>how epigenetics of genes was altered after exposure to stress</p></li>
<li><p>which different social and psychological factors caused the epigenetic changes.</p></li>
</ul>
<figure class="align-center ">
<img alt="Two paramedics helping an injured patient" src="https://images.theconversation.com/files/432767/original/file-20211118-20-6bseji.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/432767/original/file-20211118-20-6bseji.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/432767/original/file-20211118-20-6bseji.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/432767/original/file-20211118-20-6bseji.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/432767/original/file-20211118-20-6bseji.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/432767/original/file-20211118-20-6bseji.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/432767/original/file-20211118-20-6bseji.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Chronic stress, for example via a stressful job, can cause epigenetic changes.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>We found stress influenced epigenetics and this in turn led to increased rates of distress, anxiety, and depressive symptoms among participants.</p>
<p>However, students who reported high levels of perceived social support showed lesser levels of stress-related health outcomes.</p>
<p>Students with a strong sense of belonging to a group, organisation, or community dealt much better with stress and had reduced negative health outcomes following exposure to stress.</p>
<p>Both these groups of students showed fewer epigenetic changes in genes that were altered as a result of stress.</p>
<h2>COVID has made us more isolated</h2>
<p>The COVID pandemic has created heavy psychological and emotional burdens for people due to uncertainty, altered routines and financial pressures.</p>
<p>In Australia, the rates of anxiety, depression and suicide have soared since the start of the pandemic. <a href="https://www.theguardian.com/world/2021/jul/14/covids-mental-health-toll-one-in-five-australians-report-high-levels-of-psychological-distress">One in five Australians</a> have reported high levels of psychological distress. </p>
<p>The pandemic has also made us more isolated, and our relationships more remote, having a profound impact on social connections and belonging. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1271597465532325894"}"></div></p>
<p>My study highlights how family and community support, and a sense of belonging, influence our genes and act as a protective factor against the effects of stress.</p>
<p>In such unprecedented and stressful times, it’s vital we build and maintain strong social structures that contribute to good physical and mental well-being.</p><img src="https://counter.theconversation.com/content/171607/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Divya Mehta receives funding from the Australian Government National Health and Medical Research Council. </span></em></p>
Having strong social support and a sense of belonging buffered and even reversed some of the harmful effects of stress on genes.
Divya Mehta, Principal Research Fellow and Team Leader, Queensland University of Technology
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/152791
2021-01-20T13:32:01Z
2021-01-20T13:32:01Z
They don’t come as pills, but try these 6 underprescribed lifestyle medicines for a better, longer life
<figure><img src="https://images.theconversation.com/files/378940/original/file-20210114-17-2vf0g4.jpg?ixlib=rb-1.1.0&rect=8%2C22%2C2982%2C1976&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Families can prioritize learning more healthy ways to eat.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/sheriss-chacon-and-her-brother-shawn-chacon-watch-as-eden-news-photo/893170?adppopup=true">Joe Raedle/ Getty Images News</a></span></figcaption></figure><p>The majority of Americans are <a href="http://dx.doi.org/10.15585/mmwr.mm6932a1">stressed</a>, <a href="https://www.cdc.gov/sleep/data_statistics.html">sleep-deprived</a> and <a href="https://www.cdc.gov/nchs/fastats/obesity-overweight.htm">overweight</a> and suffer from largely preventable lifestyle diseases such as <a href="https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death">heart disease, cancer, stroke and diabetes</a>. Being overweight or obese contributes to the <a href="https://www.cdc.gov/bloodpressure/facts.htm">50% of adults who suffer high blood pressure</a>, <a href="https://www.cdc.gov/chronicdisease/resources/publications/factsheets/diabetes-prediabetes.htm">10% with diabetes and additional 35% with pre-diabetes</a>. And the costs are unaffordable and growing. About 90% of the <a href="https://www.cdc.gov/chronicdisease/about/costs/index.htm">nearly $4 trillion</a> Americans spend annually for health care in the U.S. is for chronic diseases and mental health conditions. But there are new lifestyle “medicines” that are free that doctors could be prescribing for all their patients.</p>
<p><a href="https://www.lifestylemedicine.org/">Lifestyle medicine</a> is the clinical application of healthy behaviors to prevent, treat and reverse disease. More than ever, <a href="https://adventisthealthstudy.org/?rsource=publichealth.llu.edu/adventist-health-studies">research</a> <a href="https://www.nurseshealthstudy.org">underscores</a> <a href="https://sites.sph.harvard.edu/hpfs/">that</a> <a href="http://www.commissiononhealth.org/Home.aspx">the “pills”</a> today’s physician should be prescribing for patients are the six domains of lifestyle medicine: whole food plant-based eating, regular physical activity, restorative sleep, stress management, addiction reduction or elimination, and positive psychology and social connection. </p>
<p>We are a primary care <a href="https://www.workpartnersblog.com/workpartners-thought-leaders-to-present-at-2019-health-benefits-conference-expo/">preventive medicine physician</a>
and a <a href="https://mirm-pitt.net/our-people/faculty-staff-bios/yoram-vodovotz-phd/">computational immunologist</a>, both committed to applying state-of-the-art research to <a href="https://www.ardmoreinstituteofhealth.org/lmrsummit">inform the clinical practice of lifestyle medicine</a>. <a href="https://doi.org/10.3389/fmed.2020.585744">Our findings and recommendations</a> were just published. We highlight the key take-home points for each of the areas below. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=473&fit=crop&dpr=1 600w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=473&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=473&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=595&fit=crop&dpr=1 754w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=595&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=595&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Use the Healthy Eating Plate as an evidence-based guide for creating healthy, balanced meals.</span>
<span class="attribution"><a class="source" href="https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/">©2011, Harvard University</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<h2>Whole-food, plant-based eating</h2>
<p>Diets high in fruits, vegetables and whole grains and lower in animal products and highly processed foods have <a href="https://eatforum.org/content/uploads/2019/01/EAT-Lancet_Commission_Summary_Report.pdf">been associated</a> <a href="http://doi.org/10.1001/jama.288.20.2569">with prevention</a> of many diseases. These diets have also <a href="http://doi.org/10.1001/jama.288.20.2569">improved health</a> <a href="https://doi.org/10.7812/TPP/17-025">and even reversed</a> common <a href="https://www.cdc.gov/chronicdisease/about/costs/index.htm">cardiovascular, metabolic, brain, hormonal, kidney and autoimmune diseases as well as 35% of all cancers</a>.</p>
<p>We believe that future research should include larger trials or new research methods with <a href="http://doi.org/10.1001/jamainternmed.2020.2790">emphasis on quality of diet</a>. This would include more data on the micronutrient composition and protein sources of plant versus animal-based foods – not just proportion of fat, carbohydrates and protein. Such trials should include children, as many adult disorders are seeded as early as infancy or in utero. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/378939/original/file-20210114-17-1fhevh1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/378939/original/file-20210114-17-1fhevh1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/378939/original/file-20210114-17-1fhevh1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/378939/original/file-20210114-17-1fhevh1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/378939/original/file-20210114-17-1fhevh1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/378939/original/file-20210114-17-1fhevh1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/378939/original/file-20210114-17-1fhevh1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">First Lady Michelle Obama led a Let’s Move! initiative to help children grow up healthy.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/first-lady-michelle-obama-participates-in-a-yoga-class-news-photo/474864367?adppopup=true">Joe Raedle/Getty Images News/Getty Images</a></span>
</figcaption>
</figure>
<h2>Regular physical activity</h2>
<p><a href="https://wonder.cdc.gov/wonder/prevguid/m0042984/m0042984.asp">For decades, surgeon generals’ guidelines</a> have emphasized that daily moderate-to-vigorous aerobic physical activity has both immediate and long-term health benefits. For example, why we age and the rate at which we age – chronological age versus biological age – is determined by multiple molecular processes that are directly influenced by physical activity. And now scientists are gaining a better understanding of the <a href="https://doi.org/10.1016/j.cmet.2015.05.011">cellular and molecular changes that exercise</a> induces to reduce disease risk. </p>
<p>Research priorities for scientists and physicians include obtaining a deeper understanding of the type, intensity and frequency of activity, and better insights into the molecular and <a href="https://doi.org/10.1016/bs.pmbts.2015.07.005">cellular alterations</a> <a href="https://doi.org/10.1016/bs.irn.2019.06.002">that occur with exercise</a>. </p>
<h2>Restorative sleep</h2>
<p>Sleep helps the cells, organs and entire body to function better. <a href="https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html">Regular uninterrupted sleep</a> of seven hours per night for adults, eight to 10 hours for teenagers and 10 or more for children is necessary for <a href="https://doi.org/10.5665/sleep.3298">good health</a>. </p>
<p>Though understudied, there is evidence that high-quality sleep can reduce <a href="https://doi.org/10.5665/sleep.3298">inflammation, immune dysfunction, oxidative stress, and epigenetic modification</a> of DNA, all of which are <a href="https://doi.org/10.1016/S1389-9457(08)70013-3">associated with or cause chronic disease</a>.</p>
<p>Therefore, research into the biological mechanisms that underlie the restorative properties of sleep could lead to environmental or population-based and policy approaches to better align our natural sleep patterns with the demands of daily life.</p>
<h2>Stress management</h2>
<p>Though some stress is beneficial, prolonged or extreme stress can overwhelm the brain and body. <a href="https://doi.org/10.1111/j.1467-8721.2006.00450.x">Chronic stress increases the risk of cardiovascular disease</a>, <a href="https://doi.org/10.1111/cns.12490">irritable bowel disease</a>, <a href="http://doi.org/10.1016/j.tem.2016.04.007">obesity</a>, depression, asthma, arthritis, autoimmune diseases, cardiovascular disease, cancer, diabetes, neurological disorders and obesity. </p>
<p>One of the most powerful mechanisms to reduce stress and enhance resilience is by <a href="https://doi.org/10.1056/NEJMp1917461">eliciting a relaxation response</a> using mind-body therapies and cognitive behavioral therapy. </p>
<p>More research is need to gain a better understanding of how these therapies work.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/378945/original/file-20210114-18-15aqmmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/378945/original/file-20210114-18-15aqmmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/378945/original/file-20210114-18-15aqmmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/378945/original/file-20210114-18-15aqmmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/378945/original/file-20210114-18-15aqmmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/378945/original/file-20210114-18-15aqmmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/378945/original/file-20210114-18-15aqmmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Thousands of people participate in yoga to improve their physical and mental health.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/kate-steinberg-age-9-from-montreal-joins-thousands-of-news-photo/980365680?adppopup=true">Timothy A. Clary/AFP via Getty Images</a></span>
</figcaption>
</figure>
<h2>Addiction reduction and elimination</h2>
<p>Many social, economic and environmental factors have fueled the national rise in substance abuse generally and, most tragically, the opioid epidemic. </p>
<p>Physicians and researchers are beginning to understand the underlying physiology and psychology of addiction. </p>
<p>Yet the <a href="https://doi.org/10.17226/25310">continued stigma and disjointed or absent access</a> to services remains a challenge. Clinicians and scientists need to explore how to predict who is more vulnerable to addiction and find ways of preventing it. <a href="https://doi.org/10.1080/00952990.2018.1546862">Treatment that incorporates integrated care</a> focused on all the patient’s needs should be prioritized. </p>
<h2>Positive psychology and social connection</h2>
<p>Maintaining a positive mindset through the practice of gratitude and forgiveness has a significant impact on psychological and subjective well-being, which are, in turn, associated with <a href="https://doi.org/10.1007/s10902-019-00082-1">physical health benefits</a>. </p>
<p>Social connectivity, namely the quantity and quality of our relationships, has perhaps <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674503816">the most powerful health benefits</a>. </p>
<p>Conversely, <a href="https://doi.org/10.1037/0033-2909.119.3.488">social isolation</a> – such as <a href="https://doi.org/10.2105/AJPH.2016.303431">living alone, having a small social network</a>, participating in few social activities, and feeling lonely – <a href="https://doi.org/10.1212/01.WNL.0000147473.04043.B3">is associated with greater mortality</a>, increased morbidity, lower immune system function, depression and cognitive decline. </p>
<p>Further study is needed to uncover how an individual’s biology and chemistry change for the better through more social interactions. </p>
<h2>Inflammation’s role in lifestyle-related diseases</h2>
<p>Unhealthy lifestyle behaviors produce a vicious cycle of inflammation. While inflammation is a healthy, natural way the body fights infections, injury, and stress, too much inflammation actually promotes or exacerbates the diseases described above.</p>
<p>The inflammatory response is complex. We have been using machine learning and computer modeling to <a href="https://www.springer.com/gp/book/9783030565091">understand, predict, treat and reprogram inflammation</a> – to retain the healing elements while minimizing the detrimental more chronic ones. Scientists are unraveling new mechanisms that explain how chronic stress can turn genes on and off. </p>
<h2>Overcoming challenges and barriers</h2>
<p>We and others who study lifestyle medicine are now discussing how we can leverage all of these approaches to improve <a href="https://www.frontiersin.org/files/Articles/585744/fmed-07-585744-HTML/image_m/fmed-07-585744-g001.jpg">clinical studies on the impacts</a> of lifestyle interventions. </p>
<p>At the same time we and our colleagues realize that there are environmental challenges and barriers that prevent many people from embracing these lifestyle fixes. </p>
<p>There are food deserts where healthier foods are not available or affordable. Unsafe neighborhoods, harmful chemicals and substances create constant stress. Poor education, poverty, cultural beliefs and racial and ethnic disparities and discrimination must be addressed for all people and patients to appreciate and embrace the six “pills.” </p>
<p>The application of lifestyle medicines is particularly important now because unhealthy lifestyles have caused a pandemic of preventable chronic diseases that is now exacerbating the COVID-19 pandemic, which disproportionately <a href="https://doi.org/10.1177/1559827620950276">afflicts those with these conditions</a>. </p>
<p>Ask your doctor to <a href="https://www.guidetogoodhealth.com/Articles/LifestyleMedicine.asp">“prescribe” these six “pills”</a> for a longer and better life. After all, they’re free, work better than or as well as medications and have no side effects! </p>
<p>[<em>The Conversation’s science, health and technology editors pick their favorite stories.</em> <a href="https://theconversation.com/us/newsletters/science-editors-picks-71/?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=science-favorite">Weekly on Wednesdays</a>.]</p><img src="https://counter.theconversation.com/content/152791/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Yoram Vodovotz is a co-founder of, and stakeholder in Immunetrics, Inc.</span></em></p><p class="fine-print"><em><span>Michael Parkinson, MD, MPH is founder of P3 Health (Prevention, Performance & Productivity). </span></em></p>
Lifestyle medicine targets the root of chronic diseases like obesity, heart disease and diabetes. Experts explain why everyone should embrace these free prescriptions for good health.
Yoram Vodovotz, Professor of Surgery, University of Pittsburgh
Michael Parkinson, Senior Medical Director of Health and Productivity, UPMC Health Plan & Workpartners, University of Pittsburgh
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/149127
2020-11-24T15:32:02Z
2020-11-24T15:32:02Z
For university students, COVID-19 stress creates perfect conditions for mental health crises
<figure><img src="https://images.theconversation.com/files/370331/original/file-20201119-17-4s7p7d.jpg?ixlib=rb-1.1.0&rect=75%2C0%2C3319%2C2576&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A lone cyclist rides past the University of Toronto campus during the COVID-19 pandemic in Toronto on June 10, 2020. </span> <span class="attribution"><span class="source">THE CANADIAN PRESS/Nathan Denette</span></span></figcaption></figure><p>The COVID-19 pandemic has impacted the lives of most, if not all, individuals living in Canada. However, it is becoming increasingly apparent that the <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/200527/dq200527b-eng.htm">mental health of younger populations</a> (ages 18-25) has been particularly affected.</p>
<p>A notable proportion of younger individuals living in Canada attend some form of post-secondary education, including university, which is considered challenging even in the best of times. Now, with an ongoing pandemic and associated physical distancing measures, many students have been faced with a set of additional challenges that includes campus closures and a quick pivot to remote learning, leading to a sense of <a href="https://doi.org/10.7759/cureus.7541">uncertainty about their academic futures</a>.</p>
<p>Perhaps most importantly, students are also facing <a href="https://www.ipsos.com/en-ca/news-and-polls/Majority-Of-Canadians-Say-Physical-Distancing-Has-Left-Them-Feeling-Lonely-Or-Isolated">social isolation</a> and a loss of social support because of the COVID-19 pandemic. Mandatory physical distancing measures and reductions on social gatherings have left many students feeling disconnected from their home campuses where support and services are typically available. </p>
<h2>Cumulative stressors</h2>
<p>The cumulative toll of these stressors is likely to have a significant impact on the health and well-being of students. With the winter months looming ahead, and no real end in sight for a return to campus, it’s important to consider how the stressors associated with COVID-19 and social isolation will impact this vulnerable population. What can we predict, and what can we do about it?</p>
<p>Even prior to COVID-19, it was clear that university students were experiencing high rates of stress and mental health issues. For instance, <a href="https://www.cacuss.ca/files/Research/NCHA-II%20SPRING%202019%20CANADIAN%20REFERENCE%20GROUP%20EXECUTIVE%20SUMMARY.pdf">data collected in the spring of 2019</a> showed that over 50 per cent of students felt so depressed that it was difficult to function, almost 70 per cent felt overwhelming anxiety and about 16 per cent had seriously considered suicide in the preceding 12 months. </p>
<figure class="align-center ">
<img alt="A young woman sitting in front a desk and laptop, looking at her phone with her face in her hand." src="https://images.theconversation.com/files/370173/original/file-20201118-17-1gkulqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/370173/original/file-20201118-17-1gkulqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/370173/original/file-20201118-17-1gkulqm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/370173/original/file-20201118-17-1gkulqm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/370173/original/file-20201118-17-1gkulqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/370173/original/file-20201118-17-1gkulqm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/370173/original/file-20201118-17-1gkulqm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Challenges that COVID-19 has created for university students include pivoting to remote learning, isolation and the loss of social support.</span>
<span class="attribution"><span class="source">(Piqsels)</span></span>
</figcaption>
</figure>
<p>Our research group has been studying stress, coping and mental health in students for over a decade. As neuroscientists, we have been particularly interested in how stress might influence a person’s biology, including their stress hormones and immune responses, to predict symptoms of depression and anxiety. We have also been interested in understanding how a person’s genetic background interacts with stressful life experiences to predict vulnerability or resilience to mental health issues.</p>
<p>Among university student populations, we have frequently shown that traumatic events together with genetic make-up predict <a href="https://doi.org/10.3389/fnbeh.2017.00241">decision-making</a>, <a href="https://doi.org/10.3389/fpsyg.2015.01133">coping abilities</a>, symptoms of <a href="https://doi.org/10.3389/fnhum.2016.00358">depression and thoughts of suicide</a>. </p>
<p>We have also highlighted the importance of social relations for well-being, revealing that university students with poorer social ties have <a href="https://doi.org/10.1371/journal.pone.0195237">higher levels of inflammatory factors</a> known to play a role in depression. Crucially, our data point to just how effective social support is at <a href="https://doi.org/10.1016/j.ynstr.2016.01.001">buffering stress hormones</a>. This is concerning, given the reduced ability to have strong social ties and support networks during the pandemic.</p>
<h2>Chronic and unpredictable stress</h2>
<p>The COVID-19 pandemic can be thought of as a chronic and unpredictable form of stress that is, in some ways, similar to the types of stressful experiences that we have been studying. We have been tracking how the pandemic is affecting the mental health and well-being of university students, and whether we can identify those who are particularly vulnerable. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/strange-physical-symptoms-blame-the-chronic-stress-of-life-during-the-covid-19-pandemic-139096">Strange physical symptoms? Blame the chronic stress of life during the COVID-19 pandemic</a>
</strong>
</em>
</p>
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<p>Preliminary data from our research suggest that COVID-19 may be affecting students who identify as male and female differently. For example, more female students indicate that the COVID-19 pandemic has been extremely disruptive to their stress and mental health, and that it has significantly disrupted their academic studies. In addition, a greater proportion of female students compared to males report that social isolation has been difficult or very difficult. </p>
<p>Given the robust relationship between <a href="https://doi.org/10.1177/0020764018776349">loneliness and depression</a>, we predict that the higher rates of depressive symptoms among female students may be exacerbated in the climate of COVID-19. It is worth noting that others have also suggested that <a href="https://dx.doi.org/10.1016%2Fj.bbi.2020.05.040">young women are at increased risk of loneliness, depression and anxiety</a> during COVID-19.</p>
<figure class="align-center ">
<img alt="Rows of empty seats in a large lecture hall." src="https://images.theconversation.com/files/370174/original/file-20201118-21-ri4qx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/370174/original/file-20201118-21-ri4qx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/370174/original/file-20201118-21-ri4qx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/370174/original/file-20201118-21-ri4qx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/370174/original/file-20201118-21-ri4qx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/370174/original/file-20201118-21-ri4qx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/370174/original/file-20201118-21-ri4qx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">With no real end in sight for a return to campus, university students are vulnerable to the cumulative stressors associated with COVID-19 and social isolation.</span>
<span class="attribution"><span class="source">(Unsplash/Nathan Dumlao)</span></span>
</figcaption>
</figure>
<p>We observed that male and female students also cope differently with the pandemic. For example, more female students indicated that they were using social media to cope, and female students scored higher than males on measures of problematic social media use (for example, using social media more often than intended, feeling irritable when not online, using to reduce feelings of anxiety or depression).</p>
<p>By contrast, we are finding that using cannabis to cope with COVID-19 is associated with a greater negative impact on schoolwork and stress levels among male students, but not females. </p>
<h2>A long winter and a second wave</h2>
<p>With the second wave of COVID-19 officially <a href="https://www.cnbc.com/2020/10/14/who-warns-canada-is-facing-a-second-wave-of-coronavirus-cases-.html">upon us</a>, fewer opportunities to socialize safely outdoors in winter, and <a href="https://globalnews.ca/news/7424561/coronavirus-canada-pandemic-fatigue/">COVID-19 fatigue</a> settling in, we must support both the physical and mental health of our communities. </p>
<p>University students are already reporting that the pandemic is negatively affecting their mental health and disrupting their studies. A subset of students has increased the use of substances such as alcohol and cannabis to cope. The unique challenges male and female students are facing suggest that we may expect to see decreases in academic performance and higher attrition rates — unless appropriate support is provided for these students. </p>
<p>For public health officials and policy-makers, that means using <a href="https://www.theglobeandmail.com/canada/article-messaging-matters-experts-urge-clearer-physical-distancing/">harm reduction approaches</a> to acknowledge and mitigate the risks associated with social contact during the pandemic, particularly among this population. University administrators must ensure there is adequate funding and resources to support student mental health, including addressing problematic substance use. Professors must be willing to acknowledge and address mental health with their student populations. </p>
<p>Now more than ever, we should be paying attention to student mental health. </p>
<p><em>If you are having thoughts of suicide or need counselling now, download the LifeLine app for hotline crisis call, text and chat options, as well as prevention and awareness tips; or call Crisis Services Canada at 1-833-456-4566, crisisservicescanada.ca.</em></p><img src="https://counter.theconversation.com/content/149127/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alfonso Abizaid receives funding from CIHR and NSERC</span></em></p><p class="fine-print"><em><span>Robyn McQuaid receives funding from CIHR. She is affiliated with the University of Ottawa Institute of Mental Health Research. </span></em></p><p class="fine-print"><em><span>Kim Hellemans, Robert Gabrys, and Zachary Patterson do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
University students had high rates of mental health issues before the pandemic. The additional stressors of COVID-19 and social isolation will make them even more vulnerable over the winter.
Kim Hellemans, Chair, Department of Neuroscience, Carleton University
Alfonso Abizaid, Professor, Department of Neuroscience, Carleton University
Robert Gabrys, Adjunct Research Professor, Department of Neuroscience, Carleton University
Robyn McQuaid, Adjunct Research Professor, Department of Neuroscience, Carleton University
Zachary Patterson, Instructor, Department of Neuroscience, Carleton University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/143792
2020-08-17T12:23:32Z
2020-08-17T12:23:32Z
Racism linked to cognitive decline in African American women
<figure><img src="https://images.theconversation.com/files/351621/original/file-20200806-18-ygkn8i.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5326%2C3564&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">For African-American women, experiencing racism can contribute to a variety of health issues.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/senior-woman-sitting-on-sofa-at-home-suffering-from-royalty-free-image/874789102?adppopup=true">Getty Images / monkeybusinessimages</a></span></figcaption></figure><p>African Americans <a href="https://doi.org/doi:%2010.1097/EDE.0000000000000747">have higher rates</a> of dementia and Alzheimer’s disease than white Americans. Chronic stress, <a href="https://doi.org/doi:%2010.1007/BF00308809">associated with</a> cognitive impairment and reduced volume in the brain’s memory area, could be a culprit. But racism may be one of the ultimate causes. And for African American women, the problem may be particularly pernicious.</p>
<p>We are <a href="https://www.bu.edu/sph/profile/lynn-rosenberg/">epidemiologists</a> at <a href="https://www.bu.edu/sph/profile/patricia-coogan/">Boston University</a>. <a href="https://www.bu.edu/sph/profile/yvette-cozier/">Our work</a> is focused on the Black Women’s Health Study (<a href="https://www.bu.edu/bwhs/">BWHS</a>), a landmark investigation that has followed 59,000 African American women since 1995. </p>
<p>Previous data from our study showed that racism experiences are associated with increased risks of <a href="https://doi.org/doi:%2010.1097/00001648-200211000-00008">premature birth</a>, <a href="https://doi.org/doi:%2010.1093/aje/kwu004">obesity</a>, <a href="https://doi.org/doi:%2010.1007/s00125-017-4400-6">Type 2 diabetes</a>, <a href="https://doi.org/doi:%2010.1097/EDE.0b013e3181567e92">uterine fibroids</a>, <a href="https://doi.org/doi:%2010.1378/chest.13-0665">adult-onset asthma</a> and <a href="https://doi.org/doi:%2010.1093/sleep/zsz208">insomnia</a>.</p>
<p>More recently, we wanted to see how racism might impact cognition in African American women. <a href="http://dx.doi.org/10.1002/dad2.12067">And we found</a> that women reporting the most racism scored lower on tests of cognitive function than those who reported few such experiences. </p>
<figure class="align-center ">
<img alt="There may be a long-term cost to the chronic stress experienced by African American women." src="https://images.theconversation.com/files/351624/original/file-20200806-16-1hixokc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/351624/original/file-20200806-16-1hixokc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/351624/original/file-20200806-16-1hixokc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/351624/original/file-20200806-16-1hixokc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/351624/original/file-20200806-16-1hixokc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/351624/original/file-20200806-16-1hixokc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/351624/original/file-20200806-16-1hixokc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The chronic stress experienced by African American women may have a long-term cost.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/multi-ethnic-businesspeople-in-urban-scene-royalty-free-image/91497103?adppopup=true">Getty Images/PBNJ Productions</a></span>
</figcaption>
</figure>
<h2>The connection between racism and health</h2>
<p>Here are the details: In 1997, and again in 2009, we asked participants about their experience with interpersonal and institutional racism. </p>
<p>For interpersonal racism, we asked questions like: How often do people act as if they were afraid of you? </p>
<p>For institutional racism, we asked: Have you been unfairly treated by police, or when looking for housing or a job? </p>
<p>Cognitive decline generally occurs at older ages. When the study began, half the participants were 38 or younger. Twenty years later, in 2015, the time was ripe to study cognitive aging. </p>
<p>More than 17,000 African American women, age 55 or older, participated. We asked them six questions to measure subjective cognitive function. Three questions asked if they had difficulties with memory, like remembering a short list of items. The other three asked about cognition difficulties, like following a group conversation. </p>
<p>Sixty percent of the women reported no difficulties with any of the six situations. Twelve percent reported difficulties with three or more. Those women scoring lowest also reported the highest level of everyday and institutional racism. The association between racism and poor cognitive function, our analysis suggests, might be partly attributable to increased depression or insomnia in the women who experienced the most racism.</p>
<p>A caveat: Our study, though large and statistically powerful, has a major limitation. As one might imagine, subjective cognitive function is a subjective measure. Although <a href="https://doi.org/doi:%2010.1002/1099-1166(200011)15:11%3C983::aid-gps238%3E3.0.co;2-5">studies show</a> subjective assessment <a href="https://doi.org/doi:%2010.1111/j.1532-5415.2011.03543.x">is associated with</a> objective measures of cognition – <a href="https://doi.org/doi:%2010.1016/j.jalz.2007.01.011">and is predictive</a> of dementia and Alzheimer’s disease onset – purely objective measures would still be preferable.</p>
<figure class="align-center ">
<img alt="The Black Women's Health Study began in 1995." src="https://images.theconversation.com/files/351626/original/file-20200806-20-1sgwkjy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/351626/original/file-20200806-20-1sgwkjy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/351626/original/file-20200806-20-1sgwkjy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/351626/original/file-20200806-20-1sgwkjy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/351626/original/file-20200806-20-1sgwkjy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/351626/original/file-20200806-20-1sgwkjy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/351626/original/file-20200806-20-1sgwkjy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The Black Women’s Health Study spans generations.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/three-generations-of-women-looking-at-photographs-royalty-free-image/519517113?adppopup=true">Getty Images/Jose Luis Pelaez Inc.</a></span>
</figcaption>
</figure>
<h2>Other studies, future studies</h2>
<p>What have other studies found on racism and cognition?</p>
<p>We found (only) three in the scientific literature. In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409294/">Minority Aging Research Study</a>, with 407 African American participants, high levels of perceived racism were associated with worse global cognition. In the <a href="https://hrs.isr.umich.edu/welcome-health-and-retirement-study">Health and Retirement Study</a>, with 1,628 African Americans, discrimination scores were higher and cognitive scores lower in African Americans than white participants at baseline. Over six years of follow-up, more discrimination was associated with faster episodic memory decline. </p>
<p>The third study – the National Survey of Midlife Development, which included 796 African Americans – had contrasting results. Little difference existed between the reported discrimination in African Americans and whites. And discrimination was not associated with cognition in the combined sample. </p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p>
<p>We will continue to study how racism intersects with cognition in our study participants. As we go forward, we will develop better assessments of cognitive function, which is affected by many factors: good jobs, housing, medical care, quality education, fair policing, access to healthy food and safe neighborhoods. </p>
<p>The demonstrations following the murder of George Floyd indicate that better conditions for African Americans may finally start to happen. But even if that occurs, self-care is imperative to help stem the effects of racism and other stressors. To that end, we will orient our analyses to how individual actions – like exercise, spirituality or religious practices – might counteract the destructive effects of racism.</p><img src="https://counter.theconversation.com/content/143792/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lynn Rosenberg receives funding from the National Institutes of Health.</span></em></p><p class="fine-print"><em><span>Patricia Coogan receives funding from the National Institutes of Health. </span></em></p><p class="fine-print"><em><span>Yvette Cozier receives funding from National Cancer Institute U01-CA164974 and the National Institute of Arthritis and Musculoskeletal and Skin Diseases R01-AR0573727.</span></em></p>
A landmark study shows chronic stress from racism can lead to loss of brain function in African American women.
Lynn Rosenberg, Professor of Epidemiology, Boston University
Patricia Coogan, Research Professor of Epidemiology, Boston University
Yvette Cozier, Associate professor, Epidemiology, Boston University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/139096
2020-06-11T22:02:36Z
2020-06-11T22:02:36Z
Strange physical symptoms? Blame the chronic stress of life during the COVID-19 pandemic
<figure><img src="https://images.theconversation.com/files/340478/original/file-20200609-165397-btma4q.jpg?ixlib=rb-1.1.0&rect=502%2C10%2C5985%2C4456&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Chronic stress can lead to inflammation, which can result in physical symptoms as well as mental health symptoms.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>During the current COVID-19 pandemic have you been wondering why you’re getting headaches more often? Or stomach aches? Or feeling itchy or getting pimples? Or why your periods are irregular or more painful than usual? Exciting recent science suggests that the answers may lie in our body’s <a href="https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780190681777.001.0001/oxfordhb-9780190681777">biological reactions to stress</a>. </p>
<p>Our biological stress response system — the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181830/pdf/DialoguesClinNeurosci-8-383.pdf">hypothalamic-pituitary-adrenal</a> (HPA) axis — evolved hundreds of millions of years ago to help our vertebrate ancestors quickly mobilize energy to confront imminent, life-or-death threats, such as predator attacks. In the short term, this system is exquisite in its efficiency and crucial to survival. </p>
<p>The problem with our current situation is that it has been going on for months, and the end is not clearly in sight. <a href="https://doi.org/10.1177%2F2470547017692328">Chronic stress</a> sends the HPA axis into overdrive, with effects felt throughout the body. These symptoms can even serve as further sources of stress. Understanding why our bodies are reacting in these ways can help us develop strategies to prevent stress from getting under our skin.</p>
<h2>The biological stress response</h2>
<p>When animals perceive a threat in their environment, the HPA axis stimulates the adrenal glands to release the hormone cortisol. Cortisol, along with adrenaline, work to pump oxygen to the major muscles to enable the animal to fight or escape. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/341207/original/file-20200611-80746-1izi19h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/341207/original/file-20200611-80746-1izi19h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=300&fit=crop&dpr=1 600w, https://images.theconversation.com/files/341207/original/file-20200611-80746-1izi19h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=300&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/341207/original/file-20200611-80746-1izi19h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=300&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/341207/original/file-20200611-80746-1izi19h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=377&fit=crop&dpr=1 754w, https://images.theconversation.com/files/341207/original/file-20200611-80746-1izi19h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=377&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/341207/original/file-20200611-80746-1izi19h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=377&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Human stress response was designed to cope with short-term threats like predator attacks, not the chronic stress of things like COVID-19.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>This “fight/flight” response produces physical symptoms such as heart palpitations and chest tightness (the heart pumping oxygen to the major muscles), and stomach butterflies, nausea and tingling (blood leaving the stomach and extremities to get to the major muscles). </p>
<p>The HPA axis also interacts with the <a href="http://www.doi.org/10.1093/oxfordhb/9780190681777.013.24">immune system</a> to help with the aftermath. Cortisol is a potent anti-inflammatory and binds to large numbers of <a href="https://doi.org/10.1155/2012/403908">receptors in the skin</a> to help repair wounds and fight infection.</p>
<p>The HPA axis doesn’t know the difference between the life-or-death threat of a predator attack and modern stressors. So, in the early stages of this crisis, if your stomach did flip-flops, or you felt your heart racing, when reading about surges in COVID-19 cases, your body was doing what it was designed to do even though at that moment you were not in any imminent physical danger.</p>
<h2>The problem of chronic stress</h2>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/341210/original/file-20200611-80770-1q5jfpa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/341210/original/file-20200611-80770-1q5jfpa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/341210/original/file-20200611-80770-1q5jfpa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/341210/original/file-20200611-80770-1q5jfpa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/341210/original/file-20200611-80770-1q5jfpa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/341210/original/file-20200611-80770-1q5jfpa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/341210/original/file-20200611-80770-1q5jfpa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Chronic stress can lead to inflammation, which can result in physical symptoms as well as mental health symptoms.</span>
<span class="attribution"><span class="source">(Piqsels)</span></span>
</figcaption>
</figure>
<p>A predator attack is time-limited. In contrast, the COVID-19 pandemic has been going on for weeks, and may be compounded by social isolation, job or financial insecurity and care-taking responsibilities. Unfortunately, all the HPA axis knows is that it needs to release stress hormones when we perceive a threat in our environment. So, if we perceive our environment as threatening all the time, then the HPA axis will release these chemicals all the time. </p>
<p>One of the most pronounced effects of long-term cortisol release is <a href="http://doi.org/10.1111/j.1749-6632.2012.06633.x">glucocorticoid resistance</a>. This is when cells in the immune system become less sensitive to the anti-inflammatory effects of cortisol. As a result, cortisol starts to increase inflammation throughout the body and brain. </p>
<p>So, your itchiness and rashes? All of the cortisol receptors in your skin may no longer be receptive to cortisol’s anti-inflammatory effects and instead, chemicals are released that <a href="https://doi.org/10.1155/2012/403908">inflame the skin</a>. </p>
<p>Your <a href="https://doi.org/10.1038/s41582-019-0216-y">headaches or stomach aches</a>? <a href="http://dx.doi.org/10.1136/oem.2003.012302">Painful periods</a>? All of these symptoms can also be the result of inflammation in these organ systems caused by chronic HPA axis activation. </p>
<p>Even psychological symptoms, such as feelings of <a href="http://www.doi.org/10.1093/oxfordhb/9780190681777.013.24">depression or loneliness</a>, have been linked to the release of pro-inflammatory chemicals caused by chronic stress. </p>
<h2>Taking control of your stress response</h2>
<p>Much of what is perceived as stressful on a day-to-day level is not specific to contracting the COVID-19 virus, but instead is the result of changes that we have had to make in our lives. A switch to working from home, or not working, has disrupted our sleeping, eating and activity schedules that regulate our internal circadian clock. Staying indoors means lower exercise and activity levels. Many people, especially those living alone, are socially isolated from friends and loved ones. </p>
<p><a href="https://doi.org/10.1186/s41606-017-0019-2">Disrupted circadian routines</a>, <a href="https://doi.org/10.1371/journal.pone.0078350">lack of exercise</a> and <a href="https://doi.org/10.1016/j.neubiorev.2020.02.002">social isolation</a> have all been strongly linked to dysregulation of the body’s stress and immune systems, and release of pro-inflammatory chemicals in the body and brain. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/340248/original/file-20200608-176560-6u5bkq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/340248/original/file-20200608-176560-6u5bkq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/340248/original/file-20200608-176560-6u5bkq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/340248/original/file-20200608-176560-6u5bkq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/340248/original/file-20200608-176560-6u5bkq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/340248/original/file-20200608-176560-6u5bkq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/340248/original/file-20200608-176560-6u5bkq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Physical distancing during COVID-19 shouldn’t mean losing contact with loved ones.</span>
<span class="attribution"><span class="source">(Unsplash)</span></span>
</figcaption>
</figure>
<p>Fortunately, even small positive changes in these areas can have strong stress-reducing effects. Keeping a <a href="https://doi.org/10.1038/nri3386">regular routine</a> by going to bed, getting up and eating at consistent times each day has been linked to greater overall health by promoting healthy function of the HPA axis and immune system. Even 20 minutes of <a href="https://doi.org/10.1016/j.bbi.2016.12.017">moderate exercise</a>, which inside could include exercise videos or jogging around at home, regulates the HPA axis, reduces inflammation and has strong mood-lifting effects. </p>
<p>Finally, talking regularly with friends and loved ones, even remotely or at a distance, is one of the best things you can do to protect against the biological and <a href="https://doi.org/10.1111/aphw.12000">psychological</a> effects of stress. Remember, we’re all in this together!</p><img src="https://counter.theconversation.com/content/139096/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kate Harkness receives funding from the Social Sciences and Humanities Research Council. Kate Harkness receives royalties from sales of the Oxford Handbook of Stress and Mental Health. </span></em></p>
Itchy skin? More aches and pains? Unusual rash? Headaches? Pimples? If you’ve been experiencing unusual physical symptoms recently, the stress of the COVID-19 pandemic may be the reason.
Kate Harkness, Professor of Psychology and Psychiatry and Director of the Mood Research Laboratory, Queen's University, Ontario
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/137963
2020-05-21T15:55:02Z
2020-05-21T15:55:02Z
The chronic stress of coronavirus is affecting your mental health. Here’s how exercise can help.
<figure><img src="https://images.theconversation.com/files/336797/original/file-20200521-102642-102vz8q.jpg?ixlib=rb-1.1.0&rect=0%2C170%2C5335%2C3682&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A brisk 30-minute walk three times a week is enough to prevent stress-induced depression.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Suffering a quarantine dip in mood? Struggling to find motivation to do anything? You are not alone. Just <a href="https://doi.org/10.1016/j.biopsycho.2018.01.015">six weeks of chronic stress can lead to depressive symptoms</a>, even in people without a prior diagnosis. We are past that six-week point in this pandemic and you may be experiencing a depressed mood unlike anything you’ve experienced before.</p>
<p>Our research in the <a href="http://neurofitlab.ca/">NeuroFit lab</a> at McMaster University shows that <a href="https://doi.org/10.1016/j.biopsycho.2018.01.015">exercise can prevent stress-induced depression</a>. A brisk 30-minute walk three times a week is enough. But even under the best circumstances, <a href="https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009613">nearly half of young adults and 70 per cent of older adults</a> find it difficult to be sufficiently active for good health.</p>
<p>Our latest research aims to develop an Exercise Toolkit for Mental Health to support people during this pandemic and in the future. <a href="https://surveys.mcmaster.ca/limesurvey/index.php/727645?lang=en">But we need your help</a>. By participating in our survey, you’ll be helping us gather the information we need to provide a toolkit based on the real circumstances that people are coping with during COVID-19.</p>
<h2>One stress response for all stressors</h2>
<p>An unfortunate side effect of the COVID-19 pandemic is its impact on psychological distress and mental health. Psychological stress, such as a conflict with a family member, <a href="https://www.karger.com/Article/Abstract/362736">activates the stress response in the same way as a physical threat</a>. It all starts in the brain stem with the activation of the hypothalamus and its two parallel axes: <a href="https://www.youtube.com/watch?v=dErTZ-zj1dQ">the SAM axis (sympathetic adrenal medullary) and the HPA axis (hypothalamic pituitary adrenal)</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/335435/original/file-20200515-138620-1dzzbxu.jpg?ixlib=rb-1.1.0&rect=204%2C0%2C1612%2C830&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/335435/original/file-20200515-138620-1dzzbxu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=260&fit=crop&dpr=1 600w, https://images.theconversation.com/files/335435/original/file-20200515-138620-1dzzbxu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=260&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/335435/original/file-20200515-138620-1dzzbxu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=260&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/335435/original/file-20200515-138620-1dzzbxu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=327&fit=crop&dpr=1 754w, https://images.theconversation.com/files/335435/original/file-20200515-138620-1dzzbxu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=327&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/335435/original/file-20200515-138620-1dzzbxu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=327&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The pandemic has brought with it numerous stressors, including health issues, financial issues, relationship issues, isolation and changes in home and work responsibilities.</span>
<span class="attribution"><span class="source">(Pixabay)</span></span>
</figcaption>
</figure>
<p>The SAM axis works quickly. Through the sympathetic nervous system, it causes a rush of adrenaline into the blood, initiating the “fight or flight” response to unleash the body’s maximum power. </p>
<p>The HPA axis works more gradually. It induces a cascade of hormones that leads to the release of cortisol into the blood, which in turn liberates stored sugars from the liver and fat cells. This provides the body with the energy it needs to endure the stressors over a longer period of time.</p>
<p>In its acute form, stress is actually a good thing because it <a href="https://doi.org/10.1053/meta.2002.33184">wakes up your brain and body for action</a> and helps <a href="https://doi.org/10.1002/smi.1182">performance</a>. However, in its chronic form, there is greater reactivity and slower recovery of the stress response. That means the stress response is triggered more easily, in response to lower levels of stress, and takes longer to revert to a normal state. The result is major strain to the brain and body that can lead to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341916/">symptoms of mental and physical illness</a>.</p>
<h2>Chronic stress of COVID-19 pandemic</h2>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/336239/original/file-20200520-152288-1lyp70v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/336239/original/file-20200520-152288-1lyp70v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/336239/original/file-20200520-152288-1lyp70v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/336239/original/file-20200520-152288-1lyp70v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/336239/original/file-20200520-152288-1lyp70v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/336239/original/file-20200520-152288-1lyp70v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/336239/original/file-20200520-152288-1lyp70v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The COVID-19 pandemic has increased stress levels, while at the same time making it more difficult to exercise, which is a proven stress management strategy.</span>
<span class="attribution"><span class="source">(Piqsels)</span></span>
</figcaption>
</figure>
<p>This pandemic is incredibly stressful. The abrupt halt to “life as usual” and the idea that things may never be the same has forced a rapid <a href="https://doi.org/10.1002/ejsp.669">evolution in our collective self-identity. As a result, many people feel like they’ve lost their place in this world</a>. This adds extra tension to daily life, making us <a href="https://doi.org/10.1016/j.psyneuen.2014.07.021">more reactive to seemingly minor events</a>, and this can play a major role in forecasting our future brain health. </p>
<p>Under normal circumstances, <a href="https://journals.sagepub.com/doi/10.1177/0956797612462222">people reported nearly a 50 per cent chance of having a stressful day</a>. This number is <a href="https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html">likely higher while people are under stay-at-home orders</a>. Although everyone feels worse on stressful days, <a href="https://doi.org/10.1177/0956797612462222">people who have more extreme mood swings</a> between stressful and non-stressful days are at an increased risk of developing depression and anxiety.</p>
<p>How long will this last? No one really knows. Over time, this uncertainty and lack of control can alter our reaction to other stressors. Instead of “fight or flight,” we “<a href="https://doi.org/10.1007/978-1-4613-8309-3_5">freeze</a>,” feeling helpless and lacking motivation. These are symptoms of stress-induced depression.</p>
<h2>Cross-training the stress response with exercise</h2>
<p>Exercise can help. Even though it’s technically a stressor and activates the stress response in the same way as a psychological stressor, the magnitude of the exercise stress response is acute and controllable by modifying intensity and duration. Like strengthening a muscle, <a href="https://doi.org/10.1007/s00421-015-3284-8">exercise “tones” the stress system so that it can tolerate a higher level of stress with less reaction and faster recovery</a>. This makes us more resilient to all forms of stressors, even the psychological ones brought on by this pandemic.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/336236/original/file-20200520-152320-1ccr78d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/336236/original/file-20200520-152320-1ccr78d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/336236/original/file-20200520-152320-1ccr78d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/336236/original/file-20200520-152320-1ccr78d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/336236/original/file-20200520-152320-1ccr78d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/336236/original/file-20200520-152320-1ccr78d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/336236/original/file-20200520-152320-1ccr78d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The closure of gyms and recreational facilities, and limited access to parks and trails, has made exercise more challenging at a time when we need it most.</span>
<span class="attribution"><span class="source">(Unsplash)</span></span>
</figcaption>
</figure>
<p>Research from our lab and others shows that about 30 minutes of moderate-intensity aerobic exercise three times weekly can boost mood, reduce psychological distress and decrease symptoms of depression and anxiety relative to those who are sedentary. When compared to <a href="https://doi.org/10.3389/fphar.2017.00257">antidepressant drugs, this dose of exercise is equally effective at treating stress-induced mental illness</a> without the potential side effects of medication, such as nausea, fatigue or loss of appetite.</p>
<p>However, the sudden closure of gyms and recreational facilities, the restricted access to public parks and trails and the closure of daycares and schools may make it more difficult for people to be sufficiently active for good health.</p>
<p>We want to know how you are doing. We have launched a <a href="https://surveys.mcmaster.ca/limesurvey/index.php/727645?lang=en">survey</a> designed to analyze the current mental health status caused by the pandemic, and pinpoint barriers preventing people from regular physical activity during the pandemic. That information will then be used to create an evidence-based physical activity toolkit, free to the public, by July 2020. For more information or to complete the survey, please visit: <a href="http://neurofitlab.ca/covid-19.html">neurofitlab.ca/covid-19.html</a></p><img src="https://counter.theconversation.com/content/137963/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer J. Heisz receives funding from NSERC, SSHRC, Canadian Foundation for Innovation, Ontario Ministry of Research and Innovation. </span></em></p><p class="fine-print"><em><span>Maryam Marashi receives funding from The Social Sciences and Humanities Research Council (SSHRC).</span></em></p>
Physical activity can help people manage the stress of COVID-19, but closures and distancing have made it even harder to exercise. These researchers are developing a free toolkit to help us all cope.
Jennifer J. Heisz, Associate Professor in Kinesiology and Associate Director (Seniors) of the Physical Activity Centre of Excellence, McMaster University
Maryam Marashi, Master's Student, Kinesiology, McMaster University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/133427
2020-03-22T12:21:19Z
2020-03-22T12:21:19Z
Anxiety about coronavirus can increase the risk of infection — but exercise can help
<figure><img src="https://images.theconversation.com/files/321442/original/file-20200318-1937-1fudgfi.jpg?ixlib=rb-1.1.0&rect=32%2C114%2C5405%2C3195&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Stress about the coronavirus pandemic can actually increase your risk of infection, but exercise can alleviate the immune system's stress response. Above, a lone jogger in Ottawa, on March 17, 2020. </span> <span class="attribution"><span class="source">THE CANADIAN PRESS/Adrian Wyld</span></span></figcaption></figure><p>Worried about COVID-19? You may be putting yourself at undue risk, because <a href="https://www.pnas.org/content/109/16/5995.short">chronic anxiety suppresses the immune system and increases our risk for infection</a>. </p>
<p><a href="https://doi.org/10.1177%2F070674370705200406">The psychological impact of the COVID-19 pandemic is causing incredible distress</a>. I ran into a friend at the grocery store the other day. She was wiping down her cart with antiseptic. Under normal circumstance, this behaviour would seem bizarre, but in the current COVID-19 climate, it has become acceptable.</p>
<p>Although it is important to be prepared during this pandemic, we do not need to panic. Physical activity can help protect the immune system from the effects of stress. </p>
<h2>Fear of the unknown</h2>
<p>As an associate professor in the department of kinesiology at McMaster University, I direct a team of researchers in the <a href="http://www.neurofitlab.com/">NeuroFit Lab</a>, where we’ve shown that <a href="https://doi.org/10.1016/j.biopsycho.2018.01.015">psychological distress can compromise mental health</a>.</p>
<p>Anxiety about the unknown (such as our risk of COVID-19) can hyperactivate the fear centre in the brain called the amygdala. In terms of evolution, this is one of the oldest parts of the brain and its operations are quite primitive; it acts like a trigger-happy alarm that interfaces with the stress system to keep our body and mind on high alert for as long as we are feeling anxious. <a href="https://doi.org/10.1038/86110">Research shows that the mere suggestion of danger, even if it never is experienced, is enough to trigger the amygdala and activate the stress response</a>. This is what keeps people awake at night, lying in bed worrying about COVID-19.</p>
<p>The problem is that chronic activation of the stress systems can damage our cells and upset many of the body’s functions. Our immune system bears the brunt. Although psychological stress is not pathogenic per se, <a href="https://doi.org/10.1016/j.bbi.2008.09.007">the damage it causes to the body’s cells triggers an immune response that makes us more susceptible to a foreign pathogen</a>. This may increase our risk for infection with SARS-CoV-2, the coronavirus that causes COVID-19.</p>
<h2>Worried sick</h2>
<p>The immune system acts like border security, patrolling the body for cells that are foreign and harmful to it. It works a lot like the Nexus or Global Entry programs for pre-approved travellers; anyone enrolled in the program <a href="https://www.cbsa-asfc.gc.ca/prog/nexus/rec-eng.html">has their iris scanned</a> to quickly confirm their identity for fast border crossing. But instead of iris scanning, the immune system scans the outer surface of a cell for its biological passport, or what scientists call a motif.</p>
<p>The body’s cells have a motif (a “self” motif) that’s different from the “non-self” motif of foreign cells and pathogens, like SARS-CoV-2. This non-self motif is known as a <a href="https://doi.org/10.1111/j.1600-065X.2012.01146.x">pathogen-associated molecular pattern (PAMP)</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/321499/original/file-20200319-129675-1teq1kh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/321499/original/file-20200319-129675-1teq1kh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=389&fit=crop&dpr=1 600w, https://images.theconversation.com/files/321499/original/file-20200319-129675-1teq1kh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=389&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/321499/original/file-20200319-129675-1teq1kh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=389&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/321499/original/file-20200319-129675-1teq1kh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=488&fit=crop&dpr=1 754w, https://images.theconversation.com/files/321499/original/file-20200319-129675-1teq1kh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=488&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/321499/original/file-20200319-129675-1teq1kh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=488&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Concerns about COVID-19 led crowds to stock up on supplies. Here, people line up at a Costco in Ottawa on March 13, 2020.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Justin Tang</span></span>
</figcaption>
</figure>
<p>Another type of motif is the “damaged self” motif, known as a damage-associated molecular pattern, or DAMP. This motif is expressed by a damaged or dying cell that no longer serves the body. Stress damages the body’s cells, transfiguring self motifs into damaged self motifs. This elevates inflammation throughout the body in a similar way as if it were infected. This response, in the absence of an actual infection, is called a <a href="https://doi.org/10.1038/npp.2016.125">sterile immune response</a>.</p>
<p>Chronic over-worrying about COVID-19 can intensify our vulnerability to viruses by creating an imbalance in immune function. This is because the immune system reacts to multiple breaches in immunity in a similar way that airport security reacts to multiple breaches in safety, by escalating the response. Think back to how vigilant airport security became after 9/11, implementing the strictest screening procedures for all passengers and luggage.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-weekly-expert-analysis-from-the-conversation-global-network-133646">Coronavirus weekly: expert analysis from The Conversation global network</a>
</strong>
</em>
</p>
<hr>
<p>Excessive anxiety about COVID-19 can trigger an immune response that increases inflammation and readies the immune system’s equivalent of special forces, known as <a href="https://doi.org/10.1016/j.bbi.2012.12.008">inflammasomes</a>. If SARS-CoV-2 acts like other viruses, then upon infection the inflammasomes will be called to action to escalate inflammation even further. <a href="https://doi.org/10.1196/annals.1351.006">But too much inflammation does more harm than good; it deregulates immune function, increasing our risk of a viral infection.</a></p>
<p>My lab recently demonstrated <a href="https://doi.org/10.1016/j.biopsycho.2018.01.015">how quickly our health declines under chronic stress</a>. We tracked sedentary but otherwise healthy students during the weeks leading up to their final exams, and we observed how six weeks of stress gave rise to the symptoms of depression.</p>
<h2>Resisting the effects of anxiety</h2>
<p>What can we do to prevent panic and bolster immune protection?</p>
<p><a href="https://doi.org/10.1016/j.jshs.2018.09.009">Physical activity can protect your body from chronic stress-induced inflammation</a>.</p>
<p>In our study, during that same stressful six-week period, we enrolled some of the students in a new exercise program in which they cycled on a stationary bike at moderate intensity for approximately 30 minutes, three times per week. Moderate intensity exercise is about 40 per cent of maximum workload: the point at which someone can still talk, but can’t sing. </p>
<p>Blood samples were collected to track changes in inflammation. Although the exercisers were exposed to the same psychological stressors as the sedentary students, their inflammation remained low and their mood remained high with no increase in symptoms of anxiety or depression. </p>
<p>But the intensity of the exercise mattered. Higher intensity exercise was not as effective at protecting mental health or reducing inflammation. The vigorous nature of the intense exercise may have exacerbated an already stressed-out system, especially in individuals who were not accustomed to exercise.</p>
<p>The key take-away from our research: a brisk walk, jog or bike ride can help keep you calm and healthy during these uncertain times so you can be prepared without the panic.</p><img src="https://counter.theconversation.com/content/133427/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer J Heisz receives funding from NSERC and SSHRC.</span></em></p>
The immune system can respond to stress in ways that harm health. But there’s a stress-buster that can help keep you calm and healthy: exercise.
Jennifer J. Heisz, Associate Professor in Kinesiology and Associate Director (Seniors) of the Physical Activity Centre of Excellence, McMaster University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/133259
2020-03-11T11:07:49Z
2020-03-11T11:07:49Z
How to recover from burnout and chronic work stress – according to a psychologist
<figure><img src="https://images.theconversation.com/files/319847/original/file-20200311-116236-evxoam.jpg?ixlib=rb-1.1.0&rect=42%2C17%2C5659%2C2975&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Burnout is on the rise.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/employee-burnout-career-stress-business-burn-1429515563">Lightspring/ Shutterstock</a></span></figcaption></figure><p>It’s pretty likely you’ve heard of burnout – and you may have even experienced it. Caused by <a href="https://www.who.int/mental_health/evidence/burn-out/en">chronic work stress</a>, it’s characterised by signs such as emotional exhaustion, lack of energy, and loss of satisfaction with work – and has been linked to a wide range of physical conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627926/">cardiovascular diseases and musculoskeletal pain</a>. </p>
<p><a href="https://journals.sagepub.com/doi/10.1177/0149206313475815">Work stress activates</a> our hormonal, metabolic, immune and cardiovascular systems. If these bodily responses are triggered <a href="https://www.tandfonline.com/doi/full/10.1080/02678373.2017.1417337">too frequently, or for too long</a>, they fail to return to normal and may alter our body’s <a href="https://www.ncbi.nlm.nih.gov/pubmed/20026349">immune and inflammation responses</a>. These changes may eventually cause other physical conditions – such as <a href="https://link.springer.com/article/10.1007/s11886-017-0919-x">coronary heart disease</a>. </p>
<p>Although an overhaul of <a href="https://theconversation.com/millennial-burnout-building-resilience-is-no-answer-we-need-to-overhaul-how-we-work-109759">work conditions and culture</a> is needed to address the rise in people experiencing burnout, there are still many things we can do ourselves to deal with it now. The most significant way we can prevent burnout is recovery.</p>
<p>Burnout is a consequence of chronic work stress over extended periods of time. It has <a href="https://www.tandfonline.com/doi/abs/10.1080/08870440108405527">three components</a>:</p>
<ol>
<li>Emotional exhaustion (feeling tired, drained, frustrated and fatigued);</li>
<li>Cynicism or detachment (caring less about coworkers or clients); </li>
<li>A loss of satisfaction in one’s work.</li>
</ol>
<p>Dealing with burnout is about <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/smi.2604">recovering well</a> from work, rather than focusing on being more productive or better at the work itself. Research continues to show how important it is to recover from work on a <a href="https://www.ncbi.nlm.nih.gov/pubmed/24885683">daily basis</a>. </p>
<p>Recovery means finding time or space for yourself where you don’t engage in things that are work-related or stressful. Recovery is about bringing physiological responses, such as cortisol (a key stress hormone), <a href="https://www.tandfonline.com/doi/full/10.1080/02678373.2017.1417337">back down to baseline levels</a>. Proper recovery helps you feel more energetic and enthusiastic to face another day at work. Recovery can take place both during the workday (internal recovery) and outside of work (external recovery).</p>
<h2>Types of recovery</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/17173204">Internal recovery</a> is about giving ourselves relief from stress by using short periods of time during work to reduce our body’s stress responses. This can include taking short breaks, doing breathing exercises, or switching tasks when you’re feeling mentally or physically exhausted. So, if you have a few minutes spare at work between tasks or meetings, you may be better off trying to relax rather than checking your emails and experiencing new stressors. </p>
<p>After work, we have the opportunity for <a href="https://www.ncbi.nlm.nih.gov/pubmed/17173204">external recovery</a>. These are things we do outside of work to help relieve stress. Instead of keeping on top of work and emails, external recovery may include doing any activities you enjoy. These might include watching TV, reading, or socialising – as long as these activities don’t encourage you to think (and stress) more about work.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/319851/original/file-20200311-116232-1enqlfm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/319851/original/file-20200311-116232-1enqlfm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/319851/original/file-20200311-116232-1enqlfm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/319851/original/file-20200311-116232-1enqlfm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/319851/original/file-20200311-116232-1enqlfm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/319851/original/file-20200311-116232-1enqlfm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/319851/original/file-20200311-116232-1enqlfm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Checking emails after work won’t help with recovery.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-frustrated-exhausted-woman-laid-her-1188695488">ViDI Studio/ Shutterstock</a></span>
</figcaption>
</figure>
<p>The key to good recovery is choosing activities based on how they make you feel. If social media creates negative feelings, don’t check it during your work breaks or after work. If socialising with certain people makes you feel drained, this isn’t going to help you recover.</p>
<p>Daily recovery is also important. Research shows <a href="https://www.ncbi.nlm.nih.gov/pubmed/25100275">the energy gained</a> from the previous day’s after-work activities <a href="https://psycnet.apa.org/record/2019-20611-001">helps manage the day’s work stress</a>. But it’s important to know that it’s not the amount of time spent on recovering, but the quality of these activities. </p>
<p>It’s important to do things that make you happy or content as you are doing them – and doing them for yourself. Research has found that picking recovery activities you find <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/joop.12050">personally satisfying and meaningful</a> is more likely to help you feel recovered by the next morning.</p>
<h2>Daily recovery activities</h2>
<p>Thinking about what you do after work to recover – and whether these activities really are helping you recover – is key. There are <a href="https://www.ncbi.nlm.nih.gov/pubmed/17638488">four types of recovery experience</a> that explain how and why recovery activities work: </p>
<ol>
<li> Psychological detachment (not thinking about work), </li>
<li> Relaxation (taking a walk in nature, listening to music, reading a book, doing nothing on the sofa)<br></li>
<li> Mastery (such as seeking out opportunities to do things unrelated to work such as learning languages or pursuing sports and hobbies), </li>
<li> Control (choosing how to spend your time and doing things the way you want to do them).</li>
</ol>
<p>It’s important to note that psychological detachment is <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/job.1924">core to recovery</a> – but it’s not as easy to achieve as it sounds. For example, smartphone use after work can <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1464-0597.2012.00530.x">interfere with recovery</a> because it blurs boundaries between work and home, stopping psychological detachment from work taking place. Similarly, meeting friends and socialising to relax will not allow psychological detachment if <a href="https://psycnet.apa.org/record/2019-20611-001">the conversation focuses on complaining about work</a>. </p>
<p>Some recovery experiences are more suited to different people. For example, sports and exercise have been shown to be <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/job.1796">more effective for workaholics than non-workaholics</a>, possibly because they make psychological detachment from work easier. </p>
<p>If you don’t feel you have much control over your job, psychological detachment and mastery experiences have been shown to be the <a href="https://www.tandfonline.com/doi/full/10.1080/02678370903415572">most effective for recovery</a>. If you feel exhausted due to time pressures at work, <a href="https://www.tandfonline.com/doi/full/10.1080/02678370903415572">relaxation is most protective</a>. People can also personalise and pick the recovery activity that suits them and provides them with the best antidote to their particular form of work stress and burnout.</p>
<p>With burnout, emotional exhaustion typically happens before other stages. It’s the <a href="https://psycnet.apa.org/record/2013-31187-001">easiest to identify</a>, and easier to change than the other stages. So if you feel emotionally exhausted after work every night – and don’t recover by the morning – your <a href="https://www.ncbi.nlm.nih.gov/pubmed/25100275">recovery is incomplete</a>. If this is the case, it might be worth taking a closer look at the quality of the after-work activities you’re doing.</p>
<p>Even if you don’t have a lot of time, it’s still important to carve out a little time for yourself to do something you find satisfying. Taking time to recover is shown to help people <a href="https://psycnet.apa.org/record/2019-20611-001">feel more engaged</a> at work, and <a href="https://psycnet.apa.org/record/2014-21961-001">protects against the longer-term consequences</a> of work stress and risk of burnout.</p><img src="https://counter.theconversation.com/content/133259/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rajvinder Samra does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Daily recovery can not only relieve burnout – it may also prevent it in the first place.
Rajvinder Samra, Lecturer in Health, The Open University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/122027
2019-10-17T11:39:59Z
2019-10-17T11:39:59Z
Study: Racism shortens lives and hurts health of blacks by promoting genes that lead to inflammation and illness
<figure><img src="https://images.theconversation.com/files/296940/original/file-20191014-135525-kqtd3e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">African Americans have worse health outcomes and die earlier than whites. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/doctor-explaining-consent-form-senior-patient-126692195?src=Cg6MV_60V7a3mb8oJlpbhw-1-2">Monkey Business Images/Shutterstock.com</a></span></figcaption></figure><p>Negative social attitudes, such as racism and discrimination, damage the health of those who are targeted by triggering a cascade of aberrant biological responses, including abnormal gene activity. It is not surprising that reports documenting lifespan and causes of mortality have demonstrated a clear pattern: African Americans die sooner and bear a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408160/">heavier burden</a> of many diseases, including hypertension, heart disease, dementia and late-stage breast cancer. </p>
<p>Scientists have searched for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449495/">genetic</a> causes to health disparities between blacks and whites but have had limited success. The strongest <a href="https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1357">evidence</a> to date points to social-environmental factors such as poverty, health care inequities and racism. </p>
<p>Our society is plagued by racism and racial inequality which is not fully recognized by all, according to a recent <a href="https://journals.sagepub.com/doi/full/10.1177/1745691619863049">study</a> showing that many Americans overestimate our progress in fixing racial inequality. On the other hand, more Americans (65%) are aware that it has become more common for people to express racist or racially insensitive views, according to a <a href="https://www.pewsocialtrends.org/2019/04/09/race-in-america-2019/">U.S. survey</a>.</p>
<p>Racism is not merely negative attitudes or treatment from one person to another. Racism has deep historical roots in American society, sustained through institutional policies and practices, whereby people of color are routinely and systematically treated differently than whites. </p>
<p>As an African American/white individual, I often experienced comments growing up like “You don’t sound black,” and “What are you?” that made me cringe. In college, I became intrigued by the field of psychology as it was a field that explained how prejudices, stereotyping and racism arise. <a href="https://scholar.google.com/citations?user=C97euQoAAAAJ&hl=en&oi=ao">My research as a clinical psychologist</a> at USC is focused on understanding how societal factors interact with biology to create disparities in health outcomes. A recent <a href="https://doi.org/10.1016/j.psyneuen.2019.04.016">study I co-authored</a> showed that racism promotes genes that turn on inflammation, one of the major drivers of disease.</p>
<h2>Less overt, but entrenched</h2>
<p>Although racism may be less overt today than during the early 20th century, government policies and norms, unfair treatment by social institutions, stereotypes and discriminatory behaviors are sobering reminders that racism is still alive – and contribute to earlier deaths in addition to poorer quality of life. </p>
<p>For example, blacks are more likely than whites to receive drug testing when prescribed long-term <a href="https://www.sciencedirect.com/science/article/abs/pii/S0376871618303855?via%3Dihub">opiates</a> even though whites show higher rates of overdose. African Americans have shouldered the burden of racism for decades, creating a level of mistrust for societal systems, be it health care or law enforcement. </p>
<p>Terms such as “driving while black” illustrate how racism and discrimination have been deeply embedded in African American cultural experience. Just imagine trying to buy a home and being turned down because of your race. This is too common of an experience for African Americans.<a href="https://www.rwjf.org/en/library/research/2017/10/discrimination-in-america--experiences-and-views.html"> Nearly half (45%) </a>reported experiencing discrimination when trying to find a home and in receiving health care, according to a Robert Wood Johnson survey that was developed by the <a href="https://www.hsph.harvard.edu/magazine/magazine_article/discrimination-in-america-polls/">Harvard T.H. Chan School of Public Health</a>, Robert Wood Johnson Foundation and National Public Radio. </p>
<h2>From macro to micro, the effect is widespread</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/296945/original/file-20191014-135505-58kbl4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/296945/original/file-20191014-135505-58kbl4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/296945/original/file-20191014-135505-58kbl4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/296945/original/file-20191014-135505-58kbl4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/296945/original/file-20191014-135505-58kbl4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/296945/original/file-20191014-135505-58kbl4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/296945/original/file-20191014-135505-58kbl4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Blacks’ exposure to chronic stress has often been cited as a reason for worse health outcomes.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/lifestyle-portrait-young-sad-depressed-black-1160694694?src=ntnDRZHp_dxfxUot1mfX-w-1-21">thevisualsyouneed/Shutterstock.com</a></span>
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<p>Until recently, we scientists did not know the mechanism linking racism to health. The <a href="https://www.ncbi.nlm.nih.gov/pubmed/31029930">new study</a> from my lab here at USC and colleagues at UCLA shows that the function of genes may explain this relationship. As it turns out, our study showed that genes that promote inflammation are expressed more often in blacks than in whites. We believe that exposure to racism is why. </p>
<p>We previously showed how activating racism, such as asking people to write down their race before taking an exam, in the form of stereotyping <a href="https://www.ncbi.nlm.nih.gov/pubmed/23388089">impairs brain functions</a> such as learning and memory and problem-solving in African Americans. This may partly explain the higher rates of dementia in African Americans compared to whites. </p>
<p>Researchers have well documented that <a href="https://www.psychiatry.wisc.edu/courses/Nitschke/seminar/gould_bio_psych_1999.pdf">chronic stress</a> alters the function of brain regions, such as the hippocampus, that are targeted in brain diseases such as Alzheimer’s disease. This work has been expanded through the field of social genomics, largely pioneered by my colleague <a href="https://people.healthsciences.ucla.edu/institution/personnel?personnel_id=45359">Steve Cole</a> at UCLA. A relatively new field called social genomics demonstrates how the function of genes – termed gene expression – is influenced by social conditions. </p>
<p>Genes are programmed to turn off and on in a certain manner. But those patterns of activity can shift depending on environmental exposures. </p>
<p>Certain marginalized groups demonstrate abnormal patterns of gene activity in genes responsible for innate immunity. Innate immunity is how the body fights off and responds to foreign pathogens. Dr. Cole named this pattern/sequence of gene activity the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637182/">Conserved Transcriptional Response to Adversity</a>. It refers to the how genes controlling innate immunity behave under positive or negative environmental conditions. </p>
<p>When environmental stresses like socioeconomic disadvantage or racism trigger the sympathetic nervous system, which controls our fight-or-flight responses, the behavior of our genes is altered. This leads to complex biochemical events that turn on genes, which may result in poor health outcomes. </p>
<p>The Conserved Transcriptional Response to Adversity profile is characterized by <a href="https://www.ncbi.nlm.nih.gov/pubmed/23927506">increased activity of genes</a> that play a role in inflammation, and decreased activity of genes involved in protecting the body from viruses. </p>
<p>We found that blacks and whites differed in the pattern of which pro-inflammatory and stress signaling genes were turned on. Our findings are particularly important because chronic inflammation ages the body and causes organ damage. </p>
<p>As my colleagues and I pulled this study together, we took into consideration the health disparities such as socioeconomic status, social stress, and health care access. For example, we recruited African Americans and whites with similar socioeconomic status. We also examined racial differences in reports of other types of stress events. Both groups reported similar levels of social stress. </p>
<p>For this particular study, none of these traditional factors explained why African Americans had greater expression in pro-inflammatory genes than whites. However, we found that experiences with racism and discrimination accounted for more than 50% of the black/white difference in the activity of genes that increase inflammation. </p>
<p>So what do these results mean for future health? I believe racism and discrimination should be treated as a health risk factor – just like smoking. It is toxic to health by damaging the natural defenses our bodies use to fight off infection and disease. Interventions tailored toward reducing racism-associated stress may mitigate some of its adverse effects on health. As a society we cannot afford to perpetuate health inequities by undermining or disguising the biological impact of racism.</p>
<p>[ <em>Insight, in your inbox each day.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=insight">You can get it with The Conversation’s email newsletter</a>. ]</p><img src="https://counter.theconversation.com/content/122027/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>April Thames receives funding from National Institutes of Mental Health and the Alzheimer's Association.</span></em></p>
The recent death of Elijah Cummings at age 68 underscores a disturbing statistic: black men die, on average, five years younger than white men. A study shows racism’s effects on gene activity.
April Thames, Associate Professor, Psychology and Psychiatry, USC Dornsife College of Letters, Arts and Sciences
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/105245
2018-11-08T14:31:14Z
2018-11-08T14:31:14Z
Being born working class is bad for your health, and moving up the social ladder cannot compensate for it
<figure><img src="https://images.theconversation.com/files/243941/original/file-20181105-83629-3t22xw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1072775438?src=N8U1Pu5uFjGwcNMrQayAJQ-1-34&size=medium_jpg">Hyejin Kang/Shutterstock.com</a></span></figcaption></figure><p>Social mobility is seen as an essential societal goal – one that occupies most democratic governments. But moving up and down the social ladder can be very stressful, and it is well documented that long-lasting or repeated stress is bad for your health. Until now, though, no one has tried to quantify the health impact of social mobility. In our <a href="https://doi.org/10.1136/jech-2017-210171">latest study</a> we set out to redress this knowledge gap. But, before we get to that, a bit of background.</p>
<p>It was a Russian-born sociologist, Pitirim Sorokin, who first wrote about the stress of social mobility. Sorokin lived a life full of mobility. Born to a peasant mother and a manual-worker father, he ended up founding Harvard’s sociology department. He was a professor there until his death in 1968. In his eventful life, he had also been a farmhand, artisan, factory worker, clerk, teacher, choir conductor, revolutionary, political prisoner, journalist, student, newspaper editor and secretary to the Russian prime minister. </p>
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<span class="caption">Pitirim Sorokin, social climber extraordinaire.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/w/index.php?curid=5807825">неизв/Wikimedia Commons</a></span>
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<p>In 1927, Sorokin claimed that mobility made the “nervous systems crumble under the burden of great strains required”. He had no systematic data to substantiate this claim, but we assume he based it on his own not inconsiderable experience. Today <a href="https://www.socialsciencespace.com/2018/09/diane-reay-on-education-and-class/">academics</a> and <a href="http://behavioralscientist.org/challenges-working-class-students-dont-end-commencement/">other high flyers</a> still talk about feelings of “class dissociation”, to use Sorkin’s phrase.</p>
<h2>Tripartite problem</h2>
<p>One problem with finding out whether social mobility is a stressful experience is that it is such a complex thing. It’s made up of three parts: the social class of your parents (your origin), your social class now (the destination), and the trajectory of movement between the two. </p>
<p>It is already known that those in higher classes often live less stressful lives than those at the bottom. For our <a href="https://doi.org/10.1136/jech-2017-210171">study</a>, published in the Journal of Epidemiology and Community Health, we wanted to know whether social mobility has an effect over and above origin class and destination class. </p>
<p>A second part of the puzzle was how to measure the consequences of social mobility. Many previous studies used subjective or self-rated measures of well-being. One common criticism of these approaches is that people may adjust their expectations to their new class position – so-called “adaptive preferences”. To overcome this, we used more objective data from a <a href="https://www.understandingsociety.ac.uk/">long-term study</a> of thousands of British people whose health was assessed by nurses and who had a blood sample taken. </p>
<p>Based on this information, we calculated their “<a href="https://en.wikipedia.org/wiki/Allostatic_load">allostatic load</a>”, which is a measure of wear and tear on the body resulting from chronic stress. This summary measure includes indicators such as blood pressure, waist circumference, cholesterol and inflammatory markers. A heavy allostatic load puts a person at increased risk of a range of health problems, from type 2 diabetes to heart disease.</p>
<h2>Allostatic load</h2>
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<img alt="" src="https://images.theconversation.com/files/243962/original/file-20181105-83641-dis4jd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/243962/original/file-20181105-83641-dis4jd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/243962/original/file-20181105-83641-dis4jd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/243962/original/file-20181105-83641-dis4jd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/243962/original/file-20181105-83641-dis4jd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/243962/original/file-20181105-83641-dis4jd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/243962/original/file-20181105-83641-dis4jd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="license">Author provided</span></span>
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<p>The results of our analysis showed that both origin and destination class matter. In fact, it seems that they each exert around the same level of influence. This means that your social class during childhood has a long reach and you cannot escape the health consequences of your social origins, even after climbing the social ladder all the way to the top. </p>
<p>For those starting at the bottom and climbing to the top, their allostatic load will be of an average level, but far above the level of people who started out in a higher class and remained there. The worst outcomes are among those for whom both origin and destination are the working class, while those falling down the ladder from higher origins will be somewhat protected by their origin.</p>
<p>We also found that social mobility by itself has no impact on your health. There is no systematic effect of mobility on allostatic load in one direction or another. Your current class matters, and your class during childhood matters, but mobility itself does not cause the wear and tear that is bad for your health. </p>
<p>Equal opportunity is an ideal that many believe in, and governments promise to facilitate social mobility for their citizens. But social mobility does not only entail climbing the economic ladder, for some, it also means falling down. Our study showed that being on top is better for your health than being at the bottom, yet neither falling down nor moving up causes long-lasting or repeated stress.</p><img src="https://counter.theconversation.com/content/105245/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Moving up and down the social ladder has long been thought to be stressful, but a new study shows that it has no impact on general health.
Lindsay Richards, Lecturer in Sociology, University of Oxford
Patrick Präg, University of Oxford
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/105209
2018-10-18T19:14:29Z
2018-10-18T19:14:29Z
With the right help, bears can recover from the torture of bile farming
<p>Bear bile farms, which exist in some Asian countries like <a href="https://www.animalsasia.org/intl/media/news/news-archive/five-things-you-need-to-know-about-bear-bile-farming.html">Vietnam</a> and <a href="https://www.animalsasia.org/intl/media/news/news-archive/five-things-you-need-to-know-about-bear-bile-farming.html">China</a>, are a terrible reality for Asiatic black bears (<em>Ursus thibetanus</em>). </p>
<p>The bears spend their lives confined in tiny steel or concrete cages. They are “<a href="https://www.animalsasia.org/au/our-work/end-bear-bile-farming/what-is-bear-bile-farming/overview.html">milked</a>” through permanent holes in their side that allow bile to be extracted from the gall bladder. </p>
<p>My research, published in the journal <a href="http://www.ingentaconnect.com/contentone/ufaw/aw/2018/00000027/00000004/art00001">Animal Welfare</a>, investigated the chronic stress created by these conditions. We found that with care and rehabilitation, rescued bears in animal sanctuaries can readjust to a normal lifestyle with a reduction in stress – a highly encouraging result.</p>
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Read more:
<a href="https://theconversation.com/hugs-drugs-and-choices-helping-traumatised-animals-80962">Hugs, drugs and choices: helping traumatised animals</a>
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<h2>What’s so precious about bile?</h2>
<p><a href="https://en.wikipedia.org/wiki/Bile">Bile</a> is a greenish-brown fluid produced by the liver in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091928/">humans</a> and <a href="https://medium.com/concepts-of-zoology-the-paradigm-shift-group/why-some-animals-dont-have-any-gallbladder-fe53cc44ee83">most vertebrates</a>. Bile acid aids digestion of fats – and one particular bile compound, called <a href="https://www.ncbi.nlm.nih.gov/pubmed/20609543">ursodeoxycholic acid</a>, could have potential <a href="https://www.medicines.org.uk/emc/product/7253/smpc">pharmaceutical applications</a>. </p>
<p>Because of this, bear bile is highly sought in <a href="http://www.onegreenplanet.org/animalsandnature/animal-products-health-benefits-driving-species-to-extinction/">traditional Chinese medicine</a>. It is believed to reduce gall stones and improve indigestion, among other things. However, non-animal-derived and synthetic alternatives exist for <a href="https://www.ncbi.nlm.nih.gov/pubmed/20609543">urosodeoxycholic acid</a> and other bile components.</p>
<p>The use of Asiatic black bears as primary sources of bile is a significant animal welfare problem that needs global awareness. Most of the bears are introduced to the trade upon poaching from the wild, and cubs as young as a few months are caged and <a href="https://www.animalsasia.org/intl/media/news/news-archive/five-things-you-need-to-know-about-bear-bile-farming.html">held captive</a> for up to 30 years. </p>
<p>I worked with the international welfare organisation <a href="https://www.animalsasia.org/au/our-work/bear-sanctuaries/">AnimalsAsia</a>, which runs <a href="https://www.animalsasia.org/au/about-us/vision-and-values.html">rescue and rehabilitation programs</a> in Asia and has moved hundreds of bears into sanctuaries.</p>
<p>My research investigated how successful this rehabilitation is, and whether rescued bears can recover from their experiences. </p>
<h2>Animal cruelty causes chronic stress</h2>
<p>Stress is <a href="https://www.lifeline.org.au/static/uploads/files/what-is-stress-wfvgiurqqawx.pdf">defined</a> as any unpleasant physical or psychological change that creates an uncomfortable feeling and negative outcome.</p>
<p>Not surprisingly, bears at bile farms in Vietnam have significantly higher levels of stress hormones than bears living in sanctuaries. This is the first scientific evidence of the chronic stress created by bear bile farming.</p>
<p>Stress in vertebrates (like humans and bears) is a physiological response in the endocrine system, also known as the <a href="https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93adrenal_axis">hypothalamus-pituitary adrenal</a> axis. This is the body’s main control centre for all things related to stress.</p>
<p>Stress hormones like cortisol help regulate the metabolism, especially in times of short-term or acute stress such as “<a href="https://en.wikipedia.org/wiki/Fight-or-flight_response">fight or flight</a>” situations. In normal situations, sharp stress causes an increase of cortisol that allows an animal to react quickly to a dangerous situation. Once the danger passes, a <a href="https://courses.washington.edu/conj/bess/feedback/newfeedback.html">negative feedback loop</a> reduces <a href="http://www.yourhormones.info/hormones/cortisol/">cortisol</a> production and keeps the body stable.</p>
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Read more:
<a href="https://theconversation.com/stress-is-bad-for-your-body-but-how-studying-piglets-may-shed-light-97650">Stress is bad for your body, but how? Studying piglets may shed light</a>
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<p>But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263906/">chronic stress</a> can lead to harmful changes in the stress endocrine system. Long-term cortisol overproduction weakens the body’s ability to fend off daily challenges, and increases the risk of disease and death. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263906/">humans</a>, chronic stress contributes to problems with the cardiovascular, immune and central nervous systems. </p>
<p>The presence of what we call “<a href="https://www.foodanimalbiosciences.org/uploads/2/4/2/6/24266896/non-domestic_felids.pdf">stress biomarkers</a>” in <a href="https://research-repository.griffith.edu.au/bitstream/handle/10072/54397/89070_1.pdf;sequence=1">faeces</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3624789/">hair</a> can be a very useful tool for assessing animal welfare. </p>
<p>We measured cortisol levels in bear faeces to rapidly and reliably check their <a href="https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11285&catId=33178&id=3976383&ind=14&objTypeID=17&print=1">stress levels</a>. </p>
<p>This was particularly useful because we did not have to restrain the rescued bears, a process that would understandably upset them more than their peers.</p>
<h2>Reversing chronic stress in bear sanctuaries</h2>
<p>Chronic stress is a massive challenge for the successful rehabilitation of animals into their new environment. Careful monitoring of stress is essential in animal rescue and <a href="https://www.ncbi.nlm.nih.gov/pubmed/12462487">translocation programs</a> because it can provide information on the physiological resilience of each animal, and help rescuers understand how the animals might respond to humane interventions and veterinary checks. </p>
<p>Rescued bears are given special veterinary care and integrated into the bear sanctuary after several months of careful physiological and behavioural assessments. </p>
<p>Our <a href="http://www.ingentaconnect.com/contentone/ufaw/aw/2018/00000027/00000004/art00001">data</a> show that although not all bears fully recover from living on a bile farm, they generally manage to reduce their stress hormone levels under the <a href="http://www.ingentaconnect.com/contentone/ufaw/aw/2018/00000027/00000004/art00001">rehabilitation program</a>.</p>
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<strong>
Read more:
<a href="https://theconversation.com/a-dogs-life-studying-stressed-humans-can-help-us-keep-animals-happy-59486">A dog's life: studying stressed humans can help us keep animals happy</a>
</strong>
</em>
</p>
<hr>
<p>Like humans, animals need <a href="https://www.everydayhealth.com/healthy-living/love-reduces-stress.aspx">love and care</a>. <a href="https://www.westernsydney.edu.au/newscentre/news_centre/more_news_stories/stress_test_how_scientists_can_measure_how_animals_are_feeling">Stress reseach</a> has shown humane treatment can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260341/">reverse chronic stress</a> – and our study has found that is true even for animals who have experienced intolerable treatment.</p><img src="https://counter.theconversation.com/content/105209/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Edward Narayan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Bears in Asia are trapped in bile farms, where they are kept in small cages for decades.
Edward Narayan, Senior Lecturer in Animal Science; Stress and Animal Welfare Biologist, Western Sydney University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/99131
2018-08-02T10:36:31Z
2018-08-02T10:36:31Z
Rising suicides in Mexico expose the mental health toll of living with extreme, chronic violence
<figure><img src="https://images.theconversation.com/files/230057/original/file-20180731-136676-1gppptv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New suicide data indicates that years of record bloodshed in Mexico have traumatized residents in places where the violence is most concentrated. </span> <span class="attribution"><span class="source">Reuters/Jorge Lopez</span></span></figcaption></figure><p><a href="https://theconversation.com/violencia-cronica-de-mexico-afecta-la-salud-mental-con-consecuencias-fatales-mas-suicidios-100993"><em>Leer en español</em></a>.</p>
<p>Mexico has suffered one of the world’s <a href="http://secretariadoejecutivo.gob.mx/docs/pdfs/tasas%20por%20cada%20100%20mil%20habitantes/Tasas052018.pdf">highest murder rates</a> for over a decade, a consequence of the government’s aggressive, 12-year-long <a href="https://theconversation.com/a-decade-of-murder-and-grief-mexicos-drug-war-turns-ten-70036">battle against drug trafficking organizations and other criminal groups</a>, which has led lethal violence to escalate across the country.</p>
<p>Almost 30,000 Mexicans <a href="http://time.com/5111972/mexico-murder-rate-record-2017/">were murdered in 2017</a>. May 2018 was Mexico’s most violent month in 20 years, with an average of 90 killings a day, according to the Mexican <a href="http://secretariadoejecutivo.gob.mx/incidencia-delictiva/incidencia-delictiva-datos-abiertos.php">secretary of the interior</a>.</p>
<p>Prominent victims of Mexico’s conflict include 136 <a href="https://www.nytimes.com/2018/07/01/world/americas/mexico-election-assassinations.html">politicians</a> and political operatives assassinated while campaigning for the July 2018 general election, 43 student teachers <a href="https://theintercept.com/2017/09/07/three-years-after-43-students-disappeared-in-mexico-a-new-visualization-reveals-the-cracks-in-the-governments-story/">who disappeared</a> in the southern Mexican state of Guerrero in 2014 and the <a href="https://www.aljazeera.com/news/2018/07/mexican-journalists-killed-separate-attacks-180724170416842.html">eight Mexican journalists</a> killed so far this year. </p>
<p>In places where the violence has been highly concentrated, residents have spent the past decade taking precautions, coping with fear and processing tragedy. </p>
<p>Now, new data from <a href="http://www.inegi.org.mx/sistemas/olap/Proyectos/bd/continuas/mortalidad/MortalidadGeneral.asp#">the northern Mexican state of Chihuahua</a> reveals the dangerous mental health toll of living with extreme, chronic violence: suicides.</p>
<h2>From murders to suicides</h2>
<p>Violence researchers like myself once <a href="https://www.insightcrime.org/news/analysis/why-juarez-security-success-difficult-duplicate/">considered</a> Chihuahua, which shares a border with Texas, to be a Mexican success story in decreasing lethal violence. </p>
<p>Its biggest city, <a href="http://www.seguridadjusticiaypaz.org.mx/sala-de-prensa/329-ciudad-juarez-por-tercer-ano-consecutivo-la-urbe-mas-violenta-del-planeta">Ciudad Juárez</a>, which sits just across the U.S.-Mexico border from El Paso, used to be one of the world’s most dangerous places. Its 2010 murder rate of 229 killings per 100,000 people was 14 times higher than the Latin American average and 38 times the <a href="https://www.unodc.org/gsh/">global homicide rate</a>. An average of 70 Ciudad Juárez residents were killed every week.</p>
<p>By 2015, thanks in large part to a pioneering public-private anti-violence initiative called <a href="https://justiceinmexico.org/todos-somos-juarez-program-explained/">Todos Somos Juárez</a>, or We Are All Juárez, the city’s murder rate had dropped to 32 murders per 100,000 residents. </p>
<p>These days, violence is <a href="https://www.elpasotimes.com/story/news/2017/04/13/jurez-among-most-dangerous-cities-world/100425962/">slowly rising again</a>. Depending on the <a href="https://www.elpasotimes.com/story/news/2017/04/13/jurez-among-most-dangerous-cities-world/100425962/">year</a>, Juárez <a href="https://www.seguridadjusticiaypaz.org.mx/biblioteca/prensa/send/6-prensa/241-la-violencia-en-los-municipios-de-mexico-2017-metodologia">ranks</a> among Mexico’s most dangerous cities. </p>
<p>But even when homicides were dropping in Juárez, suicides were steadily rising. </p>
<p>A <a href="http://www.planjuarez.org/images/docs/presentaciones/presentacion_suicidio.pdf">recent survey</a> by the Autonomous University of Juárez City and the Centro Familiar de Integración y Crecimiento, a group that helps grieving families, found that 33 city residents over the age of 18 attempt suicide every day. Another 43 Juárez residents daily will think about suicide without attempting the act. </p>
<p>The city’s 2017 suicide rate, 8.9 per 100,000, was nearly twice what it was in 2010. Last year, nearly 12,000 people – 1.3 percent of Juárez’s total population – tried to kill themselves. </p>
<p>Juárez’s mental health crisis reflects a state-wide trend. According to government data from 2016, Chihuahua state had the <a href="http://www.inegi.org.mx/sistemas/olap/Proyectos/bd/continuas/mortalidad/MortalidadGeneral.asp#">highest</a> and <a href="http://www.inegi.org.mx/saladeprensa/aproposito/2017/suicidios2017_Nal.pdf">fastest-growing</a> suicide rate in Mexico. </p>
<p>In 2010, fewer than 7 of every 100,000 people in the state committed suicide. By 2015, the figure had reached 11.4. Last year, Chihuahua saw 12.3 suicides per 100,000 residents.</p>
<p>That’s more than twice the Mexican national average and just shy of the United States’ <a href="https://theconversation.com/why-is-suicide-on-the-rise-in-the-us-but-falling-in-most-of-europe-98366">alarming</a> rate of <a href="https://data.oecd.org/healthstat/suicide-rates.htm">13.8 suicides per 100,000 people</a>. </p>
<p>Young people in Chihuahua struggle the most. Among residents aged 15 to 29, approximately 16 in every 100,000 will commit suicide – double the <a href="http://www.inegi.org.mx/saladeprensa/aproposito/2017/suicidios2017_Nal.pdf">national average for that age group</a>. </p>
<h2>The trauma of living with chronic violence</h2>
<p>Why are so many in Chihuahua driven to take their own lives? </p>
<p>Local researchers believe that chronic exposure to traumatic events causes the kind of severe mental distress that can lead to suicidal behavior.</p>
<p>Last year, the Autonomous University of Juárez City conducted <a href="https://www.researchgate.net/publication/321758814_Mental_Health_and_Paranoid_Thoughts_in_College_Students_from_Juarez">research with 315 students on campus</a>. It found that living in one of the world’s most violent cities had triggered paranoid thoughts. </p>
<p>Few of the students interviewed had been victims of Juárez’s brutal violence. But all had heard about <a href="https://elpais.com/internacional/2017/11/22/mexico/1511307168_804661.html">kidnapped women</a>, <a href="https://www.excelsior.com.mx/nacional/2018/02/07/1218734">beheadings</a> and other crimes – some equally gruesome – from friends and family or on the news. As a result, they had an unshakable feeling that their lives were in danger. </p>
<p>Researchers also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4123812/">conducted a similar study on student mental health in 2014</a>. It determined that 35 percent of students struggled with depression and almost 38 percent reported anxiety. Nearly one-third showed signs of post-traumatic stress disorder, or PTSD, including always feeling on guard, trouble sleeping and difficulty concentrating. </p>
<p>Surveys by the <a href="https://www.ncbi.nlm.nih.gov/pubmed/15173149/%20across%20nine%20developing%20countries%20the%20%5Blifetime%20prevalence">World Health Organization</a> and the <a href="https://www.ncbi.nlm.nih.gov/pubmed/15173149/,%20across%20nine%20developing%20countries%20the%20%5Blifetime%20prevalence">International Consortium of Psychiatric Epidemiology</a> across nine developing countries, including Mexico, estimate the average rate of PTSD at 2.3 percent. Anxiety affects about 6 percent of respondents.</p>
<p>Research on <a href="https://www.researchgate.net/publication/321758725_Exposure_to_Violence_in_High_School_Students_in_Ciudad_Juarez_Mexico">high school students</a> in Ciudad Juárez has likewise found a higher-than-usual incidence of depression, paranoia and PTSD.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/230255/original/file-20180801-136646-pxaw1d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/230255/original/file-20180801-136646-pxaw1d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/230255/original/file-20180801-136646-pxaw1d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/230255/original/file-20180801-136646-pxaw1d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/230255/original/file-20180801-136646-pxaw1d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/230255/original/file-20180801-136646-pxaw1d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/230255/original/file-20180801-136646-pxaw1d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ciudad Juárez sits just across the U.S.-Mexico border from El Paso, Texas.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:2008_Ciudad_Juarez_Mexico_3037729678.jpg">Scanzon/Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>War as a suicide risk factor</h2>
<p>These results are consistent with mental health surveys in other conflict zones. </p>
<p>A 2011 study of people <a href="http://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0022257">displaced during Colombia’s civil war</a> found evidence of PTSD in 88 percent of participants. Forty percent suffered from depression. </p>
<p>Researchers <a href="https://www.sciencedirect.com/science/article/pii/S0140673609610801#tbl2">interviewed 1,011 students in Afghanistan</a> in 2006, five years into the <a href="https://www.history.com/this-day-in-history/u-s-led-attack-on-afghanistan-begins">U.S.-led war against the Taliban</a>. Almost a quarter had flashbacks and anxiety, both signs of PTSD.</p>
<p>Such results have contributed to the World Health Organization’s <a href="http://apps.who.int/iris/bitstream/handle/10665/131056/9789241564878_eng.pdf;jsessionid=C43A9F9982E8463871E62E8E7375F87D?sequence=8">classification</a> of disaster, war and conflict as suicide risk factors.</p>
<h2>Mexico’s public health emergency</h2>
<p>Research on the mental health impacts of Mexico’s drug war is in very early stages. </p>
<p>I cannot conclude with certainty that chronic violence in Ciudad Juárez is driving the sharp uptick in suicides in Chihuahua state. </p>
<p>But Chihuahua’s suicide crisis may well indicate a simmering public health emergency in other Mexican states with <a href="https://elcri.men/en/lisa-map.html">high murder rates</a>, including Michoacan and Guerrero – not to mention in neighboring countries like El Salvador and Honduras that remain <a href="https://www.insightcrime.org/news/analysis/2017-homicide-round-up/">far more violent than Mexico</a>.</p>
<p>With 2018 on track to be <a href="https://elpais.com/internacional/2018/07/30/mexico/1532975393_686143.html">another year of record murders</a> in Mexico and <a href="https://www.nytimes.com/2018/07/01/world/americas/mexico-election-andres-manuel-lopez-obrador.html">president-elect Andrés Manuel López Obrador</a> taking office in December, this the moment for Mexico to begin grappling with the hidden, longer-term costs of its bloody drug war.</p><img src="https://counter.theconversation.com/content/99131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Cecilia Farfán-Méndez does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Ciudad Juárez, on the US-Mexico border, has suffered high levels of deadly violence for over a decade. New suicide data reveals the severe mental health impacts of living with chronic violence.
Cecilia Farfán-Méndez, Postdoctoral Scholar at the Center for U.S.-Mexican Studies, University of California, San Diego
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/92061
2018-02-20T13:55:00Z
2018-02-20T13:55:00Z
Growing up in poverty weakens later health – even if you escape it
<p>Poverty remains a widespread problem. In the UK, <a href="http://www.cpag.org.uk/child-poverty-facts-and-figures">30% of children</a> are growing up in poverty. More than half of these children are in <a href="http://www.independent.co.uk/news/uk/home-news/british-poverty-60-per-cent-working-families-uk-jobs-employed-study-tax-credits-housing-university-a7751201.html">working households</a>, and poverty is on the rise even for children whose parents work in <a href="http://www.independent.co.uk/news/uk/home-news/surge-in-poverty-rates-among-children-of-public-sector-worker-parents-a8211166.html">government-funded jobs</a>.</p>
<p>According to <a href="https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afy003">new research</a> from the University of Geneva, these children may be at risk of poorer health in adulthood – even if they escape poverty later in life. This suggests that childhood adversity doesn’t just affect our choices, but also directly compromises the biological ability of our bodies to stay healthy. </p>
<p>Our childhood affects our health across the course of our lives. Stress, it seems, is a major contributor. While a life lived with financial, educational and social security and stability may not be free of worries, a disadvantaged childhood means <a href="http://onlinelibrary.wiley.com/doi/10.1111/1467-8624.00469/full">more exposure to a number of difficult circumstances and events</a>. These may include social tensions, domestic abuse, neglect, food and fuel poverty, unsafe or poor quality housing, and separation from caregivers.</p>
<p>These life events understandably cause stress. Most of us will have personal experience of responding to pressure at work or a relationship breakdown with ice cream, cigarettes or alcohol, or giving the gym a miss. When facing financial troubles, the health benefits of vegetables can seem trivial to parents in the face of the time- and money-saving virtues of junk food. Feeling like you do not have enough food, money, time, or friends <a href="http://science.sciencemag.org/content/338/6107/682">occupies the mind</a> so that there is less space to focus on decisions with long-term pay-offs.</p>
<p>Experiencing these feelings over a long period of time (rather than the shorter-term stress experienced when applying for a job or studying for an exam) can make it increasingly difficult to make healthy choices. Over a lifetime, choices add up. But this latest research suggests that chronic stress impacts more than just our choices.</p>
<h2>What doesn’t kill you makes you weaker</h2>
<p>In the new study of over 24,000 people across 14 countries, <a href="https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afy003">researchers</a> found that individuals, particularly women, of lower socioeconomic status in childhood had lower hand grip strength in older adulthood – a reliable health indicator, predicting the risk of <a href="https://academic.oup.com/ageing/article/32/6/650/13078">frailty</a>, <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2010.03145.x/full">disability</a>, and death from <a href="https://academic.oup.com/ije/article/36/1/228/665601">cardiovascular disease and cancer</a> in older age.</p>
<p>While health-related behaviours such as exercise, nutrition, smoking and alcohol consumption were partially responsible for this link, adults from poorer backgrounds had weaker grip strength even if their socio-economic status improved later in life. This suggests that a tougher start in life has a direct, biological and lasting effect on an individual’s ability to stay healthy.</p>
<p>We already know that children suffering from long-term stress build up <a href="https://www.sciencedirect.com/science/article/pii/S0301051107002013">higher levels of the stress hormone cortisol</a>, making the body’s response to threats from the outside world change. Chronic stress in childhood is related to <a href="http://pediatrics.aappublications.org/content/131/2/319">a host of diseases</a> through mechanisms such as poorer mental health, changes in the body’s <a href="https://www.sciencedirect.com/science/article/pii/S0889159112001821">immune response</a> to infection and injury, and increased blood pressure. </p>
<p>Now, we have evidence that growing up in poverty has a cumulative wear-and-tear effect on the physiological systems that govern how our bodies respond to our environment, permanently disrupting the ability of affected individuals to maintain good health in old age.</p>
<p>While more work is still needed to understand how early adversity affects our immune system and other physiological systems in later life, one thing is already clear. To make our society less stressed, happier and healthier, we need to recognise just how crucial a role hardship in childhood plays in determining an individual’s long-term health.</p>
<p>The argument that poverty and poor health are <a href="https://www.sciencedirect.com/science/article/pii/S0277953696001918">down to laziness or lack of willpower</a> is itself lazy and too often thrown around. Poverty in early life affects not only how capable the mind is of making the right choices, but also how the body responds to adversity at a fundamental level. Far from being a resource drain, investing money in improving children’s quality of life could improve a <a href="http://pediatrics.aappublications.org/content/131/2/319">range of health outcomes</a>, and dramatically reduce the burden on a health-care budget stretched by the vast capital needed to care for <a href="https://www.theguardian.com/society/2016/feb/01/ageing-britain-two-fifths-nhs-budget-spent-over-65s">older people</a>.</p>
<p>Rock star Marilyn Manson got it right with the lyrics for Leave A Scar. What doesn’t kill you, in many ways, <a href="https://www.psychologytoday.com/blog/insight-therapy/201008/what-doesnt-kill-you-makes-you-weaker">makes you weaker</a>. Those who thrive amid deprivation do so in spite of, rather than because of, the difficulties they experience. Many less fortunate people will struggle to stay fit and well despite making healthy choices. We could do with providing them with a little more support, and a little less judgement.</p><img src="https://counter.theconversation.com/content/92061/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Noortje Uphoff does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Childhood adversity doesn’t just affect our choices – according to new research, it also weakens the body’s fundamental ability to stay healthy in old age.
Noortje Uphoff, Researcher in Social Epidemiology, University of York
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/86764
2018-01-02T20:51:04Z
2018-01-02T20:51:04Z
Three reasons to get your stress levels in check this year
<figure><img src="https://images.theconversation.com/files/199170/original/file-20171214-27568-nrfd00.jpg?ixlib=rb-1.1.0&rect=0%2C450%2C1879%2C916&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People who are chronically stressed are more than twice as likely to have a heart attack than those who aren't.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/1K9T5YiZ2WU">Tim Gouw</a></span></figcaption></figure><p>It’s difficult not to get stressed in our fast-paced lives. Whether you’re working overtime, battling exams, or caring for a sick relative, chronic stress has become commonplace. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=823&fit=crop&dpr=1 600w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=823&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=823&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1034&fit=crop&dpr=1 754w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1034&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1034&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Adrenaline allows us to act quickly.</span>
</figcaption>
</figure>
<p>When we’re acutely stressed, the fight-or-flight system jumps into action, sending a surge of adrenaline through the body. This product of evolution dramatically increases our reaction speed and once allowed us to escape or fight a predator. </p>
<p>But our bodies are not designed to cope with ongoing activity of these stress pathways. </p>
<p>The psychological effects of stress – such as irritability, loss of appetite, and difficulty sleeping – are obvious to anyone who has been under pressure. But stress also has subtle, underlying effects on almost every part of the body, including the heart, gut and immune system. </p>
<p>Here are just three reasons to get your stress levels in check this year. </p>
<h2>1. You’re at risk of a heart attack</h2>
<p>When activated, the fight-or-flight system causes blood pressure to spike and redirects blood flow away from non-essential parts of the body and into the muscles. </p>
<p>Consistently high blood pressure or frequent spikes strain the coronary arteries serving the heart. Higher blood pressure with each beat causes arteries to slowly stiffen and become clogged, which impedes blood flow to the heart.</p>
<p>One study found people who were chronically stressed, either in their work or home life, were <a href="https://www.ncbi.nlm.nih.gov/pubmed/15364185">more than twice as likely to have a heart attack</a> than those who weren’t.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-do-my-blood-pressure-numbers-mean-29212">Health Check: what do my blood pressure numbers mean?</a>
</strong>
</em>
</p>
<hr>
<p>Another effect of stress on the cardiovascular system is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633295/">hyper-responsiveness</a>. When a person is suffering low but persistent levels of stress, their response to an added source of stress is much more intense than normal, leading to larger spikes in heart rate and blood pressure. </p>
<p>Again, the increased blood pressure damages blood vessels and increases the chances of blockages and heart attacks.</p>
<h2>2. Your bathroom habits are unpredictable</h2>
<p>The same systems that increase blood pressure and heart rate during stress also cause food to be digested more slowly. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=649&fit=crop&dpr=1 600w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=649&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=649&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=816&fit=crop&dpr=1 754w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=816&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=816&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Chronic stress can make you constipated or have diarrhoea.</span>
<span class="attribution"><span class="source">Marcella Cheng/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>The chemicals produced by the stomach and intestines change when you’re stressed. Food gets broken down in different ways and the body may have difficulty absorbing the nutrients from it. This can lead to constipation, diarrhoea and general intestinal discomfort. </p>
<p>Chronic stress has <a href="https://www.ncbi.nlm.nih.gov/pubmed/22314561">also been linked</a> to more serious diseases such as irritable bowel syndrome and inflammatory bowel disease. While the reasons for this still aren’t clear, it’s thought that chronic stress causes bowel disease by increasing inflammation from intestinal immune cells called mast cells.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/so-you-think-you-have-ibs-coeliac-disease-or-crohns-heres-what-it-might-mean-for-you-39128">So you think you have IBS, coeliac disease or Crohn’s? Here’s what it might mean for you</a>
</strong>
</em>
</p>
<hr>
<p>Treatment for these diseases usually revolve around managing the painful and uncomfortable symptoms instead of addressing the underlying cause. However some therapies, <a href="https://www.ncbi.nlm.nih.gov/pubmed/20554042">such as the hormone melatonin</a>, work by reducing the effects of stress on the gut.</p>
<h2>3. You’re more likely to get sick</h2>
<p>We’ve long known that stress makes people more vulnerable to catching minor illnesses but we’ve only begun to understand <em>how</em> stress affects the immune system over the past few decades. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=566&fit=crop&dpr=1 600w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=566&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=566&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=712&fit=crop&dpr=1 754w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=712&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=712&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Students who were less stressed when receiving the vaccination had a better immune response than their anxious peers.</span>
<span class="attribution"><span class="source">Marcella Cheng/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>The best examples of this come from a study of chronically stressed carers who look after patients with Alzheimer’s disease, and another of medical students in the middle of their exam period. </p>
<p>When given the flu vaccine, the stressed caretakers had a lower immune response to the vaccine than normal. </p>
<p>Conversely, when the medical students in the middle of their exam periods were vaccinated against hepatitis, the students with better social support and lower levels of stress and anxiety had a much better immune response to the vaccine than other students.</p>
<p>In other words, when the participants were stressed, their immune system didn’t function as it should to recognise and defend against the virus. The same occurs for colds and flus, other viruses, bacterial infections and even <a href="https://www.ncbi.nlm.nih.gov/pubmed/15465465">cancer</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-the-immune-system-19240">Explainer: what is the immune system?</a>
</strong>
</em>
</p>
<hr>
<p>When stress causes the immune system to break down, a bug that might have been under control can suddenly start flourishing. Once a person begins feeling sick, their stress levels will likely rise and make it <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/">harder for the immune system</a> to fight off the disease. This prolongs the illness and increases the risk it will be passed on to another person.</p>
<h2>How to reduce your stress levels</h2>
<p>There are many strategies available to reduce the effects of stress, but their health benefits have only recently started to be researched and understood over the past few decades. </p>
<p>An interesting example of this came from an experiment in 2002, where subjects were given injections of artificial adrenaline to increase their blood pressure and heart rate. But when one of the subjects got bored and started meditating, their heart rate <a href="https://www.ncbi.nlm.nih.gov/pubmed/12372589">suddenly dropped back to normal</a>, even with the researchers attempting to increase it artificially.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=332&fit=crop&dpr=1 600w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=332&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=332&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=417&fit=crop&dpr=1 754w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=417&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=417&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Meditation helps some people lower their blood pressure.</span>
<span class="attribution"><span class="source">Marcella Cheng/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>This finding was applied in a 2008 study, where researchers took newly diagnosed breast cancer patients and enrolled them in a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2586059/">mindfulness-based stress-reduction program</a> that focused on breath awareness, meditation and yoga.</p>
<p>After eight weeks of participation in the program, the immune systems of the women had all made a remarkable recovery, and were functioning just as well as a healthy person’s immune system. The women also reported feeling much more optimistic about their future, as well as feeling more connected with their family and friends.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mindfulness-how-to-be-in-the-moment-right-here-right-now-31576">Mindfulness: how to be in the moment ... right here, right now</a>
</strong>
</em>
</p>
<hr>
<p>Interestingly, short bursts of acute stress can be beneficial to immune function, particularly of that associated with exercise. While solid evidence is still lacking in humans, <a href="https://www.ncbi.nlm.nih.gov/pubmed/26895752">mice received a huge benefit from frequent exercise</a> while fighting off melanoma.</p>
<p>In the end, it comes down to being aware of your stress levels, and what works for <em>you</em> to get your stress in check. You might be surprised at just how many of your bodily functions benefit from you being a bit more relaxed.</p><img src="https://counter.theconversation.com/content/86764/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Mattarollo receives funding from National Health and Medical Research Council. Previously received funding from Leukemia Foundation Queensland and Cancer Australia/Cure Cancer Australia. </span></em></p><p class="fine-print"><em><span>Michael Nissen receives funding from the Australian Federal Government in the form of a Research Training Program scholarship.</span></em></p>
Stress has subtle, underlying effects on almost every part of the body, including the heart, gut and immune system.
Stephen Mattarollo, NHMRC Career Development Fellow, Diamantina Institute, The University of Queensland
Michael Nissen, PhD Candidate in Immunology, The University of Queensland
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/71479
2017-01-24T04:54:13Z
2017-01-24T04:54:13Z
Centrelink debt debacle is bad policy for mental health
<figure><img src="https://images.theconversation.com/files/154001/original/image-20170124-8088-npxzq5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The threat of Centrelink debt is one more stressor on already vulnerable people.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/560075098?size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>The controversial <a href="https://www.theguardian.com/australia-news/2017/jan/03/minister-defends-centrelink-over-welfare-debt-compliance-system">Centrelink debt recovery system</a> shifts the onus of proof about apparent debts onto disadvantaged and vulnerable people.</p>
<p>The automated system uses <a href="https://theconversation.com/why-centrelink-should-adopt-a-light-touch-when-data-matching-70989">matching data</a> from various government agencies to generate letters to those receiving, or who have received, Centrelink payments, claiming they owe the government money. People then only have a few weeks to respond to matters that may go back years.</p>
<p>The debt recovery system could hardly have been better designed to create conditions that cause chronic stress.</p>
<p>Its approach has potentially serious consequences. UK research shows when government policies placed new and onerous demands on people receiving welfare payments this led to an <a href="http://jech.bmj.com/content/early/2015/10/26/jech-2015-206209.short">increase in mental health problems, and in suicides</a>.</p>
<p>If this debt recovery program continues, it is quite possible we may see similar, adverse effects on people’s health in Australia. As such, the government should suspend the program and rethink its approach.</p>
<h2>How does stress affect health?</h2>
<p>Stress stimulates our senses and focuses our attention. Our heart rate and blood pressure increase to support rapid changes in behaviour. Occasional relatively mild bursts of short-term stress <a href="https://www.amazon.com/Descartes-Error-Emotion-Reason-Human/dp/014303622X">are useful</a> in navigating everyday social environments and our bodies are designed to deal with it. </p>
<p>The social causes of stress are complex, but in simple terms, people are <a href="https://www.ncbi.nlm.nih.gov/pubmed/15122924">more likely</a> to experience stress arousal in situations when they believe they lack control over a situation and/or fear a possible negative evaluation from other people.</p>
<p>Unlike short-term stress, chronic stress can have more serious, long-term health consequences. It <a href="https://www.ncbi.nlm.nih.gov/pubmed/20973623">occurs</a> when people are faced with repeated environmental stressors over time and do not have (or cannot see) a way to avoid or resolve the perceived problem. Chronic stress can cause <a href="https://www.ncbi.nlm.nih.gov/pubmed/19488073">changes in the brain</a> that lead to the onset of common forms of mental illness such as depression and anxiety disorders.</p>
<p>It is almost certain chronic stress plays a significant role in <a href="https://www.ncbi.nlm.nih.gov/pubmed/20973623">mediating the effects</a> of social factors – like low income, unemployment, unsafe living environments, poor conditions in childhood, or being subject to discrimination – on health and illness across populations. <a href="http://www.who.int/social_determinants/thecommission/finalreport/en/">Research shows</a> such “<a href="https://www.ncbi.nlm.nih.gov/pubmed/15781105">social determinants of health</a>” can undermine people’s mental and physical health.</p>
<h2>How does this relate to Centrelink?</h2>
<p>In light of evidence on stress and its social causes, Centrelink’s debt recovery program is highly likely to contribute to chronic stress among people already subject to socioeconomic disadvantage and/or other life demands. So it is likely to cause or exacerbate mental health problems and illness.</p>
<p>For a person with limited resources, receiving a government letter demanding payment of large debts and threatening legal action is very likely to undermine their sense of control over their life, especially given community legal centres are <a href="http://www.abc.net.au/news/2016-08-12/community-legal-centres-push-to-reverse-funding-cuts/7730694">simultaneously being</a> <a href="http://www.naclc.org.au/cb_pages/news/MediaReleaseMYEFOfailstohaltfundingcliffforCommunityLegalCentresandAboriginalandTorresStraitIslander.php">defunded</a>.</p>
<h2>Broader lessons for policy</h2>
<p>A broader aspect of this problem is the failure of policy makers and key mental health organisations to come to terms with the causal link between social conditions and mental health and illness. </p>
<p>My research with colleagues on Australian health policy has shown although mental health policies often acknowledge social determinants of mental health, they <a href="https://www.cambridge.org/core/journals/journal-of-social-policy/article/to-what-extent-do-australian-health-policy-documents-address-social-determinants-of-health-and-health-equity/BB5C219E2D0B05C7A80262DD1418A74C">mainly focus</a> on individualised responses through medication and therapy. </p>
<p>The lack of action on social determinants of mental health and illness allows governments to avoid responsibility for the adverse health impacts of policies, like the Centrelink program.</p>
<p>It also blocks much needed public discussion on the <a href="https://croakey.org/the-centrelink-debacle-and-a-longread-about-the-dangers-of-chronic-stress/">broader impacts of stress</a> in modern societies. It lets down the Australian public and obscures the potential for Australia to do far better than our current sorry <a href="http://www.abs.gov.au/ausstats/abs@.nsf/mf/4326.0">performance</a> on mental health by pursuing a <a href="https://www.ncbi.nlm.nih.gov/pubmed/20943582">policy agenda</a> to create social conditions that support well-being for all.</p><img src="https://counter.theconversation.com/content/71479/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Matt Fisher has received funding for research on Australian health policy from the Australian Research Council. He is affiliated with the Public Health Association of Australia, the Social Determinants of Health Alliance and the Australian Greens.</span></em></p>
The controversial Centrelink debt recovery system is bad news for the mental health of the disadvantaged and vulnerable people it targets.
Matt Fisher, Research Fellow in social determinants of health, Flinders University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/68319
2016-11-07T11:00:57Z
2016-11-07T11:00:57Z
Stressed by election results? Try neuroscience
<figure><img src="https://images.theconversation.com/files/144732/original/image-20161106-27911-1yvth96.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Stressed woman at computer. Via Shutterstock.</span> <span class="attribution"><span class="source">From www.shuttterstock.com</span></span></figcaption></figure><p>The vitriolic presidential campaign left many of us feeling anger, and the election of Donald J. Trump as President hasn’t erased it. Many of us feel a deep, fire in the belly anger that it has come to this. We may feel like caged lions, spitting mad, but told to quiet down, be civil and act nice.</p>
<p>That seems like excellent advice, given the harm caused by rage, hostility, aggression, but, in reality, the <a href="http://www.apa.org/news/press/releases/2016/10/presidential-election-stress.aspx">stress we feel</a> from the campaign is not likely to fade and that ongoing political climate could become a continuing assault to our well-being. </p>
<p>Hearing about or seeing vicious personal attacks, criticism of parents who have lost a child to war, accusations of fraud and talk of sexual assault have affected our psyches, souls and bodies. </p>
<p>Stress is the number one worldwide epidemic and threat to health. It is outstripping our capacity to process that stress effectively, so increasingly the brain’s stress switch (hypothalamus) is flipping. That takes our thinking brain with its wise judgment and oversight off line and puts the reptilian brain, which is given to fight or flight extremes, in charge. Emotionally, our first response is anger, if we don’t completely dissociate and turn off feelings altogether.</p>
<p>And yet, maybe this election stress is perfect in its own way, as given the likely pile up of charges and counter charges and avalanches of stresses post-election, we will pause for long enough to upgrade our brain’s capacity to process stress, in the spirit of changing the world by changing ourselves.</p>
<p>My colleagues and I at University of California San Francisco have developed <a href="http://www.hypothesisjournal.com/?p=955">emotional brain training</a> (EBT) as a <a href="http://www.ebt.org">set of skills</a> to improve the brain’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260341/">effectiveness</a> in processing stress. Our hunter-gatherer brain adapted to the Paleolithic life of physical stress and sameness, yet we live in a world of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568977/">emotional stress</a> and overwhelming speed of change. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341916/">more than 80 percent of health problems</a> are rooted in chronic stress, we have explored four ways to update our brain’s capacity to process our anger and boost our resilience.</p>
<h2>The upside of anger</h2>
<p>The first concept in updating how we respond to stress is to stop judging our anger. <a href="https://www.ncbi.nlm.nih.gov/pubmed/9599445">It is the only negative emotion in the brain </a> associated with approach and power, the one emotion that says, “Cut it out!” It’s our protest emotion that mobilizes us to do something that helps us survive. </p>
<p>Without a robust skill to express anger, we turn that anger in on ourselves, and open the door to depression, anxiety, shame, numbness and false highs. The internalized, suppressed anger causes a rumbling of chronic stress that rears its head as stress symptoms. Those backaches, late night munchies, work stalls, and sleepless nights all add to our health care burden and cause <a href="http://wws.princeton.edu/faculty-research/research/item/rising-morbidity-and-mortality-midlife-among-white-non-hispanic">emotional diseases to overtake chronic diseases</a> in mortality rates.</p>
<p>In short, we need to honor our right to feel and express anger effectively, which takes understanding the neurobiology of anger.</p>
<h2>Knowing your number</h2>
<p>Breakthrough research at <a href="https://www.ncbi.nlm.nih.gov/pubmed/22365542">New York University Emotional Brain Institute</a> has proposed a new way to think about emotions based circuitry activated at varying levels of stress. When our stress levels are low, we activate emotional circuits that help us take wise actions that protect ourselves and others. When the fight or flight response is spewing stress chemicals through every cell of our being, we activate circuits that takes us to unhealthy extremes.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/144740/original/image-20161106-27934-1i3bqxc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/144740/original/image-20161106-27934-1i3bqxc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=243&fit=crop&dpr=1 600w, https://images.theconversation.com/files/144740/original/image-20161106-27934-1i3bqxc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=243&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/144740/original/image-20161106-27934-1i3bqxc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=243&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/144740/original/image-20161106-27934-1i3bqxc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=305&fit=crop&dpr=1 754w, https://images.theconversation.com/files/144740/original/image-20161106-27934-1i3bqxc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=305&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/144740/original/image-20161106-27934-1i3bqxc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=305&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Brain state and anger levels.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>These new learnings suggest a needed update in how we approach emotions. </p>
<p>EBT uses a five point system of stress in which we do not ask ourselves “How do I feel? but instead we ask ourselves, "What number am I?” that is, we check our stress level or brain state. That gives the thinking brain more power to determine how best to process our emotions, rather than our diving right into our feelings and potentially finding ourselves in a rage or in other destructive emotions, such as depression, panic, anxiety or numbness.</p>
<p>If you like, try using that tool now by taking three deep breaths and asking yourself, “What number am I?”, then using the technique for that stress level that turns destructive emotions into constructive feelings. The emotional technique for Brain State 5 is the damage control tool, that is, taking three deep breaths, then saying repeatedly (sometimes 5 to 20 times) “do not judge, minimize harm, know it will pass.” That calms down the reptilian brain so your thinking brain can be on line and running the show again.</p>
<h2>The power of compassion and humor</h2>
<p>Once we’re thinking in terms of brain states, it’s natural to start wondering about the brain states of others. Problems in relationships at home or at work are most apt to happen when both people are in the lower brain states.</p>
<p>The reptilian brain is in charge, so not only are emotions extreme, but the brain activates circuits of relationship dysfunction. Our thinking brain remains offline, so <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907136/">analyzing the situation </a> rapidly devolves into catastrophizing, obsessing or ruminating.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/144635/original/image-20161104-27939-1r5mvxq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/144635/original/image-20161104-27939-1r5mvxq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/144635/original/image-20161104-27939-1r5mvxq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/144635/original/image-20161104-27939-1r5mvxq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/144635/original/image-20161104-27939-1r5mvxq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/144635/original/image-20161104-27939-1r5mvxq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/144635/original/image-20161104-27939-1r5mvxq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Humor helps. Via Shutterstock.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-142809292/stock-photo-cute-couple-both-with-an-afro-posing.html?src=iaT7Gqnh9eEzCzWyFG7TlA-1-41">From www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>The solution is to appreciate that the root cause of all this intense emotion is stress. During stress nobody is “relationship material,” and so compassion and humor (e.g., “I’d like to discuss that but my reptilian brain is in charge right now.”) can go a long way toward melting that stress and hastening a healing moment of reconnection.</p>
<h2>Updating your emotional tools</h2>
<p>The third idea is to appreciate that there are new tools that can turn negative destructive emotions into positive, constructive feelings. Part of EBT includes <a href="http://www.ebtconnect.net">learning tools</a> to update our emotional skill set, that you can use internally – so nobody else knows how furious you are or how shut down you feel – that rapidly reduce stress. </p>
<p>Try the flow tool, which is effective at Brain State 3, and easy to learn. Just say the first four words of each sentence, pause so your brain connects and words “bubble up” into your conscious mind to complete the sentence. Express 1 to 10 anger statements, using words that come from your gut – release that anger, and when you do, sadness will arise. Complete one sentence for sadness and each of the other feelings. </p>
<p>The EBT Flow Tool</p>
<p>I feel angry that … I can’t stand it that … I feel furious that . . I hate it that … (up to 10)</p>
<p>I feel sad that … I feel afraid that … I feel guilty that …</p>
<p>I feel grateful that … I feel happy that …I feel secure that … I feel proud that …</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/145480/original/image-20161110-25055-9sbodn.gif?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/145480/original/image-20161110-25055-9sbodn.gif?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/145480/original/image-20161110-25055-9sbodn.gif?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/145480/original/image-20161110-25055-9sbodn.gif?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/145480/original/image-20161110-25055-9sbodn.gif?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/145480/original/image-20161110-25055-9sbodn.gif?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/145480/original/image-20161110-25055-9sbodn.gif?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption"></span>
<span class="attribution"><span class="source">Mike DeSocio/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>Here’s my flow tool in this moment: I feel angry there this election is such a mess. I can’t stand it that I don’t like either candidate. I hate it that the stress of this has taken its toll on me. I feel guilty that I can’t stop thinking about it … I feel grateful that we have elections. I feel happy that it is a sunny day. I feel secure that I can handle whatever comes and I feel proud that I used this tool. Ahhh . . now I have a smile on my face and a calm in my body. Perfect!</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/144638/original/image-20161104-27904-6aho8m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/144638/original/image-20161104-27904-6aho8m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/144638/original/image-20161104-27904-6aho8m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/144638/original/image-20161104-27904-6aho8m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/144638/original/image-20161104-27904-6aho8m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/144638/original/image-20161104-27904-6aho8m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/144638/original/image-20161104-27904-6aho8m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sunny day via Shutterstock.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-403034113/stock-photo-defocused-bokeh-background-of-garden-with-blossoming-trees-in-sunny-day-backdrop.html?src=Pxgr-Bx_NhmAfzqE6fRJVw-1-10">From www.shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Rewiring unreasonable expectations</h2>
<p>The fourth concept is to address why we are so angry. Of course there are logical reasons for being upset, but what is happening in the brain? It’s the clash between our unconscious expectations that were encoded in the past and the realities of our daily lives. When our expectations are out of date and discordant with current realities, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079864/">stress chemicals</a> surge as if hungry lions were chasing us, even though the threat is posed by dueling circuits within our own emotional brain. The greater the discord, the greater the chemical response, hence explaining why the deeply offensive, divisive election process has been so stressful.</p>
<p>On the bright side, emerging research has shown that these circuits can be aroused, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640262/">reactivated and updated</a>, so we can revise our out-dated unconscious emotional expectations that is the root cause of the amplification of our normal daily stress. This brain reset has traditionally been the work of psychotherapists in group or individual sessions, but health care is becoming neuroscience-based, so new accessible options are emerging. The EBT approach is to learn a self-directed technique (<a href="https://www.ebtconnect.net/science">“cycle tool”</a>) we can use when stressed, that both rapidly reduces our stress and updates our circuitry. Attention to accessible techniques like this one will probably grow as our concern about health care expenditure increases. </p>
<h2>Trying a little tenderness</h2>
<p>How can we boost our spirits after this election? Let’s remind ourselves that the stress of the situation is perfect in its own way. It gives us opportunities to try a little tenderness, becoming more sophisticated in how we approach our emotions, thereby discovering a new zest for life. That zest becomes our gift to ourselves – and to our nation.</p><img src="https://counter.theconversation.com/content/68319/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laurel Mellin owns shares in EBT, Inc., an organization for public information and professional certification in emotional brain training.</span></em></p>
This election season has brought more anger and name-calling than any in recent history, and it has affected many of us. Here are some ways you can ward off some of the stress associated with it.
Laurel Mellin, PhD, Associate Clinical Professor of Family & Community Medicine and Pediatrics, University of California, San Francisco
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/63704
2016-10-26T03:14:24Z
2016-10-26T03:14:24Z
Life interrupted: young people need help moving forward after cancer
<figure><img src="https://images.theconversation.com/files/140819/original/image-20161007-32713-h9leo1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">More young Australians face the daunting task of trying to live a 'normal' life while dealing with the after-effects of cancer.</span> <span class="attribution"><a class="source" href="https://hd.unsplash.com/photo-1454909516657-78526f214d05">Greg Raines/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Around 1,000 teens and young Australian adults are <a href="http://www.aihw.gov.au/publication-detail/?id=10737421461">diagnosed with cancer</a> each year. It’s well known the disease has an immense physical and psychological impact on these young people. But the ongoing challenges of life after cancer treatment are less well recognised. </p>
<p>While they vary depending on cancer type, <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737420600">overall survival rates for young people</a> are good and improving over time. The relative rate of survival for all cancers five years after diagnosis increased from 80% in 1983-1989 to 88% in 2004-2010 for teens and young adults. </p>
<p>This is great, but it also means more young Australians face the daunting task of trying to live a “normal” life while dealing with cancer’s often long-term physical, psychological and social after-effects. Working with young people to <a href="http://dx.doi.org/10.1002/cncr.26043">help them make sense of their world</a> is essential to optimise their future wellbeing.</p>
<h2>Life after cancer</h2>
<p>Close to <a href="https://dx.doi.org/10.1001/jama.290.12.1583">50% of young cancer survivors</a> will have at least one major adverse health outcome as a result of the therapy that cured their cancer. Two-thirds will <a href="https://www.ncbi.nlm.nih.gov/pubmed/15253918">experience one or more</a> chronic health issues, while one-third will experience a life-threatening complication of their cancer treatment. </p>
<p>Health issues <a href="http://dx.doi.org/10.1146/annurev.publhealth.28.021406.144049">include risks of heart problems</a>, respiratory disorders and hormonal issues. It is common for cancer survivors to deal with ongoing pain, fatigue and body changes such as hair loss, weight gain, scarring, reduced bone density or loss of limbs from amputation.</p>
<p>The increased risk of chronic conditions is exacerbated by unhealthy lifestyle behaviours, genetic factors and other health conditions. Unhealthy behaviours include poor diet, physical inactivity, smoking, alcohol use and sun exposure. The <a href="https://dx.doi.org/10.1093/jpepsy/25.7.493">impact of these behaviours is likely to be higher</a> for young cancer survivors who are already vulnerable to long-term health problems.</p>
<p>Cancer treatment can also cause cognitive difficulties later in life, in areas such as impaired concentration and memory. This can restrict education and work opportunities, leading to <a href="http://dx.doi.org/10.1007/s11764-013-0336-0">increased emotional distress</a> and reduced quality of life. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/140823/original/image-20161007-32734-1ozmb0y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/140823/original/image-20161007-32734-1ozmb0y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/140823/original/image-20161007-32734-1ozmb0y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=387&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140823/original/image-20161007-32734-1ozmb0y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=387&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140823/original/image-20161007-32734-1ozmb0y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=387&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140823/original/image-20161007-32734-1ozmb0y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=486&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140823/original/image-20161007-32734-1ozmb0y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=486&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140823/original/image-20161007-32734-1ozmb0y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=486&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A significant proportion of young adult cancer survivors report experiencing clinically relevant symptoms of anxiety, depression and post-traumatic stress.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
</figcaption>
</figure>
<p>A <a href="http://dx.doi.org/10.1016/j.ejca.2010.03.001">significant proportion</a> of young adult cancer survivors report experiencing clinically relevant symptoms of anxiety, depression and post-traumatic stress. More than 22% have reported mental health symptoms, compared to 14% of those who haven’t had cancer – a statistically significant difference. Anxiety about cancer recurrence is also common and <a href="http://dx.doi.org/10.1017/S1478951509990903">persists for many years</a> after treatment. </p>
<p>Research <a href="https://www.researchgate.net/publication/309240139_Measuring_organisational_impact_Outcomes_of_a_psychosocial_assessment_and_review_process_with_young_people_living_with_cancer">conducted by CanTeen</a> – an Australian organisation for young people living with cancer, where I’m the general manager of research and youth cancer services – shows almost 40% of survivors aged 12 to 24 report high or very high levels of psychological distress at the time of accessing support. </p>
<p>This percentage is much higher than the national average. According to other national Australian samples using the same measure, only <a href="https://www.health.gov.au/internet/main/publishing.nsf/Content/9DA8CA21306FE6EDCA257E2700016945/$File/child2.pdf">17% of those aged 11 to 15</a> and <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737420600">9% of those aged 16 to 24</a> reported high or very high distress.</p>
<p>There are <a href="http://dx.doi.org/10.1016/j.ejon.2016.06.002">complex interconnections</a> between physical and psychological effects after the cancer goes away. For instance, the psychological fear of cancer returning can persist due to the real increased physical risk of second-cancer malignancies. </p>
<p>Romantic relationships and family planning are complicated by possible sexual dysfunction and <a href="https://theconversation.com/young-people-with-cancer-should-have-affordable-options-to-preserve-their-fertility-63457">fertility loss</a> due to treatment. Physical changes can restrict participation in activities the young person previously enjoyed. This can further increase social isolation, loss of confidence and poor body image. </p>
<p>Many young adults also face an ongoing financial burden from cancer treatment, its associated costs, and missed education and employment opportunities. Previous research shows <a href="http://onlinelibrary.wiley.com/doi/10.1002/cncr.27445/full">significantly fewer young cancer survivors</a> report being employed than peers without cancer.</p>
<p>It isn’t all bad news though. Many young adult cancer survivors <a href="http://onlinelibrary.wiley.com/doi/10.1002/cncr.27512/abstract">have also reported</a> improvements in supportive relationships, compassion for others and positive world views. These become important building blocks in helping survivors develop coping skills, while supporting them to manage the negative impacts of cancer and its treatment.</p>
<h2>How services in the community can help</h2>
<p>The impact of cancer means it is common for young survivors to need ongoing care across their life, involving <a href="http://jco.ascopubs.org/content/28/32/4810">both medical monitoring and psychological support</a>. <a href="https://www.canteen.org.au/">CanTeen</a> and its specialist, hospital-based arm <a href="http://www.youthcancer.com.au/youth-cancer-services.aspx">Youth Cancer Services</a> recently <a href="https://www.canteen.org.au/wp-content/uploads/2016/09/Adolescent-and-Young-Adult-Cancer-Survivorship-Report.pdf">reported</a> on the opportunities and challenges of developing care models for young adult cancer survivors in Australia. </p>
<p>That report highlighted the need for better coordination and consultation between hospital staff and community based providers such as GPs, community mental health services, and cancer support organisations, to assist young people and their families as they navigate the complex post-cancer treatment environment. </p>
<p>Models of wellness – the preferred approach to understanding and working with people surviving cancer – emphasise the importance of integrated care involving survivors, community and health professionals. Integrated care breaks down a silo approach and improves referral pathways across the cancer journey.</p>
<p>Appropriate integrated approaches with hospitals can enable GPs to work with young people along their cancer trajectory and into later life. GPs have a role in monitoring and managing potential late effects, fertility planning and providing referrals for lifestyle management, nutrition, physical activity, and substance abuse. </p>
<p>But we also need <a href="https://dx.doi.org/10.1089/jayao.2015.0042">survivorship programs</a> that target lifestyle choices for young Australians that can <a href="https://www.ncbi.nlm.nih.gov/pubmed/25568146">exacerbate long-term physical and psychological treatment effects</a>. Strengthening referral pathways to community support organisations can also help young people and their families receive psychological and <a href="dx.doi.org/10.1200/JCO.2011.39.5467">peer support</a>. </p>
<p>This professional support can be bolstered by ongoing support from friends and family. Young people may be hesitant to let others know they still need help even though their treatment has finished. CanTeen’s “Now What” resources provide useful information for <a href="https://www.canteen.org.au/wp-content/uploads/2015/07/Supporting-your-friend-when-they-have-cancer.pdf">friends</a> and <a href="https://www.canteen.org.au/wp-content/uploads/2015/07/Dealing-with-your-siblings-cancer.pdf">young family members</a> about how to provide ongoing support to their friend or sibling impacted by cancer.</p>
<p>Friends and family should also be mindful of how their loved one’s cancer journey can impact on them and should seek support if they need it.</p><img src="https://counter.theconversation.com/content/63704/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Pandora Patterson is the General Manager, Research & Youth Cancer Services at CanTeen Australia and Adjunct Associate Professor, Cancer Nursing Research Unit, The University of Sydney. CanTeen Australia is a registered charity that receives funding from various government and individual sources, including funding from the Australian Government to run the Youth Cancer Services program.</span></em></p>
If you’re an Australian teenager or young adult diagnosed with cancer, there’s good news: overall survival rates are good and getting better. But what can you expect from life after cancer treatment?
Pandora Patterson, Adjunct Associate Professor, Cancer Nursing Research Unit, University of Sydney
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/55619
2016-03-03T05:39:35Z
2016-03-03T05:39:35Z
Chronic stress effects help cancer spread, researchers find
<figure><img src="https://images.theconversation.com/files/113635/original/image-20160302-25879-17wt03c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Prolonged periods of stress can aid in the spread of cancer.</span> <span class="attribution"><span class="source">from shutterstock.com</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Chronic stress accelerates cancer growth in mice, according to a <a href="http://www.nature.com/ncomms/2016/160301/ncomms10634/full/ncomms10634.html">paper published in Nature Communications</a> this week. The finding points to potential treatment targets to slow the progression of cancer to other organs.</p>
<p>The paper revealed findings from several studies, mostly on mice, conducted by a team of researchers from Monash University.</p>
<p>Chronic stress refers to prolonged, repeated exposure to stressful situations, such as caring for a sick relative for a long period of time. To mimic the way people feel under significant stress, researchers restrained mice with breast cancer tumours, to make them feel like they couldn’t cope with their circumstances.</p>
<p>Over time, the mice developed an increase in the number and size of of their lymphatic vessels – a network of vessels that transports fluid around the body. This enhanced the spread of cancer cells to new sites, a process called cancer progression or metastasis.</p>
<p>By blocking the activity of proteins that detect stress, or those that enhance the formation of lymphatic vessels, researchers found they could reduce the spread of cancer cells in the mice. </p>
<h2>What stress does to the body</h2>
<p>The research focused on metastasis of breast cancer to other parts of the body, building on previous findings that neurological stress hinders our defence against disease.</p>
<p>Previous findings <a href="http://www.nature.com/nrclinonc/journal/v5/n8/full/ncponc1134.html">from human studies</a> have shown poorer cancer survival in people exposed to stressful life experiences and those more prone to stress. </p>
<p>Another <a href="http://onlinelibrary.wiley.com/doi/10.1002/cncr.23969/abstract;jsessionid=5F1E795CA48D6B71FC0A85B45799D348.f04t03">clinical trial</a> showed better survival rates for breast cancer patients in remission who participated in a 12-month intervention with strategies to reduce stress, improve mood and alter health behaviours.</p>
<p>Everyday stressful experiences pose a threat to the body’s natural balance. This is because stress activates the <a href="https://www.sciencedaily.com/terms/sympathetic_nervous_system.htm">sympathetic nervous system (SNS)</a>, which is responsible for what we know as the fight or flight response. </p>
<p>Under stress, the SNS releases higher levels of neurotransmitters. These hormones, such as epinephrine, signal to other cells to activate physiological flight or flight responses, such as a faster heart rate. This is important during times of threat because it makes us more alert and increases physiological functions needed for rapid reactions.</p>
<p>But as shown in the Nature Communications study, chronic periods of stress can lead to changes in the lymphatic system. These include an increase in the number of vessels in the tumours as well as the size of these vessels. These changes are associated with the spread of cancer cells to lymph nodes and distant organs, such as the lung. </p>
<p>Clinically, we know that when cancer cells have spread through blood vessels into the lymph vessels, that’s an important indicator of poorer prognosis. Preventing this could improve survival rates.</p>
<h2>It’s not so simple</h2>
<p>The latest findings have obvious treatment implications, which include using drugs to block stress responses that lead to changes in lymphatic vessels. But blocking any part of a natural pathway can promote a cascade of negative effects.</p>
<p>The study reported that a number of patients on drugs often used to treat anxiety and high blood pressure (beta blockers that block the actions of adrenaline) were less likely to have secondary cancer that had spread from its primary site. </p>
<p>This is good news, but more work is needed before such interventions can be further tested. </p>
<p>This is because the lymphatic system is important in our immune response and manipulating any of its mechanisms could carry potential harms. These include limiting the immune system’s ability to respond to the cancer in the first place. </p>
<p>It could also increase the risk of lymphedema – swelling in one or more extremities – that results from impaired flow of the lymphatic system.</p>
<p>Although the authors did show supportive data from human clinical subjects, the bulk of the work was done in mouse models. Results from mice experiments don’t always translate to human systems, so further clinical testing is an essential step in translating these findings.</p>
<p>Overall, though, the study points the way to potentially helping prevent cancer spreading so far from the original site that it’s too hard to treat.</p><img src="https://counter.theconversation.com/content/55619/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Chronic stress accelerates cancer growth in mice, according to a new study, pointing to potential treatment targets to slow the progression of cancer to other organs.
Rik Thompson, Professor of Breast Cancer Research, Institute of Health and Biomedical Innovation and School of Biomedical Sciences,, Queensland University of Technology
Sandra Hayes, Professor, School of Public Health and Social Work, Queensland University of Technology
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/43011
2015-06-10T05:18:25Z
2015-06-10T05:18:25Z
Caffeine may reduce stress – but it won’t solve your problems
<figure><img src="https://images.theconversation.com/files/84374/original/image-20150609-10713-ehneqq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">That menu suddenly looks very affordable!</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/publicplaces/7497483734/in/photolist-cqwyGW-9kWUH8-71ZfW6-9wxhus-5DbaNS-887JXd-69jioP-5ZzVMu-cS5Yub-4YMQRb-34MHE-6F47u5-njXKZA-9kWUNr-bSS99-ryxhQk-67Biyp-o8y11t-9kZYZ5-9kWUjH-7F46BM-qiaK6b-aGPN9i-78GPF-boWrPe-8ZLTiv-d6c5a-brqgLg-9dzaug-g4fKjy-9bPUa3-kAoCde-dkwVr7-7q7wJn-mgGU2-jSsHH6-5bFMUW-nkGncz-eorrsP-pa8N1i-AHdYS-6dd9qR-e2D2vd-asXfFW-5DiJVM-5qii8m-8rTddt-6yduDw-7abZW9-7X3Z79">David Hodgson/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Coffee addicts have been saying it for years – now an <a href="http://www.pnas.org/content/early/2015/06/03/1423088112.abstract">experiment on mice</a> has found that caffeine does indeed help one stay cool in stressful situations – and has pinpointed the neurochemical pathways involved in the process. The researchers even suggest that the study may one day lead to medical therapies for stress-related illnesses in humans. </p>
<p>But while the research itself is important, we must not forget that stress is a normal human reaction to events rather than brain chemistry. The last thing we need is another psychiatric drug that ignores the root of the problem.</p>
<p>Previous research has shown a number of positive effects of caffeine, for instance on <a href="http://www.bbc.co.uk/news/health-15059266">preventing depression</a>. This study is the first to uncover the neurochemical pathways that enable caffeine to prevent some of the negative effects of stress on the brain. </p>
<p>Caffeine is known to <a href="http://www.ncbi.nlm.nih.gov/pubmed/20164566">inhibit receptors in the brain for the chemical adenosine</a>. The researchers found that these receptors also control the negative effects of chronic stress and that stress-induced behaviour can be reversed by blocking the receptors. </p>
<p>The results are important, as we do indeed know that chronic stress affects people very badly. In mice, the (rather unpleasant) stressful situations in this experiment included as damp bedding, sharing living space with others, food and water deprivation, cold baths and cages tilted at 45°. And these poor mice unsurprisingly showed the behavioural and neurological consequences of this stress. </p>
<p>In humans, chronic stress can also have disastrous consequences. For example, my colleagues have shown that the economic crisis in the years between 2008 and 2010 can be blamed for as many as <a href="http://www.bmj.com/content/345/bmj.e514">1,000 people in the UK taking their own lives</a>. We do, absolutely, need to understand how stress affects us. And we definitely need to find ways to help people (and mice) affected by stress.</p>
<h2>Handle with care</h2>
<p>But I do have a nagging concern. The paper suggests that a drug blocking this particular receptor could be used to treat illnesses stemming from chronic stress such as depression or anxiety.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/84378/original/image-20150609-10685-dt758e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/84378/original/image-20150609-10685-dt758e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/84378/original/image-20150609-10685-dt758e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/84378/original/image-20150609-10685-dt758e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/84378/original/image-20150609-10685-dt758e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/84378/original/image-20150609-10685-dt758e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/84378/original/image-20150609-10685-dt758e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Yummy molecule.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/gregrodgers/7523488962/in/photolist-csPR9W-5yC33Q-6X64cW-7B3a8v-brNZn-51LrPC-7QdpRP-5aFbDK-4Yr5SM-4Yr5bZ-7PASFZ-a5KgQf-51pHdS-fKA6Kq-4wJX7V-7n9p2Y-4oiMrb-dmWPr1-dWRPKy-6an9fd-q1ThE9-pmFtP8-qinRuh-q1ZNhc-q1ZNcT-a93yAe-4WEBaQ-EqXNQ-7gdwG9-diX6z8-8d5a53-bZudRJ-2bPRJo-jHpUrc-59Gk9R-28cbS-bJHFwF-qoaJsm-51dUon-8YPhNx-6eXSCu-5zQHdK-EF3h-86yLhr-3qHzv-adhWFg-q8iwjb-4oGyF1-jPpPBp-4kdfzG">Greg Rodgers/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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<p>It’s this that I question. While I don’t doubt that the study has revealed something fascinating about how the brain responds to chronic stress, it’s a little less certain that the research tells us anything about “disorders”. The mice seemed to respond normally to an abnormal – stressful – situation. It would be unfortunate to extrapolate that understanding to infer that such a response is a sign of abnormality, especially in humans.</p>
<p>Stressful events make us stressed, emotionally and physically; they have negative cognitive, emotional, physical and behavioural consequences. Given that we process information in the brain using neurotransmitters, it’s obvious that there will be a neurological route or pathway behind stress-induced behaviour. It’s great to know more about that pathway – and maybe that will even help us become more resilient or recover faster from stressful life events.</p>
<h2>Swerves and steering wheels</h2>
<p>An analogy might help. If a driver swerves and crashes a car, we don’t usually regard the steering wheel as the “cause” of the crash. The steering wheel was absolutely necessary (almost certainly the steering wheel was a necessary part of the causal chain), but it didn’t “cause” the crash. OK, we can imagine a weird scenario where a fault in the steering wheel (grease on the grip, perhaps) might be to blame. But such scenarios are vanishingly rare. Essentially, the wheel is a part of a mechanism whereby the cause (the driver’s swerve) translates into the crash.</p>
<p>It’s fantastic that this research has been conducted. It’s genuinely important – and potentially useful. As a scientist and I believe passionately that knowledge (and depth of knowledge) can help us understand the full implications of the embodied human experience. That includes understanding how the brain works and the neurochemical pathways of our response to stress. But it doesn’t necessarily mean that these molecular pathways are the “cause” of psychological distress. It’s probably better to think of them as enabling our normal human responses, not causing them. </p>
<p>This is important. The unfortunate tendency to label undesirable emotions as “symptoms” of “illness” may well<a href="http://www.palgrave.com/page/detail/a-prescription-for-psychiatry-peter-kinderman/?K=9781137408709"> cause us to treat people with less empathy</a> than we should, to ignore the root causes of distress and to turn to inappropriate medical treatments. I’m all in favour of understanding how our brains work. I’m slightly less keen on mistaking mechanisms for causes.</p><img src="https://counter.theconversation.com/content/43011/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Kinderman receives funding from NIHR (the National Institute for Health Research) and ESRC (the Economic and Social Research Council. He is President-Elect of the British Psychological Society.</span></em></p>
There’s great news for coffee lovers. A study has found that caffeine can help combat stress.
Peter Kinderman, Professor of Clinical Psychology, University of Liverpool
Licensed as Creative Commons – attribution, no derivatives.