tag:theconversation.com,2011:/us/topics/scizophrenia-25616/articlesScizophrenia – The Conversation2020-03-02T16:02:14Ztag:theconversation.com,2011:article/1274822020-03-02T16:02:14Z2020-03-02T16:02:14ZAntipsychotics can be life-changing, but they can also put patients at risk<figure><img src="https://images.theconversation.com/files/318021/original/file-20200302-18291-mdk4qd.jpg?ixlib=rb-1.1.0&rect=49%2C40%2C2946%2C1953&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/large-assortment-different-medication-pills-tablets-1626865900">Ashley van Dyck/Shutterstock</a></span></figcaption></figure><p>People who have a diagnosis of <a href="https://theconversation.com/is-schizophrenia-written-in-our-genes-53903">schizophrenia</a> can suffer extremely disabling and distressing symptoms, such as tormenting voices and paranoid thoughts. But with the right treatment, most people can live complete and fulfilling lives – thanks mainly to their antipsychotic medication.</p>
<p>But of course, all medications have side-effects and for some people on antipsychotics these <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127750/">side-effects</a> can range from <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.697.6247&rep=rep1&type=pdf">mildly debilitating to life threatening</a>. </p>
<p>One such drug, clozapine – often reserved for <a href="https://blogs.bmj.com/ebmh/files/2014/10/Dold-Leucht-2014_EBMH_Pharmacotherapy-of-treatment-resistant-schizophrenia_a-clinical-perspective.pdf">difficult to treat cases of schizophrenia</a> – can lower people’s white blood count to dangerous levels and can also lead to fatal constipation. Other <a href="https://www.bap.org.uk/articles/antipsychotic-medication-and-weight-gain/">antipsychotics can cause</a> weight gain, type 2 diabetes and raised cholesterol. </p>
<p>Yet despite this, <a href="https://www.tandfonline.com/doi/full/10.1080/09638237.2019.1581352">several</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327578/">studies</a> indicate that patients taking antipsychotics <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1425-9">aren’t always told about</a> the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652805/">side-effects</a> by their doctors. </p>
<h2>Clozapine and caution</h2>
<p><a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.697.6247&rep=rep1&type=pdf">Clozapine was previously withdrawn from use</a> after several patients treated with the drug died with very low white blood counts. But it was bought back into use in the 1990s after a <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/494368">six-week trial of 268 patients</a> to check its safety. People who take it today have to have mandatory and regular blood tests to check their white blood counts.</p>
<p>Recently though, the US Food and Drug Administration has highlighted another issue with the drug. Untreated constipation caused by <a href="https://www.fda.gov/drugs/drug-safety-and-availability/fda-strengthens-warning-untreated-constipation-caused-schizophrenia-medicine-clozapine-clozaril-can">clozapine can lead to serious bowel problems</a>, resulting in hospitalisation, surgery or even death in some cases.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5533872/">Constipation affects around 30-60% of patients on clozapine</a>. The main reason for this is that clozapine causes contractions of the muscles in the bowels to slow down. This is known as hypomotility and can lead to constipation. The medicine can even stop the stools being pushed through the bowels altogether. This can lead to potentially life-threatening complications if left unmanaged and untreated. </p>
<p>A research study published in 2017 looking at side-effects in 43,132 people on clozapine found that 160 patients reported <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5533872/">serious bowel hypomotility</a>. Of these, 29 are known to have died. </p>
<p>Internationally, constipation is now a factor in more clozapine-related deaths than those due to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5533872/">low white blood count</a>. The risk of constipation and bowel <a href="https://www.medsafe.govt.nz/profs/PUArticles/ClozapineJune2011.htm#1">hypomotility is higher during the first few months</a> of starting the medicine, but it can occur <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5533872/">during any stage of clozapine treatment</a>. And there have been cases where people with no previous signs of constipation have died hours after <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573205/">symptoms started</a>. </p>
<h2>Antipsychotics and awareness</h2>
<p>Given then that research <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327578/">studies</a> indicate that some people taking antipsychotics are unaware of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652805/">side-effects</a>, it is clear more needs to be done to make sure patients and their carers really understand the risks of this type of medication.</p>
<p>Healthcare professionals also need to be aware of the risks and regularly monitor patients for them and asking about constipation or other possible side effects during appointments.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/318115/original/file-20200302-18291-l2f2eu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/318115/original/file-20200302-18291-l2f2eu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318115/original/file-20200302-18291-l2f2eu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318115/original/file-20200302-18291-l2f2eu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318115/original/file-20200302-18291-l2f2eu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318115/original/file-20200302-18291-l2f2eu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318115/original/file-20200302-18291-l2f2eu.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">Patients and their carers need to be made aware of side-effects and tell a healthcare professional immediately if they develop any.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/teenage-boy-mental-health-problems-taking-1443361490">Daisy Daisy/Shutterstock</a></span>
</figcaption>
</figure>
<p>This is important, because side-effects of medicines used to treat severe mental illness – such as schizophrenia – are a contributory factor in lower life expectancy. On average, people with severe mental illness <a href="https://theconversation.com/people-with-severe-mental-illness-live-shorter-lives-on-average-but-are-tailored-health-interventions-the-solution-127397">die around 15-20 years</a> <a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/physical-health-disparities-and-mental-illness-the-scandal-of-premature-mortality/06CD314810155127BFE42EEDFFFE49BB">earlier than the rest of the population</a>. </p>
<p>This shortened life expectancy exists in countries considered to have high standards of healthcare, such as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27463/">Nordic countries</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579328/">the UK</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1563985/">and the US</a>.</p>
<p>Ultimately then, more needs to be done to help tackle the fact that people with severe mental illness die much earlier and have a higher rates of physical <a href="https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(19)30132-4.pdf">health problems such as diabetes</a>. And the more that can be done to help people on long-term medications for illnesses such as schizophrenia, to live a functional and healthy life, the better.</p><img src="https://counter.theconversation.com/content/127482/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dolly Sud 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>Patients taking antipsychotics aren’t being made aware of the risks or side-effects.Dolly Sud, Specialist Mental Health Pharmacist/PhD student, Aston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/789642017-06-14T10:25:49Z2017-06-14T10:25:49ZParents, don’t panic if your child hears voices, it’s actually quite common<figure><img src="https://images.theconversation.com/files/173645/original/file-20170613-30067-wsj5h0.jpg?ixlib=rb-1.1.0&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>Although the way we view and support people with mental health difficulties has improved over the years, experiences such as hearing voices and seeing visions are often still associated with “severe and enduring mental illness”. But what is less well-known about these <a href="https://www.hearing-voices.org/voices-visions/">voices and visions</a> is that they are <a href="https://theconversation.com/hearing-voices-is-more-common-than-you-might-think-66934">surprisingly common</a> – especially when growing up. </p>
<p>Around <a href="http://www.voicecollective.co.uk/wp-content/uploads/2015/09/Parents-Voices-and-Visions-Booklet-2014_web.pdf">8% of young people are thought to hear voices</a> at some stage in childhood, with up to 75% having a one-off experience of voice hearing. This makes hearing voices about as common for young people as having <a href="https://www.asthma.org.uk/about/media/facts-and-statistics/">asthma</a> or <a href="http://www.dyslexiaaction.org.uk/page/facts-and-figures-about-dyslexia-0">dyslexia</a>. For many children, then, it seems that hearing voices is <a href="http://www.hearing-voices.org/news/a-new-animation/">a pretty normal part of growing up</a>.</p>
<p>Research shows, the experience of hearing voices that others can’t hear – also called auditory verbal hallucinations in traditional psychiatric terms – is not usually upsetting for many children. The experience of hearing voices also <a href="https://www.theguardian.com/science/2015/jun/07/childhood-hallucinations-common-research-psychotic-schizophrenia-why">doesn’t tend to last too long</a> – meaning it can often be something children grow out of or overcome in time. </p>
<p>Nevertheless, for some young people, the experience can carry on for many years and cause confusion and distress – not only for the young person but for the family as a whole. </p>
<h2>Learning from young people</h2>
<p>Compared to adult voice-hearers, relatively little research or analysis has been carried out with young people who hear voices. Consequently, we don’t really know much about how young people make sense of these experiences or how they might look for help. </p>
<p>This is one of the main reasons why we have recently set up the <a href="https://www.facebook.com/youngvoicestudy/">Young Voices Study</a>. Over recent months, we have been <a href="https://twitter.com/youngvoicestudy?lang=en">working with young people</a> and their families to explore their views on what it’s actually like to hear voices in childhood and how parents can support their children through the experiences. </p>
<p>As well as speaking with young people and their parents or guardians in the northwest of England, we have also developed two online surveys that can be accessed internationally – one for <a href="https://mmupsych.eu.qualtrics.com/jfe/form/SV_9n99zXZM0iTc0bb">young people who hear voices</a> and one for their <a href="https://mmupsych.eu.qualtrics.com/jfe/form/SV_eLEKle2Mg511wj3">parents or guardians</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.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">Accept your child and let them know it’s okay to feel different.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>Although we are at an early stage of the research, the stories we have heard so far have offered useful insights into the complexity of these experiences.</p>
<p>Young people and their parents have described a huge range of experiences. Some young people have explained how their voices can be supportive, but also intrusive and distressing. We have also heard about a range of factors that make the voices helpful, comforting or problematic, as well as young people’s ideas about the support that would be helpful for others going through the same thing. </p>
<h2>Behind the label</h2>
<p><a href="http://www.julianjaynes.org/pdf/escher-romme-buiks-delespaul-vanos.pdf">Research with teenagers who hear voices</a> suggests that the ways young people make sense of their voices plays a crucial role in associated distress. So someone who considers hearing voices as a sign of “madness”, or as an uncontrollable power that can force them to take actions against their will, is likely to experience considerable distress. As such, they may try to “control” the experiences through either self-injury or substance use – both of which are unhelpful in the long-term. </p>
<p>But if people can take a “curious” and “accepting” view of their voices, many young people find that their voices can become <a href="http://www.intervoiceonline.org/support-recovery/a-practical-guide">a useful source of support</a> to help with other difficulties in life. As one of our participants said:</p>
<blockquote>
<p>[The voices] help me with problems I’m having and have actually helped me in school as well .</p>
</blockquote>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?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">Not all voices are hard to hear.</span>
<span class="attribution"><span class="source">Pexels</span></span>
</figcaption>
</figure>
<p>Our early data also highlights the importance of families’ reactions to the experience of hearing voices. This is because the reaction of parents is likely to influence how young people feel about their voices. </p>
<p>For instance, one young person who responded to our online survey explained how reactions from the adults around him not only upset and worried him, but also unsettled the voices. He said:</p>
<blockquote>
<p>No one would believe me and it would frighten them [the voices].</p>
</blockquote>
<p>And it is information such as this that can help us to understand the different layers of these experiences. These stories can also help us as researchers and clinicians to better comprehend the factors that can lead some children to become frightened or distressed when confronted with experiences that are not readily discussed or met with acceptance. </p>
<h2>Voicing needs and difficulties</h2>
<p>These personal stories from young people and their families also offer a unique opportunity to explore the extraordinary ways children cope with challenges.</p>
<p><a href="http://healthland.time.com/2010/01/26/hearing-voices-in-childhood-may-be-common/">Research</a> has shown that hearing voices can begin for a range of reasons, including after an operation or an acute fever – or in response to emotional distress. Voice-hearing can also be <a href="http://hearingvoicescymru.org/support/recovery-and-hearing-voices/">triggered by traumas</a>, such as bullying, loneliness, the loss of a loved one, abuse or neglect. </p>
<p>Our research builds on this and shows that while hearing voices can be a source of concern, it can also be a valuable coping strategy for some children. Indeed, one of our participants highlighted that his voices are “actually pretty cool”.</p>
<p>We also hope that our research will help to increase awareness and reduce social stigma around these experiences. This will mean young people who hear voices can be better supported and also encouraged to talk about their experiences more freely and without fear or shame.</p>
<hr>
<p><em>If you would like any further information, please email: youngvoicesstudy@mmu.ac.uk</em></p><img src="https://counter.theconversation.com/content/78964/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>Around 8% of young people are thought to hear voices at some stage in childhood, making it about as common as having asthma or dyslexia.Sarah Parry, Senior Lecturer and Clinical Psychologist, Manchester Metropolitan UniversityFilippo Varese, University of ManchesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/558982016-03-14T16:07:02Z2016-03-14T16:07:02ZEpigenetics: Can stress really change your genes?<figure><img src="https://images.theconversation.com/files/114125/original/image-20160307-31275-13ae6vf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source"> Obak/Shutterstock</span></span></figcaption></figure><p>The <a href="http://www.dutchfamine.nl/index_files/study.htm">Dutch famine</a> of 1944 was a terrible time for many in the Netherlands – with around 4.5m people affected and reliant on soup kitchens after food supplies were stopped from getting into the area by German blockades. As many as <a href="https://books.google.de/books?id=rjHBeeBACkAC&pg=PA52#v=onepage&q&f=false">22,000 people</a> were thought to have died, and those who survived would find it extremely difficult to ever fully recover.</p>
<p>The dietary intake of people in affected areas was reduced from a healthy 2000 calories a day to a measly <a href="http://www.hongerwinter.nl/item.php?id=32&language=EN">580</a> – a quarter of the “normal” food intake. Unsurprisingly, without a balanced diet, children born to mothers who were pregnant during the famine showed a <a href="http://www.naturalhistorymag.com/features/142195/beyond-dna-epigenetics">much lower than average birth weight</a>. </p>
<p>But then something <a href="http://www.naturalhistorymag.com/features/142195/beyond-dna-epigenetics">strange happened</a>: their children’s children had the same low birth weight, despite their mother’s “normal” food and calorie intake. </p>
<p>On top of this, daughters of women exposed to the Dutch famine were <a href="http://www.nature.com/news/2005/050801/full/news050801-6.html">twice as likely to develop schizophrenia</a> than the usually calculated risk. So what was happening? </p>
<h2>Welcome to epigenetics</h2>
<p>We often talk about our genetic make-up and “how good” or “how healthy” our genes are. We also know “bad genes” can lead to us having a higher chance of developing a particular disease if our parents are carriers. But while scientists can look for those faulty or changed genes, over the last decade we have learned this is not the whole story. </p>
<p>Because it is not just our genes and DNA which determines our health, but also environmental factors such as diet, stresses, and lifestyle choices – just <a href="https://books.google.co.uk/books?id=ZhwMBgAAQBAJ&pg=PA126&lpg=PA126&dq=Dutch+famine+were+twice+as+likely+to+develop+schizophrenia&source=bl&ots=NpldPxTXEt&sig=uPMuSHTCgHJTihUQ_D6k4VJHJrU&hl=en&sa=X&ved=0ahUKEwiqyMeZhK_LAhWKPxQKHVl0DjQQ6AEIIzAC#v=onepage&q=Dutch%20famine%20were%20twice%20as%20likely%20to%20develop%20schizophrenia&f=false">like in the Netherlands</a>. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/JTBg6hqeuTg?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">What is epigenetics?</span></figcaption>
</figure>
<p>These environmental conditions, alongside the life experiences of our parents, grandparents, and even our great-grandparents, have been shown to flip “stop” and “go” signals which regulate pretty much every process taking place in our cells. These signals can then cause changes on top of the inherited DNA molecules which can determine our well being – hence the lower birth weight of babies only distantly related to the famine.</p>
<h2>Being human</h2>
<p>Epigenetics takes the age-old question of “<a href="https://explorable.com/nature-vs-nurture-debate">nature vs nurture</a>” to a whole new level of scientific interest. But it is a <a href="http://www.theatlantic.com/politics/archive/2014/03/epigenetics-the-controversial-science-behind-racial-and-ethnic-health-disparities/430749/">controversial field of study</a> with wide-reaching implications which could change everything we thought we knew about genetic inheritance.</p>
<p>What we do know, though, is that the environment and our nutritional intake plays a crucial role in affecting changes to our DNA – which has been demonstrated by the effects of the Dutch famine. The famine has shown how changes in epigenetic markers – the “stop” and “go” signals – are inherited, from parent to offspring and to their offspring in turn. This process is called <a href="http://www.ncbi.nlm.nih.gov/pubmed/24679529">transgenerational inheritance</a>. </p>
<p>The <a href="http://science.sciencemag.org/content/339/6118/448">genes affected</a> are ones that are important in processing nutrients and are associated with diseases such as diabetes or are implicated in mental health conditions such as schizophrenia and bipolar disorders.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136568/">Studies</a> on identical <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240065/">twins</a> show how the environment and trauma can change these epigenetic flags. While the siblings were genetically identical, their identical epigenetics changed over time – essentially showing how environmental factors can alter genes which are linked to <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136568/">depression</a>, anxiety and obesity.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/114130/original/image-20160307-31260-ddnj9d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/114130/original/image-20160307-31260-ddnj9d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/114130/original/image-20160307-31260-ddnj9d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/114130/original/image-20160307-31260-ddnj9d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/114130/original/image-20160307-31260-ddnj9d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/114130/original/image-20160307-31260-ddnj9d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/114130/original/image-20160307-31260-ddnj9d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/114130/original/image-20160307-31260-ddnj9d.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">All in the genes?</span>
<span class="attribution"><span class="source">petarg/Shutterstock</span></span>
</figcaption>
</figure>
<p>Recently, <a href="http://www.nature.com/scitable/topicpage/obesity-epigenetics-and-gene-regulation-927">studies</a> using mice, rats, fruit flies and worms have also shown that trauma and stress can affect these epigenetic flags which then get passed on to the next generation, and then on to the next. </p>
<p>We know that if a <a href="http://learn.genetics.utah.edu/content/epigenetics/rats/">female rat takes good care of her offspring</a>, for example, then the pups are able to cope better with stress compared to rat pups that were ignored and had high levels of stress. In this instance, the removal of “stop” signals on a specific gene seems to be linked to happier offspring.</p>
<p>Similarly, male mice who experience stress early in their lives <a href="http://www.nature.com/news/fearful-memories-haunt-mouse-descendants-1.14272">pass this on</a>, even to their grand pups – which are more likely to show symptoms of anxiety and depression, even if they were looked after well and grew up in a nurturing environment.</p>
<h2>Fixing the future?</h2>
<p>Studies in humans are difficult to control as generally we do not have a reference value for epigenetic markers before a trauma or stress, so we cannot make easy comparisons. But what we do know is that <a href="http://www2.le.ac.uk/departments/genetics/vgec/schoolscolleges/epigenetics_ethics/case-studies/epigenetics-diet-and-pregnancy">women who were pregnant while experiencing extremely stressful</a> situations, such as the 9/11 attacks, apparently have passed on this experience to their child. </p>
<p>Their <a href="http://www.beginbeforebirth.org/the-science/epigenetics">children</a> have reported experiencing depression, anxiety and poor coping mechanisms in stressful situations. Similarly, children and grandchildren of Holocaust victims often have mental health issues. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/114131/original/image-20160307-31289-ta630m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/114131/original/image-20160307-31289-ta630m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/114131/original/image-20160307-31289-ta630m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/114131/original/image-20160307-31289-ta630m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/114131/original/image-20160307-31289-ta630m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/114131/original/image-20160307-31289-ta630m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/114131/original/image-20160307-31289-ta630m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/114131/original/image-20160307-31289-ta630m.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">Keeping it in the family.</span>
<span class="attribution"><span class="source">KonstantinChristian/Shutterstock</span></span>
</figcaption>
</figure>
<p>But it isn’t all doom and gloom. We aren’t simply living at the mercy of our ancestors’ past lives because we do know that at least some of the epigenetic marks are <a href="http://www.nature.com/neuro/journal/v15/n10/full/nn.3218.html">reversible</a>.</p>
<p>We potentially can affect our epigenetics by living a <a href="http://www.scienceinschool.org/2014/issue28/epigenetics">healthy lifestyle</a> and providing our body with the necessary building blocks for these epigenetic flags. </p>
<p>Recent research also shows that <a href="http://www.ncbi.nlm.nih.gov/pubmed/19501473">drugs</a> can remove negative epigenetic marks and remove “stop” signals – which has been shown to allow changed genes present in cancer, <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136568/">Alzheimer’s</a> or diabetes to go back to theie original state.</p>
<p>So while we may still be some way off fully understanding the role epigenetics plays in the “nature vs nurture” debate, one thing is clear: it’s not simply our genes that make us. So next time you’re feeling stressed or angry, or thinking about grabbing another takeaway pizza on the way home, think of your future grandchildren. It may save them a whole lot of bother.</p><img src="https://counter.theconversation.com/content/55898/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karin Garrie 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>We all know that stress can wreak havoc on your health but what does it do to your genes?Karin Garrie, Lecturer/Senior Lecturer, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.