Posts Tagged anxiety

[ARTICLE] Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury – Full Text

Traumatic brain injury (TBI) causes physical and cognitive-behavioral impairments that reduce participation in employment, leisure, and social relationships. Demographic and injury-related factors account for a small proportion of variance in participation post-injury. Personal factors such as resilience may also impact outcomes. This study aimed to examine the association of resilience alongside demographic, injury-related, cognitive, emotional, and family factors with participation following TBI. It was hypothesized that resilience would make an independent contribution to participation outcomes after TBI. Participants included 245 individuals with mild-severe TBI [Mage = 44.41, SDage = 16.09; post traumatic amnesia (PTA) duration M 24.95 days, SD 45.99] who completed the Participation Assessment with Recombined Tools-Objective (PART-O), TBI Quality of Life Resilience scale, Family Assessment Device General Functioning Scale, Rey Auditory Verbal Learning Test, National Adult Reading Test, and Hospital Anxiety and Depression Scale an average 4.63 years post-injury (SD3.02, R 0.5–13). Multiple regression analyses were used to examine predictors of PART-O scores as the participation measure. Variables in the model accounted for a significant 38% of the variability in participation outcomes, F(13, 211) = 9.93, p < 0.05, R2 = 0.38, adjusted R2 = 0.34. Resilience was a significant predictor of higher participation, along with shorter PTA duration, more years since injury, higher education and IQ, and younger age. Mediation analyses revealed depression mediated the relationship between resilience and participation. As greater resilience may protect against depression and enhance participation this may be a focus of intervention.

Introduction

Following traumatic brain injury (TBI), participation in employment, education, leisure, and relationships is often significantly reduced, leaving individuals substantially less integrated in their communities (14). As a result, many individuals spend increased time at home, straining family and other relationships (5). Given that TBI occurs commonly during young adulthood (6), participation deficits coincide with a critical period of development in which individuals are completing education, establishing a vocation, leaving home, and forming important lifelong relationships. Failure to attain these goals may profoundly impact their sense of self, mental health and general well-being. Reduced participation often extends beyond the acute recovery period and continues to be associated with poorer quality of life up to two decades after injury (7). Arguably participation in these life roles, including employment, education, leisure and relationships, represents one of the most important and objective indicators of injury outcomes.

Numerous variables have been associated with participation outcomes post-TBI, including injury-related and demographic variables as well as post-injury environmental and personal factors. Injury severity, cognitive difficulties, and limb injuries with related pain and impact on mood, affect an individual’s ability to engage socially and often present significant barriers to education and employment (816). Injury severity is a particularly well-researched predictor of participation outcomes, with duration of post traumatic amnesia (PTA) having the most robust association (1721). With respect to demographic factors, younger age, higher premorbid education level, higher premorbid IQ, and being employed prior to injury have all been associated with better participation outcomes (102229). Notably, older age at injury has been found to predict both worse participation overall as well as progressively worsening participation over time (10). Although gender does not appear to be directly associated with participation (30), it may have an indirect association, for example through mood and pre-injury education (14). Post-injury psychological functioning, particularly depression and anxiety, are also important predictors of participation outcomes (10123133). The impact of family functioning on participation is thought to be both direct, and through association with emotional well-being (3435).

Due to this broad range of factors influencing outcome, research has moved toward a multivariate approach to prediction of participation outcomes following TBI (24363738). These models contribute to a more comprehensive understanding of participation outcomes; however, the average amount of variance accounted for by predictive models is around 30% (21). This suggests there are additional predictive factors yet to be identified. One such factor that has increasingly gained scholarly recognition, due its positive association with quality of life and well-being outcomes among different clinical populations, is resilience.

Resilience has been conceptualized as a process of adaptation to adversity or the ability to bounce back after trauma or adversity. Resilience arguably influences the extent to which a person is able to resume important life roles after an injury. Resilience may impact participation outcomes directly through facilitating or promoting return to normal life or the development and achievement of new life goals (39), and indirectly through its effects on improved well-being, quality of life and psychological adjustment. Participating in employment, education, leisure, and relationships represent fundamental areas of participation. Resilience has been positively associated with physical and emotional well-being in individuals with cancer (40), Parkinson’s disease (41), diabetes (42), chronic spinal cord injury (43), multiple sclerosis, spina bifida, stroke, and posttraumatic stress disorder (4445). There has been less resilience research in TBI, with only one study to date examining the association between resilience and participation. Notably, it has been suggested that the study of resilience after TBI poses a distinct challenge, in that the skills characteristically associated with resilience are typically impaired after TBI (4547). For example, resilience requires emotional stability, a positive outlook, good problem-solving skills and social perception (47); however, TBI is commonly associated with impaired executive functioning (4849), irritability and aggression (5051), depression (3345), and difficulties with social perception (52).

The little research that has focused on resilience after TBI has been largely limited to patients with mild TBI, in whom no studies have examined impact on participation. In this group, greater resilience has been associated with less reporting of post-concussional and post-traumatic stress symptoms (5355), reduced fatigue, insomnia, stress, and depressive symptoms, as well as better quality of life (56). One study found that greater pre-injury resilience was significantly associated with greater post-concussion symptom severity 1 month post-injury (57), perhaps reflecting insufficient time for participants to “bounce back” (44), or overrating of pre-injury resilience levels, a phenomenon known as the “Good Old Days”(58).

Only three studies have examined resilience in individuals with moderate to severe TBI, of which one examined an association with participation. Marwitz et al. (39), conducted a large (n = 195) longitudinal study and found that resilience was significantly associated with participation over the first 12 months post-injury (39). Other studies have associated higher resilience in individuals with moderate to severe TBI with fewer depressive and anxiety symptoms, better emotional adjustment, use of task oriented coping and greater social support (4445). However, one of these studies used a sample of individuals who were actively seeking help with adjusting to changes post-injury, possibly biasing the sample toward those experiencing greater adjustment problems (45).

The aim of the present study was to examine the relative association of resilience, as well as demographic, injury-related, cognitive, emotional, and family factors with participation (productivity, social relations and leisure) following mild to severe TBI. To the best of our knowledge, this is the first study to examine the association between resilience and participation outcomes more than 12 months after mild to severe TBI. This critically extends previous research by examining the impact of resilience across the spectrum of TBI severity, from mild to severe, and how this association influences outcomes beyond the acute post-injury period. It was hypothesized that resilience would make an independent contribution to participation after TBI, in a model that would include demographic variables (gender, age, pre-morbid IQ, education, pre-injury employment), injury variables (injury severity, cognitive functioning, limb injury, time since injury) and post-injury personal and environmental factors (depression, anxiety, family support).[…]

 

Continue —> Frontiers | Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury | Neurology

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[WEB SITE] Christiana Care Health System opens first Epilepsy Monitoring Unit in Delaware

 

To increase access to advanced neurological care, Christiana Care Health System has opened the first Epilepsy Monitoring Unit (EMU) in the First State.

Specially outfitted private hospital rooms in the Transition Neuro Unit at Christiana Hospital provide state-of-the-art equipment for video and audio monitoring. In the rooms, brain waves are tracked with electroencephalography (EEG) and electrical activity in the heart is recorded with electrocardiography (EKG), helping clinicians understand what is happening during a seizure. To further enhance safety, nurses assist patients whenever they are out of their bed. And patients wear mobility vests that connect to a stationary lift, a system that allows patients to move around a room – and prevents them from falling if they have a seizure. This is one of the few EMUs in the U.S. that uses a patient lift to prevent falls.

Epilepsy is a central nervous system disorder, in which brain activity becomes abnormal, leading to seizures or periods of unusual behavior, sensations or loss of awareness. The U.S. Centers for Disease Control and Prevention report that there are 3.4 million Americans with epilepsy and there is a growing incidence of the disease among the adult population in Delaware, especially among people 60 and older.

“Our community deserves the very best in neurological care,” said Valerie Dechant, M.D., physician leader, Neuroscience Service Line, and medical director, Neurocritical Care and Acute Neurologic Services. “Our new Epilepsy Monitoring Unit will enable us to serve the complex neurologic needs of our adult patients.”

Christiana Care’s EMU is part of a larger effort to establish an epilepsy center of excellence, so adults of any age can receive the highest quality routine and specialty care for seizure disorders.

“We want to help patients who believe they have been over-diagnosed or under-diagnosed so they can see improvement in their lives,” said Neurologist John R. Pollard, M.D., medical director of the new EMU.

While most patients with epilepsy are successfully treated by a general neurologist or epileptologist, a significant number of patients have persistent fainting or seizure episodes – or they have unwanted side effects from medications. This new facility enables physicians to work more closely with these patients to understand their seizures and determine appropriate treatment.

“Typically, these patients visit an EMU where they may stay for several days so they can be safely taken off medications, inducing seizures that are recorded and studied so a proper diagnosis and treatment can be planned,” said Christy L. Poole, RN, BSN CRNI CCRC, a neurosciences program manager. Visiting an EMU to induce a seizure could be a source of anxiety for patients and their families.

“Our staff works with patients and families to reduce any fear by providing information on what to expect, stressing procedures that enhance patient safety and making the stay as pleasant as possible,” said Susan Craig, MSN, RNIII-BC, epilepsy clinical nurse practice coordinator.

via Christiana Care Health System opens first Epilepsy Monitoring Unit in Delaware

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[WEB SITE] Researchers develop new prediction method for epileptic seizures

Epileptic seizures strike with little warning and nearly one third of people living with epilepsy are resistant to treatment that controls these attacks. More than 65 million people worldwide are living with epilepsy.

Now researchers at the University of Sydney have used advanced artificial intelligence and machine learning to develop a generalized method to predict when seizures will strike that will not require surgical implants.

Dr Omid Kavehei from the Faculty of Engineering and IT and the University of Sydney Nano Institute said: “We are on track to develop an affordable, portable and non-surgical device that will give reliable prediction of seizures for people living with treatment-resistant epilepsy.”

In a paper published this month in Neural Networks, Dr Kavehei and his team have proposed a generalized, patient-specific, seizure-prediction method that can alert epilepsy sufferers within 30 minutes of the likelihood of a seizure.

Dr Kavehei said there had been remarkable advances in artificial intelligence as well as micro- and nano-electronics that have allowed the development of such systems.

“Just four years ago, you couldn’t process sophisticated AI through small electronic chips. Now it is completely accessible. In five years, the possibilities will be enormous,” Dr Kavehei said.

The study uses three data sets from Europe and the United States. Using that data, the team has developed a predictive algorithm with sensitivity of up to 81.4 percent and false prediction rate as low as 0.06 an hour.

“While this still leaves some uncertainty, we expect that as our access to seizure data increases, our sensitivity rates will improve,” Dr Kavehei said.

Carol Ireland, chief executive of Epilepsy Action Australia, said: “Living with constant uncertainty significantly contributes to increased anxiety in people with epilepsy and their families, never knowing when the next seizure may occur.

“Even people with well controlled epilepsy have expressed their constant concern, not knowing if or when they will experience a seizure at work, school, traveling or out with friends.

“Any progress toward reliable seizure prediction will significantly impact the quality of life and freedom of choice for people living with epilepsy.”

Dr Kavehei and lead author of the study, Nhan Duy Truong, used deep machine learning and data-mining techniques to develop a dynamic analytical tool that can read a patient’s electroencephalogram, or EEG, data from a wearable cap or other portable device to gather EEG data.

Wearable technology could be attached to an affordable device based on the readily available Raspberry Pi technology that could give a patient a 30-minute warning and percentage likelihood of a seizure.

An alarm would be triggered between 30 and five minutes before a seizure onset, giving patients time to find a safe place, reduce stress or initiate an intervention strategy to prevent or control the seizure.

Dr Kavehei said an advantage of their system is that is unlikely to require regulatory approval, and could easily work with existing implanted systems or medical treatments.

The algorithm that Dr Kavehei and team have developed can generate optimized features for each patient. They do this using what is known as a ‘convolutional neural network’, that is highly attuned to noticing changes in brain activity based on EEG readings.

Other technologies being developed typically require surgical implants or rely on high levels of feature engineering for each patient. Such engineering requires an expert to develop optimized features for each prediction task.

An advantage of Dr Kavehei’s methodology is that the system learns as brain patterns change, requiring minimum feature engineering. This allows for faster and more frequent updates of the information, giving patients maximum benefit from the seizure prediction algorithm.

The next step for the team is to apply the neural networks across much larger data sets of seizure information, improving sensitivity. They are also planning to develop a physical prototype to test the system clinically with partners at the University of Sydney’s Westmead medical campus.

 

via Researchers develop new prediction method for epileptic seizures

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[WEB SITE] Antiepileptic drug use linked to increased risk of Alzheimer’s and dementia

The use of antiepileptic drugs is associated with an increased risk of Alzheimer’s disease and dementia, according to a new study from the University of Eastern Finland and the German Center for Neurodegenerative Diseases, DZNE. Continuous use of antiepileptic drugs for a period exceeding one year was associated with a 15 percent increased risk of Alzheimer’s disease in the Finnish dataset, and with a 30 percent increased risk of dementia in the German dataset.

Some antiepileptic drugs are known to impair cognitive function, which refers to all different aspects of information processing. When the researchers compared different antiepileptic drugs, they found that the risk of Alzheimer’s disease and dementia was specifically associated with drugs that impair cognitive function. These drugs were associated with a 20 percent increased risk of Alzheimer’s disease and with a 60 percent increased risk of dementia.

The researchers also found that the higher the dose of a drug that impairs cognitive function, the higher the risk of dementia. However, other antiepileptic drugs, i.e. those which do not impair cognitive processing, were not associated with the risk.

“More research should be conducted into the long-term cognitive effects of these drugs, especially among older people,” Senior Researcher Heidi Taipale from the University of Eastern Finland says.

Besides for epilepsy, antiepileptic drugs are used in the treatment of neuropathic pain, bipolar disorder and generalized anxiety disorder. This new study is the largest research on the topic so far, and the first to investigate the association in terms of regularity of use, dose and comparing the risk between antiepileptic drugs with and without cognitive-impairing effects. The results were published in the Journal of the American Geriatrics Society.

The association of antiepileptic drug use with Alzheimer’s disease was assessed in Finnish persons diagnosed with Alzheimer’s disease and their controls without the disease. This study is part of the nationwide register-based MEDALZ study, which includes all 70,718 persons diagnosed with Alzheimer’s disease in Finland during 2005-2011 and their 282,862 controls. The association of antiepileptic drug use with dementia was investigated in a sample from a large German statutory health insurance provider, Allgemeine Ortskrankenkasse (AOK). The dataset includes 20,325 persons diagnosed with dementia in 2004-2011, and their 81,300 controls.

via Antiepileptic drug use linked to increased risk of Alzheimer’s and dementia

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[TED Talks] 5 Must watch TED Talks About Depression

Hello, my name is Faith and I’ve been managing depression and anxiety for as long as I can remember. I started this blog to share my tips and tricks and help other bad ass babes kick ass on their mental health journey. I have an online support group you can join for free here. If you need help finding a mental health care provider call 1-800-662-HELP (4357) or visit BetterHelp to talk to a certified therapist online at an affordable price.

This post contains affiliate links, you can read my full disclosure policy here.

I went down the rabbit hole of TED talks again and I thought I would share these awesome TED talks about depression. These aren’t all uplifting but sometimes you need to hear some realness. Positivety kind of feels like a big pile of garbage when you’re depressed anyways (if you’ve ever tried to watch a motivational talk when you’re depressed you probably know what I’m talking about). If you’re depressed and looking for resources checkout my articles on depression and download my free mental health planner.

David Burns talks about using cognitive therapy to treat his depressed patients. He helps his clients to change how they think in order to change how they feel.

Kevin Breel talks about breaking the stigma of depression. If you are feeling depressed and feel like you are along trust me you’re not. There are lots of us out here struggling with depression. I have a mental health support group on Facebookthat you can join if you are looking to connect with other people who are struggling with mental health.

Zindel Segal has been treating his depressed clients by teaching them to appreciate the present moment. Try out the techniques in his talk and see if you think they can help you.

I love her story about communicating with her 2 year old in a positive way. She started trying to practice unconditional positive regard with her kids and then started trying to practice giving unconditional positive regard on herself.

Here’s a kids TED talk from a girl that was hospitalized from depression and anxiety.

Thanks for checking out my post. If you’re looking for more motivation checkout my post of bad ass commencement speeches. I have a ton of mental health resources on my site that I hope you’ll checkout like my free mental health planner or my posts related to anxiety and depression.

 

via TED Talks About Depression – Radical Transformation Project

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[WEB SITE] Coping With Emotional Changes After Stroke for Families

Coping With Emotional Changes After Stroke-blog

As a stroke survivor, you can face major life changes. In the aftermath of a stroke, you may experience a sense of loss that is rooted in the feeling that you’ve lost the life you had before your stroke, or your independence. These strong emotional reactions take a toll.

It is normal to experience emotions ranging from frustration, anxiety, and depression to a sense of grief, or even guilt, anger, and denial after such a monumental change. Realizing that these emotions are normal, and that you are not alone in experiencing them, is an important step to acknowledging and coping with them in a healthy way. By doing this, you avoid becoming overwhelmed, thus avoiding further difficulties during your recovery.

Reasons for Emotional Changes After a Stroke

Young Man At Balcony In Depression Suffering Emotional Crisis And Grief

A stroke causes physical damage to your brain. Feeling or behaving differently after a stroke may be connected to the area of your brain that was damaged. If the area of your brain that controls personality or emotion is affected, you may be susceptible to changes in your emotional response or everyday behavior. Strokes may also cause emotional distress due to the suddenness of their occurrence. As with any traumatic life experience, it may take time for you to accept and adapt to the emotional trauma of having experienced a stroke.

Emotional Changes a Stroke Might Cause

PseudoBulbar Affect

crying

Sometimes referred to as “reflex crying,” “emotional lability,” or “labile mood,” Pseudobulbar Affect (PBA) is a symptom of damage to the area of the brain that controls expression of emotions. Characteristics of the disorder include rapid changes in mood, such as suddenly bursting into tears and stopping just as suddenly, or even beginning to laugh at inappropriate times.

Depression

depressed

If you are feeling sad, hopeless, or helpless after having suffered a stroke, you may be experiencing depression. Other symptoms of depression may include irritability or changes to your eating and sleeping habits. Talk to your doctor if you are experiencing any of these symptoms, as it may be necessary to treat with prescription antidepressants or therapy to avoid it becoming a road block to your recovery.

Anxiety

anxiety

Anxiety is quite common after a stroke. You may have feelings of uneasiness or fears about your health; this is normal and healthy. However, if your anxiety does not subside in time and you feel overwhelmed, you may be dealing with an anxiety disorder, which requires help from your doctor or a mental health professional.

Medical staff will perform an informal evaluation to check for anxiety while you are in the hospital. Often, this involves a quick discussion with hospital staff, during which they will ask you if you have any worries or fears about your health. This evaluation may also involve hospital staff asking your family members if they have noticed a change in your mood or behavior. It is important that you are kept in the loop about any issues that may present themselves, and that you are provided with as much information about your health and treatment options as possible.

Symptoms of anxiety to watch for may include irritability or trouble concentrating. You may also experience trouble sleeping due to your mind racing about your health. Sometimes, you can become tired easily, even if well rested.

Physical symptoms may also present themselves. These symptoms include a racing heart and restlessness and are often coupled with a sense of overwhelming worry or dread. If you find yourself avoiding your normal activities, such as grocery shopping, visiting friends, going for walks, or spending a large portion of your day dwelling on things you are worried about, you may have an anxiety disorder. Your doctor can recommend that you visit a psychologist to help cope with and eventually overcome anxiety.

Other Emotional Reactions

You may experience a range of other emotional reactions after a stroke, including anger and frustration. Additional symptoms may be a sense of apathy or a lack of motivation to accomplish things you typically enjoy.

Coping With Changing Emotions

Physician Ready To Examine Patient And Help

There are many ways to treat the emotional changes associated with a stroke. The first step is discussing how you feel, as well as any concerns you may have about your health with your doctor. One treatment option is counseling, which involves speaking about your distressing thoughts and feelings with a mental health professional or therapist. Simply talking about the way you are feeling can be helpful when coping with overwhelming emotions after experiencing a traumatic event such as a stroke.

Your doctor may also prescribe antidepressants or anti-anxiety medication to help you deal with the emotions involved with a stroke. While they are not a cure-all for emotional troubles, antidepressants change the levels of certain chemicals in your brain, alleviating the symptoms of depression and anxiety, lifting your mood, and making life feel more bearable while you’re recovering. It is important to stay in contact with your doctor if you decide to take medication, as it will not be effective for everyone and may have unpleasant side effects.

Seek Support or Professional Advice

A stroke can come on suddenly and have a monumental effect on your life. For this reason, it is common for many patients to struggle with emotional side effects following a stroke. You may suffer damage to the section of your brain that affects emotions, causing a change in personality or emotional expression known as Pseudobulbar Affect. You may also experience symptoms of anxiety or depression, along with feelings of anger, frustration, or uncharacteristic apathy.

It is important to discuss your emotional concerns with your doctor. You may need a prescription for antidepressants or anti-anxiety medication, or a recommendation to see a mental health professional who can help you form healthy coping mechanisms.


All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

via Coping With Emotional Changes After Stroke for Families

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[BLOG POST] Tryptophan in Mood, Anxiety, and Depression

 

Deficiency of monoamines, such as dopamine, epinephrine, and serotonin, is the most widely accepted theory explaining mood disorders. Among these neuromediators, serotonin deficiency is considered as most significant in relation to anxiety and depression. This theory has been proven by the effectiveness of drugs that help to increase monoamines levels in the brain, although research in this direction has been hampered by the limitations of present-day technology in measuring the levels of specific monoamines and their properties. However, studies do indicate that their deficiency plays a role in individuals prone to mood swings.

Tryptophan as precursor for serotonin

Tryptophan is one of the essential amino acids. It can’t be produced by our body and has to come through food products rich in proteins. It is required for both anabolic processes and production of various hormones. Tryptophan is a chemical precursor for the synthesis of the neurotransmitter serotonin. This means that the amount of serotonin produced in our body is dependent on the dietary intake of tryptophan. Since serotonin is related to mood regulation, it is entirely possible that tryptophan deficits may have a negative effect on our mood state. On the other hand, its supplementation may be helpful in disorders like anxiety or depression. Multiple investigations seem to support the idea that decreased levels of tryptophan lead to a reduction in serotonin and changes in mood. Some studies have indicated that higher intake of tryptophan may improve social interactions by improving mood and decreasing aggression and dominant behavior.

Serotonin in mood and cognition

Serotonin is important for both mood regulation and regulation of cognitive functions like learning and memory. The effect of monoamine inhibitors called serotonin reuptake inhibitors in various disorders of mood supports this theory. However, it is important to keep in mind that antidepressants are only partially effective in treating mood disorders since monoamine deficits are just one of the factors influencing mood. Most of the serotonin in our body is produced outside the brain, indicating that this compound has a much broader role in our normal physiology. It is possible that many functions of serotonin are still not understood.

Tryptophan depletion and mood regulation

To understand the role of serotonin, and more specifically tryptophan, many tryptophan-depletion studies have been done in recent times. In one simple crossover study, 25 healthy adults were studied for mood changes like anxiety and depression after consuming either a high tryptophan diet or a low tryptophan diet for four days. Tryptophan consumption seems to affect mood even in such a short interval. The study showed that those on a high tryptophan diet had much better mood as compared to those on a low tryptophan diet, although the negative effects of a low tryptophan diet were less pronounced. If such a quick and straightforward analysis can show the difference, it is entirely possible that long-term low tryptophan consumption or depletion may have much graver consequences for mental health.

Tryptophan and gut-brain axis

When we talk about the gut-brain axis we are not just discussing the digestive role of the gut and its effect on overall health, something that has been well known for many years. Our digestive system is also involved in neuro-hormonal signaling, through which it can have an impact on brain functioning. Recently, the influence of gut health on the brain has been the subject of many studies and for good reason. Our gut has more nerve cells than our spine, and it produces many hormones that have various implications for health. Further, it is now well understood that the neural relationship between the gut and brain is dual-sided, and there are more nerve fibers sending information from the gut to the brain rather than from the brain to the gut. Thus, due to the effect of nerves, hormones, and other neurologically active compounds, the gut plays a prominent role in mental wellbeing. Even small changes in the gut could directly affect our behavior. Gut microbiota and their relationship to mood have also recently received lots of attention.

When it comes to tryptophan, the digestive system is not solely involved in its absorption or metabolism. Now it is well-established that serotonin is mostly produced in the gut rather than in the brain, further strengthening the theory of gut-brain interrelation. This theory explains the mood alterations in irritable bowel syndrome (IBS). Further, the development of IBS has been shown to be connected to tryptophan depletion.

The studies show that tryptophan depletion, due to its relationship with serotonin, is undoubtedly one of the most essential elements to consider when analyzing altered mood and cognition. Low serotonin could generally cause a state of lowered mood, impaired cognition, poor working memory, and lower reasoning. Conversely, high tryptophan supplementation could have a positive effect on mood, memory, energy level, and emotional processing.

Low dietary consumption of tryptophan could be one of the elements leading to chronic conditions like depression and anxiety. Bowel conditions like IBS that disturb tryptophan metabolism and alter serotonin levels may also modify our behavior and feelings.

The search for effective therapeutic approaches to the treatment of mood disorders, anxiety, and depression has gained lots of attention in the last few decades. Understanding the role of tryptophan may open up new possibilities for managing mood and cognition problems. It is quite possible that a high tryptophan diet may not only help to prevent mood disorders but also increase the effectiveness of existing drug therapies.

References

Delgado, P. L. (2000) Depression: the case for a monoamine deficiency. The Journal of Clinical Psychiatry61 Suppl 6, 7–11. PMID: 10775018

Jenkins, T. A., Nguyen, J. C. D., Polglaze, K. E., & Bertrand, P. P. (2016) Influence of Tryptophan and Serotonin on Mood and Cognition with a Possible Role of the Gut-Brain Axis. Nutrients8(1). doi: 10.3390/nu8010056

Lindseth, G., Helland, B., & Caspers, J. (2015). The Effects of Dietary Tryptophan on Affective Disorders. Archives of Psychiatric Nursing29(2), 102–107. doi: 10.1016/j.apnu.2014.11.008

Young, S. N., & Leyton, M. (2002) The role of serotonin in human mood and social interaction. Insight from altered tryptophan levels. Pharmacology, Biochemistry, and Behavior71(4), 857–865. PMID: 11888576

Young, S. N., Smith, S. E., Pihl, R. O., & Ervin, F. R. (1985) Tryptophan depletion causes a rapid lowering of mood in normal males. Psychopharmacology87(2), 173–177. doi: 10.1007/BF00431803

Image via freeGraphicToday/Pixabay.

via Tryptophan in Mood, Anxiety, and Depression | Brain Blogger

 

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[BLOG POST] 5 Things Every TBI Survivor Wants You to Understand

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March is National Brain Injury Awareness Month, and as promised, I am writing a series of blogs to help educate others and bring awareness to traumatic brain injuries (TBI).

1. Our brains no longer work the same. 
We have cognitive deficiencies that don’t make sense, even to us. Some of us struggle to find the right word, while others can’t remember what they ate for breakfast. People who don’t understand, including some close to us, get annoyed with us and think we’re being “flaky” or not paying attention. Which couldn’t be further from the truth, we have to try even harder to pay attention to things because we know we have deficiencies.

Martha Gibbs from Richmond, VA, suffered a TBI in May of 2013 after the car she was a passenger in hit a tree at 50 mph. She sums up her “new brain” with these words:

Almost 2 years post-accident, I still suffer short-term memory loss and language/speech problems. I have learned to write everything down immediately or else it is more than likely that information is gone and cannot be retrieved. My brain sometimes does not allow my mouth to speak the words that I am trying to get out.

2. We suffer a great deal of fatigue.
We may seem “lazy” to those who don’t understand, but the reality is that our brains need a LOT more sleep than normal, healthy brains. We also have crazy sleep patterns, sometimes sleeping only three hours each night (those hours between 1 and 5 a.m. are very lonely when you’re wide awake) and at other times sleeping up to 14 hours each night (these nights are usually after exerting a lot of physical or mental energy).

Every single thing we do, whether physical or mental, takes a toll on our brain. The more we use it, the more it needs to rest. If we go out to a crowded restaurant with a lot of noise and stimulation, we may simply get overloaded and need to go home and rest. Even reading or watching tv causes our brains to fatigue.

Toni P from Alexandria, VA, has sustained multiple TBI’s from three auto accidents, her most recent one being in 2014. She sums up fatigue perfectly:

I love doing things others do, however my body does not appreciate the strain and causes me to ‘pay the price,’ which is something that others don’t see.  I like to describe that my cognitive/physical energy is like a change jar. Everything I do costs a little something out of the jar.  If I keep taking money out of the jar, without depositing anything back into the jar, eventually I run out of energy. I just don’t know when this will happen.  Sometimes it’s from an activity that seemed very simple, but was more work then I intended. For me, like others with TBIs, I’m not always aware of it until after I’ve done too much.

3. We live with fear and anxiety. 
Many of us live in a constant state of fear of hurting ourselves again. For myself personally, I have a fear of falling on the ice, and of hitting my head in general. I know I suffered a really hard blow to my head, and I am not sure exactly how much it can endure if I were to injure it again. I am deeply afraid that if it were to take another blow, I may not recover (ie, death) or I may find myself completely disabled. I am fortunate to have a great understanding of the Law of Attraction and am trying my hardest to change my fears into postive thoughts with the help of a therapist.

Others have a daily struggle of even trying to get out of bed in the morning. They are terrified of what might happen next to them. These are legitimate fears that many TBI survivors live with. For many, it manifests into anxiety. Some have such profound anxiety that they can hardly leave their home.

Jason Donarski-Wichlacz from Duluth, MN, received a TBI in December of 2014 after being kicked in the head by a patient in a behavioral health facility. He speaks of his struggles with anxiety:

I never had anxiety before, but now I have panic attacks everyday. Sometimes about my future and will I get better, will my wife leave me, am I still a good father. Other times it is because matching socks is overwhelming or someone ate the last peanut butter cup.

I startle and jump at almost everything. I can send my wife a text when she is in the room. I just sent the text, I know her phone is going to chime… Still I jump every time it chimes.

Grocery stores are terrifying. All the colors, the stimulation, and words everywhere. I get overwhelmed and can’t remember where anything is or what I came for.

4. We deal with chronic pain.
Many of us sustained multiple injuries in our accidents. Once the broken bones are healed, and the bruises and scars have faded, we still deal with a lot of chronic pain. For myself, I suffered a considerable amount of neck and chest damage. This pain is sometimes so bad that I am not able to get comfortable in bed to fall asleep. Others have constant migraines from hitting their head. For most of us, a change in weather wreaks all sort of havoc on our bodies.

Lynnika Butler, of Eureka, CA, fell on to concrete while having a seizure in 2011, fracturing her skull and resulting in a TBI. She speaks about her chronic migraine headaches (which are all too common for TBI survivors)

I never had migraines until I sustained a head injury. Now I have one, or sometimes a cluster of two or three, every few weeks. They also crop up when I am stressed or sleep deprived. Sometimes medication works like magic, but other times I have to wait out the pain. When the migraine is over, I am usually exhausted and spacey for a day or two.

5. We often feel isolated and alone.
Because of all the issues I stated above, we sometimes have a hard time leaving the house. Recently I attended a get together of friends at a restaurant. There were TVs all over the room, all on different channels. The lights were dim and there was a lot of buzz from all of the talking. I had a very hard time concentrating on what anyone at our table was saying, and the constantly changing lights on the TVs were just too much for me to bear. It was sensory stimulation overload. I lasted about two hours before I had to go home and collapse into bed. My friends don’t see that part. They don’t understand what it’s like. This is what causes many of us to feel so isolated and alone. The “invisible” aspect of what we deal with on a daily basis is a lonely struggle.

Kirsten Selberg from San Francisco, CA, fell while ice skating just over a year ago and sustained a TBI. She speaks to the feelings of depression and isolation so perfectly:

Even though my TBI was a ‘mild’ one, I found myself dealing with a depression that was two-fold. I was not only depressed because of my new mental and physical limitations, but also because many of my symptoms forced me to spend long periods of time self-isolating from the things — like social interactions — that would trigger problems for me. With TBI it is very easy to get mentally and emotionally turned inward, which is a very lonely place to be.

Also, check out my other blogs on the Huffington Post:
“Life With a Traumatic Brain Injury”
“Life With a TBI: March is National Brain Injury Awareness Month”

I invite you to join my TBI Tribe on Facebook if you are a survivor, or loved one of a survivor.

via 5 Things Every TBI Survivor Wants You to Understand | HuffPost

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[ARTICLE] Overcome Acrophobia with the Help of Virtual Reality and Kinect Technology – Full Text PDF

Abstract

There are many people in this world who are feared of high places. In general, there are two types of people: the prior one is people that are afraid of height and the latter one is people who really cannot handle high places (i.e. acrophobia). The purpose of this research is to reduce acrophobia level of people. The methodology which is used in this research is experiment with the help of virtual reality to simulate virtual world of high places environment as the reality in the imagination of the user. The virtual environment helps the sufferer to reduce their fear of height in a safe and controllable environment. This research shows that virtual reality is able to mimic real high places and train the users to overcome their anxiety of high places. With virtual world, the users are able to confront their fear gradually based on the level progression in the virtual world. Thus, it gives the users more experience to handle their fear in the secured environment and gradually decrease their anxiety level of acrophobia.[…]

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Source: Overcome Acrophobia with the Help of Virtual Reality and Kinect Technology

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[WEB SITE] Magnetic brain stimulation helps “unlearn” crippling fear of heights

 

New research suggests a little magnetic brain stimulation prior to being exposed to your greatest fear...

New research suggests a little magnetic brain stimulation prior to being exposed to your greatest fear in a VR headset could help you “unlearn” your anxiety response(Credit: DanRoss/Depositphotos)

Advances in technology over the last decade have led to a swift rise in the volume of research surrounding transcranial magnetic stimulation (TMS) and its therapeutic effects. A team from the Würzburg University Hospital in Germany has just published a new study demonstrating how TMS, in conjunction with a virtual reality experience, can help alleviate anxiety disorders and essentially help people “unlearn” fears.

Transcranial magnetic stimulation works by directing a targeted magnetic field toward specific areas in the brain. Depending on the frequencies delivered this can either stimulate or inhibit the brain activity of the targeted area. Initially conceived as a research tool allowing scientists to understand exactly what roles certain areas of the brain play, TMS has more recently been explored as a potential new tool for treating an assortment of problems.

TMS devices have already been approved to treat migraines and some major depressive disorders, but other research is looking into its uses as a learning aid and a way to help visually-impaired people navigate the world.

This new study looks at how the technology could improve a patient’s response when used in conjunction with a more traditional treatment method. Anxiety disorders are incredibly debilitating for many, from social phobias to more specific problems such as a fear of heights. Classically, the treatment for people with these disorders has been a type of cognitive behavioral therapy where one is exposed to the source of their anxiety under the supervision of a psychologist.

The team at the Würzburg University Hospital decided to examine whether this kind of classic therapy could be improved using TMS. Previous studies have shown that by targeting the frontal lobe with magnetic stimulation an anxiety response can be reduced, but the new research looks at how this could be incorporated into a specific treatment method for a targeted anxiety.

Even though the subject knows it is fake, exposure to great heights in a virtual reality...

Even though the subject knows it is fake, exposure to great heights in a virtual reality headset still triggers an anxiety response in sufferers(Credit: VTplus)

Thirty-nine subjects with an active fear of heights were split into two groups, including a control group which received fake TMS. The groups received 20 minutes of either real or fake TMS directed at the ventral medial prefrontal cortex, followed by virtual reality exposure to a dizzying height. After two sessions the group treated with the TMS prior to VR exposure exhibited reduced anxiety and avoidance symptoms compared to the control group that didn’t receive the TMS.

“The findings demonstrate that all participants benefit considerably from the therapy in virtual reality and the positive effects of the intervention are still clearly visible even after three months,” explains Professor Martin J. Herrmann, one of the researchers working on the study.

The researchers suggest that adding TMS and VR to an already well-proven treatment process increases the overall efficacy and essentially helps the brain “unlearn” its anxiety responses. The next phase for the study is to look at other forms of anxiety and see if the process is equally effective.

And the next fear that is being tackled? Arachnophobia.

The research was published in the journal Brain Stimulation.

Source: Würzburg University Hospital

Source: Magnetic brain stimulation helps “unlearn” crippling fear of heights

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