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Mental Health News

Following are the latest news and information resources for the various mental health topics that we cover. We hope you will find the news educational and the links in the resources section useful in helping you to get even more in-depth data.

The Many Different Types Of Depression

To say Rachel Hargrave has experienced "depression" is a bit simplistic. Thirteen years ago, Hargrave -- now a 32-year-old mother and psychology student who lives in Sabina, Ohio -- gave birth to her daughter. A month later, she recalls, "I felt like I hit rock bottom. I couldn't get off the couch. I couldn't bathe. I couldn't do anything." Hargrave visited her doctor, who prescribed her medication. Neither of them knew, however, that her lifelong struggle had only just begun.

Instead, her crippling sadness "never went away," says Hargrave, who responded poorly to multiple types of medication and now says she alleviates her symptoms with vitamins and exercise. "It comes and goes with the seasons."

Hargrave's story illustrates the complexities of depression -- a mental health condition that's as multi-faceted as its name is vague. The word "depression" itself is a loose term for multiple diagnoses, each with a differing range of symptoms and treatments, experts say. And due to a lack of education or awareness, many people don't know there are variants of depression, or that one person's symptoms of depression might not mirror another's.

"They don't realize depression comes in many different faces," says Edward Hunt, a District of Columbia-based therapist who works in private practice. "When they come to me, most of my clients only know they are hurting. They don't have an adequate grasp of what is causing the pain or how to make it stop. Some only know about medications. Some only know about what they heard about in Psychology 101, or what their high school counselor said that one time during assembly in the gym. But all of them want relief."

In Hargrave's case, she's dealt with both seasonal affective disorder -- a subtype of depression that ebbs and flows with the changing weather and light levels -- and postpartum depression, another subtype that occurs during pregnancy or within four weeks of delivery. Her experiences are relatively common, and only represent a small swath of the spectrum.

The Most Common Type Of Depression

In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), depression is divided into several subsets. The most commonly diagnosed form of depression is major depressive disorder, which is typically defined by symptoms such as "depressed mood, loss of interest, weight loss [and] loss of energy for at least two weeks continuously," Hunt says.

Major depression affects about 6.7 percent of the U.S. population over age 18, according to the National Institute of Mental Health -- although women are 70 percent more likely to be diagnosed with major depressive disorder than men. There's no clear-cut cause for major depressive disorder, although doctors think it could stem from anything from traumatic life events to brain chemistry, genetics and hormones.

However, even people with major depressive disorder might experience their "depression" differently than someone with an identical diagnosis. Four years ago, Michael Miller, a 32-year-old poet and part-time college administrator in Newark, Delaware, discovered he had major depressive disorder.

"[I had] insomnia, irritability, a tendency to draw inward and away from friends and family," Miller remembers. "Leaving the lights off and just crawling back into bed, or sitting behind a screen and filtering life through the Internet if at all possible. Just a lack of interest in doing anything - like ennui on steroids."

Miller often self-medicated with alcohol. Detailed thoughts of suicide ran through his brain. And in the spring, his depression would suddenly lift, filling him with a newfound energy. "There's a seasonal affective component to major depression, which is why I for a time thought I might be bipolar," he says -- a psychiatric condition that the DSM-5 separates from depression and is characterized by moods that swing from extreme lows (depression) to highs (mania). "In the spring, I'll suddenly feel awesome and write a lot.

Nevertheless, Stephanie Rosen, 34, encountered a different set of symptoms when she first experienced major depressive disorder. Rosen -- who now works for the National Alliance on Mental Illness, a national grassroots advocacy and education organization -- was a student in medical school when she realized she was sick. "I was sleeping about 12 hours a day," she says. "I was having actual paranoid thoughts. I would check my apartment multiple times before being able to go to sleep because I was convinced there was someone in there -- even to the point that I was checking kitchen cabinets. I had a lot of crying, a lot of distorted [ruminations] -- that nobody liked me and nobody was talking to me." Rosen also gained weight, had trouble making decisions and couldn't concentrate on her studies.

It's normal, Hunt says, to undergo a subtype of depression in one's own unique way -- even if the medical label is the same as someone else's. "The most confusing thing about the blanket term 'depression' is that some presentations appear to be completely polar opposites," he says. "Some people may not sleep. Some people may not be able to get out of bed. Some people may not eat, some may not be able to stop eating; some people may become increasingly restless, while others barely have the energy to read."

Less Common Subsets Of Depression

While major depressive disorder is the most well-known type of depression, others exist as well. Like Hargrave, many women -- an estimated 9 to 16 percent, according to the American Psychological Association -- get postpartum depression after giving birth. (Postpartum depression might be caused by a combination of stress, a lack of sleep, family susceptibility for depression and/or chemical changes in the brain when a woman's estrogen and progesterone levels drop after childbirth.) And in both Hargrave and Miller's cases, they had forms of seasonal depression -- a specifier that refers to when a person's major depressive episodes regularly occur during a particular season, particularly in the fall and winter.

However, several less common subtypes remain. One type, persistent depressive disorder -- formerly called dysthymia -- is "a type of mild chronic depression that lasts from two to five years," says Arif Khan, an adjunct professor of psychiatry at Duke University School of Medicine and medical director and principal investigator at Northwest Clinical Research Center in Bellevue, Washington.

Persistent depressive disorder appears very similar to major depressive disorder -- losing interest in normal daily activities, feeling hopeless and worthless and experiencing lessened productivity. However, it's less severe; it stretches for longer durations and fewer people are diagnosed. "While the prevalence of [persistent depressive disorder] is somewhat controversial, it could be anywhere from 1 to 3 percent [of the population]," Khan says.

Another depressive disorder -- which was recently added to the revised DSM-5 -- is premenstrual dysphoric disorder, or PMDD. With premenstrual dysphoric disorder, Hall says, women "experience one or more mood swings, marked irritability, marked depression, marked anxiety and/or decreased interest, lethargy, change in appetite, change in sleeping habits, sense of being overwhelmed and physical symptoms." Various studies estimate that 3 to 8 percent of women meet the criteria for PMDD. Although the exact cause isn't known, scientists believe PMDD is spurred by hormonal fluctuations during menstruation.

According to the DSM-5, there are more subtypes in the DSM-5 that differentiate between types of depression with unique features. For instance, depression can have mixed features -- i.e., sadness with bouts of mania, or extreme highs. It can have melancholic features, which means the depressed person loses pleasure in almost all activities. And it can have psychotic features, in which there's a presence of delusions or hallucinations.

Depression isn't just diagnosable in adults, either. Disruptive mood dysregulation disorder is a new classification in the DSM-5 -- a diagnosis for children between the ages of 6 and 18, Hunt says, who "display a variety of symptoms surrounding the inability to effectively manage their emotions -- more so than a typical child in the same developmental stage." This subtype was created to help clinicians describe a child's depression without prematurely diagnosing him or her with bipolar or some other disorder, Hunt adds.

Treatments For Depression

There's no one type of depression -- and therefore, there's no one type of treatment. However, there are some common tools used for relief. "The general treatment for major depressive disorder is medication," Khan says. "The more severe [the patients' depression is], they more they're likely to respond to antidepressants." Many people also respond to various types of therapy, he points out, including cognitive behavioral therapy.

For treatment-resistant depression, Khan says, electroconvulsive therapy -- a procedure in which electric currents are passed through the brain, inducing a brief seizure that can cause changes in brain chemistry -- is an option. Another similar option is vagus nerve stimulation, a surgery in which a doctor implants a pacemaker-like device into the body that sends pulses of electricity. The electricity travels through the vagus nerve into the brain, where it helps control mood. And physicians, Khan says, are also still exploring the effects of transcranial magnetic stimulation -- a relatively new procedure that uses magnetic fields to stimulate nerve cells in the brain to lessen depression.

"Things like exercise can also have a good effect," Khan adds. "But they key is to get into some sort of treatment - visit your doctor, visit a psychologist. That's the best indicator of prognosis."

Still, says Hargrave -- whose experiences inspired her to enroll at Capella University, where she's studying to receive her master's and doctorate degrees in psychology -- everyone has their own coping mechanisms for depression ... no matter what their diagnosis might be.

"Each person has a different personality," she says. "So they have to figure out what works for them. Read about it; get pamphlets about it; do research about it. And don't take it for granted. It is an actual disease. It's not up in your head."

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Delegate Your Anxiety!

Think about your to-do list. Sure, you are great but how much of it can you really get done in a day — and more to the point, how much is it even worth the attempt?

There’s an easier way and it doesn’t involve facing your anxiety with methods such as yoga. Instead, smart workers are dissipating it altogether and freeing up headspace. In an age where everything is outsourced — groceries are delivered and cleaners are booked by app — why not delegate what is making you tense too?

It is not shirking or being bossy but effective anxiety delegation, and it is the reason why behind every top executive there is a team of people for concerns to be passed on to.

At a time where one in five people in the UK reported high levels of anxiety in the Government’s national wellbeing survey, making them less likely to say they are happy, it is about time we stopped worrying and started assigning it elsewhere.

“Successful people are the ones that can delegate and let go,” says Julie Cooper, programme director of Spring Development people skills training and development. “This includes managing anxiety.”

While anxiety is natural and functional, if it becomes habitual and stops you healthily accepting that things can go wrong, it can be a problem. Paul Dolan, author of Happiness by Design, says:  “Not only does anxiety have negative impacts on health, relationships and cognitive performance, it also directly affects experiences of pleasure and purpose. If the anxiety is object or task-based then the best approach to reducing anxiety will often be to pass it on to someone else to deal with.”

For maximum efficiency Cooper advises pinpointing what makes you anxious and finding the appropriate person to take it on. That way it is not a case of mindless, inconsiderate offloading. “Look for someone with the right skillset, or someone who could learn. Some people worry delegation is a sign of weakness but no one can be all things to all men. Trying to do that can cause more anxiety.” As Justine Roberts, CEO and founder of Mumsnet, says: “Life isn’t perfect; it never will be. If you have a job and busy life then you have to accept a certain amount of imperfection and chaos.”

Merely passing it on can breed further guilt. Instead focus on breaking it down. One executive says: “The first thing I do in the morning is delegate as much of my anxiety as possible. The tasks that make me feel most stressed are usually ones I have a personal connection to.

“My instinct is to hang on to these and micro-manage them but since I’ve started handing them on to trusted team members to complete I’ve noticed they actually get done quicker and I’m able to take more of an overview.

“I can then focus on big important jobs that might be labour-intensive but don’t induce feelings of guilt and stress. It’s just easier all round and the whole team is more productive.”

If you lean to the control freak end of the spectrum, letting go doesn’t mean losing control, says Cooper. “When deciding who to delegate to, find someone who complements you. If you know you won’t be able to step away,  make it clear that you are supervising because of what you are like rather than because you don’t trust them to get on with it.”

Dr Michael Sinclair, clinical director of City Psychology Group and the co-author of Mindfulness for Busy People says: “Part of working life is accepting that you can’t do everything perfectly and let things be. You need to make room for uncomfortable, anxious feelings. That can mean passing it on to someone who can dedicate their time, energy and resources to it; freeing you up to carry on with what is important for you to do.” This opening it up will help with breaking it down, says Ellen J Langer, author of Mindfulness. “Events are less stressful when considered from multiple perspectives, and speaking to different people helps with this.” Once you’ve delegated, remember to be gracious and not take all the credit. Delegation makes it happen.”

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Molecular Pathway Behind Bipolar Affective Disorder Uncovered

Scientists have discovered the underlying molecular pathway that's associated with Bipolar Affective Disorder--one of a few mood disorders that are estimated to affect around 20.9 million American adults.

The findings were based on decades-old research on the Old Order Amis families in Pennsylvania that showed a high prevalence of a rare form of dwarfism known as Ellis van-Creveld (EVC) and BAP. However, the health issue had rarely been documented, according to researchers. 

"What happened is the pieces of the puzzle came together more recently over the last several months. What we are reporting is that here's the phenomena that this rare genetic disorder, the mechanism in it which was not obvious years ago, that actually protects those individuals from getting bipolar disorder," said lead study author of the Boston Globe, Edward I Ginns, in a news release. 

Researchers hypothesized that having EVC provided immunity against BAP. Furthermore, they investigated Sonic Hedgehog (SHH) signaling pathway. The disruption of this pathway is known to cause EVC and has an association that's linked between BAP and EVC. Researchers concluded that SHH plays a role in BAP and mood-related disorders.

"Since mutations causing EvC do so by disrupting Shh protein function, linking abnormal Shh signaling to major affective disorders provides a concrete molecular and medical basis for patients' symptoms that should help break down the stigma associated with mental illnesses. If we can understand more details of the Shh signaling pathway in bipolar disorder, it could dramatically change the way we diagnose and treat these conditions," Ginns concluded. 

More information regarding the findings can be seen via the journal Nature Molecular Psychiatry.

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Mental Rest And Reflection Boost Learning

A new study, which may have implications for approaches to education, finds that brain mechanisms engaged when people allow their minds to rest and reflect on things they've learned before may boost later learning.

Scientists have already established that resting the mind, as in daydreaming, helps strengthen memories of events and retention of information. In a new twist, researchers at The University of Texas at Austin have shown that the right kind of mental rest, which strengthens and consolidates memories from recent learning tasks, helps boost future learning.

The results appear online this week in the journal Proceedings of the National Academy of Sciences.

Margaret Schlichting, a graduate student researcher, and Alison Preston, an associate professor of psychology and neuroscience, gave participants in the study two learning tasks in which participants were asked to memorize different series of associated photo pairs. Between the tasks, participants rested and could think about anything they chose, but brain scans found that the ones who used that time to reflect on what they had learned earlier in the day fared better on tests pertaining to what they learned later, especially where small threads of information between the two tasks overlapped. Participants seemed to be making connections that helped them absorb information later on, even if it was only loosely related to something they learned before.

"We've shown for the first time that how the brain processes information during rest can improve future learning," says Preston. "We think replaying memories during rest makes those earlier memories stronger, not just impacting the original content, but impacting the memories to come.

Until now, many scientists assumed that prior memories are more likely to interfere with new learning. This new study shows that at least in some situations, the opposite is true.

"Nothing happens in isolation," says Preston. "When you are learning something new, you bring to mind all of the things you know that are related to that new information. In doing so, you embed the new information into your existing knowledge."

Preston described how this new understanding might help teachers design more effective ways of teaching. Imagine a college professor is teaching students about how neurons communicate in the human brain, a process that shares some common features with an electric power grid. The professor might first cue the students to remember things they learned in a high school physics class about how electricity is conducted by wires.

"A professor might first get them thinking about the properties of electricity," says Preston. "Not necessarily in lecture form, but by asking questions to get students to recall what they already know. Then, the professor might begin the lecture on neuronal communication. By prompting them beforehand, the professor might help them reactivate relevant knowledge and make the new material more digestible for them."

This research was conducted with adult participants. The researchers will next study whether a similar dynamic is at work with children.

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Aspirin And Other Anti-Inflammatory Medicines Benefit Schizophrenia Treatment

Anti-inflammatory medicines such as aspirin, estrogen, and Fluimucil can improve the efficacy of existing schizophrenia treatments, according to results announced at the European College of Neuropsychopharmacology conference in Berlin.

Doctors have long believed that helping the immune system may benefit the treatment of schizophrenia, but until now there has been no conclusive evidence that this would be effective. Now a group of researchers at the University of Utrecht in the Netherlands has carried out a comprehensive meta-analysis of all robust studies on the effects of adding anti-inflammatories to antipsychotic medication. They conclude that anti-inflammatory medicines, such as aspirin, can add to the effective treatment of schizophrenia.

Research has shown that the immune system is linked to certain psychiatric disorders, such as schizophrenia and bipolar disorder. Schizophrenia in particular is linked to the HLA gene system, which is found on chromosome 6 in humans. The HLA system controls many of the characteristics of the immune system.

According to lead researcher and psychiatry Professor Iris Sommer of University Medical Centre, Utrecht, "The picture on anti-inflammatory agents in schizophrenia has been mixed, but this analysis pulls together the data from 26 double-blind randomised controlled trials, and provides significant evidence that some (but not all) anti-inflammatory agents can improve symptoms of patients with schizophrenia. In particular, aspirin, estrogens (in women) and the common antioxidant N-acetylcysteine (fluimicil) show promising results. Other anti-inflammatory agents, including celecoxib, minocycline, davunetide, and fatty acids showed no significant effect."

In spite the fact that schizophrenia affects around 24 million people worldwide1, treatment has not changed much in over 50 years, and largely relies on correcting the regulation of dopamine in the brain of schizophrenia sufferers.

This has been shown to help symptoms such as hallucinations and delusions, but has been unable to help many other symptoms such as decreased energy, lack of motivation and poor concentration. In addition, around 20 to 30% of all patients don't respond to antipsychotic treatment. Co-treatment with anti-inflammatory agents holds the possibility of improving patient's response to treatment.

Sommer continued, "The study makes us realise that we need to be selective about which anti-inflammatory we use. Now that we know that some effects are replicated, we need to refine our methods to see if we can turn it into a real treatment. We have just started a multicenter trial using simvastatine to reduce inflammation in the brain of patients with schizophrenia. Studies like these will provide the proof-of-concept for targeting the immune system in schizophrenia." 

Commenting for the ECNP, Professor Celso Arango (Hospital General Universitario Gregorio Marañón, Madrid) said, "Inflammation and oxidative stress seem to be important factors in different mental disorders. Patients with different mental conditions, including schizophrenia, have been shown to have reduced antioxidants in the brain as well as excess inflammatory markers. Animal models and clinical trials have shown that antioxidants and anti-inflammatory drugs could not only reduce symptoms associated with the disorders but also prevent the appearance of neurobiological abnormalities and transition to psychosis if given early during brain development.

"This work is a step towards the possibility of better treatment, but we need more research in this area, especially with younger subjects where we might expect more brain plasticity".

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Gambling Addiction Linked To Brain Reward System

The 'high' or feeling of euphoria created by addictive behaviour is less obvious in the brains of problem gamblers, research suggests.

This could make them more prone to addiction as they search harder for an "endorphin rush".

Researchers from London and Cambridge scanned the brains of 30 people to find out how their reward systems responded.

The paper was presented at the European College of Neuropsychopharmacology conference in Berlin.

All humans have a natural opioid system in their brains which controls pain, reward and addictive behaviour.

In this small study, which involved 14 problem gamblers and 15 healthy volunteers, scans were used to measure the endorphins released when the opioid system in the brain was stimulated using an amphetamine tablet.

Lead researcher Dr Inge Mick, from Imperial College London, said her work showed two things.

"Firstly, the brains of pathological gamblers respond differently to this stimulation than the brains of healthy volunteers.

"And secondly, it seems that pathological gamblers just don't get the same feeling of euphoria as do healthy volunteers.

"This may go some way to explaining why gambling becomes an addiction."

This is because they have to work harder to get the same feeling of euphoria, or high, as the average person, which then encourages more gambling.

Dr Mick said the findings suggested that the opioid system had a role to play in gambling addictions. The way the system responds may be different in people addicted to alcohol or cocaine, however.

She said the study findings could help develop new treatments for gambling addictions.

Fewer than 1% of adults in the UK have a gambling addiction, equivalent to around 300,000 people.

At present, pathological gambling is treated using drugs such as naltrexone and nalmefene, which have the best results in gamblers with a family history of alcohol dependence.

Dr Mark Griffiths, professor of gambling studies at Nottingham Trent University, said: "This is an interesting study which backs up what we already know from previous research.

"Gambling is a behavioural addiction which is influenced by biological, psychological and social factors.

"As to whether a gambling addiction is different to an alcohol or cocaine addiction, the sample size in the study is small and we need to see more research in this area first."

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Exercise May Not Ward Off Teen Depression

Although exercise has long been thought to help improve the symptoms of depression, teenagers may not reap these benefits, a new British study suggests.

The study found that physical activity levels in early teen years didn't appear to affect rates of depression in later teen years.

"Those participants who were more physically active in early adolescence did not subsequently have significantly lower (or higher) depressive symptoms or significantly altered odds of depressive disorders in later adolescence," the study authors wrote.

"Although it is important to promote physical activity because of its well-documented effect on physical health, during adolescence, physical activity may not serve as a strong protective factor of developing depressive symptoms or disorders," they added.

However, some U.S. experts questioned the findings based on the study's design, noting, for example, that the researchers didn't delineate the type of activity performed, or whether it was done by choice or as part of a physical education class.

The research, published online Oct. 13 in JAMA Pediatrics, involved more than 700 teens who were tracked from November 2005 through January 2010 by a team led by Umar Toseeb from the University of Cambridge.

At the start of the study, the researchers measured weekday and weekend physical activity of the teens, whose average age was 14. They also had the teens fill out a questionnaire about their mood changes.

The teens averaged about 53 minutes of moderate to vigorous physical activity each weekday, and about 32 minutes daily on the weekends, according to the study.

Three years later, when the participants were 17, the researchers had them all fill out the mood questionnaire again.

The researchers didn't find any connection between the levels of physical activity at age 14 and any depression experienced at age 17.

"Our findings do not eliminate the possibility that physical activity positively affects depressed mood in the general population; rather, we suggest that this effect may be small or nonexistent during the period of adolescence," the researchers wrote.

Tony Tang, an adjunct professor in the department of psychology at Northwestern University, said the findings were "very intriguing, since physical exercise is often the first thing we recommend to adult clients."

Tang, who was not involved in the study, thinks there may be something unique about the physical activity teens do that makes it different from exercise done by adults. Perhaps only voluntary exercise prevents depression, he said.

"Our adult clients exercise only when they want to, but other people make adolescents exercise all the time. Their schools have PE classes; their parents sign them up for swimming lessons; their coaches make them get up early for football practices, etcetera. Perhaps 'exercise without consent' is not as psychologically beneficial as voluntary exercise," he said.

But Tang took issue with how the study was done. "The authors should have measured depression much more thoroughly," he said.

An adolescent might have been depressed during most of the three years of study, but if the depression episode ended a few weeks before the interview, then he or she would be labeled depression-free, Tang said.

"This is far from ideal. They should have tracked all depression episodes during the last year of the study," he said.

Simon Rego, director of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said, "It is surprising that the researchers failed to support their hypothesis that participants with higher levels of physical activity in early adolescence would have lower levels of depressive symptoms later on."

Rego also sees problems in how the study was done, specifically that the researchers did not measure levels of physical activity at the end of the study.

"This omission seems particularly significant, given the age of the teens at the start and end of the study and given all of the developmental and psychosocial changes that typically occur within it, such as increasing demands at school, obtaining a driver's license, not being good at sports, lack of active role models, busy/working families, dating, etc. -- any of which may negatively impact physical activity," he said.

Rego added that the amount of physical activity you do is important, but how it impacts your life also matters.

"For example, rather than just being about physical activity per se, for some patients, the physical activity may serve a social function, such as connecting with others, getting social support and generating a sense of belonging, which helps to improve their mood and/or serves as a buffer to mood slips," he said.

Unfortunately, the researchers did not collect any data on the context of physical activity, so they did not examine this aspect, Rego noted.

"Taken together, these limitations raise serious questions about the results and conclusions of this paper," he said.

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Are You Too Stressed To Sleep?

It is becoming more and more obvious that stress plays a major role in insomnia. The development of insomnia is largely determined by how we react to stress — both psychologically and physically. In fact, many people experience transient insomnia, insomnia that lasts for a short period of time, after a stressful event. However, for some of us, stressors such as illness, work schedule changes, and interpersonal conflict can lead to chronic insomnia.

How Does Stress Affect Our Sleep?

We know that those most vulnerable to stress-induced insomnia seem to have the poorest coping skills. They are more likely to ruminate and suffer frequent mental intrusions, especially around bedtime. As a result, they present to sleep specialists, such as myself, with the classic complaint of “I can’t shut my mind down,” which makes it very difficult for them to fall or stay asleep.

Many people with chronic insomnia seem to be both psychologically and physiologically ill-prepared to deal with stress. Many people with chronic insomnia experience an overproduction of stress hormones, such as cortisol and adrenaline. Several studies have demonstrated that those predisposed to stress-induced insomnia have an overactive sympathetic (fight or flight) nervous system, as well as a hyperactive HPA (Hypothalamic-Pituitary-Adrenal) axis, resulting in the overproduction of stress hormones. As a result, sleep is severely impaired and disrupted.

Even more bothersome is the fact that deep, slow-wave sleep is known to reduce the levels of these stress hormones and decrease the activity of the HPA axis. Wakefulness, on the other hand, increases its output. Thus, insufficient sleep tends to promote a vicious cycle of sleep problems, resulting in increasing levels of sleep-inhibiting stress hormones.

Lastly, high levels of cortisol can decrease levels of melatonin (a major sleep-promoting neurological hormone), which results in an even poorer sleep outcome.

Stress Less, Sleep Better

For the fifteen percent of Americans who suffer from chronic insomnia, strong coping skills are crucial.

Lifestyle changes, such as regular daily exercise, plus eliminating nicotine and caffeine is often a good place to start. Cognitive behavioral therapy, meditation, progressive muscle relaxation, hypnosis, can also help relieve anxiety levels and intrusive thoughts.

Recognizing that your lack of sleep may be related to how you deal with stress can help you remedy your sleep problems. Many people with insomnia relapse when they stop taking sleeping pills because they fail to deal with the underlying problem — stress. Learn to manage your stress. If you need help, get it. If you do, you are more likely to reap the benefits of uninterrupted deep sleep.

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Brain Scans Show Cause Of Seasonal Affective Disorder

Scientists say they have identified the underlying reason why some people are prone to the winter blues, or seasonal affective disorder (SAD).

People with Sad have an unhelpful way of controlling the "happy" brain signalling compound serotonin during winter months, brain scans reveal.

As the nights draw in, production of a transporter protein ramps up in Sad, lowering available serotonin.

The work will be presented this week at a neuropsychopharmacology conference.

The University of Copenhagen researchers who carried out the trial say their findings confirm what others have suspected - although they only studied 11 people with Sad and 23 healthy volunteers for comparison.

Using positron emission tomography (PET) brain scans, they were able to show significant summer-to-winter differences in the levels of the serotonin transporter (SERT) protein in Sad patients.

The Sad volunteers had higher levels of SERT in the winter months, corresponding to a greater removal of serotonin in winter, while the healthy volunteers did not.

Winter depression

Lead researcher, Dr Brenda Mc Mahon, said: "We believe that we have found the dial the brain turns when it has to adjust serotonin to the changing seasons.

"The serotonin transporter (SERT) carries serotonin back into the nerve cells where it is not active - so the higher the SERT activity, the lower the activity of serotonin.

"Sunlight keeps this setting naturally low, but when the nights grow longer during the autumn, the SERT levels increase, resulting in diminishing active serotonin levels.

"Many individuals are not really affected by Sad, and we have found that these people don't have this increase in SERT activity, so their active serotonin levels remain high throughout the winter."

Prof Siegfried Kasper, of the European College of Neuropsychophar­macology, which this year is holding its annual congress in Berlin, said: "SERT fluctuations associated with Sad have been seen in previous studies, but this is the first study to follow patients through summer and winter comparisons.

"It seems to offer confirmation that SERT is associated with Sad."

Sam Challis, information manager at mental health charity Mind, said: "We don't yet know enough about how serotonin levels can be affected by light levels so this is quite an interesting, albeit small, study. We would welcome more research."

She said there was a range of treatments available for Sad, such as light therapy and cognitive behavioural therapy.

"We know that eating a balanced diet, cutting down on caffeine and getting some exercise can help, as can spending as much time as possible outdoors because - even when it's overcast - light will be higher than indoors."

SAD affects about two million people in the UK, and more than 12 million people across northern Europe.

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The Sleep Whisperers!!

The shop assistant in my local corner shop had beautifully manicured nails, and there was something about the way she held - almost caressed - the groceries, as she totted them up on the till, which also gave me that same relaxed, tingling sensation.

When I was older, and showing signs of being mathematically challenged, my parents hired a maths teacher for weekly grinds. Every Thursday evening he'd sit at my mother's kitchen table and reveal to me the mysteries of Pythagoras & Co. with such a soothing, hypnotic voice that I had to fight bravely to stay awake. It didn't damage my maths education, though. I can count to 10 without using my fingers and I know about log tables. They've got some nice ones in Harvey Norman. Canadian, I think.

Those warm, fuzzy feelings I got from soothing voices or the gentle touching of inanimate objects just seemed weird and I never gave them much thought.

Until recently, fighting yet another night of insomnia, my body craving sleep and my brain yelling Party Party Party, I decided to check out relaxation techniques on You Tube. And accidentally discovered a worldwide 'whispering community', who post videos of themselves speaking softly and calmly about any number of things.

And these videos send me off to sleep quicker than a truckload of Noctamid. Many of the videos involve role-play; the 'artists' pretend to be hairdressers, or beauty therapists, or shop assistants. It's a bit odd, really. At least that's what my daughter thinks. However, there are millions of 'odd' people like me tuning into YouTube videos for sleep therapy.

The phenomenon has been given a scientific-sounding name; ASMR (Auto-Sensory Meridian Response), although, apart from one thesis still not published, there's damn-all by way of scientific data to explain it. But ASMR has been getting some media attention recently, and I figure it's about to become mainstream. The world, it seems, is full of tingleheads!

The New York Times, The Guardian, The Independent (UK) and the Huffington Post have all run features on the rising popularity of ASMR in the last two years. The American TV show, The Drs, which RTE broadcasts here, has also run a feature on it, interviewing one of ASMR's most-watched 'artists' called The Waterwhispers Ilse. The TV doctors could only surmise that ASMR is similar to relaxation CDs of ocean waves or soft-spoken meditations. And it is indeed similar. But different.

I spoke with Dutch Waterwhispers Ilse, and asked her how young she was when she first remembers experiencing the "tingles". She was about five-years-old, she says, and - like me - she felt profoundly relaxed when her hair was being brushed, or if someone spoke to her sotto voce. (These are triggers, I've learned.) When she was older, she used to watch American painter Bob Ross's TV series, The Joy Of Painting on Sunday afternoons with her grandmother. And Ross's voice would inevitably send her off to the land of nod - although it did nothing to inspire her to paint.

In 2011, she discovered the whispering community in the same way I did - searching online for some relaxation talks - and found other people who responded to triggers in the same way. In February 2012, she took it one step further and began uploading videos of herself, recorded with her phone.

The rest is YouTube history. At the time of writing, Ilse has clocked up 23 million views and 160,000 subscribers. She has gone professional now, she told me. She can make a living from voluntary donations to her channel, and she's writing a book about her experiences.

Another doyenne of the ASMR community, Maria, aka Gentle Whispering, insists that she will never make ASMR her profession. Originally from Russia and now living in Maryland, USA, Maria's YouTube stats are considerably higher than Ilse's - over 78 million views, and 280,000 subscribers.

She told me that she too experienced childhood tingles in response to touch and to visual and aural cues. And she too went online to search for a relaxing voice to help her sleep. She posted three videos of herself in 2011, took them down (she said they were "embarrassing") and tried again in 2012.

Although it's obvious that she's receiving revenue from advertisements and donations, she vows not to give up the day job in a medical office. ASMR videos are for the "virtual community", she told me, and I'm quoting: "It's not real life, it's online." She figures that the "magic" will dissipate for her if she makes it more than a hobby, albeit a lucrative one.

Breege Leddy is the Senior Sleep Physiologist and CBTi Specialist in the Bon Secours Insomnia Clinic in Glasnevin. I was interested in a professional opinion of ASMR.

And the news is not good for ASMR fans. Breege's big problem with ASMR is the use of electronic devices in the bedroom. Smartphones, laptops and tablets all emit blue light which, Breege says, reduces our production of the sleep hormone, melatonin.

She goes on to say that there's more to treating insomnia than just relaxation techniques. Anxiety is apparently the main cause of insomnia, and the Bon Secours clinic looks at a patient's lifestyle, emotional health and psychological well-being. There is, it seems, no quick fix. And none of us should be even touching our electronic devices for at least two hours before bedtime.

Trish Nannery is another psychotherapist specialising in CBT (Cognitive Behavioural Therapy), and I asked her for a second opinion. I'm afraid it's not much different from the first. Trish likens ASMR to meditation but unlike meditation, ASMR only uses the visual and auditory senses. Good meditation practices involve more than just hearing and sight, according to Trish.

She figures that we've almost lost the ability to use our combined five senses, in favour of visual and auditory stimulants such as TV and internet.

We could step outdoors and take a walk, engaging all of our senses, but not enough of us do this. And then we attempt to find solutions to our sleeping problems in technology. Or worse, in pills.

Trish insists that sensory deprivation, through lack of outdoors exercise, contributes hugely to sleep problems. This echoes Breege Leddy's point about lifestyle; it would appear that we're manufacturing our insomnia issues ourselves.

There is a kind of intimacy about the one-to-one aspect of ASMR videos which many fans feel uncomfortable discussing. The videos appear to invoke a kind of guilty pleasure, despite their non-sexual nature. The anonymous man who collates ASMR videos for his website Soothetube, told a UK newspaper that "guilt" is the wrong word. "Speaking personally," Mr Soothetube says, "it just avoids having to explain myself to people who don't get it". Nicholas Tufnell, in a Huffington Post feature on ASMR, wrote "If someone walks in on you watching porn, it's easier to explain than if they walk in on you watching ASMR videos".

I agree. When my boyfriend walked in on me watching an ASMR "facial" video, he found me prostrate and snoring, while some foreign woman on my laptop screen removed cleansing lotion from her webcam, softly telling me how good my skin was. He thought he'd barged in on some kind of fully dressed lesbo-erotic freak show via Skype.

The clinicians may well shake their heads, and without reliable scientific data, who can blame them? But millions of insomniacs are using their iPhones at night, instead of swallowing Dalmane or dubious quantities of alcohol, to secure a night's rest. Is that so terrible?

I know I should exercise more and take time to wind down at night, but ASMR videos knock me out cold in less than 10 minutes. No lavender baths or yoga breathing or silent contemplation required. Nor do I need a benzodiazepine or a long, strong whiskey. Just tune me into a YouTube facial, or haircut, or let me listen to Maria folding towels for 20 minutes. She'll have lost me after five... zzzzzzz...

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