Mini facts: What's the latest in mental health research?
This post is a round up of the best social media posts I’ve created on this topic, listed by year.
The goal is to provide a format that is easier for you to refer to, or to search. It will be updated periodically.
2019
Queuine can only be synthesized by bacteria, but it is important to your body’s homeostasis. For example, in mice without a microbiome, the lack of queuine results in a loss of activity levels of an important cofactor for producing neurotransmitters.
Queuine can be found in the diet, but in small amounts and it is unknown if this is enough to compensate for a poor microbiome. The downstream effects of low queuine are associated with numerous mental health symptoms.
Want to learn more about the influences of gut health on depression? Check out this post!
Families and friends can play an important protective role against suicidal ideation and behaviours. In fact, this study found that for adolescents with a mental health condition (compared to those without), family is especially important.
The importance of connection is also emphasized in the interpersonal theory of suicide, where “belongingness” and “burdensomeness” are influential components of the desire to live. There is some interesting research on different kinds of resources we share with each other and the balance of this “give and take” which are beyond the scope of this post.
The authors of this paper note several potential interventions stemming from available research:
🌿 schoolwide programs to improve interpersonal skills and responsible behaviours
🌿 family-based interventions addressing negative emotion, reducing conflict, and improving communication
🌿 working with individuals to change friendship quality and to recognize how other’s actions affect them
Van Meter, A. R., Paksarian, D. & Merikangas, K. R. Social Functioning and Suicide Risk in a Community Sample of Adolescents. J. Clin. Child Adolesc. Psychol. 1–15 (2019). doi:10.1080/15374416.2018.1528549
In a most curious study carried out in mice, the effects of sleep restriction on the permeability of the blood brain barrier were examined in two separate contexts. In one, the mice had a greater inflammatory status. In the other, the mice had more of an anti-inflammatory status. In pro-inflammatory mice, sleep restriction resulted in increased blood brain barrier permeability. However, changes in the blood brain barrier were not seen after sleep restriction in the anti-inflammatory mice!
While animal studies cannot necessarily translate directly to humans, this experiment reveals an interesting possibility – reducing our background inflammation may help preserve the function of the blood brain barrier during times when we don’t get enough sleep. Obviously, this doesn’t mean sleep restriction can be continued indefinitely without ill effect! But once in a while sleep is restricted for various reasons: new baby, late night exam prep, perhaps even during adolescence (something discussed in my last post), etc.
Keeping background inflammation down may set you up better for these occasional short nights. It’ll be interesting to see a human study on this topic.
When have you had to restrict your sleep? What measures did you take to give yourself extra care during these times?
Hurtado-Alvarado, G. et al. The yin/yang of inflammatory status: Blood-brain barrier regulation during sleep. Brain. Behav. Immun. 69, 154–166 (2018)
Dopamine is a neurotransmitter involved in reward circuits, and its availability increases in adolescence. In adolescence, effects of substances are experienced as more positive and less negative.
Due to a number of factors (developmental and social factors), adolescents go to bed later, but with early school start times still have to get up early. They are at an increased risk for sleep loss and circadian misalignment.
In addition to this, adolescents not only have changes in light exposure throughout the day (i.e. screentime in the evening) but also changes in their response to light exposure (light at night has more impact). Staying up later and other changes to sleep patterns changes reward circuitry and is associated with decreased response to reward, sensation seeking, low self-regulation and impulsivity amongst other things. Ultimately, this increases risk of substance use. (Not to mention the relationship between sleep deprivation and circadian misalignment and many other health conditions.) There is a compelling case for later school start times for adolescents. Such a simple-sounding intervention with wide-reaching impact on physical health, mental health, ability to make use of or even complete an education and community stability.
As a teen, I stayed up super late all the time whether doing homework or reading a book, etc. Then I’d get to school and not be able to stop yawning. I even had a teacher call home to check if everything was ok because I was so tired! Who else would have benefited from a later school start time?
Logan, R. W. et al. Impact of Sleep and Circadian Rhythms on Addiction Vulnerability in Adolescents. Biol. Psychiatry 83, 987–996 (2018).
Sometimes we need a progress check as a global society to evaluate where we’re at and how we can improve. The BMJ recently published results of an analysis of suicide mortality from 1990 to 2016. Overall, rates of suicide mortality aren’t decreasing quite fast enough to meet the Sustainable Development Goals of reducing suicide mortality by one third between 2015 and 2030 in all 118 countries involved.
But wait, there has been some progress! When the mortality rates are age standardised, we see that there has been a decline in suicide mortality by 32.7% between 1990 and 2016. There is a greater decline for women than for men, although suicide mortality rates are affected by numerous variables and vary by region studied. For example, this analysis revealed a large drop in suicide rates in China and India.
How can we help our society get on track to meet the goal by 2030? Yes, some of these changes might need to be made at levels beyond our personal scope or in countries we don’t belong to. But remember that little three degrees of influence rule? You influence not just your friends, but your friend’s friends and your friend’s friends’ friends. Never underestimate the power of one small act of kindness. You don’t save the world by helping everyone, but by helping someone.
What random acts of kindness do you find in your life?
Naghavi, M. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ 364, l94 (2019).
More reasons to do a few squats before you continue scrolling! I don’t know if it’s the New Year’s resolutions fever that’s gotten into the recent research publications, but the January issues of several journals featured research on exercise and brain health. And surprise, surprise, here are the findings from three such articles:
Physical activity and motor skills are associated with better cognitive reserve in old age independent of brain pathology such as Alzheimer’s dementia. It is unknown how much of this is due to high levels of physical activity throughout the lifespan and how much is due to physical activity later in life. [1]
Does decreased activity contribute to depression, or does depression lead to decreased activity? We have to be careful not to draw causal relationships from correlational data, but just like in the study of brain pathology and exercise, this next study also found a one-way protective effect for physical activity on risk for depression. The authors suggest changes in activity associated with depression are possibly mediated by other factors such as chronic pain, rather than caused directly by depression itself. [2]
Tying together those articles, the third article suggests physical activity may be protective to cognitive function in those with depression as they age. [3]
If these peaked your curiosity don’t stop here! Check out my friends @drtyna who knows all about muscle as medicine and @fitnessexplorer who demonstrates how play and movement can be incorporated into your routine, and why this is important for your health! How do you play throughout the day?
1.Buchman, A. S. et al. Physical activity, common brain pathologies, and cognition in community-dwelling older adults. Neurology 10.1212/WNL.0000000000006954 (2019). doi:10.1212/WNL.0000000000006954
2.Choi, K. W. et al. Assessment of Bidirectional Relationships Between Physical Activity and Depression Among Adults. JAMA Psychiatry (2019). doi:10.1001/jamapsychiatry.2018.4175
3.Hu, L., Smith, L., Imm, K. R., Jackson, S. E. & Yang, L. Physical activity modifies the association between depression and cognitive function in older adults. J. Affect. Disord.
Adolescents and their parents were interviewed about frequency of suicidal thoughts. Here’s what researchers found:
50% of parents were unaware of their child’s suicidal thoughts.
75% of parents were unaware their child had recurrent thoughts of death.
48% of adolescents denied suicidal thoughts, as reported by their parents.
67% of adolescents denied thoughts of death, as reported by their parents.
These discrepancies were greatest between parents and younger female adolescents and between parents and older male adolescents. Fathers, more than mothers, were unaware of their child’s suicidal thoughts. These findings make it all the more important to routinely screen for depression at a young age and to consider reports from multiple informants.
Jones, J. D. et al. Parent-Adolescent Agreement About Adolescents’ Suicidal Thoughts. Pediatrics 143, e20181771 (2019).
Did you know?
Levels of omega-3 fatty acids may not be as important to suicide risk as an actual change in those levels. Risk increases when levels drop. This is important to consider because many studies look at omega-3 levels at one point in time and may miss correlations to suicide risk because they are not looking at the change over time.
Case studies on fish oil in traumatic brain injury reveal both risks (due to increased bleeding risk that cannot be counteracted with medications) and rewards. I highlight two case examples in this latest blog post. In the positive scenario a teenager went from what his doctors thought would be a permanent vegetative state to being able to go home to his family.
A very interesting study revealed fish oil may make things worse in non-inflammatory causes of depression. This illuminates a need to understand causes of depression and which subsets of patients will benefit from certain treatments, such as fish oil, and which subsets of patients will not benefit from those treatments. Plus, just like we see a U-shaped curve for optimal vitamin D levels, there is a possibility of something similar with fish oil.
Did you know?
It’s not just antibiotics that are contributing to the growing problem of antibiotic-resistant bacteria. It’s other medications too. One example is the antidepressant fluoxetine (Prozac), which was recently shown to increase bacterial resistance to a number of antibiotics.
Antidepressants aren’t the only psychiatric drug to have effects on your microbiome. Some antipsychotic medications used for schizophrenia have been shown to have an effect on Toxoplasma gondii infections. This may be more than a curious side effect. It is possible that some of these psychiatric medications are effective partly because they affect your microbiome, not in spite of it.
Probiotics must be considered by the specific type of bacteria, and there is very little clinical research on any one type for the purposes of mental health. One type of bacteria that has yet to develop a backing in human studies is L. reuteri. This one is particularly interesting because of theory that it could boost our own production of oxytocin, known as the “love” hormone.
2018
`How do we break through the misconceptions that psychological symptoms are “painless”, “voluntary”, “untreatable”, “weird”, “trivial” or “not an illness”? In this study, kids as young as 10 held these misconceptions about psychological symptoms, and they worried about the stigma of seeking help. This mindset persists through adolescence. Education needs to begin at a very young age to help kids understand when these symptoms are “normal” and when to ask for help. Talk to your kids!