Download Social Anxiety Tied to Overabundance of Serotonin

Volume 6, Issue 1
Newsletter
JUNE 2015
Inside this issue:
Social Anxiety Tied to Overabundance of Serotonin
Individuals who suffer from
social phobia tend to produce too much serotonin,
according to a new study
conducted by Finnish researchers at Uppsala University. In fact, the more
serotonin they produce, the
more anxious they become
in social situations. These
findings are in complete
contrast to those of previous research which linked
social anxiety to the production of too little serotonin.
Many people feel anxious in
new social situations or are
afraid to speak in front of
an audience, but if the anxiety is persistent and severely lowers a person‟s
quality of life, it becomes a
disability.
Since the belief up until now
has been that social anxiety
is triggered from too little
serotonin, social phobia is
commonly medicated using
selective serotonin reuptake inhibitors (SSRI) medications. SSRIs increase the
amount of available serotonin in the brain.
In the new study, published
in the scientific journal
JAMA Psychiatry, the research team, led by professors Mats Fredrikson and
Tomas Furmark, used a PET
camera and a special tracer
to measure chemical signal
transmission by serotonin in
the brain.
They discovered that participants with social phobia
produced too much serotonin in a part of the brain‟s
fear center, known as the
amygdala. The more serotonin produced, the more
anxious the patients were in
social situations.
A nerve cell, which sends
signals using serotonin, first
releases serotonin into the
space between the nerve
cells. The nerve signal arises
when serotonin attaches
itself to the receptor cell.
The serotonin is then released from the receptor
and pumped back to the
original cell.
“Not only did individuals
with social phobia make
more serotonin than people
without such a disorder,
they also pump back more
serotonin. We were able to
show this in another group
of patients using a different
tracer which itself measures
the pump mechanism.
“We believe that this is an
attempt to compensate for
the excess serotonin active
in transmitting signals,” says
Andreas Frick, a doctoral
student at Uppsala University Department of Psychology.
The novel findings are a
giant leap forward when it
comes to identifying
changes in the brain‟s
chemical messengers in
people who suffer from
anxiety. Previous research
has shown that nerve activity in the amygdala is higher
in people with social phobia
and thus that the brain‟s
fear center is over-sensitive.
The new study shows that
an overabundance of serotonin is part of the underlying reason.
“Serotonin can increase
anxiety and not decrease it
as was previously often
assumed,” says Frick.
Brain Scans Help Determine Best OCD
Treatment
2
Early Psychosis and
Young People
3
For Women with Bipolar Disorder, Sleep
Quality Affects Mood
4
Inside Story
3
Inside Story
4
Inside Story
5
Inside Story
6
Source: Uppsala University
Address:
385
Princess Street
Kingston, ON
K7L 1B9
613-544-2886
Callers in crisis will be referred to
the crisis line
613-544-4229
[email protected]
2
Brain Scans Help Determine Best OCD Treatment
Obsessive-compulsive disorder, is a
condition in which obsessive thoughts
and compulsive behaviors become so
excessive they interfere with daily life.
Traditional intervention for OCD includes the use of cognitive behavioral
therapy (CBT). CBT helps people understand the thoughts and feelings that
influence their behaviors, and helps
them take action to eliminate the errant beliefs. However, not all OCD
sufferers benefit from CBT over the
long term: In an estimated 20 percent
of patients, symptoms eventually return after the therapy is complete.
A new study by University of California, Los Angeles (UCLA) researchers
suggests that a certain detail from patients‟ brain scans could help clinicians
identify which people are more likely
to relapse after cognitive-behavioral
therapy — and why. The discovery is
important as tens of millions of Americans — an estimated one to two percent of the population — will suffer at
some point in their lifetimes from obsessive-compulsive disorder. Left untreated, OCD can be profoundly distressing to the patient and can adversely affect their ability to succeed in
school, hold a job, or function in society.
Since CBT does not work for everyone, using brain scans to identify those
who may not benefit from the traditional therapy would allow alternative
forms of intervention. “The efficiency
of brain network connectivity before
treatment predicts the worsening of
symptoms after treatment,” said Jamie
Feusner, a UCLA associate professor
of psychiatry and director of the Semel Institute‟s Adult OCD Program.
Feusner and Joseph O‟Neill, a UCLA
associate professor of child psychiatry
and a research scientist at the Semel
Institute, were the study‟s co-principal
investigators. The research appears in
the open-access journal Frontiers in
Psychiatry.
In the study, researchers used functional magnetic resonance imaging, or
fMRI, to evaluate the brains of 17 people, aged 21 to 50 years old, with
OCD. Scans were taken both before
and immediately after the patients
completed an intensive four-week
course of cognitive-behavioral therapy,
and the doctors monitored the patients‟ clinical symptoms over the next
12 months. “We found that cognitivebehavioral therapy itself results in
more densely connected local brain
networks, which likely reflects more
efficient brain activity,” Feusner said.
However, the researchers also found
that people who had more efficient
brain connectivity before they began
treatment actually did worse in the
follow-up period. Surprisingly, neither
the severity of symptoms before treatment nor the amount that symptoms
improvement during treatment were
accurate predictors of the patients‟
post-treatment success.
The researchers say that knowing
more about which patients might not
fare well long-term could potentially
help doctors and patients choose the
best course of treatment. “Cognitivebehavioral therapy is in many cases
very effective, at least in the short
term. But it is costly, time-consuming,
difficult for patients and, in many areas, not available,” Feusner said.
“Thus, if someone will end up having
their symptoms return, it would be
useful to know before they get treatment.” He added that the findings
don‟t mean that some people with
OCD cannot be helped — just that
four weeks of intensive cognitivebehavioral therapy might not be the
most effective long-term approach.
OCD can also be treated with medication or through cognitive-behavioral
therapy that lasts longer than the fourweek period evaluated in the study.
The UCLA study was the first to use
brain connectivity to help predict a
post-treatment clinical course, and the
first to test the effects of cognitive-
behavioral therapy on brain network connectivity.
Feusner and his colleagues are
conducting several other studies
to understand the effects of the
treatment on the brain in people
with OCD and with other OCDrelated disorders, including body
dysmorphic disorder and anorexia
nervosa.
“We are now starting to translate
knowledge of the brain into useful
information that in the future
could be used by doctors and
patients to make clinical decisions,” Feusner said.
“Although a brain scan may seem
expensive, these scans only took
about 15 minutes and thus the
cost is not exceptionally high,
particularly in comparison to
medication or cognitivebehavioral therapy treatments,
which over time can cost many
thousands of dollars.”
The researchers plan to conduct
another study in a larger number
of patients in an attempt to validate the findings; they also will
assess additional measures of
brain function and structure that
they hope will offer more clues to
determining the long-term course
of symptoms in people being
treated for OCD.
Source: UCLA, Psych Central News
3
Early Psychosis & Young People
The word “psychosis” is used to describe conditions that affect the mind, in which there has been some loss of contact with reality. The terms
“early psychosis” or “first episode psychosis” mean that an individual is experiencing psychosis for the first time. Hallucinations, delusions (false beliefs), paranoia and disorganized thoughts and speech are symptoms of psychosis. Psychotic episodes are periods of time when symptoms of psychosis are strong and interfere with regular life. Although the lengths of these episodes vary from person to person and may only last a few days, psychosis is likely to continue for weeks, months, or even years unless the person is given the proper treatment.
Early warning signs of psychosis include: social withdrawal, reduced concentration, depression/anxiety, sleep disturbance, suspiciousness, and skipping
school or work. These symptoms could be signs of many things, including adolescent behaviour. Early intervention increases the chance of a successful recovery and so it is important to address changes in one‟s thoughts, behaviours, moods and perceptions.
Within a psychotic episode, symptoms are often separated into „positive‟ and „negative‟ categories. Positive refers to symptoms that someone would
not typically experience, and therefore they are something that has been added to the person‟s experience. Negative symptoms are things that are
typical of human functioning but that are absent.
Positive symptoms include delusions (fixed false beliefs) such as the belief that one is being followed or monitored, being plotted against, or has special abilities or powers.
Hallucinations involve seeing, hearing, feeling. Smelling, or tasting something that is not actually there. The most common type of hallucination involves hearing things, such as voices or particular sounds. These hallucinations can seem very real to the person experiencing them.
People with psychosis often have difficulty organizing their thoughts, actions and speech. One may move quickly from one topic to the next, or be
difficult to understand. The person may have trouble performing activities of daily living (cooking, self-care) or display inappropriate behaviours or
responses (laughing while describing a personal tragedy).
Examples of negative symptoms include little display of emotions, difficulties in thinking or developing ideas, lowered levels of motivation, and not
speaking very much.
Approximately 3% of people will experience a psychotic episode at some point in their life. A first episode usually occurs in adolescence or early
adult life. Psychosis occurs across all cultures and levels of socioeconomic status, and affects males and females equally. It can occur as a result of an
illness, medical condition, drug use and stress. Some conditions in which psychosis may be present include the following:
Schizophrenia
Bipolar Disorder
Depression
Brain Injury/Brain Tumor
Thyroid Disorder
There are many theories about what causes psychosis, but no definite answers. Because it occurs in a variety of mental and physical disorders, it
likely has multiple causes. Biology, stress and drug use are widely supported as being contributors to the development of psychosis. There is strong
evidence that psychosis involves a dysfunction in neurotransmitters. Those with a family history of psychosis seem to be at increased risk for developing it. There is some evidence that those who have experienced some types of psychosis have changes in their brain.
Stress, or stressful events, such as divorce, loss of a loved one, giving birth, or a traumatic event, can contribute to the development of psychosis.
The amount of stress that may trigger psychosis differs for each person and likely contributes greater to those that are already vulnerable to developing psychosis.
Psychosis can be induced by drugs or can be drug assisted. For example, it appears that amphetamines can cause a psychotic episode, while other
drugs, including marijuana, can increase a person‟s natural vulnerability to psychosis resulting in a psychotic episode.
Treating psychosis involved education, medication, close monitoring of symptoms, stress management and creating a strong, supportive environment. Education will help the person and their family better understand psychosis and how to recover. Medication can relieve symptoms and is critical in preventing relapse. Many different medications are available to treat psychosis. Stress can worsen a person‟s symptoms and ability to function.
It is important to learn your warning signs and triggers of stress and find ways to manage it, such as exercise, relaxation techniques and hobbies.
Support groups provide a safe place to meet with others who have been through similar circumstances and can offer education and support about
psychosis and the recovery process.
There are many types of talk therapy, and it is important to find a counsellor with whom you can speak openly. Cognitive Behavioural Therapy has
been found to help people understand and manage their thoughts, feelings and behaviours.
The recovery process will vary from person to person in terms of duration and degree of functional improvement. Some recover from their psychosis quickly and are rapidly ready to return to their life and responsibilities. Others need more time to respond to treatment and may need a gradual
return to their former responsibilities. Recovery from a first episode may take months or last several years. To stay well, it is important to set
achievable goals (including strategies for coping with change, staying social, and maintaining regular medical check-ups), participating in positive social,
recreational and work activities, and maintaining a healthy lifestyle (diet, exercise, sleep).
Source: http://www.mooddisorders.ca/faq/early-psychosis-and young-people
4
For women with bipolar disorder, sleep quality
affects mood
Poor sleep is associated with negative mood in women with bipolar disorder, according to researchers at Penn State College
of Medicine and University of Michigan Medical School.
Bipolar disorder is a brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to
-day tasks. The condition is marked by extreme mood episodes characterized as manic (highs), depressive (lows) or mixed.
Sleep problems are common in people with bipolar disorder, and poor sleep quality and bipolar disorder appear to exacerbate
each other. Previous research shows that poor sleep quality is a symptom of depressive and manic episodes, and that lack of
sleep can trigger mania.
"Patients with bipolar disorder often suffer with sleep problems even when many of their other symptoms are wellcontrolled," said Dr. Erika Saunders, chair, department of psychiatry at Penn State College of Medicine. "Improving their sleep
could not only better their quality of life, but also help them avoid mood episodes."
Finding the best treatments for sleep disorders in people with bipolar disorder meant investigating differences between women
and men with the condition.
"Women and men sleep differently," Saunders explained. "We know from studies of the general population that women have a
different type of sleep architecture than men, and they're at different risks for sleep disorders, particularly during the reproductive years."
Women and men also experience bipolar disorder differently. Women often have more persistent and more depressive symptoms, as well as a number of other coexisting conditions such as anxiety, eating disorders and migraine headaches. Men tend
to have shorter episodes and more time in between episodes.
"Because of these factors, we thought the impact that sleep quality might have on mood outcome in bipolar disorder may be
different for men and women," Saunders said.
The researchers analyzed data from 216 participants in the Prechter Longitudinal Study of Bipolar Disorder at the University
of Michigan Medical School. They looked at the effect of sleep quality at the beginning of the study on mood outcome over the
next two years. Mood outcome was measured by the severity, frequency and variability of depressive or manic symptoms.
"Variability meant how much the individuals went up and down in terms of their symptoms," Saunders explained.
For women, poor sleep quality predicted increased severity and frequency of depression and increased severity and variability
of mania. Among men, baseline depression score and a personality trait called neuroticism were stronger predictors of mood
outcome than sleep quality. The research was published in the Journal of Affective Disorders. One unanswered question is
why poor sleep affects women with bipolar disorder more than men. There could be a biological mechanism at work.
"There is some suggestion from animal models that reproductive hormones affect the circadian rhythm system, which is a biological system that affects our need to sleep," Saunders said. "It could be that reproductive hormones are biologically affecting
sleep in women and therefore also affecting mood outcomes. Or, it could have more to do with the type of sleep that women
are getting. We'll have to do more investigation into the biological underpinnings to understand that better."
Even before that question is answered, Saunders says the message is clear: "We feel it's extremely important for clinicians and
patients to recognize that sleep quality is an important factor that needs to be treated in patients with bipolar disorder, particularly in women."
Source: Penn State Milton S. Hershey Medical Center. "For women with bipolar disorder, sleep quality affects mood." ScienceDaily. 30 June 2015
5
Medication may stop drug, alcohol addiction
Researchers at The University of Texas at Austin have
successfully stopped cocaine and alcohol addiction
in experiments using a drug
already approved by the
U.S. Food and Drug Administration (FDA) to treat
high blood pressure. If the
treatment is proven effective in humans, it would be
the first of its kind -- one
that could help prevent
relapses by erasing the unconscious memories that
underlie addiction.
The research is published
this week in the journal
Molecular Psychiatry. Scientists once believed that drug
addiction was simply a
physical craving: Drug addicts who became sober
and then later relapsed
merely lacked willpower.
But that view has gradually
shifted since the 1970s.
Today, most experts acknowledge that environmental cues -- the people,
places, sights and sounds an
addict experiences leading
up to drug use -- are among
the primary triggers of relapses. It was an environmental cue (a ringing bell)
that caused the dogs in Ivan
Pavlov's famous experiments to salivate, even
when they couldn't see or
smell food.
Led by Hitoshi Morikawa,
associate professor of neuroscience at The University
of Texas at Austin, a team
of researchers trained rats
to associate either a black
or white room with the use
of a drug. Subsequently,
when the addicted rats
were offered the choice of
going into either room, they
nearly always chose the
room they associated with
their addiction.
Then one day, the researchers gave the addicted rats a
high dose of an antihypertensive drug called isradipine before the rats made
their choices. Although rats
still preferred the room
they associated with their
addiction on that day, they
no longer showed a preference for it on subsequent
days. In fact, the lack of
preference persisted in the
isradipine-treated group in
ways that couldn't be found
in a control group -- suggesting the addiction
memories were not just
suppressed but had gone
away entirely. "The isradipine erased memories that
led them to associate a certain room with cocaine or
alcohol," said Morikawa.
Addictive drugs are thought
to rewire brain circuits involved in reward learning,
forming powerful memories
of drug-related cues. Antihypertensive drugs all block
a particular type of ion
channel, which is expressed
not only in heart and blood
vessels but also in certain
brain cells.
The researchers found that
blocking these ion channels
in brain cells, using isradipine, appears to reverse the
rewiring that underlies
memories of addictionassociated places.
There are already medica-
tions that have been shown
to prevent people from
feeling euphoria when they
take an addictive drug and
that might prevent them
from developing an addiction. A treatment based on
this latest research, however, would be much more
effective, said Morikawa,
targeting the associations an
addict has with the experience leading up to taking a
drug.
"Addicts show up to the
rehab center already addicted," he said. "Many addicts want to quit, but their
brains are already conditioned. This drug might help
the addicted brain become
de-addicted."
Morikawa noted that because isradipine is already
labeled as safe for human
use by the FDA, clinical
trials could potentially be
carried out much more
quickly than with nonapproved drugs.
One challenge with using
isradipine in high doses to
treat addiction is that it
lowers blood pressure. So
it might be necessary to
pair it with other treatments that prevent blood
pressure from falling too
low.
Source: University of Texas at
Austin. "Medication may stop drug,
alcohol addiction." ScienceDaily.
ScienceDaily, 23 June 2015
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July 2015
Sun
Mon
Tue
Wed
Thu
Fri
Sat
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2 ABI Caregiver
Support Group
3 Walking Group
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GA
CLOSED
Canada Day
7 Mood Disorders
Groups
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GA
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10 Walking Group
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GA
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14 Mood Disorders
Groups
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GA
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17 Walking Group
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GA
20 FSG
21 Mood Disorders
Groups
22 GA
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24 Walking Group
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GA
28 Mood Disorders
Groups
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31 Walking Group
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FSG
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SBG
GA
Schedule of Events
Family Support Group (FSG) Meets the first and third Monday of the month at Ongwanada Resource Centre, (except for stat holidays) 191 Portsmouth
Ave., Kingston from 6:30—8 p.m. Drop-in format, no registration required.
Family Group An open-ended psycho-educational support group for families helping a loved one with addiction issues. A supportive, safe and confidential
setting where you will learn about yourself, your loved one, and addictive behaviour. **Will resume in the fall. Contact Melissa 613-544-1356 x 1210 for further
information.
Mood Disorders Peer Support Groups Meet every Tuesday evening at Ongwanada Resource Centre, 191 Portsmouth Ave., Kingston. Young Adults
group meets from 5:30—7 p.m.; Open Group meets from 7—9 p.m. Drop-in format, no registration needed. Affiliated with Mood Disorder Association of
Ontario (MDAO)
Gamblers Anonymous (GA) Wednesdays at 6:30 p.m. (Closed meeting—attendance restricted only to those who are suffering with a gambling problem)
and Saturdays 10 a.m.—12 p.m. (Open meeting—spouses, friends and family of a compulsive gambler are welcome to attend with the gamblers anonymous
member. 552 Princess St., Kingston. Enter the parking lot from Alfred St. and go in the back door.
Suicide Bereavement Group (SBG) Held the 4th Wednesday of the month at CMHA Kingston, 400 Elliott Ave., Unit 3, Kingston. For further information, please call 613-549-7027 or email [email protected]. Best to confirm time/place of meeting prior to attending.
Path of Recovery Walking Group This is an informal peer-led walking group for people wishing to socialize and exercise. Every walk begins at 41 Church
St., Kingston (off of Yonge St.) at St. John‟s Anglican Church. The group assembles at 10:45 a.m. on Friday, and walk starts at 11 a.m. Weather Permitting. For
more information, Call Keith 613-331-6777.
NAMI Family-to-Family Educational Classes Must be pre-registered to attend. Classes held at 552 Princess Street, Kingston, Wednesday evening,
from 6:30—9 p.m.. Register for next session (Fall 2015) by calling FRC at 613-544-2886 or email [email protected]
ABI Caregiver Support Group This group is open to any adult caregiver of people with Acquired Brain Injury. Meetings are held at the Community Brain
Injury Services office, 303 Bagot St., 4th Floor, Suite 401, La Salle Mews, Kingston. The group will regularly meet on the first Thursday of the month, 3—4:30
p.m.. For more info, call 613-547-6969.
Information about most of these groups can be obtained from the Family Resource Centre, 613-544-2886 or
[email protected]
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