Lifeline Anxiety Disorder Newsletter

Non-prescribed use of pain relievers precipitates anxiety disorders

A study published in the Journal of Psychological Medicine investigates the association between anxiety and mood disorders and non-prescription – i.e. use without a prescription or taking more than what is prescribed – of such prescription opioids as ocytocin. Opioids are highly addictive and create neurological changes and physiological dependence when over-used. Prescription opioids are currently second only to marijuana in terms of illegal drug usage in the U.S.

The researchers – from Johns Hopkins Bloomberg School of Public Health – used data from the National Epidemiologic Study on Alcohol and Related Conditions, an in-person survey of individuals aged 18 years and older during 2001 to 2002 and 2004 to 2005, to assess study participants for a history of psychiatric disorders. They found that lifetime use of non-medical prescription opioids correlated with a high lifetime risk of anxiety and mood disorders, including panic disorder, bi-polar disorder and major depressive disorder. Non-medical opioid-use disorder due to non-medical prescription use of opioids also proved to co-occur with anxiety and mood disorders.

An increased risk of opioid disorder due to non-medical use was also seen in study participants with pre-diagnosed mood disorders, major depressive disorder, dysthymia and panic disorder. This demonstrates the possibility that these participants were using opioids to alleviate their symptoms. The researchers stress the need for early identification and treatment of mood and anxiety disorders to offset the risk of self-medication with prescription opioids and the risk it leading to future development of opioid-use disorder.

Whether the co-occurrence of non-prescription use of opioids and anxiety and mood disorders is due to genetic or environmental risk factors is not known and needs to be studied so that the risk levels of those vulnerable to anxiety and mood disorders can be documented whether their use of opioids is prescribed or not. In view of the increased use of non-medical prescription drugs today, especially among adolescents, the association between opioid use and anxiety and mood disorders gives reason for great concern over the possible future development of anxiety and mood disorders among such opioid users.

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Genetic marker found to predict child’s response to cognitive behaviour therapy

The genetic marker, Serotonin Transporter Promoter Polymorphism (5HTPP), has been demonstrated by Research funded by the Medical Research Council (MRC) in the UK, to have the capacity to predict when a child suffering from anxiety disorder will benefit from cognitive behaviour therapy (CBT).

There are two forms of the 5HTTP gene - a short form and a long form. The short form has been shown in previous studies to predict which individuals are likely to be prone to depression when under stress and, more recently, it has been proposed that the short form influences how individuals respond to their environment. DNA was collected by researchers at the Institute of Psychiatry at King’s College London from 359 children diagnosed with anxiety disorder. The children found to have a shorter version of the 5HTPP genetic marker were 20 per cent more likely to respond to CBT and to be free of their anxiety six months after the end of the treatment. Having a short form of the gene can contribute to a child feeling more negative when things are stressful but on the other side of the equation, they are more responsive to the positive messages taught in CBT.

 

Omega-3 fatty acids essential to reducing anxiety in more ways than one

Higher levels of Omega-6 fatty acids are associated with increased anxiety in older adults, while Omega-3 fatty acids are known to reduce the symptoms of anxiety.

A newly published King's College London, UK, study, which included 130 participants aged 60 to 86 years of age, from outpatient psychiatric services of four hospitals, concludes that the higher levels of Omega-6 are associated with higher residual depression and anxiety.

In contrast, a 12 week, double-blind study that included 68 healthy young medical students by National Center for Complementary and Alternative Medicine of the US National Institutes of Health suggests that not only does a daily diet of Omega-3 fatty acids reduce anxiety symptoms in young and healthy individuals, but also reduces depressive symptoms in clinically depressed people. A study from the National Institute on Alcohol Abuse and Alcoholism of National Institutes of Health and the Uniformed Services University of the Health Sciences recommends 2 grams of Omega-3 fatty acids per day to reduce depression and anxiety scores among active service members with recurrent self-harm tendency.

Omega-3 and Omega-6 are Essential Polyunsaturated Fatty Acids obtained only through diet and are an important part of all cellular membranes. Omega-6 is found in most food, but Omega-3 can only be attained from leafy green vegetables and cold-water fish which is often scarce in the diet of many people. This scarcity tends to result in it being substituted with more readily available Omega-6 and it is this that causes the association with the higher anxiety and depression levels shown in the King's College study. High levels of Omega-6 actually demonstrate that there is a deficiency of Omega-3 in the diet and can only be reduced through higher dietary intake of Omega-3. Supplements are available if foods high in Omega-3 are not available.

Social phobia not necessarily related to shyness

An examination of shyness and social phobia rates among more than 10,000 teens aged 13 to 18 taking part in a national survey in the U.S., demonstrates that social phobia is not simply shyness that has been inappropriately medicalized as so many detractors claim.

Researchers from the U.S. National Institute of Mental Health found that about half of the teens said they were shy, 12 percent of these self-reported shy teens, and about 5 percent of those who said they weren't shy, had met the criteria for social phobia during their lifetime. These findings indicate that shyness and social phobia are not necessarily related. The teens with social phobia proved more likely than other teens to also have another psychiatric disorder in their lifetime, for instance depression or drug use. They also had higher levels of impairment in relating to family and to peers at school or work, but were not more likely than shy teens to be receiving professional treatment. While teens with social phobia were no more likely than shy teens to be taking prescription psychiatric medication, the rates of prescribed drugs were low for both shy teens and those with social phobia, paroxetine being taken by only 2.3 percent of teens with social phobia and 0.9 percent of shy teens. A National Institutes of Mental Health news release on the study says, "...social phobia affects a minority of youth and only a fraction of those who consider themselves to be shy. In addition, despite the greater disability that youth with social phobia experience and the greater likelihood that they will have another disorder, they are not more likely to be getting treatment compared to their peers, questioning the notion that these youth are being unnecessarily medicated." Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, responded to news of the study with, "Social phobia can be limited to only one type of situation -- such as a fear of speaking in formal or informal situations, or eating or drinking in front of others -- or, in its most severe form, may be so broad that a person experiences symptoms almost any time they are around other people. People with social phobia have a persistent, intense and chronic fear of being watched and judged by others and being embarrassed or humiliated by their own actions. The importance of identifying and treating those adolescents with social anxiety disorder is important as they have higher levels of impairment in multiple domains, including school/work ability, social life and family relationships."

The study has now been widely reported, appearing online prior to being published in the journal Pediatrics. While easier to explain than it used to be because, ironically, of the hyping of medication by the pharmaceutical industry, it is still often difficult to make people understand that the social phobia is a 'real' disorder.

 

Women with PTSD risk inflammatory disease

Researchers at the University of California San Francisco have discovered that post-traumatic stress (PTSD) can lead to a dangerous increase in the immune response in women, triggering inflammation and leading to such conditions as cardiovascular disease and arthritis. Blood was taken from 67 people, 34 of whom had PTSD and 33 serving as a control group. There was no evidence of increased immune activation among the men in the test but the PTSD women showed significant evidence of immune activation compared to the women without the disorder. This is the first evidence that men and women respond differently.

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Postpartum depression presents high risk of anxiety disorders for children

Studies have shown that the children of depressed mothers are at increased risk of developing anxiety and conduct disorders. A well-functioning oxytocin system may lessen the risk.

Postpartum depression affects up to 15% of women but often goes undiagnosed and has long-term effects on the social and emotional development of their children. Researchers at the Ban-Ilan University, Ramat Gan, Israel found that children exposed to chronic maternal depression through the first 5 years of their life were more likely to develop a psychiatric disorder by the time they reached school age. The mental health status, oxytocin levels, genetic variation in oxytocin receptors and social interactions were studied in 155 mother-child pairs. Approximately 50 of the mothers had been depressed on and off throughout the child's early life and about 60% of these children developed either an anxiety disorder or a conduct disorder by the time they reached school age compared to only 15% of the children of mentally healthy mothers. The depressed mothers and their children also proved to have lower levels of oxytocin in their saliva and were 3 times more likely than their healthy counterparts to have the variant on the oxytocin receptor known to confer a risk of depression.

The oxytocin system supports the capacity to form social affiliations and close bonds, to trust and to feel empathy. The study included videotaping family interactions which demonstrated that children of depressed mothers were less socially engaged, more withdrawn, did not have the skills interact socially within their families and had lower levels of empathy with the pain and distress of strangers. The children of depressed mothers who did not have the variant showed better social and emotional development. This research indicates the need for treatment options for postpartum depression to help the children to develop stronger oxytocin systems. Touch, close contact and eye gazing can all trigger the oxytocin system.