A new study published in BioMedical Engineering has revealed that mental health is closely aligned to blood pressure and heart rate variations. The researchers found that mental illness could cause widely fluctuating blood pressure, which can lead to cardiovascular disease and organ damage.
University of South Australia researcher Dr Renly Lim and colleagues said there is clear evidence that mental illness interferes with the body’s autonomic functions, including blood pressure, heart rate, temperature and breathing.
“We reviewed 12 studies on people with anxiety, depression and panic disorders and found that, regardless of age, mental said is significantly associated with greater blood pressure variations during the day,” Dr Lim says.
“We also found that for people who are mentally ill, their heart rate does not adapt to external stressors as it should.
“Contrary to what many people think, a healthy heart is not one that beats like a metronome. Instead, it should adjust to withstand environmental and psychological challenges. A constantly changing heart rate is actually a sign of good health.”
Reduced heart rate variation (HRV) is common in people with mental illness and indicates that the body’s stress response is poor, exacerbating the negative effects of chronic stress.
Unlike normally consistent heart rates, HRV is more complex and is the time between two heartbeats, which should change according to external stressors.
“What we aim for is not a constantly changing heart rate but a high heart rate variation. This is achieved through a healthy diet, exercise, low stress and good mental health.”
Low HRV occurs during ‘fight-or-flight’ mode, or in those who are easily stressed and is common in people with chronic diseases, including cardiovascular and mental health problems.
While large blood pressure variations (BPV) during the day are not ideal, at night the systolic pressure should dip by between 10–20% to allow the heart to rest. People with mental health issues were found to have an insufficient BP drop at night, dropping less than 10%.
The reduced dipping can be caused by many factors, including autonomic dysfunction, poor quality of sleep and disrupted circadian rhythms that regulate the sleep-wake cycle.
“The takeout from this study is that we need to pay more attention to the physical impacts of mental illness,” Dr Lim said.
“It is a major global burden, affecting between 11–18 per cent (one billion) of people worldwide. Since mental illness can contribute to the deterioration of heart and blood pressure regulation, early therapeutic intervention is essential.”
Advising people to take a week-long social media break could lead to significant improvements in their wellbeing, depression and anxiety and could become a recommended part of maintaining mental health, according to the authors of a study published in Cyberpsychology, Behavior and Social Networking.
University of Bath researchers studied the mental health effects of a week-long social media break. Some participants were able to free up 9 hours a week of time otherwise spent scrolling Instagram, Facebook, Twitter and TikTok.
Their results suggest that just one week off social media improved individuals’ overall level of well-being, as well as reduced symptoms of depression and anxiety.
For the study, the researchers randomly allocated 154 individuals aged 18 to 72 who used social media every day into either an intervention group, where they were asked to stop using all social media for one-week or a control group, where they could continue scrolling as normal. At the beginning of the study, baseline scores for anxiety, depression and wellbeing were taken.
At the start of the study, average time spend on social media was 8 hours per week. After one week, the participants who were asked to take the one-week break had significant improvements in wellbeing, depression, and anxiety than those who continued to use social media, suggesting a short-term benefit.
Participants asked to take a one-week break reported using social media for an average of 21 minutes’ use compared to seven hours for the control group, with screen usage stats used to confirm adherence to the break. Lead researcher from Bath’s Department for Health, Dr Jeff Lambert explained: “Scrolling social media is so ubiquitous that many of us do it almost without thinking from the moment we wake up to when we close our eyes at night.
“We know that social media usage is huge and that there are increasing concerns about its mental health effects, so with this study, we wanted to see whether simply asking people to take a week’s break could yield mental health benefits.
“Many of our participants reported positive effects from being off social media with improved mood and less anxiety overall. This suggests that even just a small break can have an impact.
“Of course, social media is a part of life and for many people, it’s an indispensable part of who they are and how they interact with others. But if you are spending hours each week scrolling and you feel it is negatively impacting you, it could be worth cutting down on your usage to see if it helps.”
The team’s next steps include investigating short breaks in different populations (eg younger people) and to increase follow up time. If benefits persist, they speculate that this could help in mental health management.
Over the past 15 years, social media has undergone explosive growth. In the UK the number of adults using social media increased from 45% in 2011 to 71% in 2021. As many as 97% of 16 to 44-year-olds use social media, with scrolling being most frequent online activity.
Feeling ‘low’ and losing pleasure are core characteristics of depression, whereas anxiety is characterised by excessive and out of control worry. Wellbeing refers to an individual’s level of positive affect, life satisfaction and sense of purpose. According to the UK mental health organisation Mind, one in six people experience a common mental health problem like anxiety and depression in any given week.
A new study has found a bi-directional relationship between gastrointestinal (GI) issues and internalised symptoms such as anxiety in children and adolescents with autism, which means the symptoms seem to be affecting each other. The findings could inform future precision medicine research aimed at developing personalised treatments for people with autism experiencing gastrointestinal issues. The study appears in the Journal of Autism and Developmental Disorders.
Autism is known to be often associated with GI issues, and is often overlooked in children despite being a source of pain and anxiety. Food preferences are often for carbohydrates and processed foods. The most common cause of GI issues in children with autism are abdominal pain, constipation, chronic diarrhea and gastroesophageal reflux disease (GERD).
“Research has shown gastrointestinal issues are associated with an increased stress response as well as aggression and irritability in some children with autism,” said Brad Ferguson, an assistant research professor. “This likely happens because some kids with autism are unable to verbally communicate their gastrointestinal discomfort as well as how they feel in general, which can be extremely frustrating. The goal of our research is to find out what factors are associated with gastrointestinal problems in individuals with autism so we can design treatments to help these individuals feel better.”
In the study, Ferguson and his team analysed health data from more than 620 under-18 patients with autism who experience gastrointestinal issues. Then, the researchers examined the relationship between the GI issues and internalised symptoms. Ferguson explained the findings provide more evidence on the importance of the ‘gut–brain axis’ in GI disorders in individuals with autism.
“Stress signals from the brain can alter the release of neurotransmitters like serotonin and norepinephrine in the gut which control gastrointestinal motility, or the movement of stool through the intestines. Stress also impacts the balance of bacteria living in the gut, called the microbiota, which can alter gastrointestinal functioning,” Ferguson said. “The gut then sends signals back to the brain, and that can, in turn, lead to feelings of anxiety, depression and social withdrawal. The cycle then repeats, so novel treatments addressing signals from both the brain and the gut may provide the most benefit for some kids with gastrointestinal disorders and autism.”
Ferguson is collaborating with David Beversdorf, a neurologist who also studies gastrointestinal problems in individuals with autism. Beversdorf had recently helped identify specific RNA biomarkers linked with gastrointestinal issues in children with autism.
“Interestingly, the study from Beversdorf and colleagues found relationships between microRNA that are related to anxiety behaviour following prolonged stress as well as depression and gastrointestinal disturbance, providing some converging evidence with our behavioural findings,” Ferguson said.
Ferguson and Beversdorf are now together investigating the effects of a stress-reducing medication on GI issues in a clinical trial. Ferguson cautioned that treatment could be effective for certain people with autism but not others.
“Our team uses a biomarker-based approach to find what markers in the body are common in those who respond favourably to certain treatments,” Ferguson said. “Our goal is to eventually develop a quick test that tells us which treatment is likely to work for which subgroups of patients based on their unique biomarker signature, including markers of stress, composition of gut bacteria, genetics, co-occurring psychological disorders, or a combination thereof. This way, we can provide the right treatments to the right patients at the right time.”
Over time, antidepressant use is not associated with significantly better health-related quality of life, compared to people with depression who do not take the drugs, according to a new study reported in PLOS ONE.
Depression disorder is known to have a significant impact on the health-related quality of life (HRQoL) of patients. While studies have shown the efficacy of antidepressant medications for treatment of depression disorder, these medications’ effect on patients’ overall well-being and HRQoL remains controversial.
Researchers used data on adult patients with depression drawn from the 2005-2015 United States’ Medical Expenditures Panel Survey (MEPS), a large longitudinal study that tracks the health services that Americans use. There were 17.47 million adult patients diagnosed with depression each year over the study, with two years of follow-up, and 57.6% of these received treatment with antidepressant medications.
Use of antidepressants was associated with some improvement on the mental component of SF-12 – the survey tracking health-related quality of life. However, when this positive change was compared to the change in group of people who were diagnosed with depressive disorder but did not take antidepressants, there was no statistically significant association of antidepressants with either the physical (p=0.9595) or mental (p=0.6405) component of SF-12. In other words, the change in quality of life seen among those on antidepressants over two years was not significantly different from that seen among those not taking the drugs.
The study was not able to separately analyse any subtypes or varying severities of depression. Future studies should investigate the use of non-pharmacological depression interventions used in combination with antidepressants, said the researchers.
The authors noted that, “Although we still need our patients with depression to continue using their antidepressant medications, long-term studies evaluating the actual impact for pharmacological and non-pharmacological interventions on these patients’ quality of life is needed. With that being said, the role of cognitive and behavioural interventions on the long term-management of depression needs to be further evaluated in an effort to improve the ultimate goal of care for these patients; improving their overall quality of life.”
Maladaptive daydreaming (MD) may be a better diagnosis for some people than ADHD, researchers argue in a paper in the Journal of Clinical Psychology. MD is a condition whereby people slip into involved highly detailed and realistic daydreams that can last hours at the cost of normal functioning – but it is not yet recognised as a psychiatric disorder.
Dr Nirit Soffer-Dudek of the Consciousness and Psychopathology Laboratory in the Department of Psychology at BGU is one of the leadings experts on the condition and wants to have MD added to the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM VI), by promoting rigorous research into this condition.
Explaining the concept of MD, Dr Soffer-Dudek said: “Some individuals who become addicted to their fanciful daydreams experience great difficulty in concentrating and focusing their attention on academic and vocational tasks, yet they find that an ADHD diagnosis and the subsequent treatment plan does not necessarily help them. Formally classifying MD as a mental disorder would enable psychological practitioners to better assist many of their patients.”
Previous studies had found high levels of ADHD in those also presenting with MD, thereby raising the question of whether MD was separate from ADHD. In the current study, the investigators assessed 83 adults diagnosed with ADHD for inattention symptoms, MD, depression, loneliness, and self-esteem. Of those, about 20% met the proposed diagnostic criteria for MD, with significantly higher rates of depression, loneliness, and lowered self-esteem, compared to those with ADHD that did not meet criteria for MD.
“Our findings suggest that there is a subgroup of those diagnosed with ADHD who would benefit more from a diagnosis of MD,” concluded Dr Soffer-Dudek.
University students who put a lot of pressure on themselves to be the best at everything, known as the ‘superhero ideal’, have been hit especially hard by the pandemic. Recent research has shown that by developing authentic and healthy relationships, young people can fight the depressive symptoms associated with this superhero ideal.
The ‘superhero ideal’ was based off the ‘superwoman ideal‘, which is a construct has its origins in the 1960s feminist movement where women could ‘do it all and have it all’. In an article published in Acta Psychologica, Sally A. Theran, associate professor of psychology at Wellesley College and co-author Halina Dour, explain that internalising the superhero ideal is directly related to an increase in depressive symptoms.
“No matter how much we try to deemphasise achievement and success to college-age students and encourage them to work on their own intrinsic motivation and well-being, kids are internalising this message that they feel pressure to achieve,” said A/Prof Theran, who finds in her day-to-day interactions, in addition to her research, that many of her students feel they “have to be superheroes.”
One way for students to combat the effects of the superhero ideal is to cultivate authentic relationships with peers, parents, and educators, according to the study authors They define an authentic relationship as one in which a person feels able to be honest about who they are with someone else. That does not necessarily mean acting the same way around everyone they know – a student will act differently around a teacher than a friend – but rather that in each of those interactions the person feels they are being true to themselves.
To gauge the authenticity of a relationship, A/Prof Theran said, students can ask themselves, “Does this person make me feel good? Do I feel like I can be myself around this person?”
A/Prof Theran and her team found that students who had authentic relationships were able to partially mediate the relationship between the superhero ideal and depressive symptoms. Specifically, the link between superhero ideal and depressive symptoms is in part due to the lack of authenticity in these adolescents’ relationships. The more the superhero ideal was internalised, the less the authenticity there was with parents and peers. Lower levels of authenticity with parents and peers were associated with more depressive symptoms. Thus, authenticity in relationships is part of the mechanism for explaining the significant relation between the superhero ideal and depressive symptoms.
“In college you are more able to have a shift of self,” A/Prof Theran said. “‘Is this who I am? Is this what I want?’ And you may end up having an identity crisis, but that’s really healthy, in order to figure out who you are.” A/Prof Theran particularly sees this in students who have recently started at university. They are often trying to work out what they want to put effort into and care about, rather than going along with what parents and teachers wanted. The way out of such a crisis, according to A/Prof Theran, is for them to find people, like peers, teachers, parents, around whom they can be their true selves. Being honest about their achievements, failures, and even confusion is one way to go about building such authentic relationships.
A/Prof Theran uses this skill in her own classroom, telling her students when she has a paper rejected, for example, or doesn’t get a grant for which she had applied. “If you are not robotic with your students, then they will genuinely be themselves, too,” she said, “and then hopefully they are less likely to feel such superhero pressure in class and in other areas.” A/Prof Theran said that awareness of both the external and internal pressures on students to achieve is especially important now as adolescents consume social media even more in the pandemic, often unfavourably comparing their ‘worst’ selves with someone else’s filtered online self. Parents can help, A/Prof Theran said, by pointing out the use of filters and angles, and reminding them that someone is posting one curated minute of their day, not their whole self. “Encourage your teen to consider, how authentic are people being in their online presentation? And when people espouse authenticity online, it does not mean that they are actually being their true self,” she said. “The very nature of social media encourages internalisation of the superhero ideal while discouraging authenticity, but bolstering authenticity and critical thinking skills can help combat the negative repercussions of the superhero ideal.”
A/Prof Theran has studied authenticity in relationships for 20 years. She recently co-authored a paper on the ways authentic and empowered friendships among female university students can act as a buffer between childhood emotional and physical abuse and subsequent traumatic symptoms while in university. Another paper explored the roles of authentic relationships in adolescents’ prosocial experiences, which are positive aspects of being around peers. In adolescents with low levels of secure attachments, prosocial experiences increased as their level of authenticity with peers increased, A/Prof Theran found.
“The pandemic really made clear how much relationships mean to us,” said A/Prof Theran. “We feel empowered by our friendships. Reaching out and connecting with others can improve our well-being so much.”
A recent analysis of published research found that more than half (59%) of cancer survivors and patients experience at least a moderate level of fear of cancer recurrence and that about one in five (19%) have a high level of fear. The findings, published in Psycho-Oncology, show women and younger people in particular have more fear of recurrence.
Cancer prevalence is increasing due to ageing populations, and more people are surviving cancer thanks to improved treatments. Managing fear of cancer recurrence (FCR) has been reported as one of the most important unmet needs for this growing group. FCR is defined as “fear, worry, or concern relating to the possibility that cancer will come back or progress”. Low levels of FCR can be helpful by promoting treatment compliance and healthy lifestyle adaptations. However, at clinical levels, FCR can limit quality of life and daily functioning and require professional help. Four features have been defined as key characteristics of clinical FCR: “(a) high levels of preoccupation; (b) high levels of worry; (c) that are persistent; and (d) hypervigilance to bodily symptoms”. It is important to address FCR, because FCR may also lead to increased healthcare costs14 and for most patients, it does not decrease over time without intervention.
The analysis, which is included 46 studies from 13 countries. Investigators found similar fear of cancer recurrence rates in survivors and patients. On average, younger people and women experienced more fear of cancer recurrence.
Additional research is needed to not only identify which patients desire support to address their fear of cancer recurrence but also to determine how to tailor interventions to different levels of fear and to individual needs and preferences.
“Knowing the prevalence and severity of fear of cancer recurrence for the general cancer population and for different subgroups is an important development, because it is essential for shaping healthcare provision, policy, and research on fear of cancer recurrence,” said lead author Yvonne Luigjes-Huizer, a PhD candidate at the Helen Dowling Institute and the University Medical Centre Utrecht, in the Netherlands.
Girls and boys might be more vulnerable to the negative effects of social media use at different times during their adolescence, according to a study in Nature Communications. Girls were found to experience a negative link between social media use and life satisfaction when they are 11–13 years old and boys when they are 14–15 years old. Increased social media use again predicts lower life satisfaction at age 19 years. At other times the link was not statistically significant.
Since its rapid emergence over a decade ago, social media has prompted concern over its possible impacts on wellbeing, especially in younger people.
A team of researchers analysed two UK datasets which included longitudinal data on 17 400 young people aged 10–21 years old. The team looked for a connection between estimated social media use and reported life satisfaction and found key periods of adolescence where social media use was associated with a decrease in life satisfaction 12 months later. Working backwards, the researchers also found that teens who have lower than average life satisfaction use more social media one year later.
In girls, social media use between ages 11 and 13 was associated with a drop in life satisfaction one year later, whereas in boys this occurred between 14 and 15. This suggests that sensitivity to social media use could be linked to developmental changes, possibly changes in the structure of the brain, or to puberty, which occurs later in boys than in girls.
In both females and males, social media use at the age of 19 years was again associated with a decrease in life satisfaction a year later. The researchers suggest that that social changes at this age, such as leaving home, may make people particularly vulnerable.
At other times, the link between social media use and life satisfaction one year later was not statistically significant. Decreases in life satisfaction also predicted increases in social media use one year later; however this does not change across age and or differ between the sexes.
Dr. Amy Orben, the study leader, said: “The link between social media use and mental wellbeing is clearly very complex. Changes within our bodies, such as brain development and puberty, and in our social circumstances appear to make us vulnerable at particular times of our lives.”
Professor Sarah-Jayne Blakemore, a co-author of the study, said: “It’s not possible to pinpoint the precise processes that underlie this vulnerability. Adolescence is a time of cognitive, biological and social change, all of which are intertwined, making it difficult to disentangle one factor from another. For example, it is not yet clear what might be due to developmental changes in hormones or the brain and what might be down to how an individual interacts with their peers.”
Dr. Orben added: “With our findings, rather than debating whether or not the link exists, we can now focus on the periods of our adolescence where we now know we might be most at risk and use this as a springboard to explore some of the really interesting questions.”
A further complication is that social media use can negatively impact wellbeing, but also the reverse is true, previously reported and confirmed by this study.
The researchers stress that these population-level findings do not predict which individuals are most vulnerable.
Professor Rogier Kievit said: “Our statistical modeling examines averages. This means not every young person is going to experience a negative impact on their wellbeing from social media use. For some, it will often have a positive impact. Some might use social media to connect with friends, or cope with a certain problem or because they don’t have anyone to talk to about a particular problem or how they feel—for these individuals, social media can provide valuable support.”
Professor Andrew Przybylski said: “To pinpoint which individuals might be influenced by social media, more research is needed that combines objective behavioural data with biological and cognitive measurements of development. We therefore call on social media companies and other online platforms to do more to share their data with independent scientists, and, if they are unwilling, for governments to show they are serious about tackling online harms by introducing legislation to compel these companies to be more open.”
Researchers have identified the fast-acting dissociative anaesthetic ketamine has significant potential as a treatment for mental health conditions. First manufactured more than 50 years ago, ketamine is often used in veterinary and emergency medicine. It also has a history of being an illicit party drug.
In a recent study published in the British Journal of Psychiatry, the research team found ketamine to have significant anti-depressant and anti-suicidal effects. They also found evidence that even more benefits.
Led by Psychology Professor Dr Zach Walsh and doctoral student Joey Rootman, the research team arrived at this conclusion after analysing more than 150 worldwide studies on the effects of sub-anaesthetic ketamine doses for the treatment of mental illness.
“We found strong evidence that indicates ketamine provides rapid and robust anti-depressant and anti-suicidal effects, but the effects were relatively short-lived,” explained Rootman. “However, repeated dosing appeared to have the potential to increase the duration of positive effects.”
The study also provides limited evidence to suggest a possible use for ketamine in the treatment of other disorders, such as eating disorders, problematic substance use, post-traumatic stress and anxiety.
“What our research provides is an up-to-date overview and synthesis of where the knowledge on ketamine is at right now,” said Rootman. “Our results signal that ketamine may indeed have a broader spectrum of potential applications in psychiatric treatment—and that tells us that more investigation is needed.”
This study serves as a foundation for fellow researchers looking to design ketamine-related projects and offers valuable data for clinicians considering using ketamine with their patients.
The results also help to satisfy the public’s appetite for information on innovative and emerging psychiatric treatments, said Dr Walsh, explaining that the review provides a relatively compact document with evidence regarding which ketamine treatments may be helpful for diverse diagnoses.
With many people experiencing mental health disorders, Dr Walsh said that “the reality is that existing treatments don’t work for everyone. As a result, many Canadians are curious about new approaches to help with these serious conditions.”
Overall, while Dr Walsh acknowledges research into other treatment areas is just beginning, he finds the preliminary evidence encouraging.
“We need a lot more information on how these interventions could work – for example, administering the drug is only a part of treatment. We need to figure out what amount and type of psychotherapy would best compliment the drug intervention to really maximise potential benefits,” he explained. “With that being said, it is a truly exciting time for ketamine research. If it can deliver the relief that early evidence suggests it can, this could be among the most significant developments in mental health treatment in decades.”
As the US state of Oregon becomes the first to permit psilocybin in clinical use, a new systematic evidence review reveals a lack of scientific research describing the interactions between widely used psychiatric medications and psychedelics like psilocybin and MDMA. The review was published in the journal Psychopharmacology.
The scarcity of data is problematic for people believed to benefit most from psychedelics: those with mental health conditions such as depression, anxiety and post-traumatic stress disorder.
“There’s a huge deficit in the scientific literature,” said lead author Aryan Sarparast, MD, assistant professor of psychiatry at the Oregon Health and Science University. “There’s a major incongruence between the public enthusiasm and exuberance with psychedelic substances for mental health issues – and what happens when they combine with the existing mental health treatments that we have now.”
The researchers decided to conduct the evidence review because they wanted to learn more about interactions between widely prescribed medications such as antidepressants and psychedelics, including MDMA and psilocybin.
They found a total of 40 studies dating back to 1958, including 26 from randomised controlled studies, 11 case reports and three epidemiologic studies.
Only one study was found that examined how psilocybin interacts with antidepressant medications. A/Prof Sarparast also noted that all of the clinical trials were conducted with healthy volunteers who were administered a psychiatric medication and a psychedelic at the same time – clearly showing a need for further research into combining pharmaceutical medications with psilocybin.
A/Prof Sarparast said he is concerned that the lack of evidence will lead many providers to direct patients to taper off existing medications before being offered clinical psilocybin therapy. In Oregon rules are being drawn up to permit the clinical use of psilocybin products and services from next year.
Patients with mental health conditions might well benefit from psilocybin therapy, but A/Prof Sarparast said he is concerned about the implications of stopping existing psychiatric treatment in order to receive psilocybin services. Vulnerable people may end up being forced into choosing between their existing medical treatment or psilocybin services.
“That’s a very, very tough place to be,” A/Prof Sarparast said.
A considerable amount of important data exists that is not captured in a literature review related to real-world use, noted co-author Christopher Stauffer, MD, assistant professor of psychiatry in the OHSU School of Medicine and a physician-scientist at the VA Portland Health Care System.
“Psilocybin has been around in Western society since the late 1950s, before many of our psychiatric medications have existed,” A/Prof Stauffer said. “Nonetheless, people attempting to navigate Oregon’s psilocybin services in the context of ongoing psychiatric treatment should work closely with knowledgeable professionals.”
