Stress, depression and 'hostility' put older people at greater risk of suffering a stroke, research has revealed

• Depression and stress associated with 'significantly increased risk' of stroke
• Factors could increase the risk for older people and middle-aged adults
• 'Hostility' can more than double the likelihood of having a stroke, say experts
• The research was carried out at the University of Minnesota in the U.S.

Stress, hostility and depression put older people at much greater risk of suffering a stroke, a new study has warned. 

The three factors are associated with a 'significantly increased risk' of stroke in middle-age and older adults, researchers have found. 

Hostility alone more than doubled the likelihood of having a full-blown or 'mini' stroke, also known as a transient ischaemic attack (TIA), a study claims.

Chronic stress increased stroke and TIA risk by 59 per cent, and depressive symptoms by 86 per cent.

Scientists used questionnaires to assess chronic stress, depressive symptoms, anger and hostility in 6,700 men and women aged 45 to 84.

Over a period of eight-and-a-half to 11 years, a total of 147 strokes and 48 TIAs occurred within the group.

The only trait not linked to a higher risk of stroke was anger, despite the strong association with hostility.

The researchers defined hostility as a 'negative way of viewing the world' and measured it by assessing participants’ cynicism.

Study leader Dr Susan Everson-Rose, from the University of Minnesota in the U.S., said: 'There’s such a focus on traditional risk factors - cholesterol levels, blood pressure, smoking and so forth - and those are all very important, but studies like this one show that psychological characteristics are equally important.

'Given our ageing population, it’s important to consider these other factors that might play a role in disease risk.

Older people are more likely to have a stroke if they are suffering from depression or stress, research has found.

'Stroke is a disease of the elderly predominantly, and so learning more about things that can influence risk for stroke as people age is important.'

The findings are published in the American Heart Association journal Stroke.

Chronic stress was measured in five different areas relating to personal health, the health problems of close others, work or the ability to do a job, relationships and finances.

Scientists used questionnaires to assess chronic stress, depressive symptoms, anger and hostility in 6,700 men and women aged 45 to 84

Based on participants’ answers, scores were allocated for depressive symptoms and anger levels.

The associations remained significant after accounting for age, race, sex, lifestyle and other factors known to influence stroke risk.

Dr Everson-Rose added: 'One thing we didn’t assess is coping strategies.

'If someone is experiencing depressive symptoms or feeling a lot of stress or hostility, we don’t know how they manage those, so it’s possible that positive coping strategies could ameliorate some of these associations or effects.

'We did not inquire about coping. I would say that’s one of the tasks for future studies.'

http://www.dailymail.co.uk/health/article-2687748/Stress-depression-hostility-older-people-greater-risk-suffering-stroke-research-revealed.html

What are the signs of postnatal depression?

Can staying awake all night help combat depression?

Staying awake for more than 24 hours may be the fastest treatment for moderate to major depression. 

Early research has shown six out of ten patients can get symptom relief within a day of this treatment, compared with the six to eight weeks it can take antidepressants to work. 

Sleep deprivation is thought to work by boosting brain messengers such as serotonin - the same one that antidepressants act on.

Several studies have found 40 to 60 per cent of patients are helped by staying awake for a long time. One researcher described it as 'a remarkable transformation of often deeply depressed, psychotic, suicidal patients in a few hours into their pre-illness selves'.

However, the improvement is short-lived, disappearing after the patient slept.

Now researchers at the Medical University of South Carolina and Rhode Island Hospital are looking at providing longer relief by combining sleep deprivation with two other therapies. Pilot studies have shown that the effects of this treatment, known as triple chronotherapy, are rapid and are long-lasting - nine weeks in one trial.

The U.S. researchers will test the treatment in a larger study involving 80 patients with moderate to severe depression, postnatal depression or bipolar disorder.

Current treatments range from exercise and self-help groups to antidepressants. But medication doesn't work for everyone and some reports suggest it is no better than a placebo. It can also take two months for its effects to kick in.

The triple chronotherapy treatment, which is conducted over three days, combines sleep deprivation with 'bright light therapy' - where patients  are exposed to a special lamp for up to an hour - and 'sleep-phase advancement' - when waking and sleeping times are changed.

The theory is that sleep deprivation has an anti-depressive effect; the bright light and sleep time changes then help reset the body clock, in turn helping the anti-depressive effect of sleep deprivation last longer.  On day one, patients stay awake from 10.30pm, through the night and the whole of the next day. They then sleep from 6pm to 1am the following morning when the process is repeated, but sleeping and waking at different times. 

Bright light therapy is given in the early morning of each of the three days - light is thought to stimulate the brain's hypothalamus, which controls mood, sleep and appetite, and to boost brain chemicals such as melatonin and serotonin. 

On the second day, the patient sleeps from 8pm to 3am; on the last day, sleep starts at 10pm and finishes at 5am. From then on, patients continue with this 10pm to 5am sleep pattern.

Bright light and sleep time changes help reset the body clock, in turn helping anti-depressive effect last

A previous study at the University of California found significant improvements remained in 63 per cent of depressed patients seven weeks later.

New research at Tufts University has shed some light on what might be happening. It identified a protein called adenosine which is released when you're awake. Sleep deprivation increases levels of adenosine, which alters electrical signals in the brain, causing immediate improvement in mood.

'Triple chronotherapy typically reduces depressive symptoms within one to two days,' says psychiatrist Dr John Gottlieb, of Northwestern University Feinberg School of Medicine in Chicago and a leading expert in chronotherapy. 'It's as biologically active as antidepressants, inexpensive and has minimal side-effects.'

Carmine Pariante, professor of biological psychiatry at the Institute of Psychiatry, King's College London, adds: 'By putting sleep deprivation with other sleep-related therapies that have shown some effectiveness in depression, there is a reasonable expectation the antidepressant action will be stronger and more sustained. 

'If this proves true, it will be an important step forward, both to understand mechanisms that cause depression and to find a new treatment for the one in four patients who don't improve with available treatments.'

http://www.dailymail.co.uk/health/article-2683791/Can-staying-awake-night-help-combat-depression.html

This Morning - Postnatal Depression

Mothers with postnatal depression 'failed by the NHS'

A parenting charity found only three per cent of clinical commissioning groups provided new mothers with mental health support

The National Childbirth Trust found a disturbing number of situations where there is no care or very little care for mothers with post-natal depression

Mothers with postnatal depression are being failed by the NHS because only 3 per cent of health organisations offer help with the condition.

The figures from the National Childbirth Trust (NCT) found 97 per cent of clinical commissioning groups (CCGs) had no mental health strategy for new mothers and 60 per cent said they did not have plans to put one in place.

The parenting charity sent freedom of information (FOI) requests to 194 CCGs, of which 15 per cent directed the parenting charity to local NHS trusts or NHS England. The NCT said this suggested a lack of clarity regarding who is responsible for commissioning and providing services across England.

The charity called for more staff and resources “urgently” to tackle the “huge gaps” in support and care provided to mothers experiencing postnatal depression.

NCT chief executive Belinda Phipps said: "One in ten mothers experience some form of postnatal depression, but there are clearly huge gaps in the support and care being provided to them across England.

"While we found some areas with excellent care, too often we have found situations where there is no care, or very little care. If there are whole areas where GPs, midwives and health visitors have no training or time to dedicate to this vital service then women will not get the help and support they need.

"For many parents this will result in months of misery, damaging both family relations and children's wellbeing. And, in the most extreme circumstances, it will result in tragedy and loss of life.

"We need to see properly staffed and resourced services with clear lines of responsibility and clear targets for delivery. And we need to see that happening urgently. "

The charity also contacted NHS trusts to ask if they were able to provide a perinatal mental health service with trained specialists.

Of the 193 contacted, only 26 per cent of the trusts provided a dedicated service while just 13 per cent had a full team in place.

54 per cent said they did not provide mothers with the service, but 33 trusts did not respond to the FOI request.

The charity found only 14 per cent of trusts are employing one specialist perinatal mental health midwife or doctor, usually on a part-time basis.

NCT is a member of the Maternal Mental Health Alliance (MMHA), a coalition of organisations committed to improving the mental health and wellbeing of women and their children in pregnancy and the first postnatal year.

The MMHA will launch the campaign #everyonesbusiness to highlight the gaps in provision of maternal mental health services on Tuesday.

http://www.telegraph.co.uk/women/womens-health/10949383/Mothers-with-postnatal-depression-failed-by-the-NHS.html

My Social Anxiety Story: Living it and Overcoming it

Social Anxiety

Feeling nervous before a presentation or in some social settings can be normal. But in social anxiety, everyday interactions can cause irrational fear and can hinder you from moving forward. According to Wikipedia, “Social anxiety is a discomfort or a fear when a person is in social interactions that involve a concern about being judged or evaluated by others. It is typically characterized by an intense fear of what others are thinking about them (specifically fear of embarrassment, criticism, or rejection), which results in the individual feeling insecure, not good enough for other people, and/or the assumption that peers will automatically reject them.” Social anxiety can cause impairment with your social interactions and can affect your emotions and behavior. Symptoms, causes and treatment for social anxiety are listed below: What are the Symptoms:

1) Difficulty talking

2) Avoiding social interactions, speeches, presentations

3) Fear that you will look anxious in front of others

4) Fear that you will embarrass yourself in front of others when speaking

5) Sweating

6) Heart palpitations

7) Shaking

8) Avoid being the center of attention

9) Diarrhea

10) Cold hands

11) Nausea

12) Stomach upset

Some anxiety is normal and healthy for humans. It helps our bodies and minds to take action in dangerous situation. We all feel anxious from time to time. Severe anxiety, especially social anxiety, becomes a problem when it causes major problems in our overall daily functioning. When you have social anxiety, you  are worried that you will develop some of the symptoms above and avoid situations that may trigger your symptoms. Feelings of shyness or feeling uncomfortable in situations does not mean that you have social anxiety. Comfort levels are different from person to person due to personality or experience. When you have social anxiety, the symptoms are more severe than shyness or nervousness and it causes you to avoid social situations. There are two subtypes of social phobia or social anxiety:

• Generalized: A person feels judgement and avoids social interactions
• Non-generalized: A person is not severely anxious unless they are in certain types of social situations.

What Causes Social Anxiety?

It is likely that social anxiety causes are a combination of factors. Below is a list of those factors that may cause social anxiety:

• Life Experiences: If we are put in situations where we feel different and are singled out in a negative way, we can develop beliefs about ourselves that are consistent with social anxiety. As these experiences continue, we pay attention to those parts of our environment and reinforce our negative beliefs.As these beliefs get strengthened, we tend to act, think and behave in a way that is consistent with social anxiety.
• Our Brains: “Several studies (such as that of Blair et al., 2008) have found that certain areas of the brain, such as a small, almond-shaped area called the amygdala, can be more active in individuals with social phobia.”
• Genes:A moderate level of heritability suggests a tendency towards anxiety.

What Treatment Options Do I Have?

Social anxiety disorder can be treated. The success of the treatment is different for everyone and is individualized. Therapy and medication have been effective. Cognitive behavior therapy, CBT, is a well known and effective type of therapy. It helps you ti identify, understand and challenge your thinking and behavior. The client is actively involved in this therapy and feels more in control in their treatment and recovery. Exposure therapy is a type of CBT where a person is gradually exposed to the feared situation where they learn to become less sensitive. Medication can be used in conjunction with therapy and can be short term or long term treatment options. It is best to speak with your physician or psychiatrist to see which medication would be the best approach for you in your treatment. Of course, support is important for your recovery. Finding a support group or therapist specializing in social anxiety can help to reduce the symptoms of social anxiety.

http://blogs.psychcentral.com/mental-health-awareness/2014/06/social-anxiety/