Mouse Study Provides New Understanding of OCD

-Rick Nauert, PhD

New research on genetically altered mice suggests the overactivity of a brain transmitter may be the source of neurodevelopmental diseases and behavioral and thought disorders.

Duke University researchers discovered a single type of receptor for the neurotransmitter glutamate in the brain is responsible for a range of symptoms in mice that are reminiscent of obsessive-compulsive disorder (OCD).

The findings provide a new mechanistic understanding of OCD and other psychiatric disorders and suggest that they are highly amenable to treatment using a class of drugs that has already been investigated in clinical trials.

“These new findings are enormously hopeful for considering how to approach neurodevelopmental diseases and behavioral and thought disorders,” said the study’s senior investigator, Nicole Calakos, M.D., Ph.D., an associate professor of neurology and neurobiology at the Duke University Medical Center.

The study appears online in the journal Biological Psychiatry.

OCD, which affects 3.3 million people in the United States, is an anxiety disorder characterized by intrusive, obsessive thoughts, and repeated compulsive behaviors that collectively interfere with a person’s ability to function in daily life.

In 2007, Duke researchers created a new mouse model of OCD by deleting a gene that codes for Sapap3, a protein that helps organize the connections between neurons so that the cells can communicate. Similar to the way some people with OCD wash their hands excessively, the Sapap3-lacking mouse grooms itself excessively and shows signs of anxiety.

Although researchers praised the new model for its remarkable similarity to a human psychiatric disorder, and have begun using it to study OCD, questions remain about how the loss of the Sapap3 gene leads to the grooming behaviors.

In the new study, Calakos’s team found that overactivity of a single type of receptor for neurotransmitters — mGluR5, found in a brain region involved in compulsive behaviors — was the major driver for the abnormal behaviors.

When researchers gave Sapap3-lacking mice a chemical that blocks mGluR5, the grooming and anxiety behaviors abated.

“The reversibility of the symptoms was immediate, on a minute time frame,” Calakos said. In contrast, the original study describing Sapap3-lacking mice found that antidepressants could help treat symptoms but on the time scale of weeks, as is typical with these drugs in patients.

The immediate effects seen in the new study were also surprising, given that the brains of these mice appear developmentally immature and neurodevelopmental diseases are not typically thought of as being easily reversible, Calakos said.

Intriguingly, by taking normal laboratory mice and giving them a drug that boosted mGluR5 activity, Calakos’s team could instantaneously recreate the same excessive grooming and anxiety behaviors they saw in the Sapap3-lacking mice.

The researchers found that without a functioning Sapap3 protein, the mGluR5 receptor is always on. That, in turn, makes the brain regions involved in compulsion overactive.

In particular, a group of neurons that give the “green light” for an action, like face-washing, is working overtime. (These same neurons can promote a habit, such as eating sweets, according to a study published by Calakos’s team earlier this year.)

Calakos said that mGluR5 should be considered for the treatment of compulsive behaviors. “But which people and which compulsive behaviors? We don’t know yet,” she added.

Other lines of research have explored targeting mGluR5 with drugs to move its activity up or down in the brain. For example, mGluR5-blockers are being considered for the treatment of Parkinson’s disease. But because mGluR5 inhibitors have not always panned out in clinical trials, it may make sense to target different parts of the mGluR5 pathway or identify specific patient subsets, Calakos said.

Source: Duke University/EurekAlert

Perception of Physical Attractiveness Influenced by Relationship Status

-Rick Nauert, PhD

New research suggests opposites do attract, that is, unless you are in a relationship.

Specifically, if you are in a relationship you are more likely to be attracted to faces resembling your own, but for single people, opposites attract.

In the study, Dr Jitka Lindová of Charles University in the Czech Republic and her team showed a series of photographs of faces to university students and asked them to rate their attractiveness.

The photographs were digitally manipulated so that the resemblance to the student was modified.

Images were of an individual of the opposite sex, whose face had been manipulated to look either more or less similar to the student. They were also presented with images of a same-sex individual manipulated in the same way.

“We found that single participants, those not in relationships, rate dissimilar faces as more attractive and sexy than self-resembling faces;” stated Lindová.

This was observed when participants rated both same-sex and opposite-sex faces.

“For the first time, we have observed how our partnership status affects who we find attractive” she added.

When in a relationship, the preference for someone who has some resemblance to us, may stem from a variety of motives.

“Our interpretation is that attractiveness perception mechanisms that give us a preference for a genetically suitable partner may be suppressed during romantic relationships,” explained Lindová.

“This might be a relationship maintenance strategy to prevent us from finding alternatives to our own partner, or perhaps self-resemblance becomes more important in terms of the social support we expect receive from relatives, which are known as kinship cues.”

Little research has been carried out about how our perceptions change when we enter a relationship. These findings have important sociological and biological implications that require further study.

In addition, Lindová pointed out that this work may be of interest to the applied psychological sciences.

“For example, as those not in a relationship were not influenced by kinship cues our findings might help to explain social phenomena such as parent and adolescent disaffection;” she said.

Patient’s Self-Rating of Health May Beat Medical Tests

-Janice Wood

A new study shows that patients’ self-rated health is a better long-term predictor of illness and death than standard blood tests, blood pressure measurements, or other symptomatic evidence a doctor might gather.

A research team led by Dr. Christopher Fagundes, a Rice University assistant professor of psychology, and postdoctoral researcher Dr. Kyle Murdock found evidence to bolster the theory that self-rated health — what you’d say when a doctor asks how you feel your health is in general — is as good as and perhaps even better than any test to describe one’s physiological condition.

“A couple of years ago there was a boom of work in psychology and medicine about what we call patient-reported outcomes, the idea that what patients actually feel like and say they feel like seems to be more prognostic of morbidity and mortality than all the cholesterol ratings and blood tests we get from doctors’ offices,” Fagundes said.

“That was an odd finding. You would think that objective markers like blood pressure would be more accurate. The way people generally report how they feel is more often linked to a future disease or mortality than what the doctor accesses. As psychologists, we think, ‘They’re sensing something. There’s something going on here.’ That’s what took us to this paper.”

The researchers set out to find evidence that would connect the dots between feelings and fate. They found it in existing data that established links between self-rated health and rising levels of herpesvirus activity, a marker of poor cellular immunity that promotes high levels of inflammation.

Fagundes has a long-standing collaboration with a team at the University of Texas Medical Branch at Galveston and was able to take advantage of a unique dataset it gathered a decade ago for the Texas City Health and Stress Study. The study assessed the relationship between stress and health in the community that hosts petrochemical industries at the mouth of the Houston Ship Channel.

The survey of the residents gathered self-assessments (through a 36-item questionnaire) and blood samples for nearly 1,500 individuals. Those samples were analyzed for levels of active herpesviruses and biomarkers for inflammation.

“We found that self-rated health was associated with reactivation of herpesviruses,” Murdock said. “We’re not talking about the sexually transmitted disease, but viruses that are associated with things like cold sores that are ubiquitous among adults.”

“Herpesvirus activity is a very good functional marker of cellular immunity, because almost everybody has been exposed to one type of the virus or another,” Fagundes said. “It doesn’t mean you’re sick; it’s probably been dormant in your cells for most of your life. But because it reactivates at a cellular level and prompts the immune system to fight it, it becomes a great marker of how the system is working.”

“You can imagine that when the immune system’s fighting something, you get more inflammation throughout the body, and inflammation contributes to disease. That’s it in a nutshell,” he explained.

Previous studies demonstrated the link between herpesvirus activation and inflammation. While patients may not be aware of active herpesviruses or inflammation, the researchers suspected a mechanism stronger than mere instinct was responsible for their expressions of discomfort.

“We found that poor self-rated health was associated with more reactivation of these latent herpesviruses, which was associated with higher inflammation, and we know those two things are associated with morbidity and mortality, as well as some cancers, type II diabetes, and cardiovascular disease,” Murdock said.

After eliminating data for 251 individuals who showed no sign of herpesvirus, the team wound up with a snapshot that clearly showed those who reported feeling in good health had low virus and inflammation levels, while those who said they felt poorly were high on the virus and inflammation scales.

The researchers noted that primary care physicians are unlikely to check for herpesvirus activity or inflammation.

“It’s too hard an assay to do clinically and takes too much time,” Fagundes said. “They look at things like white blood cell counts in cancer patients, but would never do a herpesvirus latency test, and tests for inflammation would be rare. These are good markers for long-term health, but not for things that are going to impact you tomorrow.”

He said scientists haven’t yet identified the channel that gives people a sense of impending illness. One theory is that fatigue is a marker.

“I’ve heard many primary care physicians say they’ve never seen anyone with a disease that wasn’t associated with fatigue,” Fagundes said.

Another possibility is a sense of imbalance in the gut microbiome, another avenue of future study.

But doctors should still pay close attention to what patients report, the researchers advise.

“When a patient says, ‘I don’t feel like my health is very good right now,’ it’s a meaningful thing with a biological basis, even if they don’t show symptoms,” he said.

“When I go to patient-advocate conferences, people say they’re grateful we’re finding biological mechanisms because they feel like doctors have ignored them for years, saying, ‘It’s in your head.’ Well, it’s in your head, but there’s a reason,” he concluded.

The study was published in Psychoneuroendocrinology.

Income Inequality Linked to Millennials Having Babies Before Marriage

-Janice Wood

New research finds that rising income inequality, and a scarcity of certain types of jobs, are key reasons many young Americans are having babies before getting married.

A study led by Johns Hopkins University sociologist Dr. Andrew J. Cherlin traces how the income gap affects individual choices about starting a family.

The study concludes that the greater the income inequality in an area, the less likely young men and women are to marry before having a first child.

“Does income inequality affect a young adult’s decision about getting married and starting a family?” asked Cherlin, the Benjamin H. Griswold III Professor of Public Policy in the Krieger School of Arts and Science. “We think the answer is ‘Yes’ for those who don’t graduate from college.”

“Places with higher income inequality have fewer good jobs for those young adults,” he explained. “They don’t foresee ever having the kinds of well-paying careers that could support a marriage and a family. But they are unwilling to forgo having children. So with good jobs in limited supply and successful marriage looking unlikely, young women and men without college degrees may go ahead and have a child without marrying first.”

The researchers found that areas with high levels of income inequality have a shortage of jobs available in the middle of the job market. These are jobs available to people without college degrees that pay wages that would keep a family out of poverty, such factory work, office clerks, and security guards.

Without access to this sort of work, young men can’t make an adequate living. They don’t see themselves as good marriage material, and their partners agree, the researchers note.

Couples like this might live together and have a child, but they are reluctant to make the long-term commitment to marriage, according to Cherlin.

The researchers studied 9,000 young people of the generation known as millennials, from 1997 when they were 12 to 16 years old, until 2011, when they were 26 to 31. By the end of the study, 53 percent of the women and 41 percent of the men reported having had at least one child — and 59 percent of those births occurred outside of marriage. Most of the first children born outside of marriage were to women and men who didn’t graduate from college.

The researchers then matched that information about birth and marriage with census data on income and employment. They found that childless unmarried men and women who lived in counties with greater household income inequality and fewer middle market jobs available were less likely to marry before having a child.

According to the study’s findings, women who lived in an area with high inequality had 15 to 27 percent lower odds of marrying before having a first child than did women who lived in an area with low inequality.

“For many young adults, having a child is still one of the most satisfying experiences they can imagine. And if there’s nothing else for a young person to look forward to, at least they can do that,” Cherlin said. “They believe that being married is optional. But having a child is mandatory.”

The study was published in the American Sociological Review.

Source: Johns Hopkins University

Sleep Disorders Among Vets on the Rise

-Traci Pedersen

U.S. military veterans were six times more likely to experience a sleep disorder in the year 2010 than they were in 2000, according to a new study of more than 9.7 million U.S. veterans published in the journal Sleep.

The largest increases were identified in patients with post-traumatic stress disorder (PTSD), other mental disorders, or combat experience. Veterans with cardiovascular disease, cancer, or other chronic diseases also experienced higher rates of sleep disorder diagnoses relative to those without comorbid conditions.

The findings also show that the prevalence of PTSD tripled during the 11-year study period.

“Veterans with PTSD had a very high sleep disorder prevalence of 16 percent, the highest among the various health conditions or other population characteristics that we examined,” said principal investigator and senior author James Burch, Ph.D., associate professor in the Department of Epidemiology and Biostatistics in the Arnold School of Public Health at the University of South Carolina.

“Because of the way this study was designed, this does not prove that PTSD caused the increase in sleep disorder diagnoses,” noted Burch, also a researcher at the WJB Dorn Department of Veterans Affairs Medical Center in Columbia, South Carolina.

“However, we recently completed a follow-up study, soon to be submitted for publication, that examined this issue in detail. In that study, a pre-existing history of PTSD was associated with an increased odds of sleep disorder onset.”

During the study period, the age-adjusted prevalence of sleep disorders increased from less than one percent in 2000 to nearly six percent in 2010. Sleep apnea was the most common sleep disorder diagnosis (47 percent) followed by insomnia (26 percent).

Sleep apnea is a sleep-related breathing disorder characterized by abnormalities of respiration during sleep, according to the American Academy of Sleep Medicine. The most common form of sleep apnea is obstructive sleep apnea, which involves repeated episodes of complete or partial upper airway obstruction occurring during sleep.

Insomnia is characterized by having frequent and persistent difficulty initiating or maintaining sleep that results in general sleep dissatisfaction and daytime impairment.

The study population consisted of all U.S. veterans seeking care in the Veterans Health Administration system between the years 2000 and 2010. Of the total sample of 9,786,778 veterans, 93 percent were men, and 751,502 were diagnosed with at least one sleep disorder.

Source: American Academy of Sleep Medicine

Danger Behind the Wheel as Emotions Explode

-Rick Nauert, PhD

As Americans drive about the country on summer vacations, profound new research should give pause, or a warning, of behind the wheel behaviors. A newly released study finds that nearly 80 percent of drivers expressed significant anger, aggression, or road rage behind the wheel at least once in the past year.

The most alarming findings suggest that approximately eight million U.S. drivers have engaged in extreme examples of road rage, including purposefully ramming another vehicle or getting out of the car to confront another driver.

The study was performed by the AAA Foundation for Traffic Safety. “Inconsiderate driving, bad traffic, and the daily stresses of life can transform minor frustrations into dangerous road rage,” said Jurek Grabowski, Director of Research for the Foundation.

“Far too many drivers are losing themselves in the heat of the moment and lashing out in ways that could turn deadly.”

A significant number of U.S. drivers reported engaging in angry and aggressive behaviors over the past year, according to the study’s estimates:

  • Purposefully tailgating: 51 percent (104 million drivers);
  • Yelling at another driver: 47 percent (95 million drivers);
  • Honking to show annoyance or anger: 45 percent (91 million drivers);
  • Making angry gestures: 33 percent (67 million drivers);
  • Trying to block another vehicle from changing lanes: 24 percent (49 million drivers);
  • Cutting off another vehicle on purpose: 12 percent (24 million drivers);
  • Getting out of the vehicle to confront another driver: four percent (7.6 million drivers);
  • Bumping or ramming another vehicle on purpose: three percent (5.7 million drivers).

Nearly two in three drivers believe that aggressive driving is a bigger problem today than three years ago, while nine out of ten believe aggressive drivers are a serious threat to their personal safety.

Aggressive driving and road rage varied considerably among drivers:

  • Male and younger drivers ages 19-39 were significantly more likely to engage in aggressive behaviors. For example, male drivers were more than three times as likely as female drivers to have gotten out of a vehicle to confront another driver or rammed another vehicle on purpose.
  • Drivers living in the Northeast were significantly more likely to yell, honk, or gesture angrily than people living in other parts of the country. For example, drivers in the Northeast were nearly 30 percent more likely to have made an angry gesture than drivers in other parts of the country.
  • Drivers who reported other unsafe behaviors behind the wheel, such as speeding and running red lights, also were more likely to show aggression. For example, drivers who reported speeding on a freeway in the past month were four times more likely to have cut off another vehicle on purpose.

“It’s completely normal for drivers to experience anger behind the wheel, but we must not let our emotions lead to destructive choices,” said Jake Nelson, AAA’s Director of Traffic Safety Advocacy and Research.

“Don’t risk escalating a frustrating situation because you never know what the other driver might do. Maintain a cool head, and focus on reaching your destination safely.”

Tips to help prevent road rage:

  • Don’t Offend: Never cause another driver to change their speed or direction. That means not forcing another driver to use their brakes, or turn the steering wheel in response to something you have done.
  • Be Tolerant and Forgiving: The other driver may just be having a really bad day. Assume that it’s not personal.
  • Do Not Respond: Avoid eye contact, don’t make gestures, maintain space around your vehicle, and contact 9-1-1 if needed.

The research report is available on the AAA Foundation’s website and is part of the annual Traffic Safety Culture Index, which identifies attitudes and behaviors related to driver safety. The data was collected from a national survey of 2,705 licensed drivers ages 16 and older who reported driving in the past 30 days.

Source: AAA

Trauma is an Experience, Not an Event

-Santiago Delboy, MBA, MSW, LSW, S-PSB

It seems like “trauma” has become one of those household terms everyone talks about. I took a look at the number of average monthly Google searches for “trauma” in the U.S., and found that it has grown 22% in only one year. As with other terms that became mainstream (for instance “addiction” or “narcissism”), I suspect the price of increased awareness is a diluted understanding of what they really mean.

After hearing my patients talk about their experiences, reflecting on my own upbringing, and studying some of the literature on trauma, I believe the following can be a useful working definition:

Trauma is an experience that overwhelms our capacity to regulate our emotions and results in fragmentation and dissociation.

While this may not be a comprehensive or final definition, I think it captures a few ideas that are important:

  • Trauma impairs our capacity to regulate our emotions. We feel worried, irritated, anxious or afraid, consciously or not, and we cannot self-soothe or seek support from others.
  • Trauma creates fragmentation and dissociation. Whether we understand this as an unconscious defense mechanism (e.g., splitting, projection or repression), as a neurological issue (e.g., thalamus gone offline, hypersensitive amygdala), or both, dissociation is a key trait of trauma.

However, in this post I want to expand on the idea that trauma is not about a past event, but about a present experience.

I think the idea of trauma as a present experience is captured dramatically and beautifully in a 1930 painting by Belgian artist René Magritte.

The Titanic Days

I have liked Magritte since I was a little boy, but I saw “The Titanic Days” (Les jours gigantesques) for the first time a couple of years ago, at a special exhibition at the Art Institute of Chicago.

I was stunned by the power and the violence of this piece. What I see is not a rape attempt happening now, but how a past experience is stored in the woman’s body and felt in the present moment. I see the terror of her frozen expression, reminiscent of the so-called “thousand-yard stare,” the tension of her entire body and the desperate attempt to push back an attacker from a real or imagined past.

I notice the stark contrast of colors in the woman’s body and I see the traumatic struggle between life and death, and the need to keep part of her in the shadows. No words are required to convey the drama, and no words could probably do justice to the horror; trauma, in fact, impairs our capacity to develop a cohesive narrative.

The experience is overwhelming and occupies most of the space on the canvas, yet the atmosphere feels completely desolate: we know nobody will come to her help. Is the blue background a wall, keeping this woman cornered against the attacker living in her body and in her mind or does it suggest an abyss, making the woman one step away from oblivion?

We can only imagine the details of what actually happened in this woman’s past. Was she sexually abused as an adult by a coworker? Was she touched in uncomfortable ways as a young girl by a family friend? Was she somehow sexualized when she was a toddler by her father? How much of what happened was real and how much a creation of her mind?

These are important questions to consider, but not as important as the terror, the isolation, an the helplessness she is experiencing in the present moment. When I stand in front of this painting, much like when I sit across from my patients in therapy, what I see is this woman’s suffering in the here and now.

I don’t need to know all the actual details of her story, but I am curious about the meaning she assigned to it, about how it feels in her body, her mind and her spirit, and about the ways it might be getting in the way of being her full self.

Trauma is Like a Splinter

I remembered Magritte’s painting some months ago, when I read Bessel van der Kolk, a leading trauma researcher, suggesting the metaphor of trauma as a splinter (Van der Kolk, 2014): it is the body’s response to the foreign object that becomes the problem, more than the object itself.

This idea has been around for some time. Almost twenty years ago Peter Lavine, developer of the somatic experiencing approach for trauma treatment, wrote:

Traumatic symptoms are not caused by the triggering event itself. They stem from the frozen residue of energy that has not been resolved and discharged; this residue remains trapped in the nervous system where it can wreak havoc on our bodies and spirits.” – Peter Levine (1997)

It is worth noting that this notion is even older. Not to make the point that everything goes back to Sigmund Freud, but over a hundred years earlier he and his colleague Josef Breuer advanced a similar idea in “Studies on Hysteria:”

Psychical trauma – or more precisely the memory of the trauma – acts like a foreign body which long after its entry must continue to be regarded as the agent that still is at work.” – Josef Breuer and Sigmund Freud (1895)

I think there is value in talking about “traumatic events,” but I believe that it is critical to shift our focus toward the ways in which trauma stays with us. Trauma is not remembered, but reenacted. It is not about something that happened in the past, but about its consequences in the present, about the conscious or unconscious meaning we give to our experience, and how that experience defines how it feels to be in our body and in our mind.

From Traumatic Experience to Healing Experience

The notion of trauma as an experience is valid for traditional PTSD trauma (e.g., when there is a specific event or situation that triggers the traumatic experience, such as sexual abuse, a war or a natural disaster), and for complex developmental trauma, which is more insidious.

Complex trauma is characterized by an upbringing defined by patterns of inconsistency, neglect or abuse. Emotions are not expressed, not allowed, or even punished. A specific “big” event is not necessary; repeated and chronic interpersonal wounds can overwhelm the child’s capacity to regulate emotions, and create fragmentation and dissociation.

Most people I have seen in therapy have experienced some form of developmental trauma. They felt unseen and unheard by physically or emotionally absent parents. They did not feel taken care of, taken seriously, or taken into account. They believed their needs were not important and would ever be met.

They had to carry within, in silence, destructive family secrets. They had to be parents to their parents from a very early age. They needed to constantly perform or pretend to be someone else, in order to feel accepted or loved. They had to learn to soothe themselves. They lived feeling that nothing they did would ever be enough.

All these experiences from the past are re-enacted and experienced in the present, keeping them from feeling safe, loved, worthy and trusting in others or themselves. They get in the way of becoming self-aware, of letting go of control, of developing vulnerable and intimate relationships. They make them feel either in high alert or depleted. These experiences keep them from being fully alive.

The most important thing therapists can do to work through traumatic experiences of this kind, is to offer the opportunity for a healing experience.

The essence of that healing experience is not a matter of technique, approach or theory and goes beyond the promise of providing a safe, calm and reliable environment. I believe the question is about love, authenticity and curiosity.

For me, the question is about being self-aware and curious about my own reactions, about how I think of, feel with, and relate to the person in front of me. It is about being a human being first and a psychotherapist second, which is a difficult task.

Often times I get caught up in the need to make sure that I am saying the right words, giving the best feedback, offering the most insightful interpretation, or providing a useful perspective. Instead, I can trust that my presence, my curiosity, my compassion and my humanity, with its flaws and imperfections, is the first thing that matters.

Do my patients feel heard and seen by me? Would they tell me if they didn’t? Do they feel there is room for their feelings toward me, whether they come from a place of anger, hurt, sadness, joy, love or desire? Can they express them trusting that our relationship will survive? Can they count on me, and trust that I will provide safe boundaries? Can they feel that every part of themselves is acknowledged, accepted and valued?

I believe these are the types of questions that define a healing therapeutic experience. They matter not only because they allow patients to recognize current dysfunctional relationship patterns in their lives, but mainly because they have the potential to provide an experience that was not available to our patients when they were growing up.

We cannot change the past, but we can offer them the opportunity to experience and develop self-awareness, acceptance and unconditional love.

These 5 Foods and Substances Can Cause Anxiety and Insomnia

Before you reach for the medicine cabinet, take a look at your dinner plate.

Do you suffer from panic attacks or have trouble sleeping? If so, you may have tried stress reduction techniques or even medications, but has anyone ever asked you what you eat? It may surprise you to learn that certain everyday foods, some of which are considered healthy, have the capacity to overstimulate your nervous system just as powerfully as a stressful life event.

Medications may be helpful in managing your symptoms in the short term, but what if you could get to the root cause of the problem once and for all? If you identify which ingredients in your menu are working against you, you can gain control over your symptoms, avoid co-pays and side effects, and most importantly, protect your health from the damaging effects of internal biological stress.

When it comes to anxiety and insomnia, the foods listed below can be chemical triggers for anyone. Those at highest risk include women, people over 40, individuals with multiple chemical/medication sensitivities or allergies, and anyone with conditions affecting the digestive or immune system such as IBS, inflammatory bowel disease, or chemotherapy treatment.

Which foods are most likely to press your panic button?

1. Caffeine

Caffeine is a notorious nemesis in sleep and anxiety disorders. In a recent study of people with panic disorder, caffeine increased stress hormone levels in all participants and triggered panic attacks in about half of them. Caffeine keeps you awake by blocking sleep-promoting adenosine receptors in the brain. Even five hours after drinking caffeine, 50% of it remains in your bloodstream and has been shown to impair sleep. In fact, it takes a staggering 16 to 24 hours for caffeine to completely leave your system. This means that even a single morning cup of coffee may affect your sleep quality at night. To see if caffeine is your culprit, gradually cut back a little each day rather than going cold turkey to minimize withdrawal headaches, fatigue, and concentration problems.

2. Nightshades (potatoes, tomatoes, eggplant, peppers, and goji berries)

Plants in the nightshade family produce natural pesticides called glycoalkaloids, which are designed to kill predators like insects and worms, but are also toxic to human cells. These cunning chemical weapons block the enzyme acetylcholinesterase, resulting in overstimulation of the nervous system in sensitive individuals. Anxiety is just one of many neuropsychiatric side effects documented in humans. Common nightshade ingredients in prepared foods include potato starch, chilies, bell peppers, tomato paste, paprika, red pepper flakes and cayenne. Most people eat nightshades in some form every day, so glycoalkaloids may accumulate in your system over time. It takes at least five days for glycoalkaloids to clear your system, so you’ll need to remove these foods completely for a week or longer to see if they are bothering you. Cooking doesn’t destroy glycoalkaloids, but there are other simple ways to minimize your exposure.

3. Alcohol

Alcohol can be very effective in relaxing you and helping you fall asleep. However, as alcohol starts to wear off in the middle of the night, sleep quality suffers significantly. Metabolism varies depending on age, gender, genetic background and other factors, but the primary predictor of how long alcohol remains in your bloodstream is quantity. On average, each “drink” (1.5-oz shot, 12-oz beer, or 5-oz wine) takes two hours to clear your system: two drinks—four hours, three drinks—six hours, etc. As alcohol wears off, “mini-withdrawal” effects can range from restless sleep to bad dreams to full-blown panic attacks. If you’re in the habit of drinking every evening, cut back gradually to minimize potential for withdrawal, which can temporarily worsen sleep and anxiety problems.

4. Aged, fermented, cured, smoked, and cultured foods (salami, cheese, sauerkraut, red wine, etc.).

The way to turn a fresh whole food like beef, milk, grapes, or cabbage into a gourmet food like aged steak, brie, merlot, or kimchi is to add bacteria to it and let it ferment. During fermentation, bacteria break down food proteins into tiny molecules called biogenic amines, which accumulate as the food ages. The most important biogenic amine found lurking within aged foods is histamine, a powerful neurotransmitter that can aggravate our digestive, hormonal, cardiovascular, and nervous systems. Histamine causes anxiety and insomnia in susceptible individuals, partly through its ability to increase levels of adrenaline, our “fight-or-flight” hormone. Histamine is indestructible, so cooking and freezing don’t help. This article contains more detailed information, including meat, seafood, and beverage tables as well as food preparation tips to keep your histamine levels low.

5. Sugar, Flour, and other Refined Carbohydrates

All sugars and starches, except those that come in the form of a natural whole food like a piece of fruit or a sweet potato, are considered refined carbohydrates.

Popular breakfast foods like orange juice, sweet yogurts, and most cereals are rich in refined carbohydrates that start your day with a blood sugar spike, setting into motion a hormonal chain reaction that can affect your mood, energy, concentration, and appetite for hours. After insulin surges to bring your blood sugar down, the stress hormones cortisol and adrenaline rush in to prevent your blood sugar from crashing. Since most people eat refined carbohydrates like bread, chips, or noodles during lunch and dinner as well, they are essentially riding this invisible roller coaster 24 hours a day.

In this study, a single serving of a glucose-sweetened beverage caused adrenaline levels to double in adults and quadruple in children, not peaking until four hours after the drink was consumed.

Adrenaline causes panic symptoms like sweating, lightheadedness, and palpitations in sensitive people. These sensations are often mistaken for “hypoglycemia” (low blood glucose) even though in most cases, blood glucose doesn’t fall below normal.

The standard advice to people who feel panicky between meals is to eat carbohydrates every three hours to prevent blood sugar from dropping. However, that approach can actually worsen the problem over time by increasing your body’s dependence on sugar as well as your risk for insulin resistance.

It is much wiser to remove refined carbohydrates from the diet to prevent blood sugar from spiking in the first place. I recommend eliminating them for at least two weeks to see how you feel. It is best for all of us to permanently avoid these processed sugar sources anyway, so in taking this one small step toward identifying your dietary demons, you’ll be taking a giant leap toward overall good health.

Bottom Line

The most powerful way to change your brain chemistry is by changing how you eat. Keep a food and symptom journal to see if you notice any patterns, keeping in mind that some foods may not trigger symptoms until many hours later. What you discover may be the key to your peace of mind and a good night’s sleep.

Where did the Joy of Learning Go?

Rekindling Your Child’s Enthusiasm for School

Connect your children to what they learn at school through their interests and past positive experiences so they will WANT to learn what they HAVE to learn.

Where did the joy of learning go?

When school stops being fun, all too frequently, learning stops. Help your child retain that kindergarten enthusiasm of embracing each day with the joy of learning.

Children who appear lazy, oppositional, inattentive, scattered, unmotivated, or inseparable from their social media may not be making voluntary choices. Their brains may be responding to the stress of sustained or frequent boredom.

We know that for most children, kindergarten is anticipated with awe and enthusiasm – especially when one or older siblings are already in school. There certainly can be anxieties, but they revolve around fear of leaving a parent or the security of the home environment. The idea of being a student is exciting. Most kindergarten or first grade students speak passionately about what they learn and do in school. Then, as years progress, burdensome memorization and test preparation are emphasized at the cost of diminished discovery, inquiry, and project-based learning. As school stops engaging children’s imaginations, boredom and frustration replace joy, and learning stops.

Students currently in public high schools in the U.S. are more likely to drop out than ever before. When the reasons for dropping out are examined, almost 80 percent of the students report that the main reason is boredom. When asked what bores them, the most frequent responses are that the material they are taught is either uninteresting or has no relevance to their lives.

The Stress of Boredom Blocks Brain Traffic Flow

Neuroimaging and other research tools continue to yield more data about the brain’s response to stress including sustained or frequent boredom. This comes at a time when boredom is increasingly problematic; as school funding and teacher performance ratings are increasingly tied to test performance. Consequently, there is more time dedicated to repetition, drill, and testing of facts that have no clear personal relevance or value to children.

Cutting edge neuroimaging research reveals significant disturbances in the brain’s information processing circuits in stressful learning environments. Information communication is blocked in these stress states and new learning cannot pass into memory storage. The “thinking, reflective” upper brain cannot downward regulate to direct behaviors, which then become involuntary.

Here’s what happens. The amygdalae are switching stations deep in the brain’s emotional limbic system that are stress-reactive. In the stress state, such as with prolonged or frequent boredom, metabolic activity of these emotional filters increases. When this happens, the ability of the amygdalae to direct input to or from the thinking and reflecting brain, the prefrontal cortex (PFC) is limited.

In the normal state, without high stress, the amygdalae allow input from the senses (what we hear, see, feel, experience) to reach the PFC where it can become long-term memory. The PFC is also the control center that, in the nonstress state, sends communications down to the rest of the brain to consciously and thoughtfully direct our responses, choices, and behaviors.

During high stress, the amygdalae block communication with the PFC and sends input to the lower, reactive brain, where memory is not constructed and behavioral responses are no longer in voluntary control. This is the involuntary fight-flight-freeze response to stress or fear in all mammals – in humans: the act out, zone out, drop out behavior reactions.

Brains Keep Track of Effort That Doesn’t Pay Off

For many children, the stress response to boredom and low personal relevance builds year after year when they do not find learning interesting or relevant. When children’s brains develop negativity to school, the stress state limits their voluntary control to sustain attention in class, do homework carefully, and persevere at challenging classwork.

Their brains learn to automatically resist putting mental effort into activities they have experienced as boring or irrelevant.

This is often the situation when children who are quite intelligent have difficulty with rote memorization. Since memorization is often what is tested it is inaccurately perceived by children as a measure of their intelligence. They develop the belief that their failure to get high grades on rote memory tests means they don’t have the ability to succeed. That mindset is not only inaccurate, but when taken on by your child, means their brains go into the fixed mindset of avoiding challenges and loss of motivation to persevere through setbacks.

Make Learning Personally Relevant

You can help your children keep their brains out of the involuntary, inefficient stress state. Keep them engaged and motivated to put effort into learning at school by connecting their classroom studies to their interests. Connecting them through personal relevance to the topics they study results in less boredom, and the opening of the neural pathways through their amygdalae to their upper, intelligent brains where true learning and creative thinking take place.

You can use strategies so they will WANT to learn what they HAVE to learn. Connect their brains to the topics they will be studying at school by looking with them at photos or videos of family trips, connecting objects they own to the countries they study, reading stories that relate to topics in science, history, and math.

The curiosity prompted by your reminders of their past experiences and current interests becomes a brain bridge ready to link with the information the must learn for school. The Velcro to stick new information is waiting in their brains for their neural circuits to engage learning through positive connections.

Questions as Curiosity Boosters

You’ll further preheat their interest in schoolwork when you ask your children questions that help them personally connect to the current or upcoming school topics. Their brains remain attentive because they are personally interested, and therefore curious, about the answer to the question.

Discussions you promote to bridge your children to their schoolwork will also serve as stronger memory cement if you are an active, attentive listener when they express their opinions about your questions as they learn more about the topic in school. This is not the time to split your focus. To keep them motivated, your children need to know you are truly interested in their ideas and opinions.

The results will more than offset your planning and preparations. Smiles will replace groans and eye-rolls as you use neuroscience to return to your child the joys of learning.

Negativity Turns to Motivation!

Your interventions will help your children avoid the learning turn off to the challenges of today’s fact heavy curriculum and limited opportunities for curiosity and discovery. You will help them construct the brain circuits to become lifelong learners who can transfer and apply what they learn to real-world situations.

They’ll respond to learning more efficiently and store what they learn in their long-term and memory. They will secure learning available not only to retrieve for the test, but also to face the unique challenges and opportunities awaiting them in the 21st century.

-Judy Willis, M.D., M.Ed.