Are Young Adults Given to More Mental Distress?


Study suggests generational shift in mood disorders, suicide-related outcomes; digital media may play role

Mood disorders increased in young adults across the past decade, with smaller and less consistent trends observed in older adults, according to national survey data.

Of more than 500,000 survey participants, the percentage of adolescents ages 12 to 17 (“iGen,” “Generation Z”) experiencing a major depressive episode in the last year increased by 52% from 2005 to 2017, while the percentage of young adults ages 18 to 25 (“Millennials”) experiencing serious psychological distress in the last month was up 71% from 2008 to 2017, reported Jean Twenge, PhD, of San Diego State University, and colleagues.

The same trends were not observed in respondents ages >25, including “Generation X,” and “Boomers,” with a slight decline in psychological distress observed among adults ≥65. The incidence of major depressive episodes was unchanged, or slightly decreased, in respondents ages ≥26, they wrote in the Journal of Abnormal Psychology.

These trends could be explained by the introduction of smartphones in the developmental stages of more recent generations, Twenge, who is also the author of “iGen,” told MedPage Today.

“When you think of how lives have changes from 2010 to 2017, a clear answer is that over time, people started spending more time on phones and on social media, less time face-to-face with their friends, and less time sleeping,” Twenge said. “As we know from other studies, spending more time with screens, less time sleeping, and less time face-to-face with friends is not a good formula for mental health.”

Depression has increased in the U.S. over recent years, with the fastest rise in youth and young adults, according to health insurance data. Certain aspects of digital media, such as the introduction of smartphones and social media, have also been linked to a higher likelihood of major depressive disorder, specifically among Millennials.

Twenge said youth might be more susceptible to some of the effects of digital media because it was such an integral part of their development early on. She also noted that the findings here contrast with other theories that the increase could be attributed to today’s teens being more open about their mental health, or more willing to seek help, she said, as the current study asked about symptoms and behaviors, instead of inpatient or clinical data regarding specific disorders.

“I think it’s possible the change in social lives of young people has been more pronounced in the age of the smartphone,” Twenge said. “Older people may already have an established social network and the change in how they use their social time may not be as extensive as it has been for teens and young adults.”

“Getting your first smartphone at 12 is fundamentally different than getting your first smartphone at 30,” she added.

Twenge and colleagues used responses from the National Survey on Drug Use and Health of individuals ≥12 years. Rates of serious psychological distress were determined through responses to the Kessler-6 Distress Scale, and rates of major depressive episodes and suicide ideation were determined through NCS-Replication interviews. Deaths by suicide were measured through CDC Fatal Injury Reports (1999-2017).

In total, 212,913 adolescents (ages 12-17) responded from 2005 to 2017 and 398,967 adults (≥18) responded from 2008 to 2017. These groups were similar in terms of sex (51% vs 52% female), race, and ethnicity, with over 50% of both samples being non-Hispanic white, close to 15% being non-Hispanic black, and 15% Hispanic in both groups. A slightly higher percentage of the older group had family incomes <$49,999 compared with the adolescent group (55% vs 46%).

Women had greater increases in mood disorders versus men across the number of reported major depressive episodes, suicide-related outcomes, and serious psychological distress, Twenge and colleagues reported.

The percentage of white Americans experiencing major depressive episodes and suicide-related outcomes increased more than it did for other races or ethnicities, although Hispanic respondents had the greatest increase in psychological stress, they added.

Finally, the biggest increases in psychological distress and suicidal ideation were observed in respondents with the highest family incomes, while increases of adult major depressive disorder and suicide attempts were greater in lower income families.

The authors cautioned against overinterpreting the suicide ideation result, as few respondents reported their thoughts about suicide or attempted suicides. However, they noted that since each later generation had increased thoughts of suicide, it appears this increase was due to cohort as well.

Study limitations included its cross-sectional design and the fact that it included only single-item assessments of suicide ideation or attempts. Suicide-related outcomes also weren’t assessed in adolescents, researchers reported, and irritability was not included in the assessment for this group’s major depressive episodes.

The results suggest a need for more research to understand the role of factors such as technology and digital media use and sleep disturbance may play in mood disorder and suicide-related outcomes, and to develop specialized interventions for younger cohorts, the authors concluded. “This work is necessary given the high cost of mood disorders and suicide.”

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Accumulating evidence suggests curcumin and turmeric can treat psychiatric disorders


Living with a psychiatric disorder can be devastating for both sufferers and their loved ones. Unfortunately, many of the solutions offered by modern medicine do more harm than good while offering little in the way of relief. Thankfully, researchers have discovered that a compound in the popular Indian spice turmeric has the potential to effectively treat psychiatric disorders like bipolar disorder and depression.

You may have heard the fanfare about turmeric’s anti-inflammatory properties, which it gets from a compound within the spice known as curcumin. It has long been used in traditional Chinese medicine and has been gaining popularity in Western medicine in recent years. This polyphenol is being revered for its protective, anti-inflammatory and antioxidant properties, and is being used to help fight cancer and stop the cognitive decline of neurodegenerative disorders like Alzheimer’s. Non-toxic and affordable, it’s showing a lot of promise in helping deal with many of the health problems facing people today.

Image: Accumulating evidence suggests curcumin and turmeric can treat psychiatric disorders

The same anti-inflammatory qualities that make it so good at addressing issues like arthritis can also extend to mood disorders. Not only does it reduce levels of tumor necrosis factor alpha and inflammatory interleukin-1 beta, but it also reduces salivary cortisol concentrations while raising the levels of plasma brain-derived neurotrophic factor.

A study carried out by researchers at Australia’s Murdoch University found that curcumin extracts reduced people’s anxiety and depression scores. They noted that it was particularly effective at alleviating anxiety. Moreover, even low doses of the spice extract were effective in addressing depression. In addition, the researchers found it worked quite well on those with atypical depression, which is a marker of bipolar depression.

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Growing evidence of curcumin’s usefulness in addressing psychiatric disorders

Curcumin has been found in other studies to be just as effective as one of the most popular SSRI antidepressants on the market, Prozac, making it an excellent option for those who wish to avoid the negative side effects of this psychiatric medication. It works by raising levels of dopamine and serotonin, two vital neurotransmitters related to depression. In addition, because depression is believed to be caused by chronic inflammation, it makes sense that curcumin’s ability to reduce inflammation could alleviate depression.

Interestingly, studies have also found that when curcumin is taken either alone or with saffron, it reduces the symptoms of anxiety and depression in those suffering from major depressive disorder. When taken alongside the herb fenugreek, meanwhile, it can reduce fatigue, stress and anxiety in those with extreme occupational stress. Curcumin supplementation has also been shown to significantly improve compulsiveness and memory loss in those with obsessive-compulsive disorder.

It’s also worth noting that curcumin can be taken alongside antidepressants safely; studies have even shown taking the two together can enhance their effectiveness. However, it’s important to keep in mind that antidepressants carry a lot of risks, so it’s worth exploring whether curcumin alone could be enough to alleviate an individual’s depression.

The idea of curcumin helping with mood is supported by a study that was published in the American Journal of Geriatric Psychiatry earlier this year. In that study, researchers found that participants who took curcumin supplements noted mood improvements, and they plan to explore this connection in a study of patients with depression. The researchers expressed optimism that curcumin could be a safe way to provide people with cognitive benefits; they also discovered the spice can improve memory.

Now, researchers are looking for ways to increase curcumin’s bioavailability so that people can enjoy the benefits of this all-star natural treatment. In the meantime, be sure to add black pepper to your dishes when cooking with turmeric or look for curcumin supplements that contain piperine, a black pepper extract, as this boosts its bioavailability.

Low levels of ‘anti-anxiety’ hormone linked to postpartum depression: Effect measured in women already diagnosed with mood disorders.


Effect measured in women already diagnosed with mood disorders

Summary:
In a small-scale study of women with previously diagnosed mood disorders, researchers report that lower levels of the hormone allopregnanolone in the second trimester of pregnancy were associated with an increased chance of developing postpartum depression in women already known to be at risk for the disorder.

In a small-scale study of women with previously diagnosed mood disorders, Johns Hopkins researchers report that lower levels of the hormone allopregnanolone in the second trimester of pregnancy were associated with an increased chance of developing postpartum depression in women already known to be at risk for the disorder.

In a report on the study, published online on March 7 in Psychoneuroendocrinology, the researchers say the findings could lead to diagnostic markers and preventive strategies for the condition, which strikes an estimated 15 to 20 percent of American women who give birth.

The researchers caution that theirs was an observational study in women already diagnosed with a mood disorder and/or taking antidepressants or mood stabilizers, and does not establish cause and effect between the progesterone metabolite and postpartum depression. But it does, they say, add to evidence that hormonal disruptions during pregnancy point to opportunities for intervention.

Postpartum depression affects early bonding between the mother and child. Untreated, it has potentially devastating and even lethal consequences for both. Infants of women with the disorder may be neglected and have trouble eating, sleeping and developing normally, and an estimated 20 percent of postpartum maternal deaths are thought to be due to suicide, according to the National Institute of Mental Health.

“Many earlier studies haven’t shown postpartum depression to be tied to actual levels of pregnancy hormones, but rather to an individual’s vulnerability to fluctuations in these hormones, and they didn’t identify any concrete way to tell whether a woman would develop postpartum depression,” says Lauren M. Osborne, M.D., assistant director of the Johns Hopkins Women’s Mood Disorders Center and assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “For our study, we looked at a high-risk population of women already diagnosed with mood disorders and asked what might be making them more susceptible.”

For the study, 60 pregnant women between the ages of 18 and 45 were recruited by investigators at study sites at The Johns Hopkins University and the University of North Carolina at Chapel Hill. About 70 percent were white and 21.5 percent were African-American. All women had been previously diagnosed with a mood disorder, such as major depression or bipolar disorder. Almost a third had been previously hospitalized due to complications from their mood disorder, and 73 percent had more than one mental illness.

During the study, 76 percent of the participants used psychiatric medications, including antidepressants or mood stabilizers, and about 75 percent of the participants were depressed at some point during the investigation, either during the pregnancy or shortly thereafter.

During the second trimester (about 20 weeks pregnant) and the third trimester (about 34 weeks pregnant), each participant took a mood test and gave 40 milliliters of blood. Forty participants participated in the second-trimester data collection, and 19 of these women, or 47.5 percent, developed postpartum depression at one or three months postpartum. The participants were assessed and diagnosed by a clinician using criteria from the Diagnostic and Statistical Manual of Mental Disorders, version IV for a major depressive episode.

Of the 58 women who participated in the third-trimester data collection, 25 of those women, or 43.1 percent, developed postpartum depression. Thirty-eight women participated in both trimester data collections.

Using the blood samples, the researchers measured the blood levels of progesterone and allopregnanolone, a byproduct made from the breakdown of progesterone and known for its calming, anti-anxiety effects.

The researchers found no relationship between progesterone levels in the second or third trimesters and the likelihood of developing postpartum depression. They also found no link between the third-trimester levels of allopregnanolone and postpartum depression. However, they did notice a link between postpartum depression and diminished levels of allopregnanolone levels in the second trimester.

For example, according to the study data, a woman with an allopregnanolone level of 7.5 nanograms per milliliter had a 1.5 percent chance of developing postpartum depression. At half that level of hormone (about 3.75 nanograms per milliliter), a mother had a 33 percent likelihood of developing the disorder. For every additional nanogram per milliliter increase in allopregnanolone, the risk of developing postpartum depression dropped by 63 percent.

“Every woman has high levels of certain hormones, including allopregnanolone, at the end of pregnancy, so we decided to look earlier in the pregnancy to see if we could tease apart small differences in hormone levels that might more accurately predict postpartum depression later,” says Osborne. She says that many earlier studies on postpartum depression focused on a less ill population, often excluding women whose symptoms were serious enough to warrant psychiatric medication — making it difficult to detect trends in those women most at risk.

Because the study data suggest that higher levels of allopregnanolone in the second trimester seem to protect against postpartum depression, Osborne says in the future, her group hopes to study whether allopregnanolone can be used in women at risk to prevent postpartum depression. She says Johns Hopkins is one of several institutions currently participating in a clinical trial led by Sage Therapeutics that is looking at allopregnanolone as a treatment for postpartum depression.

She also cautions that additional and larger studies are needed to determine whether women without mood disorders show the same patterns of allopregnanolone levels linked to postpartum depression risk.

If those future studies confirm a similar impact, Osborne says, then tests for low levels of allopregnanolone in the second trimester could be used as a biomarker to predict those mothers who are at risk of developing postpartum depression.

Osborne and her colleagues previously showed and replicated in Neuropsychopharmacology in 2016 that epigenetic modifications to two genes could be used as biomarkers to predict postpartum depression; these modifications target genes that work with estrogen receptors and are sensitive to hormones. These biomarkers were already about 80 percent effective at predicting postpartum depression, and Osborne hopes to examine whether combining allopregnanolone levels with the epigenetic biomarkers may improve the effectiveness of the tests to predict postpartum depression.

Of note and seemingly contradictory, she says, many of the participants in the study developed postpartum depression while on antidepressants or mood stabilizers. The researchers say that the medication dosages weren’t prescribed by the study group and were monitored by the participant’s primary care physician, psychiatrist or obstetrician instead. “We believe that many, if not most, women who become pregnant are undertreated for their depression because many physicians believe that smaller doses of antidepressants are safer for the baby, but we don’t have any evidence that this is true,” says Osborne. “If the medication dose is too low and the mother relapses into depression during pregnancy or the postpartum period, then the baby will be exposed to both the drugs and the mother’s illness.”

Osborne and her team are currently analyzing the medication doses used by women in this study to determine whether those given adequate doses of antidepressants were less likely to develop symptoms in pregnancy or in postpartum.

Only 15 percent of women with postpartum depression are estimated to ever receive professional treatment, according to the U.S. Centers for Disease Control and Prevention. Many physicians don’t screen for it, and there is a stigma for mothers. A mother who asks for help may be seen as incapable of handling her situation as a mother, or may be criticized by friends or family for taking a medication during or shortly after pregnancy.

Journal Reference:

  1. Lauren M. Osborne, Fiona Gispen, Abanti Sanyal, Gayane Yenokyan, Samantha Meilman, Jennifer L. Payne. Lower allopregnanolone during pregnancy predicts postpartum depression: An exploratory study. Psychoneuroendocrinology, 2017; 79: 116 DOI: 10.1016/j.psyneuen.2017.02.012

Source: Sciencedaily.com