Anne Sexton

Can stress cause psychosis?

Sometimes a stressful day can make you feel like you are going crazy. Maybe you’re not wrong to feel that way…

The hormone cortisol is released in response to stress, and researchers at James Cook University in Australia have found a link between levels of cortisol and psychosis.

Zoltan Sarnyai, an associate professor at JCU, explained that this was the first meta-analysis study comparing levels of cortisol with schizophrenia. The team reviewed a total of 11 studies. Levels of cortisol were measured when patients were awake.

Sarnyai explained that they hoped that these findings will help identify people who have the greatest risk of developing full-blown psychosis.

“Only some 20 to 30 per cent of individuals who are at high-risk of developing psychosis due to their clinical presentation or family history actually do so. Identifying those people early is where the cortisol measurement comes in. Biomarkers are very few and far between in psychiatry, so even though a huge amount of work is still needed, this could become a valuable technique,” said Dr Sarnyai.

Scientists have long suspected that cortisol plays a role in psychotic disorders, but until now the results were inconclusive.The JCU team found that patients have different levels of the stress hormone after awakening (Cortisol Awakening Response, CAR) relative to healthy people. The team also found evidence that people with a high risk of developing psychosis have changes in cortisol before they become ill.

“We were able to show that patients with psychosis fail to produce cortisol after they wake up in the morning. We found this even in patients with recent onset of the illness,” said JCU’s Dr Maximus Berger, who co-authored the study.

In case you were wondering… no, stress itself doesn’t cause psychosis. It is the inability to produce cortisol in response to stress after waking that may make some people more susceptible schizophrenia. Whether or not you are at risk, it is always wise to use healthy coping mechanisms to deal with stress.

Mindfulness can help prevent depression

Mindfulness has its critics. Mindfulness-based cognitive therapy, or MBCT was first developed by Dr Jon Kabat-Zinn from the University of Massachusetts Medical School. MBCT has been embraced by hundreds of thousands of people around the world, but some people are unconvinced. However, a new study published in the journal JAMA Psychiatry found that MBCT can help people manage depression and prevent relapses. The team, led by the University of Oxford, conducted the largest meta-analysis on the impact of mindfulness on depression.

MBCT is used to help people suffering from depression repel the thoughts and feelings they associate with the illness. This treatment generally includes guided mindfulness practices, group discussion and cognitive behavioural exercises.

Using anonymous data from nine trials involving 1,258 participants, researchers found that 38 percent of those who received MBCT experienced a depressive relapse. However, nearly half — 49 percent — of patients who didn’t receive MBCT relapsed. Age, sex and level of education had no significant influence on the therapy’s performance.

Mindfulness can work alongside medication

The researchers also looked at how MBCT worked in conjunction with anti-depressants. They wanted to know if using mindfulness alongside medication was more successful than medication alone. They found that patients who received MBCT along with anti-depressants were less likely to experience a depressive relapse than those who were only receiving medication.

Lead author of the study, Willem Kuyken, a professor of clinical psychology at the Oxford Mindfulness Centre, commented: “While MBCT is not a panacea, it does clearly offer those with a substantial history of depression a new approach to learning skills to stay well in the long-term. It offers people a safe and empowering treatment choice alongside other mainstay approaches such as cognitive-behavioural therapy and maintenance antidepressants. We need to do more research, however, to get recovery rates closer to 100 per cent and to help prevent the first onset of depression, earlier in life. These are programmes of work we are pursuing at the University of Oxford and with our collaborators around the world.”

“I’ll do it later…” Why we procrastinate

If you have a tendency to put things off, you’re not alone. It has been estimated that around 20 percent of adults procrastinate, and around half of all students do. Unfortunately procrastination has negative effects. These include poorer performance and increased stress, as well as mental and physical health impacts.

People procrastinate for different reasons. Here we look at the most common ones, and what you can do to correct your behaviour.

Lack of self-compassion

People who lack self-compassion tend to be more stressed when they are performing tasks. If this is you, try being kinder to yourself. Accept that you are human, with regular human flaws. Try to be optimistic about your success instead of pessimistic that you’ll fail.

Bad influence

If your parents, siblings or role models tended to procrastinate, chances are you’ll do so too. You can ameliorate this by reminding yourself of the negative consequences of putting things off. Try and find a new role model — ideally someone who is a go-getter type.

Fear of failure

If you think you don’t know how to do something, or worry you’ll do it badly, you’ll put it off. If help is available, you should ask for it. If not, remind yourself that you can learn as you go and that it is better to try and see what happens; you defeat yourself by not trying at all.

Bias

Certain things you just don’t like doing. Maybe you think you’re bad at a certain task, or you’ve seen other people struggling to perform it. Remind yourself that this is bias and that doing the task is an opportunity to challenge yourself and overcome you bias.

Time management

If you tend to underestimate how long something will take you to do, it can knock your feelings of competency. Make a habit of starting tasks early and giving yourself more time than you think you need. This will compensate for time management issues — and if you finish early, reward yourself!

Short term thinking

If you are focused on immediate gains, instead of long-term ones, you may display what’s known as “short range hedonism.” Focusing on short term rewards means you are less likely to persevere when things get tough. Try reminding yourself of future goals and gains, and tell yourself not to place so much emphasis on the frustrations of the present. Don’t forget to use the three-minute breathing technique to calm and centre yourself.

Perfectionism

Sometimes you let perfection be the enemy of the good. A perfectionist attitude may keep you from getting started because in your mind, if you haven’t done something yet, you haven’t messed it up either. Try to emphasis the importance of completing tasks in a timely fashion. Task completion is almost always going to be more helpful to you than perfectionism.

Depression or anxiety

Depression, anxiety and other mental health conditions can cause you to delay getting started. If you have mental health problems, or suspect that you do, see a therapist for proper treatment.

Discomfort

Most of us try and avoid discomfort, so if you don’t feel comfortable doing something, you’ll put it off. Like doing your taxes, let’s say. Try challenging your beliefs about tolerating discomfort. Focus on the long-term rewards instead. Remind yourself that getting out of your comfort zone is an opportunity for growth, and reward yourself for completing each uncomfortable task.

WHY BUSINESSES USE MINDFULNESS

Over the last few years, more and more businesses have taught mindfulness to their employees, or encouraged their workers to learn mindful meditation.

You might think that any business that uses mindfulness is probably some kind of hippy-dippy fly-by-night selling knitted yoghurt and handwoven cheese! You’d be wrong. Some of the largest and most famous companies in the world use mindfulness. Apple, Google, Goldman Sachs and Sony have all incorporated aspects of mindfulness into their thinking and routines.

The reason is simple — mindfulness has many different benefits for business. Mindfulness promotes flexible thinking, greater awareness and better decision-making, all of which contribute to better job performance. Aetna, the health care company, embarked on a 12-week pilot mindfulness programme for over 200 employees. They found that the workers who had learnt mindfulness gained 62 minutes per week of extra productivity. Translated into figures, that added an estimated $3,000 per employee each year to the bottom line. Not a figure to be sniffed at.

This makes some people suspicious that companies use mindfulness to ameliorate job stress while demanding more and more of employees. Certainly that is a possibility, but mindfulness has penetrated the upper echelons of the business community too. Intel has used mindfulness as a leadership practice and claims to have seen improvements in productivity and job satisfaction.

A number of studies examining the effects of mindfulness found that employees using mindfulness meditation report a significant reduction in stress, as well as improved communication skills and more innovative thinking. Stress, however, is one of the most pragmatic reasons for companies to encourage mindfulness. Stress is not only a silent killer, it is costly to businesses as well — the World Health Organization says stress costs American businesses a whopping $300 billion per year.

Whether companies are using mindfulness because they want to promote employee welfare, or because they are concerned with profits doesn’t really make a huge difference — either way, they end up with happier and more productive employees. It is a win for everyone.

Suffering from pain? Here’s some exciting findings about meditation and pain relief

For years now researchers have been looking at cognitive-based approaches to pain relief. There have been success with interventions using hypnosis, acupuncture and distraction, and of course, the placebo effect shows that the body can, on occasion, heal itself.

The effect isn’t magic — it is down to the opioids. The body produces these naturally to block pain.

A recent study published in the Journal of Neuroscience has looked at whether or not mindfulness meditation also stimulates the production of opioids, helping us to negate pain.

The obvious answer would seem to be yes. After all, like hypnosis and distraction, mindfulness engages the brain. But read on…

The study, conducted by Dr Fadel Zeidan at Wake Forest Baptist Medical Center found that does not use the opioid system to reduce pain.

“Our finding was surprising and could be important for the millions of chronic pain sufferers who are seeking a fast-acting, non-opiate-based therapy to alleviate their pain,” Zeidan said.

However, this didn’t mean that meditation didn’t reduce pain.

In a double-blinded study, 78 pain-free volunteers were given drug called naloxone or a placebo. Naloxone stops the pain-reducing effects of the body’s opioids, which means anyone receiving this should have been less able to reduce pain naturally. The naloxone and placebo groups were further divided — some meditated and some did not.

The brave volunteers agreed to have a thermal probe heat a patch of skin to cause pain. The probe was heated to 49 degrees centigrade — a level most people find very painful. After the probe, the participants then rated how painful they found this.

The group taking naloxone and meditating were able to reduce their reported level of pain by 24 percent. This was an important result because it shows that even when the body’s opioid receptors are blocked, meditation still reduces pain using a different neural pathway.

As Dr Zeidan explained, this is a significant finding.

“Our team has demonstrated across four separate studies that meditation, after a short training period, can reduce experimentally induced pain,” he said. “And now this study shows that meditation doesn’t work through the body’s opioid system.”

“This study adds to the growing body of evidence that something unique is happening with how meditation reduces pain. These findings are especially significant to those who have built up a tolerance to opiate-based drugs and are looking for a non-addictive way to reduce their pain.”

“At the very least, we believe that meditation could be used in conjunction with other traditional drug therapies to enhance pain relief without it producing the addictive side effects and other consequences that may arise from opiate drugs,” he said.

Can mindfulness make you eat better? It seems so…

One of the core mindfulness skills we teach on our programme is paying attention while doing everyday tasks. This includes eating.

If we are not being mindfulness, many of us eat without tasting or experiencing our food — even a favourite meal may be wolfed down in this way because our minds are elsewhere.

Obviously that means we miss out on one of life’s great pleasures, but there may be another pragmatic reason to eat mindfully too. Mindfulness may help you to have a healthier relationship with food and exercise.

A recent study conducted with adolescents found this to be the case. The study, by Dr. Vernon A. Barnes, a physiologist at the Medical College of Georgia at Augusta University found that mindful eating helped participants to eat better, exercise more and curb weight gain.

The study examined the impact of mindfulness on diet, exercise and eating habits of adolescents. A control group continued their regular school health classes and the study group underwent 12 weeks of mindfulness, starting with simple techniques such as breathing awareness meditation. The researchers also used chocolate to increase awareness of taste and taste satiety, and explained how emotions can trigger overeating. The students also learnt mindful movement and walking meditation, as well as used pedometers to measure their levels of activity.

Most of the adolescents in both groups were overweight and had bad eating habits, including binge eating. At the end of the 12 week period, the researchers looked at what the students ate, how often they exercised and whether or not they binged.

Barnes found that adolescents undergoing the mindfulness programme ate better and exercised more. Physical activity for participants increased compared with the control group, who actually exercised even less than usual over the study period by about half a day per week. Over six months, the mindfulness participants went from 2.9 to 3.6 to 4.3 days of activity each week. The control group dropped from nearly three days to about two days of activity per week.

The adolescents learning mindfulness lost weight compared with their peers in the control group, who continued to gain weight. They ate less fat and fewer calories, although many continued to binge eat.

Further research is needed to more fully examine the impact of mindfulness on eating habits, but this research is certainly promising.

“This gives us a safe, inexpensive intervention that could be translated into a real-world program for overweight kids,” said Dr Barnes. “If you can make a practice of keeping the awareness with you at every meal, this could benefit you throughout your life.”

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