Eating More Fruits and Vegetables Can Improve Mental Health

It makes sense that improvements in diet can improve not only physical but mental health as well.

The research showed a positive association between the quantity of fruit and vegetables consumed and people’s self-reported mental well-being.

Specifically, the findings indicate that eating just one extra portion of fruits and vegetables a day could have an equivalent effect on mental well-being as around 8 extra days of walking a month (for at least 10 minutes at a time).

Dr Neel Ocean of the University of Leeds, who authored the study with Dr Peter Howley (University of Leeds) and Dr Jonathan Ensor (University of York), said: “It’s well-established that eating fruit and vegetables can benefit physical health.

“Recently, newer studies have suggested that it may also benefit psychological well-being. Our research builds on previous work in Australia and New Zealand by verifying this relationship using a much bigger UK sample.

“While further work is needed to demonstrate cause and effect, the results are clear: people who do eat more fruit and vegetables report a higher level of mental well-being and life satisfaction than those who eat less.”

Dr Howley said: “There appears to be accumulating evidence for the psychological benefits of fruits and vegetables. Despite this, the data show that the vast majority of people in the UK still consume less than their five-a-day.

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Experimental Electric Therapy to Treat Mental Health Problems is Curing PTSD

This is unique research, although it is difficult to determine how valuable it is or its potential for misuse, but its potential of treating mental health disorders — an immense problem in modern society — makes it worth mentioning.

Hundreds of vets have tried out an experimental new treatment that could change how the world addresses mental disorders.

Tony didn’t know what to expect when he walked into the Brain Treatment Center in San Diego, California, last spring. The former Navy SEAL only knew that he needed help. His service in Iraq and Afghanistan was taking a heavy toll on his mental and physical wellbeing. He had trouble concentrating, remembering, and was given to explosive bursts of anger. “If somebody cut me off driving, I was ready to kill ’em at the drop of a hat,” he said. And after he got into a fistfight on the side of a California road, his son looking on from the car, he decided he was willing to try anything — even an experimental therapy that created an electromagnetic field around his brain.

What Tony and several other former U.S. Special Operations Forces personnel received Newport Brain Research Laboratory, located at the Center, was a new treatment for brain disorders, one that might just revolutionize brain-based medicine. Though the FDA clinical trials to judge its efficacy and risks are ongoing, the technique could help humanity deal with a constellation of its most common mental disorders — depression, anxiety, aggressiveness, attention deficit, and others—and do so without drugs. And if its underpinning theory proves correct, it could be among the biggest breakthroughs in the treatment of mental health since the invention of the EEG a century ago.

At the lab, Tony (whose name has been changed to protect his identity) met Dr. Erik Won, president and CEO of the Newport Brain Research Laboratory, the company that’s innovating Magnetic EEG/ECG-guided Resonant Therapy, or MeRT. Won’s team strapped cardiac sensors on Tony and placed an electroencephalography cap on his skull to measure his brain’s baseline electrical activity. Then came the actual therapy. Placing a flashlight-sized device by Tony’s skull, they induced an electromagnetic field that senta small burst of current to his brain. Over the course of 20 minutes, they moved the device around his cranium, delivering jolts that, at their most aggressive, felt like a firm finger tapping.

For Tony, MeRT’s effects were obvious and immediate. He walked out of the first session to a world made new. “Everything looked different,” he told me. “My bike looked super shiny.”

He began to receive MeRT five times a week— each session lasting about an hour, with waiting room time — and quickly noticed a change in his energy. “I was super boosted,” he said. His mood changed as well.

Today, he admits that he still has moments of frustration but says that anger is no longer his “go-to emotion.” He’s developed the ability to cope. He still wants help with his memory, but his life is very different. He’s taken up abstract painting and welding, two hobbies he had no interest in at all before the therapy. He’s put in a new kitchen. Most importantly, his sleep is very different: better.

Tony’s experience was similar to those of five other special-operations veterans who spoke with Defense One. All took part in a double-blind randomized clinical trial that sought to determine how well MeRT treats Persistent Post-Concussion Symptoms and Post-Traumatic Stress Disorder, or PTSD. Five out of the six were former Navy SEALS.

[…]

All said that they saw big improvements after a course of therapy that ran five days a week for about four weeks. Bill reported that his headaches were gone, as did Cathy, who said her depression and mood disorders had lessened considerably. Jim’s memory and concentration improved so dramatically that he had begun pursuing a second master’s degree and won a spot on his college’s football team. Ted said he was feeling “20 years younger” physically and found himself better able to keep pace with the younger SEALS he was training. All of it, they say, was a result of small, precisely delivered, pops of electricity to the brain. Jim said the lab had also successfully treated back and limb pain by targeting the peripheral nervous system with the same technique.

[…]

The lab is about one-third of the way through a double-blind clinical trial that may lead to FDA approval, and so Won was guarded in what he could say about the results of their internal studies. But he said that his team had conducted a separate randomized trial on 86 veterans. After two weeks, 40 percent saw changes in their symptoms; after four weeks, 60 did, he said.

“It’s certainly not a panacea,” said Won. “There are people with residual symptoms, people that struggle…I would say the responses are across the board. Some sleep better. Some would say, very transformative.” (Won doesn’t even categorize the treatment as “curing,” as that has a very specific meaning in neurology and mental health, so much as “helping to treat.”)

[…]

The separate notion that electricity could be used to treat mental disorder entered wide medical practice with the invention of electroconvulsive therapy, or ECT, in Italy in the 1930s. ECT — more commonly called shock therapy — used electricity to induce a seizure in the patient. Its use spread rapidly across psychiatry as it seemed to not only meliorate depression but also to temporarily pacify patients who suffered from psychosis and other disorders. Before long, doctors in mental institutions were prescribing it commonly to subdue troublesome patiets and even as a “cure” for homosexuality. The practice soon became associated with institutional cruelty.

In the 1990s, a handful of researchers, independent of another, realized that electricity at much lower voltages could be used to help with motor function in Parkinson’s patients and as an aid for depression. But there was a big difference between their work and that of earlier practitioners of ECT: they used magnetic fields rather than jolts of electricity. This allowed them to activate brain regions without sending high currents through the skull. Seizures, it seemed, weren’t necessary.

In 2008, researchers began to experiment with what was then called transcranial magnetic stimulation to treat PTSD. Since then, it’s been approved as a treatment for depression. Won and his colleagues don’t use it in the same way that doctors do when they’re looking for something simple and easy to spot, like potential signs of a seizure or head trauma. Won uses EEG/ECG biometrics to find the subject’s baseline frequency, essentially the “normal” state to return her or him to, and also to precisely target the areas of the brain that will respond to stimulation in the right way.

YOU Have a Signature. Your Signature is YOU

No two people experience mental health disorders in the same way. Some PTSD sufferers have memory problems; others, depression; still others, uncontrollable anger. But people that are diagnosed with depression are more likely to suffer from another, separate mental health issue, such as anxiety, attention deficit, or something else.

The theory that underpins MeRT posits that many of these problems share a common origin: a person’s brain has lost the beat of its natural information-processing rhythm, what Won calls the “dominant frequency.”

Your dominant frequency is how many times per second your brain pulses alpha waves. “We’re all somewhere between 8 and 13 hertz. What that means is that we encode information 8 to 13 times per second. You’re born with a signature. There are pros and cons to all of those. If you’re a slower thinker, you might be more creative. If you’re faster, you might be a better athlete,” Won says.

Navy SEALS tend to have higher-than-average dominant frequencis, around 11 or 13 Hz. But physical and emotional trauma can disrupt that, causing the back of the brain and the front of the brain to emit electricity at different rates. The result: lopsided brain activity. MeRT seeks to detect arrhythmia, find out which regions are causing it, and nudge the off-kilter ones back onto the beat.

“Let’s just say in the left dorsal lateral prefrontal cortex, towards the front left side of the brain, if that’s cycling at 2 hertz, where we are 3 or 4 standard deviations below normal, you can pretty comfortably point to that and say that these neurons aren’t firing correctly. If we target that area and say, ‘We are going to nudge that area back to, say, 11 hertz,’ some of those symptoms may improve,” says Won. “In the converse scenario, in the right occipital parietal lobe where, if you’ve taken a hit, you may be cycling too fast. Let’s say it’s 30 hertz. You’re taking in too much information, oversampling your environment. And if you’re only able to process it using executive function 11 times per second, that information overload might manifest as anxiety.”

If the theory behind MeRT is true, it could explain, at least partially, why a person may suffer from many mental-health symptoms: anxiety, depression, attention deficits, etc. The pharmaceutical industry treats them with separate drugs, but they all may have a similar cause, and thus be treatable with one treatment. That, anyway, is what Won’s preliminary results are suggesting.

“You don’t see these type of outcomes with psychopharma or these other types of modalities, so it was pretty exciting,” he said.

There are lots of transcranial direct stimulation therapies out there, with few results to boast of. What distinguishes MeRT from other attempts to treat mental disorders with electrical fields is the use of EEG as a guide. It’s the difference between trying to fix something with the aid of a manual versus just winging it.

If the clinical trials bear out and the FDA approves of MeRT as an effective treatment for concussion and/or PTSD, many more people will try it. The dataset will grow, furthering the science. If that happens, the world will soon know whether or not there is a better therapeutic for mood and sleep disorders than drugs; and a huge portion of the pharmaceutical industry will wake up to earth-changing news.

But there’s more. Won believes that MeRT may have uses for nominally healthy brains, such as improving attention, memory, and reaction time, as Ted discovered. It’s like the eyesight thing, the sudden, stark visual clarity. “These were unexpected findings, but we’re hearing it enough that we want to do more studies.”

Performance enhancement is “not something that we’re ardently chasing,” says Won. ”Our core team is about saving lives. But so many of our veterans are coming back asking.”

Already, there’s evidence to suggest that it could work. “What we’ve noticed in computerized neuro-psych batteries is that reaction times improve. Complex cognitive processing tasks can improve both in terms of speed to decision and the number of times you are right versus wrong. Those are all things we want to quantify and measure with good science,” he says.

Infections During Childhood Increase Risks of Mental Disorders Developing

The connection between mind and body is further emphasized.

A new study from iPSYCH shows that the infections children contract during their childhood are linked to an increase in the risk of mental disorders during childhood and adolescence. This knowledge expands our understanding of the role of the immune system in the development of mental disorders.

High temperatures, sore throats and infections during childhood can increase the risk of also suffering from a mental disorder as a child or adolescent. This is shown by the first study of its kind to follow all children born in Denmark between 1 January 1995 and 30 June 2012. The researchers have looked at all infections that have been treated from birth and also at the subsequent risk of childhood and adolescent psychiatric disorders.

“Hospital admissions with infections are particularly associated with an increased risk of mental disorders, but so too are less severe infections that are treated with medicine from the patient’s own general practitioner,” says Ole Köhler-Forsberg from Aarhus University and Aarhus University Hospital’s Psychoses Research Unit. He is one of the researchers behind the study.

The study showed that children who had been hospitalised with an infection had an 84 per cent increased risk of suffering a mental disorder and a 42 per cent increased risk of being prescribed medicine to treat mental disorders. Furthermore, the risk for a range of specific mental disorders was also higher, including psychotic disorders, OCD, tics, personality disorders, autism and ADHD.

“This knowledge increases our understanding of the fact that there is a close connection between body and brain and that the immune system can play a role in the development of mental disorders. Once again research indicates that physical and mental health are closely connected,” says Ole Köhler-Forsberg.

Highest risk following an infection

The study has just been published in JAMA Psychiatry and is a part of the Danish iPSYCH psychiatry project.

“We also found that the risk of mental disorders is highest right after the infection, which supports the infection to some extent playing a role in the development of the mental disorder,” says Ole Köhler-Forsberg.

It therefore appears that infections and the inflammatory reaction that follows afterwards can affect the brain and be part of the process of developing severe mental disorders. This can, however, also be explained by other causes, such as some people having a genetically higher risk of suffering more infections and mental disorders.

The new knowledge could have importance for further studies of the immune system and the importance of infections for the development of a wide range of childhood and adolescent mental disorders for which the researchers have shown a correlation. This is the assessment of senior researcher on the study, Research Director Michael Eriksen Benrós from the Psychiatric Centre Copenhagen at Copenhagen University hospital.

“The temporal correlations between the infection and the mental diagnoses were particularly notable, as we observed that the risk of a newly occurring mental disorder was increased by 5.66 times in the first three months after contact with a hospital due to an infection and were also increased more than twofold within the first year,” he explains.

Michael Eriksen Benrós stresses that the study can in the long term lead to increased focus on the immune system and how infections play a role in childhood and adolescent mental disorders.

“It can have a consequence for treatment and the new knowledge can be used in making the diagnosis when new psychiatric symptoms occur in a young person. But first and foremost it corroborates our increasing understanding of how closely the body and brain are connected,” he says.

Study: Social Media Use Can Increase Depression and Loneliness

The study essentially found that people using social media less than they typically would results in major decreases in loneliness and depression, with that effect being more pronounced for people who were most depressed at the start of the study.

Social media does have its share of positives — it allows people otherwise separated by significant physical distance to keep in touch and interact, it provides platforms for sharing ideas and stories, and it provides ways for the disadvantaged in society to gain access to opportunities. There are clear downsides to social media services though:

The link between the two has been talked about for years, but a causal connection had never been proven. For the first time, University of Pennsylvania research based on experimental data connects Facebook, Snapchat, and Instagram use to decreased well-being. Psychologist Melissa G. Hunt published her findings in the December Journal of Social and Clinical Psychology.

Few prior studies have attempted to show that social-media use harms users’ well-being, and those that have either put participants in unrealistic situations or were limited in scope, asking them to completely forego Facebook and relying on self-report data, for example, or conducting the work in a lab in as little time as an hour.

“We set out to do a much more comprehensive, rigorous study that was also more ecologically valid,” says Hunt, associate director of clinical training in Penn’s Psychology Department.

To that end, the research team, which included recent alumni Rachel Marx and Courtney Lipson and Penn senior Jordyn Young, designed their experiment to include the three platforms most popular with a cohort of undergraduates, and then collected objective usage data automatically tracked by iPhones for active apps, not those running the background.

Each of 143 participants completed a survey to determine mood and well-being at the study’s start, plus shared shots of their iPhone battery screens to offer a week’s worth of baseline social-media data. Participants were then randomly assigned to a control group, which had users maintain their typical social-media behavior, or an experimental group that limited time on Facebook, Snapchat, and Instagram to 10 minutes per platform per day.

For the next three weeks, participants shared iPhone battery screenshots to give the researchers weekly tallies for each individual. With those data in hand, Hunt then looked at seven outcome measures including fear of missing out, anxiety, depression, and loneliness.

“Here’s the bottom line,” she says. “Using less social media than you normally would leads to significant decreases in both depression and loneliness. These effects are particularly pronounced for folks who were more depressed when they came into the study.”

Hunt stresses that the findings do not suggest that 18- to 22-year-olds should stop using social media altogether. In fact, she built the study as she did to stay away from what she considers an unrealistic goal. The work does, however, speak to the idea that limiting screen time on these apps couldn’t hurt.

“It is a little ironic that reducing your use of social media actually makes you feel less lonely,” she says. But when she digs a little deeper, the findings make sense. “Some of the existing literature on social media suggests there’s an enormous amount of social comparison that happens. When you look at other people’s lives, particularly on Instagram, it’s easy to conclude that everyone else’s life is cooler or better than yours.”

Because this particular work only looked at Facebook, Instagram, and Snapchat, it’s not clear whether it applies broadly to other social-media platforms. Hunt also hesitates to say that these findings would replicate for other age groups or in different settings. Those are questions she still hopes to answer, including in an upcoming study about the use of dating apps by college students.

Despite those caveats, and although the study didn’t determine the optimal time users should spend on these platforms or the best way to use them, Hunt says the findings do offer two related conclusions it couldn’t hurt any social-media user to follow.

For one, reduce opportunities for social comparison, she says. “When you’re not busy getting sucked into clickbait social media, you’re actually spending more time on things that are more likely to make you feel better about your life.” Secondly, she adds, because these tools are here to stay, it’s incumbent on society to figure out how to use them in a way that limits damaging effects. “In general, I would say, put your phone down and be with the people in your life.”

Research Into Pain Shows That When People Expect More Pain, They Feel More Pain

A good study that’s needed to be done for a while.

Expect a shot to hurt and it probably will, even if the needle poke isn’t really so painful. Brace for a second shot and you’ll likely flinch again, even though — second time around — you should know better.

That’s the takeaway of a new brain imaging study published in the journal Nature Human Behaviour which found that expectations about pain intensity can become self-fulfilling prophecies. Surprisingly, those false expectations can persist even when reality repeatedly demonstrates otherwise, the study found.

“We discovered that there is a positive feedback loop between expectation and pain,” said senior author Tor Wager, a professor of psychology and neuroscience at the University of Colorado Boulder. “The more pain you expect, the stronger your brain responds to the pain. The stronger your brain responds to the pain, the more you expect.”

For decades, researchers have been intrigued with the idea of self-fulfilling prophecy, with studies showing expectations can influence everything from how one performs on a test to how one responds to a medication. The new study is the first to directly model the dynamics of the feedback loop between expectations and pain and the neural mechanisms underlying it.

Marieke Jepma, then a postdoctoral researcher in Wager’s lab, launched the research after noticing that even when test subjects were shown time and again that something wouldn’t hurt badly, some still expected it to.

“We wanted to get a better understanding of why pain expectations are so resistant to change,” said Jepma, lead author and now a researcher at the University of Amsterdam.

The researchers recruited 34 subjects and taught them to associate one symbol with low heat and another with high, painful heat.

Then, the subjects were placed in a functional magnetic resonance imaging (fMRI) machine, which measures blood flow in the brain as a proxy for neural activity. For 60 minutes, subjects were shown low or high pain cues (the symbols, the words Low or High, or the letters L and W), then asked to rate how much pain they expected.

Then varying degrees of painful but non-damaging heat were applied to their forearm or leg, with the hottest reaching “about what it feels like to hold a hot cup of coffee” Wager explains.

Then they were asked to rate their pain.

Unbeknownst to the subjects, heat intensity was not actually related to the preceding cue.

The study found that when subjects expected more heat, brain regions involved in threat and fear were more activated as they waited. Regions involved in the generation of pain were more active when they received the stimulus. Participants reported more pain with high-pain cues, regardless of how much heat they actually got.

“This suggests that expectations had a rather deep effect, influencing how the brain processes pain,” said Jepma.

Surprisingly, their expectations also highly influenced their ability to learn from experience. Many subjects demonstrated high “confirmation bias” — the tendency to learn from things that reinforce our beliefs and discount those that don’t. For instance, if they expected high pain and got it, they might expect even more pain the next time. But if they expected high pain and didn’t get it, nothing changed.

“You would assume that if you expected high pain and got very little you would know better the next time. But interestingly, they failed to learn,” said Wager.

This phenomenon could have tangible impacts on recovery from painful conditions, suggests Jepma.

“Our results suggest that negative expectations about pain or treatment outcomes may in some situations interfere with optimal recovery, both by enhancing perceived pain and by preventing people from noticing that they are getting better,” she said. “Positive expectations, on the other hand, could have the opposite effects.”

The research also may shed light on why, for some, chronic pain can linger long after damaged tissues have healed.

Whether in the context of pain or mental health, the authors suggest that it may do us good to be aware of our inherent eagerness to confirm our expectations.

“Just realizing that things may not be as bad as you think may help you to revise your expectation and, in doing so, alter your experience,” said Jepma.

Study: Aerobic Exercise Has Antidepressant Effects for Those With Major Depression

It seems like doctors should prescribe this sort of moderate intensity aerobic exercise instead of pharmaceutical drugs much more.

An analysis of randomized controlled clinical trials indicates that supervised aerobic exercise has large antidepressant treatment effects for patients with major depression. The systematic review and meta-analysis is published in Depression and Anxiety.

Across 11 eligible trials involving 455 adult patients (18-65 years old) with major depression as a primary disorder, supervised aerobic exercise was performed on average for 45 minutes, at moderate intensity, 3 times per week, and for 9.2 weeks. It showed a significantly large overall antidepressant effect compared with antidepressant medication and/or psychological therapies.

Also, aerobic exercise revealed moderate-to-large antidepressant effects among trials with lower risk of bias, as well as large antidepressant effects among trials with short-term interventions (up to 4 weeks) and trials involving preferences for exercise.

Subgroup analyses revealed comparable effects for aerobic exercise across various settings and delivery formats, and in both outpatients and inpatients regardless of symptom severity.

“Collectively, this study has found that supervised aerobic exercise can significantly support major depression treatment in mental health services,” said lead author Dr. Ioannis D. Morres, of the University of Thessaly, in Greece.

Three Types of Depression Identified in Research for the First Time

More knowledge about the societal problem of depression should lead to more effective treatments for it.

According to the World Health Organization, nearly 300 million people worldwide suffer from depression and these rates are on the rise. Yet, doctors and scientists have a poor understanding of what causes this debilitating condition and for some who experience it, medicines don’t help.

Scientists from the Neural Computational Unit at the Okinawa Institute of Science and Technology Graduate University (OIST), in collaboration with their colleagues at Nara Institute of Science and Technology and clinicians at Hiroshima University, have for the first time identified three sub-types of depression. They found that one out of these sub-types seems to be untreatable by Selective Serotonin Reuptake Inhibitors (SSRIs), the most commonly prescribed medicines for the condition. The study was published in the journal Scientific Reports.

Serotonin is a neurotransmitter that influences our moods, interactions with other people, sleep patterns and memory. SSRIs are thought to take effect by boosting the levels of serotonin in the brain. However, these drugs do not have the same effect on everyone, and in some people, depression does not improve even after taking them. “It has always been speculated that different types of depression exist, and they influence the effectiveness of the drug. But there has been no consensus,” says Prof. Kenji Doya.

For the study, the scientists collected clinical, biological, and life history data from 134 individuals — half of whom were newly diagnosed with depression and the other half who had no depression diagnosis- using questionnaires and blood tests. Participants were asked about their sleep patterns, whether or not they had stressful issues, or other mental health conditions.

Researchers also scanned participants’ brains using magnetic resonance imaging (MRI) to map brain activity patterns in different regions. The technique they used allowed them to examine 78 regions covering the entire brain, to identify how its activities in different regions are correlated. “This is the first study to identify depression sub-types from life history and MRI data,” says Prof. Doya.

With over 3000 measurable features, including whether or not participants had experienced trauma, the scientists were faced with the dilemma of finding a way to analyze such a large data set accurately. “The major challenge in this study was to develop a statistical tool that could extract relevant information for clustering similar subjects together,” says Dr. Tomoki Tokuda, a statistician and the lead author of the study. He therefore designed a novel statistical method that would help detect multiple ways of data clustering and the features responsible for it. Using this method, the researchers identified a group of closely-placed data clusters, which consisted of measurable features essential for accessing mental health of an individual. Three out of the five data clusters were found to represent different sub-types of depression.

The three distinct sub-types of depression were characterized by two main factors: functional connectivity patterns synchronized between different regions of the brain and childhood trauma experience. They found that the brain’s functional connectivity in regions that involved the angular gyrus — a brain region associated with processing language and numbers, spatial cognition, attention, and other aspects of cognition — played a large role in determining whether SSRIs were effective in treating depression.

Patients with increased functional connectivity between the brain’s different regions who had also experienced childhood trauma had a sub-type of depression that is unresponsive to treatment by SSRIs drugs, the researchers found. On the other hand, the other two subtypes — where the participants’ brains did not show increased connectivity among its different regions or where participants had not experienced childhood trauma — tended to respond positively to treatments using SSRIs drugs.

This study not only identifies sub-types of depression for the first time, but also identifies some underlying factors and points to the need to explore new treatment techniques. “It provides scientists studying neurobiological aspects of depression a promising direction in which to pursue their research,” says Prof. Doya. In time, he and his research team hope that these results will help psychiatrists and therapists improve diagnoses and treat their patients more effectively.