TIME Diet/Nutrition

Stressful Days Can Slow Your Metabolism, Study Says

Denny's waitress Tahmina Najemyar delivers free Grand Slam breakfasts to customers on February 3, 2009 in Emeryville, California.
Denny's waitress Tahmina Najemyar delivers free Grand Slam breakfasts to customers on February 3, 2009 in Emeryville, California. Justin Sullivan—Getty Images

Why you shouldn't reward yourself with a donut after a long day

You might think that on a high-intensity stressful day would cause you to burn more calories, but research shows you’d likely be wrong.

Women who ate a high-fat meal after they were stressed burned calories more slowly, according to a new study.

Our bodies metabolize slower under stress, but the types of food we crave when we are stressed or depressed tend to be very high in fat and sugar. New research published in the journal Biological Psychiatry suggests how that combination of factors could result in significant weight gain.

Researchers from Ohio State University’s Wexner Medical Center interviewed 58 women about stressors they experienced the day before, such as arguments with spouses or trouble with kids, before giving them a meal of eggs, turkey sausage, biscuits and gravy containing 930 calories and 60 grams of fat.

The women then wore masks which were able to measure their metabolism by calculating inhaled and exhaled airflow of oxygen and carbon dioxide. The researchers also measured the women’s blood sugar, triglycerides (cholesterol), insulin and the stress hormone cortisol.

The researchers found that women who reported being stressed out during the prior 24 hours burned 104 fewer calories than the women who were not stressed. That effect could add up to 11 extra pounds gained over a year of stress-eating, they concluded.

The women who were stressed had higher levels of insulin, which contributes to how the body stores fat, and can slow down the process of metabolizing calories into energy. If fat is not burned, it’s stored on the body. Previous research shows a similar effect in men.

It’s important to note that while stress can lead to overeating, that is not what this research showed. The women in the study were fed high-fat meals as part of the design of the study; they did not choose those foods on their own. Regardless, this adds to a large body of research suggesting the importance of reducing stress and adhering to a healthy diet.

 

TIME Depression

No, Antidepressants During Pregnancy Don’t Harm Babies’ Hearts

Silhouette of Pregnancy
Getty Images

The latest study finds no significant increase in heart malformations in babies whose moms used antidepressants during pregnancy

That should reassure the 8% to 13% of women who take antidepressants while expecting. Concerns about the risks of the drugs, primarily selective serotonin reuptake inhibitors (SSRIs), on the developing fetus prompted the Food and Drug Administration in 2005 to add warnings about the risk of heart defects in babies born to moms taking antidepressants. While studies have shown up to a three-fold increase risk in some congenital heart abnormalities associated with antidepressants, doctors couldn’t be entirely sure the higher risk wasn’t due purely to chance. Now, the New England Journal of Medicine reports that may indeed be the case, thank to the work of Krista Huybrechts, in the division of pharmacoepidemiology at Brigham and Women’s Hospital and Harvard Medical School, and her colleagues.

In their analysis involving 949,504 pregnant women, 64,389 of whom used antidepressants during the first trimester, the rate of heart defects in newborns was similar between the groups. “Based on our study, there is no evidence to support a substantial increased risk of cardiac malformations overall,” she says.

She and her team specifically focused on adjusting for potential confounding factors that could explain the heart malformations, such as age, how many children the women had had, diabetes, hypertension and use of psychotropic medications. Even after accounting for these effects, they found no strong association between antidepressant use and heart defects.

While the findings should be reassuring for expectant mothers who take antidepressants, Huybrechts says that “heart defects are one factor in a whole range of potential risks” associated with the drugs. Some studies hint, for example, that the medications may contribute to hypertension in newborns, as well as other adverse health conditions. “The study provides quite solid evidence of the low risk in terms of cardiac malformations, but the treatment decision should consider the whole range of other potential adverse outcomes,” Huybrechts says. “[Decisions also need to consider] potential risk of not treating women who are severely depressed and required pharmacologic interventions. It’s one piece of the puzzle but definitely not the whole answer.”

TIME Depression

The Latest About Antidepressants and Weight Gain

Scientists compare antidepressants to see which result in the most and least amount of weight gain

A common complaint among patients on antidepressants is that their drugs cause them to gain weight. It’s not fully understood why this happens, or which are the worst offenders, but a new study published in the journal JAMA Psychiatry tried to figure it out by comparing a variety of drugs prescribed for anxiety and depression.

The researchers looked at the electronic medical records of 22,610 adults on antidepressants and compared their reported weight gain over a year. They used the antidepressant citalopram (Celexa) as the control.

The worst offenders in regards to weight gain were mirtazapine (Remeron) and paroxetine hydrochloride (Paxil). The drugs with the lowest the rate of weight gain were bupropion (Wellbutrin), amitriptyline (Elavil), and nortriptyline (Pamelor). The researchers found that among many SSRIs, like escitalopram (Lexapro), there wasn’t a great difference in weight changes.

Exactly why antidepressants cause some people to put on a few pounds is not fully understood. One possible reason is that the antidepressants interfere with the neurotransmitter serotonin which has a role in controlling and regulating appetite. Doctors also know that some people lose their appetite when they are depressed while other people get hungrier. It’s possible that changes in weight are actually reversals in the weight status of the individuals when they were feeling anxious and depressed. “The mechanism is complicated, and we don’t completely understand it,” says study author Dr. Roy Perlis of the Center for Experimental Drugs and Diagnostics, Psychiatric and Neurodevelopmental Genetics Unit at Massachusetts General Hospital.

One of the take-aways from their findings is that if there’s weight gain from antidepressants, it’s typically modest and gradual. “People care a lot about weight gain,” says Perlis. “I think the two questions I hear the most are ‘Is this going to affect my sexual functioning?’ and ‘Is this going to make me gain weight?'”

Perlis says understanding the effects antidepressants have on weight gain is important for patient-doctor conversations about what’s working. Some patients may feel very uncomfortable with the extra pounds, but may feel uneasy telling their doctors that that is the true reason they are unsatisfied; some may even stop taking their medications.

“We don’t want people to be scared away from treatment,” says Perlis. “We hope this study provides reassurance.”

TIME PTSD

Here’s What Happens To The Mind After 5 Years of Captivity

Captured US Solider
Sgt. Bowe Bergdahl in an undated image provided by the U.S. Army. U.S. Army/AP

Sgt. Bowe Bergdahl has a lot of healing to do after five years of captivity. The physical scars may fade, but the emotional ones can sometimes be too deep to heal completely

U.S. Army Sergeant Bowe Bergdahl, the last known American POW, was finally returned home over the weekend after five years held in captivity in Afghanistan. Since Bergdahl’s return, curious details have emerged about his mental state before and after capture. And it all begs the question: What does five years in captivity do to the human mind?

Bergdahl’s repatriation is going to be a challenge, and piecing together the psychologically and physically broken veteran is a delicate process. After all, an abduction is the ultimate exchange of power, spurring the start of a complicated relationship based on both deep distrust and reliance, say experts. “He’s to some degree merged with those who held him,” says Brian Engdahl, professor of PTSD Research and Neuroscience at the University of Minnesota. “He was totally dependent on them for food, shelter, clothing. It can reduce a person to a weak state where their entire life revolves around how their captors are treating them.” A morsel of food becomes a generous gift, only to be withheld at the next feeding.

Many POWs find physical and mental strength by relying on their fellow captured soldiers, but Bergdahl was alone. Speculation about whether he suffered from Stockholm Syndrome—the phenomenon where captives identify with their captors—are not unwarranted, though so far evidence hasn’t suggested this to be true.

Studies of POWs from the Korean War show that the psychological injuries from captivity stem from two types of trauma. The first is physical and usually short-term, caused by malnutrition and injury. The more persisting trauma is, of course, psychological. At Landstuhl Regional Medical Center in Germany, which treats U.S. vets from Afghanistan and Iraq, Bergdahl is likely being tested for depression, anxiety, and PTSD, says Engdahl. “Beyond that, he could be feeling deep guilt, shame, bewilderment, and a lost sense of identity,” says Engdahl. If his English is poor, as has been reported, it’s likely from lack of speaking.

Once home, psychological challenges won’t likely abate overnight, says Barbara Rothbaum, the associate vice chair of clinical research in the department of psychiatry at Emory School of Medicine. “But even if the trauma is over, it’s not really over,” she says. POWs often experience flashbacks, and will wake up in the middle of the night thinking they are still in captivity. Many victims become avoidant and don’t want to talk about their experience because they are afraid it will trigger memories, she says. It’s one of the reasons many will forgo treatment.

“I’ve had veterans tell me they were drunk for a year,” says Rothbaum. But avoidance is one of the worst ways to deal with the harsh return, and Rothbaum’s research has shown that talking about experiences early can actually help prevent the onset of PTSD.

“People want to avoid talking about the worst parts, the most shameful, the most embarrassing,” says Rothbaum. “But it will help.”

TIME

Why Some People Get Depressed And Others Get Resilient

New research in mice show certain neurons in the brain may determine whether someone is depressed or resilient

Some people thrive under stress and tight deadlines, and others become crippled with defeat. A team of scientists looked to mice to find biological answers for these different responses and found the reason my lie deep in the brain.

The area of the brain called the medial prefrontal cortex (mPFC) is known to be involved in the regulation of emotions and behavior, and can become highly activated in people who are depressed. Researchers have long wanted to know whether hyperactivity in mPFC causes depression or if the activity in that part of the brain is a result of something else (and thus not the cause of depression). To test this, they looked at mice and were able to pinpoint the specific neurons involved with stress. Like humans, when mice are depressed, the mPFC neurons become activated. The very same neurons were weak among mice who appeared not to be bothered by added stress.

To see whether the activated mPFC was indeed causing depression in mice, the scientists engineered them with neurological conditions associated with depression. Interestingly, the mice that were once resilient became depressed and helpless, suggesting that the neuron interference was in fact causing these symptoms. The findings were published in The Journal of Neuroscience.

The researchers believe these findings support the use of a depression treatment called deep brain stimulation (DBS), which targets these very neurons. Understanding what areas of the brain are impacted by depression not only helps in the creation of better antidepressants, but the creation of therapies that do not involve drugs. Besides DBS, treatments that use magnets on the brain like transcranial magnetic stimulation (TMS) have proven successful, and another recent study showed that oxytocin is effective in regulating mood and benefiting mental disorders like depression and anxiety.

Of course, since the research is only looking at mice, it’s still preliminary, but it provides further evidence for different targeting treatments.

TIME Smoking

The Weird Link Between E-Cigarettes and Mental Health Disorders

US-HEALTH-TOBACCO-E CIGARETTE
This September 25, 2013 photo illustration taken in Washington, DC, shows a woman smoking a "Blu" e-cigarette (electronical cigarette). PAUL J. RICHARDS—AFP/Getty Images

A new study finds elevated rates of depression, anxiety and other mental disorders among users of e-cigarettes

A new study has found that people suffering from depression, anxiety and other mental disorders are more than twice as likely to spark up an e-cigarette and three times as likely to “vape” regularly than those without a history of mental issues.

Researchers at the University of California, San Diego drew their findings from an extensive survey of American smoking habits. Among 10,041 respondents, 14.8% of individuals suffering from mental health disorders said they had tried an e-cigarette, compared with 6.6% of individuals who had no self-reported history of mental disorders.

The e-smokers’ elevated rates of mental disorders reflected the elevated rates of mental illness among smokers in general. The authors note that by some estimates, people suffering from mental disorders buy upwards of 50 percent of cigarettes sold in the U.S. annually.

Many respondents said they switched to e-cigarettes as a gateway to quitting. The FDA has not yet approved e-cigarettes as a quitting aide.

“People with mental health conditions have largely been forgotten in the war on smoking,” study author Sharon Cummins said in a university press release. “But because they are high consumers of cigarettes, they have the most to gain or lose from the e-cigarette phenomenon.”

The study will run in the May 13 issue of Tobacco Control.

TIME Depression

Doctors Treat Depression With Brain Magnets

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SCIEPRO—Getty Images/Brand X

What to do when the drugs don't work

Meghan McGill was a freshman in college when she was diagnosed with depression. She lost interest in reading and dancing, two of her favorite activities, and eventually missed so many classes that she was disqualified from her university. Six years later, when she was 28, she finally saw a psychiatrist who put her on Prozac. That didn’t help either. “I lost a lot of jobs because I couldn’t call into work,” she says.

McGill’s experience is a familiar one for many patients with depression; more than one in 10 Americans take antidepressants according to the Center for Disease Control—and almost 15% of all women. But 20-40% of people cannot tolerate the side effects or do not benefit from antidepressants.

That’s why doctors are encouraged by a bizarre and novel treatment called transcranial magnetic stimulation (TMS), in which magnets (yes, magnets) are administered to alleviate depression. This strange strategies may provide a way to finally bring relief to patients like McGill, who don’t respond to antidepressant medications or who prefer non-drug treatments for their depression.

Last week, scientists presented their latest success with TMS at the 167th American Psychiatric Association Annual Meeting in New York City. TMS was approved by the FDA in 2008 for the treatment of depression and unlike electroconvulsive therapy (ECT), which uses electrical currents to stimulate the brain to treat serious mental illness like bipolar disorder, TMS does not spur seizures.

The researchers, led by Dr. Mark Demitrack, the chief medical officer of Neuronetics, Inc. and Dr. Kit Simpson of Medical University of South Carolina, studied 306 patients with major depressive disorder who were treated with a TMS device called the NeuroStar TMS Therapy®. (Neurostar was the first TMS therapy on the market, and in 2013, the FDA approved another TMS device called Brainsway.) After one year, people who received six weeks of daily TMS, which targeted the mood regions of the brain, 53% reported no or mild depression. After a comparable period of time, only 38% of people on antidepressants reported the same benefit.

“I think TMS is a very valuable addition to our treatment,” says Dr. Amit Anand, the vice chair for at the Center for Behavioral Health at Cleveland Clinic. Anand was not involved in the research. “It’s a way to treat depression directly, with few side effects. Other research has shown only a small percentage of people respond to it, but I think if even a quarter of those people respond, it’s a benefit.”

Dr. Anand says the Cleveland Clinic will soon be offering the service, which he sees as an option that lies somewhere between antidepressants and ECT. “I think it’s best for people who cannot tolerate antidepressants due to side effects,” he says. “It is does give people hope, but I think expectations should be realistic.”

Dr. Demitrack says TMS comes in when doctors and patients are looking for a second option. “The next option would be the addition of another medication, or they might be recommended to receive Electroconvulsive therapy (ECT), which is more invasive and complicated.” Instead, they could try TMS.

In TMS therapy, a large magnet is put to the left side of the patient’s head. Magnetic pulses are thought to stimulate areas of the patient’s brain that are underactive and are involved in mood regulation. The patient is awake and alert the entire time. The are few side effects other than occasional headaches.

TMS, however, is $998 more expensive than drug therapy, but since it’s a limited-time treatment, the company argues it in two years it is more affordable than additional rounds of drug therapy. Insurance companies are starting to pay for the treatment. (The study was conducted by and for the medical device company, Neuronetics, Inc.)

For now, Dr. Demitrack says TMS is only being studied in patients who don’t respond to antidepressants, and not as a first line therapy. Though, he says he could so how one day patients might prefer it as a first line treatment, even though it’s logistically more difficult than drugs. The American Psychiatric Association does not have an official statement on TMS, but it notes that meta-analyses have discovered relatively small to moderate benefits from TMS.

Encouraging results may help more patients like McGill to finally free themselves from their worst depressive symptoms. “At the second week of treatment, I was suddenly singing to the radio in my car,” she says. “I realized how very different I felt. I just thought, Wow.”

TIME U.S. military

U.S. Special Ops Are Soldiers Committing Suicide in Record Numbers

American Flags Planted On National Mall To Honor Service Members Who Committed Suicide
U.S. military veterans set up 1,892 American flags on the National Mall March 27, 2014 in Washington, DC. The Iraq and Afghanistan Veterans of America installed the flags to represent the 1,892 veterans and service members who committed suicide this year. Win McNamee—Getty Images

The head of Special Operations Command says more than a decade of "hard combat" is taking a tough toll on the mental health of his elite troops

Updated: April 18, 6 a.m. ET

U.S. special operations forces personnel are committing suicide in record numbers, according to a top military official, due to the traumatic effects of years of war.

Admiral William McRaven, who leads the Special Operations Command, told a conference in Tampa, Fla. that members of elite units like the Navy SEALs and Army Rangers have proved prone to depression and self-harm over the past two years, reports Reuters. “And this year, I am afraid, we are on path to break that,” he said.

“My soldiers have been fighting now for 12, 13 years in hard combat—hard combat,” McRaven added. “And anybody that has spent any time in this war has been changed by it. It’s that simple.”

Although precise figures were not provided, it is well known that the U.S. military has been struggling with suicides for a long time. In 2012, the estimated 350 active duty servicemen and servicewomen across the American armed forces that committed suicide surpassed the number lost in combat.

[Reuters]

TIME

Young Dads Are at Risk for Postpartum Depression

A study published in the journal Pediatrics finds that men who become fathers around age 25 see a 68 percent increase of depression symptoms over the first five years of being dads—if they live at the same home as their children

Young dads can develop depressive symptoms over their first few years of fatherhood, according to a new study.

Men who entered into fatherhood at around age 25 saw a 68% increase of depressive symptoms over their first five years of being dads—if they lived at the same home as their children.

The study, which was published in the journal Pediatrics, looked at 10,623 young men who were participating in the National Longitudinal Study of Adolescent Health. The study tracked the fathers for about 20 years, and kept score of their depression symptoms.

While fathers who didn’t share a home with their children didn’t experience the same high increase in depressive symptoms in early fatherhood, most of the fathers in the study did live with their children. Those men had lower depression symptoms before they became dads and experienced a spike in symptoms when their child was born and through the first few years.

Identifying depression symptoms in young fathers is critical, since earlier research shows that depressed dads read and interact less with their kids, are more likely to use corporal punishment, and are more likely to neglect their kids.

“Parental depression has a detrimental effect on kids, especially during those first key years of parent-infant attachment,” said lead study author Dr. Craig Garfield, an associate professor in pediatrics and medical social sciences at Northwestern University’s Feinberg School of Medicine, in a statement. “We need to do a better job of helping young dads transition through that time period.”

TIME Mental Illness

Rick Warren: Churches Must Do More to Address Mental Illness

Pastor Rick Warren speaks onstage at 'The Bible: SON OF GOD Tour 2014' Kick-Off at Saddleback Church on March 20, 2014 in Lake Forest, Calif.
Pastor Rick Warren speaks onstage at 'The Bible: SON OF GOD Tour 2014' Kick-Off at Saddleback Church on March 20, 2014 in Lake Forest, Calif. Imeh Akpanudosen—Getty Images for Word Entertainment

According to the National Alliance on Mental Illness (NAMI), 60 million Americans experience a mental health condition every year – that’s one in four adults and one in ten children. People of every race, age, religion or economic status are affected. Whether we are aware of it or not, we all know someone who is living with some form of mental illness.

Mental illness is something we are intimately acquainted with as our youngest son, Matthew, struggled with a variety of mental illnesses from a young age. Even as a toddler there were signs that things were not right. At 7, he was diagnosed as clinically depressed which surprised us as we were unaware that children that young could be that depressed. As the years went by, he began to experience major depressive episodes as well as panic attacks, extreme mood swings, obsessions/compulsions, personality disorder, and heartbreaking problems in school and relationships. Life became a painful revolving door of doctor appointments, medication, therapy, and adjustments to school classes. There were periods of relative stability but then Matthew’s suicidal ideation became a part of our daily life. Our hilariously funny, immensely creative, intensely compassionate son struggled to make sense of his life and the mental pain he was experiencing. His anguish was our anguish. On April 5, 2013, impulse met opportunity in a tragic way. Our beautiful son ran into the unforgiving wall of mental illness for the last time.

Nearly a year later, we are still reeling from his death. We’ve been devastated, yet not destroyed. Mental illness took our son’s life, as it did many of the 38,000 other Americans who took their lives last year, but we refuse to let his death be just another statistic. One way we can honor his life and use our grief is to help others living with a mental illness and also their families who suffer. On March 28, we are hosting a one-day event, The Gathering on Mental Health and the Church.

There are hundreds of conferences around the world by health professionals, government officials and NGO’s which address mental illness from medical, social, and policy perspectives, but the Church, with its vast network of volunteers and resources is rarely included in the discussion. What do churches have to offer to the mentally ill and their families in light of the multi-layered, complex set of issues that surround mental illness? The answer is – a lot! There are biblical, historical, and practical reasons that churches must be at the table with this issue.

First, from the Gospels, we know that Jesus cared for and ministered to mentally ill people during his ministry on earth. As Christ followers, we are compelled to continue His work today. In Christ’s name, the Church extends compassion, acceptance, and unconditional love to all who suffer from the pain of mental illness, and as his Body, we offer hope and the healing power of God’s grace.

Second, the church has been caring for the sick, both physically and mentally for 2,000 years longer than any government or agency. Most people are unaware that it was the Church that invented the idea of hospitals. For centuries the Church has been a refuge for the outcast, those on the margins, and anyone enduring societal stigma and shame.

Finally, studies have shown that when families or individuals experience the chaos caused by mental illness, the first place they typically call in a crisis is not a doctor, a law office, the school, or the police, but rather they call or go see their priest or pastor. Anyone who’s served as a receptionist for a church knows that they often are required to do triage in mental illness cases. Why is that? Because people instinctively know that churches are called by God to be places of refuge, comfort, guidance, and practical help for those who suffer.

It’s time to stand with those who are suffering.

Pastor Rick and Kay Warren lead Saddleback Church. They will co-host www.mentalhealthandthechurch.com [a one-day event streamed live online] on March 28 to encourage individuals with mental illness and to equip family members and church leaders to care for them.

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