Pacific Mind Health Has a Comprehensive Approach to Treating Sleep Disorders

Poor Sleep Can Impact Your Overall Health

Individuals with bipolar disorder (BD) have a higher incidence of Parkinson disease (PD), according to the results of a study published in Neurology. In addition, more frequent manic/mixed and depressive episodes increase this risk...

The study found that those with BD had a higher incidence of PD and a shorter duration from enrollment to diagnosis of PD than control individuals during the follow-up period (0.7% vs 0.1%). Patients with a higher frequency of psychiatric admission for BD had an increased risk of developing PD compared with those admitted less than once per year. The hazard ratio for developing PD for 1 to 2 manic/mixed episodes per year was 4.02, whereas for 1 to 2 depressive episodes per year, it was 2.67. For more than 2 episodes per year, the hazard ratios were 6.29 for manic/mixed and 6.19 for depressive.

Sleep-disordered breathing (SDB) is an umbrella term used to describe various conditions that cause atypical respiratory patterns (e.g., sleep apnea) and result in the partial or complete cessation of regular breathing cycles throughout the night. Sleep-disordered breathing, and the sleep disruption caused by SDB, are associated with epigenetic age acceleration, according to a new study (Li et al., 2019) from Harvard Medical School...

"People's biological age might not be the same as their chronological age," Li said in a statement. "Individuals whose biological age is higher than their chronological age exhibit age acceleration or fast aging. In our study, we found that more severe sleep-disordered breathing is associated with epigenetic age acceleration. Our data provide biological evidence supporting adverse physiological and health effects of untreated sleep-disordered breathing." 

The latest research by scientists tracking the neurological development of these children, published in the journal Developmental Science online in advance of print, shows that disruptions in caregiving produce detrimental effects on a child’s brain function, evident by EEG (electroencephalogram) analysis after children reached teen age (16-17 years old)...

This altered EEG signature has been associated with ADHD, learning disorders, disruptive behavior disorders, and psychosocial risk factors.  However, orphans who were placed in foster home care showed normal EEGs when assessed 12 years later, while those who remained in institutions still had these abnormal features in their EEG.

Personality disorders, as described in the DSM-5,1 are characterized by inflexible and maladaptive patterns of behavior, thoughts, and feelings. Furthermore, personality disorders are associated with distress or impairment. But personality disorders differ from each other in a number of important ways. In a paper published in the March issue of Journal of Clinical Psychology, researchers Stanton and Zimmerman examine shared and unique features of two of these disorders: narcissistic personality disorder and antisocial personality disorder...

Both bi-factor and traditional factor analyses were conducted. First, the results revealed a strong overlap between traits defining each personality—traits such as impulsivity, grandiosity, and callousness.

So significant was the overlap that the authors concluded antisocial and narcissistic personality disorders may not be distinct disorders but “indicators of a broad externalizing spectrum,” sharing features such as impulsivity and antagonism with other disorders in the spectrum.
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Second, regarding how to differentiate antisocial and narcissistic, the results showed that “unlawful behavior” and “outward aggression” distinguished antisocial personality, while viewing oneself as “high status” and “very special” distinguished narcissistic personality. Simply put, though both personalities tend to exploit people, an entitled and arrogant person is more likely to be narcissistic, while an aggressive individual with a criminal history is probably antisocial.

RThe gene most commonly associated with depression is the serotonin transporter gene SLC6A4 (Bleys et al., 2018). Serotonin is a neurotransmitter affecting multiple physiological processes and cognitivebrain functions, among them mood and emotions, which is why it has been linked to mood disorders such as depression. Indeed, low serotonin levels have been associated with depressed mood (Jenkins et al., 2016), and selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. SSRIs block the reuptake of serotonin during cellular communication in the brain, making more serotonin available, and thus in theory helping to reduce depression.

Along these lines, the idea that the serotonin transporter gene could affect depression risk or severity intuitively made sense. Specifically, many scientists focused on the so-called 5-HTTLPR polymorphism in the promoter region of the serotonin transporter gene to research the effects of this gene on depression...

A new study recently published by Richard Border and colleagues in The American Journal of Psychiatry(Border et al., 2019) aimed to resolve the controversy about whether or not the 5-HTTLPR genotype affects depression and whether there is a gene-by-environment interaction between this genotype and stressful life events once and for all. To avoid the statistical problems of previous studies, they obtained data from several large genetic datasets available to researchers, leading to a sample size of several hundred thousand individuals. The results of the analysis were clear as well: There was no statistical evidence for a relation between the 5-HTTLPR polymorphism and depression, and there was also no evidence that traumatic life events or adverse socioeconomic conditions might show a gene-by-environment interaction with this genotype.
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This, of course, does not mean that there is no relationship between serotonin and depression (there clearly is, as shown by the treatment success of SSRIs), but it lends further support to an emerging insight in psychiatry genetics: Mental illness is a highly complex process that is likely influenced by a large number of genetic and non-genetic effects. As such, it is unlikely that single genetic variations such as the 5-HTTLPR polymorphism have a huge impact on whether or not an individual develops depression or any other form of mental illness. 

With one in seven American children and teens now diagnosed with attention-deficit/hyperactivity disorder (ADHD) and psychostimulant medication (amphetamines such as Ritalin and Adderall) commonly used to treat the condition, often generating a range of adverse effects, the demand for alternative treatments has surged in recent years.

Mindful of that need, last Friday the FDA approved the first non-drug device to treat the disorder. Aimed at children aged 7 to 12, the prescription-only device—called the Monarch external Trigeminal Nerve Stimulation (eTNS) System—is described in an agency press release as “innovative, safe, and effective” in treating children who have difficulty staying focused and paying attention, two of the key criteria listed for a diagnosis of ADHD.

​“While the exact mechanism of eTNS is not yet known,” the FDA acknowledges, “neuroimaging studies have shown that eTNS increases activity in the brain regions that are known to be important in regulating attention, emotion, and behavior.”

Until defining characteristics were established almost 40 years ago in the DSM-III, Borderline Personality Disorder (BPD) was a vague and ambiguous concept. Because a primary characteristic is mood swings, some early researchers insisted BPD was merely a variation of Bipolar Affective Disorder (BAD). After all, if there could be Bipolar I and Bipolar II, why wasn't so-called Borderline Personality Disorder something along the line of Bipolar IV, V, or VI? ...

​Researchers discovered similarities and differences in metabolism in these two groups. Both groups, compared to controls, exhibited decreased metabolism in parts of the brain related to emotional control and social interactions. BAD II patients exhibited distinctly decreased metabolism in the cerebellum, brain stem, and parts of the cortex associated in other studies with neurobiological depression. BPD patients showed lower metabolism in other areas including the hypothalamus. The hypothalamus is intimately associated with the endocrine system, which involves stress responses and hormone secretions including cortisol, testosterone, and estrogen. The hypothalamus is also key in the production of oxytocin, which is related to maternal feelings and warm social behavior.

Long thought to be a hallmark feature of borderline personality disorder, the inability to gauge the emotions of others and then regulate their own is what can make the lives of those with this disorder exceptionally challenging. Perhaps someone you care about has this diagnosis or seems to show some of the classic symptoms of instability, problems in attachment, and lack of clear-cut boundaries. What happens when things go wrong? How does this person react? You may find yourself in a position of having to be the voice of reason as you try to get the individual to calm down. The loss of emotional control seems to occur most often in situations involving other people, which often means you’re the target. As you’re berated, cajoled, and criticized for a supposed emotional slight, you wonder if there’s any chance of helping this person gain some self-control.
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In contrast to those who lack emotional control, when distressed, people high in IER (Interpersonal Emotional Regulation) are indeed able to engage in such stress-busting strategies as seeking social support and sympathy from the important people in their lives. They can tell people how they’re feeling in a calm and non-accusatory manner. Another adaptive IER strategy is the use of problem-solving to deal with an emotionally upsetting situation. Getting practical advice is yet another known coping strategy that can both make people feel better and resolve difficult situations.

By contrast, people with borderline personality disorder, along with those who are anxious and depressed, engage in maladaptive IER strategies that don’t reduce their distress but only make it worse. Excessive reassurance seeking is one of those maladaptive coping strategies. Over the short-term, seeking reassurance may alleviate your distress, which only serves to reinforce your use of it. However, as an interpersonal strategy, it is draining on those people who must constantly help to put you out of your emotional misery. A second maladaptive IER strategy is venting, in which you try to make yourself feel better by letting it all out in the form of shouting and yelling. However, people don’t like to be around you when you do this, so as an IER approach, it won't help but will just make you more isolated and unhappy.

For children and adolescents who require medication to treat anxiety, there are two primary classes of antidepressants that are prescribed: selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs). 
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​"For a long time there had been this sense that SSRIs work better than the SNRIs in treating anxious youth, but there wasn’t clear evidence to back this up, so we wanted to put that notion to the test,” says Jeffrey Strawn, MD, associate professor in the Department of Psychiatry and Behavioral Neuroscience at the UC of Cincinnati College of Medicine, and lead author on the study.   

"What we found is that with the SSRIs, compared to SNRIs, people get better faster and see greater improvement overall. There had been some suggestion of this in some individual studies, but this is the first to evaluate the magnitude and trajectory of treatment, or in other words, how much and how quickly people get better.” 

Clinical trial results showed that a 2-week, massed course of prolonged exposure therapy was noninferior to an 8-week spaced course among active military personnel with PTSD, and reduced severity of symptoms more than minimal-contact control.
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“This study not only addresses the pressing need for an effective treatment option for PTSD but also encourages a more speedy treatment and recovery, allowing affected service members to return to active duty sooner and enabling veterans to reintegrate into civilian life more quickly,” Foa said in a press release. “Our findings are good news – about half of those treated achieved remission and many others demonstrated substantial relief from their symptoms. This is critical for the hundreds of thousands of post-9/11 combat veterans affected by PTSD and can do so much to improve lives and assist with military readiness.”

The US Food and Drug Administration (FDA) has cleared the next-generation NeuroStar Advanced Therapy transcranial magnetic stimulation (TMS) device for patients with treatment-resistant major depressive disorder (MDD), the company has announced.
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"We have widespread insurance reimbursement from most commercial and government health plans, and a next-generation NeuroStar Advanced Therapy that uses proprietary technology and a 19-minute treatment that allows patients to get in and out before work or during their lunch hour," NeuroStar President and CEO Chris Thatcher said in the release.
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Research has shown that TMS can provide lasting relief of antidepressant-resistant MDD and improved quality of life for patients.