Dr. Talia Marcheggiani, ND, naturopathic doctor and mental health expert talks about 8 whole foods you can add to your diet today to improve your mental health and emotional wellness.
Mental health
Genetic links between depression and obesity explored
Obesity – an overview
“Genetic variants linked to high BMI can lead to mental health issues,” reports The Guardian.
Depression is more common among people who are obese. But previous studies have not been able to determine whether there is a direct cause and effect relationship. So it could be the case that depression causes weight gain rather than the other way around, or indeed both could be true.
Also, it could be the complications associated with obesity, such as type 2 diabetes, are contributing to depression rather than the obesity itself.
This latest study attempted to use a genetic technique to focus on the direct effect of obesity on depression, removing the effect of other lifestyle and health factors. The researchers looked at the DNA of around half a million adults with white European ancestry in the UK.
The researchers looked at 73 genetic variations which had previously been linked to higher BMI. Some of these had also been linked to a reduction in risk of metabolic complications such as high cholesterol or blood sugar levels, rather than the increase that might be expected.
The researchers found that having a combination of the genetic variants which were associated with higher BMI was also associated with depression. This was some evidence that it was even the case when a person had the variants which reduced their risk of metabolic complications. This may suggest that obesity influences depression risk through psychological rather than metabolic changes; at least in some cases.
While we cannot change our DNA, taking regular exercise and eating healthily can help people achieve or maintain a healthy weight, and also help people with depression. Read more about how exercise can boost your mood and improve your health.
Where did the story come from?
The study was carried out by researchers from The University of Exeter Medical School, the University of South Australia Cancer Research Institute and King’s College London.
The researchers were funded by the Diabetes Research and Wellness Foundation, the Australian Research Training Program, the UK Medical Research Council, the Wellcome Trust, the European Research Council, the Royal Society, the Gillings Family Foundation, Diabetes UK, the National Institute for Health Research (NIHR) Biomedical Research Centre, Maudsley NHS Foundation Trust and King’s College London. The study was published in the peer-reviewed International Journal of Epidemiology on an open access basis so it is free to read online.
The Guardian reported the study accurately, including a mention of the limitations. The Mail Online provided sketchy details of the study, skirting over any of the genetic analysis and concluding that the psychological impact of being overweight increases the risk of depression, when this was only suggested by the results and not proven.
What kind of research was this?
This was a case-control study, comparing the genetic makeup of people with and without depression.
Depression is more common among people who are obese. However, it is not known whether obesity can directly increase a person’s risk of depression, whether the reverse is true, or both are true.
So researchers carried out a particular type of case-control study known as a Mendelian randomisation study, where researchers focused on genes known to be associated with disease risk and health outcomes rather than lifestyle factors.
The idea behind this type of study is the exact combination of DNA that people inherit from their parents is random. So the analysis reduces the possibility that other factors (confounders) are causing the links seen between obesity and depression.
What did the research involve?
The researchers used genetic information from about 450,000 UK adults with white European ancestry who had volunteered to be part of the UK Biobank, and have their DNA studied for research purposes.
The researchers identified 48,791 people with depression and 291,995 people without depression (controls) whose BMI had been measured, and compared their DNA.
People were identified as having had depression based on having reported either:
that they had seen a GP or psychiatrist for nerves, anxiety, or depression and experienced at least 2 weeks where they felt depressed or unenthusiastic
UK national hospital records indicated that they had a diagnosis of recurrent major depressive disorder (MDD) or single-episode MDD
The researchers also looked at whether analysing only those people with a hospital recorded diagnosis or who reported being diagnosed with depression by a professional affected their results.
The researchers looked specifically at whether genetic variations which have been found to be associated with obesity were also more common in people with depression.
As “markers” for obesity, if these genetic variations were more common in people with depression, this would suggest that obesity could be contributing to people’s risk of developing depression.
The researchers looked at 73 genetic variations which had been linked to having a higher BMI. The researchers excluded variants which had been linked to having a higher BMI but had stronger links to other conditions or traits such as smoking or lipid levels. Of the 73 variants, 43 were in or near to genes which could have an impact on brain and nervous system function and development (so they could theoretically be affecting depression risk directly) and 30 were not. Also, 14 of the variants were associated with increased BMI but reduced risk of metabolic disease (so these would not be influencing depression through these metabolic factors).
If the variants associated with a higher BMI, but not any of the metabolic consequences of obesity, were found to be more common in people with depression, this might suggest that the link between obesity and depression relates to psychological effects.
The researchers also looked at men and women separately, as it could be that the psychological impact of obesity might be greater in women because of issues around body image. They also repeated their analyses on a second sample of 45,591 people with depression and 97,647 controls from another study group (the Psychiatric Genetics Consortium).
What were the basic results?
The researchers found that individuals who were obese had a 45% higher chance of having depression than those in the healthy BMI range (odds ratio (OR) 1.45, 95% confidence interval (CI) 1.41 to 1.49). This link was stronger in women than in men.
Having a combination of genetic variants associated with a higher BMI (about 5kg/m2 higher) was associated with an 18% increase in the odds of having depression (OR 1.18, 95% CI 1.09 to 1.28). The link was slightly stronger in women than men, but the difference was not large enough to rule out that this occurred by chance.
The researchers found similar results when they carried out further analyses to make sure their findings were robust, for example, by excluding people without a hospital recorded diagnosis of depression.
The links to depression were stronger when looking at the BMI-linked variants which were also linked to brain or nervous system related genes. But again the difference was not large enough to rule out that it occurred by chance.
The link with depression was also found for BMI-linked variants which were associated with favourable metabolic profile, but only once data from the Biobank and Psychiatric Genetics Consortium samples were pooled.
How did the researchers interpret the results?
The researchers concluded that having a higher BMI is likely to contribute to directly increasing an individual’s chances of developing depression.
Some medications used to treat depression can cause weight gain. People who are depressed may be less likely to take good care of themselves, including eating healthily and taking regular exercise, and this may also impact their weight.
Conclusion
This study provides evidence that the link seen between obesity and depression may, at least in part, be due to a direct impact of weight on a person’s risk of depression.
This study was very large, and used many complex analyses to look at the relationship between weight, genetics, and depression. The researchers used a study design which aimed to remove the chance of factors other than weight impacting the results. They also carried out several additional analyses to test their results and make sure they were reliable.
For example, the way that people were classified as having or not having depression may not have been entirely accurate, as it was based partly on people’s reports of having seen a medical professional for “nerves, anxiety or depression”. Some people might have had depression but not sought help, or might not have had a diagnosis of depression had they been fully assessed. However, when the researchers excluded people who did not have a hospital recorded diagnosis of depression, they got similar results.
While this study contributes to what is known about the links between obesity and depression, there is still much to be learned. For example, the findings suggest the link may be psychological but researchers will now have to look more closely at how obesity might contribute to depression risk.
It is also worth bearing in mind that the causes of depression are likely to be complex, with many factors potentially playing a role. Also, the results may not apply to people of different ethnicities.
If you are overweight or obese and you are also troubled by low mood or depression then it may be a good idea to seek help for both issues at the same time.
What we do know is that mental and physical health are interrelated, and regular physical activity and eating healthily are likely to be beneficial for both.
Analysis by Bazian
Edited by NHS Website
Claustrophobia Affects One Third of Adults
Woman in Medserena Upright Open MRI scanner – no claustrophobia
Never mind samhainophobia*, it’s being cramped in a small space that really makes the blood run cold for a third (32%) of Brits.
Over half (57%) of those affected by claustrophobia say they experience it ‘sometimes’, with a further 14% saying ‘often’.
The problem is worst amongst women, with 36% suffering compared with 27% of men, according to a new poll by Medserena Upright MRI Centres.
And as many as 40% of 18-24 year olds are afflicted, falling gradually with age before rising again slightly amongst those 55+.
The top three nightmare scenarios are being in a small room with no windows (54%), crowded places (51%) and a ‘tunnel’ MRI scanner (45%).
Reported symptoms included a general feeling of panic (71%), shortness of breath/hyper-ventilation (45%) and sweating/chills (33%).
Avoiding situations known to trigger attacks is the most common step taken to help (65%), whilst 41% rely on breathing techniques and 33% try to focus on peaceful and relaxing images.
Over half (57%) of those who had been scanned in an enclosed MRI tunnel had felt ‘very nervous and claustrophobic’. A further 10% required sedation and another 13% asked for the process to be stopped altogether.
Given the choice, 71% of those surveyed said they would prefer an open, upright MRI scan where they could sit or stand with nothing in front of them. Just 11% chose the option of lying down in a conventional tube.
Over three quarters (76%) agreed that the NHS should automatically offer open, upright MRI scans to people suffering from claustrophobia.
Worryingly, a quarter of claustrophobic patients (25%) said they would prefer to leave their condition untreated, if they were very frightened of the medical test to diagnose it.
“Previous studies have indicated that around 12% of people in the UK suffer from claustrophobia,” comments Professor Francis Smith, Medical Director at Medserena.
“So for our new research to show it’s actually a third of adults suggests the problem is more widespread than originally thought. Particularly given that half of them describe their symptoms as ‘moderate’, as opposed to just ‘mild’ (44%)”.
Nearly a quarter of those surveyed thought that having been trapped in a confined space was the root cause of their claustrophobia, with a further fifth citing a traumatic or stressful life experience such as a bereavement.
Surprisingly, just 15% have tried medication and 17% psychological therapy such as CBT.
-ends-
* samhainophobia is a persistent, abnormal, and unwarranted fear of Halloween
Medserena Upright MRI Centres surveyed a nationally representative sample of 2000 UK adults. A second poll was carried out surveying 2000 UK adults who suffer from claustrophobia. The research was conducted by OnePoll between 3-22 October 2018.
28 Days of Mindfulness to Beat the Winter Blues
28 days of mindfulness
There is a growing awareness around mental health and at this time of year, Seasonal Affective Disorder (SAD) can become a real problem, as can the less serious winter blues. Seasonal Affective Disorder is depression occurring at specific times of the year, usually Autumn and Winter although some can be affected during Spring and Summer. Luckily there are lots of things that can be done to help with the winter blues and lift a low mood.
Psychologist Andrew Bridgewater spoke to us about his experience of patients with SAD and said that 20% of the patients he sees suffer with SAD each year. He said that; ‘Anyone can experience SAD, especially if they find themselves under sustained stress or experience a very challenging life event at that time of year.’
Here Insulation Express have provided tips for coping with the winter blues and a calendar to get you started on preventing SAD this autumn.
From keeping active to eating well, we’ve got all the advice on how you can help yourself this Autumn/Winter.
Remember that whenever experiencing a low mood or symptoms of depression it is best to seek medical advice. This is not meant as a diagnostic tool, but to help those with the winter blues help themselves. See your GP if you have any symptoms of depression or seasonal affective disorder.
Depression and Chronic Pain
Due to psychosomatic symptoms of mental illness, chronic pain can be caused by depression. Meaning that because of our depression we can feel like we are in pain all the time. Today I want to talk about how chronic pain (or being in pain for many weeks without a break) can lead to depression.
Imagine if you are in pain more days then not, it would be really hard to sleep, you wouldn’t want to be out with other people, and you may even struggle to concentrate. There can also be legal and financial issues associated with chronic pain as our medical bills pile up and we attempt to get disability. I only mention these issues so that you can grasp just how hard having chronic pain can be, and why it is so closely linked to depression.
I also did a video on chronic illness with Hank Green where he talked about grieving the loss of what his life could have looked like. Click here for more: https://youtu.be/IXbAYg5pp9M
He mentions how important it is that we try and focus on what we can do instead of focusing on the things that we can’t do anymore. Shifting our thoughts to a more positive place is so helpful and I honestly believe can change our overall outlook on life.
There are also treatment options available! Seeing a therapist who can work with you on processing the loss and grief that you may feel as well as helping you focus on what you can do will really help. They also mention how medication not only for your pain but also for your depression (ie. SSRIs, SNRIs, etc) can really help. Lastly, there are treatment centers that work to help us overcome both issues at the same time. The Mayo Clinic has a great one (link below) but if going into a treatment center like that doesn’t work for you, you can also treat each issue separately through pain management and psychotherapy.
The overall message I want you to hear is that help is available and it can get better. Even if the pain we feel doesn’t go away, we can find ways to better manage our emotions around it and heal our relationships with ourselves and others.