If you’ve been following me for a while now, you might know that anxiety disorder is an issue very close to my heart as I suffer from it. I’ve decided to use my platform to raise awareness on the matter, but also to help people who might not be very familiar with it understand the issue
Is there a role for melatonin in the treatment of anxiety? This video discusses the role of melatonin in the body and what we know about the impact of melatonin on sleep, anxiety, and pain. Melatonin is a hormone produced by the pineal gland in the brain in response to the presence or absence of daylight. Melatonin plays a significant role in the quality of sleep we experience and we do know that as we age the quantity of melatonin produced tends to decline.
Neuronal circuit involved in chronic pain-induced maladaptive anxiety. Increased excitability (white arrow) of BNSTCART neurons causes a sustained suppression (black arrow) of LH-projecting BNST neurons during chronic pain, thereby enhancing anxiety-like behavior (Naoki Yamauchi, et al. Science Advances. April 27, 2022). CREDIT Naoki Yamauchi, et al. Science Advances. April 27, 2022
Hokkaido University researchers have shown how chronic pain leads to maladaptive anxiety in mice, with implications for treatment of chronic pain-related psychiatric disorders in humans.
Chronic pain is persistent and inescapable, and can lead to maladaptive emotional states. It is often comorbid with psychiatric disorders, such as depression and anxiety disorders. It is thought that chronic pain causes changes in neural circuits, and gives rise to depression and anxiety.
Researchers at Hokkaido University have identified the neuronal circuit involved in chronic pain-induced anxiety in mice. Their research, which was recently published in Science Advances, could lead to the development of new treatments for chronic pain and psychiatric disorders such as anxiety disorders and major depressive disorder.
“Clinicians have known for a long time that chronic pain often leads to anxiety and depression, however the brain mechanism for this was unclear,” said Professor Masabumi Minami of the Faculty of Pharmaceutical Sciences at Hokkaido University, the corresponding author of the paper.
The researchers looked at how neuronal circuits were affected by chronic pain in mice. They used an electrophysiological technique to measure the activities of neurons after four weeks of chronic pain. They found that chronic pain caused the neuroplastic change which suppressed the neuronal pathway projecting from the brain region called bed nucleus of the stria terminalis (BNST) to the region called lateral hypothalamus (LH).
Using chemogenetics, an advanced technique to manipulate neuronal activity, they showed that restoration of the suppressed activity of this neuronal pathway attenuated the chronic pain-induced anxiety. These findings indicate that chronic pain-induced functional changes in the neuronal circuits within the BNST leads to maladaptive anxiety.
“These findings could not only lead to improved treatment of chronic pain, but also to new therapeutics for anxiety disorders,” says Minami.
Dr. Strober is senior research scientist in the Center for Neuropsychology and Neuroscience at Kessler Foundation. CREDIT Kessler Foundation
Kessler Foundation researchers published results of a survey of the emotional outcomes of individuals with multiple sclerosis (MS) during the COVID-19 pandemic. Comparison of data collected during the pandemic with pre-pandemic data for the study sample suggests the occurrence of pandemic-specific depression and anxiety. Their article, “Surviving a global pandemic: The experience of depression, anxiety, and loneliness among individuals with multiple sclerosis,” (10.1016/j.msard.2022.103497) was published online in Multiple Sclerosis and Related Disorders on January 14, 2022. The authors are Lauren Strober, PhD, Erica Weber, PhD, Anthony Lequerica, PhD, and Nancy Chiaravalloti, PhD, of Kessler Foundation.
The social restrictions mandated by the COVID-19 pandemic have heightened concerns about exacerbations of pre-existing mental health issues and loneliness among vulnerable populations, such as MS To assess the impact of the pandemic on the MS population, researchers surveyed 142 individuals who had previously reported their emotional experiences in a national online survey. Comparisons showed increases in depression, anxiety, and loneliness during the pandemic, with 54% reporting ‘new’ depression, and 33%, ‘new’ anxiety. Increases in loneliness affected all people with depression and anxiety, whether symptoms were new or pre-existing.
The research team sought to differentiate individuals with new symptoms from those with pre-pandemic symptoms and no prior reported symptoms. “We found that ‘new’ depression and anxiety appeared to be related specifically to the pandemic,” reported lead author Lauren Strober, PhD, senior research scientist in the Center for Neuropsychology and Neuroscience at Kessler Foundation. “Also, we saw no association with the person-specific factors commonly associated with depression and anxiety in individuals with MS, namely, personality and self-efficacy.”
The findings have important implications for the treatment of mental health issues in MS. “Clinicians need to be aware of the heterogenous nature of depression and anxiety in their patients with MS, and approach treatment accordingly,” said Dr. Strober. “Individuals with new symptomatology will benefit from cognitive behavioral interventions that stress coping, positive mental health habits, and encouragement to connect with others despite the pandemic,” she added, “while individuals with pre-existing symptoms may respond to those aimed at improving self-efficacy and other more fundamental factors of emotional distress.”
The results of a study presented today at the Annual European Congress of Rheumatology (EULAR) has shown that Acceptance and Commitment Therapy, a form of cognitive behavioural therapy (CBT) that focuses on psychological flexibility and behaviour change, provided a significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation programme.
This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance.
To assess the potential benefits of an 8-week programme of group Acceptance and Commitment Therapy (ACT) in people with persistent pain, measures of pain acceptance and activity engagement were taken using the Chronic Pain Acceptance Questionnaire. Measures of psychological distress using the Hospital Anxiety and Depression Scale and self-efficacy were also taken at assessment, on the final day of the programme, and at the follow up six-month review.
For those chronic pain patients with scores at all three time points, there were statistically significant improvements in all parameters between baseline and at six-months follow-up, including the change in mean score of depression, anxiety, self-efficacy, activity engagement and pain willingness (p<0.001).
“To further validate the role of ACT in the treatment of chronic pain, specifically in a rheumatology context, a randomised controlled clinical trial that includes measures of physical and social functioning within a Rheumatology service would be desirable,” said lead author Dr. Noirin Nealon Lennox from Ulster University in Northern Ireland.
ACT is a form of CBT that includes a specific therapeutic process referred to as “psychological flexibility”. ACT focuses on behaviour change consistent with patients’ core values rather than targeting symptom reduction alone. Evidence for this approach to the treatment of chronic pain has been mounting since the mid 2000’s. A previous systematic review had concluded that ACT is efficacious for enhancing physical function and decreasing distress among adults with chronic pain attending a pain rehabilitation programme.
In this study, patients were referred into the ACT programme by three consultant rheumatologists over a five-year period. Over one hundred patients’ outcome measures were available for a retrospective analysis.