Archives for February 2020

Psychoeducation and Borderline Personality Disorder

Feb 25, 2020 by United Brain Association Leave a Comment

For sufferers of borderline personality disorder (BPD), understanding more about their disorder may be enough to make it better. A new study has found that BPD patients responded well to a program of psychoeducation, a therapeutic approach that aims to help patients learn about their illnesses and the effects that the illness has on their lives. The findings could be especially beneficial for borderline personality disorder sufferers who live in communities underserved by more traditional mental health providers.

A Different Approach to Therapy

In psychoeducational group therapy programs, participants with similar diagnoses are brought together for sessions run by a leader who presents educational content about their disorder. The goal of the program is to teach participants about the effects of the disorder and help them build coping skills. The group setting surrounds participants with peers who are suffering from the same disorder, and group discussions are usually encouraged.

The advantage of psychoeducational programs is that they’re often feasible even in communities where there is a lack of traditional mental health services. Sessions are often run by mental health professionals, but they may also be led by peers or other community members. Programs are relatively short, and the group setting lowers expenses. All this can make the programs more accessible where resources are scarce.

Psychoeducation has shown to be effective in treating substance abuse. The approach has also been applied to a wide range of mental illnesses and disorders, including depression, social anxiety, and phobias.

BPD Responds to Psychoeducation

In a new study just published in the Journal of Clinical Psychiatry, a group of Italian researchers evaluated the effectiveness of a psychoeducational program for a group of borderline personality disorder patients. The study gathered a group of 96 patients with a borderline personality disorder diagnosis, and 48 of the participants were given a six-session course of psychoeducational group therapy. The other 48 participants were put on a “waitlist” and didn’t receive the therapy. All of the participants received standard, non-intensive treatment for BPD.

Before the therapy began, participants were assessed on a scale that measured the severity of their borderline personality disorder characteristics. They were assessed again at the end of the therapy program, and yet again two months after the conclusion of the therapy.

The results of the study were dramatic. The participants in the psychoeducation group saw improvement in all areas of the borderline personality disorder assessment, and in most BPD traits, the improvement was greater than that in the control group. Almost half of the psychoeducation group showed substantial improvement in their borderline personality disorder traits (as defined by at least a 50% improvement in their assessment score compared to their baseline assessment). Only 6% of those in the control group showed such marked progress. The improvement remained consistent even at the two-month mark after the end of the program.

New Opportunities for Underserved Communities

The Italian study specifically targeted participants from underserved communities in an attempt to see if psychoeducation is a good alternative where traditional therapies are unavailable. The results are good news for borderline personality disorder patients who are unable to afford individual therapy or who live in places where qualified therapists are in short supply.

Sources
Journal of Clinical Psychiatry, A Randomized Controlled Study of a Psychoeducation Group Intervention for Patients With Borderline Personality Disorder

Can Dogs Really Prevent Schizophrenia?

Feb 20, 2020 by United Brain Association Leave a Comment

Recent headlines in The New York Times and elsewhere have trumpeted a finding that sounds like great news for animal lovers. Having a pet dog as a child, a new study says, could significantly decrease your risk of developing schizophrenia later in life. But is it too good to be true? Can dogs really prevent severe brain disorders? The answer seems to be “maybe,” but we don’t know why or how.

A Surprising Study

The study, which was conducted by researchers led by Robert H. Yolken, MD, at Johns Hopkins University, was inspired by the knowledge that external environmental influences are a significant factor in the development of brain diseases such as bipolar disorder (BD) and schizophrenia. The study’s authors wanted to see if exposure to pet dogs and cats in childhood had an impact on risk for both diseases. To find out, they compared the pet histories of patients with bipolar disorder or schizophrenia to a control group of healthy participants.

The results showed that exposure to a pet dog seemed to produce a substantial decrease in schizophrenia risk, especially when the exposure began at birth or in infancy. Participants who had a pet dog at any time before the age of 13 saw a 24% decrease in risk, and those who had a dog at birth saw a 55% decrease.

The benefits were confined to schizophrenia. Exposure to a pet didn’t seem to have any effect on bipolar risk.

What About Cats?

Unfortunately for cat lovers, only exposure to dogs seems to have decreased the risk of schizophrenia. Not only did exposure to pet cats not decrease the risk, the risk of both schizophrenia and bipolar disorder actually increased slightly if children were exposed to cats between the ages of 9 and 12.

A Canine Mystery

Given that the cause of schizophrenia is unknown, it’s difficult to say why having a pet dog might prevent the disease. One theory is that problems with the body’s immune system might result in changes in brain chemistry that, in turn, trigger the onset of the disease. Studies have found a connection between schizophrenia and infection in the mother’s body during pregnancy, leading researchers to suspect that the immune system plays a role in the development of the disorder. Some researchers believe, too, that the immune system continues to play a role in the brain’s development throughout infancy.

It’s possible, the current study’s authors believe, that exposure to bacteria associated with dogs could have a beneficial effect on a child’s immune system, leading to a reduction in schizophrenia-associated chemical changes. The authors note that the effect is most pronounced when dogs are present during early childhood when the immune system has a big effect on brain development.

The Truth About Dogs

The study’s authors acknowledge some limitations in their methods. The study data didn’t fully account for differences in socioeconomic status, and it’s possible that dog ownership might be more common in certain socioeconomic communities. If that’s true, social status or household wealth, rather than the dogs themselves, might be the real key to decreased schizophrenia risk.

Another limitation is that the data didn’t include a full accounting of the patients’ physical health, and that could also cloud the picture. For example, both dog ownership and socioeconomic status might be associated with lower body mass index, and that could be the explanation for the lower schizophrenia risk.

The hypothetical connection between dogs and schizophrenia mitigation is a complex one that goes beyond the companionship and devotion that pet dogs offer to their owners. Whatever the cause, though, the connection could be a starting point for new research that furthers our understanding of schizophrenia.

Sources
Frontiers in Neuroscience, Role of the Immune System in the Development of the Central Nervous System
Neurology, Maternal immune activation, and abnormal brain development across CNS disorders
Science, Maternal immune activation: Implications for neuropsychiatric disorders
Frontiers in Neuroendocrinology, The Immune System and Developmental Programming of Brain and Behavior

Can Borderline Personality Disorder Cause a Heart Attack?

Feb 18, 2020 by United Brain Association Leave a Comment

The effects of borderline personality disorder (BPD) can extend well beyond the emotional and relationship turmoil frequently caused by the disease. A new study suggests that borderline personality disorder may increase the risk of heart attacks and cardiovascular disease. The study, which was recently published in Personality Disorders: Theory, Research, and Treatment, found that middle-aged adults with borderline personality disorder showed significantly decreased cardiovascular health compared to healthy individuals, a finding with troubling ramifications.

An Unhealthy Connection

The study drew upon health data from about 1,300 participants between the ages of 30 and 50. The data came from a survey that collected a wide range of health and psychological information from participants in Pennsylvania between 2001 and 2005.

The researchers wanted to know if borderline personality disorder carried long-term physical health implications in addition to its potential psychological complications. Specifically, they wanted to know if borderline personality disorder has a long-term effect on heart health.

“Although borderline personality disorder is well studied for its relationship to psychological and social impairments, recent research has suggested it may also contribute to physical health risks,” said Whitney Ringwald MSW, MS, lead author of the study.

To look for a possible connection between borderline personality disorder and heart disease, the researchers used participants’ answers to personality-focused questions to identify traits consistent with borderline personality disorder. The data also included responses from the participants’ friends and family.

Once the researchers identified participants who showed signs of borderline personality traits, they assessed those participants’ heart health data, including blood pressure, body mass index, and cholesterol, glucose, and insulin levels.

The results showed a clear connection between decreased cardiovascular health and borderline personality traits. There was also a correlation between poor heart health and depression, a connection that was already well documented. But when the researchers isolated the borderline traits from the depressive traits, they found that BPD sufferers still had relatively poor heart health, apart from the effects of depression.

“We were surprised by the strength of the effect, and we found it particularly interesting that our measure of borderline personality pathology had a larger effect, and a unique effect, above and beyond depression in predicting heart disease,” said Aidan G.C. Wright, PhD, one of the study’s authors. “There is a large focus on depression in physical health, and these findings suggest there should be an increased focus on personality traits, too.”

A Need for Vigilance

The study’s authors stress that their results should alert mental health professionals and physicians to the hidden dangers of borderline personality disorder. Providers already commonly watch for signs of poor cardiovascular health in depressed patients, but they’re likely unaware of the risks faced by patients with borderline personality traits. With the risks in mind, providers can help their patients understand how to keep themselves healthier later in life.

“Mental health practitioners may want to screen for cardiovascular risk in their patients with borderline personality disorder, ” said Wright. “When discussing the implications of a personality disorder diagnosis with patients, practitioners may want to emphasize the link with negative health outcomes and possibly suggest exercise and lifestyle changes if indicated.”

Sources
American Psychological Association, Middle-aged adults with borderline personality disorder potentially at higher risk for heart attacks
Personality Disorders: Theory, Research, and Treatment, Borderline personality disorder traits associated with midlife cardiometabolic risk

New Year, Healthier Brain: 10 Ways to Keep Your Brain Sharp

Feb 13, 2020 by United Brain Association Leave a Comment

The brain is your control center, playing an instrumental role in just about every major body system. Your brain allows you to have emotions, communicate your feelings, coordinate your movements, and control all your actions. It allows you to do all the things that make you human.

As the most amazing and powerful part of your body, you can intentionally contribute toward keeping your brain healthy. Research has shown that you can help prevent cognitive decline and reduce the risk of dementia with some good basic health habits.

In 2020 and beyond, we at The American Brain Society encourage you to be mindful of your brain and the many ways you can contribute to its vitality. Here are 10 tips to get you started.

1. EMBRACE A HEALTHY, BALANCED DIET.

The saying, “You are what you eat,” could not be truer in regard to your brain. While we can’t control everything that happens to our bodies, the foods we eat do influence the structure and health of our brains, supporting both short- and long-term function.

This means incorporating a diet low in saturated and trans fats and chock full of whole grains, fruits, vegetables, and Omega-3 Fatty Acids. For many people, this means adopting a Mediterranean diet, which emphasizes fish, fruits and vegetables, nuts, olive oil, and avocados, while limiting red meat OR the MIND diet – a hybrid of the Mediterranean diet and the heart-healthy DASH diet, with an extra emphasis on berries and leafy greens. This diet was created specifically to boost brain health and has been shown to lower the odds of Alzheimer’s disease.

A few superfoods that can help maintain brain health include:

Blueberries
Wild salmon
Dark chocolate
Nuts & seeds
Avocados

2. KEEP YOUR HEART HEALTHY.

To keep your brain healthy, pay attention to your cardiovascular health. Keeping blood easily moving through your heart and blood vessels is crucial to maintaining the strength and longevity of your brain.

Says Dr. Elise Caccappolo, PhD, an associate professor of neuropsychology at Columbia University Medical Center in New York to Webmd, “High blood pressure, high cholesterol levels, smoking, and diabetes all increase the risk for developing neurodegenerative diseases by impeding blood flow to the brain.”

The most important strategy, she says, is to stay on top of your heart health and work closely with your doctor to ensure your blood is pumping easily and effectively.

3. MAKE MOVEMENT A PRIORITY.

Keeping physically active is key to keeping your brain working. Studies show that at least 150 minutes of exercise per week will help to keep your brain sharp, improving cognitive function, slowing down the mental aging process and helping us process information more effectively.

Not only will you keep fit and build strength, but exercise boosts blood flow to the brain. Studies have shown it can increase the size of the hippocampus, the part of the brain responsible for memory, which naturally shrinks as you age.

Participate in physical activity you enjoy whether it’s walking, tai chi, yoga classes, or going for a swim, but the bottom line is this…

DON’T STOP MOVING!

4. GET PLENTY OF REST.

Your brain is working non-stop all day, and the best way to keep it in tip-top shape is by shutting off for at least seven-nine hours per night. Studies show that inadequate sleep is linked to slower thinking and the risk of dementia.

“Sleep is the most important thing you can do to reset the brain, allowing it to heal, and to restore mental health,” says Romie Mushtaq, MD, a neurologist, and integrative medicine specialist.

Sleep medications can sometimes make cognitive problems worse; we suggest talking to your doctor about creating healthy habits so that you can get proper rest each night.

5. IF YOU SMOKE, QUIT. IF YOU DRINK ALCOHOL, LIMIT YOURSELF.

We all know that smoking causes lung disease along with numerous other health problems, but it can also increase your risk of cognitive decline. If you’re a smoker, now is a great time to stop, as quitting can reduce that risk to levels comparable to those non-smokers.

Having a drink is fine but within moderation. According to Dr. Eric B. Larson, Executive Director, Kaiser Permanente Washington Health Research Institute, “Drinking has a stronger effect on our bodies as we age. Experts advise a limit of one drink per day for women and two drinks per day for men.”

6. STAY SOCIAL AND CONNECTED.

A big part of keeping your brain sharp and healthy is maintaining an active social life. Being engaged with family, friends and your community is good for both your physical and mental health.

According to Dr. Caccappolo, “When you’re socializing, the blood circulates to several different parts of your brain as you’re listening and formulating responses.”

Additionally, if you’re connecting with others socially, you can help stave off depression, which can negatively hamper how well your brain is working. Dr. Caccappolo says, “If you’re depressed or anxious, the brain becomes so occupied with what-ifs and worries that it’s not able to give 100% to learning new things.”

7. USE ALL OF YOUR SENSES.

Studies show that the more senses you use to learn something, the more of your brain will be involved in retaining memory. Consider challenging all your senses where possible.

A few ideas include:

Try cooking classes where you’re reading recipes, learning from the instructor, physically participating in making a dish and tasting the food as you go
By taking yoga classes, you’re listening to the yoga instructor and the music in the background, while moving your body and engaging your mind

8. NOURISH YOUR SOUL.

No matter how healthy you eat or how much you exercise, your brain needs time to settle and slow down. Don’t wait until you find yourself feeling stressed or mentally exhausted to engage in self-care.

Feed your body, mind, AND soul by engaging in things such as meditation or deep breathing exercises. Research shows that five-ten minutes of mindful meditation can help calm your brain, making it easier to sleep and reducing anxiety, depression, fatigue, and confusion.

9. KEEP YOUR MIND STIMULATED BY TRYING NEW THINGS.

Regardless of your age, don’t stop learning! Experts say that building new skills throughout your life will help keep your brain healthy by constantly creating new connections between brain cells.

Step out of your comfort zone, and challenge yourself with new games, puzzles, and hobbies. Consider learning a new skill or participate in your community doing a project that isn’t familiar to you.

Says Dr. Caccappolo says, “The more intellectual stimulation you have, the more various neural circuits are used. And the more circuits you have, the harder it is for the changes associated with neurodegenerative diseases to manifest.”

10. SET BOUNDRIES.

Our brains are often in overdrive, constantly bombarded with professional and personal demands. To maintain optimal brain health, you need to rest and recharge.

This means creating and setting boundaries – disconnect from work when you can, put your device to the side, and say nowhere possible. Plan time away so that you can mentally recharge. Make a conscious effort to have a balance in your life.

By setting necessary boundaries, you’re giving yourself permission to relax…your brain, body, and mind will thank you later!

YOUR BRAIN NEEDS YOU.
We hope that 2020 finds you taking conscious steps toward a healthier brain.

For further information and additional resources, please visit us at https://unitedbrainassociation.org/.

SOURCES:
Webmd
Kaiser Permanente
Harvard
Psychology Today
Thrive Global

Do Poor Sleep Habits Cause Bipolar Disorder?

Feb 11, 2020 by United Brain Association Leave a Comment

A connection between poor sleep quality and bipolar disorder (BD) has been obvious to scientists for decades. Periods of sleep disturbances often happen in conjunction with episodes of depression, mania or hypomania (an emotional state not quite as profound as true mania) in bipolar disorder patients. Some studies have strongly suggested that sleep disruptions might even trigger manic and hypomanic episodes.

What hasn’t been as clear is the true nature of the relationship between sleep and bipolar disorder. Does poor sleep cause manic episodes, or is it the reverse? Or are sleep disturbances an unfortunate side effect of medications used to treat bipolar disorder?

Some or all of these possibilities could be true, but some scientists have also wondered whether patterns of poor sleep might actually make it more likely that an otherwise healthy person could develop bipolar disorder. A new study provides compelling evidence of just such a connection.

Is Poor Sleep a Bipolar Trigger?

Many studies have examined the association between sleep and bipolar disorder. Bipolar disorder patients have shown a tendency to have poor sleep patterns, even when they’re not in a manic or depressed state. Other studies have shown that sleep disruptions can cause manic episodes and that improvement of sleep patterns between episodes can reduce the risk of relapse.

But some researchers have theorized that if sleep and bipolar disorder are so closely interconnected, it may be possible that patterns of poor sleep could put a healthy person at an increased risk of developing bipolar disorder. Some studies have pursued that idea, but until now, they’ve been small and have been complicated by the inclusion of people who have a genetic predisposition for bipolar disorder.

A new study recently published in the journal Translational Psychiatry attempts to focus on a large sample of healthy subjects (those who do not have a family history of bipolar disorder) to see whether or not there is a connection between sleep and bipolar disorder risk.

In the study, participants were assessed using the hypomanic personality scale (HPS), a questionnaire that has proven effective at predicting vulnerability to bipolar disorder. Their sleep patterns were also assessed using either sleep-measuring devices or a sleep-quality questionnaire. Finally, the study excluded subjects who had illnesses or were taking medications that might affect their sleep quality.

Ultimately, the study found a significant correlation between sleep and bipolar disorder risk. Those participants who showed characteristics that predict a high risk for bipolar disorder were more likely to also have sleep problems, including poor sleep quality, day-to-day sleep variability, low sleep duration, and daytime sleepiness. In particular, those who had a high level of variability in the quality of their sleep from day to day seemed to be at the highest risk for developing bipolar disorder.

Preventing Bipolar Disorder by Sleeping

Although these findings don’t, by any means, present a complete understanding of the relationship between bipolar disorder and sleep, they do suggest some encouraging possibilities. If poor sleep quality does, indeed, predispose someone to be vulnerable to developing bipolar disorder, addressing sleep disruptions could be a relatively easy way to head off the disorder before it strikes.

Sleep problems are typically easy to spot and treat, and they don’t usually carry the social stigma that sometimes prevents people from seeking treatment for mental illness. For individuals who are at high risk of developing bipolar disorder, an effective, life-changing preventive measure may be as simple as getting a good night’s sleep.

Sources
Translational Psychiatry, Vulnerability to bipolar disorder is linked to sleep and sleepiness