Lithium In Drinking Water

Take a look at the abstract from this paper:

OBJECTIVE:

We investigated the association between lithium level in tap water and mental health problems, including depressive symptoms, anxiety, and aggressive and suicidal behaviors, in a general population of adolescents using a large individual-level dataset.

METHODS:

A school-based, cross-sectional survey was conducted in Kochi Prefecture in Japan between 2008 and 2009. Students in 24 public junior high schools were asked to anonymously complete a self-report questionnaire. The main outcome measures were mental health problems, including those on the 12-item General Health Questionnaire, interpersonal violence, bullying, destructive behavior, self-harm, and suicidal ideation. Samples were collected from sources that supplied drinking water to schools, and lithium levels were measured using atomic absorption spectrophotometry. The associations of lithium levels with mental health problems were examined using a generalized linear mixed model with schools as the fixed effect. Potential confounding factors were also added into the model.

RESULTS:

A total of 3,040 students among 3,311 students responded to the self-report questionnaire (response rate, 91.8%). The mean lithium concentration in tap water was 0.48 μg/L (SD = 0.52; range, 0.01 to 2.10; skewness = 2.01; kurtosis = 4.04), and it was relatively low compared with previous studies. In multivariable regression analysis, lithium level in tap water had an inverse association with depressive symptoms (P = .02) and interpersonal violence (P = .02) but not with suicidal behaviors (suicidal ideation, P = .82; self-harm, P = .46).

CONCLUSIONS:

Lithium level in tap water was inversely associated with depressive symptoms and interpersonal violence among a general population of adolescents and may have antidepressive and antiaggressive effects.

It is unknown whether this will be reproducible and apply to other counties, and we shouldn't say we want lithium added to our water.  The main point I see here is how agents present in our environment that we may be unaware of in our everyday life can influence our behavior and our health.

A Cold Of The Soul

In Japan, like the USA, pharmaceutical companies push over-medication.  See this article, abstract:

In Japan, depression provides the most drastic example of the impact of disease awareness campaigns. Until the late 1990 s, the public's attitude toward depression was generally unfavorable, due to the negative connotations of the Japanese word for clinical depression, 'utsubyou'. After the 1999 introduction of the first selective serotonin re-uptake inhibitor, pharmaceutical companies initiated educational campaigns. In order to aid the drug's acceptance, they coined the catchphrase 'kokoro no kaze', which literally means 'a cold of the soul'. Thanks to these marketing practices, antidepressant sales have increased six fold, from ¥ 14.5 billion in 1998 to ¥ 87 billion in 2006. However, the catchphrase 'kokoro no kaze' masked a critical difference between a cold and depression. It falsified the nature of treatment for depression by concealing the putative duration of medication. Owing to this distortion of information, pharmaceutical companies were assured a steady stream of profits. Now, the pharmaceutical industry is shifting its focus from depression to bipolar disorder. Japanese psychiatrists can learn a great deal from their experience with the aggressive marketing of antidepressants. In the case of depression, over-medication arguably did more harm than good. The same risk exists with other conditions, including bipolar disorder.

Sound familiar?  Now, if medication is necessary, take it.  I do.  But take medication that is necessary, as determined by your physician, your own research, and the cooperation between yourself and your health care team. Talk to your physician, and do research.  Medication solely to boost pharmaceutical profits is not the way to go.  Good medications are saviors, antibiotics have saved millions of lives, and we should not reject biomedical advances.  But the Japanese case outlined here describe a case where unnecessary overmedication has taken place.  One must understand the difference.

Baths Vs. Showers

In Japan, people tend to take warm baths rather than showers, and now some Japanese researchers have conducted a study in which they claim baths are better for mental and physical well-being than showers  Take that for what it is worth; I am not going to change my habits based on this one way or the other.  Abstract:

Showering is the most common form of bathing worldwide. Whole-body immersion bathing in warm water (~40°C) is common in Japan and exerts sufficient hyperthermic action to induce vasodilatation and increase blood flow, supplying more oxygen and nutrients to the periphery. Cross-sectional studies report better subjective health status with an immersion bathing habit. This randomized controlled trial compared the effects on health of immersion bathing and shower bathing in 38 participants who received 2-week intervention of immersion bathing in warm water (40°C) for 10 min (bathing intervention) followed by 2-week shower bathing without immersion (showering intervention) or vice versa (n = 19 each group). Visual analog scale scores were significantly better for fatigue, stress, pain, and smile and tended to be better for self-reported heath and skin condition after bathing intervention than after showering intervention. The SF-8 Health Survey showed significantly better general health, mental health, role emotional, and social functioning scores. Profile of Mood State scores were lower for stress, tension-anxiety, anger-hostility, and depression-dejection. Immersion bathing, but not shower bathing, exerts hyperthermic action that induces increased blood flow and metabolic waste elimination, which may afford physical refreshment. Immersion bathing should improve both physical and emotional aspects of quality of life.

Exercise As An Anti-Depressant

Regular exercise can reduce depressive symptoms to an extent that can mimic chronic antidepressant treatment (of course, one likely won’t hear about this from most doctors or from the pharmaceutical companies pushing their samples onto those doctors), and there are molecular mechanisms for this, apparently involving the Wnt signaling pathway. Abstract:

Regular exercise reduces depressive-like behavior activation. In this study, we look for exact roles of exercise on molecular and neuronal mechanisms for antidepressant action by studying the hippocampal neuroplasticity and proliferation. Increased hippocampal neurogenesis with exercise has potential significance for depression. Exercise promotes brain health in the molecular levels in the hippocampus and also affects behavior in a similar way to chronic antidepressant treatment. Wingless (Wnt) and frizzled signaling system plays an important role in cell proliferation, growth, and differentiation during development. Our results demonstrate complicated, differential effects of antidepressants on Wnt signaling system, and assume a role for selected signaling molecules in the neurogenic activity of antidepressant care. Our review suggests that exercise may preserve brain function by increasing neurogenesis through activating Wnt signaling pathway in the psychiatric disorders, such as depression.

Maybe exercise rather than popping pills should be the first line treatment for many mental, as well as more directly physical, disorders?  First, ask you doctor about it - an informed doctor - and follow his or her advice.  Everyone is different.  Some people may require medication, others may only need exercise.  Get the medical consultation you require to figure out which category you may be in, if you require such help.

No Evidence For Exercise Benefit For Depression And Cognition?

Contrary to popular conceptions, a study here and another one here did not find any positive effect of exercise (at least aerobic exercise) on depression or cognition. However, this is not the last word, and more studies are necessary.  Even if these two studies are correct, exercise has enormous health benefits for physical fitness and overall physical and psychological well-being.

Beta-Catenin In Stress And Depression

The beta-catenin protein, integrally involved in Wnt signaling, influences stress and depression.  Abstract:

Beta-catenin is a protein with dual functions in the cell, playing a role in both adhesion between cells as well as gene transcription via the canonical Wnt signalling pathway. In the canonical Wnt signalling pathway, beta-catenin again plays multiple roles. In the embryonic stage, the regulation of beta-catenin levels activates genes that govern cell proliferation and differentiation. In an adult organism, beta-catenin continues to regulate the cell cycle - as a result over-expression of beta-catenin may lead to cancer. In the brain, dysfunctions in Wnt signalling related to beta-catenin levels may also cause various pathological conditions like Alzheimer's disease, Parkinson's disease, and depression. Beta-catenin can be influenced by stressful conditions and increases in glucocorticoid levels. In addition, beta-catenin can be regulated by neurotransmitters such as serotonin and dopamine. Fluctuations in beta-catenin in brain regions under duress have been associated with depressive-like behaviours. It is theorized that the change in behaviour can be attributed to the regulation of Dicer by beta-catenin. Dicer, a protein that produces micro-RNAs in the cell, is a target gene for beta-catenin. Amongst the micro-RNA that it produces are those involved in stress resilience. In this way, beta-catenin has taken its place in the well-studied biochemistry of stress and depression, and future research into this interesting protein may yet yield fruitful results in that field.

On a side note, the picture accompanying this post is a typical snapshot of the depressed attitudes of people at my workplace (including me).

More Benefits Of DASH

The DASH diet can reduce depression along with all of its other health benefits.

The popular Dietary Approaches to Stop Hypertension (DASH) diet was created to lower blood pressure, but new research says it can also reduce the risk of depression later in life.

A study, to be presented at the American Academy of Neurology’s 70th Annual Meeting in April, shows that the popular diet -- rich in vegetables, fruit, whole grains, fat-free or low-fat dairy products and very few foods that are high in saturated fats and sugar -- does more than what has been shown in multiple studies: Lowering blood pressure, bad cholesterol (LDL) and body weight.

Keep on eating those Big Macs though!

In all seriousness, people have a choice between healthy and unhealthy eating, and this choice should be reflected in health insurance premiums.

Circular RNA, Type 2 Diabetes, And Depression

Production of circular RNA.  By Helixitta - Own work, created for Biology week #3, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=56444195

There is a link between type 2 diabetes and depression; expression of circular RNAs (unusual RNAs that are in circular rather than normal linear form and are therefore more stable and may affect gene expression differently) may be mechanistically linked to this association. Abstract:

Type 2 diabetes mellitus (T2DM) is closely related to depression; however, the exact molecular mechanisms of this association are unknown. Here, we investigated whether circular RNAs (circRNAs) in the blood are related to the occurrence of depression in patients with T2DM. Fourteen patients with T2DM and depressive symptoms, as assessed by the Self-Rating Depression Scale, were included in this study. Cutoff points of 44 (total coarse points) and 55 (standard score) were used to define depression. The Patient Health Questionnaire 9 was used for common mental disorders, and a score of 5 or more the cutoff for depression. Microarray assays and quantitative real-time reverse transcription polymerase chain reaction showed that 183 hsa-circRNAs were significantly upregulated, whereas 64 were downregulated in the T2DM with depression group (p < 0.05) compared with that in the T2DM group. Differentially expressed hsa-circRNAs could interact with microRNAs to target mRNA expression. KEGG pathway analysis predicted that upregulation of hsa-circRNA_003251, hsa-circRNA_015115, hsa-circRNA_100918, and hsa_circRNA_001520 may participate in the thyroid hormone, Wnt, ErbB, and mitogen-activated protein kinase signalling pathways. We speculate that differentially expressed hsa-circRNAs could help us to clarify the pathogenesis of depression in patients with T2DM and could represent novel molecular targets for clinical diagnosis and therapy.

Stress, Dopamine, Wnt signaling, And Myelin Loss

Dopamine is related to major aspects of behavior, and abnormal regulation of the dopamine system is linked to depression and other mental disorders. Mice with knocked out dopamine receptors display increased anxiety and depression when confronted with chronic stress. Loss of myelin occurs with multiple sclerosis, and this study shows that chronic stress causes myelin loss in wild-type mice, while the dopamine receptor mutant mice have lower baseline (starting) levels of myelin, but in these mutant mice, myelin levels are not further decreased by stress.  Wnt signaling, which is abnormally regulated in different forms of cancer, is downregulated in the brains of stressed mice; this effect is reversed by lithium treatment (lithium can upregulate Wnt signaling), which normalizes myelin and behavior in stressed wild-type mice.  However, this effect of lithium did not occur in dopamine receptor-mutant mice.  This links the dopamine system with Wnt signaling affecting myelin levels and behavior in mice; the possibility exists that the same association occurs in humans. Stress has previously been linked to multiple sclerosis – with inflammation being one possible mechanism – but the dopamine pathway is another possibility, one that requires further consideration and study. Abstract:

Dopaminergic systems play a major role in reward-related behavior and dysregulation of dopamine (DA) systems can cause several mental disorders, including depression. We previously reported that dopamine D2 receptor knockout (D2R-/-) mice display increased anxiety and depression-like behaviors upon chronic stress. Here, we observed that chronic stress caused myelin loss in wild-type (WT) mice, while the myelin level in D2R-/- mice, which was already lower than that in WT mice, was not affected upon stress. Fewer mature oligodendrocytes (OLs) were observed in the corpus callosum of stressed WT mice, while in D2R-/- mice, both the control and stressed group displayed a decrease in the number of mature OLs. We observed a decrease in the number of active β-catenin (ABC)-expressing and TCF4-expressing cells among OL lineage cells in the corpus callosum of stressed WT mice, while such regulation was not found in D2R-/- mice. Administration of lithium normalized the behavioral impairments and myelin damage induced by chronic stress in WT mice, and restored the number of ABC-positive and TCF4-positive OLs, while such effect was not found in D2R-/- mice. Together, our findings indicate that chronic stress induces myelin loss through the Wnt/β-catenin signaling pathway in association with DA signaling through D2R.

From food to mood, and from mood to food

Well, from mood to food – we already know all about it. Emotional eating is not the way to go, and there is good advice on how to overcome the habit.

To me, it is more interesting how food can improve mood (from food to mood). True to my preaching that we should curate information, here is a brief advice on how some types of depression could be alleviated by diet. Severe depression seems to be linked to brain inflammation, according to a study published in JAMA Psychiatry. Inflammation, however, could be treated with diet, instead of medications, as discussed in the video “Anti-inflammatory diet for depression” by Dr. Michael Greger.

According to the video, depression is best addressed by reducing and even eliminating meat from our diet, since endotoxins in the meat induce immediate inflammatory response in our bodies. Switching to a plant-based diet is encouraged. A bit different recommendations are given in this article on seasonal depression. However, these different resources of information do agree that depression treatment would benefit from the abundance of plant-derived meals: the ones that include dark leafy greens (spinach, kale, collard greens, and chard), peas, beans, mushrooms, fruit, sweet potatoes, and sauerkraut (and other fermented foods). 

The last mentioned category of fermented foods brings another current discovery: depression might be affected by the bacteria colonizing our bodies, especially the bacteria in the gut. Therefore, eating plain yogurt with live cultures might also counteract depression (not exactly plant-based diet!). Here is a recipe on how to make your own yogurt if you decide to support the healthy bacteria in your intestines.