Mental Stresa And Exercise Recovery

Popular conceptions and anecdotal evidence suggests that chronic mental stress can impair recovery from strenuous exercise, including resistance training. This paper validates that idea with quantitative findings. Abstract:

The primary aim of this study was to determine whether chronic mental stress moderates recovery of muscular function and somatic sensations: perceived energy, fatigue, and soreness, in a 4-day period after a bout of strenuous resistance exercise. Undergraduate resistance training students (n = 31; age, 20.26 ± 1.34 years) completed the Perceived Stress Scale and the Undergraduate Stress Questionnaire, a measure of life event stress. At a later visit, they performed an acute heavy-resistance exercise protocol (10 repetition maximum [RM] leg press test plus 6 sets: 80-100% of 10RM). Maximal isometric force (MIF), perceived energy, fatigue, and soreness were assessed in approximately 24-hour intervals after exercise. Recovery data were analyzed with hierarchical linear modeling growth curve analysis. Life event stress significantly moderated linear (p = 0.027) and squared (p = 0.031) recovery of MIF. This relationship held even when the model was adjusted for fitness, workload, and training experience. Perceived energy (p = 0.038), fatigue (p = 0.040), and soreness (p = 0.027) all were moderated by life stress. Mean perceived stress modulated linear and squared recovery of MIF (p < 0.001) and energy (p = 0.004) but not fatigue or soreness. In all analyses, higher stress was associated with worse recovery. Stress, whether assessed as life event stress or perceived stress, moderated the recovery trajectories of muscular function and somatic sensations in a 96-hour period after strenuous resistance exercise. Therefore, under conditions of inordinate stress, individuals may need to be more mindful about observing an appropriate length of recovery.

Thus, if such stress exists, longer recovery times are required. For optimal gains from exercise regiments, it would therefore be recommended to avoid such stress if possible, which would of course have many other health benefits other than for exercise training.

PTSD And Gene expression: The MicroRNA Connectiom

Here is a fascinating article suggesting that post-traumatic stress disorder is associated with varying levels of certain microRNAs, which can affect gene expression.  Abstract:

Posttraumatic stress disorder (PTSD) affects many returning combat veterans, but underlying biological mechanisms remain unclear. In order to compare circulating micro RNA (miRNA) of combat veterans with and without PTSD, peripheral blood from 24 subjects was collected following deployment, and isolated miRNA was sequenced. PTSD was associated with 8 differentially expressed miRNA. Pathway analysis shows that PTSD is related to the axon guidance and Wnt signaling pathways, which work together to support neuronal development through regulation of growth cones. PTSD is associated with miRNAs that regulate biological functions including neuronal activities, suggesting that they play a role in PTSD symptomatology.

This altered gene expression may be linked to the mechanism of the disorder, both underscoring the seriousness of it and possibly pointing in the direction of therapy.  This article was from several years ago; we will be looking for any updates.

What is the worst that can happen

Recently, my girl called me in distress.  She had too much to deal with.  She is in college...

I have my doubts about an educational system that puts our children through this type of a grinder. The educational process should be an inspirational and creative process, not something that brings depression and stress. 

But this post is not about the flaws of the U.S. educational system.

This post is about being able to deal with stress and anxiety. When thinking about anxiety, this revealing formula by Chip Conley comes to mind:

Anxiety = Uncertainty x Powerlessness
 
There is always something that can be done about the right side of the equation. The uncertainty will always be present to some extent.

However, "powerlessness" is not acceptable for the most adaptable creature on earth, the human. You always have to ask yourself, what would I do if the worse comes to worst? 

Imagine the worst that can happen in a situation that stresses you. How would you deal with it? Do you have a lawful plan that addresses the worst? If you do, the anxiety will lessen.
 
Here is the brief email I sent to my child after we talked on the phone about her being stressed and depressed:

Dear X-
When you have time, please listen to this podcast.

You can listen to it when you stroll in the park one of these coming weekends... Make sure that you hear the message.

The story is empowering. Briefly, this is the journey of a driven individual:
 
extreme poverty - a useless college major - a debt-bound husband - a job, where you learn "on the job" - a six figure salary - the finding of a soulmate - a life of freedom and meaningful existence

Happy listening and do not despair!

BTW, the couple is Trin and Bonnie.

My advice is, in times of anxiety, always think, "...What is the worst that can happen?". If you start thinking and preparing for the worst then you will fare well. 


The approach of looking ahead and thinking "What is the worst that can happen?" is very similar to the advice from my first driving lessons. I was in the car with my instructor, a Russian immigrant. We were on the broadest street I have ever driven on, with multiple lanes. This is was my second time behind the wheel. I was freaking out. My hands were tight on the wheel and my eyes nailed on just a few feet in front of the car. 

The instructor, noticing my intense stare at the front hood of the car, advised, "Have your eyes way ahead, scanning the road and anticipating what might happen". Now, I "scan" every road I travel. 


I also apply the driving lesson in my life. I have learned to scan ahead, looking into the future and putting together plans that may counteract the worst in my life. 

Mental States, The Immine System, And the Gut Microbiome

Mental states can affect the gut microbiome, with downstream effects on the immune system and cancer risk. Stress alters these factors in the negative direction, while meditation changes direction positively, particularly with an optimal microbiome and suppressed inflammation.  The mind-body axis seems to revolve around the gut microbiome, and there is much potential for preventive and therapeutic interventions that include reduced stress and meditation as well as more traditional pharmacological therapeutics. Abstract:

Context • Globally, more than 25% of individuals are affected by anxiety and depression disorders. Meditation is gaining popularity in clinical settings and its treatment efficacy is being studied for a wide array of psychological and physiological ailments. An exploration of stress physiology is an essential precursor to delineation of the mechanisms underlying the beneficial effects of meditation practices. Objective • The review outlines a model of interconnected physiological processes that might support the continued inclusion and expansion of meditation in the treatment of diverse medical conditions and to investigate the role that gut microbiota may play in realizing well-being through meditation. Design • The authors conducted a scientific literature database search with the goal of reviewing the link between stress management techniques and human microbiota. Their goal was also to identify the extent of underlying epigenetic reactions in these processes. The review was completed in approximately 2 y. Databases searched included Medline via PubMed and Ovid, PsycINFO via Ovid, Spinet, ProQuest Central, SAGE Research Methods Online, CINAHL Plus with Full Text, Science Direct, Springer Link, and Wiley Online Library. Keywords searched included, but were not limited to, stress, meditation, mindfulness, immune system, HPA axis, sympathetic nervous system, parasympathetic nervous system, microbiota, microbiome, gut-barrier function, leaky gut, vagus nerve, psychoneuroimmunology, epigenetic, and NF-κB. Setting • The study took place at New York University (New York, NY, USA), the University of California, San Diego (La Jolla, CA, USA), and the Chopra Foundation (Carlsbad, CA, USA). Results • Psychological stress typically triggers a fight-or-flight response, prompting corticotropin-releasing hormone and catecholamine production in various parts of the body, which ultimately disturbs the microbiota. In the absence of stress, a healthy microbiota produces short-chain fatty acids that exert anti-inflammatory and antitumor effects. During stress, an altered gut microbial population affects the regulation of neurotransmitters mediated by the microbiome and gut barrier function. Meditation helps regulate the stress response, thereby suppressing chronic inflammation states and maintaining a healthy gut-barrier function. Conclusions • The current research team recommends the integration of meditation into conventional health care and wellness models. Concurrently, studies to explore the effects of meditation on human microbiota are warranted.

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).

Broken Heart Syndrome

By J. Heuser JHeuser - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=889151

Takotsubo cardiomyopathy or “broken heart syndrome” is a form of heart disease “precipitated by intense emotional stress.” It has previously been thought to be transient and reversible in nature, but a study has now shown sufferers exhibit long-term heart damage.  It is impossible to avoid intense emotional stress I life, but everyone must try and deal with it as best as they can, and if this disorder happens to them, they will seem to need long-term evaluation by a cardiac specialist. Abstract:

BACKGROUND: Takotsubo cardiomyopathy is an increasingly recognized acute heart failure syndrome precipitated by intense emotional stress. Although there is an apparent rapid and spontaneous recovery of left ventricular ejection fraction, the long-term clinical and functional consequences of takotsubo cardiomyopathy are ill-defined. METHODS: In an observational case-control study, we recruited 37 patients with prior (>12-month) takotsubo cardiomyopathy, and 37 age-, sex-, and comorbidity-matched control subjects. Patients completed the Minnesota Living with Heart Failure Questionnaire. All participants underwent detailed clinical phenotypic characterization, including serum biomarker analysis, cardiopulmonary exercise testing, echocardiography, and cardiac magnetic resonance including cardiac 31P-spectroscopy. RESULTS: Participants were predominantly middle-age (64±11 years) women (97%). Although takotsubo cardiomyopathy occurred 20 (range 13-39) months before the study, the majority (88%) of patients had persisting symptoms compatible with heart failure (median of 13 [range 0-76] in the Minnesota Living with Heart Failure Questionnaire) and cardiac limitation on exercise testing (reduced peak oxygen consumption, 24±1.3 versus 31±1.3 mL/kg/min, P<0.001; increased VE/VCO2 slope, 31±1 versus 26±1, P=0.002). Despite normal left ventricular ejection fraction and serum biomarkers, patients with prior takotsubo cardiomyopathy had impaired cardiac deformation indices (reduced apical circumferential strain, ‒16±1.0 versus ‒23±1.5%, P<0.001; global longitudinal strain, ‒17±1 versus ‒20±1%, P=0.006), increased native T1 mapping values (1264±10 versus 1184±10 ms, P<0.001), and impaired cardiac energetic status (phosphocreatine/γ-adenosine triphosphate ratio, 1.3±0.1 versus 1.9±0.1, P<0.001). CONCLUSIONS: In contrast to previous perceptions, takotsubo cardiomyopathy has long-lasting clinical consequences, including demonstrable symptomatic and functional impairment associated with persistent subclinical cardiac dysfunction. Taken together our findings demonstrate that after takotsubo cardiomyopathy, patients develop a persistent, long-term heart failure phenotype. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT02989454.

Youth Handles Stress Better

Chronic unpredictable stress (CUS) apparently can affect us – or at least female mice – differently based on age.  Thus the paper states: "We found that in young-adult female mice, CUS resulted in decreased anxiety-like behavior and enhanced cognitive performance, whereas in old female mice it led to weight loss, dysregulated locomotion and memory impairment."  It’s a young mouse’s world; the same likely applies to humans, also likely both sexes, but we need to study this.  Abstract:

Stress-related psychopathology is highly prevalent among elderly individuals and is associated with detrimental effects on mood, appetite and cognition. Conversely, under certain circumstances repeated mild-to-moderate stressors have been shown to enhance cognitive performance in rodents and exert stress-inoculating effects in humans. As most stress-related favorable outcomes have been reported in adolescence and young-adulthood, this apparent disparity could result from fundamental differences in how aging organisms respond to stress. Furthermore, given prominent age-related alterations in sex hormones, the effect of chronic stress in aging females remains a highly relevant yet little studied issue. In the present study, female C57BL/6 mice aged 3 (young-adult) and 20-23 (old) months were subjected to 8 weeks of chronic unpredictable stress (CUS). Behavioral outcomes were measured during the last 3 weeks of the CUS protocol, followed by brain dissection for histological and molecular end points. We found that in young-adult female mice, CUS resulted in decreased anxiety-like behavior and enhanced cognitive performance, whereas in old female mice it led to weight loss, dysregulated locomotion and memory impairment. These phenotypes were paralleled by differential changes in the expression of hypothalamic insulin and melanocortin-4 receptors and were consistent with an age-dependent reduction in the dynamic range of stress-related changes in the hippocampal transcriptome. Supported by an integrated microRNA (miRNA)-mRNA expression analysis, the present study proposes that, when confronted with ongoing stress, neuroprotective mechanisms involving the upregulation of neurogenesis, Wnt signaling and miR-375 can be harnessed more effectively during young-adulthood. Conversely, we suggest that aging alters the pattern of immune activation elicited by stress. Ultimately, interventions that modulate these processes could reduce the burden of stress-related psychopathology in late life. Molecular Psychiatry advance online publication, 19 December 2017; doi:10.1038/mp.2017.237.

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.

Social stress and teenagers

I just read "Teaching Teenagers to Cope With Social Stress", and found it useful since there is not too much advice for teenagers on how to handle social stress. And yet, the teenage years are highly formative and may reflect on almost everything that happens in adulthood. 

I will definitely share the article with my teenage daughter.

Gardens and renewal

For me, the best place to de-stress is the garden.

Years ago, I lived next to the New York Botanical Garden, and this is was my only place of refuge from the chaos of The Bronx. This is why I appreciated the recent post on Gardenista that allowed me to virtually re-visit the famous Bronx Garden.

I hope you are enjoying your Spring days as much as I do. 

And no, this blog is not going to turn into a flower-garden blog. It is just that this is the time to soak in the full glory of colors and shapes, sunlight and rich flower perfumes.

My first 2016 lily opened today.

Stress busters

"Ingemar Johansson and Floyd Pattersson 1959" by SCANPIX - hd.se. Licensed under Public Domain via Commons - https://commons.wikimedia.org/wiki/File:Ingemar_Johansson_and_Floyd_Pattersson_1959.JPG#/media/File:Ingemar_Johansson_and_Floyd_Pattersson_1959.JPG

For some of us, the workdays feel like a boxing match, during which we are sequentially or simultaneously pummeled by several people. And there is no referee to save us. For some stay-at-home parents, the days are not easier. Remember, stress not only reduces our physical and mental capabilities, lowers our quality of life, but it also causes serious illnesses. For the past three years I have been trying to find out what alleviates stress and the pressure built during the workday. Here I share what works or may work for me; hopefully, my quest would be useful to some of you.

1. Mystery books. These books do not offer wisdom, deep conclusions, novel knowledge or anything useful. However, they have an entertaining plot and I just follow it. If you can read these while on a treadmill, even better. So, head for the library!

2. Movies, but not the good ones. The very good movies are so emotionally involving that I feel more stressed after watching them. To de-stress, I choose something absolutely predictable, like a romantic movie (the chick flick category). “Predictable” means that within the first few minutes of the movie I can guess the ending. Since this can get boring, sometimes I knit or cook while watching. Do not get stuck in the chair during the movie: you can work out in front of the screen.

3. The fake smile. Force your facial features into a smile and keep the grimace there. For a bizarre reason the fake-smiling sends signals to the brain that we feel OK. This is quite applicable at work.

4. Pinterest. I accumulate a list of boards that calm me down. In my case, these are images of gardens, gorgeous flowers, awesome landscapes, flights and planes, skies and clouds, and nature frozen by winter.

5. Do nothing (that is, stop doing whatever you are doing). Sometimes simply doing nothing is the best de-stressor. Just stare from the window (if there is a view) or take a walk alone. Sounds a bit aimless, but stopping the mad rush and the constant stream of information helps.

6. Unleash your imagination, play.

Hobby is the code name for “games for grown-ups”. My biggest stress-buster is working in the garden; however, living in zone 5 U.S. means that gardening is not an option for half of the year. I try to stay creative with other “playthings” in winter – knitting, decorating, etc. 

 
7. Coloring books for adults. Coloring is the new meditation. I am yet to try it.

 
8. Laugh. Find a good comedy show on Internet and laugh, laughter is a medicine.

 
9. Sky-gazing. When was the last time you stared at the sky without hurrying? When I was a child, I used to watch the sky and discover colors and fantastic creatures in the clouds. The best sky- watching was when mom and dad held my hands and I walked between them. Then I could look up the sky with no fear of tripping. 


10. Warm showers. If you do not mind the water and gas/oil bill, try longer warm showers. This type of relaxation encourages the diffuse brain mode.

11. The wind of change. Change activities every 60-90 Such approach seems to sustain sanity and increase the feeling of fulfillment.  

12. Imagery. Do you have a tranquil and uplifting moment or image from the past?  In times of stress, bring the image back and relive it. For me, this is a moment of my childhood, when I found myself alone in the wildest part of a garden bursting with colors and shapes. I knelt down, and suddenly, I was smaller than the flowers. And as I became smaller and smaller, there was nothing but the buzz of the garden – the birds, the slight breeze and the bees, all immersed in a perfect co-existence of summer warmth and calm.

13. Never multitask. Multitasking is bad for you and for your job performance; therefore, do not even attempt it.

14. Gossip. I suspect that one big stress buster for the women in the past was gossiping.  After house chores were done, women in the neighborhood would get together for hours and while embroidering or knitting, they would gossip. For me this one does not work; in fact, gossip tires me and makes me feel uncomfortable.

15. I have not tried aromatherapy, meditation, music, lights, deep breathing, bubble baths, or massage. I am sure that these work too. Also, check the videos below - they could be helpful.


Actionable
Let us know how you de-stress, by sharing we can find the most effective ways to recover our identity after a day of "pummeling".  

 

Does stress cause cancer

In a recent post, Dr. Travis Bradberry discussed the impact of a stressful job. According to Dr. Bradberry, analyses of multiple studies have established that the stress from unstable and/or demanding jobs leads to poor health. But does this include cancer?
 

There has been a lot of confusion whether stress causes cancer. A search of evidence-based medicine resources will inform you that if there is any evidence for such connection, it is slim and weak. The difficulty of proving causation comes from the many factors that may influence cancer development, as well as from the fact that the development of cancer takes years, and measuring stress during decades of life is challenging. Some researchers have proposed that stress allows for cancer development by weakening the immune system. This hypothesis is based upon the current knowledge that a functional immune system might be able to launch a response against cells with mutations. The evidence for the direct cause and effect in this scenario is yet to be provided.
 

However, one link between stress and cancer is quite tangible. It is based upon the length of the telomeres. What is this, you may ask. Our genes are made of DNA, and this DNA forms the chromosomes in the cells of our bodies. Each of our chromosomes is protected at both ends with sequences called telomeres. As our cells duplicate (divide), the telomeres shorten. Shortening of the telomeres is equivalent to aging and it is not a good news: once the telomeres are of critical length, our cells stop dividing (this period is called senescence). However, changes (mutations) in a few genes may allow the cells to continue dividing. During such divisions, the chromosomes without their protective telomeres are subject to damage. The loss of chromosomal integrity may lead to the birth of cells with abnormal growth, and eventually, to cancer.
 

The described process partially explains why we are more prone to develop cancer at older age. The other pathway through which age contributes to cancer is the accumulation of random changes in our DNA during cell division; some of these changes (mutations) could contribute to cancer. Stress may not affect this mutational pathway; however, it may precipitate the aging (shortening) of the telomeres and thus, increase the risk of impaired chromosome integrity. Stress could do this by affecting the activity of an enzyme called telomerase. When functional, this enzyme counteracts to a certain extent the telomere shortening in special (adult stem) cells in our bodies. Stress hormones (e.g., cortisol) slow down the activity of the enzyme telomerase, making it more ineffective in preventing the telomere shortening. The fact that psychological stress shortens the telomeres faster than expected for a particular age was demonstrated with two groups of mothers: mothers of healthy children (low-stress group) and mothers of children with chronic illnesses (high-stress group). The study established that compared to the low-stress group, the high-stress group of mothers exhibited shortening of the telomeres that was equivalent to 9 – 17 additional years of age. Therefore, high stress may bring people closer to the catastrophic event when the chromosome integrity is endangered.
 

To summarize, the more stress we experience, the more cortisol we release, the more ineffective the enzyme telomerase is, the shorter the telomeres become, and the chance of chromosomal damage increases. Once our chromosomes and certain genes on them are damaged, there is a high risk of cancer development. In a future study, I would like to see a comparison of the telomere length between two groups: people with low-stress jobs and people with demanding and/or uncertain jobs.I bet the second group will exhibit shorter telomeres after adjusting for age. 

Until such study is conducted, we should remember that cancer is a result of the combined assault of age, environment, lifestyle choices, inherited genetic changes, and that stress may precipitate the process of cancer development. So, breathe deep, meditate, re-play the best moments of your life in your imagination, seize the moment through mindfulness, and laugh with the Horrible Bosses movies.