The Stress-Emotions Connnection

Yet another totally reworked article in my never-ending mcmanweb blow-everything-up-and-start-over project, edited for your reading pleasure ...

Stress is to mood what that iceberg was to the Titanic, with therapies increasingly geared toward neutralizing its vast destructive powers.  In a 2002 NIMH study, healthy subjects with a certain short variation (allele) to the serotonin transporter gene viewed images of scary faces as their brains were being scanned. The part of the brain which governs fear and arousal - the amygdala - lit up like a Christmas tree.

A year later, a study on a New Zealand population found that those with this very same short allele were far more at risk of depression after being exposed to four or more lifetime stressful events (including employment, finances, housing, health, and relationships) than their long-allele counterparts.

Vulnerability vs Resilience

Is mental illness a "vulnerability" disease? Are the lucky ones, in effect, genetically "resilient" to what life happens to throw their way? Or does life have a way of turning even resilient brains vulnerable?
At the 2002 American Psychiatric Association's annual meeting, Charles Nemeroff MD, PhD of Emory University asked his audience: "Is the biology of depression the biology of early trauma?"

In an experiment designed to startle lab rats by blowing an air puff in their faces, Dr Nemeroff and his colleagues found those who had been separated from their mothers as pups showed a greater stress response, with tissue samples revealing higher concentrations of the hormone CRF (corticotropin-releasing factor).

Women abused in childhood, Dr Nemeroff explained, end up with a sensitized brain system, where CRF receptors are to be found in abundance. Depressed patients have high concentrations of CRF in their cerebrospinal fluid.

A 2000 study that he co-authored with Christine Hein PhD found that women with a history of childhood abuse exhibited increased pituitary and autonomic responses to stress when given math tests and made to speak in public compared with the controls. This was especially true for the women with current depression and anxiety.

Stress Pathways

The stress response - fight or flight - kept our distant ancestors alert and alive long enough to pass on their genes, which certainly comes in handy in modern life, especially when a zeppelin is chasing you.

As Kurt Vonnegut describes it in his 1973 novel, "Breakfast of Champions":

My mind sent a message to my hypothalamus, told it to release the hormone CRF into the short vessels connecting my hypothalamus and my pituitary gland.
 
The CRF inspired my pituitary gland to dump the hormone ACTH into my bloodstream. My body had been making and storing ACTH for such an occasion. And nearer and nearer the zeppelin came.
 
And some of the ACTH in my bloodstream reached the outer shell of my adrenal gland, which had been making and storing glucocorticoids for such emergencies.
 
My adrenal gland added the glucocorticoids to my bloodstream. They went all over my body, changing glycogen into glucose. Glucose was a muscle food. It would help me fight like a wildcat or run like a deer.
 
And nearer and nearer the zeppelin came.
 
My adrenal gland gave me a shot of adrenaline, too. I turned purple as my blood pressure skyrocketed. The adrenaline made my heart go like a burglar alarm. It also stood my hair on end. It also caused coagulants to pour into my bloodstream, so, in case I was wounded, my vital juices wouldn't drain away.

Vonnegut is describing a neuro-endocrine loop known as the hypothalymus-pituitary-adrenal (HPA) axis as it is supposed to act in dangerous situations. But what about when there are no zeppelins in sight, when we simply need to be on our toes? The abused and depressed women in the Heim-Nemeroff study exhibited a six-fold greater ACTH increase over the controls. In effect, these women - who only needed to be sufficiently alert to do math tests and speak in public - were being primed to flee attacking zeppelins.

Throw in an over-reactive amygdala and a picture begins to emerge of the human psyche on the breaking point. As Robert Sapolsky of Stanford describes it in a Sept 2003 article in Scientific American: "When we erroneously believe a stressor is about to happen we have entered the realm of neurosis, anxiety, and paranoia."

All those glucocorticoids Vonnegut was talking about don't simply evaporate. Stress has been linked to just about every physical illness imaginable, whether as a risk factor, a cause, or the triggering event.

In the brain, the neural synapses are flooded, setting the scene for excess glutamate to overstimulate brain cells, leading to neuronal loss and atrophy. In this sense, according to Husseini Manji MD, formerly of the NIMH, mood disorders may be regarded as fundamentally atrophic (ie stemming from brain cells in physical distress) rather than symptomatic.

Back to Freud, of All Things

Of all things, the Freudian-inspired DSM-I of 1952 and the DSM-II of 1968 - the ones that everyone ridicules as pre-modern and unscientific - may have gotten it right. Those early DSMs may have wrongly attributed serious mental illness to neurotic or psychotic-reactions, but they very correctly attributed the stresses of dealing with life as the driving force to these reactions.

The "modern" DSMs III and IV, with their exclusive focus on symptom check-lists, threw us off the scent.

Maybe stress can't account for everything going wrong with our brains, but it always needs to be the first place to look. Modern brain science, in effect, has simply relocated the stress dynamic from the metaphysical construct of the mind to the decidedly more prosaic meat housed inside our skulls.

But not just any old meat. We're talking highly specialized, intricately connected meat - live meat - as sensitive to present and past experience as photosensitive paper is to light. When our environment acts, our brain reacts.

But not blindly. Our stressful reactions are telling us something. That maybe, for instance, we need to get out of our denial and recognize that things at work or in our personal relationships are not okay. That maybe, while we have a chance, we have to change ourselves or change the situation around us. Because, if we don't, our depression or anxiety or mania is going to tell us the same thing, only in a much louder voice, with far fewer choices.

Our environment molds our brains, our brains mold our environment. Round and round it goes, a constant cycle of reaction and adjustment. We the vulnerable tend to have a harder time adapting and adopting, but this very insight also tends to be our best motivator.

Be hopeful, take the initiative, live well ...

Full stress article on mcmanweb

A Lesson in History: The 1960 Presidential Campaign

I recall my father sitting me down and offering this sage advice: "Son," he said, "there is no excuse for dancing like a white man."

Actually, he said no such thing. Rather, he counseled, "Son, there is no excuse for thinking like a Republican."

Okay, he never said that either, but I do recollect my father dragging me out on a bitter cold autumn night in New England fifty years ago. I was 10 going on 11, and an historic Presidential campaign was underway.

JFK was due to address an evening rally in nearby Waterbury, Connecticut. He should have arrived hours before, but no one was leaving. I was standing in the drizzling freezing cold with my father and thousands of others. People were warming their hands around improvised fires they had lit in steel trash drums.

I don't remember much about Kennedy that night, but I vividly recall that crowd. I recall my father, I recall the emotion. History was being made. Theodore White, in his book "The Making of the President," recounted that memorable night and how Kennedy was astounded by the turn-out and the enthusiasm. That reception, others have commented, animated the exhausted candidate, gave him a second wind, imbued him with the strength to squeak out a win in what was then the closest election in history.

Had my father and others voted according to reason rather than emotion, Nixon would have easily won the election. Nixon, after all, had more experience by far, having served as Vice-President under Eisenhower, a true moderate Republican who presided over a decade of unprecedented prosperity.

A continuation of the Eisenhower years under Nixon would have been the sensible choice, but many voters harbored a visceral hatred of the Republican candidate. Part of this had to do with Nixon's early rise to fame. Conservatives saw him as a principled man standing up to home-grown communism. Liberals saw him as a rat bag red-baiter out to ruin innocent people for his own personal gain.

Part of this also had to do with Nixon's unfortunate "Tricky Dicky" image, which JFK exploited to the max. (Would you buy a used car from this man?) By contrast, JFK literally invented charisma. All politicians who came after are mere pale imitations. In their first debate (see the above YouTube clip), most of those who heard the proceedings on radio thought that Nixon had won, but JFK emerged a clear winner to the TV audience.

During the campaign, JFK resorted to a scare tactic involving a fictitious "missile gap" with the Soviet Union. Nixon could not respond without disclosing classified information. There was also the complicating variable of JFK's religion, then a contentious issue. Make no mistake about it, in our Irish-Catholic household it wouldn't have mattered if Kennedy were Forrest Gump - he had the McManamy vote securely locked away.

Conversely, all hell could have frozen over before many Protestants would have voted for a Catholic. Then there was the "solid south," in those days staunchly Democrat, still irrationally nursing a grudge against the party of Lincoln.

Nixon and Kennedy entered Congress the same year, 1946. They became good friends, Kennedy a conservative Democrat, Nixon a moderate and almost liberal Republican. Both were thoughtful men, with sharp intellects. Both were keen students of history. On paper, very little separated the two. On all the intangibles - the things that reason cannot explain - it was an entirely different story.

In the final analysis, the right man won for the wrong reasons. Such is the capricious nature of democracy. Jefferson and our Founding Fathers naively assumed that a well-informed public, making reasoned choices, could be trusted with their own government. According to a recent Pew Research Poll, 34 percent of conservative Republicans think Obama is Muslim.

This time around, capricious democracy - fueled on cynically fanned emotions - is leading us to an inexorably wrong result. God help us all.

Thinking With Our Emotions - It's Vital

We use our reason to keep our emotions in check. That way we don't do stupid things. We become masters of our domain. Plato believed that. So did the Enlightenment philosophers. So did our Founding Fathers, as did Freud. It stands to reason, right?

Not so fast, says science writer Jonah Lehrer. In his eye-opening (and highly recommended) book, "How We Decide" (published last year), Lehrer cites no end of brain science studies that show that emotion is very much involved in not only making decisions, but in making the right decisions. Not only that, the pre-frontal cortices - those parts of the brain associated with higher reasoning - are very easily tricked into making bad choices.

Lehrer begins his book with the closing seconds of the 2002 Super Bowl (click on YouTube video above). The New England Patriots have the ball on their own 17 yard line, and the Rams defense is expecting quarterback Tom Brady to pass. As Lehrer tells us, "each pass is really a guess, a hypothesis launched into the air." The best quarterbacks make the best guesses.

In the split-seconds he has at his disposal, there is no time for Brady to make a considered decision. Instead, it is his feelings that guide him. Brady starts moving the ball downfield. Then it's now-or-never time. Lehrer picks up on the action:

The primary target, a tight end running a short crossing pattern, is tightly covered. As a result, when Brady glances at the tight end, he automatically feels a slight twinge of fear, the sure sign of a risky pass.

His secondary target is also covered. Again, a negative feeling. Brady needs to get rid of the ball in a hurry. Otherwise, bad things will happen. He proceeds to his third target ...

Troy Brown is sneaking across the center of the field, threading the seam between the linebackers and the cornerbacks. When Brady looks at the target, his usual fear is replaced by a subtle burst of positive emotion, the allure of a receiver without a nearby defender. He has found an open man. He lets the ball fly. ...

As Lehrer explains later in the book, a lot of our decision-making has to do with the dopamine system, most commonly associated with the emotions of pleasure and fear. But dopamine is also involved in the process of anticipation - a lot of it driven by past experience. Thus in a gambling game, if a player drew from a bad deck, the dopamine neurons immediately stopped firing. "The player experienced a negative emotion and learned not to draw from that deck again."

This is a crucial cognitive talent, Lehrer tells us. "Dopamine neurons automatically detect the subtle patterns that we would otherwise fail to notice; they assimilate all the data that we can't consciously comprehend. And then, once they come up with a set of refined predictions about how the world works, they translate these predictions into emotions."

Oddly enough, Lehrer says later on, psychopathic behavior appears to result from lack of emotion rather than a breakdown in reason. Psychopaths tend to have above average intelligence. The problem is they are not guided by their emotions. They never feel bad when others feel bad. As a result, they show no remorse. "This emotional void means psychopaths never learn from their adverse experiences. ... The absence of emotion makes the most basic moral concepts incomprehensible."

Yes, our emotions can lead us astray, but the skilled decision-maker knows when to pay attention:

Brady yells out a snap count, sends a man in motion, then the ball is in his hands. He drops back and notices three defensive linemen are rushing him. The fourth is trying to cut off the short pass. Brady looks to his right. The receiver is covered. He looks to his left. Nobody's open. He looks to the center of the field. Troy Brown, a Patriots wide receiver, is trying to find a plane of unoccupied space ...

Something feels right to Brady. He fires a bullet 14 yards downfield. Brown runs with the ball another nine yards, then steps out of bounds. One more quick pass, then the kicking unit comes onto the field. Adam Vinatieri sends the ball 48 yards through the uprights. Zero seconds on the clock. Game over.

Much more to come ...

Jonah Lehrer authors the outstanding brain science blog, The Frontal Cortex.