We have all heard that depression, anxiety, and other mood disorders have an important “biological component.” But what does biological mean? A common misconception is that “biological” means “immutable” or “permanent.” In this blog, I would like to talk a bit about the bi-directional influence of biology and our mind-body vehicles. First, the effect of mood on one’s functioning. Followed by what each of us can do to minimize our vulnerability to emotion dysregulation.
Effects of Mood on Functioning
Some people do have a family history and genetic predisposition; a certain type of mind-body vehicle, with certain innate vulnerabilities. This biological component can make the road of life feel much more challenging, with difficult thoughts and feelings overwhelming one’s capacity to take effective actions toward life goals. This is what I call the 'mood soup' problem; when the collective “soup” of physical, emotional, and cognitive dysregulation adds an extra challenge to skillful action. Because there is such a tight causal link between mood and actions, we often see increased behaviors such as substance use and abuse, emotional eating, more salty fat and sugar, thus an increase in weight gain, reduced activity, over sleeping, and naturally, less social involvement, more arguments and/or increased isolation. Unfortunately, the outside world (friends, family) can view the interruption in activity as lazy, flaky, irresponsible. When in fact, these actions are the natural extension of the emotion dysregulation.
The biology of mood
To make things even more complicated, the biology of disorders related to mood is still not fully understood. There are numerous proposed biological pathways, which may contribute to anxiety and mood disorders. But there is no single, direct pathway. This is why it is believed that psychotropic medications only work about 50% of the time, and predominantly in moderate to severe cases. For this reason, researchers and psychologists assess and treat mental health from, what we call the “bio-psycho-social,” model of mental health. To get a complete picture, we look at all three; family/biological pre-dispositions (what type of vehicle are you), the social and cultural environment (what roads your vehicle has traveled; your experience) and the meaning each individual makes of the interaction between your vehicle and the road (passengers/psychology).
Effects of Behavior on Mood
The very important thing to remember is that the influence of each on the others is both ways. In other words, the kind of vehicle you are (biology) will influence the roads you choose and thus, the psychological perspective (passengers) you develop. But equally true, and far more empowering, is the fact that we have the power to choose different roads, which will in turn, effect the wear and tear of our vehicle and our passengers. This is not just a theory, research is now conclusive, genetic makeup is only part of the equation. We know this from twin studies. Genes are identical, but genetic expression (symptoms) only occurs in one of the twins. This means, something in the environment (something consumed, experienced, or perceived) switched on the genetic expression. So the good news is, just as with any physical health risk, knowing our biological predisposition, we can take responsibility and make better choices about promoting resilience.
While it is fairly common knowledge for this generation, that our health choices influence our physical health and longevity. Many people still fail to consider personal choices when thinking about their mental wellbeing. This is in no small part due to the influence of the medical model in Western medicine. The Western view is traditionally allopathic, that is a one-to-one relationship between illness and something must be broken. But more and more practitioners are adopting a more Eastern view. A holistic view considers the system, such as the bio-psycho-social perspective noted above, as well as illness and well being on a continuum, rather than on-off.
It is helpful to think of the biology of emotion as similar to one who has Diabetes. Some people have Type I diabetes, which means their was a heavy genetic loading so that their ability to metabolize sugar is severely impaired from the get go. Some people develop Type II diabetes from dietary stress to the system and an overload of their ability to produce insulin. In both cases, however, how we care for our vehicle can have a significant impact on the symptoms one experiences. Similarly, more and more research is demonstrating the biological effects of stress on mental health symptoms, and how stress management skills can moderate these effects.
Vulnerability-Resilience Basics
Stress accumulates over time to build allostatic load and break down the system. Recovery begins to take longer, and illness more likely. Here is just a quick run down of some of the most powerful allies in promoting your psycho-biological resilience. (Of course, check with your doctor and make self informed decisions).
Avoid/Minimize mood altering substances: This may seem like common sense. But the desire to feel other than how we do can lead to over consumption of alcohol or other substances. In turn however, the biological pathways create a rebound effect. For example, when calming or Opiate like substances are consumed, these neuro transmitters are less capable of receiving the inhibitory neural transmission. This leads to rebound irritability or anxiety. The reverse is true for stimulants. After a bout of cocaine use, which amps up our happy neurotransmitter (dopamine), puppies and sunsets no longer bring us the same joy. We feel depressed.
Maintain consistent sleep patterns: Sleep hygiene is critical for maintaining and managing daily hormone shifts. This is one of the most critical modifications in the treatment of bipolarity. Individuals with a predisposition to Bipolar disorder, often report that their first episode was after a disruption in sleep. So take these simple precautions to minimize dysregulation due to poor sleep hygiene.
1. Figure out how many hours sleep you need. Then count backwards, and get in bed that number, plus 30 minutes.
2. Dim lights one hour before bed time
3. Do not consume aggressive or agitating content
4. Avoid caffeine after 3:00 pm
Monitor-Treat physical health: Do have yearly physicals with blood work. I cannot tell you how many times a simple blood test has solved the mystery of a client’s depressive or anxiety symptoms. Your blood work might hold the answer, particularly if you are noticing a sudden, uncharacteristic change. Have your doctor check the following important biomarkers of stress resilience and mental well-being.
• Thyroid
• B-12
• Cortisol
• Inflammatory markers
Eat low fat, complex carbohydrate diet with lean proteins and fish. A diet rich in complex carbohydrates can promote mental health resilience to stress. Carbohydrates increase brain tryptophan levels, which is the precursor to serotonin. Serotonin is a primary neurotransmitter in the brain associated with mood. Under increased stress serotonin neurons are activated and thus in need of more serotonin.
It is tempting to reach for simple sugar snacks because glucose is the brains main source of fuel and can facilitate memory in the short term. But, beware! A diet high in simple or refined sugars can increase base-line circulating cortisol, which has been linked to neural degeneration and depression. Fruits and vegetables on the other hand are a source of complex carbohydrates as well as neuro-protective antioxidants. There is evidence that dietary antioxidants present in fruits and vegetables may improve cognitive function.
For protein, load up on fish and turkey. Fish oils and other foods containing high amounts of Omega-3 fatty acids contribute to a protective layer around brain cells, called mylenation. Mylenation is like insulation around the neurons, which improves the conductivity, making brain signals more clear. Think of this as reducing the static in your brain! There has been ample evidence that Omega-3 fatty acids are helpful in managing mood. Turkey on the other hand, increases the amino acid L-Tryptophan. As noted above, tryptophan is an essential building block for serotonin.
Cardiovascular Exercise: Exercise is a physical stressor, which results in similar cortisol reactivity to psychosocial stress. However, through physical fitness training, the threshold of cortisol activation can be elevated, which means you will be more resilient to the degenerative effects of stress. Studies in adult exercisers have found that aerobically fit individuals do not exhibit the same degree of cortisol reactivity and cognitive decrements as unfit individuals exposed to stress.
Medications: Antidepressant medications have an important role in recovery once a mood or anxiety disorder has taken hold. And….as one of my esteemed colleagues, a prominent Harvard educated psychiatrist once said, “there is no pill for crummy life experiences.” These medications tend to be most effective for moderate to severe disability and can also be helpful in getting the ball rolling in assimilating Cognitive and Behavioral skills. The good news about choosing to learn the skill building approach is the only side effects are increased sense of self-efficacy and confidence in your ability to cope in the future!
