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Stress mismanagement: Link to mental illness

Minae Niwa, one of the authors of the paper published in Science, conducts research in the Johns Hopkins Schizophrenia Center. PHOTO BY Shin-Ichi Kano
Minae Niwa, one of the authors of the paper published in Science, conducts research in the Johns Hopkins Schizophrenia Center. PHOTO BY Shin-Ichi Kano

As the semester begins to unfold, students may find they have an old friend returning for a visit. It’s a friend no one really likes, but many find themselves running into him at the most inconvenient times: before that impending midterm, or right before an oral presentation. This friend is stress, and no matter how much you try to avoid it, stress is that friend that just won’t go away.

Students may be all too familiar with stress, but a study performed by Akira Sawa, a professor of psychiatry and behavioral sciences and director of the Johns Hopkins Schizophrenia Center, has shed new light on the phenomenon. The study, reported in Science on Jan. 18, suggests a connection between adolescent stress and permanent mental illnesses in adult life.

While mental illness has always been a popular topic, it has become more widely discussed with the recent influx of aggressive and violent acts, making this study’s finding central to future well being.


What is stress?

Stress is the brain’s response to any demand, including episodes of frustration or anger, according to the National Library of Medicine. The manifestation of stress can be short-lived or chronic, though either case is on the rise.

In a 2011 American Psychological Association survey, 39 percent of adults reported an increase in stress level over the past year, and 44 percent reported an increase in the past five years.

Though the definitive causes of this stress upsurge is unclear, survey subjects listed money, work and the economy as major contributors to stress.

It is widely accepted that stress can be debilitating to the bodies and minds of adolescents and young adults.

College of Communication junior Austin Corbett said he thinks stress can affect one’s ability to focus.

“Stress can cause a lack of focus, physical implications such as headaches or other bodily ailments,” Corbett said. “It can also negatively affect relationships if the stress is not handled properly, whether that be friendships or otherwise.”


A new study

Four unique groups of adolescent mice set the stage for Sawa’s, research: normal mice, normal mice with isolation stress, mice with genetic risk and mice with genetic risk and isolation stress.

Each enclosure at the research center contained between three and five mice. From our human sense, Sawa explained, this condition can be overcrowded. For mice, it is comfortable, so when a mouse is taken from this environment and isolated for three weeks, it becomes stressed.

The study focused on adolescent-aged mice to mirror the effects of stress in human adolescents, who are undergoing a critical period of brain development, according to the Johns Hopkins Medicine website. Therefore, according to the study, adult behavior is highly dependent on environmental conditions as children and adolescents.

“Most of the major mental illnesses, such as schizophrenia, mood disorder [and] substance use are in early adult onset, and the adolescent pathology just before onset is of the most interest,” Sawa said in a phone interview.

The normal mice showed no changes in behavior after this isolation, but mice with a genetic predisposition to characteristics of mental illness began exhibiting signs of mental illness. When returned to their regular housing, the new behavior endured, hinting that these effects may be permanent.

To record these effects on behavior, mice were tested post-isolation. These mice were examined in the forced swim test, in which they were placed in a pool filled with water. Genetically predisposed mice failed to swim.

“The FST is used to examine efficacy of antidepression,” Sawa said. “This reflects some aspect of depression, a condition familiar to humans.”

The mice with genetic risk also exhibited hyposensitivity to a psychostimulant, which, according to the online Farlex dictionary, is a drug with antidepressant or mood-elevating properties. This is also a known reaction in patients with schizophrenia.

Sawa said some mice behavior can mimic human behavior, and the implications of this study may be significant.

“Even without the external stress the genetically predisposed mice show milder defect in later adulthood, but the extent is subtle,” Sawa said. “Only by combining with isolation, the aberrant phenotypes occur, especially from early adulthood.”

College of Arts and Sciences sophomore Joseph Hannawi said he agreed that stress and mental health are closely related.

“I wouldn’t say stress causes mental health illness,” Hannawi said, “But it may promote the onset of symptoms.”

When asked about the effects of stress, CAS sophomore Myrna Jreige said she thinks people with stress might withdraw themselves from others, affecting their mental health.

“Stress as a whole is not good for a person’s mental health,” she said, “though it depends on how long or drawn out it is.”


Stress and the body

The study focused on the gene DISC1, a risk gene that is implicated in a wide range of mental illnesses, Sawa said. The gene has been identified as a schizophrenia susceptibility gene and Sawa said subjects with the mutation have been diagnosed as depressed, schizophrenic or bipolar. There are many risks with mental illness, though, Sawa said, so there is not a specific significance in this gene.

In the predisposed mice, the study found the DISC1 gene is overexpressed.

The mice with the DISC1 gene had elevated levels of Cortisol, a steroid hormone familiarly known as the stress hormone, as it is involved in the nervous system and in stress responses.

According to Sawa, they also showed lower levels of dopamine, a neurotransmitter in the brain involved in motivation, reward, cognition and mood. Low levels of dopamine correlate with higher levels of anxiety, depression, as well as some symptoms of schizophrenia, according to News Medical and Cornell Chronicle.

Researchers used RU-486, a glucocorticoid receptor, to determine whether the high cortisol levels caused the changes in dopamine. Hopkins Medicine reported that this steroid — which, according to The New York Times, is known as the abortion drug — blocks cells from receiving cortisol.

In administering RU-486, conditions in mice were normalized. Sawa said the drug had been previously used in patients with psychotic depression, a subgroup of depression that is difficult to treat. He hopes that the mouse study may provide a new model for psychotic depression.


The severity of stress

With the onset of stress, only 29 percent of people surveyed by the American Psychological Association said they are doing a good job of reducing it, and 94 percent believe that stress can contribute to the development of major illnesses.

It is not surprising, then, that emotional health in college students has decreased over time while feelings of being overwhelmed have risen.

In the University of California, Los Angeles survey “The American Freshman: National Norms,” self-rated emotional health for freshman was at its lowest point in 2010 since the survey began in 1985.

Olivia Jake, a junior in the College of Engineering, said if she doesn’t keep her stress in check she feels major impacts.

“If you don’t find healthy ways of dealing with stress, you’ll go insane,” Jake said. “If I don’t find ways to manage my time, I’ll have a breakdown.”

However Jriege said stress is not always a negative sensation. “Some people can be debilitated by stress,” she said, “whereas other people may thrive under the pressure.”

Some students said the major issue at hand is the prevention of mental health issues.

“This can help us as a society to recognize those with mental health issues,” Corbett said. “On the other hand, it could cause a negative stereotype for those with the predisposition, because we wouldn’t want to put them in a separate class due to their issues.”

Hannawi said mental health issues are in the news seemingly every day.

“Whether these cause people to be violent or more aggressive is definitely a hot issue these days, especially after the recent school shootings,” he said.


The future

Sawa said he hopes that this study, which tested how broadly RU-489 affected molecular change, will affect the way psychotic depression is treated in the future.

“If we have animal models, developing a new compound is easier” he explained, “We can develop new drugs to treat it.”

Sawa also said he will study the causes of substance use, as it is believed that adolescent stressors are one cause. He said researchers plan to test how an animal model may have a program in substance use, as it did in mental health.

Scientists do not yet completely understand why the past often affects adults’ mental health years later.

However, Sawa said we must continue to focus on how adolescent stress can result in neuropsychiatric disorders. He said it is vital to improve preventative care for teenagers with mental illness in the family and for those with high stress levels to manage it properly.

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