The importance of friends during times of crisis.

Over at PsychCentral's World of Psychology blog, Dr. John Grohol recently made a nice post entitled Where Do Friends Go when You're Coping with a Crisis? He writes, "Have you ever noticed that when something bad happens to you or to someone close to you in your life (like a son or daughter, or a parent), some friends might offer help, while others disappear?"

Most of those who've experienced mental health crises can relate.

Grohol's blog post is built around a New York Times article which cites feelings of helplessness, vulnerability, guilt, and awkwardness among the reasons why people fail to "show up" and help friends in need emotionally or logistically. From the article:

“We all live in some degree of terror of bad things happening to us,” said Barbara M. Sourkes, associate professor of pediatrics at the Stanford University School of Medicine. “When you’re confronted by someone else’s horror, there’s a sense that it’s close to home.”

Dr. Sourkes works with families confronted with the unfolding trauma of a child’s serious, and possibly fatal, illness. “Other people’s reactions are multifaceted,” she said. “There’s no formula, and it’ll change from person to person.” The only certainty is that traumatic events change relationships outside the family as well as within it.

Often the closer one feels to the family in crisis, the harder it is to cope. “Most people cannot tolerate the feeling of helplessness,” said Jackson Rainer, a professor of psychology at Georgia Southern University who has studied grief and relationships. “And in the presence of another’s crisis, there’s always the sense of helplessness.”

Feelings of vulnerability can lead to a kind of survivor’s guilt: People are grateful that the trauma didn’t happen to them, but they feel deeply ashamed of their reactions. Such emotional discomfort often leads them to avoid the family in crisis; as Dr. Sourkes put it, “They might, for instance, make sure they’re never in a situation where they have to talk to the family directly.”

Awkwardness is another common reaction — not knowing what to say or do. Some people say nothing; others, in a rush to relieve the feelings of awkwardness, blurt out well-intentioned but thoughtless comments, like telling the parent of a child with cancer, “My grandmother went through this, so I understand.”

Importantly, Grohol discusses the necessity of reaching out to our friends when we're in trouble. Unfortunately, shame can make asking for help a difficult task. But typically our friends do want to help, and just need a nudge to get them past whatever's making them hesitate, or to see that yes, indeed, there is something they can do. Grohol's advice:

Ask your friends to help out with specific things — the more specific the better. This may not stop others from their distancing behavior, but it has a good chance of making yourself feel less isolated. It also makes them feel like they’re doing something that is actually helping you, which is an empowering feeling.

The beneficial mental-health effects of being in nature.

It's no secret that spending time in the great outdoors can have calming, clarifying effects on the psyche. For those of us without a meditation practice, contemplating an alpine lake or a seaside sunset is probably the quickest path available to true stillness of mind. Anyone who's athletically inclined will tell you it's much more enjoyable to cycle or run through the woods or along the beach than it is to get your heart rate up on an exercycle or a treadmill or some other machine -- and from my perspective, when you're dealing with panic, the prospect of being outdoors typically creates far less anxiety than that of being in a crowded, noisy gym. (I actually have a piece in the most recent esperanza magazine about how I used mountain biking to get through a period of panic when I lived in Los Angeles; at the time, just the thought of entering a gym would've made my skin crawl with claustrophobia.)

Poets and painters have been communicating this truth for eons, but it's only recently that science has gotten in on the act. Despite its subjectivity-focused origins, today the field of ecopsychology is bringing hard evidence into our understanding of the effects of the natural world on mental health:

In the past few years, some ecopsychologists have made significant strides in adding scientific rigor to their field. What their research suggests so far is that even subtle interactions with nature provide a range of cognitive benefits, including elevated mood, enhanced memory, and decreased stress. Staring out a window at pretty scenery can significantly lower one’s heart rate, for example, and some studies even indicate that hospital windows with views of nature can facilitate healing. What’s more, nature provides measurably greater benefits than both manmade environments and simulations of nature. Research demonstrates that walking through the city can tax our attention, whereas a park restores our concentration and can even improve our performance on tests of memory.

The field is introducing new forms of therapy to the psychological toolkit:

Standing alone atop a modest mountain in rural Maine, Eric Adams looked out into the darkness all around him. Between the silhouettes of boulders and trees, slivers of yellow light wandered and winked — the eyes of wild animals. Fears began to crowd his mind, but he did not push them away. This was part of his therapy....
 
“I don’t have an office — all my meetings are outside regardless of the weather,” said Dennis Grannis-Phoenix, an ecotherapist in Bangor, Maine who began counseling Adams in 2004. Hiking, camping, kayaking — each therapeutic session centered on an outdoor activity. Grannis-Phoenix asked Adams to climb the mountain alone as an exercise in learning to face his fears and anxieties. Instead of rationalizing his fears, Grannis-Phoenix wanted Adams to embrace them — something both therapist and patient feel is easier to learn in nature than in an office.

A final note: This piece brings to mind an interesting recent article from the New York Times about what happened when a group of busy neuroscientists went camping "off the grid" for a week earlier this year. The bottom line: It worked.

Radiolab (from NPR's Morning Edition) on fear memory.

I've looked at the science of fear a lot here at PANIC!, so my ears perked up this morning when I started listening to this program on public radio this morning, about how fear memories alter one's sense of time. From the program description:

When Alice fell down the rabbit hole, her fall seemed to last forever. Neuroscientist David Eagleman had the same experience as an 8 year old boy while falling off a roof. This led him to wonder, what is it about brushes with death that cause this slow-mo effect? He now thinks he knows.

It's a fascinating program, well worth the seven minutes and change it takes to listen to.

During my search for the link to the program, I also came across this program, featuring NYU scientist Joseph LeDoux, about erasing fear memories, another topic I've discussed repeatedly on this blog. The program description:

What is a memory? Science writer Jonah Lehrer tells us is it’s a physical thing in the brain… not some ephemeral flash. It’s a concrete thing made of matter. And NYU neuroscientist Joe LeDoux, who studies fear memories in rats, tells us how with a one shock, one tone, and one drug injection, you can bust up this piece of matter, and prevent a rat from every making a memory. LeDoux’s research goes sci-fi, when he and his colleague Karim Nader start trying to erase memories. And Nader applies this research to humans suffering from PTSD. 

Good stuff; I particularly like the way the programs go into the philosophical implications of the science.

The neurobiology of fear.

"The neurobiology of fear", a post from the blog Neurophilosophy, provides a thorough overview of the latest science of how fear works in the brain and body. Lots of interesting stuff here, like this look at the role of something called the stathmin gene in the creation of fear memories:

It was known for some time that the encoding and consolidation of fearful memories can be blocked by inhibiting protein synthesis in the amygdala, but it was not clear which proteins are involved. Recently, however, Gleb Shumyatsky and his colleagues at Rutgers University in New Jersey discovered several genes that are highly expressed in the amygdala, and which appear to be involved in this process. One of these encodes a  protein called stathmin (also known as oncoprotein 18), which is now known to be involved in mediating the formation of memories of both conditioned and unconditioned fear. There is a high level of expression of the stathmin gene, and a corresponding high concentration of stathmin protein, in the amygdala, but not in the adjacent hippocampus. 

Mutant mice lacking the stathmin gene were unable to learn new fears or to act instinctively in a fearful situation, i.e. they had weaker memories of fearful experiences. The stathmin knockout mice also showed less anxiety when presented with new mazes to explore or with potentially dangerous situations. Upon further examination, it was observed that mice lacking the stathmin gene had a less dynamic microtubule network than wild type (normal) mice. Memories are formed by the establishment of new synaptic connections, which require a re-arrangement of microtubules. In the absence of the stathmin protein, microtubules aren't re-arranged so easily, and, as a consequence, the synapses that would normally be modified during memory formation are not as plastic as they should be.

A nice piece, if you're looking for a better understanding of the science of panic. If you want to learn even more, this is a good place to start.

Exercise and anger.

I've talked about how anger is related to panic and depression. I've talked about how exercise can lessen panic and anxiety. So it's only natural I'd point out that exercise may moderate anger. From the link:

During the two days of the study, the men were each fitted with high-tech hairnets containing multiple sensors that could read electrical activity in the brain. Next, researchers flashed a series of slides across viewing screens set up in front of each young man. The slides, intended to induce anger, depicted upsetting events like Ku Klux Klan rallies and children under fire from soldiers, which were interspersed with more pleasant images. Electrical activity in the men’s brains indicated that they were growing angry during the display. For confirmation, they described to researchers how angry they felt, using a numerical scale from 0 to 9.

The results showed that when the volunteers hadn’t exercised, their second viewing of the slides aroused significantly more anger than the first. After exercise, conversely, the men’s anger reached a plateau. They still became upset during the slide show — exercise didn’t inure them to what they saw — but the exercise allowed them to end the session no angrier than they began it.

What the results of the study suggest is that “exercise, even a single bout of it, can have a robust prophylactic effect” against the buildup of anger, said Nathaniel Thom, a stress physiologist who was the study’s lead researcher.

Learning from anxious monkeys.

A recent study of anxious monkeys illuminates subtle aspects of why and how they are anxious:

- Young rhesus monkeys from a large, related family showed a clear pattern of inherited anxious temperament.

- Monkeys with anxious temperaments had higher activity in the central nucleus of the amygdala and the anterior hippocampus. In addition, researchers could predict an individual’s degree of anxious temperament by its brain activity.

- Genes and environmental factors affected activity in the amygdala and hippocampus in different ways, providing a brain-based understanding of how nature and nurture might interact to determine an individual’s vulnerability to developing common psychiatric disorders

The hope is that what researchers are learning about anxiety in young monkeys may someday help identify and intervene with anxious children:

The new discovery may ultimately lead to new ways to detect anxiety in children, says Drew Fox, a graduate student ... and a co-author on the study.

"Markers of familial risk for anxiety could be identified by understanding alterations in specific genes that influence hippocampal function," says Fox.

The study suggests that there is a tremendous opportunity to modify the environment to prevent children from developing full-blown anxiety.