Omega 3 Fatty Acid and Mental Health – A Case for Treatment of Bipolar Individuals

omega-3-fatty-acidsIn the world of internet success stories, few industries are as common as the lucrative supplement industry. On the internet you can buy supplements that claim to improve mental health, reduce risk of cancer, improve your libido, help cure psychological disorders and more (really, the only limit is your ability to think of something that needs fixing). Omega-3 fatty acids are a naturally occurring fats found most-often in fish and some vegetables. And they are purported to have many positive health effects ranging from improved cognitive aging, reduced inflammation and even helping to prevent cardiovascular disease. Unlike many supplements sold, omega-3 fatty acids have been studied in-depth.  There is some evidence that another benefit to omega 3 fatty acids is as a potential alternative treatment to bipolar disorder.

Lithium

Traditional treatment of bipolar disorder has historically been the ingestion lithium salts.   The mood-stabilizing effects of lithium are well accepted.  This powerful drug, while very effected, does tend to come with some unfortunate side effects. These include everything from tremors and an overall “dazed” feeling to potential birth defects when exposed in utero as well as potential negative long-term effects for those it is prescribed to. Furthermore, lithium is highly potent and risk of overdose is severe (and it’s impacts, when not fatal, can be long-lasting).

As effective as lithium can be for those with mood disorders, such as bipolar disorder, alternatives would be welcomed and although there have been many alternatives developed in the last 50 years, these too come with their own side effects.

Enter Omega 3 Fatty Acids?

Fortunately, evidence suggests that Omega 3 Fatty Acids, among their many other purported benefits, also have a mood-stabilizing effect for patients suffering from bipolar disorder.  A double-blind, placebo study indicates that patients diagnosed with bipolar disorder show signs of mood-related improvement over a 4 month period while administered omega-3 fatty acids.

The omega 3 fatty acids were administered twice daily, a randomly selected control group received identical looking capsules of olive oil.  Because of the safety of these substances, relatively high doses were used to avoid dosage that would be below an effective amount.  Over the course of the study, a significant portion of the experimental group showed signs of improvement in their disorder.

Although the effects were small and the research needs to be further investigated, the possibility that a relatively harmless and naturally occurring supplement can help stabilize individuals with mood disorders is exciting.  If nothing else, it is another promising reason to purchase omega 3 fatty acid supplements or at least increase your intake of fishes high in the substance, such as salmon.

Pain Tolerance and The Psychology of Cyclists and Other Endurance Atheletes

George Hincape at the 2004 Paris RoubaixEndurance sports, such as cycling,  require a different set of skills over their game sport counterparts. The very nature of endurance sports – pushing oneself to the limit for extend periods of time – taxes the mind much differently then other sports.  While there are plenty of heroic stories of football or hockey players playing through some ungodly injury, this is not inherent to the sport.  When Ray Lewis sacks Tom Brady, it hurts but when Brady throws a touchdown pass, there is nothing inherently painful about this success.  To win a bike race, though, is inherently painful.  What about cyclists allow them to tolerate this pain so well?  Do they even feel it the same way we do?  Does their mind approach the pain differently? Do they address the pain differently?  The following seeks to answer some of these questions.

As a competitive cyclist myself, I’ve spent a lot of time on the bike with a lot of different personalities.  I’ve had the fortune of racing with several state and national champions, professionals and Olympians. Certainly some individuals are blessed with a genetic gift that allows them and their physical systems to excel and I would argue that these genetically-gifted individuals are rare.  I would also argue that these people are less rare than most realize. The one thing I’ve learned is that as an endurance athlete, you are only as good as your mind allows and I know of several individuals that are physically strong yet mentally weak that cannot succeed.  The fact is that the winners and the ones at the top of the sport are different types of people. Not different from each other but different from you and me.

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Grit is a Requisite For Success

Common sense tells us that top endurance athletes probably have a little more “grit” than the average person.  It’s that type of grit that allowed Tyler Hamilton to win a stage of the Tour De France with a broken collarbone. Hamilton, known for his incredible pain tolerance, embodies the difference between “them” and “us”.  The insane pain tolerance of him and his peers is obviously the difference, but what drives that difference?   Perhaps their tolerance isn’t different, perhaps their pain is different.  What if these athletes feel pain differently than you and me?   That would be a convenient explanation but as it turns out it’s not likely true.

A 2012 meta-analysis of 15 pain-tolerance  and pain threshold studies studies  showed that athletes feel pain in the same way and same levels as non-athletes.  The only difference was that they were able to tolerate the pain better.  This tells us that their bodies aren’t different (they still feel the pain) but their brains might be (they have a much higher tolerance).  Additionally, it was found that the type of sport seems to matter with endurance athletes mostly having similar pain tolerances and thresholds  which were different than other sports.  This indicates some similarity within but not necessarily across sports.  A cyclist handles pain differently than a baseball player, for example.

Higher pain tolerance in athletes may hold clues for pain management

The Pain Does Matter

It would be easy to dismiss all this talk of pain tolerance and make an argument that it’s not the pain that matters, but the physical ability. It’s common to hear excuses in sport about why things didn’t work out as well as a cyclist might have liked on race day. Many like to cite physical differences and ability and at times people will note that they were just “off” that day. These things are real, and they do matter, but it’s not the whole story. Alexis Mauger, Andrew Jones and Craig Williams of the School of Sport and Health Sciences at the University of Exeter decided to investigate the influence of pain medication on performance during time trial cycling.

Subjects were split into two groups and were given either acetaminophen (Tylenol) or a placebo prior to a self-paced 10 mile time trial. Subjects were also asked to rate subjective levels of pain. Although there was no significant difference in perceived pain tolerance (IE all subjects felt the time trial was equally hard and equally painful), the group given a pain reducing medication had a significantly higher heart rate and a significantly better time trial time, which is to say that they pushed themselves harder. This tells us that pain seems to be a limiter both in performance and in the ability to push oneself further. The findings would arguably be less interesting if the faster group stated that the time trial was less-painful, but the fact that they didn’t feel it was any less painful, and yet they went significantly faster, tells us that the a major speed limit is the individual’s pain tolerance.  If an individual is able to tolerate pain better (or in the case of this study, merely reduce the pain), they can go faster.

Tyler Hamilton wins Tour De France Stage with Broken CollarboneDo Not Ignore The Pain – Address It

“Pain is temporary. Quitting lasts forever” – Lance Armstrong

“If it hurts me, it must hurt the other ones twice as much, they are only human, they cannot go faster than you.” – Jen’s Voigt

“Pain is a big fat creature riding on your back. The farther you pedal, the heavier he feels. The harder you push, the tighter he squeezes your chest. The steeper the climb, the deeper he digs his jagged, sharp claws into your muscles.”  – Scott Martin

“You can’t block out the pain. You have to embrace it.” – Tyler Hammilton

In most sports, the ones at the top are often the most-quoted. Part of this is just because they are more in the spotlight, but what they say is also an excellent reflection of how they approach their craft. In a 1998 study by Jeffery Kress and Traci Statler of California State University, the quotes of Olympic cyclists were examined to determine how they attempt to deal with pain while training and competing.

Kress and Statler concluded that top cyclists utilize an array of tactics and techniques to address the pain associated with their sport. The key point is not that they are able to handle the pain better, it’s that they actually seek to embrace and deal with the pain, rather than ignore it as much of the population does during exercise. Simply put, top athletes approach the pain in a unique way by paying attention to it, rather than ignoring it.

A Naturalistic Investigation of Former Olympic Cyclists’ Cognitive Strategies for Coping With Exertion Pain During Performance

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Learning to Deal With Pain

With the above facts in mind a fair question to ask is whether or not this is a natural state or if it is a learned ability.  Do cyclists and other endurance athletes learn to deal with the pain over time or are they born with these unique abilities?

A meta-study of pain tolerance and perception in athletes and non athltes, published in the journal Pain in 2012 seeks to answer whether or not pain tolerances and perception can be altered over time.  The study looked at 15 studies including 900 individual subjects.  The results of this meta-study, which are extensive, indicate that individuals can actually alter their perceptions and tolerance to pain over time through regular physical activity.  Much like the act of strengthening the legs and the lungs, prolonged cycling seems to build towards a higher tolerance to pain.

What Placebos and Mental Illness can Teach us About Pain Tolerance

The placebo effect has long allowed scientists to test the effectiveness of medication (and other variables) but the effect itself has come under the scientific spotlight.  The ability for a sugar pill to reduce pain, for example, opens up many questions about how pain works.  Numerous studies over many years have proven time and again that a placebo can reduce pain in test subjects.  This indicates that pain reduction can be modulated both by external chemicals (in the form of pain medicine, for example) but also by internal psychological factors (which very well could ultimately alter brain chemistry as well).

Mental illness seems to effect pain tolerances as well.  Elderly individuals suffering from dementia have different pain tolerances and thresholds. Additionally, the specific type of dementia seems to cause unique changes of these tolerances and thresholds.

Individuals that self-mutilate also, not surprisingly perhaps, have unique pain tolerances and thresholds.  What is interesting about these individuals, though, is that the differences only seem to surface in instances of interpersonal distress.  In other words, the very scenarios that would lead to a self-mutilating episode seem to be the only time they have a heightened tolerance to pain.  This indicates that pain tolerances actually change depending on context.

Conclusion

Cyclists and other endurance athletes have to be able to face the pain inherent with their sport if they are to succeed.  Although physical prowess is an obvious requirement to succeed in endurance racing, the ability to mentally deal with the physical pain is arguably equally important.  It cannot go without saying that there are known genetic drivers behind individual differences in pain tolerance.  This helps explain why some individuals are better at dealing with pain than others (regardless of their athletic ability).  It seems likely that to become a top cyclist one must have been born with both extreme physical ability as well as an elevated natural tolerance to pain.  Beyond this, there are some differences that set the cyclists apart.  Although they may have an inherent elevated tolerance to pain, the pain itself does not differ from other individuals.  We also know that pain is an important limiter in endurance sport and if a cyclist or other endurance athlete can manage the pain better they can go faster.  Lastly, pain is very psychological so the way in which an athlete copes with it likely plays a significant role in their ability to deal with it. In the words of Tyler Hamilton a cyclist cannot block out the pain, but must embrace it.

Alcohol, Violence and Aggressive Individuals

Alcohol Violence and Aggressive PeoplePart of the awesomeness of being human is the diversity of our personalities. Put another way, different people act differently. We act differently from each other in all situations: at work, at play, when we’re tired, when we’re cranky, and when we’re drunk. There are some standard effects of being drunk but many will agree that there are different types of drunks too.  Most of these “types” are harmless but most everyone that has been in a bar has encountered the aggressive drunk.  Why are some people more prone to being violent when they drink? Is there something measurable; something predictable? It turns out, it seems there is.

Consideration of Future Consequences

The Consideration of Future Consequences scale (CFC) attempts to measure a person’s ability to consider future consequences of an action taken now.  People that score lower on the CFC test are less able to consider the consequences of their actions. Probably not surprising, aggressive individuals tend to score lower on the CFC Scale.

Alcohol and Consideration of Future Consequences

One of alcohol’s trademark effects is that it reduces people’s ability to make intelligent decisions.  People under the influence of alcohol tend to act without thinking. In other words, they tend not to consider the consequences of their actions.

The Study

To test whether certain people were more-prone to being aggressive while under the influence of alcohol, Bushman, Giancola, Parott and Roth wanted to test if individuals with low CFC scores were more aggressive while under the influence of alcohol (http://www.sciencedirect.com/science/article/pii/S0022103111002903).

A random group of individuals were measured on the CFC scale and then broken into two groups, either drinking a placebo drink or an alcoholic drink.  Participants were then subjected to a inter-personally adversarial competitive task. This tasks pits two individuals against each other, with the winner allowed to administer an uncomfortable but otherwise harmless shock to the loser.  The nature of the reward allows psychologists to measure a certain level of aggression.

The Results

The results showed that individuals that drank alcohol were more aggressive than those that were not and that those with lower CFC scores were more aggressive than those with higher CFC scores.  The most aggressive group were individuals with low CFC scores that drank alcohol.

Conclusion

As with many psychology studies, the tested population was limited to young college students.  Having said this, the study seems to make it clear that individuals with traits that often lead to a more-aggressive personalities (low CFC scores) in combination with alcohol, tend to lead to more aggressive behavior.

What’s this mean? It’s probably not an illusion that some people are more aggressive than others while drunk. Furthermore, I’m sure you can think of one or two people that fit that bill that also have troubles making wise decisions even while sober.

 

Sensory Adaptation

Last week I touched on the concept of priming in which exposure to a stimulus heightens the response to that stimulus .  More exposure increases the response to that stimulus so, as in the example I gave before, when you are shopping for a specific model of car you are probably going to notice that car more often.  This effect is so profound that it can begin to feel that there are actually more Nissan Altimas on the road than before (or more people talking about priming, or more websites about psychology, or whatever else you may stumble upon).

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This can be useful for us because when something novel is introduced to us, it’s probably a good idea to keep an eye on it until we know what it is.  If I’m a caveman just hanging out in my cave and I see a new animal around my sweet cave dwelling, it’s probably not a bad idea to be ever-aware of its presence until I figure out whether or not it’s a threat to me.  So what happens when I determine it’s not a threat?  What happens when the novel and the insignificant just becomes insignificant?  Dedicating energy (physical or mental) to insignificant stimuli is a waste of our resources, so how do we handle that?

Sensory Adaptation

Sensory Adaptation and Priming
Initially we are more aware of a new stimuli but as time passes we become less aware.

In my post about The Psychology of Stimulation I hinted at the effect of sensory adaptation in my example of the large furnaces that were in my childhood schools.  These absurdly loud things buzz and hum so loudly that when they turned off the teacher inevitably spent a few seconds yelling at us before adjusting to the change in noise level.  That’s not the interesting part though.  The interesting thing about this example is that in spite of their loudness, they were inevitably tuned out while they were on. They were tuned out so effectively that their silence was temporarily more intruding than their loudness.  What’s going on here?

The answer is sensory adaptation.   In the most simple terms, as our brain determines that a stimulus is unimportant, or even distracting, it (more accurately, central nervous system) simply begins to ignore it.  We will cover the biology of this process in a later post but the chart above provides a nice visual.

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Real World Example

Sensory adaptation happens every day and all around.  It’s why your friends house stinks yet they don’t know what you’re talking about. It’s why you don’t smell the perfume you put on this morning by the time you get to class.  It’s why the buzzing of the florescent light above you doesn’t seem to buzz, until I just pointed it out to you. This is a very cool video that does a great job explaining sensory adaptation and shows you a really neat trick in which you will see sensory adaptation at work firsthand.  Here’s a hint: Do this right, and you’ll see the network of capillaries that feed blood to your eye. Were you able to get it to work? Let us know!

What is Priming?

How Many People Own That Car?

Volkswagen Golf
What a cute car. Mrs. LaymanPsych would be the only person on my block with one. Except for everyone on the planet that owns one!

A few months ago I was exploring the idea of buying a new car with Mrs. LaymanPsych.  We had a few cars that we thought would fit the bill but she really settled on the Volkswagon Golf.  Affordable, good gas mileage, sporty enough to be fun, and gosh darn-it  was it cute (and what’s more important than cute?).  We visited a few dealerships and even found a few potential cars we figured we might consider purchasing.  We mulled over the decision, weighed in on other cars and tried to establish if it was a cost we wanted to take on.

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Something strange started happening over these couple of weeks.  We really thought we had stumbled upon a unique fun little car.  Sure we’d seen a few around here and there but nothing crazy.  Seemingly out of nowhere we started seeing this thing everywhere.  Every time we went out we counted 3, 5, 10 different people driving the Golf. The car was everywhere. It seemed like everyone owned a golf.  A few weeks later we ditched the idea on the Golf. Not because we thought too many people owned them but because a Nissan Altima became available from a family member.

I was happy. Another affordable car with decent gas millage and was well taken care of.  Besides, not too many people own Altimas.  But you know what? Shortly after getting the Altima I started seeing them everywhere. New ones, old ones (like mine).  It seemed like everyone owned an Altima and no one owned anything else…like a Golf.

Obviously the rest of society isn’t changing their cars to annoy me. So what’s going on here?  Often referred to as The Baader-Meinhof Phenomena, this tendency to see things consistently only shortly after first recognizing them is the result of a cognitive bias that leads to a distorted perception of reality (there aren’t actually more VW’s on the road). Part of what is fueling this is Priming.

Priming

This story is nothing unique to myself and I know that you’ve experienced it too.  Something that you think is novel, new or obscure suddenly seems very common once you hear about it.  What’s happening here is a simple psychological effect that healthy individuals can’t avoid called priming. When we are exposed to something enough it sort of rises to the surface of our consciousness.  The idea is that by exposing the mind to a stimuli or memory, the pathways to that memory, stimuli, or construct are reinforced.

An analogy: If the park is your memory, then the path from your house to that park is the pathway.  The number of people that use that pathway and the frequency with which it’s used determines how defined the path is.

Our memories work in much the same way.  Since I kept looking up Golf’s online, looking at them in person, thinking about them in the car (should I get a Golf?) then when I’m around them, I’m more likely to see them. Not because there are more of them (obviously) but merely because I have conditioned my mind to be more aware of them.

This is why things like cramming for tests does not work.  Although it seems like you can “prime yourself” for a test, the truth is that there simply isn’t enough time dedicated to a single topic to do well on an entire test. You might be able to cram one formula in your head the night before, but not an entire chapter.  This is also why we are very prone to hearing our name if someone says it in a group of large people (known as the cocktail party effect).

Have you ever experienced this phenomena? Share it in the comments below.