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Your Mental Health

Misophonia

Do you find it annoying to hear the sounds of someone else chewing or slurping? This is a pet peeve for many people – but for some, small sounds like these pose a big problem.

Individuals experiencing a condition called misophonia or selective sound sensitivity syndrome can become anxious or enraged by small sounds such as other people eating, breathing, coughing, typing, a dripping faucet or other every day noises. Until fairly recently, these people have often been told they are simply over-reacting, but this view is changing now.

Misophonia (which means hatred of sound) is a newly recognized condition with little research surrounding it as yet. It is considered a cousin to tinnitus and is characterized by an involuntary decreased tolerance to specific sounds.

Not much is understood about misophonia yet, but it is thought to result from a physiological abnormality in the structures of the brain involved with processing sounds.

There is no good data on its prevalence, but the condition does seem to have genetic roots and begins typically in late childhood or early adolescence and gets worse over time. Often, it starts with sensitivity to just one kind of sound and gradually expands to include more noises.

Until now, many people experiencing this sensitivity have been mistakenly diagnosed with other problems when presenting their specific symptoms – they have been told they have a phobia or obsessive compulsive disorder, mania or an anxiety disorder.

Sometimes, misophonia is confused with another condition called hyperacusis – where sound is perceived as abnormally loud or physically painful. However, the two conditions are not the same. Indeed, the sounds that trigger rage or anxiety in misophonia are quiet, hardly audible noises rather than loud noises.

No effective treatment exists for misophonia. Most people go out of their way to avoid the sounds they can’t tolerate. Obviously, this can cause issues in relationships and social settings. When it is impossible to avoid the sounds, some people try to mask them by timing their own chewing to match the other, wearing earplugs or using white noise machines.

Some people feel better if they vocalize their discomfort by telling the person who is eating near them that the noise bothers them. Others find mimicking the offending noise can provide some relief to the feelings of anxiety and anger that arise.

More research into misophonia will help us to better understand the exact physiological cause of the condition and may also lead to more effective ways to deal with the symptoms.



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Pet effect needs more research

 
A study published a couple of years ago makes an important point about the importance of thorough scientific research to prove any kind of therapeutic product or treatment.
 
I have written in the past about the psychological and physical benefits of pet ownership. Almost anyone who has a pet will tell you their furry, feathered or scaly friend provides companionship, entertainment and unconditional love. All good things that must translate into some sort of health benefit – right?
 
Indeed, animals have been used therapeutically for centuries and some research has suggested those who have pets are happier, healthier and live longer than those without pets.
 
A study out of Western Carolina University and published in Current Directions in Psychological Science, examined past data on the subject and found that more research is needed before we can be sure the ‘pet effect’ is a real thing.
 
Studies conducted in the past have produced conflicting results and the authors of this study have noted that the more optimistic results have received much publicity while the less positive studies have largely been ignored.
 
A 1980 study that found heart attack victims with a pet were four times more likely to survive for more than a year than their peers with no pets. However a study done just last year found pet owners were more likely to die or suffer a second heart attack with a year than those without a pet.
 
Other studies from all over the world also yielded conflicting results. Some suggest the existence of a ‘pet effect’ while others show little or no evidence of one.
 
Although pets are a wonderful addition to many people’s lives, provide enjoyment and companionship and are undoubtedly beneficial for some people, there is simply not enough evidence to make the claim that there is an overall health benefit to be derived simply from having a pet.
 
Conflicting data in any area of science can only be cleared up with further, properly controlled studies. It is important that we not simply believe something to be established in fact before there is sufficient evidence.
In the meantime, whether or not there is a general health benefit to be gained, there is no reason for therapy animal programs to stop their work wherever it is welcomed and those of us who are pet owners can continue to enjoy our animal friends.


Depression - what is it good for?

Many times I have talked about the prevalence of depression. Of all the psychiatric conditions, depression and anxiety are by far the most common and major depression is thought to affect roughly eight percent of the population at some point in life.

Compare that with the less than one percent of people who experience schizophrenia or bipolar disorder and it seems a very large number. So what is it about depression that allows it to continue existing in our species at such a high prevalence?

We often think of depression as similar to an illness in any other major organ – simply a malfunction that needs to be treated. Of course, treatment is important and helps many people in their ability to function on a daily basis, but we still don’t know why the illness continues to occur in such abundance. Researchers have been studying this question for some time.

One theory involves the purpose or value of rumination – the process of pondering and thinking things over and over and over – that is one of the hallmarks of depression.

Individuals who self profess to be ruminators do seem to be more prone to depression as well as to being unnerved by stressful events. Therapy often encourages people to get out of the habit of excessive rumination as it can lead to fixating on flaws or problems and thus extend negative thoughts.

According to proponents of this theory of depression, this kind of thinking is not necessarily bad but may be a useful skill for us to learn from our mistakes or sort through complex problems. Some go so far as to say depression is a way of forcing the mind to focus on its problems.

A couple of studies have found some benefits to this kind of analytical thinking. One found that individuals with depression seem better able to make complex decisions because they are more willing to spend the time to thoroughly analyze the options and information put before them.

Certainly, there have been and are today many great thinkers, artists and poets whose melancholy has undoubtedly informed and inspired their craft. I have talked about this in past columns.

At the same time, research has also shown individuals with major depression experience cognitive impairments in other areas and imaging studies have shown cumulative damage to some areas of the brain with each episode of depression experienced.

Perhaps an argument can be made that depression has some helpful element to it when it is mild – however anyone who has experienced a severe depression can tell you the benefits are far outweighed in these circumstances. A severely depressed person who cannot be motivated to get out of bed or who is experiencing a psychotic episode is not going to be a more effective problem solver.

I don’t believe treating depression will eliminate a person’s ability for complex or analytical thought – but it will help in getting back to enjoying life.



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Autism genes complex

 
Yet again, genetic research is teaching us so much more about the way things work in the human body and taking us down unexpected paths.
 
For the past couple of decades we have suspected genetic involvement in the cause of autism spectrum disorders (ASD). Over the past couple of years, research is confirming this but its genetic complexity has also surprised scientists.
 
In the 1990s it was thought there may be as many as about 15 different genes involved in the development of ASD and its associated symptoms. Newer research is showing us there are likely hundreds of unique gene mutations involved in these disorders that may arise spontaneously and occur in a different combination in almost every person with ASD.
 
Several studies published in the journal Neuron examined the genetics of autism in more than 1,000 families with only one affected child. Analysis suggests the genes may be part of a large network involved in controlling the development of the synapses between nerve cells, which allow them to communicate.
 
One team of researchers discovered a particular cluster of pathways involved in the development of synapses in young brains was being interrupted as a result of some gene mutations. In these cases, there was an overabundance of connections between nerve cells in autistic children. These same genetic mutations causing too many connections in autistic children seemed to produce an opposite effect among children with Williams syndrome – a rare developmental disorder in which people tend to be highly social, sensitive and empathetic.
 
Researchers have also long been interested in the reasons why four times as many boys are affected by ASD as girls. After analyzing data from these studies, it did appear the mutations were much likely to cause autism in boys than girls. Girls seem able to better resist the development of symptoms and need larger gene disruptions to actually cause the disorder – more research is needed but scientists involved in these studies believe girls might have some unique protection against genetic anomalies.
 
Although many clues have been uncovered in recent years, the research has also revealed just how complex ASD truly is. With no universal gene responsible for the disorder and literally hundreds of different variations, it will be a long time before we get concrete answers about many aspects of these disorders. Even the most common mutations were seen in only about one percent of affected children – and experts say we still cannot understand most cases of ASD.
 
There is still much to learn about the rare mutations involved with autism and why the condition seems to be on the rise in our population. I look forward to seeing more data as it comes forward.


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About the author...

Paul Latimer has over 25 years experience in clinical practice, research and administration. After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar. Since 1983 he has been practicing psychiatry in Kelowna, BC where he has held many administrative positions and has done numerous clinical trials. He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders. He is an avid photographer, skier and outdoorsman.

 

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet presents its columns "as is" and does not warrant the contents.


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