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Stress and Mental Health > Lectures 2 > Flashcards

Lectures 2 Flashcards

1
Q

Acetylcholine is one of the main NT where?

A

In the periphery

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2
Q

Which other NT balances out ACh?

A

Epinephrine

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3
Q

What is parasympathetic overdrive?

A

When your parasympathetic system kicks in too strongly and you get negative effects fainting, dizziness)

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4
Q

When you are stressed, what NT goes up to compensate for the rising levels of epinephrine?

A

ACh

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5
Q

Which NT rises faster: epinephrine or ACh?

A

Epinephrine

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6
Q

What other major function does ACh do?

A

plays a role in muscle movement

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7
Q

What drugs block ACh?

A

Anticholinergic drugs

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8
Q

ACh has been used as war gasses. What are its effects?

A

Irreversibly increases the concentration of ACh in the body and results in a slow death

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9
Q

What are two main anticholinergic drugs?

A

Atropine and scopolamine

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10
Q

Which drug is better, atropine of scopolamine? Why?

A

Atropine

The difference between its LD50 and LD50 are higher so there is more room for error

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11
Q

What is an unintended side effect of atropine?

A

It greatly reduces inhibitions

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12
Q

What is another word for neurotrophins?

A

Growth factors

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13
Q

What do growth factors continue to do throughout life?

A
  • Create myelin

- Grow dendrites and synapses

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14
Q

The brain works on a “use it or lose it” principal. What cell prunes unused synapses?

A

Macrophages (microglia)

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15
Q

What is the main role of BDNF?

A

Promote growth and synaptic plasticity, and maintaining synapses over time

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16
Q

Learning and levels of BDNF

A

Need to have BDNF in order to form the new synapses that are the neural basis of learning /memory

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17
Q

BDNF is particularly responsive to what types of events? What does that mean?

A

Stressful

It makes the events more memorable

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18
Q

Are all memories kept forever? Why?

A

No

If you had all memories it would be confusing for your mind

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19
Q

What is a disease that is related to not forgetting?

A

PTSD

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20
Q

In what situations does BDNF crash? What does this mean for making happy memories?

A

During chronic stress

You have no more BDNF so you will not remember the happy event (will continue to be sad)

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21
Q

FGF 22 is similar to what other molecule?

A

BDNF

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22
Q

Why do we need both FGF 22 and BDNF?

A
  • Because it makes a redundant system (a back up)
  • They work synergistically and symbiotically
  • They kick in at different times
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23
Q

Can decreasing the amount of BDNF take away a memory?

A

No, the memory is already formed

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24
Q

What is EPO (Erythropoietin)

A

It is a drug that increases oxygen supply in the blood

–> Helps cells grow

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25
Q

Other than a growth factor, what can EPO be used for?

A

As an antidepressant (it increases BDNF)

- Used in conjunction with other treatments

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26
Q

In really basic terms, what is the role of the immune system?`

A

To know what is “me” and what is not

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27
Q

70% of the immune system is located where?

A

In the gut

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28
Q

Antigen:

A

A foreign particle

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29
Q

Pathogen:

A

A foreign particle that makes you sick

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30
Q

What is a neutrophil?

A

One of the first response immune cells

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31
Q

What is a macrophage?

A

It is the second immune cell that identifies and envelops the pathogen

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32
Q

How do macrophages identify particles?

A

After enveloping the partile, it send 2 “flags” up to its surface that mark:

  1. That it is active and has something
  2. Epitope (signature if the foreign particle)
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33
Q

Epitope:

A

Part of a particle that gets sent to the surface of a macrophage that identifies it

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34
Q

What types of cells are lymphocytes?

A

White blood cells

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35
Q

What are the different kinds of lymphocytes?

A

T-Helper Cells (Th1 & Th2)
B - Cells
Natural Killer Cells

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36
Q

What do Th1 cells do?

A

They respond to the epitope and get an immune response going is necessary

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37
Q

How does the Th1 cell decide if it needs to initiate an immune response?

A

It sorts through a “data bank” to see if the epitope is recognizable and/or harmful

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38
Q

What do Th2 cells do?

A

Stop the immune response

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39
Q

What cell do Th1 cells activate for an immune response?

A

T-Cytotoxic cells

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40
Q

What do T-cytotoxic cells do?

A

They will rapidly multiply to build an army against the pathogen

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41
Q

Why doesn’t the immune system kill off pathogens right away?

A

Because the pathogen is dividing at the same time so it can take time to win the battle

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42
Q

What are B-Cells

A

They rapidly multiply and attach themselves to the pathogen, disabling it

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43
Q

How do B-cells know what to attach to?

A

There are antibodies on its surface that recognize everything they encounter

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44
Q

How do B-cells attach to the pathogens?

A

It binds to the epitope and holds onto it

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45
Q

How do B-cells disable pathogens?

A

Once it binds, compliment factors will cause destructions

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46
Q

What are the chemical messengers of the immune system?

A

Chemokines/Cytokines

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47
Q

What do Th-regulatory cells do?

A

Keep the immune system from becoming over active

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48
Q

What do cytokines do?

A

They activate immune cells

- can act as growth factors

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49
Q

Macrophages release what kinds of pro-inflammaory cytokines?

A

IL-1beta
IL-6
Tumor necrosis factor alpha

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50
Q

What does IL-1beta do?

A

It is the strongest cytokine

- Produces the “sick” feelings (tired, sore muscles)

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51
Q

What does IL-6 do?

A

It has a much smaller effect

–Effects mood

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52
Q

Collectively, what do the macrophage’s cytokines do?

A

Will activate the T-helper cells, causing them to multiply

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53
Q

Which cytokines do Th1 cells release? What do they do?

A

IL-5
IL-18
» Cause t-cytotoxic cells to be released

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54
Q

What anti-inflammatory cytokines do the Th2 cells release?

A

IL-4

IL-10

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55
Q

What are microglia?

A

Macrophages in the brain

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56
Q

What do microglia do

A
  1. Sense damages cells
  2. Deal with dead cells and foreign particles
  3. Synaptic pruning
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57
Q

What can make microglia dysfunctional?

A

Seizures

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58
Q

Can cytokines cross the BBB?

A

Not easily

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59
Q

What happens to the BBB during stress?

A

it increases its permeability

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60
Q

The balance of cytokines

A

If levels are too high or low it can be neuro-destructive

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61
Q

Stress usually increases cytokines, but huge stressors do not result in toxic levels, why?

A

During stress cortisol is released and it suppresses the immune system (limits cytokine release)

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62
Q

What can be a danger of too much immunosupresstion when stressed?

A

It allows for illnesses to proliferate, like cancer

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63
Q

Physiological dose:

A

The amount of something under normal conditions (like baseline cortisol that limits cytokine release)

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64
Q

Pharmacological dose:

A

A high dose that alters the resting system (too much cortisol during stress limits immune system too much)

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65
Q

What effect does estrogen have on the immune system?

A

it can increase the release of cytokines

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66
Q

What diseases are more prevalent in women?

A

Depression and auto-immune disorders

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67
Q

If a woman has an autoimmune disorder, during what time in her life will the disease be suppressed?

A

During pregnancy because estrogen levels are lower

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68
Q

What type of immune response is best during an acute stressor, why?

A

A rapid response

It will be prepared to react quickly if you are injured

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69
Q

Cytokines = ______ stressor

A

systemic

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70
Q

What happens to the release of cytokines during a chronic stressor?

A

Originally cytokines go up, but eventually corticoid receptors down-regulate so cortisol can no longer put a cap in cytokines, and there is a damaging increase on cytokines&raquo_space; can lead to disease

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71
Q

When does the immune system build up tolerance?

A

when it comes in contact with something regularly

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72
Q

Does the immune system always build up tolerance?

A

No

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73
Q

What 4 things dictate the quality of the immune system?

A
  1. How many immune cells there are at baseline/are they circulating
  2. Are they being released?
  3. Are they multiplying well?
  4. Are they good at killing
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74
Q

Why do diseases seem to appear suddenly but there usually it has been a long time coming?

A

Usually there has been an immune battle with no one winning for a long and then the disease finally takes over

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75
Q

Is there an immune response to a fetus?

A

Yes, the body does not recognize it as “me”

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76
Q

What hormone protects the baby from the mothers immune system and builds the baby’s immune system

A

CRH from the mother

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77
Q

Is antibody acquisition random? Why?

A

No, you get antibodies in a certain sequence

> Do not want to be protecting something that does not need protection

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78
Q

A big player in immunity is IGE. What can happen if it is over active?

A

It can activate mast cells which release histamine and you get have an allergic reaction or asthma

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79
Q

What can make allergies worse?

A

Stress

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80
Q

What is the hygiene hypothesis about why there are more allergies now?

A

We are too clean and are not exposed to as many things so we cannot build antibodies response towards it

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81
Q

What is an autoimmune disorder?

A

It is a hyperactive immune system that starts to attack the host

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82
Q

How does an autoimmune disorder choose where to attack?

A

There are different auto-antibodies, so it depends on which ones get activated

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83
Q

How does stress affect autoimmune disorders?

A

It makes a stronger immune response

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84
Q

Immune Surveillance Hypothesis

A

The immune system is always on the lookout for mutations and cancer cells

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85
Q

Not all mutations are bad. What is the example of the mutation in the inuit population

A

There is a polymorphism that all inuits have that protects them from getting heart disease even though they have such a high fat diet

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86
Q

What is the right to try?

A

when someone is dying, they have the right to try an experimental treatment

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87
Q

What are compliment cells?

A

They form a complex with B-cells that kill antigens

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88
Q

Which immune cell tries to stop a pathogen from getting onto an organ, and which one fights cells already in organs?

A

B-cell

T-cell

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89
Q

How do T-cells kill pathogens?

A

It attaches to the pathogen and pokes a hole in the particle to inject its own material which kills the pathogen

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90
Q

Once the kill switch on the immune system is activated, what bad thing can happen?

A

The immune system can start attacking the body

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91
Q

If our immune system is go great, why do we get sick?

A

It can take a few days before it gets fully up and running

|&raquo_space; Some things impair the immune system like a lack of sleep or stress

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92
Q

How was the first small pox vaccine made?

A

There was a group of women (milk maids) who never got sick and someone figured out it was because they had come into contact with a less harmful cow pox and the women had built up antibodies. So as a vaccine, children were injected with cow puss

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93
Q

How are modern vaccines made

A

The virus is killed (heat or chemicals) but the outside remains with the epitope

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94
Q

How do vaccines work?

A

Your body will mount an immune response to the foreign particle and have memory antibodies to be able to quickly respond in the future

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95
Q

What is the secondary immune response?

A

The T and B cells are activated faster and they are stronger

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96
Q

How long does a normal vs secondary immune response take

A 
Normal = ~4 days 
Secondary = ~2 days
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97
Q

Sepsis:

A

Blood infection

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98
Q

Virus vs bacteria replication

A

Viruses need a host to replicate

Bacteria can replicate outside of a host

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99
Q

How did Alexander Flemming discover penicillin?

A

By accident. He spilled some chemical on mould and saw that it died

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100
Q

What are unintended effects of penicillin?

A

People started to be less careful because there was a treatment. It got over used and now the bacteria is evolving

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101
Q

Antibiotic resistant bacteria

A

Antibiotics only kill 99% of bacteria, so the strongest1% stays alive and multiplies. Now there are new bacteria that are not treatable with antibiotics

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102
Q

Inevitability of a mass super bug pandemic

A

People live in more dense and more populated areas so disease can spread very quickly

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103
Q

Vaccine resistance

A

Some viruses have also started to mutate and are now resistant to the vaccines

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104
Q

What are some ways that viruses and cancer cells have started to trick the immune system?

A

They disguise themselves as body cells so they can go undetected

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105
Q

If you get the flu shot are you guaranteed not to get the flu?

A

No, there are many different strains and the doctors have to guess which one will be around the most but they do not always get it right

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106
Q

What is the primary activation of the immune system? what is it caused by?

A

Inflammation

Cytokines

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107
Q

Comorbidity and inflammation

A

Many diseases have an inflammation component, so they often occur together

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108
Q

Genetics of cancer

A

You can inherit genes that make you more susceptible to cancer, but you cannot get cancer from someone

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109
Q

What is on the end of DNA to keep it from being degraded during replication? What happens when it gets too short

A

Telomeres

When they degrade too much they are susceptible to mutations (cancer)

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110
Q

If the programmed death segments of DNA get disrupted, what can happen?

A

The cell may never die and they can become cancerous

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111
Q

Multi-hit hypothesis in cancer

A

You can have genes that make you susceptible to cancer, but by themselves they will not result in cancer, there needs to be another trigger to give you cancer

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112
Q

What factors along with genes can give a person cancer?

A 
Other genes
Foods 
bad lifestyle 
Belly fat
No social support
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113
Q

Is it the severity of the hit or the number of hits that plays the most significant roll in your chances of pathology?

A

The number of hits

> multiple traumas are more impactful than one major trauma

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114
Q

Does stress cause cancer?

A

No studies have been able to find causality, but it makes cancer worse and it likely plays a role in the development

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115
Q

How does stress make cancer worse? (2 NT)

A
  1. Cortisol suppresses the immune system, so the body is less able to fight off the cancer cells
  2. Norepinephrine can stimulate cancer growth
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116
Q

How does norepinephrine help cancer grow?

A

It helps angiogenesis (developing small veins to the tumour) to feed it

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117
Q

What is the major limitation (2) in studying the effect that stress had on cancer development/

A
  1. Retrospective studies about how stressful life was prior to cancer diagnosis is coloured by current stressors
  2. Also cancer takes a long time to develop before it is detected, so you cannot know what is “before” cancer
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118
Q

Malignant vs Benign tumor

A 
Malignant = can metastasize and it is harder to remove (no clear margins)
Benign = does not metastasize, clear margins
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119
Q

What in terms of your weight makes chemo not work very well?

A

If you are over weight with lots of belly fat

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120
Q

Health span vs life span

A

Health span = number of years you were alive in good health

Life span = number of years alive

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121
Q

It is best to have cancer treatments that prolong what two spans?

A

Health span and life span

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122
Q

That cancer treatment increases health span but not necessarily life span?

A

CBT

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123
Q

What common notion do chemo and radiation operate on?

A

That cancer cells are multiplying at a faster rate so they need more food. You can poison the food to kill the cells

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124
Q

What is the main physical drawback from chemo and radiation?

A

healthy cells are killed alongside the cancer cells

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125
Q

if the cancer has come back do you use the same treatment again?

A

no, you usually use a more aggressive treatment

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126
Q

what are the 3 typical cancer treatments?

A
  1. Surgery
  2. Chemo
  3. Radiation
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127
Q

Why can’t chemo be used long term as a cancer treatment?

A

because the cancer cells develop a tolerance to it

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128
Q

What dose schedule can slow down tolerance?

A

Smaller doses over a long period of time

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129
Q

What was shown in the experiment with nude mice about cancer?

A

They did not have an immune system and they did not die from cancer
» but they died from other things so there is no conclusion about to role of the immune system and cancer

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130
Q

What are 2 alternative treatments that have are being used as cancer “treatments”

A

Managing diet

Mindfulness

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131
Q

What is the effectiveness of immuno-therapy for cancers/

A

20-30% effective

> many cancers that were not treatable before

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132
Q

Precision medicine

A

Use genes and bio-markers to target treatments for people

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133
Q

Precision medicine for people with cancers that respond to hormones

A

They can be treated with 80% success for people with the triple positive gene

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134
Q

Treatments with IL-2 and interferon alpha are really good at treating what?

A

Good viral and cancer killer

> Used for Hepatitis C and melanoma

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135
Q

If IL-2 and interferon alpha treatment is so effective, why is it not used often?

A

It makes people very ill

Half of people who use it get severely depressed

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136
Q

Why might IL-2 and interferon alpha cause depression?

A

Because depression is an inflammatory disorder so a heightened immune response would make it worse

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137
Q

How does injecting a virus into a tumour (viral therapy) help treat a tumour?

A

It will attract the immune system to the cancer cells and the immune system will try to kill the infected cells

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138
Q

What are immune check points?

A

There are certain points in a cell cycle where the immune system checks up on developing cells

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139
Q

How do cancer cells use checkpoints to grow?

A

They mask themselves to look like they are at a different stage in the cell cycle so the immune system does not check up on them

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140
Q

How do check point inhibitors work?

A

They do not allow the tumour to disguise itself so the immune system can kill the dysregulated cells

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141
Q

What is the success rate of check point inhibition therapy?

A

20-30%

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142
Q

How does CAR-T cancer therapy work?

A
  1. Isolate a person’s T-cells in a bottle
  2. Add the antigen and the T-cells will multiply
  3. Inject the T-cells back into the person for a heightened immure response
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143
Q

What is the major problem of CAR-T therapy?

A

It makes people so sick they want to die

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144
Q

What is the success rate of CAR-T therapy?

A

20-30%

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145
Q

Is the number of bacteria or diversity of bacteria most important?

A

Diversity

but number is also important

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146
Q

What is the enteric nervous system

A

the nervous system in the gut

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147
Q

What is the main NT of the enteric nervous system

A

Serotonin

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148
Q

Can the serotonin from the gut get into the brain?

A

No, it cannot cross the BBB

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149
Q

The vagus nerve is activated by what? (3)

A

Serotonin and bacteria (because they act on serotonin)

>also fungi

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150
Q

Dysbiosis

A

When there is an unbalance of the gut bacteria

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151
Q

If all illnesses involve the micro biome, what does that tell us

A

Not much because there is no specificity

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152
Q

Manipulating the microbiota

A

You can increase or decrease certain bacteria to result in different illnesses

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153
Q

What happens to your bacteria when you are stressed

A

The bacteria will start to die off

154
Q

How has the protective nature of the microbiome been shown in mice?

A

If they are raised in a germ free environment and then exposed to a real environment, they will get sick. If you give them bacteria from a healthy person, the diseases will get better

155
Q

How has it been shown that microbiome is implicated in “causing disease” in mice?

A

If you give a healthy mouse a poop transplant from a depressed human, the mouse will develop ulcers (stress)

156
Q

Prebiotic vs probiotic

A 
Prebiotic = food for bacteria that already exist 
Probiotic = a substance that contains bacteria to give you more bacteria
157
Q

Are pre or pro biotics better?

A

Prebiotics seems to be better

158
Q

What types of bacteria do antibiotics kill

A

All bacteria, good and bad

159
Q

How can antibiotics be bad for an individual?

A

It kills the good bacteria so then potentially bad bacteria can take its place

160
Q

What in our diet affects the microbiome?

A

Everything we eat affects it

161
Q

Is the bacteria stable?

A

No it changes throughout the day (like when we eat)

162
Q

What helps insulin take glucose into the cell when we eat?

A

IL-1

163
Q

Bacteria can secrete what? Is it all the same type?

A

Cytokines

No, different types

164
Q

How is the microbiome implicated in cancer

A

Some bacteria will secrete types of cytokines that will inactivate cancer treatments

165
Q

When is the immune system the most active?

A

In the morning

> best time to have surgery or get cancer treatment

166
Q

What is the adaptive nature of depression?

A

It is a signal to yourself and others that something is wrong

167
Q

What brain area involved in physical pain is also active during depression?

A

Anterior cingulate cortex

168
Q

How can mild depression help you?

A

Signals that something is not working and that there needs to be a change

169
Q

What are the 2 main symptoms of depression (need to have one to be diagnosed)

A
  1. Sadness

2. Anhedonia

170
Q

What are the other symptoms that you need to have some of to be diagnosed with depression? (5)

A
  1. Eat (more or less)
  2. Sleep (more or less)
  3. Lethargic
  4. Weight (loss or gain)
  5. Fatigue
171
Q

What makes symptomology in depression difficult for diagnosis. What does that people for treatment

A

People can have different symptoms for the same illness but they will often be given the same treatment

172
Q

What are the 3 main types of depression

A
  1. Melancholy
  2. Typical
  3. Atypical
173
Q

What is melancholy depression

A

The most sever type, both sadness and anhedonia
- less food and sleep, lots of fatigue
> have positive neurovegetative symptoms

174
Q

What is typical depression?

A

A less severe form of melancholy

- eat less but still eat some

175
Q

What is atypical depression?

A

Sleep more, eat more, don’t show fatigue

> Eat when stressed

176
Q

In what type of depression is the HPA axis and immune system more affected?

A

Atypical

177
Q

People with atypical depression are hyper-responsive to external stimuli, what does that mean for compliments?

A

They will feel very good about themselves

178
Q

What is dysthymia

A

A low grade of depression for at least 2 years that waxes and wanes

179
Q

What is the ratio of depression in woman and men?

A

3:1
60% atypical
40% typical

180
Q

Dysthymia is often associated with a personality disorder so it can be thought of as a ____

A

trait

181
Q

People with dysthymia are often aversive, how does this affect their social life?

A

They lose friends, become more lonely and more depressed

182
Q

What is double depression

A

When someone has dysthymia and also gets a major depressive episode

183
Q

Do people with dysthimia seek treatment?

A

Often they do not because they have been dealing with it for so long

184
Q

Cyclothymia

A

Depression that cycles dramatically

185
Q

What are the two best predictors of depression?

A
  1. Rumination

2. Negative world view

186
Q

With someone with double depression, what is the outcome of treatment?

A

They go back to being just dysthymic, that is there new normal

187
Q

What is thought to be the cause of postpartum depression?

A

hormones and inflammation

188
Q

What does Aaron Beck say is the cause of depression

A

Worked with learned helplessness so he says they have a schema of negativity about the world

189
Q

How effective is CBT in treating depression?

A

50-60%

190
Q

What did the yokes experiments with animals show about helplessness?

A

When the stressor is uncontrollable, the animal stops trying to do anything about it

191
Q

What attributional style is most linked to depression?

A

Internal
Global
Stable

192
Q

What are the problems of the learned helplessness theory in humans?

A
  1. Not everyone who have an uncontrollable stressor becomes depressed
  2. Does not consider biology
193
Q

The drug reserpine does what?

A

it depletes monoamines

194
Q

What did researchers find when they gave prisoners reserpine?

A

They got depressed

195
Q

What was the issue with studying reserpine in a prison population?

A

Of course prisoners got depressed, they were in jail

196
Q

What happens when the normal population is given reserpine?

A

They do not experience depression

197
Q

What did the reserpine show us about the development of depression

A

it depends on both neurochemical and environmental factors

198
Q

Is not having any control the worst thing?

A

No, having control and losing it is worse

199
Q

When norepinephrine and ACh were looked at in the blood did they correlate with depression?

A

No

200
Q

L-DOPA did not help cure depression, does that mean dopamine is not involved?

A

No, new drugs have shown that it is involved

201
Q

Drugs for what NT work the best for treating depression?

A

Serotonin

202
Q

What is the issue of monoamine oxidase inhibitors?

A

They cause a lot of side effects

203
Q

Are SSRIs all they were stacked up to be?

A

No, they are not as effective as first thought

204
Q

How many ineffective treatments does it take for someone to be diagnosed with treatment resistant depression

A

3

205
Q

What therapy can work on people with treatment resistant depression?

A

Electro convulsive shock therapy

206
Q

What are the results of electro convulsive shock therapy?

A

it works quickly and there are many changes in NT

207
Q

What food should you not eat while on MAOs?

A

blue cheese

208
Q

What are SNRIs (depression treatment)

A

Drugs that are broad spectrum re-uptake inhibitors

209
Q

What was the theory behind SNRIs

A

If all the monoamines were increased it would have the biggest effect

210
Q

What is a big problem of SNRIs

A

Monoamines are involved in lots of different systems so the drugs have many unintended effects

211
Q

Why can taking anti-depressants be a bad thing?

A

Because they do not get at the root of the problem, so once you stop taking them you relapse

212
Q

If antidepressants are not super effective, why take them?

A

Because not taking them could be worse

213
Q

WHat are the results of testing antidepressants in animals?

A

It does not translate well to humans because humans are more complex than lab animals

214
Q

CBT with antidepressants

A

It works pretty well. People get better coping skills so there is less rapid relapse

215
Q

Mindfulness and antidepressants

A

Only works for people with a certain mindset

216
Q

What are the 2 notions of mindfulness

A
  1. Think in the moment

2. Don’t be judgemental and be more accepting

217
Q

What is the result of some people being naturally more mindful?

A

They are less likely to be depressed and they can be treated with mindfulness (combined with drugs)

218
Q

WHat is the success rate of SNRIs

A

about 50%

219
Q

What do the 5HT1A receptors look like in people with depression?

A

They are down regulated (or less sensitive)

220
Q

WHat is the pattern of 5HTT in depression?

A

Disrupted

221
Q

What are the 2 primary types of serotonin transporters?

A

Long and short

222
Q

Short 5HTT

A

A person has a higher likelihood of becoming depressed

***Must be accompanied by a stressor

223
Q

If you have the short rather than long 5HTT will you be depressed?

A

Not necessarily, it just makes you predisposed

|&raquo_space; There is a gene-environment interaction

224
Q

Often in science, what happens when you find part of the reason for something

A

You stop looking

225
Q

If you alter levels of CRH does that affect depression?

A

No

> it is more related to anxiety

226
Q

Balance of GABA and glutamate in depression

A

if either one is too high it can result in depression

227
Q

Glutamate, immune response, and depression

A

If you have a pathogen, an immune response will be activated and glutamate will be released. This can cause sick behaviours that resemble depression

228
Q

The “goldie locks range” of glutamate

A

The levels of glutamate need to be just right otherwise you get sick

229
Q

What is ketamine

A

a drug that is a hallucinogen and gives an anesthetic like feeling

230
Q

Ketamine blocks what receptors

A

the 2 glutamate receptors (AMPA and NMDA)

231
Q

What are the benefits of using ketamine as an antidepressant

A

it works very quickly and in people who previously could not be treated

232
Q

How long does ketamine work for?

A

5-7 days

233
Q

The fact that ketamine treatment works so quickly, what notion changed about depression?

A

depression was not thought of as a personality type any more

234
Q

If ketamine works quickly, why do SSRIs work so slowly

A

May take longer because it makes a series of chemical changes
» Untimately change glutamate

235
Q

If you ___ levels of BDNF in mice they get depressed

A

lower

236
Q

Is BDNF an effective treatment for depression?

A

Not very often

When it does work, it effects glutamate

237
Q

What neurotransmitter initiates an immune response?

A

Norepinephrine

238
Q

What are C-reactive proteins (CRP)

A

Substances that are released from the liver whenever there is an immune response

239
Q

What do C-reactive proteins do?

A

Increase inflammation

Associated with a rise in cytokines

240
Q

Have C-reactive proteins been found to cause depression

A

No conclusive supporting evidence

241
Q

Stress & depression and illness susceptability

A

the more stressed or depressed you are, the more likely you are to get sick

242
Q

The level of interleukin is related to the severity of what?

A

Depression

243
Q

The cancer treatment interferon alpha can make people majorly depressed with what factors?

A
  • history of depression
  • short 5HTT allel
  • female
  • low tryptophan (serotinin)
  • if you have a massive cytokine response
244
Q

If you give what with interferon alpha it can help with the side effects?

A

Antidepressants

245
Q

Is anxiety always bad?

A

No, it can be helpful in small doses

246
Q

Anticipation of an event can create what?

A

Anxiety

247
Q

People with elevated levels of CRH in their amygdala show what?

A

Anxiety profiles

248
Q

CRH1 vs CRH2 stimulation in anxiety

A 
CRH1 = when you stimulate you get a clear anxiety response 
CRH2 = when you stimulate you do not get an anxiety response
249
Q

CRH1 is ____ symptoms

CRH2 is _____ symptoms

A

Cognitive

Somatic

250
Q

Why can you feel anxious for no apparent reason?

A

when there are unconscious cues

251
Q

How does the hippocampus cause place specific anxiety

A

it remembers that something bad happened there before and it lets you know that there could be trouble

252
Q

Most phobias are ______

A

learned

253
Q

What type of therapy gets rid of most fears?

A

Exposure therapy

|&raquo_space; progressively face fear until it is no longer scary (extinction)

254
Q

Why is anti-anxitey medication not helpful in exposure therapy?

A

Because you will not feel anxious during the exposure so you will not get to work through fear

255
Q

Is there a treatment for generalized anxiety?

A

Nothing is very effective becuase it is such a complicated disease

256
Q

The locus coruleus is over active during generalized anxiety, why is this bad?

A

because it keeps a person constantly vigulant

257
Q

What happens if there is a dysfunction in the pathway between the PFC and the amygdala

A

The PFC might not be able to inhibit the amygdala and it will be over active

258
Q

The microbiome has a large effect on NT, what 2 disorders can it produce?

A

Depression and anxiety

259
Q

Anhedonia may be caused by what NT not working, why?

A

Dopamine

it is involved in the reward pathway

260
Q

How can you induce depression?

A

By changing the microbiome

261
Q

What 3 things can alter the microbiota?

A

Food
Stress
Antibiotics

262
Q

What NT in the gut can affect the brain through the vagus nerve

A

Serotonin

263
Q

When is IDO present?

A

When there is an immune response

264
Q

What NT does IDO decrease, why?

A

Serotonin

by shunting the precursor tryptophan

265
Q

IDO is converted into what?

A

Kyneurin

266
Q

When there is dysbiosis what NT is most affected and in what brain region

A

Norepinephrine

Locus coruleus

267
Q

Benzodiazepines (which affect GABA and Glutamate) are not used to treat generalized anxiety for what reason?

A

They can be addictive so they are not recommende for long term use

268
Q

WHich drug is best for generalized anxirty

A

SSRIs

269
Q

What is the effect of having one panic attack? Why

A

You are more likely to get another one

May have epigenetic effect

270
Q

Why are benzodiazepines not used to treat panic attacks

A

Would need to take it every day and it is not good for long term use

271
Q

Pure ____ can induce a panic attack

A

oxygen

272
Q

What non-drug treatments are used to treat panic attacks? How effective are they

A

CBT and mindfulness

~50%

273
Q

Is treatment for panic disorders better with drugs?

A

Not really, there is no additive effect

274
Q

What are the two components of OCD

A
  1. Obsession = thinking about something and cannot let it go
  2. Compulsion = need to do something and cannot let it go
275
Q

Does there need to be both obsession and compulsion on OCD

A

No but they often occur together

276
Q

Obsession creates anxiety so you do what?

A

Act out the compulsion

277
Q

What happens when you act out the compulsion?

A

Anxiety decreases so it is rewarding so you keep doing it

278
Q

Son vs daughter with mom with OCD

A

Son: more likely to get Tourette’s
Daughter: more likely to have OCD

279
Q

Does blocking dopamine and shutting down the reward centre work as an OCD treatment?

A

Not in humans

280
Q

What two NT seem to work together to make OCD

A

GABA and dopamine

281
Q

Yeda-Sentience =

A

Always on alert

282
Q

What state is the brain in in people with OCD

A

It is always on alert

283
Q

What do people with OCD need to find or else they go “crazy”

A

Security and safety

284
Q

What maladaptive behaviours overlap with OCD

A

Gambling and addiciton

285
Q

Is Tourettes learned?

A

no it is a compulsion

286
Q

Compulsion/impulsivity is linked with low levels of what NT

A

Serotonin

287
Q

ODC is comorbid with what?

A

Depression

288
Q

What dose of SSRIs do you need to treat OCD

A

higher than in depression

289
Q

All but what disorders can be seen in childhood

A

panic disorders

290
Q

Trauma and phobia

A

A bad experience can lead to a phobia

291
Q

Phobias are mostly learned but there is also a small ____ component

A

genetic

292
Q

What type of therapy gets rid of most fears?

A

Exposure therapy

293
Q

Who does exposure therapy work?

A

Through gradual steps that result in systematic desissitazation

294
Q

WHat type of phobia cannot be avoided?

A

Social phobias

295
Q

WHat fears do social anxiety include?

A

Fear that everyone is looking at them and that they are being judged

296
Q

For people with social anxiety, how big is the cortisol increase before public speaking? Why?

A

300%

Because public speaking exposes you to humiliation and shame q

297
Q

What are the different patterns of anxiety of experts and novices?

A

Novice: starts being nervous in the morning and it gets worse as the event nears
Experts: not nervous in the morning, a little right before, and then not at all during

298
Q

WHat can happen if the social anxiety is bad enough?

A

A person will just stay in their house

299
Q

Do drug treatments work for social anxiety ?

A

No

300
Q

What is the best treatment for social anxiety?

A

CBT

But relapse is common

301
Q

When does social anxiety start?

A

Usually in childhood, but it can start in childhood

302
Q

WHat is often reported when adults get social anxiety

A

They say that they were shy but not overly shy as children

>Social anxiety probably learned

303
Q

In people with social anxiety, what brain regions get very active in anticipation of a social situation?

A

Orbital frontal cortex (decision making) and anterior cingulate cortex

304
Q

What does it take for a person to develop social anxiety?

A

One really strongly humiliating event can cause it

305
Q

Example: you are a minority and someone discriminates against you, how do you protect yourself from social anxiety

A

Not internalizing the event and knowing it is directed at the group, not you personally. Identifying with the group can help you feel stronger

306
Q

How many people get PTSD during their life?

A

8-10%

307
Q

How much more do women get PTSD than men?

A

2x more

308
Q

How did PTSD used to be viewed?

A

it was shameful

especially after the WW1, it was thought that they were weak

309
Q

Now that trauma is more well understood and accepted, what is the big research question?

A

Why are some people not affected by the trauma

310
Q

What use to be a requirement (but no longer is) of PTSD?

A

That a person encountere an abnormal stressor and that the event had to cause feelings of horror, fear and helplessness

311
Q

In the DSM5 what is PTSD classified as?

A

A stress disorder

312
Q

Now it is understood that PTSD can be induced by:

A

anything if your reaction is strong enough

313
Q

Acute stress disorder:

A

the symptoms that you see right away after a stressor

314
Q

If the symptoms of acute stress disorder last for more than __ weeks it is considered PTSD`

A

4

315
Q

WHat are the 2 main PSTD symptoms?

A
  1. Hyper-arousal

2. Flashbacks (from a variety of cues)

316
Q

What does not occur in people with PTSD?

A

Normal extinction of the trauma response

317
Q

Does exposure therapy help treat PTSD?

A

No, repeated exposure makes it worse

318
Q

What factors can make revisiting a traumatic memory therapeutic?

A

If it is done in a completely safe environment

319
Q

What can memories be modifed?

A

When they are in short term memory (for the first time or when being remembered)

320
Q

Why are things in long term memory easier to remember?`

A

Because there are lots of connections to it

321
Q

What are 2 ways to disrupt a memory before it is formed?

A

ECT or give a drug that blocks protein synthesis (propanolol)

322
Q

What is the goal when modifying traumatic memories

A

To change the valence of the memory

323
Q

How is Eye-Movement-Desensitization Therapy proposed to work?

A

Moving your eyes takes a lot of mental effort so the brain is confused when recalling the memory so you are no longer able to tell if the memory is fearful

324
Q

WHat are 2 NT involved in PTSD

A

CRH and epinephrine

325
Q

Could one drug fix PTSD?

A

No because it involves so many different brain regions involved in vigilance (locus coereleus) and high arousal

326
Q

WHat are 3 factors that are shared amongst many disorders/diseases?

A
  1. Alteration in synaptic plasticity and development of growth factors
  2. Inflammation
  3. Stress (predictive of later illness)
327
Q

Hypertension:

A

High blood pressure

328
Q

Any stress will always do what?

A

Affect the immune system and cause inflammation

329
Q

What organ does norepinephrine affect during stress, what does it do?

A

Spleen

Causes cytokines to be released

330
Q

What goes up when stressed?

A

blood pressure

331
Q

If there is weakness in an artery and your blood pressure goes up as a result of stress, what can happen

A

you can have an aneurism

332
Q

What is a brain bleed called? Is it fatal?

A

Hemorrhagic stroke

>almost always fatal

333
Q

Hypertension increases your risk of what?

A

heart attack or stroke

334
Q

What usually treats hypertension, but what is the issue with it?

A 
Beta blockers (norepinephrine agonist)
> Not very effective
335
Q

What new drugs are more effective at treating hypertension

A

Ace inhibitors

336
Q

What are the 2 best ways to prevent hypertension?

A

Eating right and exercise

337
Q

What is a danger of using beta blockers?

A

You are more likely to bleed out during surgery

338
Q

What are the 2 best predictors for heart disease?

A
  1. Depression

2. Inflammation

339
Q

What is an index of the amount of inflammation in the body?

A

The amount of C-reactive proteins in the blood

340
Q

Kyneurin is broken down into what?

A

A toxic substance

341
Q

What is highly comorbid with heart disease

A

Depression

342
Q

What is LDL

A

Bad cholesterol

343
Q

What makes LDL dangerous

A

it builds up in veins and can cause a blockage

344
Q

Why does LDL build up

A

Where there is a tear in a vein, it tries to repair it, but it will attract immune cells, and since LDL is sticky, they will build up in the vein

345
Q

When do people notice a clogged artery

A

WHen it is 80% clogged

|&raquo_space;too late

346
Q

How does nitroglycerine help with clogged arteries?

A

It opens them up to allow for better blood flow

347
Q

What surgery treats clogged arteries

A

Bypass surgery

348
Q

Why is being overweight bad for heart disease?

A

Likely have more cholesterol and blood sugar

349
Q

Why is excise good for you in terms of heart disease? (5)

A
  • increases blood flow
  • promotes neurogenesis
  • strengthens heart muscles
  • affects growth factors in the heart
  • decreases inflammation
350
Q

Chronic stress can result in what for heart disease

A

Increases blood pressure, which causes tears in veins and causes build up of plaques and choleterol

351
Q

What can happen is a plaque gets disloged?

A

It can block an artery to the brain (stroke) or heart (heart attack)
> usually fatal

352
Q

WHy do rich people live longer?

A

Because they can afford to live healthier

353
Q

What makes low level jobs so stressfull

A

lots of responsibility but lack of control

354
Q

What job stressor is the hardest on the heart?

A

Unfairness

355
Q

Is type A personality related to heart disease?

A

Not really, only the hostility aspect

356
Q

What type of hostility is related to heart disease?

A

Internal (self blame) but not external

357
Q

Which personality type seems to actually be more predictive of heart disease and why?

A

Type D

Because they tent to ruminate, are pessimistic, and internalize problems

358
Q

What are preventatives against heart disease?

A
  • Lots of social support

- Anti-inflammatories (baby aspirin)

359
Q

WHat is the best drug treatment for heart disease

A

“Cholesterol busters”

360
Q

Hemorrhagic vs Ischemic stroke

A 
Hemorrhagic = brain bleed 
Ischemic = blocked artery
361
Q

Why is there continued brain damage after the stroke is over

A

There is a glutamate storm and an excess of cytokines, both of which are toxic

362
Q

Why do many people get depressed after a stroke

A

There is lots of inflammation and also a loss of function

363
Q

What is treatment for stroke?

A

Rehab

>can use video games

364
Q

What happens when mice are raised in a germ free environment? How can you fix this?

A

-Hyper-anxious
-More prone to stress related diseases
»Fix it through a poop transplant from a healthy mouse

365
Q

Can microbiome treatments work if you already have heart disease?

A

No because they damage is already done

366
Q

What are the demographics of type 1 diabetes?

A

Equal male and female

Usually peaks at 14

367
Q

Why do autoimmune disorders get worse over time?

A

There is sensitization

368
Q

WHat cells, when damaged, no longer produce insulin

A

Beta cells (type 1)

369
Q

What happens when there is a lack of insulin?

A

Glucose is not being takes up into cells and they starve

370
Q

Why is it bad if there is too much glucose in the blood

A

it damages cells, especially the kidneys

371
Q

Which diabetes is most stress reactive?

A

Type 2

372
Q

what disease is a precursor to type 2 diabetes? what else is it a precursor for?

A

Metabolic syndrome

heart disease

373
Q

What is metabolic syndrome

A

a build up of cholesterol and the heart cannot function properly

374
Q

WHat dug is used to treat pre-diabetes?

A

Metformin

375
Q

Why can’t cells with type 2 diabetes take in glucose?

A

Because the insulin receptors are not reactive

376
Q

Why can’t massive amounts of insulin be given to treat type 2 diabetes

A

Even though it works, insulin has other affects on growth factors

377
Q

Why do some women get gestational diabetes?

A

They are usually already more susceptible and it is caused by hormonal changes

378
Q

What does gestational diabetes often turn into?

A

Type 2 diabetes

379
Q

What makes studying illnesses hard?

A

Animal models are not perfect and we cannot use humans like lab rats

380
Q

Innate vs acquired immunity

A 
Innate = immune system that developed as a fetus that you are born with 
Acquired = immune system that you build over life
381
Q

What is adaptive immunity

A

Immunity that is adaptive (can be innate or acquired)

Stress and Mental Health (3 decks)

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