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Sunday 14 April 2013

Cortisol, AVP, Oxytocin - Part I Depression & Stress

Today starts a mini-series inspired by a reader’s comment about depression.  Angie, from Australia, pointed out that while the kids with ASD might not be depressed, many of the parents certainly are.  Not only will we address Angie’s point, but we will extend it a little and show how this can also help in our quest for the grail.

Many people have stressful lives, but some have discovered a special way to overcome this.  I was reading an English newspaper recently and there was an article about a celebrity cook, Nigella Lawson, who is very popular on the BBC.  While Jamie Oliver appears not to overindulge on his own cooking, it appears that Nigella does. Nigella was giving her tips to losing those excess pounds or kilograms.  The interesting part was not the treadmill in the spare room, but her comment about singing extremely loudly while using it.  
Here comes the science part.  Cortisol is an important hormone; and as we learnt previously when studying TRH, while a hormone may have a well-documented primary function, there may also have numerous additional effects.  The most important roles of cortisol are the activation of three metabolic pathways:-

1.    Generating glucose

2.    Anti-stress

3.    Anti-inflammation

The function that Nigella has stumbled upon is number two.  While we all need cortisol, too much is not good for you.
Cortisol is released in response to stress and while short term increases serve a valuable purpose, prolonged cortisol secretion, perhaps caused by chronic stress, can cause damaging physiological changes.
It would be nice if there was a way to reduce excess, stress-induced, cortisol and then you would feel calm, refreshed and ready to fight on.  While exercise is also very good for you, it is actually the singing that really makes Nigella feel good.

It is scientifically established that singing substantially reduces your level of cortisol, which in turn makes you feel much better.  Here is a link to simple study done in Angie’s home country and with the help of the Macquarie University Choir.
I could now tell you all about music therapy and its application in psychiatry.  If you are interested, do look into it; it is used to treat everything from autism to alcoholism.

In essence music is good for you; but it seems that making your own music is far more beneficial than just listening to other people.

Tip for parents
Follow Nigella’s example (and mine) and sing.
I will check to see if Angie does.


Back to ASD
Have you noticed that an autistic child is at their most stressed first thing in the morning?  I certainly have; this was particularly marked when Monty’s behaviour regressed.  My approach was and remains to have Monty through this possible trouble zone quickly; so once he is up, he should have breakfast, brush teeth and get dressed promptly. It proved an effective strategy.
I did wonder what the reason for this phenomenon was.  Originally, I thought it was just the fact that he had not eaten for a long time and so his blood sugar level had dropped.  This applies with all kids; if they have not eaten, they will get cranky.

Now I have an alternative explanation, and probably a better one. It is likely to do with the natural variation in cortisol levels in the blood that apparently peaks at about 8am and falls to a low for the day at bed time.  Wait to read more in Part II.

Autism, Depression and Suicidal Tendencies
It may not make cheerful reading, but one factor these three groups all have in common is dysregulation of the HPA, which is the Hypothalamic-Pituitary-Adrenal Axis.  There is also the well documented phenomenon of enhanced cortisol response to stress in children in autism. This will be continued in a science-heavy Part II and quite possibly will result in another hypothesis regarding a practical intervention.

Just to let you know, that my very long recent post about the TRH hypothesis has now gone for review to a clever and interested neuroscientist in the US.  I have a feeling that it will shortly be joined by my CRH (corticotropin releasing hormone) hypothesis; but maybe it should be called Angie’s CRH hypothesis?   
 

4 comments:

  1. Peter, just curious, what is your CRH hypothesis?

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    Replies
    1. Tanya, this post is quite old and while I do recall my TRH hypothesis, I have forgotten about my CRH hypothesis.

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  2. Do you think low dose clonazepam could block CRH in cases of situational anxiety/trauma triggers? I do not think verapamil would work in this case, and haven't re-trialed neuroprotek/Brain Gain products to see if it would make a difference at this stage. I think it is only Dr Theoharides addressing blocking CRH as a treatment, correct?

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  3. Hi Peter, a while ago, I left another post reporting that my 2.5 yo moderate autistic boy has repeatedly demonstrated improved behaviour, speech and overall cognition after an outburst of cry + tears. It's almost like a cycle. Now after reading this earlier article of yours I think I have a hypothesis for it. It is likely that he has built up emotional stresses continuously through different daily events, and that increases different issues including stims, screams and other behavioural problems. Then up to a point that aggravation forces a confrontation with us, he would then become so sensitive to cry even by one of my sharper gazes. His consequential outburst of tears would put him back to this calmer state with a much better clarity of mind and responses. I have tried to give him Biogaia which I think should provide oxytocin thus a better stress balance. Do you have any other suggestions that may help him to maintain a better balance?

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