Mental Health Archives -

Is Pain an Emotion?

Tarik Regad — Mon, 11 Oct 2021 22:11:06 +0000

Pain is not only emotion as it is both a sensory and emotional experience. An individual can feel pain after being physically hurt (sensory) such as falling, burning skin after long hours of training, or touching something hot. Being physically hurt will trigger an emotion afterward [1].

However, pain is not only physical because a sensory experience can also be due to mental health conditions such as depression, anxiety, or anger.

Therefore, a difference exists between pain and the cause of the pain. The link between the two is mediated by our nervous system through a process known as nociception.

It was estimated that 20.4% of adult individuals had chronic pain and that 7.4% of adult individuals had chronic pain which limited their activities, such as working, in the past 3 months [2].

1- What is emotional pain?

Emotional pain can be defined by the heartache we feel when losing someone or something that was important to us.

2- Is pain an emotion or feeling?

A Feeling is the outcome or expression of our interpretation of an emotion that was caused by pain (physical or psychological).

3- What is the worst mental pain?

They are several mental conditions that are characterized by unbearable psychological and emotional pain that is characterized by suicidal thoughts (suicidal ideation).

These include Emotionally unstable personality disorder (borderline personality disorder) and seasonal affective disorder.

4- What are Nociceptors?

Nociceptors are sensory neurons that respond to damage or potential damage through alerting communications to the brain and spine [3].

Nociceptors can be mechanical, thermal, mechano-thermal, polymodal, or silent.

Mechanical nociceptors respond to mechanical damage or pressure, while thermal nociceptors respond to cold or hot temperatures.

Mechano-thermal nociceptors respond to both mechanical and thermal stimuli, while silent nociceptors respond to inflammatory mediators.

5- What Are the Types of Pain?

Acute Pain

Acute pain is caused by spasms of skeletal muscles and the activation of the sympathetic nervous system that is due to an injury or a trauma. The duration of the pain is short and disappears with the healing of the injury.

Chronic Pain

Chronic pain is also caused by an injury or a disease, but the pain would continue even after the healing period.

Nociceptive Pain

Nociceptive pain is caused by an injury, trauma, chemicals, or surgery that results in the activation and release of inflammatory mediators by nociceptor neurons (sensory neurons) which activate inflammation in the injured area [4].

Neuropathic Pain

Neuropathic pain is due to direct damages or compression of the sensory nerves associated with sciatica, neuropathies such as phantom limb pain, Wallerian degeneration, segmental demyelination, or diabetic neuropathies.

5- Are There Other Classifications of Pain?

Allodynia

Allodynia is a pain that is caused by a stimulus that is not the one that initiated the pain, such as feeling pain after a gentle shake of hands or light touch on the back.

Analgesia

Analgesia is characterized by the inability to feel the pain caused by a stimulus (cause) that should normally have caused pain.

Hyperpathia

Hyperpathia is a neuropathic pain characterized by an abnormal, repetitive, and elevated pain reaction to the stimulus (cause).

Causalgia

Causalgia is neuropathic pain that combines a sensation of burning pain, hyperpathia, and allodynia.

Dysesthesia

Dysesthesia is an unpleasant and abnormal sensation such as cold sensation, tingling, burning, numbness, tickling, or pain that is caused by nerve trauma or irritation.

Hyperalgesia

Hyperalgesia is characterized by an abnormally increased sensitivity to pain due to the release of inflammatory hormone-like substances, known as prostaglandins, that increase the sensitivity of the nociceptors.

Hyperalgesia can be caused by fibromyalgia, diabetes, infection, trauma, postherpetic neuralgia, and complex regional pain syndrome.

Hyperesthesia

Hyperesthesia is characterized by an increased sensitivity to stimuli associated with senses such as hearing, tasting, touch, smelling,

Hyperesthesia is caused by excessive stimulation of the nervous system such as overconsumption of caffeine.

Hypoalgesia

Unlike analgesia characterized by the inability to feel pain, hypoalgesia is associated with a reduced response to a painful stimulus.

6- What Are the Symptoms of Pain?

The symptoms of pain are categorized corresponding to the pain intensity, duration, and pain-related disability [5]. These categories allow the classification of pain into mild, moderate, or severe using assessment methods:

Visual Analogue Scale

This method consists in drawing a line between two points. The first point is the “no pain” and the second point is the “as bad as it could be”.

The individual in pain is requested to mark the level of pain within the two endpoints.

Graphic Rating Scale (GRS)

This method represents a drawing of a line with levels from 1 to ten representing the intensity of pain. No pain is represented by the number 0 and “as bad as it could be” is represented by the number 10.

The individual in pain is requested to indicate the number from 0 to 10 which represents the level of pain experienced by the individual.

Verbal Rating Scale

This method evaluates the pain experienced by the patient using adjectives to describe the level of pain.

Pain Drawing

In this method, the patient is requested to indicate the location of the pain on a drawn human body.

McGill Pain Questionnaire (MPQ)

This questionnaire assesses the pain-rating index, the number of words describing the pain, and the level of pain on a scale of 1-5.

8- What Is the Treatment of Pain?

Pain is mainly managed.

Non-pharmacological Management

Non-pharmacological management involves:

– Exercise such as swimming, walking, yoga, Pilates, and exercise bike.

– Physical therapy through physiotherapists and occupational therapists who will help with stretching and pain-relieving exercises.

– Psychological management through social support, psychologists, and psychotherapists.

Pharmacological Management

For mild and moderate pain, non-opioid analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are used.

Although there is a high risk of dependency, opioid analgesics (e.g., morphine) are used for the treatment of severe pain.

Conclusion

Although the risk factors in the progression from acute to chronic pain are well known, identifying patients who are predisposed to this progression through assessing the status of the acute pain, the physiological and reactivity of the patients to pain, should help better manage this switch from acute to chronic pain.

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What Are the 7 Major Nutrients for Mental Health?

Tarik Regad — Mon, 04 Oct 2021 22:05:47 +0000

Mental health issues can be prevented or significantly reduced by ensuring that the foods we eat contain the following nutrients:

Omega-3
B Vitamins
Amino Acids
Essential Minerals
Vitamin D
Plant-Based Antioxidants
Probiotics and Prebiotics

1. Omega3

1.1. What Are Omega3 Fatty Acids Good For?

Omega-3 fatty acids are essential for the metabolism of lipid in our body and that can only be provided by the diet.

Omega-3 fatty acids are not a single entity, but they are divided into docosahexaenoic acid (DHA), linolenic acid (ALA), and eicosapentaenoic acid (EPA) [1].

Docosahexaenoic Acid (DHA)

Docosahexaenoic Acid (DHA) is the principal constituent of the plasma membrane of neurons found in the brain and cerebral cortex. It is also found in the retina and skin.

Eicosapentaenoic Acid (EPA)

Eicosapentaenoic Acid (EPA) is essential for the synthesis of the vasodilator, anticoagulant, and inflammatory hormone, Prostaglandin (PG).

Eicosapentaenoic Acid (EPA) is also essential critical for the synthesis of the pro-coagulation and thrombosis factor, thromboxane, and the inflammation mediators, leukotrienes.

Linolenic Acid (ALA)

Linolenic Acid (ALA) is involved in the regulation of blood lipids and endothelial (Vessels) function. It has also significant anti-inflammatory and anti-thrombotic effects.

1.2. Why Are Omega 3 fatty Acids Good for Mental Health?

Several studies reported that the reduction in intake of Omega 3 fatty Acids results in mood disorders [2].

Major depression and schizophrenia were also associated with reduced consumption of fish and omega 3 fatty acids [2].

The severity of depression was linked with the reduction of omega 3 fatty acids concentrations in the blood.

When comparing with healthy individuals, patients with schizophrenia had significantly lower levels of EPA and DHA.

1.3 Which Food Contains More Omega-3?

Foods that are rich in Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA) include fatty fish such as salmon, tuna, herring, mackerel, sardine, and fish oils, while flaxseed, chia, walnuts, hemp, and vegetable oils are rich in Linolenic Acid (ALA).

2. B Vitamins

2.1. What Are B Vitamins Good For?

Through their co-enzymatic (help other enzymes) activities, B vitamins are essential players in the cell metabolism of sugars, amino acids, and lipids. They are also involved in the synthesis of neurotransmitters necessary for the nervous system functions.

2.2. Why Are B Vitamins Good for Mental Health?

Alterations in the activity of neurotransmitters have been associated with changes in mood, depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder (OCD). B vitamins are essential for the synthesis of several neurotransmitters and in the conductance (transmission) of nerve impulses [3] [4].

Vitamin B1 (Thiamine)

Through its activity as a coenzyme, vitamin B1 (Thiamine) is involved in the synthesis of the neurotransmitters, GABA, Acetylcholine, and glutamate.

Vitamin B6 (Pyridoxine)

Through its activity as a coenzyme, vitamin B6 (pyridoxine) is involved in the synthesis of neurotransmitters, dopamine, histamine, serotonin, norepinephrine, and GABA.

Vitamin B9 (Folate, Folic Acid)

Folate has several roles in the nervous system:

– Increases the level of the neurotransmitter, serotonin, by reducing the breakdown of tryptophan which is an essential amino acid involved in the synthesis of serotonin.

– Through its activity as a coenzyme, folate contributes to the synthesis of the monoamine neurotransmitters, serotonin, norepinephrine, and dopamine.

– Contributes to the synthesis of compounds necessary for the energy metabolism of the brain.

Vitamin B12 (Cobalamin)

Vitamin B12 (cobalamin) has also several roles in the nervous system:

– Through its activity as a coenzyme, vitamin B12 (cobalamin) contributes to the synthesis of the monoamine neurotransmitters, serotonin, norepinephrine, and dopamine.

– It is involved in the maintenance of myelin sheets that envelop neurons and which are involved in the transmission of nerve impulses.

– Helps the activity of folate.

2.3. Which Food Contains More B Vitamins?

Vitamin B1 (Thiamine) is naturally present in food such as whole grains, legumes, and fish.

Vitamin B6 (Pyridoxine) is mainly found in meat products such as Beef, pork, and fish.

Vitamin B9 (Folate) is found in many types of food; however, due to its instability (e.g., high heat cooking), it is being added to several food sources as a fortifier to prevent a vitamin B9 deficiency.

Vitamin B12 (Cobalamin) is naturally present in foods such as meat, liver, milk, clams, fortified breakfast cereals, and eggs.

3- Amino Acids

3.1. What Are Amino Acids Good For?

Amino acids are the building blocks of proteins that are essential for life. Proteins are a vital part of building cells, tissues, and organs. They are also critical for their functions as all physiological processes of the cells require proteins.

3.2. Why Are Amino Acids Good for Mental Health?

Amino acids play a critical role in the function of the nervous system and in mental health. The amino acid glutamate is a neurotransmitter, while other amino acids are necessary for the synthesis of several neurotransmitters.

The neurotransmitters dopamine, norepinephrine, and epinephrine are made from the amino acid, Tyrosine, that is also made from phenylalanine.
The neurotransmitter serotonin is made from tryptophan

3.3. Which Food Contains More Amino Acids?

Foods that are rich in amino acids include meats, eggs, and milk, and other dairy products.

4- Essential Minerals

4.1. What Are Essential Minerals Good For?

Essential minerals are essential for life through their role in the production of energy, bone formation, nucleic acid synthesis (DNA and RNA), hemoglobin synthesis, and metabolism of the cells.

4.2. Why Are Essential Minerals Good for Mental Health?

Zinc

Zinc is involved in the regulation of gene expression and protein synthesis. As a cofactor for many enzymes, zinc is involved in several metabolic reactions.

Zinc intake has been associated with a reduced incidence of depression [5]. Zinc deficiency is also involved in learning impairment and olfactory dysfunction [6].

Iron

Iron is essential for the production of energy (ATP) in the brain. As a coenzyme, Iron is involved in the synthesis of the neurotransmitters, serotonin, dopamine, norepinephrine, and epinephrine [4].

Magnesium

Magnesium is involved in several mental health disorders, including anxiety, depression, and migraine.

Magnesium has an essential role in neurotransmission and neuromuscular transduction through its protective function against excitotoxicity (excessive transmission by neurotransmitters) [7].

4.3. Which Food Contains More Essential Minerals?

Foods that are rich in Zinc include oysters, beef, lobster, pork, cereals, crab, chicken, pumpkin seeds, baked beans, dairy products (milk, yogurt, cheese), cashews, chickpeas, and oatmeal.

Foods that are rich in Iron include dark-green leafy vegetables, nuts and seeds, meat, fish, tofu, eggs, brown rice, and dried fruit.

Foods that are rich in Magnesium include green leafy vegetables, such as spinach, nuts, seeds (chia and pumpkin seeds), legumes, and whole grains

5. Vitamin D

5.1. What Is Vitamin D Good For?

Vitamin D is involved in the intestinal absorption of magnesium, phosphate, and calcium necessary for calcium homeostasis and bone metabolism.

5.2. Why Is Vitamin D Good for Mental Health?

A study reported the involvement of vitamin D in schizophrenia associated with low levels of maternal vitamin D during pregnancy [8].

Another study reported an association between low levels of vitamin D and depression [9].

5.3. Which Food Contains More Vitamin D?

Vitamin D is naturally found in many foods such as beef liver, cod liver oil, eggs, salmon, tuna, mackerel, and sardines.

6. Plant-Based Antioxidants

6.1. What Are Plant-Based Antioxidants Good For?

Plant-Based Antioxidants prevent oxidative stress damage to cells that can lead to their death. They perform this action by neutralizing free radicals.

6.2. Why Are Plant-Based Antioxidants Good for Mental Health?

Unbalance in plant-based antioxidants such flavones, polyphenols, flavonoids, phytoestrogens, and catechins, has been shown to promote anxiety and depression.

Plant-based antioxidants prevent anxiety and depression through their role in reducing the inflammation of brain cells and restoring balance to neurotransmitters [10].

6.3. Which Food Contains More Plant-Based Antioxidants?

Foods that are rich in plant-based antioxidants include oilseeds, legumes, tree nuts, plants of the Lamiaceae family, tea and coffee, cereals, fruits, and berries.

7. Probiotics and Prebiotics

7.1. What Are Probiotics and Prebiotics Good For?

Probiotics are the gut’s most known “good bacteria” that are Lactobacillus and Bifidobacterium. These bacteria help other gut bacteria by providing them with nutrients that are commonly known as prebiotics [11].

The most common prebiotics are fructooligosaccharides, galactooligosaccharides, and trans-galactooligosaccharides, but other prebiotics plays important roles in health and aging such as insulin enriched-oligofructose, lactulose, and oligofructose.

7.2. Why Are Probiotics and Prebiotics Good for Mental Health?

The administration of prebiotics such as non-starch polysaccharides was shown to improve the performance of working and recognition memory and cognitive functions [16][17].

Another prebiotic known as insulin enriched-oligofructose enhances mood and immediate memory [18].

Lactulose was also shown to improve cognitive function and health-related quality of life [19].

7.3. Which Food Contains More Probiotics and Prebiotics?

Probiotics are found in yogurt, lactobacillus milk, some cheeses such as Gouda, cheddar, cottage cheese, and mozzarella, pickles, sauerkraut, kefir, kimchi, tempeh, kombucha, and miso.

Prebiotics are found in carrots, quinoa, radishes, onions, chicory roots, konjac roots, oats, yams, garlic, barley, wheat bran, berries, apples, asparagus, bananas, leeks, chia seeds, flax seeds, cocoa, coconut, jicama root, and dandelion greens.

Conclusion

Although sometimes we are not aware of the importance of the food we consume, consuming the right nutrients such as omega 3 fatty acids, B vitamins, plant-based antioxidants, probiotics and prebiotics, essential minerals, vitamin D, and amino acids can make a big difference in preventing or reducing mental health issues.

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Are Energy Drinks Bad for You?

Tarik Regad — Mon, 06 Sep 2021 22:49:03 +0000

Energy drinks are one of the most consumed dietary supplements that are popular among men between the ages of 18-34 years and teens between the ages of 12-17 years. They contain large amounts of caffeine, sugars, taurine, B vitamins, glucuronolactone, carnitine, ginseng, Yohimbe, and bitter orange.

Although energy drinks may enhance alertness and improve reaction time, there is a growing body of scientific evidence showing that energy drinks can have serious health effects on children, teenagers, and young adults. These effects include seizures, diabetes, cardiac abnormalities, and mood and behavioral disorders [1].

What Are the Effects of Energy Drinks on Health?

1- Effects of Energy Drinks on Mental Health

Many studies investigated the link between energy drinks and mental health problems such as stress, anxiety, and depression; however, further studies are required to confirm this relationship.

Effects of Energy Drinks on Stress

Although several studies reported a positive correlation between energy drinks and stress, most of them were inconclusive due to the statistical methods used and the measuring factors included in the studies.

A study that investigated the relationship between perceived stress, consumption of energy drinks, and academic performance among 136 college students found positive correlations between the student’ perceived stress and energy drinks consumption. [2]. However, several studies provided no significant correlations between the consumption of energy drinks, stress, and PTSD (Post-Traumatic Stress Syndrome) [1].

Effects of Energy Drinks on Anxiety

A positive correlation between energy drinks and anxiety was reported by some studies, while others lacked statistical significance to back up their results. Two studies reported a positive correlation between the consumption of energy drinks and anxiety scores.

One study that included 107 young adults consisting of college student-athletes, Reserve Officers Training Corps cadets, and psychology students, found that 29% of the participants who consumed energy drinks had anxiety [3]. The other study reported a similar result; however, the effect was only significant in male participants [4].

On the other hand, a study reported a positive correlation between caffeine consumption and anxiety in secondary school children; however, no statistically significant correlation between caffeine consumption from energy drinks and anxiety was observed [5].

Effects of Energy Drinks on Depression

A very large study of Canadian schoolchildren (N = 8210) reported a correlation between depression and the consumption of energy drinks at least once per month or more [6]. A similar result was also reported by another study that reported a correlation between anxiety and consumption of ≥100 mL/day of energy drinks [7].

Interestingly, a study reported a correlation between the consumption of energy drinks and depression, self-harming behavior, and suicidal thoughts in 10th-grade students from Turkey [8].

However, other studies that investigated the association between the consumption of energy drinks and depression in British secondary school children and fourth-year US undergraduate students, have found no positive association [5][9].

2- Effects of Energy Drinks on the Cardiovascular System

Energy drinks have a high content of caffeine that has been associated with multiple cardiac comorbidities including palpitations and arrhythmias such as atrial fibrillation and supraventricular and ventricular ectopy due to the increase in blood pressure [10]. Additionally, symptoms of caffeine overdose also include irritability, insomnia, tremors, and seizures.

3- Effects of Energy Drinks on Sleep

Sleep is controlled by the brain through the suprachiasmatic nucleus of the hypothalamus. The sleep pattern occurs through repetition of a cycle that comprises 5 phases, including light sleep, slow-wave sleep, delta sleep, deep sleep, and REM.

Several studies in adults have found that drinking high amounts of caffeine reduces the percentage of time spent in slow-wave or deep sleep in a dose-related manner and leads to insomnia. They also found that it alters the temporal organization of rapid eye movement (REM)/non-REM sleep [11]. In teens, caffeine intake has also been associated with shorter sleep duration [11].

5- Energy Drinks and Diabetes

The consumption of high amounts of sugar for a prolonged period can result in obesity due to an unbalance in energy consumption. Energy drinks contain large amounts of sugar which result in excessive consumption of energy leading to its storage in the form of fat. Obesity has been reported as one of the major risks of diabetes type 2.

Conclusion

Although energy drinks are widely commercialized as products that increase energy, mental alertness, and physical performance, some studies highlighted their potential negative effects on mental health, cardiovascular system, and risk of diabetes. Therefore, reducing or stopping their consumption may be a good way of preventing any potential health issue. Additionally, the high content of sugar in energy drinks is also a sufficient alarm that should raise awareness about their consumption, particularly by young individuals.

References

[1] Richards, G. and Smith, A.P., 2016. A review of energy drinks and mental health, with a focus on stress, anxiety, and depression. Journal of caffeine research, 6(2), pp.49-63.

[2] Pettit, M.L. and DeBarr, K.A., 2011. Perceived stress, energy drink consumption, and academic performance among college students. Journal of American college health, 59(5), pp.335-341.

[3] Stasio, M.J., Curry, K.I.M., Wagener, A.L. and Glassman, D.M., 2011. Revving up and staying up: energy drink use associated with anxiety and sleep quality in a college sample. College Student Journal, 45(4), pp.738-749.

[4] Trapp, G.S., Allen, K., O’Sullivan, T.A., Robinson, M., Jacoby, P. and Oddy, W.H., 2014. Energy drink consumption is associated with anxiety in Australian young adult males. Depression and anxiety, 31(5), pp.420-428.

[5] Richards, G. and Smith, A., 2015. Caffeine consumption and self-assessed stress, anxiety, and depression in secondary school children. Journal of psychopharmacology, 29(12), pp.1236-1247.

[6] Azagba, S., Langille, D. and Asbridge, M., 2014. An emerging adolescent health risk: Caffeinated energy drink consumption patterns among high school students. Preventive Medicine, 62, pp.54-59.

[7] Trapp, G.S., Allen, K., O’Sullivan, T.A., Robinson, M., Jacoby, P. and Oddy, W.H., 2014. Energy drink consumption is associated with anxiety in Australian young adult males. Depression and anxiety, 31(5), pp.420-428.

[8] Evren, C. and Evren, B., 2015. Energy-drink consumption and its relationship with substance use and sensation seeking among 10th grade students in Istanbul. Asian journal of psychiatry, 15, pp.44-50.

[9] Arria, A.M., Caldeira, K.M., Kasperski, S.J., Vincent, K.B., Griffiths, R.R. and O’Grady, K.E., 2011. Energy drink consumption and increased risk for alcohol dependence. Alcoholism: Clinical and Experimental Research, 35(2), pp.365-375.

[10] Wassef, B., Kohansieh, M. and Makaryus, A.N., 2017. Effects of energy drinks on the cardiovascular system. World journal of cardiology, 9(11), p.796.

[11] Roehrs, T. and Roth, T., 2008. Caffeine: sleep and daytime sleepiness. Sleep medicine reviews, 12(2), pp.153-162.

[15] Bray, G.A., 2004. Medical consequences of obesity. The Journal of Clinical Endocrinology & Metabolism, 89(6), pp.2583-2589.

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What Is Chronic Fatigue Syndrome?

Tarik Regad — Wed, 18 Aug 2021 22:32:12 +0000

Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is an illness characterized by profound disabling tiredness, a diminished capacity to perform routine tasks, and sleep disruption that lasts for more than 6 months.

1. Epidemiology of Chronic Fatigue Syndrome

Based on prevalence estimates from the Institute of Medicine, chronic fatigue syndrome affects around 0.2-2.6% of the global population. It mainly affects adults between 40 and 60 years, with a female predominance [1][2]. It also occurs in children and adolescents; however, it appears to be at a lower rate [3].

2. What Causes Chronic Fatigue Syndrome?

There are several causes of chronic fatigue syndrome including genetic, neurological, immunological, infectious, sleep-related, and psychiatric [2].

A. Is Chronic Fatigue Syndrome a Genetic Condition?

Several studies investigated the association between chronic fatigue syndrome and family genetic history. One of the studies compared the rate of chronic fatigue syndrome (CFS) between 25 individuals with CFS and 36 control subjects and found significantly higher rates of CFS in individuals with CFS relatives [4].

By analyzing data from a chronic fatigue twin registry, other studies found higher rates of chronic fatigue syndrome in monozygotic (identical) compared to dizygotic twins and that a genetic predisposition to chronic fatigue syndrome exists in female twins [5].

However, further investigations are required to confirm the involvement of family genetic history in the etiology of CFS [2].

B. Is Chronic Fatigue Syndrome a Neurological Condition?

Due to the presence of symptoms of fatigue, impaired concentration diminished attention and memory, and headache in cases of CFS, neuropsychological and neuroendocrine studies, were performed by several research groups.

Neuropsychological studies

Although studies tested the capacity of information processing, working memory, and poor learning in CFS individuals, the results showed that these individuals have normal cognitive and global intellectual abilities [6].

Neuroendocrine studies

Abnormalities in the hypothalamic-pituitary-adrenal axis and serotonin pathways were reported in patients with CFS. These individuals had an altered physiological response to stress associated with reduced levels of cortisol, a disorder of central neurotransmitters, and disturbance of the functional relationship between cortisol and central neurotransmitters [7].

C. Is Chronic Fatigue Syndrome an Immunological Condition?

Analysis of the immune system in CFS individuals demonstrated the presence of alterations affecting the function of natural killer (NK) cells and regulatory T and B cells, and higher frequencies of various autoantibodies [8] [9]. However, other studies showed the absence of changes in lymphocyte subsets in CFS individuals [10].

D. Is Chronic Fatigue Syndrome Due to Infections?

Although several studies reported potential associations between CSF and viral infections, such as Epstein–Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus (HHV) 6, HHV-7, HHV-8, human parvovirus B19 (B19V), enteroviruses, lentiviruses, the role of viral infections in CSF etiology have not been confirmed and remains inconclusive [11].

E. Is Chronic Fatigue Syndrome Due to Sleep Disruption?

Although many studies suggested an association between CSF and sleep disturbances using sleep parameters such as slow-wave sleep, apnea-hypopnea index, spectral activity, and multiple sleep latency testing, a recent study showed that the reported results are inconsistent due to subjects’ recruitment decisions, confounding factors, small sample sizes and unconfirmed findings [12].

F. Is Chronic Fatigue Syndrome a Psychiatric Condition?

Several studies suggested that CSF is a psychiatric disorder that originates in CSF individuals who have mood disorders, such as anxiety, and major depression, and somatization disorder which includes symptoms such as headaches, dizziness, generalized pain, bowel movement, and fatigue [13] [14].

H. Is Chronic Fatigue Syndrome Due to Lack of Exercise?

A study showed that CSF individuals have less physical activity than non-CSF individuals, suggesting that the lack of physical activity could aggravate fatigue in CSF patients [15]. Interestingly, another study showed that individuals with CSF who received a graded exercise program had improvements in physical activities and in some cognitive variables [16].

3. How Is Chronic Fatigue Syndrome Diagnosed?

Unfortunately, there is no specific test for CSF, and the diagnosis is based on the observation of symptoms including sleep disturbances, headaches, joint, and muscle pain, disabling tiredness, flu-like symptoms, dizziness, and heart palpitations.

4. How Is Chronic Fatigue Syndrome Treated?

The treatment of chronic fatigue syndrome is symptomatic and involves the use of a graded exercise program to improve physical activity, medications to control sleeping disruptions and pain, and cognitive behavioral therapy to improve cognitive disorders, and behaviors, and to develop coping strategies.

5. Frequently Asked Questions about What Is Chronic Fatigue Syndrome?

What is Chronic Fatigue Syndrome (CFS)?

Chronic Fatigue Syndrome, also known as myalgic encephalomyelitis (ME/CFS), is a complex disorder characterized by extreme fatigue that doesn’t improve with rest and may worsen with physical or mental activity.

What are the symptoms of CFS?

The main symptom of CFS is severe fatigue that lasts for at least six months and is not alleviated by rest. Other common symptoms include muscle pain, joint pain, headaches, unrefreshing sleep, memory problems, and difficulty concentrating.

What causes Chronic Fatigue Syndrome?

The exact cause of CFS is unknown, but it is believed to involve a combination of factors, including viral infections, immune system dysfunction, hormonal imbalances, and genetic predisposition. Psychological factors such as stress may also play a role.

How is Chronic Fatigue Syndrome diagnosed?

There is no specific test for CFS, so diagnosis is based on ruling out other possible causes of the symptoms. Doctors may perform a thorough medical history, physical examination, and various tests to rule out other conditions with similar symptoms.

Is there a cure for Chronic Fatigue Syndrome?

Currently, there is no cure for CFS. Treatment focuses on managing symptoms and improving quality of life. This may include medications to relieve pain and improve sleep, as well as lifestyle changes such as pacing activities and managing stress.

Can exercise help with Chronic Fatigue Syndrome?

While exercise is important for overall health, it can be challenging for people with CFS due to their extreme fatigue and other symptoms.

A carefully tailored exercise program, such as graded exercise therapy, may be beneficial for some individuals, but it should be approached cautiously and under the guidance of a healthcare professional.

Is Chronic Fatigue Syndrome a mental illness?

No, CFS is not a mental illness, although psychological factors such as stress may contribute to its development or exacerbation. CFS is recognized as a physical illness by major medical organizations, including the World Health Organization and the Centers for Disease Control and Prevention.

Can children get Chronic Fatigue Syndrome?

Yes, children and adolescents can develop Chronic Fatigue Syndrome. It may manifest differently in younger individuals compared to adults, with symptoms such as difficulty concentrating, school absences, and reduced participation in activities.

How common is Chronic Fatigue Syndrome?

CFS is estimated to affect between 0.1% and 0.4% of the population, though rates may vary depending on the criteria used for diagnosis and other factors. It can occur in people of all ages, genders, and ethnicities.

What should I do if I think I have Chronic Fatigue Syndrome?

If you are experiencing persistent, unexplained fatigue along with other symptoms of CFS, it’s important to consult with a healthcare professional. They can perform a thorough evaluation to determine the cause of your symptoms and develop an appropriate treatment plan.

Conclusion

Although chronic fatigue syndrome appears to be associated with psychiatric and neurological disorders, other factors such as viral infections, immunity, and hereditary, may also be involved. A better understanding of the etiology of this syndrome using studies that comprise larger cohorts of CSF patients would certainly lead to the development of more efficient therapies that are specific to chronic fatigue syndrome.

References

[1] https://www.cdc.gov/me-cfs/healthcare-providers/presentation-clinical course/epidemiology.html

[2] Afari, N. and Buchwald, D., 2003. Chronic fatigue syndrome: a review. American Journal of Psychiatry, 160(2), pp.221-236.

[3] Lim, E.J., Ahn, Y.C., Jang, E.S., Lee, S.W., Lee, S.H. and Son, C.G., 2020. Systematic review and meta-analysis of the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Journal of translational medicine, 18(1), pp.1-15.

[4] Walsh, C.M., Zainal, N.Z., Middleton, S.J. and Paykel, E.S., 2001. A family history study of chronic fatigue syndrome. Psychiatric genetics, 11(3), pp.123-128.

[5] Buchwald, D., Herrell, R., Ashton, S., Belcourt, M., Schmaling, K., Sullivan, P., Neale, M. and Goldberg, J., 2001. A twin study of chronic fatigue. Psychosomatic medicine, 63(6), pp.936-943.

[6] Tiersky, L.A., Johnson, S.K., Lange, G., Natelson, B.H. and Deluca, J., 1997. Neuropsychology of chronic fatigue syndrome: a critical review. Journal of Clinical and Experimental Neuropsychology, 19(4), pp.560-586.

[7] Parker, A.J.R., Wessely, S. and Cleare, A.J., 2001. The neuroendocrinology of chronic fatigue syndrome and fibromyalgia. Psychological medicine, 31(8), pp.1331-1345.

[8] Barker, E., Fujimura, S.F., Fadem, M.B., Landay, A.L. and Levy, J.A., 1994. Immunologic abnormalities associated with chronic fatigue syndrome. Clinical Infectious Diseases, 18(Supplement_1), pp.S136-S141.

[9] Brenu, E.W., Huth, T.K., Hardcastle, S.L., Fuller, K., Kaur, M., Johnston, S., Ramos, S.B., Staines, D.R. and Marshall-Gradisnik, S.M., 2014. Role of adaptive and innate immune cells in chronic fatigue syndrome/myalgic encephalomyelitis. International immunology, 26(4), pp.233-242.

[10] Mikecz, A.V., Konstantinov, K., Buchwald, D.S., Gerace, L. and Tan, E.M., 1997. High frequency of autoantibodies to insoluble cellular antigens in patients with chronic fatigue syndrome. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 40(2), pp.295-305.

[11] Rasa, S., Nora-Krukle, Z., Henning, N., Eliassen, E., Shikova, E., Harrer, T., Scheibenbogen, C., Murovska, M. and Prusty, B.K., 2018. Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Journal of translational medicine, 16(1), pp.1-25.

[12] Maksoud, R., Eaton-Fitch, N., Matula, M., Cabanas, H., Staines, D. and Marshall-Gradisnik, S., 2021, May. Systematic Review of Sleep Characteristics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. In Healthcare (Vol. 9, No. 5, p. 568). Multidisciplinary Digital Publishing Institute.

[13] Stewart, D.E., 1990. Emotional disorders misdiagnosed as physical illness: Environmental hypersensitivity, candidiasis hypersensitivity, and chronic fatigue syndrome. International Journal of Mental Health, 19(3), pp.56-68.

[14] Shorter, E., 2008. From paralysis to fatigue: a history of psychosomatic illness in the modern era. Simon and Schuster.

[15] van der Werf, S.P., Prins, J.B., Vercoulen, J.H., van der Meer, J.W. and Bleijenberg, G., 2000. Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. Journal of psychosomatic research, 49(5), pp.373-379.

[16] Wallman, K.E., Morton, A.R., Goodman, C., Grove, R. and Guilfoyle, A.M., 2004. Randomised controlled trial of graded exercise in chronic fatigue syndrome. Medical Journal of Australia, 180(9), pp.444-448.

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Video Gaming Effects on Mental Health

Tarik Regad — Wed, 04 Aug 2021 19:44:01 +0000

Approximately 2.7 billion video gamers were reported worldwide in 2020 and this number is likely to increase in the next years and decades with the development of new video gaming technologies such as digital technologies, including web-based and smartphone-based games delivery.

Although video gaming is entertaining, its implications on mental health are beginning to emerge through studies that evaluated its benefits and disadvantages on anxiety, depression, and cognition.

1. Benefits of Video Gaming on Anxiety, Depression, and Cognition

A. Benefits of Video Gaming on Anxiety

Based on 2017 estimates, 284 million people live with anxiety disorder globally, and this number is likely to be higher now [1]. Interventions with digital technologies have been shown to improve the quality and accessibility of mental health care in high- and low-income countries [2].

Several studies demonstrated the positive effects of video gaming on reducing anxiety. Web-based video games were shown to lower anxiety levels and increase the feeling of belonging to a group in adolescent boys [3].

Another study included 59 participants diagnosed with depression and divided them into video game participants (30 participants) and non-video game participants (29 participants).

Using the STAI (State-Trait Anxiety Inventory) test which is designed to assess the anxiety of an individual from everyday situations, the researchers showed that the video gamer group had a significantly reduced severity of state and trait anxiety compared to the non-video game participants [4].

Other studies have shown that games such as MindLight (strategy game), Max and the Magic Marker (commercial video games (CVGs)), Rayman (CVG), Nintendo Wii Exergames, and RPGs, significantly prevented or reduced anxiety after or following continual play, while exergames, video games that require physical activity or movement of the body, have been shown to combat anxiety associated with COVID-19 lockdowns [5][6].

B. Benefits of Video Gaming on Depression

Based on 2017 estimates, 264 million people lived with depression globally, and this number is also likely to be higher now [1]. Several studies reported improvement in clinical cases of depression through playing games such as Candy Crush (CVG), Angry Birds (CVG), Limbo (CVG), and casual games.

These games have been shown to decrease depression by promoting enjoyment, motivation, and flow states in veterans who were treated for mental and/or behavioral health problems, and other individuals who were diagnosed with depression [7][8].

Another study assessed the effect of commercial video games (CVGs) on participants with depression. The participants were prescribed to play CVGs for one month, three times per week (with 24 hours between each session), and for 30 minutes.

The effects were measured using the PHQ-9 questionnaire which monitors the severity of depression and response to treatment. The results showed that participants who played CVGs had significantly reduced symptoms of clinical depression [9]. These observations confirm that CVGs can also alleviate clinical depression in patients.

C. Benefits of Video Gaming on Cognition

Anxiety and depression can have effects on multiple levels of cognition ranging from effects on perception to attention to learning and executive function [10][11]. Several studies have demonstrated the benefits of video gaming on cognition, and mental health [12]. The effect of video gaming on cognition is assessed using the Stroop test and the Trail-Making Test.

The Stroop test, which was first developed by Stroop in 1935 [13], assesses the response of subjects to stimuli based on characteristics other than those typical of the most relevant and more readily apparent ones. For example, naming the colors of displayed words instead of naming the words.

The Trail-Making Test (TMT) relies on drawing lines between circles that contain consecutive numbers (e.g., 1, 2, 3…etc.) to evaluate both the memory and executive function of the subjects.

The results of one of the studies investigated the effects of video gaming on cognition and showed that video gamers respond faster to the Stroop test, but make significantly more errors compared to non-video gamers.

In the Trail-Making test, video gamers had faster response times, but errors did not differ from those in non-video gamers. The study’s authors concluded that video gamers possess enhanced processing speed and task-switching ability; however, they favored speed over accuracy on the task that evaluated cognitive inhibition ability compared to non-video gamers [14].

2. Disadvantages of Video Gaming on Mental and Physical Health

Although many studies demonstrated the benefits of video gaming on anxiety, depression, and cognition, other studies also highlighted the negative effects. These effects were shown to be associated with increased violence, headaches, stress, obesity, and harm to vision (eyes).

In a study that tested the idea that violent video game exposure (VVE) influences not only the player but also the player’s social network, it was found that aggressive video games can increase aggressive behaviors and desensitization to violence which could spread among connected individuals who did not play violent video games [15].

A study included 87 participants who played a violent or nonviolent game for 20 minutes and were asked to read a stress-provoking story aloud while their voices were recorded. The researchers found that voice stress was higher among violent video game players than among nonviolent video game players [16].

The effect of video gaming on headaches was evaluated by a study that included 954 adolescents who answered a questionnaire about the use of video games, and the presence of headaches. The results showed an association between excessive use of video games and the presence of headaches, that could develop into a migraine-type [17].

Physically, the effect of video gaming can lead to obesity, especially, when playing for long hours video games that do not require physical activity or movement of the body such as exergames. Long hours of exposure to video game screens can also affect the eyes and harm the vision.

3. Frequently Asked Questions about Video Gaming Effects on Mental Health

Does playing video games make you violent?

Research shows no direct link between playing video games and increased violence. However, excessive gaming may desensitize individuals to violence in some cases.

Can video games cause addiction?

Yes, excessive gaming can lead to addiction, known as Gaming Disorder. It’s characterized by loss of control over gaming habits, prioritizing gaming over other activities, and continued gaming despite negative consequences.

Do video games contribute to anxiety and depression?

While gaming itself isn’t a direct cause, excessive gaming or using games to escape from real-life problems can exacerbate feelings of anxiety and depression. However, some games designed for relaxation or cognitive therapy can have positive mental health effects.

Are there age restrictions for video game content to protect mental health?

Many countries have age ratings systems (e.g., ESRB, PEGI) to guide parents and consumers about appropriate content for different age groups. However, individual tolerance to content varies, and parental guidance is crucial.

Can playing video games improve cognitive functions?

Some research suggests that certain types of video games, particularly those involving strategy, problem-solving, and memory, can enhance cognitive functions. However, moderation is key to avoiding negative effects on mental health.

How can I balance gaming and mental well-being?

Set limits on gaming time, prioritize real-life social interactions and activities, and be mindful of how gaming affects your mood and behavior. Taking regular breaks, engaging in physical activity, and seeking professional help if gaming interferes with daily life, are essential.

Do violent video games desensitize players to real-life violence?

There’s an ongoing debate, but some studies suggest that prolonged exposure to violent video games can desensitize individuals to violence. However, the effects vary among individuals, and other factors like upbringing and personality play a role.

Are there therapeutic benefits to playing video games?

Yes, certain games are designed for therapeutic purposes, such as reducing stress, improving mood, and enhancing cognitive skills. However, it’s essential to use them in conjunction with professional guidance for maximum benefit.

Can gaming help with social connections and loneliness?

Online gaming can facilitate social connections and provide a sense of belonging for some individuals. However, it’s important to balance virtual interactions with real-life socializing to maintain overall well-being.

How can parents support their children’s gaming habits while safeguarding their mental health?

Parents can set reasonable limits on screen time, encourage a balance of gaming with other activities, monitor content, and have open discussions about gaming habits and their impact on mental health. Additionally, being a positive role model for healthy screen use is crucial.

Conclusion

Besides exposure to violent video games that can lead to aggressive behaviors and the length of time playing video games that can damage the eyes, promote obesity, and increase headaches, video gaming appears to be beneficial in decreasing anxiety and depression, and in improving cognition in individuals.

Additionally, because of their wide availability and lower cost compared to medication-based therapies, video games can be used as an alternative therapy to traditional mental health care for some mental health issues such as anxiety and depression.