OVERCOMING DEPRESSION AND ANXIETY

____________________________________________________________________________

A scientific article discussing the science behind depression and anxiety and providing guidance and resources for those battling depression, anxiety, and stress.

Emma CarpenterRyan FinneganNimisha Jain

Anant KanungoJackson Stone

Acknowledgements and Dedication

We would like to thank our AP Biology facilitator, Mrs. Kim Wootton, for giving us the

opportunity to dedicate our time and effort to a worthy cause that takes part in guiding the betterment of healthy lifestyles of young adults.

We’d also like to acknowledge Mr. Ed Guignon for inspiring us to influence our community.

We dedicate this article and info graphic to all young adults struggling with their mental and physical health.

2

Abstract

The purpose of this document is to portray all current information on depression and anxiety without any bias with the audience of young adult readers in mind. Every year more information on brain function, as well as depression and credible research institutions publish anxiety. These publications are not always congruent which can cause confusion in the general public. Formatting these complex medical journals into easily understood sources for the public is vital to slow down the epidemic of depression and anxiety.

Table of Content

Introduction…………………..…..……..Page 4Introduction to depression, what it is, and statistics behind depression.

Brain Physiology………..…..…………..Page 4Basic anatomy of the brain and all vital parts including neurons, axons, synapses, etc.

Monoamines…………..…..…………….Page 5Discussion of the effect of chemical imbalances on monoamines and the brain overall.

Connections………..……..……………..Page 6

Connecting brain physiology, neurotransmitters, and symptoms of depression to explain why this all effects depression.

Deficiency Diseases…………..…....…….Page 7

Discusses different deficiency diseases that affect the brain.

Vitamins Chart……..……......…Page 8Minerals Chart……..…………..Page 9

Managing Anxiety and Depression…….Page 10How to live with depression. Includes recommendations for daily practices, nutrition, and lifestyle tips.

Glossary………….……………..………..Page 13Work Cited……………..………………..Page 15

Bibliography…………..……………..…..Page 16About the Authors………...……….……Page 17

3

Introduction

The ADAA (Anxiety and Depression Association of America) emphasizes that anxiety disorders are the most common mental illnesses in the U.S, impacting 40 million adults; 18% of the population. The DBSA (Depression and Bipolar Support Alliance) emphasizes that untreated depression is the number one suicide risk for young adults. The impact and number of diagnosed patients of these mental illnesses are rapidly increasing every year. And it’s not only affecting those with these mental illnesses but the rest of the American population as well. There is a direct correlation between depression and violence, according to a study conducted in Sweden by the University of Oxford. As well as a link between failure and dropout rates in school and depression, according to NAMI (National Alliance of Mental Illness) This is not only harmful to those suffering, but it’s also negatively impacting the rest of the population and our growth towards a strong future as well.

Brain Physiology

Understanding the physiology of the brain can help provide answers to the chemical imbalances in individuals affected by anxiety and depression. The brain is the spongy organ that is taken under protection by the skull. There are many different parts of the brain but they all can be split into 3 main sections: cerebrum, cerebellum, and the brain stem. Each section serves the brain in a unique way, but as of right now researchers are still uncovering new theories and studies as to how each part of the brain works.

The cerebrum is the largest part of the brain located at the top of the organ as shown in the figure. It is divided into 2 halves, the right side of the cerebrum controlling the left side of the body and vice versa. For instance if an individual was right handed, they would be left brain dominate. Additionally the cerebrum is split into 4 lobes each currently understood to control a separate part of one’s feelings and senses. The frontal lobe controls your movement, speech, behavior, memory, intellectual functions, and personality. The back lobe or occipital lobe directs your your vision. The recognition of pain, temperature, and spatial orientation is associated with the parietal lobe. On the bottom of the cerebrum is the temporal lobe that stores your emotions and memories. Although the cerebrum is split into parts, each of them are surrounded by a synapse membrane called the cerebral cortex. This area is where the nerve cells make contact with the brain in order to transfer information to your mind.

4

This is the process of oxidation on a histamine molecule. As you can see, the nitrogen is removed and oxygen is left.

The cerebellum is the second largest organ of the brain and is housed right beneath the cerebrum. Movement is one of the key functions of the cerebellum as it aids in balance, posture, and reflexes. Some people with weaker balance could be considered to have slight cases of cerebellar dysfunction. While this may not have an impact on your everyday life it can greatly decrease one's aptitude in sports.

The brainstem is the part of your brain that helps hold it into the skull while connecting nerve tissues to the spinal cord. Due to the location of the brain stem it is often the involuntary controller of your heartbeat as well as the intake of oxygen. In addition, the desire to eat and drink can be linked to connections that occur in the brain stem. The most common incidents of damage to the Brainstem occur in car accidents which often leads to comas, stupors, vegetative states or death.

Monoamines

The human brain is run by many different neurotransmitters, which are called monoamines. These are proteins that receive, control, and send out electric signals that flow through the brain to control our actions and thoughts. Some of these monoamines are serotonin, dopamine, adrenaline, noradrenaline, and histamine. The regulation of these monoamines comes from the Monoamine Oxidase Enzyme, an enzyme (A protein that stimulates a biological process, like breaking down molecules) attached to the mitochondria of brain cells (St. Edward’s University).

These enzymes break down monoamines by oxidizing the neurotransmitters, which removes the nitrogen amine groups on the ends of it and leaves oxygen on the monoamines. The monoamine oxidase enzyme exists in two different forms that are called MAO-A and MAO-B. Although the use of MAO-A is unknown, MAO-B is used to break down dopamine and serotonin. MAO-B will break down dopamine to create ammonia (A vital nutrition source for other cells) and hydrogen peroxide, which eventually gets turned into a waste. MAO-B breaks down serotonin by taking off the

5

This is a diagram of the interaction between axons, synapses, and neurotransmitters. As seen, to send electric pulses, axons release neurotransmitters into the synapses.

nitrogen in the molecule, causing a deactivation reaction which creates ammonium and an inactive molecule, essentially destroying the serotonin (St. Edward’s University).

When neurons in our body transmit electron signals, some neurotransmitters are released from the neuron's axon terminal across a synaptic gap. When they are released, they “trigger” other neuron axons neighboring the current one. After triggering the other neuron axon, they attach themselves to the axon terminal for later impulse transmissions. If an axon releases too many monoamines and not all reattached to the axon, then that would leave excess of monoamines, which would spontaneously, send transmissions. The body responds to this by releasing cells with MAO-B to break down the monoamines and get rid of the excess (St. Edward’s University).

If there were no cells with monoamines oxidase enzymes, or if they were not functioning properly, this would lead to an excess of dopamine and serotonin in the body, which would relay random signals to other axons and cause sudden changes in a subject’s thinking process, mood, and overall mental state. Because of the uncontrolled electric signals being sent out, it could even lead to mental retardation (St. Edward’s University). On the other hand, if there are too many cells with MAO-B, there would be a deficiency of serotonin and dopamine. Without these neurotransmitters to regulate smooth electron signals, neurons would fire out of control and would lead to a poor mental state.

The amount of cells with monoamine oxidase enzymes in our bodies can be regulated indirectly with the amount of organic compounds we intake. Proteins are the building blocks of enzymes and carbohydrates and a primary source of energy for cells. If we do not eat enough proteins or carbohydrates, there will be no sources to build the enzymes or not enough energy to keep the cells with the enzymes alive. This will lead to a deficiency in MAO-B, and thus a surplus in serotonin, dopamine, and other monoamines. If we intake too many proteins and carbohydrates, that will lead to an excess of cells with MAO-B, and thus a depletion of neurotransmitters, also causing a poor mental state.

Connections

Mental disorders are caused by chemical imbalances in the brain. Consuming a diet that replenishes the chemical deficiencies can aid the effects of depression and anxiety. It has been found that the average diet of Asian and American countries are lacking certain properties.

6

The brain contains neurotransmitters, such as dopamine and serotonin. Clinical studies show that the brain cannot fully function properly when it does not have an abundant amount of these neurotransmitters, creating a high risk of mood changes, and ultimately the development of depression or anxiety (U.S. National Library of Medicine).

There are ways to both prevent and reduce the symptoms of mental disorders naturally. First of all, by generally taking care of your body (sleeping for 9 hours a night, getting at least 30 minutes of exercise each day, eat the right foods in the right portions), that already puts you at advantage against any diseases in general. More specifically, there are certain foods that can be consumed that have vital components for the brain when attempting to subside depression and anxiety. According to UCLA Newsroom, Omega-3 fatty acids have been found to fight against mental disorders. In addition to this, omega-3’s support a healthy heart It has also been discovered that depression can result from a deficiency in the molecule BDNF (brain-derived neurotropic transmitter).

In order to keep the body healthy and free of depression or anxiety, one could consume a diet high in omega-3 fatty acids. This could include a variety of fish and nuts. An alternative option would be to take an omega-3 fatty acid daily vitamin, which supplies the body with the proper amount of omega-3 fatty acids, regardless of the daily food consumption.

Deficiency Diseases

The neurons in our body are cells and require not only organic compounds to function, but also vitamins and minerals to act as aids for their enzymes to break down different materials. Vitamins and minerals specifically act as keys to the enzymes in the cells to help them catalyze chemical reactions that go through nerve cells. Without vitamins or minerals, the enzymes that keep neurons alive and functioning would not be able to perform their jobs and the neurons would be destroyed or dysfunctional. Specifically, the tissue made of neurons in the brain would send or inhibit random signals from neurotransmitters, which would trigger other functions in our brain randomly and cause more damage. On page’s 8 and 9 are some of the many vitamins and minerals we need and the result of their deficiency.

Vitamin Sources Function and Deficiency Results

Thiamin Grain Products, Pork, Legumes, Nuts, Seeds, and Organ Meats

Involved in metabolising glucose, which is brain's main energy source. Deficiency can lead to Wernicke-Korsakoff Syndrome and memory loss.

7

Vitamin B-12 Foods of Animal Origin (Meat, Milk, Eggs)

Required to maintain myelin sheath, the outer coating for nerve cells. Deficiency leads to permanent nerve damage and dementia.

Folic Acid Liver, Yeast, Asparagus, Fried Beans & Peas, Wheat, Broccoli

Involved in protein metabolism and creation of amino acids. Deficiency leads to general mental health problems.

Niacin Grains, Meat, Fish Assisting mitochondria in releasing energy in body from organic compounds. Deficiency leads to pellagra.

Vitamin B-6 Chicken, Fish, Pork, Rice Involved in production of brain neurotransmitters and hormone production. Deficiency leads to fatigue, depression, and insomnia.

Vitamin E Plant Oils, Leafy Vegetables Vitamin E is used to cure Vitamin E deficiency (WebMD). Deficiency can lead to Parkinsons & Alzheimers Disease.

Vitamin A Meat, Fish, Eggs Deficiency leads to fatigue, irritability, and loss of appetite

Mineral Name Sources Function and Deficiency Results

Iron Meat, Poultry, Fish > Enriched Grains, Green Vegetables, Dried Beans/Peas/Fruit

Iron is used to create Hemoglobin which carries Oxygen throughout your body. People with Iron deficiency can get Anemia which leads to a shutoff to oxygen to the brain.

8

This can lead to fatigue and impairing mental functions.

Magnesium Green Vegetables, Whole Grains, Nuts, Seeds, and Bananas

Magnesium helps your body transmit nerve impulses and strengthen bone structure. Deficiency to Magnesium leads to restlessness, nervousness, muscular twitching, and unsteadiness.

Manganese Whole Grains, Nuts, Fruits, and Vegetables

Manganese supports carbohydrate metabolism and brain functioning. Deficiency of Manganese is rare, but can lead to abnormalities in the brain.

Copper Meats, Seafood, Nuts, Seeds, Whole Grain Breads, Cereal, and Chocolate

Copper maintains the iron metabolism in the body and in the brain. Like Iron, deficiency in Copper leads to Anemia which lowers the amount of oxygen the brain receives. Lack of Copper also impairs brain functions, the immune system, chemical receptors, and neurotransmitters.

Zinc Red Meat, Liver, Eggs, Dairy Products, Vegetables, and some Seafood

Zinc protects the body's cells by maintaining cell membranes. Zinc deficiency leads to neurological impairments, as well as changes in taste, smell, and vision.

Selenium Seafood, Liver, Grains, Seeds and Eggs

Selenium helps produce protein hormones and protection for the cell membrane. Selenium deficiency is very rare due to the low levels needed. Lack of selenium can eventually lead to nervous system damage.

Managing Anxiety and Depression

Meditation1. Find a quiet location.

9

2. Find an object to focus on. (The ceiling, a blank wall, a fan, etc.)3. Either sit or lay down, whatever feels comfortable.4. Optional Step: Turn on any music of your choice that you find soothing/calming.5. Stare at the chosen object while taking in deep breaths.6. Close your eyes and take deep breaths.7. Switch between steps 5 and 6 as you feel comfortable.

This meditating activity should take about 10-15 minutes.

Peer SupportThere are multiple support groups available for people battling the anxiety and depression. If you don’t feel comfortable leaving the house, there are multiple online support groups as well.The ADAA has a list of support groups on their website at: http://www.adaa.org/supportgroupsThey also have a list of online support groups on their website as well at:http://www.adaa.org/finding-help/getting-support/support-groups/online-phone

Muscle RelaxationDepression and Bipolar Support Alliance promotes this activity of muscle relaxation for those with anxiety who have trouble relaxing and calming down.

Follow these steps and relax your muscles after the completion of each step.

● Clench your left hand into a fist.● Flex your biceps while bending your elbows.● Wrinkle your forehead.● Close your eyes tightly.● Press your lips together tightly.● Press your tongue against the roof of your mouth.● Clench your jaw.● Suck in your stomach and hold it; then expand it by taking a deep breath to fill it with air.● Arch your back to tense it.● Press your heels into the ground to flex your thighs.● Make your calves tense by curling your toes down.● Tense your shins by bending your toes towards the top of your foot.

MedicationSertraline (Zoloft)

● Antidepressant- selective serotonin reuptake inhibitor● Used to treat depression and anxiety● Side Effects

○ Drowsiness, dizziness, tired feeling○ Mild nausea, stomach pain, upset stomach, constipation

10

○ Dry mouth○ Changes in appetite or weight○ Sleep problems (insomnia)

Fluoxetine (Prozac)● Antidepressant- selective serotonin reuptake inhibitor● Used to treat depression, anxiety and panic disorders● Side Effects

○ Sleep problems (insomnia), strange dreams○ Headache, dizziness, vision changes○ Tremors or shaking, feeling anxious or nervous○ Pain, weakness, yawning, tired feeling○ Upset stomach, loss of appetite, nausea, vomiting, diarrhea○ Dry mouth, sweating, hot flashes○ Changes in weight or appetite○ Stuffy nose, sinus pain, sore throat, flu symptoms

Create a Trigger TableKeeping a record of your thoughts and feelings during this process is extremely helpful, since it keeps records of your stress and trigger patterns. The DBSA (Depression and Bipolar Support Alliance) has created a table that can help you record such information:

Event My Reaction (Thoughts, Emotions, Actions)

What can I do?

Get ActivePhysical activity has been scientifically proven to make people feel better and happier. Exercise stimulates chemicals in your brain and releases endorphins, which are hormones that reduce the sensation of pain. Not only that, but exercise boosts your energy, while it delivers oxygen to your tissues, which relieves the feeling of fatigue for those battling depression.

Get InvolvedWhen struggling with anxiety and depression, it’s easy to get lost in negative thoughts. It’s important to have an activity of your liking that you can focus on and work on. For example, if you’re someone that likes art, coloring or painting are known stress-relievers that give you something focus on and keep you away from negative thoughts.

SleepKimberly Babson, a health science specialist, says that, “we are more likely to react emotionally to stressful situations when we are sleep deprived.” Other research as also shown has also linked sleep deprivation with anxiety and depression. Getting enough sleep is already very important to

11

everyone, especially teens as their body grows and releases hormones while they are deep in sleep.

QuizIf you think you have anxiety and/or depression and have been experiencing some symptoms, here is the link to quiz that can give you an idea of where you are.

Link: http://goo.gl/AVk7i5

*Please keep in mind that this quiz was not created by an actual doctor or scientist, it is just to give you an idea or where you are and if you maybe need to see a doctor for more information

Glossary

Organ: A part of an organism that is typically self-contained and has a specific vital function, such as the heart or liver in humans.

12

Neurotransmitters: A chemical substance that is released at the end of a nerve fiber by the arrival of a nerve impulse and, by diffusing across the synapse or junction, causes the transfer of the impulse to another nerve fiber, a muscle fiber, or some other structure.

Mitochondria: An organelle found in large numbers in most cells, in which the biochemical processes of respiration and energy production occur. It has a double membrane, the inner layer being folded inward to form layers (cristae).

Hydrogen Peroxide: A colorless, viscous, unstable liquid with strong oxidizing properties, commonly used in diluted form in disinfectants and bleaches.

Oxidizing: Combine or become combined chemically with oxygen.

Axon: The long threadlike part of a nerve cell along which impulses are conducted from the cell body to other cells.

Synaptic Gap: The minute space between the cell membrane of an axon terminal and of the target cell with which it synapses

Mental Retardation: Below average intelligence and set of life skills present before age 18.

Organic Compounds: Any member of a large class of gaseous, liquid, or solid chemical compounds whose molecules contain carbon.

Wernicke-Korsakoff Syndrome: chronic memory disorder caused by severe deficiency of thiamine.

Dementia: A chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning.

Amino Acids: A simple organic compound containing both a carboxyl (—COOH) and an amino (—NH2) group.

Pellagra: A deficiency disease caused by a lack of nicotinic acid or its precursor tryptophan in the diet. It is characterized by dermatitis, diarrhea, and mental disturbance, and is often linked to over-dependence on corn as a staple food.

Insomnia: Habitual sleeplessness; inability to sleep.

13

Parkinson’s Disease: A progressive disease of the nervous system marked by tremor, muscular rigidity, and slow, imprecise movement, chiefly affecting middle-aged and elderly people. It is associated with degeneration of the basal ganglia of the brain and a deficiency of the neurotransmitter dopamine.

Alzheimer’s Disease: A progressive disease that destroys memory and other important mental functions.

Metabolism: The chemical processes that occur within a living organism in order to maintain life.

Hormones: A regulatory substance produced in an organism and transported in tissue fluids such as blood or sap to stimulate specific cells or tissues into action.

Works Cited

(n.d.). Retrieved October 16, 2015, from http://citeseerx.ist.psu.edu/viewdoc/download?

doi=10.1.1.413.5448&rep=rep1&type=pdf

(n.d.). Retrieved October 16, 2015, from

http://www.cs.stedwards.edu/chem/Chemistry/CHEM43/CHEM43/AmineOxidases/function.htm

(n.d.). Retrieved October 16, 2015, from http://newsroom.ucla.edu/releases/scientists-learn-how-

food-affects-52668

Biogenic Amine Neurotransmitters (Section 1, Chapter 12, Part 1) Neuroscience Online: An

Electronic Textbook for the Neurosciences | Department of Neurobiology and Anatomy - The

University of Texas Medical School at Houston. (n.d.). Retrieved October 16, 2015, from

http://neuroscience.uth.tmc.edu/s1/chapter12.html

Is Depression Just a Chemical Imbalance? - Depression Treatment Program at Portland

Psychotherapy. (2011, October 9). Retrieved October 16, 2015, from

http://www.portlanddepressiontreatment.com/is-depression-just-a-chemical-imbalance/

14

Omega-3 Fatty Acids: An Essential Contribution. (n.d.). Retrieved October 16, 2015, from

http://www.hsph.harvard.edu/nutritionsource/omega-3-fats/

Omega-3 fatty acids. (n.d.). Retrieved October 16, 2015, from

http://umm.edu/health/medical/altmed/supplement/omega3-fatty-acids

Rao, T., Asha, M., Ramesh, B., & Rao, K. (n.d.). Understanding nutrition, depression and mental

illnesses. Retrieved October 16, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/

What causes depression? - Harvard Health. (n.d.). Retrieved September 25, 2015, from

http://www.health.harvard.edu/mind-and-mood/what-causes-depression

Vitamin E. (n.d.). Retrieved October 18, 2015, from

http://www.webmd.com/vitamins-supplements/ingredientmono-954-vitamine.aspx?

activeingredientid=954&activeingredientname=vitamin e

Bibliography

(n.d.). Retrieved October 16, 2015, from

http://www2.nami.org/Content/NavigationMenu/Inform_Yourself/About_Public_Policy/

Policy_Research_Institute/Policymakers_Toolkit/

A_Primer_on_Depressive,_Bipolar_and_Anxiety_Illnesses_Facts_for_Policymakers.pdf

Anatomy and physiology of the brain and spinal cord - Canadian Cancer.

(n.d.). Retrieved October 16, 2015, from

http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/anatomy-and-physiology/?

region=on

Anxiety disorders. (n.d.). Retrieved October 16, 2015, from

http://umm.edu/health/medical/reports/articles/anxiety-disorders

15

Depression (major depressive disorder). (n.d.). Retrieved October 16, 2015, from

http://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-

20046495?pg=1

Diagnosed Depression Linked to Violence. (n.d.). Retrieved October 16, 2015, from

http://www.theguardian.com/society/2015/feb/25/diagnosed-depression-linked-to-violent-says-

university-oxford-study-sweden

Facts & Statistics | Anxiety and Depression Association of America, ADAA. (n.d.). Retrieved

October 16, 2015, from http://www.adaa.org/about-adaa/press-room/facts-statistics

Hotline Information. (n.d.). Retrieved October 16, 2015, from

http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_depression

Meditation for Depression and Anxiety. (n.d.). Retrieved October 16, 2015, from

http://www.hopkinsmedicine.org/news/media/releases/meditation_for_anxiety_and_depression

Mind Matters. (n.d.). Retrieved October 16, 2015, from

https://www.psychologytoday.com/articles/200301/mind-matters

About The Authors

Nimisha Jain is currently a hard-working student who loves to learn new things and is curious about how things work. Jain likes to be involved and part of the community and for that reason, she is a part of numerous clubs and organizations, such as DECA, NT Motorsports, NT Ambassadors, Outdoor Adventure Club, Community Service, Student Reporting Labs, Red Cross, Farmers Club and much more. She currently has a psychology internship for which she

16

writes articles to be published on a psychology website. Jain also has a job tutoring kids. She loves to read, paint, film, and take pictures in her free time.

Emma Carpenter has been an avid lover of music her entire life. She began playing piano at the age of eight, picked up percussion in 6th grade, and most recently started teaching herself guitar when she was fifteen. Emma also participated in dance both in and outside of school, and was a member of the JV Silver Stars drill team for two years, her second year in which was head lieutenant. Aside from her large passion for the arts, she has been a motivated and dedicated student; she was accepted into the Gifted and Talented program in the first grade and excelled in the curriculum all throughout elementary, middle, and high school. In addition to that, she has been a member of the National Honor Society for two years. In her spare time, Emma enjoys spending time with her friends and family, and of course both listening to and performing all kinds of music on various instruments.

Anant Kanungo is a senior student, an NHS member, part of the Garden Club, and a Community Service Club Member at New Tech High @ Coppell. He is a part of the CHS Varsity Swim Team and an Eagle Scout of Troop 840 as well as the President of Venturing Crew 808. In his free time, he likes to learn about math and science, and engineer a variety of things. Anant is passionate about the study of mathematics, physics, and electrical engineering and would like to study in one of those fields.

Jackson attends New Tech High School @ Coppell as a senior. He values science and mathematics as vital to his future success as an engineer. To achieve his goals Jackson actively strives to finish above his peers in all aspects of adolescence. Participating in the Young Men’s service League, Boy Scouts, National Honor Society, and Community Service Club he has acquired over 300 hours of community service. In addition to service, Jackson spends his free time playing lacrosse, tennis, golf, and ultimate Frisbee, as well as any outdoor activity that the weather will allow. Through AP biology he hopes to better understand life, the earth, and how to preserve it.

Ryan Finnegan is currently a senior at New Tech High @ Coppell. He is a part of the school's student council organization (LLC) as well as a proud member of NHS. Ryan spends his time doing community service as well as hanging out with his friends. He is currently unsure of what major he is interested in. He would like to look into the fields of Computer Science, Aerospace Engineering, Astronomy, etc. in the near future.

17