HOW DO YOUR HORMONES WORK?

Endocrine System- regulate bodily processes, not control humans

Three features of Endocrine System:

 Glands
 Hormones
 Cell receptors

 Hormone-producing glands = 3 in brain, 7 in the body; each surrounded by blood vessels

(to extract ingredients to produce hormones)
 Hormone-receptor combination triggers range of effects (increase or decrease process)
Receptors – help hormones to locate target cells
 Thyroid and 2 hormones (triiodothyronine, thyroxine)- travel to body’s cells, influence
how quickly cells use energy (breathing rate, heartbeat)

Puberty

Men- testes secrets testosterone, development of sexual organs (facial hair, deepen
voice)

Women- ovaries secrets estrogen (hips widen, thickens womb lining)

**Misconception- there are exclusively male and female hormones

 Both have estrogen and testosterone, just in different amounts

 Hormonal change = fluctuations in mood
 Hormones influence production of serotonin (chemical in brain)
 Behavior- shaped by variety of influences (brain and neurotransmitters, hormones,
social factors)
 Disease, stress, diet can disrupt function of endocrine system

Diabetes- one of most common hormonal disorder; pancreas secrete too little insulin

Hypo and hyperthyroidism- thyroid gland makes too little or too much thyroid hormone

Too little thyroid hormone= slowed heart rate, fatigue, depression

Too much thyroid hormone= weight loss, sleeplessness, irritability

STRESS

 Stress and Memory relationship

 Short term stress impact on memory for facts

Process of Facts to Memories

 Acquisition- encounter new information

 Consolidation- by hippocampus (to be lasting memories) influenced by amygdala
(emphasizes experiences and strong emotions)
o Hippocampus encodes info
  Retrieval- prefrontal cortex (signals retrieval, for remembering, thought, attention,
reasoning)

 In the first 2 stages, moderate stress can help experiences enter memory
 Brain responds to stressful stimuli by releasing the hormone corticosteroids (activates
threat detection and response in amygdala)
 Amygdala prompts hippocampus to consolidate stress-inducing experience into a
memory
 Corticosteroids stimulates hippocampus and prompts memory consolidation
 Moderate stress (memory task) = positive effect
 Extreme and chronic stress gives opposite effect

**Rats injected with stress hormones - increase dose of corticosteroids, performance on

memory tests increased at first but dropped off at higher doses

 Sustain corticosteroids result from chronic stress damages hippocampus, decrease

ability to form new mmries
 Corticosteroids stimulate amygdala- amygdala inhibits/lessens activity of prefrontal
cortex
 Reason for inhibition is the fight-flight-freeze response can overrule slower, more
reasoned thought in dangerous situation
 Act of trying to remember is a stressor = more corticosteroid release, smaller chance of
remembering

Turn Stress to advantage:

1. Stressful situation is coming, prepare conditions similar to stressful environment

2. Exercise, increase heart and breathing rate is linked to chemical changes in brain,
reduce anxiety

3. Actual day, deep breaths to counteract flight-fight-freeze response

Deep breathing exercise reduces anxiety


Stress isn’t always a bad thing; handy for a burst of extra energy and focus
 Continuous, it actually begins to change your brain.
 Chronic stress (overwork)- affect brain size, structure and fxn
 Stress begins with hypothalamus pituitary adrenal axis- series of interactions
between endocrine glands in the brain and on kidney which controls body’s rxn to
stress
 Brain detects stressful situation, HPA axis is activated, releases cortisol – primes
body for instant action
 Chronic high level of cortisol wreak havoc in brain
 Chronic stress increases activity level and number of neural connections in
amygdala (brain’s fear center)
 Increase cortisol- electrical signal in hippocampus (learning, mmries, stress
control) deteriorate
  Hippocampus inhibits activity of HPA axis, weakens ability to control stress
 Cortisol- shrink brain size
 Too much cortisol- loss of synaptic connections between neurons, shrink prefrontal
cortex (concentration, decision making, judgement, social interxn

Fewer new brain cells being made in hippocampus

Chronic stress- hard to learn, remember things, set stage for mental problems
(depression to Alzheimer’s dse)

Effect of stress filter to brain’s DNA

Exp= amount of nurturing mother rat provides its newborn baby plays part in determining
how baby responds to stress later in life **Pups of nurturing moms are less sensitive to
stress bc brains developed more cortisol receptors

Epigenetic changes- affect which genes are expressed without changing genetic code,
changes can be reversed if moms are swapped

Epigenetic changes caused by one single mother rat were passed down to many
generations of rats after her

Reverse effect of cortisol to stressed brain (increase size of hippocampus)– exercise and
meditation

Stress- feeling when challenged or overwhelmed

-physical response that travels throughout entire body

Stress Response - designed to gives quick burst of heightened alertness and energy
needed to perform our best.
Stress is activated too long or too often- fight or flight stress response damages parts of
body

Adrenal gland- release stress hormone (cortisol, epinephrine “adrenaline”,

norepinephrine)

Hormones to bloodstream to blood vessels and heart

Adrenaline- causes heart to beat faster, raises bp, hypertension

Cortisol- causes endothelium (inner lining of blood vessels) to not function normally
**early step in Atherosclerosis

**Together, increases chance of heart attack or stroke

Brain sense stress, activates autonomic nervous system, brain communicates stress to
enteric or intestinal N.S.

Brain-gut connection- disturb natural rhythmic contractions that move food through gut
leading to irritable bowel syndrome, increasing gut sensitivity to acid, feel heartburn

Via gut’s N.S., stress changes composition and fxn of gut bacteria which affects
digestive health
Chronic stress affects waistline

Cortisol increase appetite, tells body to replenish energy stores with energy defense
foods and carbs

High level of cortisol causes extra calories as visceral or deep belly fat (organ that
releases hormones and immune system chemicals called cytokines, increasing risk to
develop chronic diseases *heart dse and insulin resistance)

Stress hormones- affect immune cells in variety of ways, initially helps fight invades and
heal after injury

Chronic stress dampen fxn of immune cells, making more susceptible to infxns and slow
healing rate

Longer life = limit chronic stress (shortened telomeres- shoelace tip ends of
chromosomes that measure cell’s age) Telomeres cap chromosomes to allow DNA to get
copied every time cell divides without damaging genetic code, shorten with cell division
*Too short telomeres, cell no longer divides, die

Chronic stress – acne, hair loss, sexual dysfunction, headaches, muscle tension,
difficulty concentrating, fatigue, irritability

Choking- despite of practice, a person fails right when it matters most

- common in sports, performance occurs under intense pressure and depends on key
moments

2 THEORIES – chocking under pressure boils down to focus

Distraction theories- performance suffers when mind is preoccupied

Mental “scratch pad” (used to temporarily store memories)- vulnerable to pressure

2004 study- math problem solving (easy vs complex) (half completed both with
nothing at stake; half completed when calm and under pressure)

Stressed performed worse on complex task

Explicit monitoring theories- how pressure can cause ppl to overanalyze task at hand

- once a skill is automatic, thinking about precise mechanics interferes with ability to do
it

- tasks done unconsciously are vulnerable to choking

Golf players (accuracy vs primed to be acutely aware of putting stroke)

Those who suddenly turned in to the precise details of own move became worse at
making accurate shots

Choking is not inevitable for everyone, some are more susceptible than others esp those
self-conscious, anxious, and afraid of being judged negatively by others

How to avoid choking:

1. Practice under stressful conditions (study on dart players, those who do not practice
under stress performed worse when anxious vs those who are accustomed to pressure)

2. Pre-performance routine (few deep breaths, repeating a cue word, rhythmic sequence
of movements)

Golfing, bowling, water polo- short rituals lead to more consistent and accurate
performance under pressure

3. External focus on the ultimate goal works better than internal focus

Golfers- hit chip shots while focused on the flight of the ball performed better than those
focused on the motion of arms

Practice, under pressure, with focus, end goal, makes perfect

RELATIONSHIP OF SLEEP DEPRIVATION WITH MENTAL ILLNESS

1965- 17 y/old HS student (Randy Gardner) stayed awake for 264 hours (11 days)

 2nd day- eyes stopped focusing, lost ability to identify objects by touch
 3rd day- moody and uncoordinated
 End of experiment- struggling to concentrate, trouble with short term memory,
became paranoid, hallucination
 Recovered without long-term psychological or physical damage

**Losing shuteye results in hormonal imbalance, illness, death

 Adults need 7-8 hrs of sleep, 10 hrs for adolescents

 Sleep-inducing chemicals: Adenosine, Melatonin
 This non-REM sleep is when DNA is repaired and body replenish for day ahead
 US – 30% of adults and 66% of adolescents are regularly sleep-deprived
 Sleeplessness affects learning, memory, mood, rxn time, cause inflammation,
hallucinations, high BP, linked to diabetes, obesity

2014- soccer fan died after staying awake for 48 hrs watching World Cup (due to stroke)

**Study shows that chronically sleeping fewer than 6 hrs a night increases stroke risk by
four and a half times

Fatal Familial Insomnia- Ppl with rare inherited genetic mutation, sleeplessness is a daily
reality, may lead to dementia and death

 Sleep deprivation cause immense suffering= accumulation of waste products in the

brain
 Waking hrs- cells use energy which breaks down (adenosine) adenosine buildup
increases urge to sleep “sleep pressure”

Glymphatic system- clean-up mechanism that removes buildup, more active when asleep
- uses CSF to flush away toxic byproducts
Lymphatic vessels- pathway for immune cells, also helps on clearing out waste products

Insomnia- or sleep deprivation, world’s most common sleep disorder

- chemical mechanism similar to anxiety attacks, and depression

 Long term conditions (respiratory disorders, etc) overpowers fatigue

 Insomniacs are stressed, brains hijack the stress response system, flooding the body
with fight-flight-freeze chemicals
 Cortisol and adrenocorticotropic hormones course through bloodstream, increasing
heart rate and bp, jolting the body into hyperarousal (brain is hunting for potential
threats)

Cerebral glucose- brain’s primary source of energy

Healthy sleep- metabolism slows to conserve glucose for waking hours

Positron Emission Tomography (PET)- show the adrenaline that prevents sleep for
insomniacs also speeds up metabolism

 While asleep, brain’s supply of energy giving glucose is drained

 Waking in state of exhaustion, confusion, and stress

Chronic insomnia- Cycles of stress last several months

Ways to Break Cycle of Sleeplessness:

- manage stress that leads to hyperarousal

- dark and comfortable bedroom to minimize threats

- if restless, leave the room and do activities

- regulate metabolism by setting consistent resting and waking times to help biological
clock

Circadian Rhythm ‘biological clock’- sensitive to light

- medications- no reliable med that helps, OTC sleeping pills are addictive

 8% of patients diagnosed with chronic insomnia suffers from genetic prob “Delayed
sleep phase disorder (DSPD) – circadian rhythm longer than 24 hrs

PSYCHOLOGOCAL CONDITIONS

Depression- mental illness; leading cause of disability in the world

- lingers for at least two consecutive weeks

- Depression not equal to feeling depressed

US- 10% of adults has depression

Symptoms:
  Low mood
 Lost of interest in things
 Changes in appetite
 Feeling worthless or excessively guilty
 Too much or little sleep
 Poor concentration
 Restlessness or slowness
 Loss of energy
 Recurrent thoughts of suicide

**At least 5 of the symptoms = qualified for diagnosis of depression

Physical manifestations inside the brain:

X-ray vision: Smaller frontal lobes and hippocampal volumes

Microscale: abnormal transmission or depletion of neurotransmitters (serotonin,

norepinephrine, dopamine)

blunted circadian rhythms or changes in REM and slow-wave parts of sleep

cycle

hormone abnormalities (high cortisol and deregulation of thyroid hormones)

**Cause of depression not fully understood

- connected with complex interaction between genes and environment

National Institute of Mental Health- it takes the average person with a mental illness
over ten yrs to ask for help

Treatments:

 Medication and therapy boost brain chemicals

 In extreme cases, ECT (controlled seizure in brain)
 Transcranial magnetic stimulation

**Asking someone about suicidal thoughts reduces their suicide risk

**Open conversation about mental illness help erode stigma, makes it easier for ppl to
ask for help

Bipolar Disorder

 Bipolar- two extremes

 Life is split between 2 different realities- Elation and Depression

Manic episodes- extreme highs; feeling irritable to invincible; euphoric episodes exceed
ordinary feelings of joy

Symptoms: racing thoughts, sleeplessness, rapid speech, impulsive actions and

risky behaviors
 Without treatment: frequent episodes, intense, longer to subside

Depressed phase of bipolar disorder

 Low mood
 Dwindling interest in hobbies
 Changes in appetite
 Feeling worthless or excessively guilty
 Too much or little sleep
 Restlessness or slowness
 Recurrent thoughts of suicide

**1-3% of adults worldwide experience broad range of symptoms that indicate bipolar
disorder

**most are contributing members of society

Consequences: Undermine educational and professional performance, relationships,

financial security and personal safety

Causes of BD: Brain’s intricate wiring

Magnetic Resonance Imaging (MRI)- brain’s pruning ability is disrupted in ppl with BP;
neurons go haywire and create a network impossible to navigate, develop abnormal
thoughts and behavior

Psychotic symptoms: disorganized speech and behavior, delusional thoughts, paranoia,

hallucinations

- attributed to overabundance of neurotransmitter ‘dopamine’

Amygdala- thinking, long term memory, emotional processing

- factors as varied as genetics and social trauma create abnormalities, trigger

BD

**BD run in families, genetics

- likelihood of developing BD is driven by interactions of many genes

**BD is controllable

- medication ‘lithium’ helps manage risky thoughts and behavior by stabilizing moods;
works by decreasing abnormal activity in the brain, strengthening viable neural
connections

- other medications ‘antipsychotics’ alter effect of dopamine, and ‘ECT’ as emergency

treatment

**Some reject treatment, afraid it will dim their emotions & destroy creativity

**Doctors work on case-by-case basis to administer treatment and therapies

**Changes like regular exercise, good sleep habits, sobriety from drugs and alcohol
Post-Traumatic Stress Disorder (PTSD)

- trauma that lingers, causing symptoms like flashbacks, nightmares, and negative
thoughts

- not a personal failing; a treatable malfunction of certain biological mechanisms that

allow ppl to cope with dangerous experiences

 Ordeals (rape, death) brings feeling of danger and helplessness, activates brain’s
alarm system aka “fight-flight-freeze” response

When activated, the hypothalamic, pituitary and adrenal systems (HPA axis) sends signal
to parasympathetic nervous system – network that communicates with adrenal glands
and internal organs to regulate fxn like heart rate, digestion and respiration

 Signals starts chemical cascade, floods body with different stress hormones
causing physiological changes that prepares body to defend
 Heart rate speed up, breathing, and muscle tense
 Escalated levels of stress hormones lasts for days, jittery feelings, nightmares
(disappear few days to two weeks, as hormone levels stabilize)
 Some have persistent problems, sometimes vanishing temporarily and resurface
months later
 Stress hormone “cortisol” activates “fight-flight-freeze” response while reducing
brain functioning

SYMPTOMS:

 Intrusive thoughts: dreams, flashbacks

 Avoiding reminders of trauma
 Negative thoughts and feelings: fear, anger, guilt
 Reactive symptoms: irritability and difficulty sleeping

**When problems last more than a month, PTSD is diagnosed

Genetics, ongoing stress, and other risk factors like preexisting mental illness or lack of
emotional support play a role in determining who will experience PSTD

**Cause is still unknown

Major challenge in coping with PTSD: sensitivity to triggers, physical and emotional
stimuli that brain associates with original trauma

**Trying to avoid the triggers (unpredictable) can lead to isolation

**First, evaluation with mental health professional

 Psychotherapy helps patient understand triggers

 Medication helps PTSD to be manageable, as well as self-care practices,
mindfulness, regular exercise

**PTSD “the hidden wound” comes without outward physical signs

Schizophrenia

 first identified more than a century ago, but we still don’t know its exact causes
 one of the most misunderstood and stigmatized illnesses today
 a syndrome, may encompass number of related disorders that have similar
symptoms but varying causes
 slightly different symptoms, first signs easy to miss (subtle personality changes,
irritability, gradual encroachment of unusual thoughts)
 Patients usually diagnosed after onset of psychosis (occurs in late teens or early
twenties for men; late twenties or early thirties for women)

 First psychotic episode (delusions, hallucinations, disordered speech and behavior)

= Positive symptoms – occur in ppl with schi but not in general pop
 Misperception: ppl with schi have multiple personalities, symptoms indicate
disruption of thought processes rather than other personality
 Negative symptoms- qualities reduced in ppl with schi

- motivation, expression of emotion, or speech

- Cognitive symptoms- difficulty concentrating, remembering info, making decision

Cause of onset of psychosis: genetic and environmental risk factors

Genetic

o strongest genetic links of any psychiatric illness

o 1% of ppl with schi, children or sibling with schi are 10X likely to develop schi
o identical twin with schi- 40% of being affected
o relatives with schi experience milder version

Environmental

o exposure to certain viruses in early infancy

o drug use (marijuana)
o **Very low genetic risk, no amount of exposure to environmental risk factors will
lead to schi
o **Very high genetic risk, moderate additional environmental risk might tip the
balance

 Traditional antipsychotic block dopamine receptors – effective in reducing positive

symptoms, linked in excess dopamine
 Same drugs make negative symptoms worse, negative symptoms are tied to too
little dopamine in other brain areas
 Schi- loss of neural tissue
 New gen. of antipsychotics targets multiple neurotransmitters like serotonin in
addition to dopamine
 Antipsychotic + Cognitive-behavioral therapy or ECT = effective
 Untreated psychosis can embed in personality
  Ppl with schi are seen as dangerous, but they are victims of violence

Obsessive Compulsive Disorder (OCD)

- serious psychiatric condition frequently misunderstood by society and mental health

professionals alike

- neurobiological disorder, OCD sufferers brains are hardwired to behave in a certain

fashion

- Orbitofrontal cortex (complex cognitive planning, social behavior)

- Caudate nucleus (voluntary movement)

- Cingulate gyrus (emotional and motivational responses)

- OCD associated with low serotonin level

MYTHS

1. Repetitive or ritualistic behaviors are synonymous with OCD

2 aspects of OCD

- Obsession – intrusive thoughts, images, impulses

- Compulsion – relieve anxiety the obsessions cause

*ppl with OCD- little or no control over obsessive thoughts and compulsive behavior

2. Main symptom of OCD is excessive hand washing

 Obsession can manifest as fears of contamination and illness, worries about

harming others, preoccupation with numbers, patterns, morality, or sexual identity
 Compulsion ranges from excessive cleaning or double checking, to fastidious
arrangements of objects or walking in predetermined patterns

3. Individuals with OCD don’t understand that they are acting irrationally

 Ppl with OCD actually understand relationship between obsession and compulsion
 OCD sufferers report feeling crazy for experiencing anxiety based on irrational
thoughts and difficulty in controlling responses

TREATMENTS

 Medication- increase serotonin in brain by limiting reabsorption by brain cells

 Behavioral therapy- desensitizes patients to their enxiety
 ECT, surgery
PROCEDURES IN DIAGNOSING/TREATING PSYCHIATRIC PATIENTS

Inkblots – 20th century; Swiss psychiatrist Hermann Rorschach

Rorschach Test- less about specific things seen, more on general approach to perception

**Developed a system to code responses, reducing wide range of interpretations

Kinds of Test Takers:

 Creative and imaginative

 Detail oriented
 Big-picture perceivers
 Flexible

Findings:

 Healthy subjects with same personalities have similar approaches

 Same mental illness, same approach

1921- Rorschach published coding system and ten blots

1960’s- test administered millions of times in US

**Rorschach died less than a year after publishing the test

 Researchers gave test to Nazi war criminals (reason for mass murder)
 Anthropologist gave test to remote communities (universal personality test)
 Employers on hiring decision
 Test left clinics, entered popular culture, blots fall out of clinical use
 2013 review of all Rorschach research, test yield valid results, can diagnose
mental illness

Electroconvulsive therapy (ECT)

1982 - young nurse suffered from severe depression.

- After two courses of ECT, her symptoms lifted

1195- more than a decade after first course of ECT, she published an account of her
experience

ECT

- carried a deep stigma

- first used in medicine in 1938

- early years, strong electrical current to brain, causing whole body seizure (bite tongue,
break bones)

Modern ECT

- patient is under general anesthesia

 - electrodes deliver a series of mild electrical pulses to the brain causing neurons
to fire in unison, a brief controlled seizure

- muscle relaxant keeps spasms from spreading to rest of the body

- physical indication of electricity flooding the brain: twitching foot

- 1 minute treatment, 1 hour of normal activities after each session

- Commonly used to treat severe cases of major depression or bipolar disorder

- In patients who haven’t responded to other therapies, or who had adverse rxn to meds

- 2 or 3 sessions per week for several weeks

- Less frequent treatment for several months to a year, some needs maintenance
sessions

Side effects of Modern ECT

- Achy, fatigued, nauseated right after treatment

- Trouble remembering what happened before session (rare- weeks/months before)

**Cannot be explained how ECT works

 Neurons communicate via electrical signals which influence brain chemistry, mood
and behavior
 Flood of electrical activity sparked by ECT alters the chemistry
 ECT triggers the release of neurotransmitters (molecules that help carry signals
between neurons and influence mental health)
 ECT stimulates the flow of hormones that may help reduce symptoms of
depression
 ECT maintenance works better together with medication, even to those resistant
to medication