Diseases of the Nervous System Mini-Review


It​ ​is​ ​clear​ ​socially,​ ​academically,​ ​and​ ​financially​ ​that​ ​today’s​ ​generation​ ​has​ ​an​ ​increased​ ​number of​ ​individuals​ ​with​ ​stress​ ​than​ ​previous​ ​generations.​ ​Most​ ​of​ ​this​ ​stress​ ​falls​ ​under​ ​chronic​ ​stress which​ ​interferes​ ​with​ ​people’s​ ​ability​ ​to​ ​function​ ​normally​ ​long​ ​term.​ ​The​ ​highest​ ​stress​ ​level​ ​is currently​ ​found​ ​in​ ​millennials​ ​born​ ​from​ ​1984-1999,​ ​aged​ ​18-33​ ​years​ ​old​ ​with​ ​an​ ​even​ ​higher concentration​ ​in​ ​college​ ​students.​ ​Common​ ​symptoms​ ​that​ ​occur​ ​are​ ​mood​ ​swings,​ ​lack​ ​of​ ​or excessive​ ​amounts​ ​of​ ​sleep,​ ​drug​ ​or​ ​alcohol​ ​abuse,​ ​social​ ​withdrawal,​ ​lack​ ​of​ ​motivation, anxiety,​ ​and​ ​feeling​ ​overwhelmed.​ ​However,​ ​at​ ​what​ ​point​ ​does​ ​it​ ​stop​ ​being​ ​college/young​ ​adult stress​ ​factors​ ​and​ ​actually​ ​becomes​ ​a​ ​mental​ ​challenge​ ​that​ ​gets​ ​in​ ​the​ ​way​ ​of​ ​daily​ ​activities. The​ ​symptoms​ ​typically​ ​used​ ​to​ ​describe​ ​depression​ ​include​ ​all​ ​of​ ​the​ ​ones​ ​previously​ ​mentioned from​ ​stress,​ ​however​ ​at​ ​a​ ​more​ ​profound​ ​emotional​ ​state​ ​and​ ​includes​ ​anhedonia,​ ​the​ ​lack​ ​of anything​ ​pleasurable,​ ​and​ ​also​ ​when​ ​an​ ​individual​ ​seems​ ​capable​ ​of​ ​harming​ ​themself​ ​or​ ​others. It​ ​is​ ​often​ ​common​ ​for​ ​individuals​ ​in​ ​high​ ​demand​ ​jobs​ ​or​ ​those​ ​with​ ​pressure​ ​in​ ​daily​ ​tasks​ ​and assignments​ ​to​ ​brush​ ​off​ ​serious​ ​symptoms​ ​in​ ​behavior​ ​and​ ​just​ ​call​ ​it​ ​stress​ ​in​ ​fear​ ​of​ ​seeing​ ​a mental​ ​health​ ​professional​ ​because​ ​of​ ​lack​ ​of​ ​time​ ​or​ ​being​ ​accustomed​ ​to​ ​their​ ​concerns​ ​being trivialized​ ​by​ ​others.​ ​A​ ​social​ ​initiative​ ​to​ ​be​ ​properly​ ​trained​ ​in​ ​recognizing​ ​factors​ ​across students,​ ​faculty,​ ​instructors,​ ​bosses,​ ​and​ ​friendly​ ​strangers​ ​can​ ​help​ ​give​ ​the​ ​individual​ ​support and​ ​to​ ​not​ ​fear​ ​asking​ ​for​ ​help​ ​when​ ​it​ ​is​ ​necessary.​ ​This​ ​review​ ​will​ ​focus​ ​on​ ​finding​ ​if​ ​there​ ​is​ ​a correlation​ ​between​ ​stress​ ​and​ ​depression,​ ​as​ ​well​ ​as​ ​what​ ​differentiates​ ​them​ ​and​ ​how​ ​further research​ ​can​ ​help​ ​find​ ​ways​ ​to​ ​lessen​ ​the​ ​amount​ ​of​ ​stress​ ​or​ ​depression​ ​in​ ​individuals​ ​and​ ​how to​ ​combat​ ​it.

What​ ​is​ ​depression?

Depression​ ​has​ ​been​ ​mentioned​ ​in​ ​literature​ ​since​ ​the​ ​pre-Hippocrates​ ​era.​ ​Greek​ ​mythology recognized​ ​mania​ ​and​ ​melancholy​ ​as​ ​abnormal​ ​mood​ ​states.​ ​Aretaeus​ ​of​ ​Cappadocia,​ ​a​ ​medical scholar​ ​from​ ​the​ ​first​ ​century​ ​A.D.,​ ​described​ ​the​ ​commonality​ ​between​ ​melancholia​ ​as​ ​the beginning​ ​of​ ​mania​ ​and​ ​the​ ​two​ ​as​ ​counterparts.​ ​A​ ​Persian​ ​physician​ ​in​ ​the​ ​eleventh​ ​century described​ ​symptoms​ ​that​ ​included​ ​anxiety,​ ​phobias,​ ​and​ ​suspicions​ ​of​ ​other​ ​systems.​ ​Emil Kraepelin​ ​in​ ​1896​ ​made​ ​the​ ​key​ ​distinction​ ​in​ ​defining​ ​depression​ ​from​ ​schizophrenia​ ​as​ ​having manic​ ​and​ ​depressed​ ​phases​ ​however,​ ​without​ ​any​ ​intellectual​ ​deterioration.​ ​Freud​ ​declared​ ​a connection​ ​between​ ​melancholia​ ​and​ ​mourning​ ​or​ ​grief​ ​in​ ​1917.​ ​In​ ​the​ ​mid​ ​1970s,​ ​the​ ​possibility of​ ​depression​ ​occurring​ ​due​ ​to​ ​a​ ​chemical​ ​imbalance​ ​in​ ​neurotransmitters​ ​of​ ​the​ ​brain​ ​came​ ​to light​ ​and​ ​was​ ​called​ ​major​ ​depressive​ ​disorder.​ ​Today,​ ​15​ ​million​ ​Americans​ ​a​ ​year​ ​struggle​ ​with depression​ ​by​ ​itself​ ​and​ ​along​ ​with​ ​other​ ​mental​ ​and​ ​physical​ ​health​ ​concerns​ ​that​ ​affect​ ​bodily functions​ ​such​ ​as​ ​disruption​ ​of​ ​sleep,​ ​appetite,​ ​and​ ​weight.​ ​While​ ​there​ ​is​ ​no​ ​distinct​ ​cure, depression​ ​is​ ​highly​ ​treatable,​ ​even​ ​and​ ​especially​ ​if​ ​it​ ​is​ ​focused​ ​in​ ​treating​ ​according​ ​to​ ​each individual.

Depression​ ​however,​ ​is​ ​not​ ​the​ ​same​ ​as​ ​sadness​ ​or​ ​unhappiness.​ ​It​ ​includes​ ​an​ ​extended period​ ​of​ ​time​ ​in​ ​a​ ​profound​ ​emotional​ ​state​ ​of​ ​feelings​ ​such​ ​as​ ​worthlessness,​ ​desperation,​ ​and hopelessness​ ​to​ ​the​ ​point​ ​where​ ​one​ ​loses​ ​libido​ ​and​ ​energy​ ​and​ ​has​ ​suicidal​ ​or​ ​harmful​ ​thoughts. Different​ ​forms​ ​of​ ​depression​ ​can​ ​be​ ​broken​ ​down​ ​into​ ​subcategories​ ​such​ ​as​ ​grieving,​ ​secondary depression,​ ​clinical​ ​depression​ ​and​ ​bipolar​ ​depression,​ ​as​ ​organized​ ​by​ ​Harold​ ​Sontheimer. Grieving​ ​differs​ ​since​ ​it​ ​typically​ ​lasts​ ​up​ ​to​ ​12​ ​weeks​ ​after​ ​losing​ ​a​ ​loved​ ​one​ ​or​ ​dealing​ ​with life​ ​struggles​ ​such​ ​as​ ​being​ ​laid​ ​off​ ​or​ ​financial​ ​struggles​ ​where​ ​daily​ ​motivation​ ​is​ ​hard​ ​to​ ​come by.​ ​Secondary​ ​depression​ ​is​ ​associated​ ​with​ ​the​ ​difficulty​ ​in​ ​dealing​ ​with​ ​illness​ ​where treatments​ ​or​ ​solutions​ ​are​ ​uncertain.​ ​Clinical​ ​depression​ ​tends​ ​to​ ​occur​ ​in​ ​young​ ​adults​ ​but​ ​is twice​ ​as​ ​common​ ​in​ ​women​ ​as​ ​it​ ​is​ ​in​ ​men​ ​and​ ​has​ ​a​ ​direct​ ​correlation​ ​as​ ​age​ ​increases.​ ​Bipolar depression​ ​includes​ ​unexplained​ ​mood​ ​swings​ ​that​ ​can​ ​vary​ ​between​ ​euphoria​ ​and​ ​depression. Individuals​ ​can​ ​have​ ​states​ ​of​ ​severe​ ​mania​ ​with​ ​paranoia​ ​and​ ​delusions​ ​or​ ​be​ ​in​ ​a​ ​manic​ ​state​ ​or high​ ​states​ ​of​ ​enthusiasm,​ ​expectations​ ​and​ ​energy.​ ​It​ ​is​ ​the​ ​leading​ ​disability​ ​for​ ​young​ ​adults from​ ​the​ ​ages​ ​of​ ​20​ ​to​ ​30​ ​and​ ​affects​ ​males​ ​and​ ​females​ ​equally.​ ​It​ ​is​ ​also​ ​believed​ ​that​ ​higher depression​ ​rates​ ​in​ ​this​ ​age​ ​group​ ​could​ ​be​ ​an​ ​underlying​ ​factor​ ​explaining​ ​higher​ ​rates​ ​of substance​ ​abuse​ ​of​ ​recreational​ ​drugs,​ ​alcohol​ ​and​ ​smoking.​ ​Individuals​ ​often​ ​experience changes​ ​in​ ​cognitive​ ​function​ ​which​ ​in​ ​turn​ ​affects​ ​cognitive​ ​performance​ ​in​ ​executive​ ​functions, attention,​ ​memory,​ ​and​ ​psychomotor​ ​speed​ ​(Hammar​ ​&​ ​Årdal,​ ​2009).

On​ ​the​ ​molecular​ ​level,​ ​depression​ ​has​ ​been​ ​associated​ ​with​ ​region​ ​specific​ ​neuronal​ ​cell loss​ ​and​ ​retraction​ ​of​ ​dendrites​ ​which​ ​causes​ ​changes​ ​in​ ​synaptic​ ​activity.​ ​This​ ​has​ ​been​ ​seen​ ​in the​ ​effect​ ​of​ ​antidepressant​ ​drugs​ ​in​ ​imaging​ ​studies.​ ​The​ ​neural​ ​circuits​ ​that​ ​are​ ​primarily affected​ ​in​ ​the​ ​brain​ ​include​ ​the​ ​prefrontal​ ​cortex,​ ​the​ ​hippocampus,​ ​and​ ​the​ ​limbic​ ​system​ ​and its​ ​structures​ ​including​ ​the​ ​ventral​ ​tegmental​ ​area,​ ​nucleus​ ​accumbens,​ ​locus​ ​coeruleus, thalamus,​ ​hippocampus,​ ​and​ ​amygdala.​ ​There​ ​are​ ​all​ ​structures​ ​known​ ​to​ ​affect​ ​and​ ​regulate emotions,​ ​reward​ ​feelings,​ ​motivation​ ​and​ ​executive​ ​functions.​ ​Patients​ ​with​ ​chronic​ ​depression have​ ​shown​ ​enhanced​ ​activity​ ​of​ ​the​ ​amygdala,​ ​decreased​ ​gray​ ​matter​ ​volume​ ​in​ ​the​ ​prefrontal cortex​ ​and​ ​hippocampus​ ​​​which​ ​also​ ​leads​ ​to​ ​a​ ​reduction​ ​in​ ​size​ ​of​ ​pyramidal​ ​neurons​ ​and​ ​a​ ​loss of​ ​GABAergic​ ​interneurons​ ​as​ ​well​ ​as​ ​a​ ​decline​ ​of​ ​astrocytes​ ​and​ ​oligodendrocytes​ ​in​ ​the prefrontal​ ​cortex.​ ​Antidepressant​ ​drugs​ ​prescribed​ ​today​ ​focus​ ​on​ ​changing​ ​the​ ​concentration​ ​of monoamines​ ​in​ ​the​ ​brain​ ​and​ ​balancing​ ​the​ ​connectivity​ ​of​ ​neural​ ​circuits​ ​and​ ​their​ ​signaling cascades​ ​in​ ​the​ ​networks​ ​of​ ​emotion​ ​as​ ​shown​ ​in​ ​Figure​ ​1.​ ​The​ ​blockage​ ​of​ ​serotonin​ ​reuptake causes​ ​the​ ​activation​ ​of​ ​G-protein-coupled​ ​receptors​ ​leading​ ​to​ ​enhanced​ ​cAMP​ ​signaling​ ​which leads​ ​to​ ​transcriptional​ ​changes​ ​in​ ​the​ ​cAMP-protein​ ​kinase​ ​response​ ​element​ ​binding​ ​pathway also​ ​known​ ​as​ ​the​ ​CREB​ ​pathway.​ ​This​ ​pathway​ ​is​ ​responsible​ ​for​ ​increasing​ ​or​ ​decreasing​ ​the transcription​ ​of​ ​downstream​ ​genes.​ ​A​ ​number​ ​of​ ​genes​ ​including​ ​neurotrophic​ ​factors​ ​such​ ​as BDNF​ ​(brain​ ​derived​ ​neurotrophic​ ​factors)​ ​are​ ​transcribed.​ ​Chronic​ ​treatments​ ​of​ ​antidepressant medication​ ​increase​ ​BDNF-mediated​ ​signaling​ ​because​ ​BDNF​ ​transcription​ ​and​ ​signaling​ ​in​ ​the hippocampus​ ​has​ ​been​ ​shown​ ​to​ ​be​ ​reduced​ ​in​ ​patients​ ​with​ ​stress​ ​and​ ​in​ ​post-mortem hippocampus​ ​of​ ​humans​ ​with​ ​depression​ ​(Krishnan​ ​&​ ​Nestler,​ ​2008).​ ​Understanding​ ​the molecular​ ​pathways​ ​of​ ​depression​ ​is​ ​a​ ​continuous​ ​process​ ​with​ ​tremendous​ ​amount​ ​of information​ ​still​ ​unknown.

Figure​ ​1:

A​ ​greater​ ​lifetime​ ​risk​ ​of​ ​mood​ ​disorders​ ​has​ ​been​ ​reported​ ​as​ ​well​ ​as​ ​an​ ​increase​ ​in​ ​each successive​ ​generation.​ ​In​ ​longitudinal​ ​studies​ ​done​ ​by​ ​Compton​ ​et​ ​al.,​ ​the​ ​prevalence​ ​of depression​ ​in​ ​U.S.​ ​adults​ ​rose​ ​from​ ​3.33%​ ​to​ ​7.06%​ ​between​ ​1991-2​ ​and​ ​2001-2.​ ​In​ ​college students​ ​and​ ​young​ ​adults,​ ​it​ ​was​ ​found​ ​that​ ​their​ ​psychopathology​ ​score​ ​on​ ​the​ ​clinical depression​ ​scale​ ​in​ ​2007​ ​compared​ ​to​ ​1938​ ​was​ ​6-8​ ​times​ ​more​ ​likely​ ​to​ ​meet​ ​the​ ​cutoff.​ ​In​ ​a Swedish​ ​population​ ​study​ ​1947,​ ​1957,​ ​and​ ​1972,​ ​researchers​ ​observed​ ​the​ ​increased​ ​risk​ ​of depression​ ​for​ ​all​ ​age​ ​groups​ ​however,​ ​young​ ​adults​ ​exhibited​ ​a​ ​tenfold​ ​increased​ ​risk​ ​from​ ​1957 to​ ​1972​ ​(Compton​ ​et​ ​al,​ ​2006).​ ​The​ ​rise​ ​in​ ​depression​ ​amongst​ ​individuals​ ​has​ ​been​ ​credited​ ​to the​ ​changes​ ​in​ ​diagnosis​ ​criteria​ ​that​ ​fail​ ​to​ ​include​ ​and​ ​recognize​ ​the​ ​variation​ ​of​ ​symptoms​ ​to classify​ ​the​ ​normal​ ​response​ ​of​ ​sadness​ ​as​ ​a​ ​mental​ ​disorder​ ​(Hidaka,​ ​2012).​ ​However,​ ​it​ ​can also​ ​be​ ​attributed​ ​to​ ​change​ ​in​ ​societal​ ​concepts​ ​and​ ​culture​ ​that​ ​the​ ​youth​ ​face​ ​when​ ​growing​ ​up and​ ​learn​ ​to​ ​yearn​ ​for​ ​a​ ​feeling​ ​of​ ​acceptance​ ​or​ ​of​ ​fitting​ ​in​ ​throughout​ ​social​ ​media​ ​platforms, in​ ​friend​ ​groups,​ ​or​ ​within​ ​their​ ​family​ ​and​ ​community.​ ​An​ ​increase​ ​in​ ​alcohol​ ​and​ ​drug​ ​usage found​ ​more​ ​commonly​ ​in​ ​young​ ​adults​ ​may​ ​​​also​ ​be​ ​a​ ​factor​ ​as​ ​to​ ​higher​ ​depression​ ​rates amongst​ ​this​ ​age​ ​group.​ ​“Anxiety​ ​in​ ​children​ ​and​ ​college​ ​students​ ​has​ ​increased​ ​almost​ ​one standard​ ​deviation​ ​from​ ​the​ ​1950’s​ ​to​ ​the​ ​1990’s”​ ​(Twenge,​ ​2000).​ ​A​ ​direct​ ​correlation​ ​amongst developed​ ​countries​ ​and​ ​the​ ​prevalence​ ​of​ ​psychiatric​ ​disorders​ ​has​ ​been​ ​observed​ ​as​ ​urban citizens​ ​have​ ​higher​ ​mood​ ​and​ ​anxiety​ ​disorders​ ​compared​ ​to​ ​rural​ ​citizens.​ ​Since​ ​young​ ​adults and​ ​college​ ​students​ ​are​ ​at​ ​the​ ​forefront​ ​of​ ​modernization​ ​in​ ​lifestyle,​ ​social​ ​networks,​ ​media​ ​and more,​ ​a​ ​higher​ ​depression​ ​prevalence​ ​and​ ​risk​ ​can​ ​be​ ​associated.​ ​Along​ ​with​ ​modernization, western​ ​culture​ ​has​ ​gained​ ​the​ ​reputation​ ​for​ ​not​ ​being​ ​as​ ​health​ ​conscious​ ​in​ ​terms​ ​of​ ​nutrition and​ ​physical​ ​health​ ​and​ ​fitness.​ ​A​ ​poor​ ​diet​ ​with​ ​low​ ​levels​ ​of​ ​physical​ ​activity​ ​and​ ​distractions that​ ​lead​ ​to​ ​more​ ​time​ ​inside​ ​and​ ​less​ ​sleep​ ​can​ ​all​ ​lead​ ​to​ ​the​ ​imbalance​ ​of​ ​body​ ​functions related​ ​to​ ​the​ ​endocrine​ ​and​ ​nervous​ ​system.​ ​It​ ​is​ ​commonly​ ​known​ ​that​ ​most​ ​young​ ​adults​ ​and especially​ ​college​ ​students​ ​lack​ ​proper​ ​nutrition​ ​as​ ​they​ ​are​ ​now​ ​responsible​ ​in​ ​providing​ ​their own​ ​meals​ ​and​ ​also​ ​rarely​ ​reach​ ​the​ ​recommended​ ​hours​ ​of​ ​sleep​ ​for​ ​their​ ​age​ ​range.​ ​The​ ​higher the​ ​level​ ​of​ ​stress​ ​the​ ​body​ ​faces,​ ​the​ ​higher​ ​its​ ​successability​ ​to​ ​depression​ ​(Wood​ ​&​ ​Bhatnagar, 2014).​ ​There​ ​is​ ​a​ ​difference​ ​with​ ​clinical​ ​depression​ ​and​ ​the​ ​large​ ​amounts​ ​of​ ​stress​ ​that​ ​can​ ​be obtained​ ​from​ ​jobs​ ​and​ ​school​ ​that​ ​leads​ ​to​ ​similar​ ​symptoms,​ ​however​ ​detecting​ ​the​ ​difference is​ ​the​ ​main​ ​concern​ ​of​ ​this​ ​review.

What​ ​is​ ​stress?
Stress​ ​is​ ​the​ ​body’s​ ​natural​ ​response​ ​to​ ​a​ ​pressure​ ​or​ ​threat.​ ​In​ ​small​ ​amounts​ ​it​ ​can​ ​be motivational,​ ​especially​ ​in​ ​the​ ​work​ ​environment​ ​as​ ​it​ ​keeps​ ​individuals​ ​alert,​ ​focused​ ​and energetic.​ ​However,​ ​in​ ​large​ ​amounts,​ ​it​ ​becomes​ ​easier​ ​for​ ​the​ ​body​ ​to​ ​be​ ​in​ ​a​ ​continuous heightened​ ​state​ ​of​ ​stress​ ​that​ ​can​ ​lead​ ​to​ ​health​ ​problems.​ ​As​ ​an​ ​individual’s​ ​age​ ​increases, stress​ ​commonly​ ​accumulates​ ​in​ ​a​ ​direct​ ​correlation​ ​as​ ​more​ ​responsibilities​ ​are​ ​assigned​ ​to​ ​the individual.​ ​It​ ​is​ ​mostly​ ​done​ ​at​ ​a​ ​manageable​ ​rate​ ​where​ ​the​ ​individual​ ​accustoms​ ​to​ ​the increasing​ ​amount​ ​and​ ​is​ ​not​ ​fully​ ​aware​ ​as​ ​to​ ​the​ ​levels​ ​of​ ​stress​ ​they​ ​endure​ ​until​ ​it​ ​begins​ ​to take​ ​a​ ​noticeable​ ​toll.​ ​This​ ​toll​ ​affects​ ​and​ ​suppress​ ​the​ ​immune​ ​system,​ ​digestive​ ​and reproductive​ ​system​ ​as​ ​well​ ​as​ ​circadian​ ​rhythms,​ ​it​ ​increases​ ​the​ ​risk​ ​of​ ​heart​ ​attacks​ ​and​ ​speeds up​ ​the​ ​aging​ ​process.​ ​It​ ​leaves​ ​individuals​ ​more​ ​susceptible​ ​to​ ​anxiety,​ ​depression,​ ​and​ ​other mental​ ​health​ ​problems.

There​ ​are​ ​different​ ​kinds​ ​of​ ​stressors​ ​that​ ​individuals​ ​will​ ​encounter.​ ​Primarily​ ​in​ ​young adults,​ ​intrapersonal​ ​sources​ ​of​ ​stress​ ​are​ ​the​ ​most​ ​frequent​ ​and​ ​reported​ ​source.​ ​Changes​ ​in sleep​ ​habits,​ ​breaks,​ ​eating​ ​habits,​ ​workload,​ ​and​ ​new​ ​responsibilities​ ​are​ ​what​ ​causes​ ​the​ ​highest amounts​ ​of​ ​stress​ ​(Ross​ ​et​ ​al,​ ​1999).​ ​A​ ​study​ ​done​ ​on​ ​the​ ​association​ ​between​ ​computer​ ​use​ ​and mental​ ​health​ ​symptoms​ ​in​ ​young​ ​adults​ ​found​ ​sleep​ ​disturbances​ ​due​ ​to​ ​high​ ​and​ ​medium computer​ ​usage​ ​in​ ​men,​ ​and​ ​high​ ​email​ ​and​ ​chat​ ​usage​ ​in​ ​women​ ​(Thomée​ ​et​ ​al,​ ​2012.). Computer​ ​usage​ ​can​ ​be​ ​synonymous​ ​to​ ​smartphone​ ​usage​ ​as​ ​it​ ​has​ ​become​ ​the​ ​most​ ​common and​ ​easiest​ ​mode​ ​of​ ​access​ ​to​ ​media.​ ​For​ ​college​ ​students,​ ​the​ ​transition​ ​to​ ​college​ ​is​ ​a​ ​natural stressor​ ​in​ ​itself​ ​as​ ​students​ ​try​ ​to​ ​fit​ ​in​ ​and​ ​become​ ​accustomed​ ​to​ ​life​ ​on​ ​their​ ​own​ ​while​ ​older students​ ​deal​ ​with​ ​the​ ​challenge​ ​of​ ​earning​ ​their​ ​degree,​ ​finding​ ​a​ ​job​ ​or​ ​in​ ​some​ ​cases​ ​a​ ​potential life​ ​partner.​ ​Regardless,​ ​all​ ​students​ ​deal​ ​with​ ​the​ ​common​ ​frequent​ ​stressors​ ​such​ ​as​ ​evaluations,

tests,​ ​critiques​ ​from​ ​professors​ ​or​ ​coaches,​ ​and​ ​sometimes​ ​it’s​ ​even​ ​more​ ​daunting​ ​when​ ​a student​ ​feels​ ​uncomfortable​ ​in​ ​the​ ​classroom​ ​or​ ​surroundings​ ​that​ ​they​ ​are​ ​in,​ ​or​ ​in​ ​relationships with​ ​faculty​ ​members.​ ​Ultimately,​ ​perceived​ ​stress​ ​is​ ​an​ ​important​ ​risk​ ​factor​ ​for​ ​low​ ​mental health​ ​and​ ​suggest​ ​that​ ​mastery​ ​and​ ​self-esteem​ ​are​ ​important​ ​protective​ ​factors​ ​of​ ​mental​ ​health among​ ​young​ ​adults​ ​(Bovier​ ​et​ ​al,​ ​2004).​ ​It​ ​is​ ​important​ ​for​ ​students,​ ​faculty,​ ​family​ ​members and​ ​really​ ​anyone​ ​to​ ​be​ ​able​ ​to​ ​recognize​ ​the​ ​difference​ ​between​ ​stress​ ​and​ ​depression​ ​before​ ​it​ ​is too​ ​late.
Call​ ​to​ ​action

So,​ ​what​ ​should​ ​be​ ​done?​ ​

Beginning​ ​with​ ​the​ ​people​ ​who​ ​spend​ ​the​ ​most​ ​time​ ​with​ ​young​ ​adults and​ ​students,​ ​faculty​ ​and​ ​staff​ ​of​ ​schools​ ​and​ ​colleges,​ ​camps,​ ​and​ ​community​ ​areas​ ​should​ ​all​ ​be aware​ ​of​ ​symptoms​ ​and​ ​make​ ​the​ ​individuals​ ​know​ ​that​ ​they​ ​are​ ​welcomed​ ​and​ ​always​ ​available as​ ​a​ ​listening​ ​source​ ​that​ ​can​ ​also​ ​provide​ ​the​ ​individual​ ​with​ ​connections​ ​or​ ​further​ ​resources​ ​if needed.​ ​Counseling​ ​services​ ​in​ ​the​ ​wellness​ ​center​ ​need​ ​to​ ​be​ ​able​ ​to​ ​accommodate​ ​appointments for​ ​all​ ​the​ ​students​ ​who​ ​come​ ​to​ ​them,​ ​and​ ​also​ ​create​ ​a​ ​common​ ​practice​ ​of​ ​speaking​ ​to​ ​the student​ ​body​ ​about​ ​recognizing​ ​the​ ​different​ ​symptoms​ ​within​ ​themselves​ ​and​ ​peers​ ​as​ ​well​ ​as destroying​ ​any​ ​taboo​ ​misconceptions​ ​that​ ​mental​ ​health​ ​is​ ​a​ ​myth​ ​or​ ​something​ ​that​ ​they​ ​can​ ​just get​ ​over​ ​with​ ​on​ ​their​ ​own.​ ​Having​ ​resources​ ​such​ ​as​ ​creating​ ​a​ ​stress​ ​management​ ​program​ ​may also​ ​be​ ​very​ ​beneficial​ ​as​ ​a​ ​different​ ​course​ ​of​ ​action​ ​for​ ​individuals​ ​who​ ​don’t​ ​know​ ​where​ ​to start​ ​or​ ​wish​ ​to​ ​improve​ ​their​ ​mental​ ​health.​ ​Assessing​ ​the​ ​different​ ​stressors​ ​to​ ​individuals including​ ​the​ ​ones​ ​that​ ​accumulate​ ​over​ ​time.​ ​The​ ​College​ ​Chronic​ ​Life​ ​Stress​ ​Survey​ ​created​ ​in 1996​ ​by​ ​Towbes​ ​and​ ​Cohen​ ​focused​ ​on​ ​the​ ​frequency​ ​of​ ​chronic​ ​stress​ ​in​ ​the​ ​lives​ ​of​ ​college students​ ​and​ ​evaluated​ ​how​ ​many​ ​times​ ​students​ ​dealt​ ​with​ ​these​ ​stresses​ ​on​ ​a​ ​weekly​ ​basis. They​ ​found​ ​that​ ​first​ ​year​ ​students​ ​had​ ​higher​ ​levels​ ​of​ ​chronic​ ​stress​ ​than​ ​the​ ​other​ ​students. Keeping​ ​an​ ​updated​ ​survey​ ​like​ ​this​ ​can​ ​be​ ​beneficial​ ​in​ ​helping​ ​faculty​ ​or​ ​school​ ​counselors realize​ ​where​ ​different​ ​individuals​ ​stand​ ​and​ ​assist​ ​them​ ​in​ ​an​ ​individualized​ ​matter.​ ​It​ ​can​ ​also help​ ​boards​ ​of​ ​higher​ ​institutions​ ​evaluate​ ​these​ ​results​ ​to​ ​see​ ​if​ ​there​ ​is​ ​a​ ​commonality​ ​amongst the​ ​students​ ​that​ ​is​ ​causing​ ​repeated​ ​high​ ​levels​ ​of​ ​stress​ ​and​ ​possibly​ ​adjust​ ​to​ ​accommodate​ ​the student​ ​body​ ​as​ ​a​ ​whole.​ ​Providing​ ​workshops​ ​or​ ​educational​ ​lectures​ ​that​ ​teach​ ​students​ ​how​ ​to recognize​ ​symptoms​ ​is​ ​important​ ​as​ ​many​ ​students​ ​would​ ​rather​ ​talk​ ​and​ ​confide​ ​in​ ​a​ ​friend before​ ​reaching​ ​out​ ​to​ ​a​ ​professional.​ ​Close​ ​friends​ ​can​ ​also​ ​detect​ ​abnormal​ ​behaviors​ ​in​ ​the individual​ ​that​ ​act​ ​as​ ​a​ ​signal​ ​for​ ​them​ ​to​ ​step​ ​in​ ​and​ ​help.​ ​They​ ​don’t​ ​have​ ​to​ ​become​ ​their friend’s​ ​therapist​ ​or​ ​certified​ ​counselor,​ ​however​ ​they​ ​can​ ​help​ ​by​ ​finding​ ​resources​ ​and​ ​in​ ​more serious​ ​cases,​ ​they​ ​can​ ​take​ ​action​ ​by​ ​reaching​ ​out​ ​to​ ​professionals​ ​for​ ​their​ ​friend​ ​or​ ​by practicing​ ​the​ ​concepts​ ​of​ ​QPR​ ​training​ ​which​ ​stands​ ​for​ ​question,​ ​persuade,​ ​and​ ​refer.​ ​This practice​ ​is​ ​a​ ​training​ ​done​ ​by​ ​many​ ​colleges​ ​or​ ​wellness​ ​centers​ ​to​ ​teach​ ​others​ ​how​ ​to​ ​recognize and​ ​help​ ​those​ ​at​ ​risk​ ​of​ ​suicide​ ​or​ ​who​ ​have​ ​thoughts​ ​of​ ​suicide.​ ​It​ ​can​ ​be​ ​applied​ ​to​ ​depression by​ ​gently​ ​confronting​ ​or​ ​bringing​ ​up​ ​the​ ​topic​ ​to​ ​their​ ​friend​ ​in​ ​mentioning​ ​that​ ​they​ ​have​ ​noticed a​ ​difference​ ​and​ ​are​ ​there​ ​to​ ​help​ ​them.​ ​Providing​ ​reassurance​ ​to​ ​the​ ​individual​ ​and​ ​helping​ ​them escape​ ​their​ ​doubts​ ​until​ ​a​ ​professional​ ​may​ ​be​ ​reached​ ​is​ ​a​ ​simple​ ​way​ ​a​ ​friend​ ​can​ ​help.​ ​Aside from​ ​educational​ ​staff​ ​and​ ​friends,​ ​family​ ​members​ ​and​ ​society​ ​as​ ​a​ ​whole​ ​needs​ ​to​ ​be​ ​reminded and​ ​educated​ ​that​ ​mental​ ​health​ ​is​ ​a​ ​real​ ​thing.​ ​It​ ​is​ ​not​ ​“just​ ​a​ ​phase”​ ​that​ ​one​ ​can​ ​easily​ ​get​ ​over with​ ​after​ ​a​ ​few​ ​days.​ ​Providing​ ​education​ ​and​ ​facts​ ​and​ ​reaching​ ​out​ ​to​ ​the​ ​public​ ​is​ ​the​ ​most essential​ ​way​ ​to​ ​get​ ​the​ ​message​ ​across​ ​which​ ​in​ ​turn​ ​creates​ ​a​ ​larger​ ​push​ ​for​ ​more​ ​research​ ​in labs​ ​and​ ​medication​ ​for​ ​individuals.

In​ ​research,​ ​finding​ ​better​ ​or​ ​more​ ​animal​ ​models​ ​that​ ​correlate​ ​to​ ​human’s​ ​mechanisms​ ​of actions​ ​may​ ​assist​ ​in​ ​further​ ​understanding​ ​both​ ​stress​ ​and​ ​depression​ ​in​ ​individuals.​ ​It​ ​is​ ​also important​ ​to​ ​keep​ ​in​ ​mind​ ​that​ ​young​ ​adults​ ​are​ ​not​ ​the​ ​only​ ​ones​ ​dealing​ ​with​ ​mental​ ​disorders. Frequently,​ ​individuals​ ​have​ ​struggled​ ​growing​ ​up​ ​but​ ​have​ ​never​ ​reached​ ​out​ ​or​ ​been​ ​told​ ​to seek​ ​help.​ ​There​ ​is​ ​a​ ​high​ ​percentage​ ​of​ ​older​ ​adults​ ​with​ ​mental​ ​disorders​ ​that​ ​still​ ​struggle​ ​on​ ​a daily​ ​basis​ ​who​ ​have​ ​just​ ​as​ ​many​ ​rights​ ​to​ ​access​ ​in​ ​resources​ ​and​ ​medications​ ​at​ ​their​ ​point​ ​of life​ ​as​ ​well​ ​(Kennedy​ ​&​ ​Ceϊde,​ ​2017).​ ​Being​ ​able​ ​to​ ​recognize​ ​any​ ​symptoms​ ​or​ ​disabilities related​ ​with​ ​depression,​ ​anxiety,​ ​stress,​ ​and​ ​impaired​ ​cognition​ ​earlier​ ​on​ ​can​ ​lead​ ​to​ ​an​ ​easier​ ​or better​ ​appreciated​ ​lifestyle​ ​further​ ​on.



Works​ ​Cited

Bovier,​ ​P.A.,​ ​Chamot,​ ​E.​ ​&​ ​Perneger,​ ​T.V.​ ​Qual​ ​Life​ ​Res​ ​(2004)​ ​13:​ ​161. https://doi.org/10.1023/B:QURE.0000015288.43768.e4

Compton​ ​WM,​ ​M.D.,​ ​M.P.E.,​ ​Conway​ ​KP,​ ​Ph.D.,​ ​Stinson​ ​FS,​ ​Ph.D.,​ ​and​ ​Grant​ ​BF,​ ​Ph.D. (2006).​ ​Changes​ ​in​ ​the​ ​prevalence​ ​of​ ​major​ ​depression​ ​and​ ​comorbid​ ​substance​ ​use disorders​ ​in​ ​the​ ​United​ ​States​ ​between​ ​1991-1992​ ​and​ ​2001-2002.​ ​American​ ​Journal​ ​of Psychiatry.​ ​Doi:​ ​​10.1176/ajp.2006.163.12.2141

Hammar,​ ​Å.,​ ​&​ ​Årdal,​ ​G.​ ​(2009).​ ​Cognitive​ ​Functioning​ ​in​ ​Major​ ​Depression​ ​–​ ​A​ ​Summary. Frontiers​ ​in​ ​Human​ ​Neuroscience​,​ ​​3​,​ ​26.​ ​http://doi.org/10.3389/neuro.09.026.2009

Hidaka,​ ​B.​ ​H.​ ​(2012).​ ​Depression​ ​as​ ​a​ ​disease​ ​of​ ​modernity:​ ​explanations​ ​for​ ​increasing prevalence.​ ​​Journal​ ​of​ ​Affective​ ​Disorders​,​ ​​140​(3),​ ​205–214. http://doi.org/10.1016/j.jad.2011.12.036

Krishnan,​ ​V.,​ ​&​ ​Nestler,​ ​E.​ ​J.​ ​(2008).​ ​The​ ​molecular​ ​neurobiology​ ​of​ ​depression.​ ​​Nature​, 455​(7215),​ ​894–902.​ ​​http://doi.org/10.1038/nature07455

Kennedy,​ ​G.​ ​J.,​ ​&​ ​Ceïde,​ ​M.​ ​E.​ ​(2017).​ ​Screening​ ​Older​ ​Adults​ ​for​ ​Mental​ ​Disorders.​ ​​Clinics​ ​in Geriatric​ ​Medicine​.​ ​DOI:​ ​​10.1016/j.cger.2017.09.005

Ross,​ ​S.​ ​E.,​ ​Niebling,​ ​B.​ ​C.,​ ​&​ ​Heckert,​ ​T.​ ​M.​ ​(1999).​ ​Sources​ ​of​ ​stress​ ​among​ ​college​ ​students. Social​ ​psychology​,​ ​​61​(5),​ ​841-846.

Sontheimer,​ ​H.​ ​(2015).​ ​​Diseases​ ​of​ ​the​ ​Nervous​ ​System​.​ ​Academic​ ​Pr.

Thomée,​ ​S.,​ ​Härenstam,​ ​A.,​ ​&​ ​Hagberg,​ ​M.​ ​(2012).​ ​Computer​ ​use​ ​and​ ​stress,​ ​sleep​ ​disturbances, and​ ​symptoms​ ​of​ ​depression​ ​among​ ​young​ ​adults​ ​–​ ​a​ ​prospective​ ​cohort​ ​study.​ ​​BMC Psychiatry​,​ ​​12​,​ ​176.​ ​​http://doi.org/10.1186/1471-244X-12-176 Towbes,​ ​L.C.​ ​&​ ​Cohen,​ ​L.H.​ ​J​ ​Youth​ ​Adolescence​ ​(1996)​ ​25:​ ​199. https://doi.org/10.1007/BF01537344

Twenge,​ ​J.​ ​M.​ ​(2000).​ ​The​ ​age​ ​of​ ​anxiety?​ ​The​ ​birth​ ​cohort​ ​change​ ​in​ ​anxiety​ ​and​ ​neuroticism, 1952–1993.​ ​​Journal​ ​of​ ​Personality​ ​and​ ​Social​ ​Psychology,​ ​79​(6),​ ​1007-1021.

Wood,​ ​S.​ ​K.,​ ​&​ ​Bhatnagar,​ ​S.​ ​(2015).​ ​Resilience​ ​to​ ​the​ ​effects​ ​of​ ​social​ ​stress:​ ​Evidence​ ​from clinical​ ​and​ ​preclinical​ ​studies​ ​on​ ​the​ ​role​ ​of​ ​coping​ ​strategies.​ ​​Neurobiology​ ​of​ ​stress​,​ ​1, 164-173.​ ​​https://doi.org/10.1016/j.ynstr.2014.11.002

How To Not Kill A Tomagotchi

The summer after my freshman year of college, I applied to a program called EBICS (Emergent Behaviors of Integrated Cellular Systems) and received the opportunity to participate in paid undergraduate research at the Massachusetts Institute of Technology for ten weeks in Boston.

Credit “Massachusetts Institute of Technology” by Iara Moran is licensed under CC BY 4.0

I worked under a P.h.D candidate at MIT in a biosynthetic lab in the bioengineering department. The entire experience was exciting from start to finish but as I had just finished my freshman year of college, I was still very new and not really knowledgeable in the type of science that was being worked with in the lab. A clear memory I have from my time there was hearing MIT’s president talk at an event where he used the analogy of the amount being taken in by a student there is like being hit with the water pressure of a broken fire hydrant. I related to this quite strongly. I had no idea how to read genetics on paper. Each part of a gene has a different symbol and name that consists of blocks, triangles, arrows, and various colors. Along with reading 10 page articles, I had to learn what each symbol meant and how to recognize them as well. Aside from the literature, I also learned how to take care of cells and lab techniques. However, I didn’t just work with any kind of regular cell line. I was given stem cells. These are some of the hardest, most expensive, and fragile cells to work with as they are in a state where they can become any kind of cell before they develop into their assigned function, also known as differentiation, in scientific terms. My mentor named this cell line tamagotchi. I had to feed them, nurture them, let them grow, and most important of all, not let them die, just like my own baby tamagotchi. The countless hours spent in that lab every day for those 10 weeks was enough for me to run PCR in a blindfold. My lab skills improved dramatically and became an ease to the point that when I went back to school the following semester, I was the designated lab technician for my science classes at Agnes Scott. At the end of the 10 weeks, I was able to present my work on a poster and attend the EBICS conference in Chicago and also SPArC at Agnes Scott.

Credit “MIT Poster Presentation” by Iara Moran is licensed under CC BY 4.0

I really enjoyed this experience and the opportunity to do such important and prevalent work. I believe that this experience helped me decide to become a Neuroscience major. However, it also helped me realize that this path of wet lab research is not for me. The long and usually lonely hours with just you, the cells, and machines whirring around you are not for me. I prefer the clinical side of science and medicine, which is just as important but has more human interaction. This  has allowed me to focus more on working in hospitals, clinics, or private practice settings to acquire more experience this way earlier on in my medical career and in the fields of work that I enjoy.


SUMMIT Learning Outcomes associated with this reflection:

  • 4. Communicate effectively through writing and speaking
  • 5. Recognize, analyze, and evaluate arguments
  • 7. Recognize, analyze, and evaluate arguments
  • 8. Identify and assess one’s values, interests, and abilities
  • 10. Interpret quantitative information or demonstrate the methods of inquiry appropriate for investigating the natural world
  • 12. Cultivate and maintain interpersonal relationships and networks
  • 14. Practice continual improvement of one’s whole person and seek and utilize feedback
  • 16. Demonstrate honorable and ethical behavior and civic engagement

Dominican Republic

My GBL 101 class my first semester of Agnes Scott consisted entirely of the Dominican Republic’s history, society, politics, and current events. We mostly focused on their ongoing relationship and conflicts with Haiti, and the country’s healthcare system since our class was led and taught by public health professor. Being from a hispanic country as well, most of the “shocking” events having to do with politics, society, corruption, economics, and more, did not surprise me much in comparison to my classmates. While I did learn a few new things about the DR in particular, it was nice to see my classmates learn and have their eyes open to just a little part of the world outside of the United States. It was as if they gained the two-sided perspective that I had grown up with while growing up in the United States but having my Argentinian language and culture at home.

Credit “Santo Domingo, DR” by Iara Moran is licensed under CC BY 4.0

Having learned as much as possible, the weeks leading up to the trip were buzzing with excitement. We flew from Hartsfield Jackson to the dreaded Miami airport before flying to Santo Domingo. We were greeted

by our Peacework ambassador who surprised us by giving us water in bags since the local water isn’t potable. We traveled by bus to our hostel in the center of the city were we spend the following 2-3 days getting to do a little bit of tourism and embrace the Dominican culture and food especially.

The second half of the week, we travelled across the country to a smaller city called Puerto Plata. Here, we stayed in an Ecolodge at the top of a rocky mountain. I had never been so glad to have dramamine on hand. The view from this ecolodge over the luscious forest of the Dominican were unlike anything I had ever seen before. The photo doesn’t do it justice but it can give you an idea.

Credit “View of Puerto Plata, DR from Ecolodge” by Iara Moran is licensed under CC BY 4.0

Aside from exploring the beauty that the DR has to offer, we dove deeper into its society by visiting a woman’s health clinic and a Haitian community. In the woman’s health clinic we were able to see what resources are available to mothers and their children, sex workers, and also homosexual individuals. Being a predominantly traditional and Catholic-affiliated country, a lot of healthcare and resources are denied to these people. While the woman who ran the clinic could speak a little bit of Spanish, some of the medical terms can easily get lost as most are not cognates to English words. Fortunately, my experience shadowing the Spanish translator at a hospital for the entirety of the previous summer came into good use and I was able to translate most of the lady’s presentation. This was a very interesting presentation that allowed us students, used to the healthcare system in the United States to reflect on their experiences and compare the differences in society.

Credit “Haitian Community in Puerto Plata, DR” by Iara Moran is licensed under CC BY 4.0

When we went to visit the local Haitian community, the main focus of going there was not to act as missionaries or have a superior “God-saving complex” to us. This is a focus I appreciated greatly that our class professor and Agnes Scott emphasize while teaching us to become global citizens and not tourists. Our purpose in visiting the community was to learn about the conflict between Haitian citizens in the Dominican Republic. Many Haitians face the same problem that immigrants to the United States face. They were brought over to another country at a very young age and grew up there without any knowledge or connections to their “native” country. The Dominican Republic’s government began to deny citizenship to those in this situation and even deporting them back across the border. These communities have helped many Haitians in this situation thanks to non-profit organizations and health workers that are like ambassadors between the community and the Dominican government to make sure that people continue to receive basic and necessary resources for living. To make our visit somewhat beneficial to the community, the students that were bilingual in Spanish or French assisted the health worker by going from house to house, more realistically, from shack to shack, and inquiring about the number of children in that household below the age of 12. This allowed for the health worker to have a census of the children population that would be needing vaccinations.

Credit “Haitian Community Children” by Iara Moran is licensed under CC BY 4.0

We played soccer with the children, we thanked and paid the mothers of the village who fed us, we shopped at the community’s artist’s home, and we even helped the educators teach the children how to make recyclable trash cans from used water bottles and barbed wire.

It was honestly very mind-opening. Even for me, someone who thinks they have seen it all of poverty, third-world countries, discrimination, racism, and more. However, it never ends, and there will always be an abundance of it in this world for a while. The thing that surprised us all the most, that even in the conditions that these people live in, who know the status of their lives depends on the country’s daily decision to send them past a river, still wake up every day with a smile on their faces and count their blessings for their health and the family that surrounds them.

Credit “DR Group Photo” by Iara Moran is licensed under CC BY 4.0



SUMMIT Learning Outcomes associated with this reflection:

  • 1. Identify, explain, and analyze global themes, process and systems
  • 2. Demonstrate knowledge and skills essential for global engagement
  • 3. Critically examine the relationship between dominant and marginalized cultures, subcultures or groups
  • 4. Communicate effectively through writing and speaking, especially across cultural or linguistic differences