Does sadness make you sick?

LeafMeme20160107

We’ve all heard of being “homesick”, or “heartsick”, or “lovesick”.   Sometimes when we’re extremely sad, we feel the knot in our stomachs, the pressure in our chests, or the confusion and distraction in our minds as the waves of sadness wash over and discombobulate us.

But can being sad really make you physically ill as well as emotionally distraught?

Dr Caroline Leaf declared today on her social media platforms that “Feeling sad can alter levels of stress-related opioids in the brain and increase levels of inflammatory proteins in the blood that are linked to increased risk of comorbid diseases including heart disease, stroke and metabolic syndrome.”

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist.  She believes that our cognitive stream of thought determines our physical and mental health, and can even influence physical matter through the power of our minds.

She also added some further interpretation to her meme: “So this is more evidence that our thoughts do count: they have major epigenetic effects on the brain and body! We need to apply the principles in the Bible and listen to the Holy Spirit – no excuses this year!”

With all due respect to Dr Leaf, the study she quotes doesn’t prove anything of the sort.

Dr Leaf’s meme is a copy and paste of the opening paragraph of a news report published by the university’s PR people to promote their faculty.  This isn’t a scientific summary, it’s a hook to draw attention to an article which amounts to a PR puff piece.  If Dr Leaf had read further into the article, I don’t think she would have been quite so bold in claiming what she did.

The article discussed a study by Prossin and colleagues, published in Molecular Psychiatry [1].  You can read the original study here.  The study specifically measured the change in the level of the activity of the opioid neurotransmitter system and the amount of a pro-inflammatory cytokine IL-18 across two experimental mood states, and in two different groups of volunteers, people with depression, and those without.

For a start, it’s important to note that the study isn’t referring to normal day-to-day sadness.  This was an experimentally induced condition in which a sad memory was rehearsed so that the same feeling could be reproduced in a scanner, and the study was looking at the effect of this sad “mood” on people who were pathologically sad, that is, people diagnosed with major depression.

It’s well known that people with depression are at a higher risk of major illnesses, such as heart attacks, strokes and diabetes [2] The current study by Prossin et al looked experimentally at one possible link in the chain, a link between a neurotransmitter system that’s thought to change with emotional states, and one of the chemical mediators of inflammation.

They found that:

> Depressed people were much sadder to start with, and remained so throughout the different conditions.  The depressed people stayed sadder in the ‘neutral’ phase, and the healthy cohort couldn’t catch them in the ‘sad’ phase.
> Depressed people had a much higher level of the inflammatory marker to start with, and interestingly, this level dropped significantly with the induction of the neutral phase and the sad phase.  What was also interesting was that the level of the inflammatory marker was about the same in the baseline and the sad phase for the healthy volunteers.
> A completely different pattern of neurotransmitter release was seen in the two different groups.  People with depression had an increase in the neurotransmitter release over a large number of areas of the brain, whereas in the healthy controls with normal mood, the sad state actually resulted in a decreased amount of neurotransmitter release, and in a much smaller area within the brain.  This suggests that the opioid neurotransmitter system in the brains of depressed people is dysfunctional.

Affect/Sadness Scores - Prossin et al Molecular psychiatry 2015 Aug 18.

Affect/Sadness Scores – Prossin et al Molecular psychiatry 2015 Aug 18.

IL18 v Mood state/diagnosis - Prossin et al Molecular psychiatry 2015 Aug 18.

IL18 v Mood state/diagnosis – Prossin et al Molecular psychiatry 2015 Aug 18.

Effectively, the results of the study reflect what’s already known – the emotional dysregulation seen in people with depression is because of an underlying problem with the brain, not the other way around.  And, sadness in normal people is not associated with a significant change in the evil pro-inflammatory cytokine.

So, according to Prossin’s article,

  1. normal sadness in normal people is not associated with physical illnesses.
  2. sadness is abnormally processed in people who are depressed, which maybe related to an abnormal inflammatory response, which might explain the known link between depression and increased risk of illness

The article is not “more evidence that our thoughts do count.”  If anything, it shows that underlying biological processes are responsible for our thoughts and emotions and their downstream effects, not the thoughts and emotions themselves.

And unfortunately, it appears that Dr Leaf hasn’t got past the opening paragraph of a puff piece article before jumping to a conclusion which only fits her worldview, not the actual science.

References

[1]        Prossin AR, Koch AE, Campbell PL, Barichello T, Zalcman SS, Zubieta JK. Acute experimental changes in mood state regulate immune function in relation to central opioid neurotransmission: a model of human CNS-peripheral inflammatory interaction. Molecular psychiatry 2015 Aug 18.
[2]        Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence. Med J Aust 2009 Apr 6;190(7 Suppl):S54-60.

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Prayer Proof?

In Wisconsin, USA, Leilani Neumann is found guilty of second degree reckless homocide of her 11-year-old daughter Kara.  During her recent trial, the prosecution alleged that she ignored the worsening symptoms of Kara’s undiagnosed diabetes for two weeks, and chose prayer instead of seeking medical advice.  Even during the last hours before Kara’s death, Leilani stood with her husband and Bible study members praying for her.  Witnesses said that it was only when the comatosed girl stopped breathing that someone called paramedics.  Neumann family supporters state that the trial was misconducted, without a single witness called for the defense, and an appeal is planned.

Across the other side of the US, Billy is a graduating student of the Bethel School of Ministry, in Redding, California.   He reported on a recent trip to Ecuador where he prayed for a seven year old boy with leg deformities from birth. It was hard for the boy to walk and impossible for him to run, which made him the target of taunts when he tried to play soccer.  Despite their best efforts, doctors had failed to correct the deformities.  Billy prayed for him three times, and after the third prayer, the boy said he saw “the hand of God come down” and touch him.  He took a few tentative steps, and his legs became straighter and straighter.  His mother tearfully confirmed that her previously lame son could now walk and run.  The last thing Billy saw as he was driving away from the crusade was the boy running up and down the car park, staring in wonder at his perfectly straight legs.

Same act of prayer, same God, but two contradictory results.  It is a conundrum that has confused the church for centuries.  Why does God answer some prayer with miracles, and why are some prayers for healing seemingly unanswered?  What is the effectiveness of prayer?

There have been some attempts to measure the effects of prayer scientifically.  One of the first published clinical trials of intercessory prayer was a 1988 study by Randolph Byrd.  Almost 400 patients over a period of time were randomized to receive prayer from born-again Christians, while the other half received no prayer.  The results showed a positive outcome for prayer in six of the twenty-nine variables observed.  Unfortunately, the study was plagued by problems in the construction of the trial, and many feel that the positive results were because of study bias, not the prayer itself.

There have been better studies since then.  The “Study of the Therapeutic Effects of Intercessory Prayer” (“STEP”) was a well conducted trial that took 10 years and $US2.4 million.  1800 patients, all admitted to hospital for the same condition, were divided into three groups: one received prayer and knew they were prayed for, another group received prayer without knowing about it, and the last received no prayer.  The prayer was performed by committed Christians experienced in praying for the sick.  The results were not encouraging for intercessory prayer, with the two groups receiving prayer actually having poorer outcomes than those not prayed for.

On the surface this does little to help the dilemma of prayer for healing.  On deeper analysis, there may have been confounding factors.  Those in the control group (without prayer in the study) may have been praying themselves.  Or perhaps the answer to prayer in those studied came outside of the study’s parameters.  Perhaps God wants us to trust in him and his word, the raw power of faith, rather than in the science of a clean-cut clinical study that “proved” the benefits of prayer.  When it comes to the studying of prayer, Christians and clinicians have noted that prayer is not an easily quantifiable substance.  And neither is God for that matter.  When God works supernaturally, he works super-naturally, literally above the laws of nature.  Prayer, then, cannot be studied scientifically since the scientific method relies on observing and controlling variables within the natural order.

In fact, I personally think that God delights in performing miracles that are beyond our reasoning.  The miracles of Jesus provide many good examples – he placed mud, made out of the mixture of dirt and his saliva, onto a blind mans eyes.  He touched lepers.  He told Peter to find tax money in the mouth of a fish.  These sort of miracles perplex yet inspire us.  Scientifically quantifiable or not, they still move us to worship the greatness of God.

How do we find the wisdom to know when to choose medicine or miracle?  Two of Jesus’ miracles come to mind that might shed light on this delicate balance.  The woman with the issue of blood (Luke 8:43-48) had “spent all her living upon physicians, neither could be healed of any.”  She touched Jesus and was healed, and Jesus told her “thy faith hath made thee whole.”  The lame man at the pool of Bethesda (John 5:1-9) waited patiently near the waters edge and tried as best he could to make it into the waters to be healed but was unable to get there by himself.  When Jesus told him to walk, he got up instantly and was healed.

Both stories are of people in need who didn’t wait passively for healing.  Each did whatever was in their power to find healing, and were at the point where their effort was not enough.  The woman pursued Jesus, whereas Jesus came to the man, but in both cases their faith engaged God and they received healing.  I think the same is true in modern day life.  Healing is by the grace of God.  We do nothing to earn it.  But like many things in the kingdom of God, we also need to ask, to seek and to knock.

I understand that my profession as a GP makes me a little biased, but the healing or prevention of many diseases is available simply by following modern medical advice, or by using simple therapies like vaccinations or antibiotics.  For Kara Neumann, the answer to prayer was in the insulin and fluids that doctors would have given her had they been called in time.  Perhaps it’s because we are so used to the benefits of medicine that we do not see immunizations or pharmaceuticals as miracles, or answers to prayer.  But imagine if you could go back in time one hundred years with some of todays basic medicines like penicillin.  You would be able to cure diseases like syphilis or pneumonia, in that time untreatable and fatal, and you would be labelled as a miracle worker.  Modern medicine is miraculous.

But when modern medicine cannot touch a sickness, either because of limited access to medicine or the limits of medical science itself, the “miraculous” can take place.  Like the boy in Ecuador, or the woman with the the issue of blood, physicians could not heal them, but God did, when personal faith touched his power and grace.

It would be absurd to stand outside in a thunderstorm and pray for God to shelter us when we could just walk inside our house.  In the same way, common sense dictates that we thank God for modern medicine and use it appropriately, because it is just as much a gift of God as our houses are.  Medicines sit along side the astounding phenomena of supernatural power that we define as “miraculous.”  And while the power of prayer may not be quantifiable or reproducible like modern pharmaceuticals, it is nevertheless tangible, just like the love of God that has provided them both.

(Originally published in Alive Magazine, June/July 2009)