New Studies Show Anxiety, Depression, Guilt Harm the Brain

Two studies in recent weeks have found that anxiety, depression and guilt can physically change and damage the brain from preschool through adulthood.

In a study published in JAMA Psychiatry it was found that an important brain area involved in emotion— the right anterior insula— is smaller in school-aged children diagnosed with depression as preschool-aged children, and can predict risk of future struggles with depression.

Guilt and depression in preschool-aged children

There are two insulas in the brain. They are believed to be associated with perception, emotion, cognition and self-awareness. Researchers with the Washington University School of Medicine used MRIs to make the above determinations. They also discovered that the right anterior insula is smaller in school-aged children diagnosed with pathological guilt in their preschool years.

"That's not a complete surprise because for many years now, excessive guilt has consistently been a predictor of depression and a major outcome related to being depressed," Andrew Belden, the study’s first author said in a statement.

Pathological guilt can signal clinical depression, anxiety, obsessive-compulsive and bipolar disorders. Belden, an assistant professor of child psychiatry, said guilt is easy to spot in kids, as they are prone to it.

"A child with pathological guilt can walk into a room and see a broken lamp, for example, and even if the child didn't break it, he or she will start apologizing," he said.

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The team does not know whether depressed children are more prone to guilt, or guilt-ridden children are more prone to depression. Regardless, the link between pathological guilt, and physical changes in the brain that increase future risk, is new.

In the study, 47 children diagnosed with depression and 82 non-depressed children were analyzed for depression and guilt each year from age three to six. Some 55 percent of the depressed children had excessive pathological guilt as preschoolers. Only 20 percent of the non-depressed children displayed excessive guilt.

All children had MRI brain scans almost every 18 months from age seven to 13.

The researchers found that children with a smaller insula in the right brain hemisphere— associated with depression or excessive guilt— were more likely to experience repeated bouts of depression as they aged.

Effectively, it was found that guilt, early on, can shrink the brain. The researchers plan to continue the study for at least five more years, following the children as teens— and maybe into adulthood.

Accelerating Alzheimer's in adults

Meanwhile, a recent study in The American Journal of Geriatric Psychiatry found that anxiety can accelerate the path to Alzheimer’s disease in people with mild cognitive impairment. It has been known that people with mild cognitive impairment (MCI) are at heightened risk of Alzheimer's disease, but the new study warns the risk is significantly increased in anxiety-ridden people with MCI.

In an ahead-of-print publication of the journal, a team from Baycrest Health Sciences' Rotman Research Institute showed for the first time that anxiety can hasten the route from MCI to Alzheimer's— independent of depression. For MCI patients with mild, moderate or severe anxiety, Alzheimer's risk increased by 33 percent, 78 percent and 135 percent, respectively.

The team also found that MCI patients reporting anxiety symptoms at any given juncture during a follow-up exam experienced greater atrophy in the medial temporal lobe regions, areas critical in the generation of memories and implicated in Alzheimer's disease.

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Anxiety has never before been strongly linked, in a longitudinal study, to Alzheimer's in people with MCI. Many studies have found late-life depression to be a significant risk marker for Alzheimer's. But anxiety has simply been seen as a form of depression in psychiatry. Depression is routinely screened for; anxiety is not.

The findings indicate clinicians should routinely screen for anxiety in people with memory deficits. Behavioral stress management programs might be recommended.

The Baycrest team analyzed data from the Alzheimer's Disease Neuroimaging Initiative to analyze anxiety, depression, cognitive and brain structural changes in 376 adults, aged 55 to 91, for three years. The changes were monitored every six months. All adults had a clinical diagnosis of amnestic MCI and a low depression score.