In March this year researchers showed that rats exposed to high-altitude conditions exhibited increased depression-like behaviour. This study proved that hypoxia (low oxygen levels) is a distinct risk factor for depression in those that either live at high altitudes or suffer from COPD, asthma or who smoke.
The link between altitude and high depression rates and suicide is very obvious in the intermountain region of the United States where the rates are considerably higher than any other part of America. The region has earned itself the nick-name of the ‘suicide belt’.
Rats are not however subject to the same psychological and social pressures as people are and more research on humans would need to be undertaken in order to substantiate this link. Other risk factors are also important such as poverty, low population and psychiatric disorders. This study shows that this risk factor would be present with everybody who either live in high altitudes or suffer with a condition that results in a lowering of oxygen levels in your blood.
Hypoxia is thought to impair an enzyme involved in the synthesis of serotonin (a compound that contributes to happiness and feelings of well-being), resulting in lower Serotonin levels and leading to depression. Depression is normally treated with anti-depressants however ‘The Utah Paradox’ illustrates how drugs do not necessarily work in high-altitude regions, as Utah has the highest depression index and the highest use of antidepressants in the country.
The fact that both depression and suicide rates increase with altitude, where there are low oxygen levels, implies that antidepressant treatment is not adequate for those suffering from depression and as low oxygen is the main common factor in most cases, maybe this needs to be looked into as a possible new treatment for depression in those that experience low oxygen levels.
Significant improvements were demonstrated when schizophrenic patients underwent oxygen therapy and now they will try it out on sufferers of depression. Oxygen therapy is easy, non-invasive and safe so new research will trial it on sufferers of low and medium-level depression.
Researchers found that exposing psychiatric patients to 40% concentration of oxygen rather than 21% oxygen levels from the air, via a plastic tube is safe and effective and the patients functioned significantly better than those who inhaled normal air. Increasing the supply of oxygen to the brain will increase the function of mitochondria which produce energy in the cells. Poorly functioning mitochondria can disrupt the functioning of neurones and the electrical activity of the brain. Theoretically therefore raising oxygen levels inhaled by patients can improve psychiatric functioning, it now just needs to be proven. If it is proven to be the case then oxygen therapy could relieve depression symptoms in hours/days and weeks compared to antidepressants which can take months and years to take full effect. You wouldn’t be using medications but a natural substance, which is easy to use, cheaper and brings about results a lot quicker, reducing the likelihood of a potential attempt on life.
References: http://www.jpost.com and http://www.sciencedaily.com
An Increasing number of people are now travelling to greater heights as it is becoming more readily accessible and cheaper to do so. However there can be adverse medical implications from doing so. Altitude sickness can affect people that ascend to more than 2500 metres of altitude, whether by climbing or being transported to these heights. It can also affect a person if they ascend too quickly for the body to adapt. It can present with mild symptoms that can subside when the individual has rested or returned to a lower altitude. However more extreme symptoms can be life-threatening if not counter-acted or treated.
Altitude sickness occurs because as you ascend to higher altitudes the air pressure reduces. The air still contains the same proportion of oxygen but as the air is thinner at higher altitudes there are fewer oxygen molecules available in each breath. This means that you have to breathe deeper and faster to obtain the same amount of oxygen that your body requires. If you ascend at a slow rate your body has a chance to acclimatise and adapt to the changing conditions. Your breathing rate will slow down as your body makes more red blood cells to carry more oxygen in your blood.
The most important initial treatment for someone displaying signs of altitude sickness is to stop the ascent and rest to allow the body to acclimatise. If symptoms persist then drop to a lower altitude. Normal symptoms illustrated by the body whilst it is acclimatising can be an increased breathing rate, deeper breathing, shortness of breath on exercise, changes to breathing patterns during sleep, disturbed sleep or passing more urine than normal.
If the affects of altitude are more severe than this then the body can display symptoms of the following three problems; acute mountain sickness, high-altitude cerebral oedema or high-altitude pulmonary oedema.
The exact cause of acute mountain sickness (AMS) is not known but it is thought to be a response of the brain to lower oxygen levels in the blood at higher altitudes which produces some swelling of the brain.
High-altitude cerebral oedema (HACE) usually develops in someone who already has acute mountain sickness (AMS). The swelling of the brain that has led to AMS gets worse and starts to interfere with the function of the brain. So, HACE is really a severe form of AMS.
High-altitude pulmonary oedema (HAPE) is a build-up of fluid within the lungs. The exact reasons why HAPE can develop are unknown. It is thought that the high altitude causes an increase in pressure in the blood vessels around the lungs which leads to smaller blood vessels becoming ‘leaky’, allowing fluid to escape from the blood vessels into the lungs.
The most important treatment if you start to develop symptoms of mild AMS is to stop your ascent and to rest at the same altitude. For most people, symptoms will improve within 24-48 hours with no specific treatment. Adapting to conditions (acclimatisation) usually occurs after 1 to 3 days at a given altitude. Simple painkillers and anti-sickness medication can help headache and sickness. You should also make sure that you drink plenty of fluids.
However, if your symptoms are severe, they do not improve after 24 hours, or they are getting worse, you need to descend to a lower altitude. You also need to descend urgently if you develop any symptoms or signs of HACE or HAPE.
Treatment of HACE and HAPE is similar and most importantly it is to move down to a lower altitude immediately. If this does not happen, or is delayed, death can occur. Treatment with oxygen and medicine can help to relieve symptoms and can mean that getting someone down to a lower altitude becomes easier. However, these treatments do not remove the need for descent. The descent should be at least to the last altitude at which the person woke up feeling well. A device has been developed called a portable hyperbaric chamber. It is, essentially, an airtight bag that is pressurised by a pump. The person with HACE is placed inside it and it can provide the same effect as a descent. They will be breathing air equivalent to that at much lower altitude. This can be life-saving when descent is not possible and oxygen is unavailable.
You can also use oxygen (small cylinder) to avoid these problems. OxygenWorldwide has on certain occasions arranged medical oxygen for mountain climbing. (For availability on your destination check with [email protected].