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Alexander Karabatsiakis would like to draw attention to the fact that there are effective remedies for depression and other psychiatric disorders.

With energy against depression

Tiredness, lack of energy, sleep disorders or apathy - many people suffer from the symptoms of chronic stress, which can develop into depression. Since January 2020, Alexander Karabatsiakis has been studying the biological changes in the body's own energy system, the mitochondria, at the Institute of Psychology.

People who suffer from depression due to chronic or traumatic stress often experience a reduction in mental as well as physical performance, they sleep less well and often fall into an intense brooding mode. As a molecular biologist and systemic neuroscientist, Alexander Karabatsiakis searches for biological changes that occur in depression at the level of psychoneuroimmunology. "The brain is one of the organs with the highest energy consumption in the human body. Energy is the prerequisite for work, and performance is defined as work per time. Since affected patients are less able to call up psychosomatic performance, there is much to suggest that something is wrong with the energy metabolism. Because of the high energy consumption, the brain therefore seems to be particularly vulnerable to changes in bioenergetic supply. But other parts of the body are also affected by depression, including the heart and the immune system. Our research focuses on the mitochondria, the power plant organelles in our cells," explains Karabatsiakis. The main function of mitochondria is the production of adenosine triphosphate (ATP), the body's biochemical energy currency. "As a biological cause, depression could result from a functional change in the mitochondrial system, which slips into a kind of 'biochemical burnout' and loses its performance capacity when chronically overstressed by stress," explains the scientist, who, together with his team, measures the oxygen consumption of immune cells to characterise the performance potential of mitochondria. The technology required for this will be provided by the Innsbruck-based company Oroboros Instruments as part of a joint project. Karabatsiakis also cooperates with the Innsbruck-based company Biocrates, an international reference in the field of mass spectrometry-based biomarker research. As an interdisciplinary researcher, Alexander Karabatsiakis also aims to network all the players involved even more closely. This is intended to make Innsbruck more visible internationally as a scientific location, also in the field of biomolecular depression research.

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Alexander Karabatsiakis was a guest in our podcast "Time for Science". The psychologist talks about his work in the field of psychoneuroimmunology and explains why everyone can potentially contract depression and why stigmatisation is therefore completely inappropriate: https://www.uibk.ac.at/podcast/zeit/sendungen/zfw046.html

Approved

The performance and integrity of the mitochondria as cellular energy producers is essential for human well-being and health. Alexander Karabatsiakis looks for biological changes that occur in depression and also investigates the extent to which these can be reversed through psychotherapeutic intervention. "If you want a sticker for your car, the mechanics also check the engine and exhaust gases. We do something similar. In our laboratory 'test bench', the Oroboros Oxygraph, we investigate how mitochondria behave when you look at the cellular engine at idle, when you put the throttle down to full throttle, or how they react when you stall their engine. What is particularly interesting for us is how much 'exhaust gas' is produced," Karabatsiakis explains. In a study, the scientist and his team have already been able to show that there is a significant reduction in mitochondrial performance in patients with depression, depending on the severity of the clinical symptoms. "The more depressed people were, the less the immune cells used up oxygen to produce energy via the mitochondria," says Karabatsiakis. In a study completed last year, the molecular biologist was able to show that psychotherapy applied to depressed patients and the associated improvement in symptoms also brought about improvements in mitochondrial activity. The possibility of being able to determine the impact of a therapy against depression on a biological level should support the diagnosis and the course of therapy in the future. "Not every patient responds to antidepressants or psychotherapy For very severe forms of depression, electroconvulsive therapy can also be used. A flow of current triggers a muscle spasm in patients under short-term anaesthesia. Through mechanisms that have not yet been fully understood, a strong neurological stimulation with extreme antidepressant effects occurs in a very short time," explains the scientist, who points out that this form of therapy only works in about half of the patients. "If no improvement in the mitochondrial system can be observed in the affected patients after half of the applications, then they would no longer have to be anaesthetised for the further treatments and the further course of therapy would have to be adjusted. On the other hand, a mitochondrial function test could objectively demonstrate an improvement in bioenergetic care. Both approaches are currently being prepared within the framework of a newly planned study for examination at the Innsbruck site," says Karabatsiakis.

Do not remain silent

Mental stress and psychiatric illnesses are still often treated as taboo subjects in society today. "The task of science is to enlighten and demystify about these topics as well. If we can prove that psychiatric illnesses are also caused by a lack of energy or increased inflammatory reactions in the body, we will also achieve a better understanding of the illness in society. It is important to de-stigmatise and draw attention to the fact that there are effective treatments for depression and other psychiatric disorders. In this way we can achieve a lot of positive things for those affected", says Karabatsiakis, who is also the Austrian representative in the European Depression Association. The scientist also points out that the health effects of Covid-19 also include the psyche of people. "We must not only focus on the physical complications, but also on the psychosomatic stress. Fear of the threat element corona pandemic, poor sleep, increased brooding and the added financial and family worries can build up a stress construct that in the long run channels into depression," he says. Continued stress, social isolation and psychosocial and economic burdens increase the risk of depression. The expert advises preventive measures to regulate the individual moments of stress through targeted intervention. "With a little more mindfulness in life, a healthy lifestyle including good sleep and a healthy diet, sufficient physical activity, reduced workloads or less stressful activities, we can also protect ourselves from too much stress," recommends Alexander Karabatsiakis, whose research in the still little-understood field of biomolecular depression research will contribute to improving therapy.

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