Epicurean Stability (eustatheia): A Philosophical Approach of Stress Management

Epicurus used an empirical and sensualistic approach to knowledge, creating a consistent, naturalistic, pragmatic and consequentialistic philosophy. The scientific observations of the last centuries have confirmed the basic principles of Epicurean physics, as well the psychotherapeutic approach of Epicurean ethics, which fits human nature. We know from the work “On Frank Criticism” of Epicurean philosopher Philodemus of Gadara, that the teaching methodology of Epicureans included psychoeducational counseling through therapeutic criticism based on friendly freedom of speech and aiming at τῆς ψυχῆς θεραπείαν (psychotherapy) and at knowledge of maintaining mental health and well-being. The Epicureans called εὐστάθεια (eustatheia, “stability”) the psychosomatic balance (τὸ τῆς σαρκὸς καὶ ψυχῆς εὐσταθὲς κατάστημα), which today we call homeostasis (ὁμοιόστασις), and considered it the basis of true happiness. They recognized empirically the stress that disturbed psychosomatic homeostasis as an agitation of the psyche or a painful feeling of the body and used a number of mental and affective techniques (including the tetrapharmakos) to manage stress at its onset, so that it does not evolve into the particularly troublesome conditions of anxiety and/or depression, which may become chronic psychosomatic disorders with significant social consequences. The article discusses the relation of the main ethical teachings of Epicurus with the biological basis of human brain functions and with the management of stress by cognitive and behavioral psychotherapy

From Brain Organoids to Networking Assembloids: Implications for Neuroendocrinology and Stress Medicine

Brain organoids are three-dimensional cultures that contain multiple types of cells and cytoarchitectures, and resemble fetal human brain structurally and functionally. These organoids are being used increasingly to model brain development and disorders, however, they only partially recapitulate such processes, because of several limitations, including inability to mimic the distinct cortical layers, lack of functional neuronal circuitry as well as non-neural cells and gyrification, and increased cellular stress. Efforts to create improved brain organoid culture systems have led to region-specific organoids, vascularized organoids, glia-containing organoids, assembloids, sliced organoids and polarized organoids. Assembloids are fused region-specific organoids, which attempt to recapitulate inter-regional and inter-cellular interactions as well as neural circuitry development by combining multiple brain regions and/or cell lineages. As a result, assembloids can be used to model subtle functional aberrations that reflect complex neurodevelopmental, neuropsychiatric and neurodegenerative disorders. Mammalian organisms possess a highly complex neuroendocrine system, the stress system, whose main task is the preservation of systemic homeostasis, when the latter is threatened by adverse forces, the stressors. The main central parts of the stress system are the paraventricular nucleus of the hypothalamus and the locus caeruleus/norepinephrine-autonomic nervous system nuclei in the brainstem; these centers innervate each other and interact reciprocally as well as with various other CNS structures. Chronic dysregulation of the stress system has been implicated in major pathologies, the so-called chronic non-communicable diseases, including neuropsychiatric, neurodegenerative, cardiometabolic and autoimmune disorders, which lead to significant population morbidity and mortality. We speculate that brain organoids and/or assembloids could be used to model the development, regulation and dysregulation of the stress system and to better understand stress-related disorders. Novel brain organoid technologies, combined with high-throughput single-cell omics and gene editing, could, thus, have major implications for precision medicine

Stress and disorders of the stress system

Abstract | All organisms must maintain a complex dynamic equilibrium, or homeostasis, which is constantly challenged by internal or external adverse forces termed stressors. stress occurs when homeostasis is threatened or perceived to be so; homeostasis is re-established by various physiological and behavioral adaptive responses. Neuroendocrine hormones have major roles in the regulation of both basal homeostasis and responses to threats, and are involved in the pathogenesis of diseases characterized by dyshomeostasis or cacostasis. The stress response is mediated by the stress system, partly located in the central nervous system and partly in peripheral organs. The central, greatly interconnected effectors of this system include the hypothalamic hormones arginine vasopressin, corticotropin-releasing hormone and pro-opiomelanocortinderived peptides, and the locus ceruleus and autonomic norepinephrine centers in the brainstem. Targets of these effectors include the executive and/or cognitive, reward and fear systems, the wake-sleep centers of the brain, the growth, reproductive and thyroid hormone axes, and the gastrointestinal, cardiorespiratory, metabolic, and immune systems. Optimal basal activity and responsiveness of the stress system is essential for a sense of well-being, successful performance of tasks, and appropriate social interactions. By contrast, excessive or inadequate basal activity and responsiveness of this system might impair development, growth and body composition, and lead to a host of behavioral and somatic pathological conditions

Stress and disorders of the stress system

Abstract | All organisms must maintain a complex dynamic equilibrium, or homeostasis, which is constantly challenged by internal or external adverse forces termed stressors. stress occurs when homeostasis is threatened or perceived to be so; homeostasis is re-established by various physiological and behavioral adaptive responses. Neuroendocrine hormones have major roles in the regulation of both basal homeostasis and responses to threats, and are involved in the pathogenesis of diseases characterized by dyshomeostasis or cacostasis. The stress response is mediated by the stress system, partly located in the central nervous system and partly in peripheral organs. The central, greatly interconnected effectors of this system include the hypothalamic hormones arginine vasopressin, corticotropin-releasing hormone and pro-opiomelanocortinderived peptides, and the locus ceruleus and autonomic norepinephrine centers in the brainstem. Targets of these effectors include the executive and/or cognitive, reward and fear systems, the wake-sleep centers of the brain, the growth, reproductive and thyroid hormone axes, and the gastrointestinal, cardiorespiratory, metabolic, and immune systems. Optimal basal activity and responsiveness of the stress system is essential for a sense of well-being, successful performance of tasks, and appropriate social interactions. By contrast, excessive or inadequate basal activity and responsiveness of this system might impair development, growth and body composition, and lead to a host of behavioral and somatic pathological conditions

Philosophical Management of Stress based on Science and Epicurean Pragmatism: A Pilot Study

In the first months of the COVID-19 pandemic, we created and implemented from November 2020 to February 2021 a monthly educational pilot program of philosophical management of stress based on Science, Humanism and Epicurean Pragmatism, which was offered to employees of 26 municipalities in the Prefecture of Attica, Greece. The program named “Philosophical Distress Management Operation System” (Philo.Di.M.O.S.) is novel and unique in its kind, as it combines a certain Greek philosophical tradition (Epicurean) that concurs with modern scientific knowledge. The program was designed to be implemented in a period of crisis; therefore, it used a fast-paced, easy to learn and practice philosophical approach to stress management, based on cognitive psychotherapy. The philosophical approach to stress management has the advantage that it can be offered to most people, regardless of age and educational level. The pilot program was effective in achieving its objectives, shown by statistical comparisons of the trainees’ responses to anonymous questionnaires before and after the month-long training. The successful Philo.Di.M.O.S. program, thus, based on a solid scientific and philosophical basis, offers a paradigm of stress management during crises and could be useful in Greece and internationally

Could COVID-19's Aftermath on Children's Health Be Felt into the 22nd Century?

The COVID-19 pandemic has massively affected people’s health, societies, and the global economy. Our lives are no longer as they were before COVID-19, and, most likely, will never be the same again. We hypothesize that the effect of the COVID-19 pandemic on population health and the economy will last for a very long time and will still be felt in the 22nd century. Our hypothesis is based on evidence from the 1918–1919 influenza pandemic, the Dutch famine during the Second World War, and the 2007–2008 economic crisis, as well as from the rationally predicted impact of COVID-19 on human development. We expect that the COVID-19 pandemic, including the mitigation measures taken against it, will affect children’s development in multiple ways, including obesity, both while in utero and during critical and sensitive windows of development, including the early childhood years and those of puberty and adolescence. The psychosocial and biological impact of this effect will be considerable and unequally distributed. The implications will last at least a lifetime, and, through inter-generational transmission, will likely take us to future generations, into the 22nd century. We argue for the urgent need of designing and initiating comprehensive longitudinal cohort studies to closely monitor the long-term effects of COVID-19 on children conceived, born, and raised during the pandemic. Such an approach requires a close and effective collaboration between scientists, healthcare providers, policymakers, and the younger generations, and it will hopefully uncover evidence necessary to understand and mitigate the impact of the pandemic on people’s lives in the 21st and 22nd centuries

High/low cortisol reactivity and food intake in people with obesity and healthy weight

Increased food intake, termed “comfort eating”, is a pathologic coping mechanism in chronic stress. Cortisol reactivity under stress is a potent predictor of stress-induced eating behavior affecting the body mass index (BMI). However, cortisol reactivity and food intake under stress in people with obesity has not been evaluated. The aim of this study was to investigate the effect of high/low cortisol reactivity on food intake in people with obesity and healthy weight test controls, following standardized stress induction and a resting condition. Thirty-six men and women with obesity (BMI: 33.00 ± 3.23 kg/m²), as well as 36 age- and gender-matched healthy weight controls (BMI: 21.98 ± 1.81 kg/m²) were categorized into high cortisol reactors (HCR) and low cortisol reactors (LCR) in the Trier Social Stress Test (TSST). Following the TSST and a resting condition, the food intake of all participants was recorded in a standardized laboratory meal. Obese HCR demonstrated a significantly higher food intake than LCR (t (34) = −2.046, p ≤ 0.05). However, there were no significant differences between HCR and LCR in the healthy weight controls (p = 0.26). In addition, HCR of the people with obesity showed lower values in the emotion coping strategy of cognitive reappraisal than obese LCR (t (32) = 2.087, p ≤ 0.05). In conclusion, the magnitude of the cortisol reactivity to stress predicts stress-induced food intake in people with obesity, but not in the healthy weight controls. Limited use of cognitive reappraisal in emotion regulation in the obese HCR may be a marker of vulnerability to stress-induced eating