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Posts Tagged ‘Depression’

Childless Women With Fertility Problems at Higher Risk of Hospitalization for Psychiatric Disorders

Posted by Sun on July 6, 2012

ScienceDaily (July 2, 2012) — While many small studies have shown a relationship between infertility and psychological distress, reporting a high prevalence of anxiety, mood disorders and depressive symptoms, few have studied the psychological effect of childlessness on a large population basis. Now, based on the largest cohort of women with fertility problems compiled to date, Danish investigators have shown that women who remained childless after their first investigation for infertility had more hospitalisations for psychiatric disorders than women who had at least one child following their investigation.

The results of the study were presented July 1 at the annual meeting of ESHRE (European Society of Human Reproduction and Embryology) by Dr Birgitte Baldur-Felskov, an epidemiologist from the Danish Cancer Research Center in Copenhagen.

Most studies of this kind have been based on single clinics and self-reported psychological effects. This study, however, was a nationwide follow-up of 98,737 Danish women investigated for infertility between 1973 and 2008, who were then cross-linked via Denmark’s population-based registries to the Danish Psychiatric Central Registry. This provided information on hospitalisations for psychiatric disorders, which were divided into an inclusive group of “all mental disorders,” and six discharge sub-groups which comprised “alcohol and intoxicant abuse,” “schizophrenia and psychoses,” “affective disorders including depression,” “anxiety, adjustment and obsessive compulsive disorder,” “eating disorders,” and “other mental disorders.”

All women were followed from the date of their initial fertility investigation until the date of psychiatric event, date of emigration, date of death, date of hospitalisation or 31st December 2008, whichever came first. Such studies, said Dr Baldur-Felskov, could only be possible in somewhere like Denmark, where each citizen has a personal identification number which can be linked to any or all of the country’s diagnostic registries.

Results of the study showed that, over an average follow-up time of 12.6 years (representing 1,248,243 woman-years), 54% of the 98,737 women in the cohort did have a baby. Almost 5000 women from the entire cohort were hospitalised for a psychiatric disorder, the most common discharge diagnosis being “anxiety, adjustment and obsessive compulsive disorders” followed by “affective disorders including depression.”

However, those women who remained childless after their initial fertility investigation had a statistically significant (18%) higher risk of hospitalisations for all mental disorders than the women who went on to have a baby; the risk was also significantly greater for alcohol/substance abuse (by 103%), schizophrenia (by 47%) and other mental disorders (by 43%). The study also showed that childlessness increased the risk of eating disorders by 47%, although this was not statistically significant.

However, the most commonly seen discharge diagnosis in the entire cohort (anxiety, adjustment and obsessive compulsive disorders) was not affected by fertility status.

Commenting on the study’s results, Dr Baldur-Felskov said: “Our study showed that women who remained childless after fertility evaluation had an 18% higher risk of all mental disorders than the women who did have at least one baby. These higher risks were evident in alcohol and substance abuse, schizophrenia and eating disorders, although appeared lower in affective disorders including depression.

“The results suggest that failure to succeed after presenting for fertility investigation may be an important risk modifier for psychiatric disorders. This adds an important component to the counselling of women being investigated and treated for infertility. Specialists and other healthcare personnel working with infertile patients should also be sensitive to the potential for psychiatric disorders among this patient group.”


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What Is The Link Between Women’s Hormones And Mood Disorders?

Posted by Sun on July 5, 2012

ScienceDaily (Dec. 12, 2007) — Countless movies and TV shows make light of women’s so-called “moodiness”, often jokingly attributing it to their menstrual cycle or, conversely, to menopause. In fact, mood disorders are a serious and pervasive health problem, and large-scale population studies have found women are 1.5 to 3 times more likely to suffer from major depressive disorder than are men.

In a newly published study, women’s health experts from the University of Alberta argue there is an urgent need for carefully designed, gender-specific research to better understand the relationship of female sex hormones to mood states and disorders.

“The reasons for the gender disparity in rates of depression are not completely understood,” says Kathy Hegadoren, the Canada Research Chair in Stress Disorders in Women at the University of Alberta.

“But there is growing evidence that estrogens have powerful effects beyond their role in reproduction–that they play a critical role in mood disorders in women–and this opens new avenues for research into the underlying biological mechanisms and treatment of depression.”

Estrogen can be used to treat various mood disturbances in women–such as perimenopausal, postmenopausal and postpartum depression–but the results of these treatments can be difficult to interpret because researchers are only beginning to recognize the complex interactions among estrogens, serotonin and mood.

“Right now, clinical use of sex-hormone therapies for the treatment of mood disorders is severely hampered by the inability to predict which women would respond well to such therapies,” explains study co-author and U of A nursing professor Gerri Lasiuk.

“Most animal studies looking at the causes of depression have been conducted with male animals and use chronic-stress models, which are assumed to be similar to depression.”

Hegadoren and Lasiuk’s study recognizes that multiple factors may be at play in the development of mood disturbances, with individual, psychosocial and environmental factors interacting in complicated ways to create differential vulnerability in women and men. But they also point out that the link to sex hormones is hard to deny.

“Previous research has found that, before puberty, the rates of mood and anxiety disorders are similar in boys and girls. It’s only after females begin menstrual function that a gender differential in mood disorders manifests itself. This, coupled with the observation that women appear to be especially vulnerable to mood disturbances during times of hormonal flux, certainly lends support to the claim that a relationship exists between sex hormones and mood,” says Hegadoren.

The study, co-authored by Hegadoren and Lasiuk, appears in the October 2007 issue of the journal Biological Research for Nursing.

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Alcohol, Mood and Me (Not You)

Posted by Sun on June 15, 2012

ScienceDaily (Apr. 28, 2011) — Thanks in part to studies that follow subjects for a long time, psychologists are learning more about differences between people. In a new article published in Current Directions in Psychological Science, a journal of the Association for Psychological Science, the author describes how psychologists can use their data to learn about the different ways that people’s minds work.

Most psychology research is done by asking a big group of people the same questions at the same time. “So we might get a bunch of Psych 101 undergrads, administer a survey, ask about how much they use alcohol and what their mood is, and just look and see, is there a relationship between those two variables,” says Daniel J. Bauer of the University of North Carolina at Chapel Hill, the author of the article.

But a one-time survey of a bunch of college students can only get you so far. For example, it might find that sad people drink more, but it can’t tell us whether people drink more at times when they are unhappy, whether the consequences of drinking instead result in a depressed mood, or whether the relationship between mood and alcohol use is stronger for some people than others.

One way psychologists have used to learn more about people is collecting data from people over a longer time period. For example, they might give each subject an electronic device to record blood pressure and stress several times a day, or ask them to log on to a website every night to answer a survey. In one case, Bauer’s colleague, Andrea Hussong, asked adolescents to complete daily diaries with ratings of their mood and alcohol use over 21 days. The data showed that the relationship between mood and alcohol use is not the same for everyone. Adolescents with behavioral problems drink more in general, irrespective of mood, but only adolescents without behavioral problems drink more often when feeling depressed.

Analyzing this kind of data requires tougher math than the simple survey data, which is where quantitative psychologists like Bauer come in. “I think even though a lot of researchers are starting to collect this data, I don’t think they’ve taken full advantage of it,” he says. In the new paper, Bauer points to other methods that can do a better job of showing how variables relate differently for different people.

The point of all of this is to help people, Bauer says. For example, if psychologists discover that certain kinds of people are more likely to drink when depressed, it would be possible to help those people early. “Ultimately, the idea would be to identify people who might be more at risk and try to help them,” he says.

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Depression Treatment Can Prevent Adolescent Drug Abuse

Posted by Sun on June 15, 2012

ScienceDaily (June 4, 2012) — Treating adolescents for major depression can also reduce their chances of abusing drugs later on, a secondary benefit found in a five-year study of nearly 200 youths at 11 sites across the United States.

Only 10 percent of 192 adolescents whose depression receded after 12 weeks of treatment later abused drugs, compared to 25 percent of those for whom treatment did not work, according to research led by John Curry, a professor of psychology and neuroscience at Duke University.

“It turned out that whatever they responded to — cognitive behavioral therapy, Prozac, both treatments, or a placebo — if they did respond within 12 weeks they were less likely to develop a drug-use disorder,” Curry said.

The study found no such relationship when it came to thwarting alcohol abuse, however.

The researchers followed nearly half the 439 participants from the “Treatment for Adolescents with Depression Study” (TADS; 2000-2003), led by Dr. John March, chief of Child and Adolescent Psychiatry at Duke University Medical Center. TADS is considered the largest sample of adolescents who had been treated for major depression.

The participants analyzed by Curry’s study were ages 17-23 at the end of the five-year follow-up study and had no preexisting problems with abusing alcohol or drugs.

“Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression” (2004-2008), found that marijuana was the most prevalent drug used by study participants (76 percent); other drugs included cocaine, opiates and hallucinogens.

The adolescents must have had at least five symptoms for a length of time to be diagnosed with major depression prior to treatment: depressed mood; loss of interest; disruptions in appetite, sleep or energy; poor concentration; worthlessness; and suicidal thoughts or behavior.

The researchers said that improved mood regulation due to medicine or skills learned in cognitive-behavior therapy, along with support and education that came with all of the treatments, may have played key roles in keeping the youths off drugs.

The researchers were surprised to find no differences in alcohol abuse and do not have an answer for why. Curry thinks the prevalence of alcohol use among people ages 17-23 may be a key factor.

“It does point out that alcohol use disorders are very prevalent during that particular age period and there’s a need for a lot of prevention and education for college students to avoid getting into heavy drinking and then the beginnings of an alcohol disorder,” Curry said. “I think that is definitely a take-home message.”

Alcohol abuse also led to repeat bouts with depression for some participants, he said.

“When the teenagers got over the depression, about half of them stayed well for the whole five-year period, but almost half of them had a second episode of depression,” Curry said. “And what we found out was that, for those who had both alcohol disorder and another depression, the alcohol disorder almost always came first.”

Curry and co-author Susan Silva, associate professor and statistician in the Duke School of Nursing, believe more study is needed because the number of participants who developed drug or alcohol disorders was relatively small.

Also, there was no comparison group of non-depressed patients, so the researchers could not be sure that rates of subsequent drug and alcohol abuse disorders were higher than those for adolescents not treated for depression.

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Women More Depressed And Men More Impulsive With Reduced Serotonin Functioning

Posted by Sun on June 4, 2012

ScienceDaily (Sep. 17, 2007) — Women and men appear to respond differently to the same biochemical manipulation. Major depressive disorder (MDD) is one of the most common mental disorders, and it is also one of the most studied.

It is already known that reduced serotonin transmission contributes to the pathophysiology, or functional changes, associated with MDD and most of today’s most popular antidepressants block the serotonin “uptake site”, also known as the transporter, in the brain. It is also known that people with MDD are frequently found to have impaired impulse control.

A new study being published in the September 15th issue of Biological Psychiatry now reports on important sex and genetic differences in the way that men and women react to reductions in serotonin function, specifically in terms of their mood and impulsivity.

Using a technique in healthy participants called acute tryptophan depletion, which decreases serotonin levels in the brain, Walderhaug and colleagues found that men became more impulsive, but did not experience any mood changes in response to the induced chemical changes. However, women in this study reported a worsening of their mood and they became more cautious, a response commonly associated with depression. The researchers also discovered that the mood lowering effect in women was influenced by variation in the promotor region of the serotonin transporter gene (5-HTTLPR).

One of the study’s authors, Dr. Espen Walderhaug, explains, “We were surprised to find such a clear sex difference, as men and women normally experience the same effect when the brain chemistry is changed… Although we have the same serotonergic system in the brain, it is possible that men and women utilize serotonin differently.”

These findings highlight the complexity of studying and treating these disorders, as the interactive effects of gender and genetic coding impacted the outcomes in the men and women when their serotonergic functions were disrupted.

Dr. Walderhaug comments that their study’s findings “might be relevant in understanding why women show a higher prevalence of mood and anxiety disorders compared to men, while men show a higher prevalence of alcoholism, ADHD and impulse control disorders.” John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, adds that the response patterns that have emerged in these findings are “the beginnings of an understanding for these sex-related effects.” Ultimately, it is hoped that these findings further advance the ability to quickly and more accurately treat patients.

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Cognitive Behavioral Therapy for Major Depression

Posted by Sun on June 3, 2012

Modern cognitive behavioral therapy (CBT) was developed independently by two separate individuals: Aaron Beck, a psychiatrist, and Albert Ellis, a clinical psychologist. Both Beck and Ellis began working on their versions of the therapy in and around the late 1950s and early 60s. Both versions of the therapy are founded on the single basic idea that cognition, in the form of thoughts and preconceived judgments, precedes and determines people’s emotional responses.

In other words, what people think about an event that has occurred determines how they will feel about that event. Depression happens because people develop a disposition to view situations and circumstances in habitually negative and biased ways, leading them to habitually experience negative feelings and emotions as a result.

More specifically, Cognitive-Behavioral (CBT) therapists suggest that depression is caused by a combination of an unhelpful dysfunctional thought process and by maladaptive behaviors motivated by that thought process. Because these dysfunctional thoughts and behaviors are learned, people with depression can also learn new, more adaptive skills that raise their mood and increase their ability to cope with daily hassles and stressors. Another basic idea behind CBT is that if a person changes their thoughts and behavior, a positive change in mood will follow.

The cognitive aspect of CBT involves learning to identify distorted patterns of thinking and forming judgments. These maladaptive thought patterns are also known as negative or maladaptive schemas, or core beliefs. Core beliefs are fundamental assumptions people have made that influence how they view the world and themselves.

People get so used to thinking in these core ways that they stop noticing them or questioning them. Simply put, core beliefs are the unquestioned background themes that govern depressed people’s perceptions. For example, a depressed person might think “I am unlovable” or “I am inadequate and inferior” and because these beliefs are unquestioned, they are acted upon as though they are real and true.

Core beliefs serve as a filter through which people see the world. Core beliefs influence the development of “intermediate beliefs”, which are related attitudes, rules and assumptions that follow from core beliefs. When depressed people’s core beliefs are negative and unrealistic, they lead people to experience predominately negative and unrealistic thoughts.

Following along with the example started above, our depressed person might develop the attitude that, “It’s terrible to be unloved”. Similarly, the intermediate belief might include the following rule, “I must please everyone” and an assumption to the effect that, “If I please everyone then people will love me.”

Intermediate beliefs can influence people’s view of a particular situation by generating “automatic thoughts,” the actual thoughts or images that people experience flitting through their minds. Automatic thoughts are evaluative cognitions which occur in response to a particular situation. They are spontaneous (hence the term automatic), rather than the result of deliberate extended thinking or the logical reasoning that occurs when someone concentrates.

Automatic thoughts occur effortlessly, more or less all the time. Most of the time we are unaware that they are occurring, not because they are unconscious sorts of things but rather because we’re so used to them that we don’t notice them anymore. Automatic thoughts influence emotions and behaviors and can provoke physiological responses.

To continue the above example, if a friend of our depressed person does not return a phone call, our depressed person might think, “He’s not calling me back because he hates me”. It may never occur to her to generate alternative and less irrational explanations for the lack of a callback such as,”He must be really busy today.” Because the automatic thought “he hates me” is allowed to stand unchallenged, our depressed person starts feeling hated, and thus depressed.

Though every patient’s automatic thoughts are unique, there are also clear patterns of depressive automatic thoughts that form that are common across many depressed people’s minds. Some common patterns of negative and irrational automatic thoughts include:

  • Catastrophizing – always anticipating the worst possible outcome to occur (e.g., expecting to be criticized or fired when the boss calls).
  • Filtering – exaggerating the negative and minimizing the positive aspects of an experience (e.g., focusing on all the extra work that went into a promotion rather than on how nice it is to have the promotion).
  • Personalizing – automatically accepting blame when something bad occurs even when you had nothing to do with the cause of the negative event (e.g., He didn’t return my phone call because I am a terrible friend or a boring person; I caused him to not call.).
  • (Over)Generalizing – viewing isolated troubling events as evidence that all following events will become troubled (e.g., having one bad day means that the entire week is ruined).
  • Polarizing – viewing situations in black or white (all bad or all good) terms rather than looking for the shades of gray (e.g., “I missed two questions on my exam, therefore I am stupid”, instead of “I need to study harder next time, but hey – I did pretty good anyway!”).
  • Emotionalizing – allowing feelings about an event to override logical evaluation of the events that occurred during the event. (e.g., I feel so stupid that it’s obvious that I’m a stupid person).

Dysfunctional beliefs are thinking habits that people learn which happen to be irrational and not based on reality (e.g., on objective, unbiased observation). Because such beliefs are not linked to reality very well, they tend to appear rather distorted when compared with reality.

Distorted though they may be, dysfunctional beliefs are all people typically have to help them make sense out of the events that happen to them. Snap judgments are made (called Cognitive Appraisals) based on the assumptions present within dysfunctional beliefs, and those judgments end up being, not surprisingly, biased and irrational.

People look to their appraisals of stressful situations to know how to react, and when they do, they see that situations look simply awful (worse than it really would appear if some reality testing were to occur). They react to that false or exaggerated sense of awfulness, and correspondingly experience depressive symptoms.


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People Sometimes Less Trusting When in a Good Mood

Posted by Sun on June 1, 2012

ScienceDaily (Mar. 2, 2010) — It seems to make perfect sense: happy people are trusting people. But a new study suggests that, in some instances, people may actually be less trusting of others when they are in a pleasant mood.

“A person’s mood may determine how much they rely on subtle — or not so subtle — cues when evaluating whether to trust someone,” said Robert Lount, author of the study and assistant professor of management and human resources at Ohio State University’s Fisher College of Business.

In five separate experiments, Lount found that people in a positive mood were more likely than those in a neutral mood to follow cues or stereotypes when determining whether they should trust someone.

If you are predisposed to trust a stranger — because he belongs to the same club as you, or he has a “trustworthy” face — a happy mood makes you even more likely to trust him.

But if you are predisposed to not trust him, a positive mood will make you even less trusting than normal.

“I think the assumption is that if you make someone happy, they are going to be more likely to trust you. But that only works if they are already predisposed to trust you,” Lount said.

“If you’re a professional meeting new clients, you may think if you buy them a nice lunch and make them happy, you’re building trust. But that can actually backfire if the client has some reason to be suspicious of you,” he said.

The study appears in the March 2010 issue of the Journal of Personality and Social Psychology.

All five experiments involved undergraduate students who took part in various scenarios in which they were put into positive or neutral moods, and were then given the opportunity to show trust or distrust toward a stranger.

In one study, for example, participants were first asked to write one of two short essays. Some wrote about an experience that made them happy while others wrote about what they did in a typical day. Those writing tasks were previously shown to put people in a happy or neutral mood.

The participants were then shown a picture of a person and asked a variety of questions designed to find out how much they would trust him. For example, one question asked how likely the participants thought it would be that the person would intentionally misrepresent their point of view to others.

All the pictures were created by a software program that made the faces appear trustworthy or untrustworthy to most people. A trustworthy person had a round face, round eyes and was clean shaven. An untrustworthy person had a narrow face, narrow eyes and facial hair.

The results were striking: participants in a positive mood evaluated the person with the trustworthy features as more trustworthy than did those in a neutral mood.

Conversely, the happy people were less trusting of the person with untrustworthy features than were those in the neutral mood.

“For those in a good mood, it all depended on the cues that the pictured person gave that suggested whether he was trustworthy or not,” Lount said.

But why would happy people rely more on stereotypes and cues to evaluate a person’s trustworthiness?

Research suggests the answer relies on motivation, Lount said.

“When you’re happy, you’re less motivated to carefully process information,” he said.

“You feel like everything is going OK, so there is no reason to search out new information. You can rely on your previous expectations to guide you through a situation.”

Another one of the experiments provided evidence for that theory. In this experiment, the participants were put in a happy or neutral mood. They were then asked to memorize a nine-digit number, which they would be asked to repeat in a few minutes.

Then, they were shown pictures of untrustworthy faces and asked to rate how trustworthy each face looked.

In this case, people in a neutral mood responded much as did the happy people in the previous experiments — they rated untrustworthy faces as even more untrustworthy.

“In this experiment, people’s minds were busy trying to remember the number so they processed information differently than they normally did,” Lount said.

“They relied more on the cues, just like happy people did.”

Lount said people aren’t aware of this process and don’t even know how their mood is affecting how they evaluate others.

“You need to be careful, especially when you’re happy. You should ask yourself how your mood may be affecting your willingness to trust or distrust another person.”

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Happiness: It’s Not in the Jeans

Posted by Sun on June 1, 2012

ScienceDaily (Mar. 8, 2012) — You may throw on an outfit without much thought in the morning, but your choice is strongly affected by your mood. And the item of casual wear in almost everyone’s wardrobe — denim jeans — is what most people wear when depressed, new research from psychologists at the University of Hertfordshire reveals.

A study conducted by Professor Karen Pine, co-author of “Flex: Do Something Different, found that what a woman chooses to wear is heavily dependent upon her emotional state.”* One hundred women were asked what they wore when feeling depressed and more than half of them said jeans. Only a third would wear jeans when feeling happy. In a low mood a woman is also much more likely to wear a baggy top; 57% of the women said they would wear a baggy top when depressed, yet a mere 2% would wear one when feeling happy. Women also revealed they would be ten times more likely to put on a favorite dress when happy (62%) than when depressed (6%).

The psychologists conclude that the strong link between clothing and mood state suggests we should put on clothes that we associate with happiness, even when feeling low.

Professor Pine said: “This finding shows that clothing doesn’t just influence others, it reflects and influences the wearer’s mood too. Many of the women in this study felt they could alter their mood by changing what they wore. This demonstrates the psychological power of clothing and how the right choices could influence a person’s happiness.”

Accessories can make a difference too. The study found that:

  • •Twice as many women said they would wear a hat when happy than when depressed.
  • •Five times as many women said they would wear their favorite shoes when happy (31%) than when depressed (6%).

The study found that ‘happy’ clothes — ones that made women feel good — were well-cut, figure enhancing, and made from bright and beautiful fabrics. Professor Pine pointed out that these are exactly the features that jeans lack: “Jeans don’t look great on everyone. They are often poorly cut and badly fitting. Jeans can signal that the wearer hasn’t bothered with their appearance. People who are depressed often lose interest in how they look and don’t wish to stand out, so the correlation between depression and wearing jeans is understandable. Most importantly, this research suggests that we can dress for happiness, but that might mean ditching the jeans.”

*FLEX: Do Something Different. How to use the other 9/10ths of your personality, by psychologists Professor Ben (C) Fletcher and Professor Karen Pine, published January 2012 by University of Hertfordshire Press.

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Music Changes Perception, Research Shows

Posted by Sun on June 1, 2012

ScienceDaily (Apr. 27, 2011) — Music is not only able to affect your mood — listening to particularly happy or sad music can even change the way we perceive the world, according to researchers from the University of Groningen.

Music and mood are closely interrelated — listening to a sad or happy song on the radio can make you feel more sad or happy. However, such mood changes not only affect how you feel, they also change your perception. For example, people will recognize happy faces if they are feeling happy themselves.

A new study by researcher Jacob Jolij and student Maaike Meurs of the Psychology Department of the University of Groningen shows that music has an even more dramatic effect on perception: even if there is nothing to see, people sometimes still see happy faces when they are listening to happy music and sad faces when they are listening to sad music.


Jolij and Meurs had their test subjects perform a task in which they had to identify happy and sad smileys while listening to happy or sad music. Music turned out to have a great influence on what the subjects saw: smileys that matched the music were identified much more accurately. And even when no smiley at all was shown, the subjects often thought they recognized a happy smiley when listening to happy music and a sad one when listening to sad music.


The latter finding is particularly interesting according to the researchers. Jolij: ‘Seeing things that are not there is the result of top-down processes in the brain. Conscious perception is largely based on these top-down processes: your brain continuously compares the information that comes in through your eyes with what it expects on the basis of what you know about the world. The final result of this comparison process is what we eventually experience as reality. Our research results suggest that the brain builds up expectations not just on the basis of experience but on your mood as well.’

The research was published in the open access journal PLoS ONE on 21 April.

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Depression Can Be Defeated

Posted by Sun on May 30, 2012

Depression is a serious state of mind and body that needs to be taken seriously now. The prevalence of depression has increased dramatically since the turn of the Twentieth Century. In any year about 10 percent, or 30 million, of the US population will suffer from a serious depression. Depression is currently the number one disability for women. By the year 2020, depression is expected to follow coronary heart disease as the second most common form of disability for both sexes.

The rate of depression for adolescents has increased about one-thousand fold since 1950, which is partly due to earlier pubescence, less exercise, and social changes. The elderly are four times more likely to experience a serious depression than they would at a younger age.

As the US demographic shifts toward a larger elderly population, the numbers of people depressed will increase. The time to consider prevention methods, is now. There are a variety of preventative methods to reduce the risk of future depression, including depression education courses and research-based psychology self-help books on depression.

A US Department of Mental Health report offers encouragement to those experiencing depression. About eighty-percent of those who suffer from depression can significantly improve or overcome this disability, while others can make lesser but still significant changes. Practically any gambler would take those odds. However, depression merges with pessimism, so the odds typically look bleak to the depressed perceiver. A shift in belief to thinking that a positive change is possible, can make a big difference.

Depression is a disability and not a choice. People do not normally choose to depress themselves. The choice comes in what to do to arrest depression. In this regard the old saying, “different strokes for different folks,” has merit.


Depression is more than the blues and blahs that temporarily come and go in life. When experiencing a persistently depressed mood, our psychology, biology, and social experiences are distorted.

People suffering from depression suffer from an intense melancholic mood, and typically experience a loss of pleasure and experience oppressive depressive thoughts that can negatively affect how they go about their day, interact with others, and perform work responsibilities. A persistently depressed mood is often accompanied by unpleasant physical symptoms such as fatigue, lower back pain, headache, sleep disturbances, and a problem appetite.

There are several different types and causes of depression. Persistent depressive distress often follows a trauma or a loss, a pattern of stressful inner dialogues, or can come out of the blue. This condition of mind and body affects people from all walks of life from Presidents to the person on the street.

Depression is nothing to take lightly. A lingering mild, moderate, or severe depression represents a serious disability. The personal cost is found in intense anguish and bodily distress. The current economic burden is estimated at $85 billion annually.

Depression is not a simple unitary condition. This psychological, biological, and social form of disability is often complicated with coexisting conditions such as anxiety, perfectionism, and substance abuse. Because of the different forms, causes, and complications of depression, any general formula to arrest depression is bound to fail as a universal remedy.


The recent FDA announcement of a planned new “black box” warning for antidepressant medications, grabs attention. The proposed FDA black box warning involves extending a similar 2004 warning about elevated suicide risk following the use of antidepressants for adolescents and young adults. The warning encourages suitable precautions.

Rather than view the warning with alarm, the FDA announcement represents an opportunity for people to better education themselves about depression and how to address it with or without antidepressant pills.


Since the US Food and Drug Administration (FDA) allowed pharmaceutical companies to advertise their products directly to the consumer, the use of antidepressants has increased significantly. The companies take in about $10.9 billion in annual sales in the US alone; the sales charts continue to show an upward trend.

There has been a heavy reliance on antidepressants to stem the flow of depression. This represents a quick and initially inexpensive approach that had been favored by managed care insurance companies that have a strong voice in treatment decisions for addressing depression. But it seems like this emphasis has been too great for too long to the detriment of many who suffer from depression for whom a less costly or natural alternative might prove preferable. The long-term use of antidepressants is also proving more costly than many equally effective alternative approaches, and so the winds are beginning to shift.

The antidepressants are not panaceas for defeating depression and for preventing it from coming back. In controlled laboratory studies, about sixty-percent of antidepressant users start to improve in a two to six-week period. But the laboratory is different from the real world where the adherence and improvement rates are often lower.

Antidepressants do seem to have a medicative effect for a subgroup of people with certain forms of depression. The majority of people who use antidepressants do not suffer major side effects. However, for others, the drugs have side-effects that can be worse than the depression.

Antidepressants can be a productive way to help alleviate depression but the pills have limitations:

  1. For some, antidepressants have side effects that are serious enough to warrant stopping their use immediately.
  2. The relapse rate following the use of antidepressants is significant. Following the termination of an antidepressant, about fifty- to eighty-percent get depressed again. The current drug company solution is to encourage switching antidepressant drugs. If one doesn’t work, try another. Although the switch over approach can be profitable to the drug companies, it detracts from the use of other methods that can initially be equally or more effective and have the added benefits of preventing depression from coming back.
  3. Depression comes in different forms including major depression, bipolar depression, and atypical depression. Some suffer from forms of depression that can get worse following the use of antidepressants.
  4. Adherence is a problem. An estimated twenty-five to fifty-percent on antidepressants stop taking the antidepressant pills within a month.
  5. The elderly who use SSRI antidepressants (Zoloft, Prozac), show reduced bone mineral density in their hips and higher risk for fractures following falls. Such falls may occur due to low blood pressure and dizziness associated with antidepressant use.
  6. It’s a fact that pharmaceutical companies have held back negative results from their own antidepressant studies. This very serious omission cannot ethically be justified. If the scientific findings are open to question, then this information flashes a warning signal to the consumer that is as loud as the FDA warning.
  7. Some experience increased suicidal urges.

When antidepressants fail, alternatives are sometime sought. However, reframing the question from “what can one do if antidepressants fail” to “what can one do before antidepressants are used,” can cause a radical–and needed–shift in perspective.

The reframed question suggests the importance of prevention, and prevention programs do work. It also suggests that there are equally or better and often less costly ways to defeat depression and to defend against depression relapses. Armed with such information, an informed consumer is likely to make better choices.


If one assumes that the first line of defense against depression is the antidepressant drugs, then antidepressants will typically be used first. Alternatives may be sought in cases where the pills don’t work. But if you operate on the assumption that there are evidence-based alternatives to arrest depression, you might consider those approaches first. That is the approach taken here. Cognitive forms of therapy, exercise, structured routines, and the use of the herb, St. Johns wort, represent priority alternatives.

The following describes a sample of alternative methods that have been found effective in addressing depression:

  1.  Antidepressants can be effective when the user believes that the drugs will help. A significant part of an antidepressive’s effectiveness can be attributed to a placebo effect where depressed persons come believe they will get over depression. This effect suggests that overcoming depressive thinking–especially the hopelessness variety–can lead to relief from depression. This change in thought also can be accomplished through recognizing and challenging depressive irrational belief systems. Recognizing and challenging depressive beliefs can give the person a sense of individual control that does not depend upon “placebo magic.”Can the known power of a placebo be economically harnessed without antidepressants? Definitely yes! Learning and practicing positive critical thinking techniques can have a placebo effect. But more than that, developing and applying rational skills to overcome depressive thinking, can have a durable effect in stopping depression and preventing it from coming back.
  2. Decreasing depressive thinking is associated with an improved mood and reduction in physical symptoms.Cognitive methods used to help eliminate distorted depressive thinking are significantly more effective than antidepressants in preventing depression from coming back. That added benefit is especially important for people with a history of repeat bouts of depression. The Cognitive Therapy method has strong research support. Multi Modal Therapy holds promise as a comprehensive approach for dealing with multiple tiers of depression.Rational Emotive Behavioral Therapy (REBT) methods can be beneficially directed toward addressing both irrationalities in depressive thinking but also conditions that commonly coexist with depression such as anxiety, anger, panic, and an inappropriately low tolerance for frustration. Effectively dealing with depressive thinking and these coexisting conditions can open opportunities for fulfillment as well as for preventing depression from coming back. Among the various cognitive methods for arresting depression, the REBT method would seem to be the more comprehensive approach for defeating both depressive thinking and the sort of negative thoughts that are part of those conditions of mind that so often coexist with depression.Fascinating new brain scan research shows that applying cognitive procedures to reduce depressive thinking commonly results in measurable changes in the brain that are associated with a significantly lower relapse rate. Following the use of cognitive methods, brain wave studies show more normalized wave patterns. Following cognitive interventions, brain imaging shows a shift from the color of a depressed brain toward the color of a “normal” brain. These physical measures, coupled with reports of feeling better, make a compelling case for using cognitively oriented methods for defeating depressive thinking.
  3. One of the best antidepressant methods is exercise. A Duke University study found exercise to be initially as effective as the antidepressant Zoloft. Over a longer period, compared to Zoloft users, exercise was associated with a lower relapse rate. Exercise has strong research support.
  4. The herb, St. Johns wort, is an effective antidepressant with strong research support. It has few side effects. The herb is significantly less expensive than antidepressant medication products. It is more widely used in Europe and Canada than in the US and equals the drug company antidepressants in its overall effectiveness.
  5. Does combining antidepressant medications with cognitive approaches more rapidly reduce depression and prevent it from coming back? There is modest evidence that combining cognitive methods with antidepressant medications may prove more effective than either approach alone. It is the direction of this combined approach that is intriguing. Adding a cognitive therapy to an already existing antidepressant medication approach increases the rate of improvement for the medication group. Adding antidepressants to an ongoing cognitive therapy program, adds little to nothing. One might consider adding a cognitive component to an antidepressant drug approach to help speed recovery and to reduce the risk of a relapse.
  6. Stressful relationships can increase the risk for a depressive outlook and a depressive outlook can act as a catalyst for stressful relationships. Interpersonal Therapy or Cognitive Behavioral Therapy interventions can effectively help reduce interpersonal stresses and improve the quality of relationships for a subgroup of people suffering from depression, and correlate with the reduction of depression. Isolation, especially during “senior years,” is associated with depression. Planned social experiences can reduce a sense of loneliness and the risk for depression among the elderly. Social support groups can be beneficial for this subgroup.
  7. Activity is a time-proven remedy for depression. Creating and following through on a predictable scheduled set of activities of daily living, can help create a forward momentum against depression. The schedule can involve a simple and basic routine that includes awakening at a set time, dressing at a set time, eating breakfast at a local restaurant, and retiring to sleep at an anointed hour. It can include weeding a garden daily. The idea is to work a basic routine that is realistic under depressive circumstances, and manageable.
  8. Can reading a professionally written cognitive behavioral psychology self-help manual for defeating depression prove effective? This bibliotherapy approach is effective for a subgroup of depressed people who believe that if they had the tools to address their depression, they’d consider using them. The research strongly supports this approach. The Cognitive Behavioral Workbook for Depression, cited below, describes a comprehensive approach for dealing with depression that has a heavy loading of REBT methods. This easily read book contains many innovative techniques including the application of procrastination technology for defeating depression.
  9. People with histories of recurrent depression can improve their chances for reducing the risk of future depressions through psychological health maintenance efforts. These efforts can involve scheduled rereading of appropriate self-help sections of bibliotherapy references, prophylactic meetings with a qualified psychotherapist, maintaining exercise or diet programs, and so forth.

As a public service, New Harbinger Publications posted a guide to depression research and practice that I wrote. The report describes a broad range of methods that are effective in addressing depression. This information can be found at:

Those who want to learn about techniques to quell a winter depression can get information at:

About the Author

Bill Knaus, Ed.D. — One of the original Directors of Training, REBT. Fellow, REBT. Training Faculty, REBT. Originator of Rational Emotive Education. Taught at City University of New York: Queens College, Springfield College, & American International College. Former president, Advocacy Network. He is the author of twelve books including The Cognitive Behavioral Workbook for Depression. New Harbinger, November 2006.


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Group therapy ‘beats depression’

Posted by Sun on May 30, 2012

Group-taught meditation is as effective as staying on drug treatments for stopping people slipping back into depression, say UK scientists.

Compared to one-to-one sessions, or medication, “mindfulness-based cognitive therapy” (MBCT) is cheaper for the NHS, they say.

The trial of 123 people found similar relapse rates in those having group therapy and those taking drugs.

The study was published in the Journal of Consulting and Clinical Psychology.

 It’s given me the ability to come up against something that would have previously thrown me, think it through, come up with a solution and then move on. 
Di Cowan

Recent years have seen much more evidence that so-called “talking therapies” can be as effective as drugs in alleviating mild to moderate depression, and health secretary Alan Johnson recently announced millions in new funding for the treatments.

However, this is the first time, according to its authors, that a group therapy has been shown as an alternative to a prescription.

The study, funded by the Medical Research Council, found MBCT, developed in 2002 by a team of psychologists from Canada, Oxford, and Cambridge, was actually more effective than medication in improving patients’ quality of life.

The sessions involve the teaching of meditation techniques based on some found in Buddhism.

The aim is to teach skills which help patients recognise and cope with their tendency towards depression.

GP alternative

Di Cowan, from East Devon, had suffered from depression since his late teens.

The 53-year-old said: “It’s helped me immensely – it’s given me the ability to come up against something that would have previously thrown me, think it through, come up with a solution and then move on.

“My view of the world has changed and I look at life in a new light.”

One of those championing the technique is Professor Willem Kuyken, of the Mood Disorders Centre at the University of Exeter.

He said: “Our results suggest MBCT may be a viable alternative for some of the 3.5 million people in the UK known to be suffering from this debilitating condition.

“I think we have the basis for offering patients and GPs an alternative to long-term antidepressant medication.”

Marjorie Wallace, the chief executive of mental health charity SANE, said the charity would be helping to fund future research into how “ancient meditative techniques” could work together with modern psychotherapy in people with long-term depression.

She said: “We are delighted that this study shows the potential of Mindfulness-Based Cognitive Therapy as an alternative for the treatment of severe and recurring depression.

“Just one in five depressed callers to our helpline report that they are receiving any kind of talking therapy, which is recommended as a first line of treatment.”


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Music therapy may help depression

Posted by Sun on May 28, 2012

Music therapy can be used to improve treatment of depression, at least in the short term, say researchers in Finland.

The technique used non-verbal communication to help patients express their emotions.

A study on 79 people, published in the British Journal of Psychiatry, showed a greater improvement than in patients receiving standard therapy.

British experts said music may engage people in ways that words cannot.

Music therapists are used, including by the NHS, to help children who struggle to communicate. Playing instruments and singing with a trained music therapist is supposed to help children express themselves.

Initial improvement

In this study, all patients with depression received the standard practice of counselling and appropriate medication. Thirty three of them were also given 20 sessions with a trained music therapist, which involved things such as drumming.

After three months, patients receiving music therapy showed a greater improvement in scores of anxiety and depression than the other set of patients.

However, there was no statistical improvement after six months.

Professor Christian Gold, from the University of Jyväskylä, said: “Our trial has shown that music therapy, when added to standard care helps people to improve their levels of depression and anxiety.”

“Music therapy has specific qualities that allow people to express themselves and interact in a non-verbal way – even in situations when they cannot find the words to describe their inner experiences.

Dr Mike Crawford, who specialises in mental health services at Imperial College London, said in a journal editorial: “The results suggest that it can improve the mood and general functioning of people with depression.

“Music-making is social, pleasurable and meaningful. It has been argued that music making engages people in ways that words may simply not be able to.”


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Depression leads to worst health

Posted by Sun on May 28, 2012

Depression is a more disabling condition than angina, arthritis, asthma and diabetes, World Health Organization research shows.

And those with depression plus a chronic illness, such as diabetes, fare particularly badly, the study of more than 245,000 people suggests.

Better treatment for depression would improve people’s overall health, the researchers concluded in the Lancet.

Experts called for better funding for mental health services.

Dr Somnath Chatterji and colleagues asked people from 60 countries taking part in the World Health Survey a variety of questions about their health, such as how they sleep, how much pain they have, and whether they have any problems with memory or concentration.

 A vast sea of misery could be avoided if this condition received the same attention and resources as Aids or cancer 
Marjorie Wallace, Sane

Participants were also asked about how they manage with day-to-day tasks.

After taking into account factors such as poverty and other health conditions, the researchers found that depression had the largest effect on worsening health.

And people with depression who also had one or more chronic diseases had the worst health scores of all the diseases looked at or combinations of diseases.


Dr Somnath Chatterji said: “The co-morbid state of depression incrementally worsens health compared with depression alone, with any of the chronic diseases alone, and with any combination of chronic diseases without depression.

“These results indicate the urgency of addressing depression as a public health priority to reduce disease burden and disability, and to improve the overall health of populations.”

The team called on doctors around the world to be more alert in the diagnosis and treatment of the condition, noting that it is fairly easy to recognise and treat.

Marcus Roberts, head of policy at mental health charity Mind, said the impact of depression could be devastating on relationships, finances and physical health.

“The treatment of depression must be given equal footing to the treatment of other conditions.

“While treatments for most physical health problems are readily accessible, mental health treatments such as talking therapies are limited, with some patients waiting months or even years for their first appointment with a therapist.”

He added that mental health was often overlooked in those with chronic health problems, as doctors focused on the physical symptoms.

‘Vast sea of misery

A spokesperson for the Department of Health said: “Seven million adults in England suffer from a common mental health problem such as anxiety, eating disorders and depression.

“We recognise that many of those with depression do not receive treatment at the moment, partly because they do not seek appropriate help.

“The government is committed to providing greater choice and access to timely and appropriate treatment options and is currently working to expand access to and choice of talking therapies in the NHS.”

Marjorie Wallace, chief executive of the mental health charity SANE, said: “We now have yet more evidence, as if it were needed, of the destructive and life-threatening effects of depression, which this global study shows can be an even greater danger than many chronic physical conditions.

“Yet even in developed countries like our own, proper diagnosis and appropriate treatment can be patchy at best.

“A vast sea of misery could be avoided if this condition received the same attention and resources as Aids or cancer.”

Lynn Mitchell, who has terminal lung condition, chronic obstructive lung disease, reached rock bottom two years ago with her depression.

And although she had always received quick treatment for her lung problems on the NHS she struggled to get help for her mental illness.

Now she is on antidepressants and feels a different woman.

“I think if I hadn’t had help with my mental attitude I would have been dead.

“My life was so bad and so bleak it was just horrendous really. I didn’t want to live but now I don’t want to die.” 


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Urinary Incontinence Doubles Risk of Postpartum Depression

Posted by Sun on May 25, 2012

ScienceDaily (June 20, 2011) — Women with urinary incontinence after giving birth are almost twice as likely to develop postpartum depression as those without incontinence, according to a new study led by Wendy Sword, a professor in McMaster University’s School of Nursing.

Postpartum depression negatively affects the mother, child, partner, and other children in the family. According to the Canadian Mental Health Association, up to 20 per cent of new mothers experience postpartum depression and an estimated 10 to 35 per cent of women will experience a recurrence of postpartum depression.

In their research, appearing online in the British Journal of Obstetrics and Gynecology, Sword and her colleagues set out to examine the relationship between mode of delivery and postpartum depression at six weeks following hospital discharge. They evaluated almost 1,900 new mothers. One-third had C-section deliveries.

Almost eight per cent had postpartum depression at six weeks after discharge.

The research team found no association between postpartum depression and mode of delivery, and this finding is consistent with previous studies.

But their investigation did show the five strongest predictors of postpartum depression are the mother being less than 25-years-old; the mother having to be readmitted to hospital; non-initiation of breastfeeding; good, fair, or poor self-reported postpartum health; and urinary incontinence or involuntary urination.

“We were surprised to find that urinary incontinence is a risk factor for postpartum depression,” said Sword. “Urinary incontinence following childbirth has not received much attention as a factor contributing to postpartum depression and we do not yet fully understand the reasons incontinence is linked to depression.”

Sword notes that urinary incontinence is not an uncommon problem after giving birth, and although women may be embarrassed by this issue, it is important that they talk to their health care providers about their concerns. She adds that health professionals should also be proactive and ask women about any bladder problems as part of their postpartum assessments, as it is important to identify problems early so that appropriate action can be taken to improve symptoms and women’s well-being.

This study was funded by the Canadian Institutes of Health Research.

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Seniors Show Greater Life Satisfaction Than Young People, Study Suggests

Posted by Sun on May 25, 2012

ScienceDaily (Feb. 13, 2012) — Study results recently published in the Journal of Aging Researchfound that healthy older adults reported less negative thinking compared to other age groups, leading to greater life satisfaction in seniors. Stefan Sütterlin and colleagues of the University of Luxembourg (Integrative Research Unit for Social and Individual Development — INSIDE) and the University of Würzburg (Germany) examined the complex relationship between aging and factors leading to depression.

Research suggests differences in the way age groups think can influence the onset of depression. Sufferers of negative thinking, or brooding, tend to fixate on their problems and feelings without taking action, which can intensify depressive moods and lead to the onset of depression.

Three hundred individuals (118 women), aged 15 to 87 years, were asked to rate their negative thoughts, depression and personal well-being. Researchers found that life satisfaction was negatively impacted by brooding, with participants aged 63 and above reporting less brooding compared to others.

Studies aimed at gaining a better understanding of age-associated negative thinking and life satisfaction are still needed to help researchers develop age-specific therapies for the treatment of depression.

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Skin Condition Associated With Depression, Anxiety and Suicidal Feelings

Posted by Sun on May 25, 2012

ScienceDaily (Aug. 16, 2010) — Individuals with psoriasis appear to have an increased risk of depression, anxiety and suicidality, according to a report in the August issue of Archives of Dermatology, one of the JAMA/Archives journals.

Psoriasis affects 1 percent to 3 percent of the general population, and estimates suggest 0.4 percent to 2.3 percent of adults have the condition but have not been diagnosed. “Psoriasis has long been recognized to be associated with potentially adverse effects on mental health,” the authors write. “In the 1960s, a popular ad campaign labeled the emotional burden of this skin disease as the ‘heartbreak of psoriasis.’ However, there have been relatively few studies evaluating psychological outcomes in patients with psoriasis.”

Shanu Kohli Kurd, M.D., M.S.C.E, M.H.S., and colleagues at the University of Pennsylvania, Philadelphia, studied data from electronic medical records in the United Kingdom from 1987 to 2002. The analyses included 146,042 patients with mild psoriasis, 3,956 patients with severe psoriasis and 766,950 patients without psoriasis (five control patients for each patient with psoriasis, selected from the same practice and similar entry dates). Patients were defined as having new-onset depression, anxiety or suicidality if corresponding diagnostic codes appeared in their records after follow-up began.

Of patients with mild or severe psoriasis, 25.9 per 1,000 individuals per year were diagnosed with depression, 20.9 per 1,000 per year with anxiety and 0.9 per 1,000 per year with suicidality. The rate of these cases attributable to psoriasis was 11.8 per 1,000 individuals per year for depression, 8.1 per 1,000 per year for anxiety and 0.4 per 1,000 per year for suicidality.

“Stated another way, the excess risk attributable to psoriasis is one case of depression for every 39 patients with severe psoriasis per year (or per 87 patients in patients with mild psoriasis per year),” the authors write. “The excess risks associated with psoriasis for anxiety and suicidality correspond to one case per 123 and 2,500 patients with psoriasis per year, respectively.” Considering this data and the prevalence of psoriasis in the U.K., the authors estimate that there are more than 10,400 diagnoses of depression, 7,100 of anxiety and 350 of suicidality related to psoriasis each year.

“It is important to identify these psychiatric disorders because they represent substantial morbidity that can be improved with a variety of pharmacological and non-pharmacological approaches,” the authors conclude. “Recent data suggest that psychiatric co-morbidity may negative affect response to certain psoriasis treatments (e.g., photochemotherapy), while other studies suggest that control of psoriasis is associated with improvements in psychological symptoms. Future studies are necessary to determine the mechanisms by which psoriasis is associated with depression, anxiety and suicidality as well as approaches to prevent such adverse outcomes in patients with psoriasis.”

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Depression and Chronic Stress Accelerates Aging

Posted by Sun on May 24, 2012

ScienceDaily (Nov. 9, 2011) — People with recurrent depressions or those exposed to chronic stress exhibits shorter telomeres in white blood cells. This is shown by a research team at Umeå University in a coming issue of Biological Psychiatry.

The telomere is the outermost part of the chromosome. With increasing age, telomeres shorten, and studies have shown that oxidative stress and inflammation accelerates this shortening. On this basis it has been suggested that telomere length is a measure of biological aging, and telomere length has subsequently been linked to age-related diseases, unhealthy lifestyle, and longevity. The research team shows that shorter telomere length is associated with both recurrent depression and cortisol levels indicative of exposure to chronic stress.

The study includes 91 patients with recurrent depression and 451 healthy controls. Telomere length, measured in white blood cells, is shorter among the patients compared with the control group. The scientists also examined the participants’ stress regulation using a so-called dexamethasone suppression test.

“The test revealed that cortisol levels indicative of chronic stress stress are associated with shorter telomeres in both depressed and healthy individuals,” says Mikael Wikgren, a doctoral candidate in the research group. The fact that depressed patients as a group have shorter telomere lengths compared to healthy individuals can be largely explained by the fact that more depressed people than healthy people have disturbed cortisol regulation, which underscores that cortisol regulation and stress play a major role in depressive disorders.

The article is part of Mikael Wikgren’s dissertation work. The research team, led by Professor Rolf Adolfsson, also includes Karl-Fredrik Norrback, Ph.D, (supervisor), doctoral candidate Martin Maripuu, and project coordinator Annelie Nordin. The study was carried out in collaboration with researchers from the Department of Medical Bioscience, Umeå University, as well as scientists at Stockholm University, Linköping University, and Antwerp University.

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Does Depression Contribute to the Aging Process?

Posted by Sun on May 24, 2012

ScienceDaily (Feb. 21, 2012) — Stress has numerous detrimental effects on the human body. Many of these effects are acutely felt by the sufferer, but many more go ‘unseen’, one of which is shortening of telomere length.

Telomeres are protective caps on the ends of chromosomes and are indicators of aging, as they naturally shorten over time. However, telomeres are also highly susceptible to stress and depression, both of which have repeatedly been linked with premature telomere shortening.

The human stress response is regulated by the hypothalamic-pituitary-adrenal axis, or HPA axis. This axis controls the body’s levels of cortisol, the primary stress hormone, and it generally does not function normally in individuals with depression- and stress-related illnesses.

Scientists of a new study published this week in Biological Psychiatrysought to bring all this prior work together by studying the relationships between telomere length, stress, and depression.

They did so by measuring telomere length in patients with major depressive disorder and in healthy individuals. They also measured stress, both biologically, by measuring cortisol levels, and subjectively, through a questionnaire.

They found that telomere length was shorter in the depressed patients, which confirmed prior findings. Importantly, they also discovered that shorter telomere length was associated with a low cortisol state in both the depressed and healthy groups.

First author Dr. Mikael Wikgren further explained, “Our findings suggest that stress plays an important role in depression, as telomere length was especially shortened in patients exhibiting an overly sensitive HPA axis. This HPA axis response is something which has been linked to chronic stress and with poor ability to cope with stress.”

“The link between stress and telomere shortening is growing stronger. The current findings suggest that cortisol levels may be a contributor to this process, but it is not yet clear whether telomere length has significance beyond that of a biomarker,” commented Dr. John Krystal, editor of Biological Psychiatry.

Future studies will be needed to determine whether normalizing telomere length is an important component of the treatment process.

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Good Ruminations or Bad Ruminations in the Depressed Brain

Posted by Sun on May 23, 2012

ScienceDaily (Aug. 22, 2011) — All of us, at times, ruminate or brood on a problem in order to make the best possible decision in a complex situation. But sometimes, rumination becomes unproductive or even detrimental to making good life choices. Such is the case in depression, where non-productive ruminations are a common and distressing symptom of the disorder. In fact, individuals suffering from depression often ruminate about being depressed. This ruminative thinking can be either passive and maladaptive (i.e., worrying) or active and solution-focused (i.e., coping).

New research by Stanford University researchers, published in Elsevier’sBiological Psychiatry, provides insights into how these types of rumination are represented in the brains of depressed persons.

The interactions of two distinct and competing neural networks, the default mode network (DMN) and the task positive network (TPN), are particularly relevant to this question. Whereas the DMN supports passive, self-related thought, the TPN underlies active thinking required for solving problems, explained study author J. Paul Hamilton.

Using brain imaging technology, Hamilton and his colleagues found that, in depressed patients, increasing levels of activity in the DMN relative to the TPN are associated with higher levels of maladaptive, depressive rumination and lower levels of adaptive, reflective rumination. These findings indicate that the DMN and TPN interact in depression to promote depression-related thinking, with stronger DMN influence associated with more worrying, less effective coping, and more severe depression.

“It makes sense that non-productive ruminations would engage default-mode networks in the brain as these systems enable the brain to ‘idle’ when humans are not focused on specific tasks,” commented Dr. John Krystal,editor of Biological Psychiatry. “Better understanding the factors that control the switch between these modes of function may provide insights into depression and its treatment.”

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Hope for Those With a Depressive Disposition

Posted by Sun on May 23, 2012

ScienceDaily (Jan. 27, 2012) — Good news for the 13 per cent of the population with depressive personality traits: their negative outlook does not have to be permanent. This has been shown by psychologist Rachel Maddux in new research from Lund University in Sweden.

Depression is a serious and sometimes devastating health problem which affects millions of people worldwide. In her previous work with depressed patients, Rachel Maddux often felt frustrated that treatments were not helpful for all of those diagnosed with depression. The main focus of her thesis therefore asked the question: why is it that some people are helped but others are not?

Her hypothesis was that those with depressive personality traits — chronic melancholics — are more difficult to treat, especially when they suffer from depression. These people generally feel down and worried, have low self-esteem and are dissatisfied with their lives and environment.

Rachel Maddux found that 13 per cent of residents in Lund have these personality traits.

“This is a very large number, but the results are in line with other studies carried out in the US and Canada.”

The next study looked at how many of those who seek help from a psychologist have depressive personality traits — a large portion, 44 per cent. These people were more seriously ill than other patients when they sought specialist help, according to Rachel Maddux.

Contrary to what she had believed, psychotherapy — both cognitive-behavioural and psychodynamic therapy — helped the depressive personality types as much as those without the disposition.

“The interesting thing was that therapy not only improved the depression itself, it also ameliorated the pervasive depressive traits,” says Rachel Maddux.

She cannot say whether the effect is maintained over time. However, she thinks the study indicates that therapy is good for people with this characteristic manner of depressive thinking and behaviour, even if they are not suffering from acute depression.

The main issue for Rachel Maddux’s research still remains: why aren’t all those diagnosed with depression helped by the treatment they receive? Why do antidepressants or talk therapy work for some but not others?

“But now I know that there is hope for those with depressive personality,” says Rachel Maddux. “The next step will be to study other factors that could affect the outcome of treatment; biology, childhood and development, trauma, etc.”

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