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Depression & Mental Health FAQs
US Centers for Disease Control and Prevention (CDC) estimated 40 million Americans living today will suffer from major depressive illness during their lives. Seasonal affective disorder is major depression that appears in the fall or winter and goes away in spring, thought to be caused by lack of sunlight.
Postpartum depression occurs within four weeks of a women giving childbirth. Most new mothers suffer from some form of the �baby blues.� Postpartum depression, by contrast, is major depression, thought to be triggered by changes in hormonal flows associated with childbirth. Catatonic depression is a rare form of major depression characterized by (at least two): Stupor, excessive motor activity, extreme negativism, peculiarities in voluntary movement, and repetition of other people's words or actions. - mcmanweb.com
Psychotic depression is a rare form of depression characterized by delusions or hallucinations, such as believing you are someone you are not and hearing voices.
According to the National Institute of Mental Health, approximately 18.8 million American adults, or about 9.5 percent of the US population age 18 and older in a given year, have a depressive disorder. Depression is a chronic illness that exacts a significant toll on
America's health and productivity. It affects more than 21 million
American children and adults annually and is the leading cause of
disability in the United States for individuals ages 15 to 44.
Lost productive time among U.S. workers due to depression is estimated
to be in excess of $31 billion per year. Depression frequently
co-occurs with a variety of medical illnesses such as heart disease,
cancer, and chronic pain and is associated with poorer health status
and prognosis. It is also the principal cause of the 30,000 suicides
in the U.S. each year. In 2004, suicide was the 11 th leading cause of death in the United States, third among individuals 15-24.
According to the World Health Organization, depression is presently on track to becoming the world's second-most disabling disease (after heart disease) by the year 2020. Depression is responsible for some $87 billion a year in lost productivity in the US (a conservative estimate), and according to Bank One, is responsible for most lost work days in its employees after pregnancy and childbirth. Additionally, one million people worldwide die by their own hand, most as a result of a mood disorder. Finally, the linkage between depression and a host of physical illnesses makes it arguably the world's greatest killer.
Research presented at the 56th Annual Conference of the Canadian
Psychiatric Association shows a marked link between bipolar disorder
and migraines. The odds of migraine in persons with bipolar disorder were 40% higher than the general population. Data
obtained from 36,984 people aged 15 and over, who screened positive for
manic or depressive episodes with migraine, were compared against those
who screened positive for mania but who didn�t suffer from migraines. Amongst
males, 14.9% of those with manic episodes were also diagnosed with
migraines compared with 5.8% of the general population. Amongst
females, 34.7% had both migraines and bipolar disorder compared with
14.7% who only had migraines.unquote.gif While the research was
skewed towards persons who were already diagnosed with bipolar
disorders, what does it mean for people who suffer from migraines but
who may have an undiagnosed bipolar disorder?
Migraines and headaches aren�t fully understood but the manifestations are very real and debilitating for their sufferers: Throbbing pain Nausea Heightened sensitivity to light or sound Seeing dots, wavy lines, flashing lights, or blind spots Difficulty with speech, sensation, or movement
An estimated 2.1 million
American adolescents have experienced major depression within the last
year, according to a new comprehensive government study. Researchers
surveyed more than 67,000 young people ages 12 to 17 and found that one
in 12 had suffered from serious depression in the previous year.Nearly
13 percent of girls had struggled with depression, compared to less
than 5 percent of boys. Odds of depression increased with age -- just 4
percent of 12-year-olds experienced depression but that climbed to 11
percent for older teens.
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NARSAD Researchers Showcase New Treatment Options For Severe Depression
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22 May 2008
New findings from research supported by NARSAD, the world's
leading charity dedicated to mental health research, and conducted by
scientists at Washington University's School of Medicine (WUSM) now
point to new options for treating preschool-aged children with
significant clinical depression as well as those severely depressed
adults who don't respond to standard treatments, such as
antidepressants and psychotherapy.
Presented at NARSAD's 5th annual St. Louis Mental Health Research
Symposium on May 18th at Washington University, the studies, conducted
by four leading St. Louis-based researchers, shed new light on what
happens in the brains of children and adults who are affected by
clinical depression, anxiety disorders and schizophrenia. Coming at a
time when more than 57 million Americans suffer from a diagnosable
mental disorder, the new findings have immediate relevance in terms of
new treatment options and different strategies for designing more
targeted therapies for the future.
Robert Freedman, M.D., chair of the Department of Psychiatry and
director of the Schizophrenia Research Center at the University of
Colorado Health Sciences Center and Denver VA Medical Center, moderated
the discussion.
Electrical Stimulation of the Vagus Nerve: A New Treatment for Depression
Among the most significant new developments in the field is vagus nerve
stimulation (VNS), a novel procedure pioneered at St. Louis University
and WUSM that acts on the brains of patients with "treatment-refractory
depression," a particularly virulent form of depression now affecting
between 5-10 percent of those diagnosed with clinical depression.
Originally developed to treat epilepsy and then approved by the Food
and Drug Administration (FDA) in 2005 for use in treating depression,
VNS is a small electrical impulse generator attached to the large vagus
nerve in the neck region that acts as a "pacemaker for the brain."
According to Charles R. Conway, MD, associate professor of psychiatry
at WUSM and formerly the medical director at the Vagus Nerve
Stimulation Clinic in the St. Louis University Department of
Psychiatry, approximately one-third of patients receiving VNS
experience significant improvement in mood and better social and
cognitive functioning, and for up to 70 percent of these individuals,
the reduction in symptoms is long-lasting. An additional one-third of
the patients receiving VNS have shown a limited response and the
remaining third have not been helped.
VNS acts by stimulating a large nerve in the neck (vagus nerve) which
sends thousands of fibers higher up into the brain. Dr. Conway reported
that the existing evidence suggests that most patients who respond
positively to this treatment do not see immediate results. Although
some patients receiving VNS therapy experience improvements within the
first few weeks after implantation, there is often a long delay (9-14
months or longer) as the brain adapts to the stimulation and develops
an anti-depressive response.
VNS: A Patient's Perspective
This was the case for St. Louis institutional bond trader, Charles E.
Donovan III, who spent years being incapacitated by severe,
treatment-resistant depression and was one of the first patients to be
implanted with the vagus nerve stimulator in 2001 as part of an
investigational trial.
"When I was implanted with VNS, I had been suffering from severe
depression for several years and had gotten to the point where I was
feeling completely isolated and emotionally paralyzed, " said Donovan
who wrote the book, Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression,
to raise awareness about VNS. "It took 14 months for the complete
effects of VNS to take place, but now my depression is gone. Not
everyone responds to VNS as I did but my story offers hope for those
who have long suffered without successful treatment that new options
are now possible."
In fact, because VNS works successfully in some depressed patients but
not in others, Dr. Conway is now conducting research with neuroimaging
techniques to determine which patients are likely to respond to VNS
therapy. With research funding from NARSAD, Dr. Conway and his team are
recruiting patients in the St. Louis area for a study that will use PET
scans to look at how the stimulation of the vagus nerve can lead to
short- and long-term changes in the brain's activity and exactly what
regions of the brain undergo change with long-term treatment with VNS.
"We know that the depressed brain looks a specific way on a PET scan.
And when we can see what regions of the brain are positively affected
by VNS therapy, our hope is to be able to identify the best candidates
for this new treatment option," Dr. Conway explained. "Having this new
data will not only lead to improved treatment outcomes, but it will
support current efforts to get insurance companies to reimburse for VNS
implantation." Currently, insurance companies have covered VNS on a
case-by-case basis.
Depression in Preschoolers
While Dr. Conway's research may lead to better treatments for severely
depressed adult patients, Joan L. Luby, MD, associate professor of
child psychiatry and founder and director of WUSM's Early Emotional
Development Program, is currently investigating the efficacy of a new
treatment program for clinically depressed children as young as age 3
-- a time of significant neurobiological change when there is the
potential to alter the course of depression later in life.
"Clinicians used to think that very young children were not developed
enough to experience depression, but studies going back to the 1980s
changed this viewpoint," said Dr. Luby. "Now, we know that depression
is a major childhood illness with potentially debilitating
consequences."
A number of epidemiological studies have reported that up to 2.5
percent of children and up to 8.3 percent of adolescents in the U.S.
suffer from depression. But until recently, very little was known about
the impact of depression on very young children, which is why Dr. Luby
and her colleagues are studying children between the ages of 3 years
and 6 years old to identify what clinical depression looks like in
preschool children.
Starting with a large-scale study funded by NARSAD and the National
Institute of Mental Health, Dr. Luby and her team identified anhedonia
-- the inability to experience pleasure from activities and play -- as
a key symptom of depression in very young children. Another common
symptom is that depressed children often use play to explore themes
about death and sometimes even suicide.
"We learned that depressed children don't derive pleasure from the same
things as a typical 3- to 5-year-old child," said Dr. Luby. "They're
less joyful when they encounter the pleasures of daily life."
Now, Dr. Luby and her colleagues are testing a new treatment program
for depressed preschoolers in their laboratory that applies these
findings. Using a model similar to speech or other developmental
therapies, this new program utilizes the interaction between parents
and their children to teach depressed children how to experience
positive emotions, manage negative emotions and more generally, how to
enhance emotional development on a sustained basis. After pre-testing
the new program in eight preschoolers, Dr. Luby's team is now
recruiting 30 more young children from the St. Louis area for the new
treatment study.
"The normal developmental curve for any child is very steep at this
point in life and being depressed and dysfunctional for a long period
of time could actually impair normal development," Dr. Luby explained.
"It's very important that we find a safe way to help them get better
and to prevent future episodes."
Understanding and Regulating Anxiety, The Most Prevalent Mental Illness
It is also important to find ways to improve the functioning of the
more than 40 million Americans or 18.1 percent of the population that
suffer from anxiety disorders -- the most common psychiatric illnesses.
For this reason, the NARSAD symposium provided the latest thinking on
how anxiety disorders affect decision-making, perceptions, learning and
concentration.
According to Christina Fales, Ph.D., a postdoctoral fellow in
psychology at Washington University, people with general anxiety
disorders (GAD) may process information differently than healthy
people. They may be more susceptible to attention lapses, making
reasoning and problem-solving as well as the avoidance of undesirable
thought patterns more difficult.
Compared to people with low anxiety who, on a sustained basis, activate
the regions of the brain involved in cognition and problem-solving --
called the working memory network -- Dr. Fales has found that people
with high levels of anxiety access working memory in a transient
manner. This doesn't mean that anxious people are cognitively impaired
but rather, they are less efficient in carrying out cognitive tasks,
and have to work harder to process information. This extra effort may
be necessary because unregulated emotional arousal interferes with
normal cognitive processing.
What makes these findings significant is the potential for developing
new therapies to improve the cognitive regulation of emotion, explained
Dr. Fales. "Many GAD patients report that antidepressants have limited
success in dealing with their anxiety, "she said. "The more we know
about the interaction between the networks in the brain that process
cognition and help regulate emotion, the easier it will be to design
more targeted therapies for anxiety disorder."
Living with Schizophrenia: Overcoming Emotional and Motivational Challenges
New research findings may also pave the way for new therapies to
regulate the memories and emotions of people with schizophrenia, one of
the most debilitating psychiatric disorders. Complementing
NARSAD-funded research which showed people with schizophrenia can be
assisted in remembering things if they are given proper cues and memory
aids, Dr. Deanna M. Barch, Ph.D., director of the Conte Center for the
Neuroscience of Mental Illness and chief neuropsychologist at the
Washington University Treatment Units Research Network Site, is now
focusing on the emotional and motivational problems that affect how
people with schizophrenia function on a daily basis.
According to Dr. Barch, research has demonstrated that people with
schizophrenia are able to experience the same pleasurable responses to
stimuli, such as seeing a movie, listening to music, or drinking a
beverage, but these reactions were much more intact than what subjects
with schizophrenia reported in questionnaires that ask them to imagine
how they would feel in very situations.
This inability to either retain pleasurable memories or to anticipate
pleasurable experiences in the future may be a major factor
contributing to what Dr. Barch calls "the negative symptoms" associated
with schizophrenia - including the lack of energy, drive and
motivation.
Using functional MRI, structural MRI and cognitive neuroscience
methods, Dr. Barch and her research team are trying to identify the
neurobiological disturbances in the brain that may cause these negative
emotional symptoms. Between 50 and 70 percent of people with
schizophrenia have these negative symptoms, especially those who have
earlier onset of the disease, according to Dr. Barch.
"This is a very serious public health issue," she said. "Current
therapies for schizophrenia have not proven effective in treating
negative emotional symptoms, making it harder for those who experience
these symptoms to live independently and seek treatment. The goal is to
explain what is happening in the brain so we can design better
treatments in the future."
About NARSAD
NARSAD's St. Louis Mental Health Symposium is one of several such
programs the organization presents annually around the country to bring
the latest development in research to the attention of the public.
NARSAD's primary mission is to raise funds to advance research on the
causes, treatment and prevention of psychiatric disorders. Since it
began giving grants in 1987, as the National Alliance for Research on
Schizophrenia and Depression, NARSAD has awarded more than $233 million
in competitive grants to nearly 2,700 scientists leading universities,
medical centers and research institutions around the world who are
conducting research on schizophrenia, depression, bipolar disorder,
anxiety disorders, childhood mental disorders and other serious mental
illnesses.
For additional information on the work of NARSAD, the research it
supports, and various psychiatric disorders, visit the organization's
web site at http://www.narsad.org.
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Depression & Mental Health FAQs 2
What is Clinical Depression? Clinical
depression can affect your body, mood, thoughts, and behavior. It can
change your eating habits, how you feel and think about things, your
ability to work and study, and how you interact with people. Clinical
depression is not a passing mood, a sign of personal weakness or a
condition that can be willed away. Clinically depressed people cannot
"pull themselves together" and get better. Depression can be
successfully treated by a mental health professional or certain health
care providers. With the right treatment, 80 percent of those who seek
help get better. And many people begin to feel better in just a few
weeks.
Depression a Big Factor in Poor Health World Health Organization Finds Depression Often Goes Untreated By Salynn Boyles WebMD Medical News Reviewed by Louise Chang, MD Sept.
6, 2007 -- Depression has a greater impact on overall health than
arthritis, diabetes, angina, and asthma, but it all too often goes
unrecognized and untreated, a report from the World Health Organization
(WHO) suggests. more... Depression a Big Factor in Poor Health
For Additional Information About Depression Write To: The National Institute of Mental Health (NIMH)6001 Executive Boulevard, Room 8184, MSC 9663 Bethesda, MD 20892-9663
For free brochures on depression and its treatment call: 1-800-421-4211. or visit: http://www.nimh.nih.gov
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