If you - or someone you know - are having thoughts about suicide, call 1-800-273-TALK (8255). Calls are connected to a certified crisis center nearest the caller's location. Services are available 24 hours a day, seven days a week. If you - or someone you know - are having thoughts about suicide, call 1-800-273-TALK (8255). Calls are connected to a certified crisis center nearest the caller's location. Services are available 24 hours a day, seven days a week.
Our mission is to create an atmosphere that is both supportive and informative in a caring, safe environment for our members to talk to their peers about depression, anxiety, mood disorders, medications, therapy and recovery.
Our vision is to advance the public awareness of mental health issues so as to eliminate the stigma that surrounds depression and mood disorders through education and advocacy, as well as striving to obtain quality medical care for mental health patients, as it is no different from any other medical illness.
Disconnect in informational priorities between those seeking treatment for depression, clinicians
More than 15 million American adults seek treatment for depression each year. However, a first-of-its-kind study reveals an eye-opening disconnect between the priorities of patients and clinicians when it comes to the information needed to make decisions about treatment options.
More than 15 million American adults seek treatment for depression each year. However, a first-of-its-kind study by researchers at The Dartmouth Institute for Health Policy & Clinical Practice reveals an eye-opening disconnect between the priorities of patients and clinicians when it comes to the information needed to make decisions about treatment options.
"The good news is that both patients and clinicians who treat depression consider whether a treatment will work to be the most important priority," said Paul Barr, an assistant professor at The Dartmouth Institute and the study's lead author. "However, while consumers place a high priority on cost and insurance information, clinicians do not always prioritize this as highly."
The study, published online by BMJ Open, surveyed close to 1,000 Americans who were currently undergoing or have previously sought treatment for depression and 250 clinicians who had recently treated patients for depression in the United States. Patients were recruited to reflect the age, gender and education level of the population of U.S. adults suffering from depression. Clinicians surveyed had an average of 15 years of professional experience and included therapists, psychiatrists and primary care physicians.
Let’s say you’ve been down in the dumps for months, but are leery of taking psychiatric drugs. Your doctor may recommend cognitive behavioural therapy (CBT), a form of “talk therapy” that focuses on changing the underlying thought patterns and distorted perceptions that perpetuate the “stinkin’ thinkin’” brought on by mood disorders. Several trials have shown that CBT is just as effective as medication, and highly successful in treating mild to moderate depression and anxiety. But what if you don’t have the time or money to see a therapist?
You could go online. In the past 10 years, dozens of Internet-delivered CBT programs have cropped up, many of them free of charge. In countries such as Australia and Britain, computerized CBT is being touted as a cost-effective way to treat greater numbers of patients suffering from the most common mental illnesses – mild to moderate anxiety and depression.
But is online CBT as effective as face-to-face sessions with a compassionate therapist? Advocates note that some patients prefer the anonymity of Internet-delivered CBT, even as they acknowledge that the treatment model still needs tweaking. Critics insist that mentally ill patients need the human touch. Both agree that more research is needed, but as things stand, here are the promises and pitfalls of psychotherapy at your fingertips.
How does it work?
Using a computer, tablet or smartphone, patients log on to an online program such as Beating the Blues or MoodGYM (which has at least 600,000 registered users worldwide). At their own pace, patients complete interactive modules on how to identify symptoms, set goals and find new ways of thinking about everyday events. For example, a module might teach the “three Cs”: Catch the unhelpful thought (“I am an idiot for forgetting my friend’s birthday”). Check it to identify the distorted thinking pattern (over-generalizing, focusing on the negative). Change it to a more accurate or helpful thought (“Everyone makes mistakes,” and “I am a good friend most of the time”). Online CBT programs may include quizzes, homework exercises and self-assessments to monitor progress.
Learning that your teen has depression can be terrifying for a parent – concerns range from getting the right treatment to general safety. It was estimated in 2013 that 8 percent of high school students attempted suicide one or more times in the previous 12 months, according to the Centers for Disease Control and Prevention.
And now, a reanalysis of data in The BMJ last week found that Paxil, one of the most prescribed antidepressants on the market, is ineffective and even harmful for treating major depression in adolescents.
The new findings are in contrast to the original study from 2001. Researchers of the original industry-funded study found Paxil, just one of a group of serotonin re-uptake inhibitors, was safe and effective. The reanalysis showed that a number of adolescents from the original study did experience increased thoughts of suicide. But the suicidal thoughts were simply counted as generic adverse events and not clearly presented in the results.
For a long time, there have been some indications that these medicines may raise the rates of thoughts of self-harm in adolescents. This led the U.S. Food and Drug Administration in 2007 to issue a “black box” warning about increases in suicidal thoughts. In December 2014, the warning was revised to state that attempts at self-harm decreased in patients ages 24 and older with anti-depressant use, but there was no change on the warning for adolescents.
During this nearly decade long discussion, most psychiatrists and many other mental health professionals felt that the warnings were too strict. As a result, they thought many teens were not getting the help that they needed – while others worried that these medicines were possibly harmful.
What has followed in the wake of this latest reanalysis are stories in the press which have raised the issue of the safety and effectiveness of some antidepressant medications for adolescents.
One in five New Yorkers have a mental health disorder, and at least 8% suffer from symptoms of depression, a new report by the city Department of Health says.
“Major depressive disorder is the single greatest source of disability in NYC,” the report says. "At any given time over half a million adult New Yorkers are estimated to have depression, yet less than 40% report receiving care for it.”
Despite lots of advancements in the psychology world, many aspects of depression remain mysterious, to mental health professionals and their patients alike. The video below, one of the latest from TEDEd, suggests that this is due to the condition's intangibility — depression isn't a cold or some other illness with physical symptoms that are clear and consistent. However, the video, created by Helen M. Farrell, MD, provides some insight into what depression is, and what signs to look for (in yourself and your loved ones).
It's vital to understand the difference between feeling depressed and having depression. Just about all people deal with feelings of sadness, but they pass or are eventually (at times, even easily) resolved. Depression, on the other hand, lasts much longer, following those who suffer from it to the point that they may lose hope of finding a solution. Clinical depression, as explained in this video, can cause sufferers to avoid activities or people that used to excite and engage them, exacerbating the sense of guilt and worthlessness that also accompanies the condition. A lack of energy, appetite, and concentration commonly occurs as well. Most alarmingly, people with depression may deal with recurring thoughts of suicide.
If you are unfortunate enough to develop acute chest pain this winter you will probably be assessed by a clinician who will order a battery of tests to determine if your symptoms result from pneumonia, bronchitis, heart disease, or something else. These tests not only can yield a precise diagnosis, they ensure you will receive the appropriate treatment for your specific illness.
If you are unfortunate enough to have a psychotic episode this winter, the process of arriving at a diagnosis will be quite different. In fact, there are not many choices. Most people with a psychotic disorder are labeled as having either schizophrenia or bipolar disorder. The distinction has been in textbooks for a century: schizophrenia (originally dementia praecox) is associated with delusions, hallucinations, an absence of affect, and a chronic course; bipolar (originally manic depressive disorder) can also involve delusions and hallucinations, and ,typically, dramatic swings in mood and a fluctuating course. But outside of textbooks, in the real world of the emergency room or clinic, these distinctions are less clear as many patients do not neatly fit the formal descriptions. Sadly, there are no blood tests or scans to distinguish schizophrenia from bipolar disorder.
While clinicians have become very skilled at assessing symptoms and signs, the absence of diagnostic laboratory tools or biomarkers poses a serious problem in psychiatry. Do all people with a label of schizophrenia have the same disorder? What about the large number of people who appear to have aspects of both schizophrenia and bipolar? Are these disorders, diagnosed exclusively by signs and symptoms, identifying distinct biological entities or could there be many different illnesses with a continuum of psychotic signs and symptoms? These questions are not merely academic. As with chest pain, getting a precise diagnosis is important for selecting the best treatment.
I have learned that anxiety and depression go hand-in-hand, and there is no shame in having either — although it’s tough for many people to get their arms around that concept. When I struggled with both in my last couple years as the Texas Rangers’ baseball play-by-play announcer, the few people in whom I confided expressed genuine shock. “Depressed? About what? You’ve got a great job! Legions of adoring fans! A wonderful family! Dude, what’s your problem?”
Growing up, I had always been, quite naturally, the life of any party. But over a period of several years, I began to stay away from such parties. When I did go and fake my way through, I would usually leave upset, gripped by the weight of having been such a fraud.
Scared, Lonely, Exhausted
At my lowest moments, everything and everyone in the world was a threat. Not just people I knew, but people I knew I’d never meet. Brad Pitt’s looks? A threat. Same for Peyton Manning’s arm, Josh Groban’s voice, Justin Timberlake’s talent, the neighbor’s house...all things to threaten me, instead of for me to simply enjoy.
In an anxious state, all I could see were the things I couldn’t do or didn’t have, and people I couldn’t be. I had no appreciation whatsoever of anything I already was. No matter what I did, the foreboding sense was that it would never be enough. And if the people in my life who mattered had the “gall” to appreciate or acknowledge the talents of others, I took it as a punch in the face. It was a scary, lonely, exhausting way to go through life.
The crux of an anxiety disorder is the complete inability to be at peace with the present moment. Always expecting the other shoe to drop. Waiting for something to go wrong. I’d be racked with guilt about things I’d done poorly and trembling with worry that I’d soon screw something else up too. Professionally, that would all come crashing down within an hour of air time. Quite routinely, I’d seek refuge in the press box bathroom, head in my hands, trying to remind myself “it’s okay. I’m okay.” Sometimes I was…most times I wasn’t.
As someone new to The Depression Forums, as well as to the possibility of depression, I wanted all of you to know how enormously I respect you at DF. Having a small inkling of what you go through, I see the remarkable strength that each of you have. I know that so much of the time it feels like it's our fault, but it's not. Keep your strength, keep whatever hope you have left, and keep holding on. You inspire me to keep going.
Three In Five Patients Feel Depressed Or Anxious As A Result Of Their Pain
22 Oct 2008
Despite treatment efforts, chronic pain management is failing one in three (n = 377) patients suffering from severe chronic pain, and three in five (n = 336) patients feel moderately or extremely anxious or depressed as a result of their pain. Whilst eight in ten (n = 377) chronic pain patients are taking prescription medication, one in two (n = 307) of these patients are suffering the additional burden of side effects. These are the findings released today from the interim data from PainSTORY (Pain Study Tracking Ongoing Responses for Year), the first survey of its kind to provide in-depth insight into how chronic pain impacts the lives of patients over one year in 13 European countries.
Today's data provide a picture of patients' lives over the three months since the survey was initiated and shows that despite consultation with a healthcare professional and treatment patients are still struggling with their pain, impacting patients' quality of life.
"Interim results from PainSTORY are important and highlight that patients continue to suffer from chronic pain despite seeking medical attention," said Dr Varrassi, President of the European Federation of IASP Chapters, a leading pain society. "The medical community need to provide adequate treatment for patients in moderate-severe pain, but there seems to still be barriers that need to be overcome".
Since their initial interview three months ago, for 77 percent (n = 377) of patients the level of pain they experience has either stayed the same or even deteriorated further. 33% (n=377) of patients continue to suffer from severe chronic pain, 15% (n = 377) had progressed from moderate to severe pain, and 1% (n = 377) from mild to severe pain.
PainSTORY shows that both the physical and psychological aspects of patients' lives are affected by their pain. Six out of ten (n = 336) patients are experiencing problems walking about and over half (n= 336) experience problems sleeping. The influence of pain also extends into patients' working lives, and almost half (n = 195) have changed the way they work. "I couldn't interact. The pain trapped me and I couldn't socialise. I felt like a prisoner of the pain and really conditioned by it," said patient 14 from the United Kingdom.
Today's data show patients are being prescribed suboptimal treatment for their pain. Of the 81 percent (n = 377) of patients in moderate-severe pain on prescription medication, only 13 percent were prescribed strong opioids. Over half of patients were suffering at least one side effect as a result of their prescribed medication (n = 162), including constipation, dizziness and drowsiness, which are common symptoms for both weak and strong opioids.
"Side effects are affecting these patients. Patients are finding themselves in situations where they need to choose between using pain relief medications, or compromising their pain management by not taking medications to avoid the burden of side effects," stated Professor Erdine from the World Institute of Pain. "We are interested to see the next wave of results for PainSTORY. There has already been some interesting issues that have been brought to light. This survey demonstrates the pressing need for improved management of pain across Europe."
About the survey
PainSTORY (Pain Study Tracking Ongoing Responses for a Year) is the first study of its kind to track patients with chronic pain for a year, providing a picture of the lives of people living in pain, and the management of pain in 13 European countries.
Baseline results from the study show that chronic pain has a significant impact on the daily lives of patients. The survey aims to better understand the management of chronic pain across Europe.
The PainSTORY survey is being conducted by an independent research company, IPSOS, in collaboration with the following independent third parties:
- European Federation of IASP Chapters - World Institute of Pain - Arthritis and Rheumatism International - OPEN Minds The survey is sponsored by a restricted educational grant from Mundipharma International Limited.
PainSTORY recruited patients suffering from non-malignant (osteoarthritis, back pain / lower back pain, osteoporosis, neuropathic pain, mixed pain, other long term pain), moderate to severe (rate 5-10 on a pain scale) chronic pain (i.e. lasting for more than three months). Respondents are studied for 12 months. The research is being carried out in 13 countries across Europe: United Kingdom, France, Germany, Switzerland, Italy, Spain, Ireland, Belgium, Sweden, Denmark, Finland, Netherlands, Norway by an independent research company, IPSOS.
The study consists of four waves of qualitative interviews between April 2008 and March 2009. Interim engagement activities between the four waves are sent to patients to provide additional insight, such as diaries and lifebooks. Comparisons between baseline data and subsequent wave results will show how the impact of pain and pain management changes over the course of a year.
About the European Week Against Pain
The European Week Against Pain (EWAP) which takes place annually, was started as part of the European Federation of IASP Chapters' (EFIC's), Europe Against Pain Initiative, in October 2001. EWAP aims to create more awareness of pain as a major healthcare problem amongst the general public, healthcare workers and healthcare policy makers.
The theme of this year's EWAP is fibromyalgia, a widespread musculoskeletal pain and fatigue disorder that occurs predominately in women. Unexplained widespread pain occurs in about 10% of the general adult population in Western countries, with approximately half of those affected meeting American College of Rheumatology (ACR) classification criteria for fibromyalgia.
The PainSTORY survey was sponsored by a restricted educational grant from Mundipharma International Ltd, Cambridge, England
Forum Admins note: results from the pain story is in the link below. 3-2010