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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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Polycystic Ovary Syndrome (PCOS)
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The Facts about Polycystic Ovary Syndrome
Polycystic Ovary Syndrome (PCOS), also called Stein-Leventhal Syndrome, is a disorder characterized by irregular, abnormal or absent menstruation; excessive amounts of body hair; excessive body weight and decreased fertility. The syndrome is caused by elevated levels of testosterone and other hormones, which disrupts the normal menstrual cycle. Immature cysts remain on the ovaries, giving them a characteristic "string of pearls" appearance. A faulty response to insulin is also suspected, but does not explain all cases of the syndrome. It's estimated that this condition affects 6% to 10% of premenopausal women of all races and ethnicities, beginning between puberty and the early 20s.
Symptoms
Irregular Menstruation. The most common symptom of PCOS is irregular menstruation, which can take several forms:
* Oligomenorrhea: 8 or fewer periods per year.
* Polymenorrhea. Too many periods with excessive bleeding, and periods that may stop and start.
* Amenorrhea. No menstrual cycles at all.
Infertility. The three types of menstrual disorders have the same underlying cause: the ovaries don't release an egg each month. Women with PCOS do not ovulate regularly, and while fertility experts do assist many women with PCOS in becoming pregnant, PCOS may account for as many as half of all cases of infertility.
Hirsutism. Excess hair or coarse, thick hair on the face and arms, legs, abdomen and pubic area are also symptoms of PCOS. Changes in hair are stimulated by the free androgens in the system, present because of the hormonal imbalance.
Thinning hair. Male-pattern hair loss is also related to the excess androgens associated with PCOS.
Skin abnormalities. The skin abnormalities associated with PCOS can take several forms, including skin flaps or small tags of skin in the armpits or neck area, and acanthosis nigricans, which darkens and thickens the skin, usually on the neck or in the underarms or groin. This condition results from excess insulin in the blood stream.
Weight gain. Many women with PCOS experience weight gain, have a high hip to waist ratio ("apple" rather than "pear" shape), and have more than normal difficulty losing weight.
PCOS also has a complex relationship to depression and anxiety. Depression is not considered a symptom of PCOS per se, but the range of physical, cosmetic and physiological symptoms experienced by PCOS sufferers present a suite of underlying causes. In some women, correction of insulin-related problems through diet, exercise and medication help to alleviate depression and anxiety.
Diagnosis
A diagnosis of PCOS is made on the basis of the range of symptoms and on the patient's menstrual, reproductive and medical history (including any diabetes or insulin-related symptoms), blood tests to determine hormone levels, physical examination and diagnostic ultrasound.
Blood tests, indicate PCOS when the ratio of luteinizing hormone (LH) to Follicular Stimulating Hormone (FSH) is equal to or greater than a 3:1 ratio, and there are elevated levels of androgens including free and total testosterone. Glucose and insulin tests can be used to screen for insulin resistance and type II diabetes. Many women with PCOS have insulin-related problems, and some research indicates that this may be a root of the problem. The blood is also tested for lipids to find the levels of cholesterol and trigylcerides. High levels of LDL ("bad cholesterol") are common with PCOS, and this suggests that women with PCOS are at higher risk for heart disease.
Ovarian cysts are no longer the basis for a definitive diagnosis of PCOS (it is possible to have polycystic-appearing ovaries without actually having PCOS); many physicians rely on ultrasound imaging to confirm their diagnosis.
Treatment Options
PCOS is can be treated by a family physician or gynecologist, but the patient may also be referred to doctor who specializes in hormonal disorders - an endocrinologist, reproductive endocrinologist or fertility specialist.
Many standard therapies for PCOS treat specific symptoms, but might not address the underlying causes. Oral contraceptives have traditionally been used to regulate menstrual cycles. Anti-androgenic agents such as spironolactone block the effect of androgens (male hormones, including testosterone), and can reduce unwanted hair growth and acne. Assisted reproduction techniques - like oral and injectable medications that stimulate ovulation, and in vitro fertilization - enable women with PCOS to become pregnant.
New treatments aim at the insulin resistance that might be a root cause of PCOS. Many new therapies are designed to lower insulin levels and thus reduce testerone production.
Drug Therapy
New evidence suggests that using medications that lower insulin levels in the blood may be effective in restoring menstruation and reducing some of the health risks associated with PCOS. Lowering insulin levels also helps to reduce the production of testosterone, diminishing many of the symptoms associated with excess testosterone: body hair growth, hair loss, acne, obesity and cardiovascular risk.
* Metformin (sold as Glucophage) is a diabetes drug that improves both glucose tolerance and insulin sensitivity. About one-third of patients on Glucophage experience gastrointestinal symptoms (diarrhea, nausea, vomiting, abdominal bloating, flatulence and loss of appetite), but these are usually temporary and disappear after 1 to 4 weeks.
* Pioglitazone (ACTOS) was developed for use in type II diabetes and works primarily by improving insulin sensitivity and glucose tolerance. There were few notable side effects in clinical trials. Another added benefit seen with Pioglitazone is the reduction of triglyceride levels.
* Rosiglitazone (Avandia) also works by improving insulin sensitivity. A low incidence of side effects was noted in clinical trials.
There are several excellent online resources for people who want to learn more about PCOS. The Polycystic Ovarian Syndrome Association web site has information for patients (some which we have brielfy summarized here), as well extensive listings of ongoing clinical trials and research studies, and support groups all over the US.
This article includes information from the Polycystic Ovarian Syndrome Association.
For more information on this topic, see the HealthLink article Polycystic Ovary Syndrome and Facial Hair.
SOURCE:- © 2003 Medical College of Wisconsin
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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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