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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.
Our DF Members
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The Chemistry of Depression
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You've probably probably heard the term "neurotransmitter" before, but what does this really mean? Neurotransmitters are chemical messengers in the brain that facilitate communication between nerve cells. Let's illustrate with serotonin. Figure 1 depicts the junction between two nerve cells. Packets of serotonin molecules are released from the end of the presynaptic cell (the axon) into the space between the two nerve cells (the synapse). These molecules may then be taken up by serotonin receptors of the postsynaptic nerve cell (the dendrite) and thus pass along their chemical message. Excess molecules are taken back up by the presynaptic cell and reprocessed.
Several things might potentially go wrong with this process and lead to a serotonin deficit. Just to enumerate a few possibilities:
Not enough serotonin is produced,
Not enough receptor sites to receiveserotonin,
Serotonin is being taken back up too quickly before it can reach receptor sites,
Chemical precursors (molecules that serotonin is manufactured from) may be in short supply, or
Molecules that facilitate the production of serotonin may be in short supply.
As you can see, if there is a breakdown anywhere along the path, neurotransmitter supplies may not be adequate for your needs. Inadequate supplies lead to the symptoms that we know as depression.
The Primary Players
There are three basic molecules, known chemically as monoamines, which are thought to play a role in mood regulation: norepinephrine, serotonin and dopamine.
In the 1960s Joseph J. Schildkraut of Harvard University cast his vote with norepinephrine as the causative factor for depression in the now classic "catecholamine" hypothesis of mood disorders. He proposed that depression stems from a deficiency of norepinephrine in certain brain circuits and that mania arises from an overabundance of this substance.1 There is indeed a large body of evidence2 that supports this hypothesis, however, changes in norepinephrine levels do not affect mood in everyone. The implication is that medications such as reboxetine, which specifically targets norepinephrine, will work for some persons but not others.3
Obviously there must be some other factor that interacts with norepinephrine to cause depression. Serotonin has been found to be this other factor. This molecule has taken center stage in the past two decades thanks to Prozac and other Selective Serotonin Reuptake Inhibitors (SSRI's), which selectively act on this molecule. Serious investigations into serotonin's role in mood disorders, however, have been going on for almost 30 years, ever since Arthur J. Prange, Jr., of the University of North Carolina at Chapel Hill, Alec Coppen of the Medical Research Council in England and their co-workers put forward the so-called "permissive hypothesis". This view held that synaptic depletion of serotonin was another cause of depression, one that worked by promoting, or "permitting," a fall in norepinephrine levels. So, although, norepinephrine still played a major role in depression, serotonin levels could be manipulated to indirectly raise norepinephrine. Newer antidepressants like Effexor are actually targeted at both serotonin and norepinephrine.4 Tricyclics (TCAs) also affect both norepinephrine and serotonin, however, they have the added effect of influencing histamine and acetylcholine, which produces the side-effects that TCAs are known for, such as dry mouth or eyes, peculiar taste in mouth, sensitivity to light of the eyes, blurry vision, constipation, uninary hesitancy, and others. SSRIs do not affect histamine and acetylcholine and thus do not have the same side-effects as the older medications.5
A third substance that may play a role in mood is dopamine. Dopamine is associated with the reward, or reinforcement, that we get which causes us to continue participating in an activity. It has been implicated in such conditions as Parkinson's Disease and schizophrenia. There is also some evidence that, at least for a subset of patients, dopamine plays a role in depression.6 Dopaminergic substances and stimulants have been used as antidepressants when other measures have failed.7 Some studies have investigated dopaminergic agents as a rapid method of relieving depression (in contrast to medications which may take up to six weeks to exhibit their full effect).8
Although agents that work selectively on dopamine have the benefit of fast action, they have also exhibited some properties which have kept them from being as widely used as other antidepressants. Dopamine is a neurotransmitter that is associated with addiction and it's production is stimulated by drugs such as cocaine, opiates and alcohol (which may explain why depressed persons choose to self-medicate with drugs and alcohol.9) Drug specifically targeted at dopamine, for example amineptine (Survector), present the potential for abuse.10 For this reason, amineptine is not approved for use in the US or Britain at this time.
References
Nemeroff, Charles B. The Neurobiology of Depression. Scientific American, June 1998 ; Internet; cited May 15, 2000.
Goldberg, Ivan T. The Cholinergic Hypothesis of Affective Disorders: A MEDLINE Search. ; cited May 15, 2000.
Nemeroff.
Ibid.
Gelwan, Eliot. Tricyclic Antidepressants. Posted 9/30/92. ; Internet, cited May 15, 2000. (No longer available)
California State University, Chico, Department of Psychology. Dopamine. ; cited May 15, 2000. (No longer available)
Nierenberg, AA, Dougherty D, Rosenbaum JF. Dopaminergic agents and stimulants as antidepressant augementation strategies. J Clin Psychiatry, 1998, 59 Suppl 5:60-3, discussion 64. ; Internet; cited May 15, 2000.
Willner P. The mesolimbic dopamine system as a target for rapid antidepressant action. Int Clin Psychopharmacol, 1997 Jul, 12 Suppl. 3:S7-14. ; Internet; cited May 15, 2000.
Flaherty, Michael T. What is the Relationship between Depression and Alcohol Use? ; cited May 15, 2000.
Perera, I, Lim L. Amineptine and Midazolam Dependence. Singapore Medical Journal, date unknown. ; Internet; cited May 15, 2000.
Source: About.com
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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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