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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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Child and Teen Brains Very Sensitive to Stress, Likely a Key Factor in Mental Illness
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Child and Teen Brains Very Sensitive to Stress, Likely a Key Factor in Mental Illness
Read more... Schizophrenia Causes, Risk Factors & Prevention
New research is showing that the brains of children and adolescent (teens) are much more sensitive to stress than the brains of adults. Chronic stress seems to be particularly damaging. Researchers believe that this is likely to be an important factor in the development of schizophrenia and other mental illnesses that begin during the teen years, and therefore stress is a potential target to minimize or prevent mental illness.
At a high level, this new research highlights the fact that neuroscience and psychology are now generally understood by researchers to be highly interdependent, and even different views of the same thing. In fact researchers, as can be seen below, increasingly have both neuroscience degrees and psychology degrees to integrate these two viewpoints.
Researchers are finding that chronic moderate stress or shorter term high stress is very damaging to the brain. Additionally, past research has also shown that stress during pregnancy can further increase the sensitivity of a child's brain to stress - thereby multiplying the risk of future mental illness.
Research has shown that when an adult animal is under chronic stress, stress hormones called glucocorticoids can attack nerve cells in the hippocampus, causing dendrites to shrivel and cells to shrink. Stress can also halt neurogenesis (growth of new brain cells). In the amygdala, the brain's emotional center, the opposite occurs: More dendrites are grown from the neurons when an mammal is chronically stressed.
Scientists now believe these changes may help to explain the behavior a person shows months after a highly stressful event such as surviving an assault, or in the death of a family member, or long term stressors such as persistent social stress and ongoing discrimination. Shrinkage of brain cells in the hippocampus is associated with depression and memory loss. The growth of cells in the amygdala has been linked to overwhelming emotions, and in turn, anxiety disorders. These changes in the hippocampus are usually reversible. Once the stress is relieved, memory and mood improve. But even in adults, changes in the amygdala - emotional changes - don't always change back.
brain.amygdala.jpg
Depression, what Dr. Robert Sapolsky of Stanford University has called the "common cold of psychopathology," also attacks the hippocampus with stress hormones. Massive long-term depression, he said, was almost certain to cause permanent damage in the form of memory loss.
"All of this is perfectly disturbing, especially when you think about it in the realm of kids’ brains that are all about making new neurons and growing new processes. Everything I just told you about adult stress on the brain. . .multiply it ten-fold when you think about a ten year-olds brain."
In fact research studies have shown that children who grow up in households with high hostility levels between parents tend to have chronically elevated levels of stress hormones, and frequently have very poor memory of their childhoods later in life.
Other research is suggesting that it is psychological or social stress that for children these days, is perhaps the most common type of stress. At the same time, high stress jobs have been shown to increase risk for depression and anxiety. This, and related research, suggests that these stress hormones likely plays a key roll in serious mental illness in general, and schizophrenia specifically.
The Scientist magazine states that
"Elaine Walker, a developmental psychologist and neuroscientist at Emory University, says Russell Romeo's research (see below) is important in the context of psychological problems that emerge during adolescence. Stress is linked to virtually all physical and mental disorders, she says, adding that steroid hormones are believed to have both activational and organizational effects on the human brain. Walker also says that adolescence is a uniquely important time for intervention: "Preventive intervention in adolescence may be most effective because it is a developmental stage when we can most easily identify those who are vulnerable and potentially change the course of development." (Source: The Scientist magazine)
Russell Romeo, PHD, a researcher at Rockefeller University, is doing a lot of research in this area and it was the topic of a recent article in The Scientist magazine (a leading British science publication). We also interviewed Dr. Romeo by email to get a deeper look at his research as it relates to schizophrenia.
Russell Romeo (who has his PHD in neuroscience and psychology) is a young scientist at Rockefeller University who is trying to figure out how stress impacts the brains of adolescents by doing research with rats. Rats are commonly used in brain research because they share over 99% of the genes that humans have, and a long history of research suggests that their brains work very, very similarly to the way human brains work - so they are an inexpensive and ethical way to test the effects of stress on young mammals; a type of research that could not be done directly on humans due to ethical concerns. Because of these reasons, most experimental brain research today is done with rats.
Russell Romeo has found that juveniles were exposed to stress hormones longer (after a stressful event, or chronic stress) than the adults. "All things being equal, they're going to be experiencing higher levels for a longer period of time," and "This might be why stress can be so damaging to an individual during adolescence."
"The basic idea that has come from the kind of studies that I and Robert Sapolsky and others have done on animal models, is that the human brain does change volumetrically and functionally in some of these stress-related disorders," Professor McEwen, or Rockefeller University, says. Chronic stress is reshaping the brain in sometimes permanent, sometimes harmful ways. The amygdala, the hippocampus, and the prefrontal cortex are three brain areas that undergo major changes during puberty.
These cellular changes come at a particularly vulnerable time for teenagers. The overwhelming majority of people with schizophrenia start showing symptoms as adolescents. The prevalence of depression, which affects about two percent of children, climbs to seven percent after puberty. Although genetic factors play a large role in the onset of these diseases, some scientists say that chronic stress during adolescence tips the balance, causing someone who would otherwise be mentally sound to have a mental disorder. For all of these reasons, Romeo believed that the effects of stress on the changing brain during adolescence was an area that needed more research.
4 years ago, Russell Romeo started an experiment that would change the course of his career. Romeo, only 31 years old at the time, was a young neuroscientist working in one of the best stress research labs in the country, he was fascinated by recent research on the vast remodeling that takes place in the human brain during adolescence. Rats, Romeo felt, would provide a good model for better understanding the adolescent stress response in humans.
Very little was known about stress and the adolescent brain. Was it possible that stress affected young brains and older brains differently, in ways that researchers and clinicians had overlooked?
His question was simple: Do adolescents and adults undergo a similar brain hormone response when stressed? He knew of two other experiments in the previous 20 years that had involved stressing adolescent rats by using foot shock or ether inhalation. Romeo was subjecting his teenage rats to a different kind of stress: restraint. Restraint stress, he says, is both a physical and a psychological stressor, and he knew that it would activate the part of the brain that is called the hypothalamic-pituitary-adrenal (HPA) axis, the part of the brain hormone system that regulates stress.
When an animal encounters a stressful experience, the HPA axis is immediately activated. Cells in the hypothalamus release corticotropin-releasing hormone (CRH), which triggers the pituitary, a pea-sized gland nestled into a bony enclave at the base of the brain, to secrete adrenocorticotropic hormone. ACTH then acts on the adrenal glands to release glucocorticoids: cortisol in humans and corticosterone in rats.
Romeo's plan was to first compare the stress response of young rats with that of adult rats to find out whether stress reactivity changed during puberty. In his experiment, he would put each rat under stress for a short time, and then measure the levels of stress hormones - corticosterone and ACTH - in its blood. After the experiment, Romeo measured the hormone levels in the blood samples.
When he arrived at the lab the morning after his experiment and started to check the levels of the stress hormones in the rats' blood, he remembers the raw data of the hormone levels coming off the printer. To maintain the integrity of the experiment, the data was blinded, so he didn't know which number was associated with which rat. Romeo began matching number to animal and punching them into a computer spreadsheet. "I'm going, holy sh**,' as I'm putting them in," he says. "I'm looking at the data and thinking, wow, this really is a robust effect'."
In all the animals, the corticosterone levels had shot up to about 420 nanograms immediately followed the stressor. After 30 minutes, however, adult levels had dropped down to about 150 ng, while the juveniles' levels remained suspended at 400 ng. By 60 minutes, adult cortisone levels were at 120 ng, while levels for the young rats had dropped to only 260 ng. Two hours later, adult cortisone had returned to base level, while the juveniles' cortisone levels were still at about 80 ng, far above base level. Both released similar amounts of corticosterone, but the young rats took nearly an hour longer than the adults to recover.
The juvenile animal was mounting a longer stress response, which meant that the juvenile brain was exposed to stress hormones for a longer period than the adult brain. Romeo thought the physiologic and behavioral implications of the extended response were unknown, but since puberty is a time of increased susceptibility to drug abuse and mental disorders, and since these disorders appear to be exacerbated by stress, this area of research, he concluded, needed further investigation.
With the lab's senior advisor's blessing, Romeo initiated a second experiment. In his first, he had examined the hormonal stress response between adults and juveniles by looking at an acute, one-time stressor and found that hormonally, juveniles take longer to recover. In the second, he wanted to test the difference between the pups and the adult rats under chronic stress. This was an important step, because scientists knew that chronic stress was linked to depression and other mental disorders in adults. Knowing how chronic stress affected the adolescent brain could potentially shed light onto treatment for these disorders.
This time, Romeo stressed the rats - 36 young and 36 old - for thirty minutes each day for seven days. His questions: How do young rats and adults compare in their reactions to long-term stress? If they've experienced the stressor before, will they react to it differently when it repeats?
In the adult rats, hormone levels shot up on the first day of restraint but then dropped each ensuing day, as if they were growing accustomed to the stress. In the juveniles, on the other hand, corticosterone levels shot up even higher after the first day of stress and didn't drop until the stressor was removed. But, once it was removed, the juveniles showed a much faster return to baseline.
Chronic stress during adolescence, Romeo found, also led to changes in the behavior of his rats. When he subjected rats to stress throughout the course of puberty, they lost weight, had elevated levels of corticosterone, and showed symptoms of depression, like learned helplessness. This was not the case for adults subjected to stress. These data, he says, indicate that animals are particularly sensitive to stress during adolescence, but it will take more investigation to determine exactly what is changing during puberty to account for the difference in stress reactivity.
Romeo's next line of research, however, will be to investigate neurotransmitter systems, with a particular focus on norepinephrine and serotonin. He will investigate how adolescent stress affects the serotonergic and noradrenergic pathways in the brain. "We know that dysfunction of these pathways in adulthood can lead to psychological disorders, but know relatively little how challenges during puberty may affect their immediate or long-term functioning," Romeo wrote in a recent e-mail.
What Romeo does know is that stress, often linked to depressive and anxiety disorders, affects the adolescent human brain differently than that of an adult. And, he says that treatment should vary accordingly. The lumping together of age groups is a problem, he says.
"Psychological dysfunction in adolescence is a very different beast from psychological dysfunction in adults, just like it's very different when you have psychological dysfunction in an aged person versus a young adult." In other words, he says, adults and teenagers may require different drugs and different treatment plans. He says he hopes that his research will help advance treatment designed specifically for teenagers.
Romeo found that for adolescent rats, stress was also linked to signs of depression. By stressing adolescent rats and then observing them in an open maze and a forced swim test, Romeo has found that they are particularly sensitive to stressors, more sensitive than adults. The adolescent rats that were isolated or restrained in Romeo's experiments lost more weight, struggled less in the swim test and showed less movement in the open maze. Rats that he restrained as adolescents were also more prone to showing depressive tendencies later in life.
Dr. Romeo also mentioned the recent progress in "modeling" schizophrenia in mice, such as described in the paper cited below just appeared in the journal of Molecular Psychiatry this week.
Adult mice with reduced Nurr1 expression: an animal model for
schizophrenia, Mol Psychiatry. 2007 Aug;12(8):756-66. Epub 2007 Apr 24.
Russell Romeo believes it would be interesting to start studying these mice and their responses to stress, especially during perinatal development. However, at this time, he is not sure what has and hasn't been done with mouse models such as these. We'll report more as the progress continues in this important area.
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Depression Forums would like to hear from you!
Mental illness affects one in seventeen Americans. However, in this country alone, funding for mental health
facilities is dropping drastically and the care for the mentally disabled.
When the people who need those facilities have no where to go, they end up overcrowding emergency rooms.
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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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