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January 2011



Recent Posts


"Myth"(Sphinx) Sculpture

10 Common Myths About Clinical Depression

Almost every mental illness ends up accompanied by a barrage of myths, misunderstandings, and misconceptions that cloud the minds of the populace and ultimately produces muddied opinions of the true threat. Unfortunately, one of the most marginalized and ridiculed conditions is also one of the most common. An estimated 17 million Americans suffer from some form of clinical depression a year, most of whom end up never seeking psychological assistance due to feeling undermined and discouraged by the perceptions of society at large. Because those suffering from depression run a much higher risk of committing suicide or acts of self-mutilation than their comparatively healthier peers, it is absolutely integral to understand the complexities and widespread influence of the disease. Only by making an earnest effort to combat these negative and patently false perceptions can the depressed begin to realize that no shame or weakness lay in their situation, thereby removing many of the stigmas and reservations still undeservedly attached to entering into therapy.

Read in Full:  http://onlinepsychologydegrees.org/10-common-myths-about-clinical-depression/

Survey finds big gap in knowledge of depression


Americans do not believe they know much about depression, but are highly aware of the risks of not receiving care, according to a survey released today by the National Alliance on Mental Illness (NAMI).

The survey provides a “three dimensional” measurement of responses from members of the general public who do not know anyone with depression, caregivers of adults diagnosed with depression and adults actually living with the illness.

  • *Seventy-one percent of the public sample said they are not familiar with depression, but 68 percent or more know specific consequences that can come from not receiving treatment-including suicide (84%).
  • *Sixty-two percent believe they know some symptoms of depression, but 39 percent said they do not know many or any at all.
  • *One major finding: almost 50 percent of caregivers who responded had been diagnosed with depression themselves, but only about 25 percent said they were engaged in treatment.
  • *Almost 60 percent of people living with depression reported that they rely on their primary care physicians rather than mental health professionals for treatment. Medication and “talk therapy” are primary treatments-if a person can get them-but other options are helpful.
  • *Fifteen percent of people living with depression use animal therapy with 54 percent finding it to be “extremely” or “quite a bit” helpful. Those using prayer and physical exercise also ranked them high in helpfulness (47% and 40% respectively).
  • *When people living with depression discontinue medication or talk therapy, cost is a common reason, but other significant factors include a desire “to make it on my own,” whether they believe the treatment is actually working and in the case of medication, side effects.

The survey reveals gaps and guideposts on roads to recovery,” said NAMI Executive Director Michael J. Fitzpatrick. “It tells what has been found helpful in treating depression. It can help caregivers better anticipate stress that will confront them. It reflects issues that need to be part of ongoing health care reform.

There are many treatment strategies,” said NAMI Medical Director Ken Duckworth. “What often works is a combination of treatments that fit a person and their lifestyle. Research indicates that the combination of medication and psychotherapy are most effective. But physical exercise, prayer, music therapy, yoga, animal therapy and other practices all can play a role. The good news is that 80 percent or more of the public recognize that depression is a medical illness, affecting people of all ages, races and socioeconomic groups, which can be treated.

Harris Interactive conducted the survey for NAMI on-line between September 29 and October 7, 2009. Participants included 1,015 persons who did not know anyone diagnosed with depression, 513 persons living with depression and 263 caregivers of a family member or significant other diagnosed with depression.

The full survey results are at: http://www.nami.org/depression.

The survey was made possible with support from AstraZeneca, Bristol-Myers Squibb, Eli Lilly & Co. and Wyeth. NAMI does not endorse or promote any specific medication, treatment, product or service.

Van Gough

The Evolution of Depression

November 10, 2009 | By Dirk Hanson, MA

Millions of people around the world suffer from depression, the most common mental disorder of all. Since depression appears to be largely genetic, several long-standing questions continue to bedevil researchers. Have the genes for clinical unipolar depression undergone selective evolution–or is depression a random product of mutation, evolutionary drift, or other non-selective forces? The symptoms of depression are found in every culture and time period, from the ancient Greeks to modern New Yorkers, from the !Kung of southern Africa to ranchers in the American West. Why is depression so much more common than any other major mental illness? Clearly, it is a malfunction, a maladaptation — or is it?

Read in Full:  http://brainblogger.com/2009/11/10/the-evolution-of-depression/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+GNIFBrainBlogger+%28Brain+Blogger%29

Deep Brain Stimulation For Clinical Depression?

Posted on: November 11, 2009 11:49 AM, by Dave Munger

This week on SEED, I’m writing about Deep Brain Stimulation (DBS), a promising new way to treat clinical depression. Here’s a snippet:

In DBS therapy, one or more electrodes the size of a spaghetti strand are precisely positioned in the patient’s brain, then connected by wire around the skull and through the neck to a pacemaker-like device, a neurostimulator, just below the collarbone. The neurostimulator is activated and deactivated by a magnet that the patient carries, so if a tremor is beginning to become disruptive, DBS can be self-administered in an instant, with near-instantaneous results. A video provided by the manufacturer of a DBS device shows how it works in ideal cases.

Now new uses for the treatment are being tested. One observed side effect of DBS for Parkinson’s is excessive happiness, to the point of uncontrollable elation–the sort of unhealthy, personality-changing reaction that everyone fears when they think of electrodes being implanted in their brain. Tuning the device can minimize this side effect, but its very existence suggests that DBS might be a useful therapy for clinical depression.

For more, read the whole article

John Hopkins: Antidepressant Medication “Poop Out”

A reader from Roswell, Georgia asks: “I have been taking 20 mg/day of Celexa (citalopram) for about a year and a half for depression. It was the first medication I tried, and it worked great. For the past two months or so, however, I haven’t been feeling great. I have been sleeping a lot, crying a lot, and feeling antisocial. Is it possible for Celexa to “poop out” and just stop working over time? Should I talk to my doctor about increasing my dosage or changing medications? Or maybe this bout with depression is just extra bad and I should tough it out?” Here’s our advice.

Antidepressant tachyphylaxis — known less formally as the “poop out” effect — was first described in 1984 when researchers observed that some patients experienced relapse of mood symptoms on antidepressants that had previously been effective therapies. There is some suggestion that serotonin reuptake inhibitors, or SSRIs, such as Celexa, are more prone to tachyphylaxis than other antidepressants, such as tricyclic medications like nortriptyline and serotonin norepinephrine reuptake inhibitors (SNRIs) like Effexor.

When antidepressants appear to “poop out,” there are four options available to the physician and patient. The first is to increase the medication dosage in an effort to boost the antidepressant effect, assuming the maximum dose is not already prescribed. For example, the maximum dose of Celexa is 60 mg daily. A common pattern with SSRIs is for there to be an initial response to a lower dose that is not sustained, requiring titration over time to higher doses. Increasing the dosage alone may be sufficient to jumpstart recovery.

Read in Full: 


Abstract: Trends in prescribing and self-poisoning in relation to UK regulatory authority warnings against use of SSRI antidepressants in under-18-year-olds

Bergen H, Hawton K, Murphy E, Cooper J, Kapur N, Stalker C, Waters K.

Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford; Centre for Suicide Prevention, University of Manchester, Manchester; Derbyshire Mental Health Trust, Derby, UK

AIMS: To assess the impact of the UK Medicines and Healthcare products Regulatory Authority (MHRA) warning in December 2003 not to prescribe selective serotonin reuptake inhibitor (SSRI) antidepressants, except fluoxetine, to under-18-year-olds.

METHODS: Interrupted time series analysis of prescriptions (UK) and general hospital presentations for nonfatal self-poisoning (three centres in England) for 2000-2006.

RESULTS: Following the MHRA warning in December 2003 there were significant decreases in prescribing of SSRI antidepressants (conservative estimate 51%) to young people aged 12-19 years. Surprisingly, this decrease also affected fluoxetine (conservative estimate 20%) and tricyclics (conservative estimate 27%). Nonfatal self-poisoning in this age group following the warning also declined significantly for SSRIs (conservative estimate 44%), but not for fluoxetine, tricyclic antidepressants, or all drugs and other substances. Rates of nonfatal self-harm did not change significantly over the study period.

CONCLUSIONS: The reduction in both prescribing and self-poisoning with SSRI antidepressants (except fluoxetine) following the MHRA warning is in keeping with reduced availability of these drugs. There was some evidence of substitution from other SSRIs to fluoxetine for use in self-poisoning. Importantly, overall rates of nonfatal self-harm and self-poisoning did not change, indicating no substitution of method or increases in self-injury.

Source… © 2009 The Authors; Journal compilation © 2009 Blackwell Publishing Ltd

Abstract+: A investigation of cognitive ‘branching’ processes in major depression

Nicholas D Walsh , Marc L Seal , Steven CR Williams and Mitul A Mehta

Background: Patients with depression demonstrate cognitive impairment on a wide range of cognitive tasks, particularly putative tasks of frontal lobe function. Recent models of frontal lobe function have argued that the frontal pole region is involved in cognitive branching, a process requiring holding in mind one goal while performing sub-goal processes. Evidence for this model comes from functional neuroimaging and frontal-pole lesion patients. We have utilised these new concepts to investigate the possibility that patients with depression are impaired at cognitive `branching’.

Methods: 11 non-medicated patients with major depression were compared to 11 matched controls in a behavioural study on a task of cognitive `branching’. In the version employed here, we recorded participant’s performance as they learnt to perform the task. This involved participants completing a control condition, followed by a working memory condition, a dual-task condition and finally the branching condition, which integrates processes in the working memory and dual-task conditions. We also measured participants on a number of other cognitive tasks as well as mood-state before and after the branching experiment.

Results: Patients took longer to learn the first condition, but performed comparably to controls after six runs of the task. Overall, reaction times decreased with repeated exposure on the task conditions in controls, with this effect attenuated in patients. Importantly, no differences were found between patients and controls on the branching condition. There was, however, a significant change in mood-state with patients increasing in positive affect and decreasing in negative affect after the experiment.

Conclusions: We found no clear evidence of a fundamental impairment in anterior prefrontal `branching processes’ in patients with depression. Rather our data argue for a contextual learning impairment underlying cognitive dysfunction in this disorder. Our data suggest that MDD patients are able to perform high-level cognitive control tasks comparably to controls provided they are well trained. Future work should replicate these preliminary findings in a larger sample of MDD patients.

Source | Full text (PDF0

Open access

Women More Likely Than Men To Suffer Depression After Stroke

Article Date: 11 Nov 2009 – 2:00 PST

Depression occurs in as many as one-third of patients after a stroke, and women are at somewhat higher risk, according to a large new review of studies. Post-stroke depression is associated with greater disability, reduced quality of life and an increased risk of death.

The systematic review appears in the November-December issue of the journal Psychosomatics.

Brittany Poynter, M.D., and colleagues from the University of Toronto looked at 56 studies on stroke and depression comprising more than 75,000 people, about 12,000 of them women. The time between the stroke and onset of depression ranged from less than two weeks to 15 years.

In women, rates of post-stroke depression ranged from about 6 percent to 78 percent, while in men depression rates ranged from 4.7 percent to about 65 percent.

These findings are important, Poynter said, because women who have had a stroke generally do more poorly than men. They tend to have higher rates of disability and longer hospitalization times. The authors say this might be due in part to higher rates of depression. In addition, “women may have less access to care,” Poynter said.

“People think of stroke as a ‘male’ disease and it is slightly more common in men but because it increases with age, more women end up having strokes because they live longer,” said Linda S. Williams, M.D., chief of neurology at the Roudebush VA Medical Center in Indianapolis. She is not associated with the review.

Read in Full:  http://www.medicalnewstoday.com/articles/170526.php

Psychiatry’s dirty little secret

Scott Mendelson, MD

When I was in medical school, I learned one of psychiatry’s dirty little secrets. That is, that of people prescribed an antidepressant to treat their Major Depression, only about 25% enjoy complete resolution of symptoms, another 50% feel some but not complete relief, and the last unfortunate 25% get no relief at all. This was true 15 years ago and remains true today. As a psychiatrist, I prescribe antidepressants, and I have seen these medications improve and even save lives.


Copyright © 2009 HuffingtonPost.com, Inc.

Study finds clear connection between depression and osteoporosis

Jerry Barach
The Hebrew University of Jerusalem

Research carried out among thousands of people has shown a clear connection between depression and a loss of bone mass, leading to osteoporosis and fractures. according to Hebrew University of Jerusalem researchers, Prof Raz Yirmiya, head of the Brain and Behavior Laboratory, and Prof Itai Bab, head of the Bone Laboratory. They further revealed that the relationship between depression and bone loss is particularly strong among young women.

Osteoporosis is the most widespread degenerative disease in the developed world, afflicting 1 in 3 women and 1 in 5 men over 50. Sufferers experience decrease in bone density, which often leads to bone fractures. In many cases, these fractures cause severe disability and even death.

Despite the accumulating evidence for a connection between depression and decreased bone density, official authorities, such as the US National Institutes of Health and the World Health Organization, have not yet acknowledged depression as a risk factor for osteoporosis, due to the lack of studies in large samples. To remedy this situation, the researchers assembled the data from all studies on the subject conducted to date, and analyzed them using a special statistical approach called meta-analysis.

The results were recently published in the journal Biological Psychiatry. In the article the Hebrew University scientists assessed data from 23 research projects conducted in eight countries, comparing bone density among 2,327 people suffering from depression against 21,141 non-depressed individuals.

The results, say the researchers, show clearly that depressed individuals have a substantially lower bone density than non-depressed people and that depression is associated with a markedly elevated activity of cells that breakdown bone (osteoclasts).

Yirmiya and Bab found that the association between depression and bone loss was stronger in women than men, especially young women before the end of their monthly period. This connection was especially strong in women with clinical depression diagnosed by a psychiatrist, but not in community studies, in which women subjectively identified themselves as being depressed using self-rating questionnaires.

Based on the present findings, Profs. Yirmiya and Bab propose that “all individuals psychiatrically diagnosed with major depression are at risk for developing osteoporosis, with depressed young women showing the highest risk. These patients should be periodically evaluated for progression of bone loss and signs of osteoporosis, allowing the use of anti-osteoporotic prophylactic and therapeutic treatments.

Yirmiya R, Bab I. Major depression is a risk factor for low bone mineral density: a meta-analysis. Biol Psychiatry. 2009 Sep 1;66(5):423-32   [Abstract]

Having Mental Illness Does Not Make People More Accepting, Research Shows

Article Date: 10 Nov 2009 – 0:00 PST

Having a mental illness does not make people more accepting of others with a similar problem, research says.

Amy Klassen asked 1073 people in Alberta, Canada, about their attitudes generally toward people who had a mental illness.

She found that those among the 1073 who had themselves been treated for a mental illness were no more accepting of others who have a mental illness.

However Ms Klassen, who worked with the Population Research Laboratory and the Department of Sociology at the University of Alberta, Canada, found that those questioned were less willing to reject those with a mental illness if they knew someone who had had such a problem.

Those surveyed were given eight statements, including ‘being around a mentally ill person would make me feel nervous’ and ‘even though former mental patients may seem fine, it is foolish to forget that they are mentally ill’ and asked to say how much they agreed or disagreed. From this their desire for ‘social distance’ from those with mental illness – how rejecting or not they were – was calculated.

Read in Full:  http://www.medicalnewstoday.com/articles/170321.php

[VIDEO] Guide To Cognitive Behavioural Therapy

Wednesday 4 November 2009

Authoritative information from the British Medical Journal on CBT, a psychotherapy used to treat depression, anxiety, panic attacks and obsessive-compulsive disorder

View Video:  http://www.guardian.co.uk/lifeandstyle/video/2009/nov/04/cognitive-behavioural-therapy-cbt-guide

TMS As Drug-Free Depression Treatment

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on November 6, 2009

Transcranial Magnetic Stimulation (TMS) is a FDA-approved, non-invasive antidepressant device-based treatment clinically proven for treatment of depression.

Rush University Medical Center has opened a clinic that uses the TMS therapy system to deliver highly focused magnetic field pulses to a specific portion of the brain, the left prefrontal cortex, in order to stimulate the areas of the brain linked to depression.

The repeated short bursts of magnetic energy introduced through the scalp excite neurons in the brain.

Depression affects at least 14 million American adults each year. Researchers estimate that by the year 2020, depression will be the second leading cause of disability worldwide.

Read in Full:  http://psychcentral.com/news/2009/11/06/tms-as-drug-free-depression-treatment/9392.html

Emotional Resilience: Coping with Life, It’s Tragedies and Its Stresses

Allan Schwartz, LCSW, Ph.D. Updated: Nov 7th 2009

I am relatively certain that all of you have heard the saying, “G-d does not give you more of a burden than you are able to hold.” I suppose it is a way to assure people that they can handle anything.

However, all of us know that there are times when it feels like a burden is too heavy to carry.

The sources of these burdens are such things as the death of a loved one, being caught in a war, earthquake, hurricane or tornado. For others, it may be having a spouse suddenly and unexpectedly decide to move away and end the marriage with no explanation. In fact, there are many scenarios that are traumatic and depressing. Another way of thinking about this is that life tests us and our capacity to cope.

As a result of these difficult times it is common to think such things as, “This is not what I bargained for. This is beyond me and who I am. This is beyond the emotional resources that I have. No one else goes through this type of thing. I just want to die!”

In psychology, there is a concept known as “emotional resilience.” The following Mental Help.Net article defines emotional resilience. It can be found at this URL:


One aspect of emotional resilience is:

“to be able to spring back after suffering through difficult and stressful times in one’s life. Stressed people experience a flood of powerful negative emotions which may include anger, anxiety, and depression. Some people remain trapped in these negative emotions long after the stressful events that have caused them have passed. Emotionally resilient people, on the other hand, are quickly able to bounce back to their normal emotional state. In a way, they have learned to wear a “hard hat,” a protective cover that allows them to move on.

Read in Full:  http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=33772&cn=298

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