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March 2013



Recent Posts



Genetics Impacts Depression Meds’ Effectiveness


By Senior News Editor
Reviewed by John M. Grohol, Psy.D. on March 29, 2013


Unfortunately, antidepressant drug therapy does not work for everyone. But new research finds that improved identification of genomic predicators — that is, how a person’s genetic makeup might impact their response to medication — will help future treatment of depression.


The National Institute of Mental Health’s STAR*D study, the largest and longest study ever conducted to evaluate depression treatment, has determined that only one-third of individuals respond to the first medication prescribed for depression, and that another one-third do not have an adequate response despite being treated with several medications.


Thus, identifying predictors of antidepressant response could help to guide the treatment of this disorder.


A new study, published in Biological Psychiatry, discusses new initiatives for identifying genomic predictors of antidepressant response.


Many previous studies have searched for genetic markers that may predict antidepressant response, but have done so despite not knowing the contribution of genetic factors, said Katherine Tansey, Ph.D., a psychiatric researcher at King’s College, London.


“Our study quantified, for the first time, how much is response to antidepressant medication influenced by an individual’s genetic makeup,” said Tansey.


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Untreated depression during pregnancy is not well-recognized and is certainly under-treated. The risks of letting perinatal depression go untreated can extend beyond pregnancy itself. While there is no gold standard treatment that most experts endorse, there is certainly a lot of discussion going on. A research article was published in the scholarly journal Human Reproduction in January, 2013. It is a detailed examination of potential risks for infertile women taking SSRI antidepressants. The article also discusses SSRI use in pregnant women.


Whether you agree with their conclusions or not, this is a fascinating read. Each potential risk is described in detail with research citations. Perhaps the most practically useful part of the article is the discussion on alternative treatments for depression during pregnancy.


These treatments could be done with or without also taking medication. The list includes cognitive behavioral therapy with a counselor, yoga, relaxation training, and more. Not every therapy has solid research results behind them, but it’s a good list for further study at the least.

There is one part I completely disagree with, mostly because it is done in such a broad sweeping way as to appear almost not-believable. The authors state that “the best meaningful evidence suggests that antidepressants do not provide clinically meaningful benefit for most women with depression.” I was a depressed mom that finally came out of the deep hole of depression with the help of medication. I am a counselor who has seen many people of both genders benefit from counseling and medication. I have also been connected with the postpartum depression community for a number of years. I’ve heard countless stories of women who were so grateful for the change they experienced after taking medication. Having seen all of this, I cannot believe such a broad- brush statement refuting the effectiveness of antidepressants for “most women with depression”. I just can’t.


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Antidepressants for Pregnant Moms Don’t Affect Infants’ Growth, Study Suggests


Mar. 20, 2013 — Selective serotonin reuptake inhibitor (SSRI) antidepressants taken by a woman during pregnancy do not impact her infant’s growth over the first year, reports a new study from a Northwestern Medicine scientist.


There had been concern that antidepressant treatment during pregnancy reduced growth during the first year. Previous data suggested depression during pregnancy also could diminish infant growth.


But the new study showed infants born to mothers who took SSRIs during pregnancy had a similar weight, length and head circumference over the first year as infants born to non-depressed women who did not take antidepressants. The infants whose mothers took antidepressants were shorter at birth, but the difference disappeared by two weeks of age.


In addition, growth measurements for the infants of depressed women who did not take SSRIs were similar to the general population.


“Most women want to know about the effect of their depressive illness or the medication they take during pregnancy not only on the infant at birth, but also on the baby’s longer-term growth and development,” said Northwestern Medicine lead author Katherine L. Wisner, M.D. “This information may help women balance the risks and benefits of continuing their antidepressant treatment during pregnancy.”


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Cognitive Behavioral Therapy and Depression

By  In this age of advanced modern medicine, it is a depressing fact that not all people suffering with a depressive illness respond to antidepressants.


The mental health charity Mind UK recently highlighted their concern that there is a serious need for a range of therapies to be made available to depression sufferers.


According to the best psychological working practices, medication is now considered to be only one option for effectively treating the illness.


Talk therapies — otherwise known aspsychotherapy — such as cognitive behavioral therapy (CBT) have proven effective at alleviating melancholic symptoms in hundreds of research studies conducted around the world. In Australia, the Australian Psychological Society has identified a serious need for psychotherapeutic interventions in the lives of people with depression.



Cognitive behavioral therapy (CBT) is a form of psychotherapy. Participants work with a specially trained psychologist to make positive steps in changing their thoughts and feelings. Committing to CBT means accepting that your actions affect your emotions and reasoning. Therapists help you to learn skills and strategies for changing negative thinking. This helps many people to learn to cope with depressive illness.


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Depression May Reduce Cardiac Benefits of Healthy Behaviors


By  Senior News Editor
Reviewed by John M. Grohol, Psy.D. on March 27, 2013


New research raises the depressing possibility that depression may counteract the health benefits of performing physical activity or light to moderate alcohol consumption.

Researchers from Duke Medical base their findings on measurements of the cardio-metabolic risk marker C-reactive protein (CRP). “Our findings suggest depression not only directly affects an individual’s mental and physical health; it might also diminish the health benefits of physical activities and moderate alcohol consumption,” said lead author Edward C. Suarez, Ph.D.


“This appears to be specific to inflammation, which we know increases the risk for heart disease, so our findings suggest that depression could be a complicating risk factor.”


CRP is a biomarker that predicts future risk of heart disease and other chronic inflammatory conditions. It may also play a role in the formation of plaque that builds up in arteries.


Physical activity and moderate alcohol consumption, defined as one drink a day for women and two a day for men, have each been shown to lower the risk of cardiovascular disease and type 2 diabetes.


Read More …




Rethinking the Diagnosis of Depression


Associate Editor


Most people diagnosed withdepression today aren’t depressed, according to Edward Shorter, a historian of psychiatry, in his latest book How Everyone Became Depressed: The Rise and Fall of the Nervous Breakdown. 


Specifically, about 1 in 5 Americans will receive a diagnosis of major depression in their lifetime. But Shorter believes that the term major depression doesn’t capture the symptoms most of these individuals have. “Nervous illness,” however, does.


“The nervous patients of yesteryear are the depressives of today,” he writes.


And these individuals aren’t particularly sad. Rather, their symptoms fall into these five domains, according to Shorter: nervous exhaustion; mild depression; mild anxiety; somatic symptoms, such as chronic pain or insomnia; and obsessive thinking.



As he writes in this recent blog post:


… The problem is that many people who get the diagnosis of major depression aren’t necessarily sad. They don’t cry all the time. They drag themselves from bed and go to work and plow through family life, but they aren’t sad. They may well have one of the “D-words”  — dysphoria, disenchantment, demoralization – but they aren’t necessarily depressed.


Instead, what do they have in addition? They’re anxious. They’re exhausted and often report crushing fatigue. They have all kinds of somatic pains that come and go. And they tend to obsess about the whole package.


What they have is a whole-body disorder, not a disorder of mood. And that is the problem with the term depression: it shines the spotlight on mood, a spotlight that belongs elsewhere.


Severe depression, which has been lumped in with depression, is a completely different disorder. It’s a serious illness akin to melancholia, a term used around the mid 18th century to the early 20th century. Melancholia speaks more accurately to the gravity of this severe depression and its serious symptoms, which include despair, hopelessness, lack of pleasure in one’s life and suicide.


Shorter also describes melancholia as a “dejection that appears to observers as sadness but that patients themselves often interpret as pain.” It’s recurrent. “Melancholia digs deep into the brain and body, putting patients in touch with their most primeval – and often sinister – impulses. Fantasies of murder and suicide are common themes.”


So how did everyone become depressed?


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