Depression and Anxiety
Written and researched by Bob Murray, PhD
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Maternal Deprivation Triggers Manic Depression
In a ground-breaking study scientists in Italy and Holland have shown that, at least in rats, if you separate an infant from its mother for a period of time this triggers a genetic response in the young rat's brain.
Over the last few years, several lines of investigation have suggested that adverse life events during infancy can be critical for brain development. The results of these traumas (as we would call them) are known to produce lasting changes in brain function and increase the individual's vulnerability to psychiatric disorders.
In their study, the authors have used maternal deprivation (MD) on postnatal day 9 in order to investigate long-term effects of early adverse life situation on brain function. They found that, as adult, MD animals show reduced expression of BDNF. (Brain Derived Neurotrophic Factor is a trophic protein that plays an important role in regulating neuronal function and plasticity and glutamate NMDA receptor subunits, which are important players in cellular plasticity.)
These changes occur specifically in the hippocampus, a region important for cognition, and are only observed in adult animals.
The study, published in the August issue of Molecular Psychiatry, provides evidence for the presence of anatomically-defined molecular changes in the brain following exposure to adverse experience early in life. Although the study was conducted in rodents, it emphasizes the vulnerability of the brain to stressful condition during development. This work might contribute to understanding the molecular mechanisms that underlie brain vulnerability for psychiatric disorders and =ltimately allow the identification of novel targets for the cure of psychiatric disorders that, to some extent, may be associated to an impairment in brain plasticity.
Genetic Predisposition Discovered
In the same issue of Molecular Psychiatry, researchers from Harvard and Johns Hopkins Universities reported their work in finding the gene most likely to produce manic depression (or bipolar disorder).
Of the 76 genes most often mentioned in the literature as being responsible for the disorder, they discovered one which they think is the culprit: a gene found on chromosome 11 belonging to a family of so-called neurotrophins -- nerve chemicals that promote the growth and survival of neurons).
By using high-throughput genotyping technology at the Whitehead Genome Center, they analyzed the patterns of inheritance in the DNA from parents to their children with bipolar disorder. A single letter variation (SNP) of this gene seems to be the commonality that suffers of bipolar disorder have in common. This SNP causes a change in the BDNF protein in the hippocampus ( an area of the central brain that deals with memory and emotion) and this causes the illness.
The Full Story
Taking the two studies together we have an interesting situation. There seems to be a genetic link in the transmission of bipolar disorder, however the illness can be induced through a traumatic event such as maternal separation in infancy. The Europeans suggest that if there is such a genetic predisposition then the traumatic early life event may be like a switch which turns the SNP "on."
More controversially they imply that a change in life circumstances in adulthood (the BDNF damage only shows up physically in adulthood) may switch the gene to "off."
Both sets of researchers admit that more studies need to be carried out both to confirm their results and to discover practical treatments derived from them.
That genetic predispositions can be switched "on" and "off" through environmental circumstances is something I have been saying for some time and is the basis of some of the work that we do for depression in the Uplift Program. BM
Read more in Molecular Psychiatry
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A Better Mood Only a Short Walk Away
July 7, 2002
This is in contrast to previous exercise-psychology assumptions that such mood changes "occur only with exercise that exceeds certain strenuous 'thresholds' of intensity and duration," according to study authors Dr Panteleimon Ekkekakis and Roxane Joens-Matre of Iowa State University.
"We believe that these results have implications for whether exercisers will stick with the exercise program over the long haul or not," Ekkekakis told Reuters Health. "People generally repeat what makes them feel good and avoid what makes them feel bad."
Ekkekakis and Joens-Matre's study included 20 men and women who completed various questionnaires before, during, and at the end of a 15-minute self-paced treadmill walk or a 15-minute rest period after walking. The study participants were 53 years old, on average.
After the walks, participants reported greater energy and less tiredness, and also tended to report more pleasurable feelings, according to the investigators. In addition, after their post-walking rests, participants said they felt calmer than they were before they began walking.
"We think that, based on our results so far, a walking program might be a lot more likely to be continued over the long haul compared to a program of more vigorous activity," Ekkekakis said.
Walking has been the only activity to produce the positive changes noted in this study both during and after the walking exercise, according to Ekkekakis. While more intense exercisers may report positive changes after their exercise activity, they do not always report similar feelings during the activity, he said.
Further, "walking is inexpensive, familiar and safe," Ekkekakis added. And contrary to the popular "no pain, no gain" mantra, "regular walking at a moderate pace has been shown to reduce body weight, reduce the incidence of type 2 diabetes and lower blood pressure," he said.
That's why, Ekkekakis noted, "Many have argued that the most effective piece of exercise equipment is a dog."
The findings were presented earlier this month during the North American Society for the Psychology of Sport and Physical Activity Conference in Hunt Valley, Maryland.
That gentle exercise is beneficial for mood is not a particularly new concept, and one which we have been hammering away at for some time. Our own Repatterning Movement tape sets are great in this regard. BM
Read more in Reuters Health
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Suicide Highest Killer of Pregnant Women
July 7, 2002
Contrary to the old belief that a woman would do anything to protect her child and therefore the will to live would be strongest during pregnancy and shortly thereafter, a team of British researchers have found that exactly the opposite may be true. They have found that suicide is the main cause of death among pregnant women and new mothers. The report notes many suicides are "violent" and take place before the child's first birthday. According to a paper delivered to the Royal College of Psychiatrists the problem is increasing and health workers need to stay alert for signs of extreme depression. Many new mothers or pregnant women die by hanging, jumping off bridges, drowning, cutting their throats and throwing themselves in front of moving vehicles, rather than opt for the popular suicide method of overdosing.
Read more in American Psychological Association site Psychport
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Couples Therapy Beats Antidepressants If One Partner is Critical
July 7, 2002
According to a study published in the British Journal of Psychiatry couples therapy is better and cheaper than antidepressants in preventing a relapse into depression if one of the pair has a critical personality. A team of British psychologists and psychiatrists set out to discover whether drugs or talk therapy were better for couples who suffered from depression. They were particularly interested in the drop-out rate and in the overall benefits of the two approaches. The study involved 77 couples where there was a history of depression and where one of the partners was critical. What they found was that the drop-out rate was higher for couples therapy (15%) but that talk therapy was more effective in both the medium and long term in alleviating depression. They concluded "For this group couple therapy is much more acceptable than antidepressant drugs and is at least as efficacious, if not more so, both in the treatment and maintenance phases."
Reported in the British Journal of Psychiatry
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Children Unhappy With Their Bodies
July 7, 2002
A study found almost half of girls and a third of boys aged between seven and 12 wanted to be thinner. The research, carried out at Surrey and Melbourne Universities, shows children are aware of their body shape and image at a much younger age than previously thought. It is believed they are influenced by images in the media of very thin celebrities such as Gerry Halliwell and Ally McBeal star Calista Flockhart.
The study examined the attitudes of 312 children. A body mass index (BMI) measurement was taken -- calculated by dividing weight in kilograms by the square of height in metres. In adults, a BMI of more than 25 is classed as overweight, and over 30 as obese.
The children were photographed so that the researchers could identify the range of body sizes. From these, the researchers generated a set of seven body images for both boys and girls. The children were then asked to pick out which image they perceived to be most like their own, and which one they thought was an ideal figure.
The difference between perceived and ideal ratings was then used as a way of measuring dissatisfaction with body size. Forty-eight percent of girls selected an ideal body image that was thinner than their own, 42% a figure the same size, and 10% a larger body size. Among boys, 36% preferred a thinner body image, 44% the same, and 20% a larger image than their own.
The research team, led by psychologist Dr Helen Truby from the School of Biomedical and Life Sciences at the University of Surrey, say their findings support previous studies which indicated unhappiness with body size is frequent even before children reach puberty.
They say further research is needed to prevent such dissatisfaction developing into more serious body image and eating disorder problems in teenagers and adults. And they call for the development of a specific BMI scale for children. Dr Truby told a national newspaper: "It is surprising how many young children are aware of their body shape and size at such an early age. It was believed children didn't develop an adult ideal until puberty. But children at seven are aware whether they are satisfied with their bodies."
She added: "The consequences to public health in these findings in relation to the desire for a thin body, which is relatively unachievable for most children, needs careful consideration."
Read more in the British Journal of Clinical Psychology
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Patients May Sue Over Anti-depressant
June 24, 2002
More than 100 people who say they have suffered serious side effects after taking a pill for mental illness are deciding whether to take legal action. Seroxat was meant to be the wonder drug of the last decade -- giving relief to patients with a range of mental health problems. Three million prescriptions for the drug are given out in the UK alone each year. Those suing the manufacturer, GlaxoSmithKline, claim that the drug is highly addictive and impossible to come off without side effects such as "buzzing through the mind, splitting headaches, and an inability to sit still." GlaxoSmithKline are being pressured to put warning labels on the drug and have already reprinted the leaflet that comes with Seroxat. It now warns of serious side effects resulting from coming off the drug too quickly and mentions "suicide" for the first time.
Read more in BBC News
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Brain Scan Predicts Path of Depression
June 24, 2002
Researchers at the University of California, Los Angeles have detected signs of changes to patients' brain waves weeks before they showed any visible benefits from taking medication. The scientists, led by Dr Ian Cook, say the method could minimize the waste of drugs on patients who are unlikely to respond positively. This is doubly important, as the drugs are expensive and can have serious side effects.
Dr Cook said: "This is the first study to detect specific changes in brain wave activity that precede the clinical changes in a way that can usefully predict response."
Many depressed patients do not respond to the first medication they try, or any. Since it takes several weeks for an effective treatment to produce clear improvement, doctors often wait six to 12 weeks to decide that a particular drug just isn't right for that patient and move on to another treatment. Recent studies have also shown that patients may respond to dummy pills in much the same way they respond to antidepressants.
The scientists used an EEG (electroencephalogram) to measure electrical activity in an area of the brain called the prefrontal cortex, which is involved in judgment and motivation. They detected changes in some cases just two days after patients began taking medication, even though clear clinical differences did not become apparent for about four weeks.
In total, 51 patients with acute depression took part in the study. They were given either Prozac, Effexor or a dummy pill. Overall, about 50% of the volunteers responded to one of the two drugs, while 38% responded to the placebo. EEG scans picked up changes in activity in the prefrontal cortex in patients from all three groups who responded positively.
However, the changes took longer to appear in those patients who responded to the dummy pill, and when they did come, they were different. Patients who responded to medication registered a decrease in prefrontal cortex activity, while those who responded to the placebo registered an increase in activity. The researchers wrote that their findings may well one day revolutionize the whole basis of drug therapy for depression.
Read more in Neuropsychopharmacology
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Disconnection Leads to Depression
June 24, 2002
Modern art has often been accused of being meaningless but could this mean it can bring on mental illness? A man who studied art theory and postmodernism at university says feelings of disengagement and alienation as a result of his studies caused him to suffer serious depression after graduation.
Scott Reid, 28, currently a secondary school history teacher in Hackney, London says the theory of postmodernism and its teachings that everything is relative made him feel he no longer knew what reality was. "I felt that no activity had any more meaning than any other. I became seriously depressed," he said.
"What was the point of concentrating on any activity if it had no real point? If you believed what we had been taught at university, everything had equal meaning. If you took this to its logical conclusion, everything meant nothing."
Some health experts say a major cause of depression in modern societies can be caused by feelings of a lack of engagement or alienation with a community and a lack of purpose. A sense that there is no structure to society may increase a vulnerable person's sense of disengagement from the world and could increase their chance of suffering from depression.
Studies from the University of Manchester psychiatry unit show that problem solving skills and engagement with the community can successfully treat depression. "A lack of problem solving skills and separation from community can cause a person to find life more difficult," said a spokesperson.
Read more in BBC News
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Materialism Breeds Depression, Makes Happiness Elusive
June 10, 2002
The old saying that money doesn't bring happiness seems to be backed up by two researchers, Dr Richard Ryan and Dr Tim Kasser, of the University of Rochester in New York. Their work was recently reported in that most materialist of websites CBS MarketWatch. There among the stock market recommendations, economic prognostications and flashing ads for on-line casinos was an interview with the two anti-materialist academics.
"When we started out, we were looking at people's value systems and their emphasis on relationships, commitment, and personal growth," Ryan told MarketWatch. "When we put the relative importance value on money, it had strong mental affects."
"Our studies weren't intended to show the pursuit of affluence created unhappiness, it just turned out that way," said Ryan, a professor in the Department of Clinical and Social Sciences in Psychology. Ryan's thesis basically says most people are barking up the wrong tree. "People who had financial success also had discontent with their family relationships and their caring relationships. If I wake up and all I think about is the next consulting job or the next seminar and my kid is asking me a question about something important to him but I'm too preoccupied to pay attention, there is a problem -- for the child and for me."
Money doesn't help, says Ryan, nor does it seem to hurt personal wellbeing. It's bad if "it's about being rich. When your personal wellbeing is attached to the attainment of goals, and the attainment of those goals doesn't produce happiness, look out," says Ryan. Then depression sets in.
"Our intrinsic values have to be satisfying in their own right," Ryan said. "If they happen to have an extrinsic benefit, that's happenstance. After the 1960s and now, after two periods of affluence, people are asking 'What now?' more and more. When we get things, we realize that we aren't all that satisfied by them."
Ryan pointed out that philanthropy is up more than 1,000 percent over the last five years. The material, or extrinsic, things can never replace our internal, or intrinsic, needs, try as we might.
In his research, Ryan studied a group of about 300 18-year-olds from Russia and the United States. Among the individuals who wanted material trappings, the majority had mothers who were cold or distant to them as children. "They want material trappings because they giver the promise of intimacy and a sense of security and love. It doesn't happen. If someone loves you because of your car, it means that they don't love you. So you can't win," Ryan expounded.
This happens with couples too. "When you are with someone because they look good, and their looks somehow, you think, will reflect upon you, that's not a start to a healthy relationship. You have to find a spiritual partner, someone you can relate to on a deeper level."
How do we get there? How do we escape from these "surface trappings," as Ryan calls them, and go deep? "Those people who are higher in mindfulness and are attuned to what's going on around them are also attuned to their intrinsic values. Those who contribute, who are caring toward others and for the earth, can find intrinsic satisfaction even though happiness wasn't the goal."
In our workshop we concentrate on reinforcing people's intrinsic value and help them establish a nexus of relationships that reinforce this. BM
Read more in CBS MarketWatch
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Federal Panel Pushes Depression Screening
June 10, 2002
A federal task force recommended that all adults be screened for depression during regular visits with their doctors, saying as many as half of all cases are missed and others are mistreated. The US Preventive Services Task Force said the nation's primary care doctors could begin to identify as much as 90 percent of cases by asking questions about depression.
The task force, an independent medical panel asked by the federal government to evaluate the latest research in deciding what routine medical screening Americans need, released the findings in the Annals of Internal Medicine. The task force said it recommends screening adults for depression in clinical settings that allow for effective treatment and follow-up.
They said doctors should start by asking patients two questions: "Over the past two weeks, have you felt down, depressed or hopeless?" and "Over the past two weeks, have you felt little interest or pleasure in doing things?" A 'yes' answer to either question should be followed with in-depth questionnaires to determine whether the patient is depressed, the panel said.
A WHO study in Europe found that less than 50% of doctors could recognize the symptoms of depression. Before MDs can really help their depressed patients some education would seem to be in order. BM
Read more in the Annals of Internal Medicine
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About the Author
Dr Bob Murray is a widely published psychologist and expert on emotional health and optimal relationships. Together with his wife and long-term collaborator Alicia Fortinberry, he is founder of the highly successful Uplift Program, and author of Raising an Optimistic Child (McGraw-Hill, 2006) and Creating Optimism (McGraw-Hill, 2004).
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