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Seasonal Affective Disorder (SAD) - Take Action

SAD patients who take antidepressants in autumn can prevent winter depression

For patients with seasonal affective disorder (SAD), starting treatment with an antidepressant medication during the fall can reduce the risk of developing depression throughout the fall and winter months, reports a study in the Oct. 15 issue of Biological Psychiatry, official journal of the Society of Biological Psychiatry, published by Elsevier, a world-leading scientific and medical publisher.

"These are the first systematic studies that indicate that SAD can actually be prevented in some patients by starting antidepressants early in the season, before the development of symptoms," comments Norman E. Rosenthal, M.D., Clinical Professor of Psychiatry, Georgetown Medical School, and one of the authors of the paper and leader of the research team that first described SAD over 20 years ago.

Dr. Rosenthal and colleagues performed a study with more than 1,000 patients with SAD from the northern United States and Canada. The patients, 70% of whom were women, reported an average of 13 previous episodes of fall-winter depression. Notwithstanding this long history, almost 60% of patients had received no previous treatment for their episodes of depression.

The researchers attempted to prevent the development of fall-winter depression though pre-emptive treatment with the antidepressant bupropion extended release tablets. One group of patients was randomly assigned to start treatment with bupropion-XL during the fall, while they were still well. Patients in the other group received an inactive placebo. The two groups were then followed over the winter season.

The relapse rate was 16% for patients taking bupropion extended release compared with 28% for those taking placebo. Early antidepressant treatment reduced the overall risk of fall-winter depression by about 44%. The antidepressant medication was generally well tolerated. When the patients stopped taking bupropion extended release in the spring, there was no increase in the depression relapse rate compared with the placebo group.

Patients with SAD have episodes of depression occurring in the fall and winter months. Although the cause is unknown, SAD appears related to reduced exposure to sunlight during the fall and winter in northern latitudes-genetic factors likely play a role as well. As in the current study, many patients with SAD are not treated with antidepressant medications, despite having many previous episodes of seasonal depression.

Starting antidepressant treatment in the fall offers a new option for reducing the rate of fall-winter depression in patients with SAD, the results suggest. "It is a highly novel approach to start treatment before the development of a major depressive disorder," says Dr. Rosenthal, author of the newly revised Winter Blues: Seasonal Affective Disorder: What It Is and How to Overcome It (Guilford Publications, 2005).

"The strategy makes sense when dealing with a condition where the pattern of relapse is somewhat predictable and the symptoms being prevented can be highly distressing and debilitating," comments Dr. Rosenthal. "In my opinion, the treatment used in the present study offers a valuable new option for those afflicted year after year by winter depression."

About the Society of Biological Psychiatry

The Society of Biological Psychiatry was founded in 1945 to emphasize the medical and scientific study and treatment of mental disorders. Its continuing purpose is to foster scientific research and education and to raise the level of knowledge and comprehension in the field of psychiatry. To achieve its purpose, the Society sponsors an annual meeting, grants awards to distinguished clinical and basic research workers, and publishes the journal Biological Psychiatry. Visit the Society's website at sobp.org

About Elsevier

Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier's 7,000 employees in over 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (sciencedirect.com), MD Consult (mdconsult.com), Scopus (mdconsult.com), bibliographic databases, and online reference works.

Joshua R. Spieler, Publisher
j.spieler@elsevier.com
Elsevier
http://www.elsevier.com
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Stress, Deprivation Leads To Overeating - And Adds To Your Depression!

Mix stress, deprivation and tempting foods and you get overeating

DAVE'S COMMENTS: Articles like these are important. Often depression treatment involves issues of compulsive eating. Remember, professional help is always available here.

Two studies in the October issue of Behavioral Neuroscience show that when animals are stressed, deprived and exposed to tempting food, they overeat, with different degrees of interaction. The powerful interplay between internal and external factors helps explain why dieters rebound and even one cookie can trigger a binge if someone's predisposed to binge.

The findings also implicate the brain's opioid, or reward, system in regulating overeating, especially when the food is extra-tempting - and not only in under-fed animals. This knowledge may help even non-stressed people to avoid overeating, keep their weight down and improve their health. Behavioral Neuroscience is published by the American Psychological Association (APA).

A study by M. Flavia Barbano, PhD, and Martine Cador, PhD, at the University of Bordeaux 2 in France, separated the distinct roles in consumption played by food deprivation and the "yum" factor, establishing that the interplay between internal and external factors regulates food intake, at least in mammals. Although much has been learned about human overeating, it is easier to untangle and verify the different variables involved in controlled animal studies.

Working with laboratory rats, the researchers tested three aspects of eating behavior: motivation (how bad did they want it), anticipation (how excited were they in advance), and intake (how much did they eat), all relative to homeostasis (satiety or deprivation) and food type (ordinary lab chow or "highly palatable" chocolate breakfast cereal, as verified by a pre-test of different foods).

For motivation, the researchers measured how fast 16 rats - who either had eaten freely or been put on a diet -- ran down an alley to a bowl of either chow or Choc and Crisp, a German-brand cereal. The animals ran faster when they were either food-deprived or presented with the chocolate cereal. However, when the food-sated animals were presented with Choc and Crisp, they ran just as fast as the hungrier rats.

The authors also measured anticipation in 32 rats by comparing activity levels when placed in individual cages where they would get either chow or cereal. First, the authors got the rats used to unpredictable feeding times; then for 10 days fed them a half hour after they went into the cage. Whether they expected chow or cereal, the food-restricted rats were more active, rearing up a lot more. Regardless of food type, only the deprived rats were more active, so the researchers concluded that anticipatory activity depends not on food type but on whether the animal has had enough to eat (homeostatic state).

As for actual intake, when presented with the Choc and Crisp, the food-sated group ate almost as much as the food-deprived group. But when presented with lab chow, they ate very little. Barbano and Cador concluded that highly palatable food motivates an animal to eat more than it really needs. When food type and satiety interact, attractiveness overrides satiety -- a phenomenon known to anyone who has ever stood in a buffet line.

In another key study, neuroscience psychologist Mary Boggiano, PhD, and her colleagues at the University of Alabama at Birmingham focused on the regulatory role of the brain's opioid system. Opioids or endorphins (the brain's "feel good chemicals") play a key role in our liking of food. Yet external substances such as heroin and morphine mimic endorphins by binding to the same receptors in the brain, produce a sense of reward (among other functions). The researchers compared how binge-eating rats versus non-binge eating rats responded to drugs that either turn on opioid receptors (butorphanol, which treats pain) or block them (naloxone, which treats heroin addiction).

From the rats' responses to these drugs, Boggiano and her colleagues inferred how stress and dieting change the brain's opioid control of eating. The binge eating occurred after rats experienced both foot shock (stress) and cyclic caloric restriction (dieting). Either caloric restriction or stress alone were not enough to produce changes in food intake, but stressed and underfed rats ate twice the normal amount of Oreo® cookies, which rats find rewarding. In other words, animals subjected to both stressors became binge eaters, confirming how strongly these outside factors interact to change eating behavior.

The findings also implicated opioids in the neurochemistry of binge eating. The highly rewarding butorphanol enhanced the binge eating; the reward-blocker naloxone suppressed how much the stress/deprived rats ate, to the level of the control rats. The authors say this pattern of findings in rats who were sated at the time of testing strengthens the evidence that reward, more than metabolic need, drives binge eating. Boggiano and her colleagues speculate that sensitized opioid-receptor signaling may be necessary to initiate binge eating. In the rats, stress and reduced calories seemed to sensitize those receptors to the presence of highly palatable food, in this case cookies. This, they write, "may underlie the common clinical observation that just a bite of highly palatable (often forbidden) food triggers binges and makes it difficult to abstain from binge eating."

The researchers speculate that the deprived and stressed rats may have been in a "hedonic deprivation state," essentially craving something good and rewarding. The research underscores how what is viewed as an unhealthy behavior (indulging in palatable foods, which are cheap, convenient and often high in fat and sugar) may have its roots in the need to survive. It suggests that binge eating is an adaptive response to abnormal environmental conditions. Boggiano cites other scientists' findings that among healthy people without eating disorders, dieting is the biggest predictor of stress-induced overeating.

In light of their findings, she says, "Highly palatable food can mimic opioid drugs by releasing opioids or activating sensitized receptors, so imagine so imagine what it can do in a human with a history of dieting. If only rat chow is available, even rats with a history of dieting when stressed rats don't binge -- but when they get a little bite of cookie first, they do." As a result, she says when treating bulimics and binge eaters, it may not be a good idea to introduce palatable (junk) food too early in therapy.

However, she thinks that binge eaters' sensitized opioid receptors should return to normal as long as they stay away from very-low-calorie diets and from trigger foods for a long time, perhaps relative to the amount of time they've had the disorder. In the meantime, scientists could perhaps develop a safe opioid blocker that could help binge eaters fight off food cravings. However, Boggiano believes that the main key is not drugs but behavioral change around food, recognizing stressors and avoiding restrictive diets.

"Binge eating is normal," she says. "It's your brain's best way to respond to expected starvation. It's restrictive dieting and stressing so much about your body weight and shape that is abnormal."

Articles both appear in Behavioral Neuroscience 2005, Vol. 119, No. 5:

1. "Various Aspects of Feeding Behavior Can Be Partially Dissociated in the Rat by the Incentive Properties of Food and the Physiological State;" M. Flavia Barbano, PhD, and Martine Cador, PhD, Laboratoire de Neuropsychobiologie des Désadaptations, Centre National de la Recherche Scientifique, Unite Mixte de Recherche 5531, Universite Victor Segalen Bordeaux 2, Bordeaux, France.

(Full text of the article is available from the APA Public Affairs Office and at: Feeding Behavior:
apa.org/journals/releases/bne11951244.pdf)

2."Combined Dieting and Stress Evoke Exaggerated Responses to Opioids in Binge-Eating Rats;" Mary M. Boggiano, PhD, Paula C. Chandler, M.A., Jason B. Viana, B.S., Kimberly D. Oswald, B.S., Christine R. Maldonado, B.S., and Pamela K. Wauford, B.S.; University of Alabama at Birmingham.

(Full text of the article is available from the APA Public Affairs Office and at Dieting and Stress:
apa.org/journals/releases/bne11951207.pdf)

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 53 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

Pam Willenz
public.affairs@apa.org
American Psychological Association
apa.org
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Depression treatment requires persistence - Please Don't Give Up!

"Nothing in the world can take the place of Persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan 'Press On' has solved and always will solve the problems of the human race."



Calvin Coolidge
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Is BipolarGenetic? Evidence Says YES!

Evidence linking bipolar disorder to two chromosomal regions in the human genome


An international team of 53 researchers has offered the most convincing evidence so far linking bipolar disorder, also known as manic depression, to two chromosomal regions in the human genome. The finding gives scientists refined targets for further gene studies.

"Even though bipolar disorder affects millions of people around the world--sometimes throughout their lifetimes--what we understand to be biologically relevant at the genetic level is not terribly characterized," said Matthew McQueen, lead author and postdoctoral fellow in the Department of Epidemiology at the Harvard School of Public Health (HSPH). "This research can help focus the field to identify viable candidate genes."

The study will appear in the October issue of the American Journal of Human Genetics.

More than two million American adults have bipolar disorder, according to the National Institute of Mental Health. Patients typically experience dramatic mood swings from episodes of euphoria and high energy to feelings of intense sadness, fatigue, and even suicide. Psychiatrists have identified two primary forms of the illness: bipolar I disorder, which is the classic form of recurring mania and depression, and bipolar II disorder, which has less severe episodes of mania. Treatment often includes medication.

The exact cause of the illness remains unknown, but scientists suspect the involvement of several genes, coupled with environmental influences. A number of individual studies have suggested genomic regions linked to bipolar disorder, but their results have been inconsistent and difficult to replicate, leaving the field "standing at a crossroads, wondering in which direction to go next," said McQueen.

To establish more definitive research, McQueen and his colleagues did something unusual. They secured and then combined original genome scan data from 11 independent linkage studies, instead of relying on the more common approach of using summary data from such studies.

"The use of original data made a significant difference in our ability to control for variation in several factors among the different data sets and to make the overall analysis much more consistent and powerful," said Nan Laird, HSPH Professor of Biostatistics and senior author on the paper.

The resulting analysis involved 1,067 families and 5,179 individuals from North America, Italy, Germany, Portugal, the UK, Ireland, and Israel, who had provided blood samples and family medical histories. The research team combined the data into a single genome scan and found strong genetic signals on chromosomes 6 and 8. The team now hopes to narrow the search to find associations between specific genes and the mental illness.

The analysis was funded through the Study of Genetic Determinants of Bipolar Disorder Project at the National Institute of Mental Health. Other researchers on the analysis team represented Massachusetts General Hospital, The Broad Institute, and the University of Pittsburgh.

Harvard School of Public Health is dedicated to advancing the public's health through learning, discovery, and communication. More than 300 faculty members are engaged in teaching and training the 900-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights.

Christina Roache
croache@hsph.harvard.edu
617-432-6052
Harvard School of Public Health
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Does Bipolar Affect Memory and Attention?

Does Bipolar Illness Affect Attention And Memory?

A report published in the September issue of Psychotherapy and Psychosomatics by a group of investigators of the University of Barcelona suggests that cognitive deficits may occur in bipolar disorder.

In clinical practice, bipolar patients complain of cognitive deficits such as attentional or memory disturbances. The main aim of this study was to determine whether subjective cognitive complaints were associated with objective neuropsychological impairments.

Sixty euthymic bipolar patients were assessed through a neuropsychological battery. A structured clinical interview was used to determine subjective cognitive complaints in patients. Thirty healthy controls were also included in the study in order to compare the neuropsychological performance among groups. Bipolar patients with a higher number of episodes, especially the number of mixed episodes, longer duration of the illness and the onset of the illness at an earlier age showed more subjective complaints.

Furthermore, bipolar patients with subjective complaints showed lower scores in several cognitive measures related to attention, memory and executive function compared with the control group. Nevertheless, patients without complaints also performed less well than controls in some neuropsychological measures.

Bipolar patients who were aware of cognitive deficits were more chronic, had presented more previous episodes, especially mixed type, and their illness had started at an earlier age compared with patients who did not complain about cognitive problems. Moreover, patients with good cognitive insight also had a poorer social and occupational functioning as well as a poorer neuropsychological performance.

However, the bipolar group without complaints also obtained lower scores in several tests compared with healthy controls. Cognitive status of bipolar patients should be routinely assessed, regardless of the patients awareness about their cognitive deficits.

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Know For Certain If You're Depression Is Cured

Curing Depression? 7-item questionnaire to determine if you are recovered.

Determining when treatment of a depressed patient can safely be discontinued is important but difficult for clinicians; until now, no tests have been available that are simple to administer in a doctor's office.

Roger McIntyre and colleagues developed a brief 7-item questionnaire to determine if a patient with depression has recovered, and have now evaluated it for use in primary care.

In a randomized controlled trial involving 454 patients with major depressive disorder across 47 medical practices in 4 provinces, outcomes of antidepressant therapy were determined with the brief HAMD-7 questionnaire or the standard longer questionnaire (the HAMD-17) that is used in research and specialty settings.

Results from the 2 study instruments showed good agreement, which suggests that the shorter version is accurate and could be used in clinical practice by physicians.

p. 1327 Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale -- R.S. McIntyre et al

Find PDF of study here - http://www.cmaj.ca/cgi/data/173/11/1327/DC2/1


Dr. Roger McIntyre
Canadian Medical Association Journal
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Phone Counseling Study Shows Good Results

Phone-Based Psychotherapy Helps Ease Depression



** CounselingPros has been offering online and phone counseling since 1998!!

Telephone-administered psychotherapy may help relieve the depression of patients battling multiple sclerosis (MS), according to a new study.

Researchers at the University of California, San Francisco, found that 16 weeks of therapy by phone helped ease feelings of depression, particularly sessions focusing on what psychologists call cognitive-behavioral therapy. In this type of therapy, patients are taught to manage the thoughts and behaviors that contribute to depression.

Therapy delivered by telephone could prove a key way to combat depression, the researchers said in an article in the September issue of Archives of General Psychiatry.

Although two-thirds of depressed patients prefer psychotherapy to antidepressants, just 10 percent to 45 percent ever make a first appointment, and half will drop out by the end of treatment, experts say. Reasons driving this poor turnout include physical impairments, transportation problems, proximity of services and lack of time or financial resources.

Phone-based therapy gets around many of those problems, but the researchers say further research is necessary "to examine if the outcomes of telephone-administered therapies are equivalent to face-to-face interventions."

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Second Generation Antidepressants Equally Effective

Second-Generation Antidepressants Equally Effective



Widely prescribed second-generation antidepressants all work equally well, a new study finds.

Side effects -- including nausea, dizziness, weight gain, insomnia and sexual-performance issues -- also do not appear to differ significantly among this group of drugs, which includes such brand names as Prozac, Paxil, Wellbutrin and Zoloft.

In the Sept. 20 issue of the Annals of Internal Medicine, researchers report that, overall, patient outcomes were similar regardless of which second-generation antidepressant they had been prescribed.

In light of these findings, the researchers suggest that deciding which drug is best may boil down to cost.

"The bottom line is that the comparative evidence on the newer drugs is that there is very minimal differences in efficacy between one and the other," said study author Richard Hansen, an assistant professor in the division of Pharmaceutical Policy and Evaluative Sciences at the University of North Carolina. "So, given that there are 10-plus of the newer agents on the market, it's really difficult to say which is best, aside from the fact that there are tremendous cost differences."

One side effect that the researchers did not address -- the possible link between suicidality and antidepressant use -- prompted the U.S. Food and Drug Administration in March 2004 to put black box label warnings on many of these newer drugs, particularly in reference to children. After published reports pointed to the possibility of the same risk in adults taking antidepressants, the agency issued a second warning this summer that applies to adults.

However, the authors of this latest report note there were reasons why they did not deal with the suicidality issue.

"I will emphasize that we did not feel strongly enough about the evidence that we reviewed to draw any conclusions on suicidality. One of the primary reasons for that was that the information that has been reviewed that led to the FDA's decision for putting that warning on all secondary-generation antidepressants was derived from information that is not publicly available," Hansen explained.

"These were studies that were submitted by pharmaceutical companies to the FDA," he added. "They were not published in the peer-reviewed literature. And some of the information comes from an analysis that I believe was done in the U.K. by the National Health Services, where they used pool data from published and unpublished studies -- where again we did not have access to the unpublished data -- where they found significant risk with certain drugs."

"A second point on suicide in the randomized, control trials and some of the prospective observational studies that were reviewed is that the way that suicide or suicidal behavior was classified really differs between studies," Hansen said. "So, it's difficult to say suicidal issues or behaviors are greater with one drug than with another when we weren't confident enough about how the researchers characterized or classified those behaviors to draw a parallel between those studies."

Available since the late 1980s, this newest generation of antidepressants works by inhibiting the activity of neurotransmitters -- such as serotonin and norephinephrine -- which scientists believe play a part in the onset and progression of clinical depression.

These selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors have largely replaced the first generation of antidepressants, which are as effective but more likely to produce side effects.

To assess the differences between all the second-generation antidepressants, Hansen and his team reviewed 46 studies conducted between 1980 and early 2005.

The researchers also looked at an additional 24 non-comparative studies, which had observed the benefits of a single second-generation antidepressant -- in some cases relative to a placebo.

Among the studies analyzed, the benefits of six SSRIs had been compared or observed: citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). Four non-SSRI second-generation antidepressants were also assessed -- bupropion (Wellbutrin), duloxetine (Cymbalta), mirtazapine (Remeron) and venlafaxine (Effexor).

All the drugs had been used in the initial treatment of patients suffering from major depression. Most of the patients were between 18 and 60 years old, and most of the studies in which they had participated had been sponsored by a pharmaceutical company that manufactured one of the medications.

On basic measures -- such as speed of patient response and quality of life improvements -- the drugs were found to be more or less equally effective.

In terms of side effects, the results were also similar across the class of medications -- although some differences were evident.

The researchers noted, for example, that some trials indicated that nausea and vomiting were higher for venlafaxine than for other drugs. Dizziness was also most commonly found among patients taking this medication.

Paroxetine, sertraline and mirtazapine demonstrated a tendency to provoke higher rates of sexual side effects in several studies, while others noted that bupropion appeared to have one of the lowest rates of sexual side effects.

Weight gain appeared to be most prevalent, on average, among patients taking mirtazapine, while headaches and insomnia were most commonly reported among patients treated with bupropion.

However, the study authors cautioned that although differences in the incidence of side effects existed, they were minimal. And they added that wide disparities in the way side effects had been assessed among the studies made it difficult to draw any strongly negative conclusions about any one drug.

The researchers also stressed that results that indicated slight benefits of one drug over another had to be taken with a grain of salt -- as studies with some sort of connection with a drug manufacturer tended to slightly favor that company's drug over a competitor's.

Dr. Lorrin Koran, a professor of psychiatry and behavioral science at the Stanford University School of Medicine in California, said the study should raise awareness of the comparative value of the most widely used antidepressants.

"The second generation helps some people that wouldn't have been helped, they have better side-effect profiles, and some of them have fewer drug interaction problems," he said. "So the advantages are clearly there."

More information

For more on depression and treatment go to Overcoming Depression

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Downward Mobility Puts Men At Risk For Depression

Downsized Men High Risk For Depression

"Downward mobility," or a drop in economic and social class, quadruples the risk of depression in middle-aged men but doesn't have the same kind of impact on older women, British researchers say.

Reporting in the current issue of the Journal of Epidemiology and Community Health, researchers at the University of Newcastle upon Tyne who studied more than 500 men and women found that more women than men were clinically depressed at age 50.

In total, twice as many women as men reported downward social mobility between birth and 50 years of age. The study also found that women's risk of depression at mid-life was strongly associated with their social class at birth.

However, by age 50, downwardly mobile men were more than 3.5 times as likely to be depressed as downwardly mobile women, the researchers found. Men who fell to a lower socioeconomic class were about four times as likely to be depressed as men who remained in the same social class, the study concluded.

The findings indicate that women may be more sensitive than men to low socioeconomic status when they're very young, but less so as they age, the researchers said.

They also noted that service industries have grown while Britain's manufacturing base has declined. And because service industries tend to employ more women than men, work in these sectors may affect men's role-identity and self esteem.

More information

For more information and expert guidance contact Dave Turo-Shields at 317-865-1674 USA or online at: CounselingPros for Online and Phone Counseling

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8% Americans Depressed

8% of US Adults Experienced Major Depression in Past Year


An estimated 17 million adults ages 18 and older (8.0 percent) reported having experienced at least one major depressive episode during the past year, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported today. Around two thirds of them reported receiving treatment for that depression in the past year, according to the new report, “Depression among Adults”.

SAMHSA extracted the data from the 2004 National Survey on Drug Use and Health, which for the first time asked adults in the survey ages 18 and older questions reflecting the criteria for major depressive episodes in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). That manual, by the American Psychiatric Association, specifies that a major depressive episode is two weeks or longer during which there is either depressed mood or loss of interest or pleasure and at least four other symptoms that reflect a change of functioning, such as problems with sleep, eating, energy, concentration or self-image.


During the 12 months prior to the interview, 65.1 percent of adults who had experienced a major depressive episode in the past year reported seeing or talking to a medical doctor or other health professional, or taking prescription medications for depression. This is the first time that questions about depression were asked in the National Survey on Drug Use and Health.


“The good news is almost two thirds of people with depression are seeking help,” SAMHSA Administrator Charles Curie said. “Clearly, we are making progress in overcoming the stigma that has prevented people from seeking help. Mental illness is not a scandal. It is an illness. It is a treatable illness. And most important, we need to send the message that with help there is hope, and recovery is the expectation.”

Past month illicit drug use was nearly twice as high among adults who had experienced a major depressive episode (14.2 percent) compared with adults who had not experienced such an episode (7.3 percent), and cigarette use was much more likely. The data show 39.7 percent of adults who suffered a major depressive episode in the past year smoked cigarettes during the past month compared to 25.9 percent of adults 18 and older who did not have a major depressive episode.

Women were almost twice as likely as men to report a major depressive episode in the past year (10.3 percent versus 5.6 percent) and women who experienced a major depressive episode were more likely to receive treatment for depression (70.1 percent) than their male counterparts (55.2 percent). Major depressive episodes are more prevalent among adults ages 18-49, approximately 9-10 percent, than among adults ages 65 or older (1.3 percent).

SAMHSA defines illicit drugs as marijuana, cocaine, inhalants, hallucinogens, heroin or non medical use of prescription drugs. The National Survey on Drug Use and Health surveys close to 70,000 people ages 12 and older in their homes each year.


The report and the complete survey are available on the web at oas.samhsa.gov.
SAMHSA, is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions, treatment, and mental health services delivery system.

http://www.samhsa.gov
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SSRI Drives Costs Up In Canada

People with mild depression are more tuned into the feelings of others


Surprisingly, people with mild depression are actually more tuned into the feelings of others than those who aren't depressed, a team of Queen's psychologists has discovered.

"This was quite unexpected because we tend to think that the opposite is true," says lead researcher Kate Harkness. "For example, people with depression are more likely to have problems in a number of social areas."

The researchers were so taken aback by the findings, they decided to replicate the study with another group of participants. The second study produced the same results: People with mild symptoms of depression pay more attention to details of their social environment than those who are not depressed.

Their report on what is known as "mental state decoding" - or identifying other people's emotional states from social cues such as eye expressions - is published today in the international journal, Cognition and Emotion.

Also on the research team from the Queen's Psychology Department are Professors Mark Sabbagh and Jill Jacobson, and students Neeta Chowdrey and Tina Chen. Drs. Roumen Milev and Michela David at Providence Continuing Care Centre, Mental Health Services, collaborated on the study as well.

Previous related research by the Queen's investigators has been conducted on people diagnosed with clinical depression. In this case, the clinically depressed participants performed much worse on tests of mental state decoding than people who weren't depressed.

To explain the apparent discrepancy between those with mild and clinical depression, the researchers suggest that becoming mildly depressed (dysphoric) can heighten concern about your surroundings. "People with mild levels of depression may initially experience feelings of helplessness, and a desire to regain control of their social world," says Dr. Harkness. "They might be specially motivated to scan their environment in a very detailed way, to find subtle social cues indicating what others are thinking and feeling."

The idea that mild depression differs from clinical depression is a controversial one, the psychologist adds. Although it is often viewed as a continuum, she believes that depression may also contain thresholds such as the one identified in this study. "Once you pass the threshold, you're into something very different," she says.

Funding for this study comes from a New Opportunities Grant from the Canada Foundation for Innovation.
Nancy Dorranedorrance@post.queensu.caQueen's Universityhttp://www.queensu.ca
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How To Stay Positive During The Holidays

by Deborah Serani, Psy.D.
~~~~~~~~~~~~~~

I came across this post from author Lucy MacDonald and her blog Positive Perspectives. I think it has such great information, I asked if I could post it here.

"Whatever holiday is on your calendar in December - Christmas, Hanukkah, Kwanzaa - it is sometimes is a challenge to stay positive in the midst of the commercialism and general hub-bub.Here are a few ways to stay positive during the holidays:

1. Avoid overscheduling yourself. Use an agenda to keep track of your holiday commitments so that you can physically see what you are committing yourself to. Along with your commitments to others make sure to include some downtime for yourself - even if it is half an hour here and there. Knowing that you have some personal time will help you to stay positive.

2. Lower your expectations don’t strive for perfection, good enough is okay.Don’t expect your family to be perfect during the holidays. Be realistic about who they are and what your relationship is like with them all year around. That is especially true of step-families.

3. Make a budget and stick to it. The price of the gift is not equal to how much you love them. Focus on the people that you care about instead of the stuff that really doesn’t matter. Beware of the joy-to-stuff ratio: more stuff does not equal more joy.

4. Spread your socializing in the months after the holidays. Don’t try to pack a year’s worth of socializing into a few weeks. Start a new tradition with friends and make a date with friends for mid January or early February.

5. Get as much sleep as you can. Schedule one or two pajama days for yourself or for the whole family - stay in your pj's and stay home and give yourself permission to rest and enjoy some time together without rushing about.Holidays are for celebrating what is truly important to you, your family, and friends. Make it the holiday you want it to be and chances are you will keep a positive attitude. "


I think that this is just great advice to get off the "dreadmill" , as Lucy MacDonald says.
Check out her book, Learn to Be an Optimist, for even more positive ways of coping!
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Faith, Cymbalta, Buspar, meditation for depressino

This must be the solution for many, but here it is anyways.  My faith in Jesus Christ and his permannet help is what definitely works for me. Also, I go to a psychiatrist for Cymbalta, Buspar, and some sleep help like Traxene.
Other things that I use is reading.  First, I studied the Bible and meditation. But I also read books of self-help. In addition to those books, I read fiction by Clyve Cussler, Michener; classics like The Iliad, The Odyssy.
 
Other books I like reading are about history, and texts about Biology, etc.
The important thing is not to feel depressed because you have the condition of depression.  One always needs to value oneself no matter what.
Angel
 
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Get Help Now For Depression

 
Hi i'm 17 years old and i have just recovered from a five year bout of depression. My depression was caused mostly by biological issues. I was also diagnosed with ADHD, which seemed to be the cause also. Now that all my medications have been sorted out,i'm feeling much better. If you are feeling depressed and aren't getting help, get help now. The best possible thing for me was to get a psychiatrist and a psychologist, and i recommend both. Try to open up, because all they want is to help you, thats their proffession. You will make it through, just keep trying. The people that suicide are mostly the ones that didn't get help. just remember to keep trying, and although it seems hard, you do get there eventualy, i'm evidence of that. For every step you take backwards, remind yourself that you have taken two steps forward. Best of luck
Nicole
 
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Depression Recovery Takes Time

 
 I am not trying to be a smart ass. I just think that you could not possibly fight depression by just reading somebody else experience or any suggestion on the web. Would you follow what works for other is another question. Suffering for depression for just 3 years are short experience if compared with some of you. But I do think I am qualified as my depression is a major one. It has symptoms like all of you experienced.I cannot enjoy the things that I usually like. It is just not pleasurable anymore. Yes, socially active is a method  to combat depression. But, how many of us is socially active? and how could you tell a socially inactive person to be one? For me, depression set in because of a lot of things but I do believe there one of them is the dominant one.
 
And this event is always there. Unless it changed, or I quit, I will always feel depressed. No friends can really console me or they do not even know. Yes, this affected my spouse. He felt very angry towards my behaviour and I felt angry for his lack of empathy. I realise there is typical one group of people who will seek for other people's help by asking other people why they become like that. Just to feel frustrated when no one can give them answer that satisfied them.
 
Even they did get it, eventually they will not believing it the next day. Depression is just so subtle that no one can really understand it thoroughly. Sufferers are definitely has some weak points in their life that they are not satisfied with and could not do anything to deal with it.even there is, they do not want to do. Unless the situation changed, it will always be like that. It will further carry in your behavior to tackle other things and the other stuff too will be unsuccessful because of your new set in depression. Vicious cycle get progressively worst. Medicine is good in some case, but it probably makes you feel even lost when the real things that makes you depressed is not dealt with.
 
It should thus be taken on holidays. Because I took it myself, just to find that my mood is not too bad and I felt lack of responsibility to do the things I supposed to be doing which could combat my depression by itself. Dealing with that depression source is extremely difficult no matter what the origin is for any people. That's why we get depression in the first place. The solution I know of is, get to know another person who is suffering from depression and did not recover. It makes you feel really good that you are not inferior as it is not common for people to win depression and that you don't feel you are a jerk or the most miserable people in the Earth. Conscience is scarce in depression people. Who would have sympathy for other people when they are themselves suffering so much? even for the most generous people in the world. They would questioned themselves why would they not get good return since whole their life were dedicated to other people. Is that worth it?
I just want to emphasize that all of you who have no solution to depression and could not exploit one of the other people's idea. It is okie and it takes time
 
Sophia
 
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So Depressed But Felt Connected Here - Thanks

 
I have been depressed for many years. I am 25 years old and tried seeking couseling at 18, at 22, and again at 24. I just broke up with my boyfriend with whom I've had a very rocky relationship and who cares deeply about me but- he is 20 years old, is at a different stage in his life, and thinks he is incapable of truly loving someone (yikes). My bf loves me but his own issues made us incompatible and ultimately unhappy so I made the decision. Today I feel horrible, like the pain in my heart is so bad that I can't breathe. I am at work and have been crying for most of the day, worried someone will see me. Needless to say I did not earn my salary today. I came across this website and while I still feel horrible, after reading Vicky's post I identified so much with her- I too am so career-oriented, I've moved around and miss ANY stability in my life, I think I have to be tough. The only difference is there is no man waiting for me. Anyways I was ready to go tell my boss I was feeling horribly and go home and cried desperately in bed- but after reading her post I felt a tiny bit better- enough to make it through the workday.
 

ScaredMe
 
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Anyone want to share? Depression and OCD

ANYBODY INTERESTED IN SHARING THEIR PAIN OF DEPRESSION / OCD WITH ANOTHER DEPRESSED PERSON (ME)??
 
 
 
Sharon
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Exercise in place of antidepressants

Hi all,
 
I want to share my story of how I am coping with depression and weaning off medication.
 
I was diagonised with severe depression couple of years ago. The doctor put me on Prozac and I was doing fine. But whenever I try to reduce the medication my depression comes back. Later I decided to be a part of my healing process.
 
I jog on treadmill early morning for 40 minutes and work out a sweat. Since then I have successfully reduced the dosage of medication from 20mg per day to 20 mg alternate days. Now I take 20mg every 3 days
and hoping to reduce it further and finally get out of medication and lead a normal life like everybody else.
 
Thanks.
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Depression and obsessive compulsive disorder - want to share?

Hi
I am suffering from depression and obsessive compulsive disorder since the past 7-8 yrs. I am a girl from India, and feel more helpless in my bouts of depression because of nobody around me with whom I could actually sharewhat i feel, i feel so lonely in such cases, though my family members are v good. I can't afford regular visits to a psyciatrist. I'm looking for a friend across the seven seas with whom i could share my pain, who has gone through something similar and who can also share her/ his experience with me.
 
Shruti
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Breaking Barriers: Short Men and Their Appeal

Deborah Serani, Psy.D.
~~~~~~~~~~~~~~~~~

In the upcoming December issue of Maxim Magazine, Angus Young, lead guitarist of AC/DC, tops the list of the "25 Greatest Short Dudes of All Time," standing tall at 5 feet 2 inches. Former NBA guard Spud Webb (5 feet 7 inches) is Number 2, followed by Napoleon Bonaparte (5 feet 4 inches), at number 3.
Yoda, at number 6, is the shortest on the list, his height approximated at 2 feet 2 inches tall.

Maxim Magazine claims to be helping women "begin a long overdue fight against their genetically determined shallowness when choosing a partner." Other great short dudes on the list are Martin Scorsese, Jon Stewart, Prince, Kurt Cobain and two of the Hobbits from "The Lord of the Rings" films — Elijah Wood and Sean Astin. The tallest "short dude" is Pro football player Doug Flutie, at 5 feet 10 inches, who is ranked at Number 24.

Psychologically speaking, I like to think these these men show the world that altitude is a matter of attitude!

Reference
http://www.maximonline.com
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Sharing and Reaching Out

hi, i'm a 19 yr old girl who is constantly in depression since i was a child ,my parents and me never had a close relationship,dad was always bullying us by controlling our lives, by us i mean my mom ,my brother and me,my brother is an angel compared to me ,he is 4 yrs younger than me, dad always decided what i had to do or not,i didn't realise that i was depressed until i was at the gae of 17 when i decided to talk about my problems to a nun who was doing counselling at my school,when i talked to her i felt relieved and realised that i was a depressed child and i had never cured myself,instead it had been deteriorating ,i had developed a low self - esteem of myself since i was a child ,i let people bullying me and tell me anything,i was so depressed that i never saw me as a pretty girl,i never had a bf ,i was jeolous of my friends who had but couldn't tell them,i didn't know how to dress myself and still dress myself badly and tell myself that i'm ugly and like a devil,i had faith in god for 2 yrs and did all my prayer but afterwards i don't know what happenend and i stopped praying and start doing all kinds of bad actions,i needed people to give me attention ,this is y i always tell people exagerated stories abt me if ever dad has beaten me so that i can get the pity of others ,to get their attention too,i stole monet from my parents rooma nd grand-ma too and bought jewellery,girls in my class liked my jewels and i was glad to get the attention ,i don't like to be the centre of sttention ,i know what i'm saying is strange but i don't like being popular,i have no hobby at all,i don't know anything except dreaming about actors whom i see in films and make them my boyfriends in my dreams ,its always the same and i still do these dreams, since at home we r not so close i never did tell my parents how much i was suffering,i even attempted suicide several times but nobody found out and they were not that serious ,so i escaped.

as i told u at the age of 17 i started to talk to a nun and she helped me to a great extent and i was determine to change my life ,i read several books on how to have confidence and high self-esteem but i didn't find anything ,actually i was looking for a magic solution but of course u cannot get it from books,i stopped reading those books 1 yr later,the nun left school and i didn't get any contact with her,there was another counsellor who came and i had to tell her again my whole story ,she helped me too by listening and i had stopped attempts of suicide but unfortunately she got sick and had to leave too,i remain in touch with her but cannot talk to her about my problems since she has problems too,finally i started to surf on the net and look for sites for depressed people ,i found many but i didn't get what i wanted really ,and theni found this blog and now i'm telling my story,now i am still low in self esteem and i want someone whom i can talk and guide me ,i cannot go toA a psychologist because my parenst will know and it will end up ina fight. so i really want to talk to someone ,this might help me too as i don't have too many friends too,

so e-mail me if u want to know something or share something with me,i will be glad to do so.

Rucksaar
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Exercise Reduces Need For Medication

I want to share my story of how I am coping with depression and weaning off medication.

I was diagonised with severe depression couple of years ago. The doctor put me on Prozac and I was doing fine. But whenever I try to reduce the medication my depression comes back. Later I decided to be a part of my healing process.
 
I jog on treadmill early morning for 40 minutes and work out a sweat. Since then I have successfully reduced the dosage of medication from 20mg per day to 20 mg alternate days. Now I take 20mg every 3 days
and hoping to reduce it further and finally   get out of medication and lead a normal life like everybody else.

Thanks.

 
Sia
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Please Share

ANYBODY INTERESTED IN SHARING THEIR PAIN OF DEPRESSION / OCD WITH ANOTHER DEPRESSED PERSON PLEASE SHARE IT HERE WITH ME.
 
Sharon
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Need Fellowship

I am suffering from depression and obsessive compulsive disorder since the past 7-8 yrs. I am a girl from India, and feel more helpless in my bouts of depression because of nobody around me with whom I could actually sharewhat i feel, i feel so lonely in such cases, though my family members are v good. I can't afford regular visits to a psyciatrist. I'm looking for a friend across the seven seas with whom i could share my pain, who has gone through something similar and who can also share her/ his experience with me thru the net.
 
Shruti
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Just Sharing My Story

Hello, I am, Johanna Mora, an 19 year old girl who has lost her spirit to live and enjoy the true beauty in life. I have always been the type of person that has a great attitude towards everything and everyone that she meets. I am tha kind of person that normally would not fall into a depressive state of mind, although I believe ever since I have been involved with an older man it has kind of hurt my whole being. I met this man when I was 17 years old while I was working at my second job at a bathing suit and accessories store, my first job was clerical receptionist/warranty asst. @Chrylser.
 
I took the habit of smoking as a way to cope with issues of back-stabbing friends and relationship lies with the opposite sex. There was a point that I recall that I would even smoke a pack of cigarrettes a day while working both jobs and babysitting my younger siblings because my parents went to Mexico. I also recall that is when I really began to heaveanly rely on this man's help emotionally and his services to bring my family and I food because I was way to tired to go out and buy it. I have always spoiled my little brothers because I never had anyone to do that fo me so I was really spoiling myself at the same time and it would feel empowering.
 
The main point is that eventually I began a serious relationship with this man whom I come to later find out has many dirty secrets that are not regular when you meet someone regardless their age or preference. I found out that he was really attracted and interested to a younger kind of crowd because he would reveal information about things that I was open to because of my age and he would somehow imitate mannerisms of young people behavior. For Instance, he would sometimes say shut-up or chew gum with his mouth open, I mean that to me was fully disguisting because I did'nt do it and I knew better. All in all, I fell in love with the person he was, but now am disallusioned because of all the things I later come to find out. So I cry myself to sleep every night and really hurt for this man that really had no regard for me, but took advantage of me. He knew that I was vulnerable and cradled me into his arms instead of back to health.

Hopefully, I'll get my piece of mind back, but until then I truly regret not listening to the advice of my parents-who I love, but haven't expressed it greatly to them because of my position.

Johanna
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Right Medication

I am finally, finally, finally feeling like the demon of depression is lifting and it is due to the right medication.  I know that anti-depressants are not the "be all and end all" to depression -- I am also seeing a therapist and trying to eat right, exercise right, meditate, etc.  But really, truly, for me, the right antidepressants make all the rest of it work and "stick." 

It has been a hard struggle from the time people suggested I try antidepressants and I became furious, to admitting I needed something, about four years ago.  Well I feel like I've tried them all - prozac, zoloft, wellbutrin, paxil, lexapro, effexor, and others.  Some didn't work, some I didn't like the side effects.  But finally I found one that works.  I know medication won't work for everyone but it did work for me.  The key was seeing a psychiatrist I trusted ... my regular physicians didn't know the medications that well and were leery to prescribe some of them.  The other key was reminding myself, it was not "me" it was a disease or a condition that could be treated just like anything else. 

cheers,

Rachel
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Exercise & Nutrition

I'm a 41 year-old unemployed engineer, finally finishing a Bachelor's degree. I have been depressed for at least 25 years, since I severely injured my back at age 15. I was raised in a very abusive family and was not given any medical treatment, so I lived in chronic pain until age 25.
 
I was finally able to get medical care for my back when I started working in the U.S. defense industry. However, my spinal pain was then replaced by neurological trauma. I was tortured for over two years by the U.S.  government, who used infrasound and modulated ultrasound (and possibly other things)to experiment on my mind and nervous system. Several attempts were made to kill me using some especially horrifying psychological techniques. In the last 9 years since getting out of the defense industry, I have been regularily harrassed by the local police and sheriff's departments, anomg other law enforcement agencies. I have told some people about my experiences, but I am either disbelieved or laughed at and told that I "deserved it". I have not been able to get any help from either psychologists or psychiatrists.
 
So, what keeps me alive? Hard exercise and good nutrition. I find if I do enough aerobic exercise each day, I can eventually feel well enough to endure another day. I don't believe there is any God or after-life. That helps me realize the importance of this life, the only eternity any of us will ever have, and how important it is to take every opportunity to live when we are able. Never give up on yourself! Never stop fighting for the life you deserve! Do what you can on the bad days, and do as much as you can on the good days. Above all else, believe in your right to exist and your intrinsic value. Only truly human beings give any meaning to this universe - that's how important you are! Good luck to each of you.
Paul
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Life Is A Beautiful Thing

I have been and seen so much. I use what I have had in the past to overcome
what I have now. I use expieriences to get thorough what seems so hopeless
at times. I journal thoughts and moods that only stay in that journal entry.
I look forward to the next minute if need be. I look forward to what I have
accopmlised as a woman. In times of relaps I force my self to remember only
what makes me feel worth the while to come out of what only brings me down.
Face reality instead of living in a fantasy world. Keep a picture of my son
with me and when i feel bad look at it and remember what thinks the world of
me when I feel like I aint shit.

I have overcome some serious times of depression in my life. When the entire
being around me but my journal and one friend and a chaplin turned their
back on me for who I was as a person because of a wrongful action I'd
endulged in. I was in serious hopeless mode. I walked around with only my
feet and the few feet ahead of me to look at. It was only the meer thoght of
my son and his outlook on his own mother that gave me the strength to pick
up the pieces and move on. I held my head up high I started to smile and
things turned around. Everything that seemed so gone did a complete 180
infront of me day by day. I only kept those very things with me to live each
day and I got a lot of respect and I grew up a little after that.

I am 22 years old and a mother of a beautiful baby boy named, Gavin Dax
Gilbert. The one thing in my life that I can honesly truly be proud of and
commend my self time and time againe for. I believe that everything in life
happens for a reason and with that I am able to depict things in life that I
never was able to prior to some of the things I have over came since I've
had my son. I grew up! I faced my fears and lived through them rather than
push it away for a later relaps and worse off depression that I'd started
out with.

Life is a beautiful thing and it has so much for you to just make it even
through the day that we always seem to dismiss at a time of a depressed
state of mind. It always at its worst before it gets better.

Evelyn

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It's That Time of Year Again: Seasonal Affective Disorder

by, Deborah Serani, Psy.D.
~~~~~~~~~~~~~

Question: What is seasonal affective disorder?
Answer: Seasonal Affective Disorder (SAD) is a pattern of significant depressive symptoms that occur and then disappear with the changing of the seasons. SAD has also been called "Winter Depression" or "Winter Blues". The reason for these names is that SAD occurs when days get shorter around November and lasting until Spring.

Question: What's the difference between seasonal affective disorder and other forms of depression?
Answer: SAD is similar to other major depressions in its severity and symptoms; however, it occurs seasonally usually starting in the fall and lasting until early spring. This disorder is cyclical. SAD patients also tend to sleep and eat more compared to patients with other types of clinical depression — usually, depression patients have insomnia and loss of appetite.

Question: How many people are affected by this disorder each year?
Answer: SAD affects millions of individuals worldwide. The illness is more common in higher latitudes, that is locations farther north or south of the equator, because the timeline of darkness is longer.

Question: What are the symtpoms of SAD?
Answer: Symptoms include many of the same symptoms of depression: sadness, anxiety, lost interest in usual activities, withdrawal from social activities and an inability to concentrate. The difference though, is that these symptoms resolve each Spring and tend to occur again in late Fall.

Question: What is the cause of Seasonal Affective Disorder?
Answer: Melatonin, a sleep-related hormone secreted by the pineal gland in the brain, has been linked to SAD. This hormone, which may cause symptoms of depression, is produced at increased levels in the dark. Therefore, when the days are shorter and darker the production of this hormone increases.

Question: What kind of treatments are available?
Answer: Phototherapy or bright light therapy has been shown to suppress the brain’s secretion of melatonin. Although, there have been no research findings to definitely link this therapy with an antidepressant effect, many people respond to this treatment. The device most often used today is a bank of white fluorescent lights on a metal reflector and shield with a plastic screen.

For mild symptoms, spending time outdoors during the day or arranging homes and workplaces to receive more sunlight may be helpful. One study found that an hour’s walk in winter sunlight was as effective as two and a half hours under bright artificial light.

If phototherapy doesn’t work, an antidepressant drug may prove effective in reducing or eliminating SAD symptoms.

Daily exercise has been shown to be helpful, particularly when done outdoors. For those who tend to crave sweets during the winter, eating a balanced diet may help stave off SAD.

Question: How Do I Seek Treatment for SAD?
Answer: If you have noticed a pattern to your depressive symptoms, make an appointment with your physician and bring this to his or her attention. Medical tests and exams should be up to date to rule out any other reason for depressive symptoms. Thereafter, a consult with a psychologist, social woker, psychiatrist or psychopharmacologist so that together you can formulate a treatment plan with light therapy, medication, talk therapy or a combination of them.

Resources
Seasonal Affective Disorder Association: http://www.sada.org.uk/

Society for Light Treatment :www.websciences.org/sltbr

The Circadian Lighting Association: www.claorg.org
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Virtual Reality Therapy: The New Horizon


I just attended a conference on Virtual Reality Therapy... a treatment that uses custom virtual environments that have been carefully designed to address a particular anxiety or phobia. Being a lover-of-all-things-new and an member of the geek squad, I could barely hold my enthusiasm for this promising clinical intervention. Right now, Virtual Reality Therapy is a small niche, where several research universities and forward thinking practitioners are using this exposure therapy for anxiety and phobic disorders[1].

The treatment involves exposing a patient to a virtual environment containing the feared situation rather than taking the patient into the actual environment or having the patient imagine the anxiety promoting situation. The patient puts on the headgear, and the virtual environment is controlled by the therapist through a computer keyboard. The treatment sessions allow the therapist and the patient full control of the exposure to the feared situations. Virtual reality exposure treatment allows the therapist to manipulate situations to best suit the individual patient during a standard therapy hour (usually 45-50 minutes) and within the confines of the therapist's office [2].

Here are actual Virtual Reality Therapy Scenes...

Fear of Flying
(Aviophobia)








Fear of Spiders
(Arachnaphobia)





Fear of Heights
(Acrophobia)







Fear of Thunder and Lightning Storms
(Astraphobia)





Fear of Public Speaking
(Glossophobia)








Virtual Reality Therapy does not only address psychological issues. VRT has also been used in the hospital and medical settings.















Dr. Hunter S. Hoffmann, a pioneer in Virtual Reality Therapy, recently completed a study of burn patients using headgear that allowed patients to enter a pleasant virtual reality environment as they underwent painful wound care.

Although this line of research is just beginning (with funding from NIH, the Paul Allen Foundation), results indicate a significant decrease in pain that patients experience[3].

And researchers at Emory University School of Medicine, Virtually Better Incorporated, and The National Institutes of Health (NIH), are testing the use of Virtual Reality Therapy to find out if it can help people with lower back pain learn how to relax, breath properly, and manage their pain [4].



Footnotes

[1]Schare, M. (2005) Virtual Reality Psychotherapy: Anxiety Treatment and Beyond. Nassau County Psychological Association Annual Conference, Garden City, New York, 10/28/2005.

[2] Virtually Better Website: http://www.virtuallybetter.com/

[3] Scientific American Hoffman, H. (2004) Virtual Reality Therapy accessed @ http://www.sciam.com/print_version.cfm?articleID=000CDC34-D80E-10FA-89FB83414B7F0000

[4] Emory University: http://www.whsc.emory.edu/pressreleases2.cfm?announcementidseq=2539


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The Ghost Network







If you live in the United States, has this ever happened to you?

You call a psychologist, social worker of psychiatrist who is "on your plan" only to find out that they "are not" on your plan?"

Have you found yourself feeling disgusted and exhausted from this experience, and deciding not to go further with finding a therapist?

Consider yourself haunted... By a Ghost Network.

A Ghost Network, also called a Phantom Network, is a collective list of doctors and specialists that your insurer insists are contracted providers for your medical or mental health needs. However, many of these identified individuals are not members of the network [1].

I have been part of a Ghost Network, haunting the managed care company of Group Health Insurance, for almost a decade. I do not participate with them, have signed no contract with them - - yet, year after year, they have my name in their panel of specialists. Many potential patients call my office thinking that I am in their plan, only to discover I am not. I do not participate with *any* managed care companies because I think they are unethical in the way they regulate health care, but that is for another post.

When the person calling discovers that I am not in their network, I always help them try to find a good therapist... and I always educate them about the Ghost Network they have found themselves in. I tell them to inform their employer and colleagues about the situation so that the next time a choice for a different insurance coverage comes up, a change can occur. Managed Care companies sell their services by "showing off" the list of specialists they have in their network. The Managed Care organizations that use a Ghost Network are engaging in fraudulent behavior and bad faith, making promises they cannot deliver. Before my phone call ends, I tell them to call GHI to share their dismay as well. I am not the only ghost haunting GHI or other insurance and managed care organizations. This is a rampant problem in the United States!

The real issue here is the method behind the madness...Insurance companies and managed care companies want you, the person looking for help, to get frustrated. They want you to fatigue and get disgusted in the hopes that you will chuck all your plans for intervention or treatment. Yes, Ghost Networks are about making money.

Ghost and Phantom Networks are very difficult with which to get removed. I have written, faxed and called many, many times over the years, only to learn that I am still haunting and lurking in spirit. There are even deceased practitioners listed in Phantom Networks. I wonder how they sign their yearly contracts?

Ghost Networks are widespread throughout the United States says Dr. Lawrence Lurie, chair of the APA Committee on Managed Care. Dr. Russ Newman agrees and adds,"When a consumer tries to access the promised benefit, he or she finds that many of the health professionals on the provider list are simply 'phantoms' of managed-care marketing and not really available" [2]. The legal issue here is that you are entitled to a specialist for your needs. If there are no specialists because of the Ghost Network practice, your are entitled to have one at no additional cost to you. You can find the specialist if one is not provided for you. Many people do not know this.

The National Coalition of Mental Health Professionals & Consumers wants to know about the experience that you have had with a Ghost or Phantom Network. If you have found yourself unable to access covered mental health or medical services because you can't find a professional in the network they want to know. This grass roots movement is a great resource. You can also contact your State Attorney General to file a complaint should you be unable to find a health care practitioner.

How does finding a therapist or doctor work in other countries...are there obstacles too?

Good services should never be hard to find!


Footnotes
[1] Psychiatric News:
http://www.psych.org/pnews/00-11-03/its.html
[2] American Psychological Association:
http://www.apa.org/monitor/feb02/phantoms.html
[3] National Coalition of Mental Health Professionals & Consumers
http://www.nomanagedcare.org/article.html


References
Citizens for the Right To Know:
http://www.rtk.org/grievance.htm

How to Play HMO Hardball:
http://www.hmohardball.com

National Alliance for the Mentally Ill:
http://www.nami.org

American Board of Examiners in Clinical Social Work:
http://www.abecsw.org

The American Psychiatric Association:
http://www.psych.org/

The American Psychological Association:
http://www.apa.org

The American Counseling Association:
http://www.counseling.org

The American Medical Association
http://www.ama-assn.org/

The American Mental Health Alliance
http://www.americanmentalhealth.com/

The Clinical Social Work Federation:
http://www.cswf.org

The National Coalition of Mental Health Professionals and Consumers
http://www.thenationalcoalition.org/

The Unites States Senate Site Patient's Bill of Rights:
http://www.senate.gov/~dcp/patients_rights
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Famous Psychology Quotes













People are like stained glass windows. They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within.
~ Elisabeth Kubler-Ross (1926-2004) Swiss American Psychiatrist & author.


"Thought is action in rehearsal."
~ Sigmund Freud (1856-1939) Austrian founder of psychoanalysis


"Success is a state of mind. If you want success, start thinking of yourself as a success."
~ Dr. Joyce Brothers (1928-) American psychologist, TV-radio personality, columnist & author.


"Education is not just the filling of a pail, it is the lighting of a fire."
~ B. F. Skinner (1904-1990) American psychologist


"Your vision will become clear only when you look into your heart. Who looks outside, dreams. Who looks inside, awakens." ~Carl Jung, (1875-1961),Swiss psychiatrist, psychoanalyst


"Hate is a product of the unfulfilled life."
~ Erich Fromm (1900-1980) American psychologist, psychoanalyst.


"When I look at the world I'm pessimistic, but when I look at people I am optimistic."
~Carl Rogers (1902-1987), American psychologist.


"The only normal people are the one's you don't know very well."
~ Alfred Adler (1870-1937), Austrian psychologist.


"All the art of living lies in a fine mingling of letting go and holding on."
~Henry Ellis (1859-1939), British Psychologist


"Sex is not a sin. Many people have complained that this is taking all the fun out of sex."
~ Ruth Westheimer (1928 - ), German-American psychologist, TV radio personality & author.


"If you only have a hammer, you tend to see every problem as a nail."
~Abrahamm Maslow (1908-1970), American psychologist.




"All of us are much more human than otherwise. "
~Harry Stack Sullivan (1892-1941), American psychologist.



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Blogging Seen As Good Therapy




















A new study finds that blogs are more likely to deal with personal matters than politics or current events, and nearly 50% of bloggers see the activity as a form of therapy.

According to an AOL survey conducted by Digital Marketing Services Inc., many bloggers write about "anything and everything." But while blogs often include comments on news topics, they are more likely to be about friends, family and other personal interests.

Although bloggers say they write about personal matters on their blogs, 43.9% of respondents said that they read other blogs to get a different perspective on the news. These findings are similar to a Harris Interactive survey from March 2005, which found that about 44% of US Internet users read political blogs, including 16% who read them less than once a month. And although most bloggers read other blogs, the AOL survey found that almost one-quarter of them do not.

About one-half of bloggers (48.7%) keep a blog because it serves as a form of therapy, and 40.8% say it helps them keep in touch with family and friends. Just 16.2% say they are interested in journalism, and 7.5% want to expose political information. Few see blogging as their ticket to fame.

Bill Schreiner, Vice President, AOL Community, puts it in perspective: "In a way, blogs serve as oral history. When it comes to sharing blogs and reading other people's blogs, we like to connect with people, learn about their lives, and find common ground. There's no pressure to write about a particular subject or keep blogs maintained a certain way, and it's not necessarily a popularity contest."

©2005 eMarketer Inc. All rights reserved @ http://www.emarketer.com/Article.aspx?1003595
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Psychological Reactions To Disaster


In light of the devastation and suffering from the aftermath of Hurricane Katrina, this list is offered to help individuals understand "Disaster Reactions". Witnessing a traumatic event sets into motion a variety of psychological reactions. These psychological reactions have physical, cognitive, emotional and behavioral presentations. This list is not exhaustive but serves to illustrate many of the reactions people experience.


Psychological Reactions

•Anger
•Anxiety
•Apathy, diminished interest in usual activities
•Appetite change
•Avoidance
•Blame
•Confusion
•Criticalness
•Decreased sexual interest
•Denial
•Depression
•Difficulty concentrating
•Difficulty making decisions
•Difficulty using logic
•Difficulty naming objects
•Difficulty focusing
•Disorientation
•Distortions in time perspective
•Exaggerated startle reaction
•Excessive worry about safety of others
•Emotional numbing
•Fatigue
•Faintness or dizziness
•Fearfulness
•Feelings of being unappreciated
•Feelings of inadequacy
•Feelings of loss
•Feelings of gratefulness for being alive
•Feelings of isolation or abandonment
•Feeling high, heroic, invulnerable
•Feeling a “lump in the throat”
•Feeling uncoordinated
•Forgetfulness
•Frustration
•Grief
•Guilt
•Headaches
•Helplessness
•Hyperactivity or an inability to rest
•Increased heartbeat, respiration, blood pressure
•Increased alcohol use or substance abuse
•Intense concern for family members
•Inability to express self verbally or in writing
•Irritability
•Letdown
•Loss of appetite
•Loss of objectivity
•Lower back pain
•Memory problems
•Muffled hearing
•Nausea, upset stomach, diarrhea
•Nightmares
•Numbness
•Pains in chest
•Periods of crying
•Persistent interest in the event
•Persistent or obsessive thoughts
•Sense of being in a bad dream
•Sense of unreality or being in a movie
•Shock
•Sleep disturbance
•Slowness of thinking, difficulty comprehending
•Social withdrawal, distancing, limited contacts with others
•Soreness in muscles
•Stomach and muscle cramps
•Strong identification with victims
•Strong identification with survivors
•Sweating or chills
•Tremors, especially of hand, lips, eyes
•Trouble catching breath
•Visual flashbacks
•Withdrawal


Coping with Disaster Stress

1. Stay active. Falling into passivity can worsen psychological and physical disaster reactions.

2. Resume a normal routine as soon as possible.

3. Remind yourself that you are normal and having normal reactions in the face of the disastrous event. It is especially important to teach children that reactions like these are normal.

4. Be aware of numbing the pain with overuse of drugs or alcohol.

5. Avoid caffeine as its effects can amplify anxiety.

6. It is all right to spend time by yourself, or on the other hand, feel the need to be with others.

7. Avoid over-exposure to media images and newscasts.

8. Realize that those around you are also under stress and may not act or react in a manner you would normally expect.

9. Keep a journal or start a blog. Written expression can have healing benefits.

10. Make decisions that will give you the control over your life.

Of course, consult a mental health professional if you need assistance in coping with disaster-related stress reactions.
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The Anniversary Effect

Birthdays.
Thanksgiving.
Christmas. Kwanzaa. Hanukkah.
Halloween. Carnivale. New Year's Day. Cinco de Mayo.
Bastille Day. Boxing Day. Labor Day. Independence Day.
The first day we met.
The last day of school.
There are so many dates that mark occasions throughout the year that bring us happiness. But there are days in the calendar year that make us feel unsettled. These dates go unnoticed. Not that we don't remember them, but unnoticed as to how that date presses on our psyche. This experience is known as "The Anniversary Effect".


What the Anniversary Effect?

"The Anniversary Effect" or an anniversary reaction may be defined as upsetting behavior, reactivation of symptoms, and/or distressing dreams that occur on an anniversary of a significant experience. Sometimes we know why we are feeling melancholy, irritability or anxiety. For example, 9/11 holds an anniversary effect for many Americans and others in the world. And now, hurricane Katrina will also hold anniversary reactions for survivors and those who witnessed its aftermath. These dates will continue to be recognizable sources for our psyche's disturbance. We have conscious awareness of these dates and events. We are aware of the trauma time-line and the current calendar time-line[1]. Anniversary dates that are known to us enable us to identify why we are upset or in mourning. We connect the dots from our current emotional state to the trauma date or the traumatic event. Other obvious dates make the anniversary reaction traceable: birthday of a loved one that is not living, the date of an accident, a loved one's death, the holiday time when something traumatic happened, just to name a few.

But, there are dates that have a time-specific relationship to us that are not recognized or readily made conscious to us in the calendar year [2]. There is no conscious awareness of the trauma or calendar time-line. These "Anniversary Effects" take us by surprise. We don't know why we are feeling so down, anxious, upset, lost, or confused. Our bodies take on the psychological impact of the anniversary date, and we can also feel physically ill or sick. For example, the date you signed your divorce decree, not the day your loved one died but the day of the burial, listening to certain song that elicits a swirl of emotions, the season of the year when your child goes off to college, the scent or smell of something that triggers a deep response in you, or a current event that recalls a trauma in the past[3].

Anniversary reaction types, whether single, repetitive, or generational, are ways by which a person re-experiences mourning in an attempt to gain mastery. It is important for the individual who moves through this to realize that it is a part of the normal grieving process. In the first year of healing, a feeling of pain or anxiety may occur at the 3 month, 6 month, and one-year anniversaries of the date. After the first year, people tend to experience "The Anniversary Effect" on the year-marker. For vulnerable individuals, a specific time of day, a certain day of the week, a season of the year, a scent or a glimpse of something related to the trauma can trigger an anniversary reaction [4].


What You Can Do

Despite the fact that "The Anniversary Effect" was first identified almost 100 years ago, it is often overlooked as a source for psyche disruption. There are things that you can do to help yourself with this experience.

An anniversary marks a time of heightened vulnerability. Being aware or predicting anniversary reactions is always helpful. I often advise people I work with to look at a calendar and explore dates and memories attached to such dates. This framework can help prepare one for the anniversary reactions, and how the present day time-line can be connected to losses in the past.

Anniversaries of public trauma,crises or disasters receive significant media coverage, and re-visit imagery of damage and destruction. Such exposure can intensify "The Anniversary Effect" --- so it would be important to limit media watching and reading in and around those dates.

Journaling or blogging can be a helpful outlet for "The Anniversary Effect". Such expression can provide an opportunity for emotional healing. By recognizing, allowing and attending to feelings, memories and thoughts, an individual can make significant steps forward through the natural process of grief [5].


References


[1] Mintz, I. (1971). The anniversary reaction: A response to the unconscious sense of time. Journal of the American Psychoanalytic Association, 19, 720-735.

[2] Campbell, R. (1981). Psychiatric dictionary. New York: Oxford University Press

[3] Dlin, B. (1985). Psychobiology and treatment of anniversary reactions. Psychosomatics, 26, 505-520.

[4] Pollock, G. H.(1971). Temporal anniversary manifestations: Hour, day, holiday. Psychoanalytic Quarterly, 40, 123-131

[5] Myers, D. (1994). Disaster response and recovery: A handbook for mental health professionals. Rockville, MD: Center for Mental Health Services.
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