Know the depression treatment guidelines

According to our research – Depression is the most dangerous mental disorder found in the human beings. The main reason it is considered dangerous is because those people who suffer from this disorder generally have a killer instinct and they just would want to die. They may find ways and means to kill themselves. Hence they have to be taken care very minutely.

There are various depression treatment guidelines which are available in the medical science to treat the person from depression.

1. Medication – The medication is the most common type of treatment which is used for curing the depression. There are various specific medicines which are prescribed by the psychiatrist to treat the depression. The medication would differ from person to person depending on the volume of depression in the person. Even though medication is most preferred depression treatment; it also has many side effects on the health of the person. The side effects would differ from person to person. Another drawback of the medication treatment is that the cost of medicines is high which may not be affordable by all.

2. Psychotherapy another form of depression treatment guidelines which can be checked from www.newspsychology.com.  Since this is a psychiatric treatment it does not have any kind of side effect on the person. This is also known as the talking therapy. The experts believe that if the person is able to speak up his heart then they can be easily treated out of the depression.

The specialist doctors try and talk to the patients to understand the situation of the patients. When they talk to the patient they make sure that their family members and their best friends are with the patient. This provides more confidence to the patient and they can come out of depression faster.

This treatment is rated among the best treatments. The cost of the psychotherapy may differ from person to person.

3. Electroconvulsive therapy or the ECT is also an effective treatment for depression. This is considered as the easiest and fastest way to treat this mental disorder. This type of treatment is mostly used for patients who are into severe depression and always show suicidal signs. This treatment should be administered on the patients very carefully as this may prove fatal if not done properly.

Fight Depression Using These Mobile Apps

The most common problems which are faced by most of professionals are depression and anxiety. This is because of the work stress at the work places and also due to the increasing competition in every industry. Every person is given a target – some may have the quantitative targets others may have qualitative targets but one has to fulfill in order to win the rat race. Due to depression and anxiety the person generally does not get good sleep; they have very less or poor diet. These are the reasons that the person has a poor mental health. This health situation should be treated on time otherwise it would lead to further health hazards.

With the advancement in the technology in the present modern times you have many mobile applications which have been developed in order to treat the problem of depression and anxiety and this has been proved by our research. This is the latest in the technological world and one can know more from our other research works at this website. One should definitely try out these applications which are capable to treat anxiety and depression. Those users who use Android and iOS have a huge choice on these applications.

Sad scale– this is an application which is developed in order to make the user get engrossed in some fun filled activity. Here the user has to fill up a questionnaire having 20 questions. These questions help them to reflect about the mood of the person. This graph helps the psychologist in order to understand the exact problem behind depression or anxiety.  The details of these questions should be shared with the consulting doctor so that they can understand the state of mind of the patient.

Live happy– those who have lots of stress at their work place and do not find time to keep themselves fresh should definitely try the Live Happy application. This application has a huge variety of activities which are supposed to increase the spirit of the person and thus making the person happier. This application should be used at regular time intervals so that person does not get into depression or anxiety. This application keeps the person involved. Thus you shall feel more happy and satisfied in your life.

Understanding different types of depression

The general impression about depression is a person who has become very lethargic and does not respond to the positive side of life. Depression could be caused due to various reasons – it is advisable that one goes to the psychiatrist before things get worsened. There are cases where depression has led to death of the person.  The people who are under this disorder feel that they are a burden to the family and society and hence many of them commit suicide.

Our experts have done a clinical research on depression symptoms and in most cases we found that the people who are depressed are the ones who have been reprimanded without any specific reason or they have been mentally tortured. If you read our work at https://newspsychology.com you will find details about different types of depression. Here we discuss some of them:

  • Minor or mild depression – this is the initial stage or first form of depression. This type of disorder is not an alarming one and can be treated easily. The symptoms are not very severe and there is no major impact on the life of the person. This type of depression goes away over a certain period of time.
  • Dysthymic disorder – this situation is caused when the mild depression lasts for a longer period of time let’s say for more than a period of two years. This definitely calls for a proper treatment. In most of the cases people ignore but in the long run it is life threatening. The person who suffers from dysthymic disorder generally does not remember when his / her problem of depression started.
  • Bipolar depression – this can be considered as the most dangerous phase in depression. People who are in such a stage   have a major mood swings and during this period they resort various eccentric and dangerous activities. 

Depression in older ages: a challenging diagnosis

Depression is a serious illness affecting approximately 3% to 6% of adults over age 65 in the United States. Also depression affects a much higher percentage of people in hospitals and nursing homes. Depression in late life can be a relapse of an earlier depression, But when it occurs for the first time in older adults, it usually is a consequence of a medical illness. With coexisting medical illness, depression can be more difficult to recognize and also more difficult to endure.however  A majority of the people diagnosed with depression in primary care settings, , do not meet the diagnostic criteria for major depressive disorder.

Fatigue, lack of energy and sleep problems associated with medical conditions often mimic depressive symptoms and makes difficult the diagnose of depression in primary care settings, in older adults. Furthermore, losses of friends and loved ones and a shrinking social network in old age result in diminished social involvement, which is a common feature of depression. These problems of old age are sometimes difficult to distinguish from depressive symptoms.

The challenge of correctly identifying depression in primary care is compounded by the fact that depressed patients seen in these settings have less-clear-cut symptom profiles than those seen in specialty mental health settings, mainly because their symptoms are less severe or disabling. Some patients diagnosed with depression in primary care may meet the criteria for dysthymia or adjustment disorder with mood symptoms. Others may have mild depressive symptoms that don't reach the threshold for diagnosis of major depressive disorder. Many such patients would benefit from supportive counseling or lifestyle modification. In some cases, watchful waiting with regular follow-up may be appropriate. Yet the majority of primary care patients diagnosed with depression are simply prescribed antidepressants.

 

The guidelines discourage routine use of antidepressants for persistent subthreshold depressive symptoms or mild depression. However, clinicians may consider these medications for patients with a history of moderate or severe depression, subthreshold symptoms lasting 2 years or longer, and subthreshold symptoms or mild depression that persists after low-intensity psychosocial interventions. Medications (typically selective serotonin-reuptake inhibitors) or high-intensity psychosocial interventions, such as individual cognitive behavioral therapy or interpersonal therapy, alone or combined with medications, may be considered as a third step for patients with no response to low-intensity psychosocial interventions and those with moderate-to-severe depression. When medication has been started, the guidelines recommend continuing it at a therapeutic dose for at least 6 months after remission of an episode.

With the looming shortage of geriatric mental health care providers, general medical clinicians' role in managing older adults' mental health problems will probably increase. A nuanced approach to depression diagnosis and treatment may improve the management and outcome of geriatric depression in primary care settings. Incorporating the stepped-care approaches into generalists' training and making low-intensity psychosocial interventions more widely available may help prepare clinicians to more effectively meet future needs.

Effective treatments—including psychopharmacologic, psychotherapeutic (behavioral or counseling), and complementary and alternative therapies—and combinations of these are available for depressed patients identified in primary care settings. Cognitive-behavioral therapy (CBT) and interpersonal therapy are psychotherapeutic approaches used in the treatment of patients with major depressive disorder, with documented beneficial outcomes.

In general, evidence-based recommendation for treatment of moderate to severe depression in the primary care setting in elderly patients involves a combination of pharmacotherapy and psychotherapy, and for the treatment of mild to moderate depression, psychotherapy alone.

A Breakthrough In Depression Treatment

Research out of the University of Texas Southwestern Medical Center claims it’s found a “breakthrough” way to treat depression, which affects nearly one in 10 adults in the U.S.

Researchers led by Dr. Jeffrey Zigman, associate professor of internal medicine and psychiatry at UT Southwestern, have improved their understanding of how a certain natural antidepressant hormone referred to as ghrelin works in the brain. In their study, they point to ghrelin as a potential new antidepressant with powerful effects.

Ghrelin, known as the “hunger hormone,” arouses appetite, and has been found to contain natural antidepressant properties that appear when its levels increase due to caloric restriction. The hormone, which is produced in the stomach and intestines, can lead to the formation of new neurons in the hippocampus — a region in the brain that moderates memory, mood, and complex eating behaviors. New neurons generating in the brain is known as neurogenesis.
 

A mix of the hunger hormone, ghrelin, and the P7C3 compound could trigger the production of new neurons and work against depression/ Photo courtesy of Shutterstock

The research is preceded by a study previously completed by Zigman back in 2008, when he discovered that chronic stress causes ghrelin to increase; this led to a decrease in depression and anxiety in mice.

While increased amounts of ghrelin leads to neurogenesis, the researchers decided to add another component to the antidepressant mix. Certain compounds known as P7C3 have been shown to exhibit neuroprotective abilities, especially in people with Parkinson’s disease, traumatic brain injuries (TBI), or amyotrophic lateral sclerosis (ALS). P7C3 can also be used in battling depression — the scientists found that the compound, mixed with ghrelin, actually improved neurogenesis.

“We found that P7C3 exerted a potent antidepressant effect via its neurogenesis-promoting properties,” Dr. Pieper, associate professor of neurology and psychiatry at the University of Iowa Carver College of Medicine, said in a press release. “Also exciting, a highly active P7C3 analog was able to quickly enhance neurogenesis to a much greater level than a wide spectrum of currently marketed antidepressant drugs.”

Certain types of depression, such as those associated with chronic stress or ghrelin resistance (linked to obesity or anorexia nervosa), may be the most treatable using this new method. The scientists plan on studying this potential treatment further.

“By investigating the way the so-called ‘hunger hormone’ ghrelin works to limit the extent of depression following long-term exposure to stress, we discovered what could become a brand new class of antidepressant drugs,” Zigman noted in the press release.

Spouses of people suffering a heart attack need care for increased risk of depression and suicide

Spouses of people who suffer a sudden heart attack (an acute myocardial infarction) have an increased risk of depression, anxiety, or suicide after the event, even if their partner survives, according to new research published online in the European Heart Journal. They suffer more than spouses of people who die from, or survive, other conditions.

The study, which is the first to investigate this and to compare it with people whose spouse died or survived from something other than a heart attack, also found that men were more susceptible to depression and suicide after their wife's survival or death from an acute myocardial infarction (AMI), than women.

Using Danish registries, including the National Civil Status Registry that shows whether people are married or not, researchers in the USA and Denmark compared 16,506 spouses of people who died from an AMI between 1997 and 2008 with 49,518 spouses of people who died from causes unrelated to AMI. They also matched 44,566 spouses of patients who suffered a non-fatal AMI with 131,563 spouses of people admitted to hospital for a non-fatal condition unrelated to AMI. They looked at the use of antidepressants and benzodiazepines (used for treating anxiety) before and up to a year after the event, records of contact with the health system for depression, and suicide.

"We found that more than three times the number of people whose spouses died from an AMI were using antidepressants in the year after the event compared with the year before. In addition, nearly 50 times as many spouses used a benzodiazepine after the event compared to before. For people whose spouse had died from a non-AMI cause, we saw a much higher rate of medication use than for other causes and they had an approximately 50% higher likelihood of claiming a prescription for these drugs," said the first author of the study, Dr Emil Fosbøl. "Those whose spouse survived an AMI had a 17% higher use of antidepressants after the event, whereas spouses of patients surviving some other, non-AMI related condition had an unchanged use of antidepressants after the event compared to before."

Dr Fosbøl, who was a cardiology research fellow at Duke Clinical Research Institute, Duke University Medical Center, North Carolina (USA) at the time of the research, but has now returned to Denmark to work as a cardiologist in Copenhagen, continued: "Overall, the rates of depression were significantly higher after the event in the fatal AMI group and in the fatal non-AMI group. Although the rates were low, those who had lost a spouse to a fatal AMI or whose spouse survived an AMI more often committed suicide than those with spouses who died from, or survived, a non-AMI-related event. We also found that men were more likely to suffer depression and commit suicide after an event than women."

The researchers speculate that it is the sudden and unexpected nature of an AMI that causes the more extreme impact on the spouse. "If your partner dies suddenly from a heart attack, you have no time to prepare psychologically for the death, whereas if someone is ill with, for example, cancer, there is more time to grow used to the idea," said Dr Fosbøl. "The larger psychological impact of a sudden loss is similar to post-traumatic stress disorder."

Dr Fosbøl said their findings have large public health implications as more than seven million people worldwide experience an AMI a year, with around 16% of them dying from it within a month. "This could mean that around 11,000 people would be likely to start antidepressants after a spouse's non-fatal AMI, and 35,000 after their spouse died from an AMI. Moreover, although suicide rates were low, we could expect approximately 1,400 people to take their own life in the year following a spouse's death from a heart attack.

"This is a major public health issue for which there seems to be very little awareness among doctors and policy makers. I think the most important finding of this study is that the system needs to consider the care needs for spouses too, not only when a patient dies from an AMI, but also when the patient is 'just' admitted to hospital with an AMI and survives. Previously, we did not have any data on those patients' spouses where the patient survived the event."

The authors say that there appear to be no mechanisms in place currently to identify spouses at risk and to institute preventive strategies such as screening for depression and grief counselling.

"I think it would be worth conducting a study of a targeted intervention to prevent depression for the spouse," concluded Dr Fosbøl. "I believe that treatment of an acute event also should include screening the spouse for possible psychological effects and a plan should be in place for how to take care of this, if indeed the spouse is severely affected."


Journal Reference:

  1. Emil L. Fosbøl, Eric D. Peterson, Peter Weeke, Tracy Y. Wang, Robin Mathews, Lars Kober, Laine Thomas, Gunnar H. Gislason, and Christian Torp-Pedersen. Spousal depression, anxiety, and suicide after myocardial infarction. European Heart Journal, 2012; DOI: 10.1093/eurheartj/ehs242

Suicide prevention expert outlines new steps to tackle military suicide

The suicide rate in the U.S. Army now exceeds the rate in the general population, and psychiatric admission is now the most common reason for hospitalization in the Army. These concerning trends are described by Timothy Lineberry, M.D., a Mayo Clinic psychiatrist and suicide expert for the Army, in the September edition of Mayo Clinic Proceedings.

In the article, he also outlines steps to assess and address military suicide — an issue he calls a major public health concern. Dr. Lineberry proposes greater use of gun locks, improving primary care for depression, and better monitoring for sleep disturbances, among other steps.

"Despite the anticipated end of large-scale military operations in Afghanistan and Iraq, the effects on the mental health of active-duty service members, reservists, and veterans is only just beginning to be felt," Dr. Lineberry says. "Moreover, the potential effect on service members of their war experiences may manifest indefinitely into the future in the form of emerging psychiatric illnesses."

In the article, Dr. Lineberry integrates published research on increased rates of psychiatric illness in the military during the past decade and highlights the need for ongoing resources for prevention, diagnosis and treatment. While the National Institutes of Health and the Department of Defense have already invested millions of dollars into military suicide prevention and research, some key clinical steps can also be taken to tackle the problem.

Dr. Lineberry outlines four steps based on past research and emerging evidence that he believes could help begin curbing military suicide:

  • Reduce access to guns and other means of suicide. Nearly 70 percent of veterans who commit suicide use a gun to do it. Veterans are more likely to own firearms. All veterans with psychiatric illness should be asked about their access to firearms and encouraged to lock up guns, giving someone else the key, or remove them from the home altogether. Just slowing down gun access by a few minutes may be enough to stop the impulse.
  • Watch for sleep disturbances. Complaints of insomnia or other sleep disturbances in otherwise healthy soldiers, reservists, or veterans may signal the need for taking a careful history and screening for depression, substance misuse and post-traumatic stress disorder. Sleep disturbances have been previously identified as a risk factor for suicide. These complaints may also serve as opportunities for referring those potentially needing more intensive treatment.
  • Prescribe opioid medications carefully and monitor. Unintentional overdose deaths, primarily with opioids, now outnumber traffic fatalities in many states. Individuals with psychiatric illness are overrepresented among those receiving prescriptions for opioids and those taking overdoses. This same trend has been seen in former military personnel. A recent study found that Iraq and Afghanistan veterans with a diagnosis of post-traumatic stress disorder who were prescribed opioids were significantly more likely to have opioid-related accidents and overdoses, alcohol and non-opioid drug-related accidents and overdoses, and self-inflicted and violence-related injuries.
  • Improve primary care treatment for depression. Research suggests that patients who die by suicide are more likely to have visited a primary care physician than mental health specialist in the previous month. Programs developed to improve primary care physicians' recognition and treatment of depression could help lower suicide rates.

Journal Reference:

  1. Timothy W. Lineberry, Stephen S. O'Connor. Suicide in the US Army. Mayo Clinic Proceedings, 2012; 87 (9): 871 DOI: 10.1016/j.mayocp.2012.07.002

Common parasite may trigger suicide attempts: Inflammation from T. gondii produces brain-damaging metabolites

 

The Toxoplasma gondii parasite has been linked to inflammation in the brain, damaging cells. (Credit: Image courtesy of Michigan State University)

A parasite thought to be harmless and found in many people may actually be causing subtle changes in the brain, leading to suicide attempts.

New research appearing in the August issue of The Journal of Clinical Psychiatry adds to the growing work linking an infection caused by the Toxoplasma gondii parasite to suicide attempts. Michigan State University's Lena Brundin was one of the lead researchers on the team.

About 10-20 percent of people in the United States have Toxoplasma gondii, or T. gondii, in their bodies, but in most it was thought to lie dormant, said Brundin, an associate professor of experimental psychiatry in MSU's College of Human Medicine. In fact, it appears the parasite can cause inflammation over time, which produces harmful metabolites that can damage brain cells.

"Previous research has found signs of inflammation in the brains of suicide victims and people battling depression, and there also are previous reports linking Toxoplasma gondii to suicide attempts," she said. "In our study we found that if you are positive for the parasite, you are seven times more likely to attempt suicide."

The work by Brundin and colleagues is the first to measure scores on a suicide assessment scale from people infected with the parasite, some of whom had attempted suicide.

The results found those infected with T. gondii scored significantly higher on the scale, indicative of a more severe disease and greater risk for future suicide attempts. However, Brundin stresses the majority of those infected with the parasite will not attempt suicide: "Some individuals may for some reason be more susceptible to develop symptoms," she said.

"Suicide is major health problem," said Brundin, noting the 36,909 deaths in 2009 in America, or one every 14 minutes. "It is estimated 90 percent of people who attempt suicide have a diagnosed psychiatric disorder. If we could identify those people infected with this parasite, it could help us predict who is at a higher risk."

T. gondii is a parasite found in cells that reproduces in its primary host, any member of the cat family. It is transmitted to humans primarily through ingesting water and food contaminated with the eggs of the parasite, or, since the parasite can be present in other mammals as well, through consuming undercooked raw meat or food.

Brundin has been looking at the link between depression and inflammation in the brain for a decade, beginning with work she did on Parkinson's disease. Typically, a class of antidepressants called selective serotonin re-uptake inhibitors, or SSRIs, have been the preferred treatment for depression. SSRIs are believed to increase the level of a neurotransmitter called serotonin but are effective in only about half of depressed patients.

Brundin's research indicates a reduction in the brain's serotonin might be a symptom rather than the root cause of depression. Inflammation, possibly from an infection or a parasite, likely causes changes in the brain's chemistry, leading to depression and, in some cases, thoughts of suicide, she said.

"I think it's very positive that we are finding biological changes in suicidal patients," she said. "It means we can develop new treatments to prevent suicides, and patients can feel hope that maybe we can help them.

"It's a great opportunity to develop new treatments tailored at specific biological mechanisms."

Brundin and co-senior investigator Teodor Postolache of the University of Maryland led the research team. Funding for the project came from several sources, most notably the Swedish Research Council and American Foundation for Suicide Prevention.

 

Journal Reference:

  1. Yuanfen Zhang, Lil Träskman-Bendz, Shorena Janelidze, Patricia Langenberg, Ahmed Saleh, Niel Constantine, Olaoluwa Okusaga, Cecilie Bay-Richter, Lena Brundin, Teodor T. Postolache. Toxoplasma gondiiImmunoglobulin G Antibodies and Nonfatal Suicidal Self-Directed Violence. The Journal of Clinical Psychiatry, 2012; DOI: 10.4088/JCP.11m07532

How well is depression in women being diagnosed and treated?

Major depression affects as many as 16% of reproductive-aged women in the U.S. Yet pregnant women have a higher rate of undiagnosed depression than nonpregnant women, according to a study published in Journal of Women's Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers.

Jean Ko, PhD and coauthors from the Centers for Disease Control and Prevention (CDC), Atlanta, GA, found that more than 1 in 10 women ages 18-44 years had a major depressive event during the previous year — representing about 1.2 million U.S. women — but more than half of those women did not receive a diagnosis of depression and nearly half did not receive any mental health treatment. The article "Depression and Treatment among U.S. Pregnant and Nonpregnant Women of Reproductive Age, 2005-2009," further reports that disparities in receiving a diagnosis and treatment were associated with younger age, belonging to a racial/ethnic minority, and insurance status.

The accompanying Editorial entitled "Depression: Is Pregnancy Protective?" by Jennifer Payne, MD, Johns Hopkins School of Medicine, Baltimore, MD, explores the ongoing challenges in the adequate diagnosis and treatment of major depression, the additional factors that come into play during pregnancy, and the implications of the Ko et al. study results.

"As health care providers, we simply must do a better job at diagnosing depression and referring women for mental health treatment. Reproductive health care visits provide an opportune time to address this ," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, and President of the Academy of Women's Health.


Journal References:

  1. Jean Y. Ko, Sherry L. Farr, Patricia M. Dietz, Cheryl L. Robbins. Depression and Treatment Among U.S. Pregnant and Nonpregnant Women of Reproductive Age, 2005–2009. Journal of Women's Health, 2012; 21 (8): 830 DOI: 10.1089/jwh.2011.3466
  2. Jennifer L. Payne. Depression: Is Pregnancy Protective? Journal of Women's Health, 2012; 21 (8): 809 DOI: 10.1089/jwh.2012.3831

Evaluate children's stress after natural disasters

As Hurricane Isaac nears the Gulf Coast, one may wonder what the impact of natural disasters are on children. Who is most at risk for persistent stress reactions? How can such youth be identified and assisted in the aftermath of a destructive storm?

Dr. Annette M. La Greca, a professor of psychology and pediatrics at the University of Miami, and her colleagues, have been studying children's disaster reactions following Hurricanes Andrew (1992), Charley (2004) and Ike (2008). Recent findings from Hurricane Ike shed light on these questions about children's functioning.

The new findings suggest that it is important to evaluate children's symptoms of post-traumatic stress and depression, in order to identify those who may be the most adversely affected. Findings also suggest that helping children cope with stressors that occur during or after the disaster may improve children's psychological functioning. "Children may have to move or change schools. Their neighborhood may not be safe for outdoor play and they may not be able to spend time with their friends. Children need help coping with these and other post-disaster stressors," La Greca says.

In collaboration with Scott and Elaine Sevin, Dr. La Greca developed a workbook for parents to help their children cope with the many stressors that occur after disasters. The book gives parents tips for helping children stay healthy and fit, maintain normal routines, and cope with stressors and with emotions, such as fears and worries. The After the Storm workbook is available at no cost at www.7-dippity.com.

A paper to be published in the Journal of Affective Disorders indicates that, eight months after the disaster, children with signs of both post-traumatic stress and depression represent a high-risk group for longer-term adverse reactions. Such children are less likely to recover by 15 months post-disaster than other youth. They also report more severe levels of psychological symptoms and experience more post-disaster stressors than other youth. The authors on this paper are Drs. Betty Lai and Annette La Greca from the University of Miami, Dr. Beth Auslander from the University of Texas Medical Branch, and Dr. Mary Short from the University of Houston-Clear Lake.