In a small study involving 52 women, Johns Hopkins researchers found that epigenetic changes in two genes - which can be detected by a simple blood test - were predictive of whether a woman would develop postpartum depression.
Epigenetic changes are those which alter the way genes function without creating any differences in the underlying DNA.
It is not known what causes postpartum depression, but it has long been believed that the sharp drop-off in estrogen after giving birth could be a factor, so the study authors first studied mice, looking for any estrogen-induced epigenetic changes that were likely to be related to postpartum depression. They identified two likely genes as candidates: TTC9B and HP1BP3. They then confirmed their findings in humans by testing for biomarkers of these epigenetic changes during pregnancy and checking to see how well these test results correlated to the later development of postpartum depression.
What the scientists found was that they could predict with 85% certainty just who would go on to develop postpartum depression. "We were pretty surprised by how well the genes were correlated with the development of postpartum depression," said lead author Zachary Kaminsky. "With more research, this could prove to be a powerful tool."
Kaminsky says that if his work continues to go well, a blood test for these two epigenetic biomarkers might eventually be a part of the screening tests which women routinely receive during pregnancy, making it much easier to make treatment decisions for at-risk women.
The study was published online on May 21, 2013 in the journal Molecular Psychiatry.
Earlier this month, the National Institute of Mental Health (NIMH) announced that it would be "re-orienting its research away from DSM categories."
According to the director of the NIMH, Dr. Thomas Insel, the Diagnostic and Statistical Manual of Mental Disorders (DSM) - which is a handbook used by clinicians when making diagnoses of conditions such as depression - lacks validity. "Unlike our definitions of ischemic heart disease, lymphoma, or AIDS," said Dr. Insel, "the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."
What the NIMH proposes in its stead, its Research Domain Critieria (RDoC), could, with its emphasis on genetics, imaging and cognitive science, represent the future of the diagnosis of mental illness. Rather than relying on sets of symptoms in order to make a diagnosis, doctors could, perhaps, order laboratory tests, much like other biologically-based illnesses.
However, we won't see the replacement of the DSM quite yet. Insel noted in his letter on the topic that, "This is a decade-long project that is just beginning."
The fifth edition of the DSM, which is due to be released later this month, has previously faced criticism for its move to make the diagnostic criteria for depression what some considered to be "too broad."
Childhood depression is a topic very close to my heart, and, given that National Children's Mental Health Awareness Day is coming up on May 9th this year, I thought I would speak a bit about my experiences.
My first episode of depression that I can remember occurred when I was about seven. I can remember waking up day after day thinking, "I hope today is a good day." It never was a "good day", however.
The depression and anxiety followed me until I was thirty-years-old and decided to see a psychiatrist about how I was feeling. The first time I visited him, I was filled with dread. I wanted to believe that I could feel better, but I knew deep inside that I was just weak and lazy and the doctor was going to tell me that there was nothing medically wrong. Instead, he told me that I had clinical depression and that there was hope for me to get better. Learning that my depression was biologically-based and not a character flaw changed my life completely.
Today, as I look back on my childhood I regret that none of the adults in my life recognized that I was depressed. In fact, there was still quite a bit of stigma surrounding mental disorders back then. I believe that things could have been much different for me if only people were more knowledgeable about depression and I had gotten help with it early on. Luckily, we are much more open and educated about depression today and our children do not have to suffer with depression or carry the burden well into adulthood before getting help. Please, help educate yourself and others so no child has to endure years of depression and self-doubt like I did.
According to the Priory Group, a seasonal variability in suicide rates exists worldwide, with more suicides occurring in the warm, sunny days of spring and early summer than any other time of the year. In the northern hemisphere, May and June and are peak months for suicide, while the southern hemisphere sees a peak in the month of November.
No one is sure why this occurs, but scientists theorize that it has something to do with sunlight and how it affects hormones. It is well known that the shorter days of winter are associated with depression, which is called seasonal affective disorder. It is thought that perhaps when spring returns people start to feel more energetic and this enables them to carry through on suicide plans that they were previously too depressed to carry out.
Suicide Prevention Resources, a non-profit organization based in New York, describes the following suicide warning signs:
- Previous suicide attempts, "mini-attempts".
- Explicit statements of suicidal ideation or feelings.
- Development of suicidal plan, acquiring the means, "rehearsal" behavior, setting a time for the attempt.
- Self-inflicted injuries, such as cuts, burns, or head banging.
- Reckless behavior. (Besides suicide, other leading causes of death among young people in New York City are homicide, accidents, drug overdose, and AIDS.) Unexplained accidents among children and the elderly.
- Making out a will or giving away favorite possessions.
- Inappropriately saying goodbye.
- Verbal behavior that is ambiguous or indirect: "I'm going away on a real long trip.", "You won't have to worry about me anymore.", "I want to go to sleep and never wake up.", "I'm so depressed, I just can't go on.", "Does God punish suicides?", "Voices are telling me to do bad things.", requests for euthanasia information, inappropriate joking, stories or essays on morbid themes.
A. Nervous breakdown is not a term that the medical community uses. Historically people have been embarrassed by mental illness and the term nervous breakdown is a euphemism that has been used for any acute mental illness, whether it's depression, anxiety, schizophrenia or other illness. It's less embarrassing to say Uncle Joe had a nervous breakdown, for example, than to say he attempted suicide or became psychotic and had to be hospitalized.
In an article entitled "You Are What You Think" I wrote about a form of psychotherapy called cognitive therapy. The premise of cognitive therapy is that our thoughts are quite powerful and if we habitually think in a negative way our mood will follow our thoughts causing feelings of depression. Defeating depression thus becomes a matter of recognizing these faulty thoughts and replacing them with more truthful, positive thoughts.
If our thoughts are powerful enough to influence how we feel, it stands to reason that how good or bad our reality is is simply a function of how we wish to perceive it; and, not surprisingly, some of our greatest, most respected thinkers have stated this same concept in their own words:
"I saw all things that I feared, and which feared me, had nothing good or bad in them save insofar as the mind was affected by them."
--Benedict de Spinoza
"People and things do not upset us, rather we upset ourselves by believing that they can upset us."
"We become what we think about all day long."
--Ralph Waldo Emerson
"There is nothing either good or bad, but thinking makes it so."
"People are about as happy as they make up their mind to be."
"Change your thoughts and you change your world."
--Norman Vincent Peale
"As you think, so shall you be."
What do you think? Is it possible to think ourselves into feeling depressed? Do our thoughts really create our reality? Or are all these men wrong?
Bellaclarke recently posted on the forum:
Hi, I've been treated for depression for 12 years with various different antidepressants. At best, they make me feel numb. Also, I experienced side effects from every single type I've taken. I've reached my breaking point and don't feel like antidepressants are the answer any more. I've recently done a significant amount of research into high doses of niacin as an alternative to traditional pills. This week I started taking 1000mg of non-flush niacin.
Has anyone on here every taken it?
What doses did you take?
Did it work?
Did you take flush or non-flush niacin?
Do you have any experiences to share on this topic? Post your comments down below.
Published reports about how common sexual side-effects are vary quite a bit, probably because many patients are shy about such a personal topic. How common are they really? Voting in our poll does not reveal your identity to anyone. Please join us in creating an honest assessment of just how common sexual side-effects are. Any type of sexual difficulty that you developed as a direct result of taking an antidepressant that can't be accounted for otherwise by other drugs, illness or the depression itself would count. Symptoms that you might have experienced would include low libido, difficulty with orgasm, erectile dysfunction, decreased vaginal lubrication or ejaculatory difficulties.
POLL: Do You Experience Sexual Side-Effects Due to Your Antidepressant?
If you've been feeling tired and depressed you may think you have depression, but did you know that hypothyroidism can mimic the symptoms of depression? This disease, in which the thyroid gland fails to produce adequate amounts of thyroid hormone, can cause symptoms similar to depression, such as tiredness, sleepiness, slowed speech, apathy and a loss of interest in persona relationships. Before seeking treatment for depression, it is a good idea to visit your family doctor for a checkup. He can perform tests for hypothyroidism as well as other medical illnesses which may present with symptoms similar to depression.
One of the things I love about the Internet is that you can find information about anything and everything under the sun. Need to know how late your local bank is open? It's there. Looking for an antique sock knitting machine. That's probably there too.
But, how do you know that the information you're getting is credible? When it comes to health information, there are a few things you can do to make sure you are obtaining the most reliable information:
- Never take medical advice over the Internet - That person you think is a doctor could be Joe Schmo from down the street who thinks he's an expert about bipolar disorder because Grandma had it. Even if you can confirm that they have a license to practice medicine, talking with someone by email or a chat room cannot replace a face-to-face consultation with a doctor.
- Know your source - Is the information from a trusted source, for example a government agency or a drug manufacturer's site? Is the content written by a qualified professional? Does it undergo medical review for accuracy?
- Is the site HONcode accredited? - HONcode accredited sites must go through an approval process and agree to follow a set of ethical guidelines.
- Don't self-diagnose or self-treat - Internet information is a great way to educate yourself and supplement the information provided by your doctor, but it is always wise to leave the diagnosis and treatment up to your physician, who has years of education and experience.
What do you personally do to evaluate whether a site contains reliable health information? Join the discussion below.