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Nancy Schimelpfening

Depression Blog

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Poll: Do You Experience Sexual Side Effects Due to Your Antidepressant?

Tuesday April 22, 2014

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?

(1) Yes
(2) No
(3) Not Sure

View Results


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You Are What You Think?

Tuesday April 22, 2014

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."
--Albert Ellis

"We become what we think about all day long."
--Ralph Waldo Emerson

"There is nothing either good or bad, but thinking makes it so."
--William Shakespeare

"People are about as happy as they make up their mind to be."
--Abraham Lincoln

"Change your thoughts and you change your world."
--Norman Vincent Peale

"As you think, so shall you be."
--Jesus Christ

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?

Zoloft and Nightsweats

Tuesday April 22, 2014

Jessica1307 posted the following question to our forum:

I have been on Zoloft 50 mg for 3 years and it has been a miracle drug -really cut down on obsessive thoughts and chronic unhappiness.

My major side effect is frequent, severe night sweats. I get them several nights a week. I know this is a common side effect for some people. I'm wondering if anyone has a good solution besides going off the Zoloft.

BTW, I am healthy, not overweight, don't drink caffeine, don't drink alcohol before bed and my bedding is not excessive.

Thank you for any help - even commiseration - you offer.

Do you have an advice to give Jessica1307?  Share your experiences below.

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Meds Don't Help Anymore

Tuesday April 22, 2014

Tortoiseshell on our forum asked the following question:

I feel it is time for me to change meds or add something to the current meds.

I am currently on Pristiq 100mg/day and Lamictal 200 mg/day. Increasing the dose didn't help, but worsened the side effects. These meds worked relatively well for me for 3 years until last September I had very emotionally difficult situation and got into destructive relationship. It threw me back again. Since then I haven't been able to enjoy myself and life despite of going to counseling weekly. Just not getting better.

I am seeing my psychiatrist next week. She is very flexible about med options. She pretty much lets me decide if I want to try something or stay the same.

In 12 years I tried a lot, so don't really know what other options are. Here is what I tried:

SSRI/SNRI/other: Pristiq (worked the best so far), Zoloft (no effect), Prozac (no effect but side effects), Effexor, Paxil, Wellbutrin (hated it)

Mood stabilizer: Lamictal (seems to be working so far)

Antianxiety: Buspar (no help with anxiety, but was making me more depressed)

Antipsychotic: Abillify (tried for 1 day, I thought I would jump out of my own skin)

I am not sure what else to try. Maybe keep Pristiq and Lamictal and add something. I am not getting restful sleep, maybe try Trazodone. Not sure. Any ideas?

Do you have any advice for Tortoiseshell?  Share your comments below.

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Internet Use May Help Prevent Depression in the Elderly

Monday April 21, 2014
While many elderly people are at risk for increased depression due to feelings of loneliness and isolation, a new study indicates that using the Internet could help ameliorate these feelings and prevent depression in this population.

The study followed thousand of retired Americans for a period of six years, finding that depression could be reduced by over 30 percent in those who use the Internet.

According to Sheila Cotten, the Michigan State University professor in charge of the study, this "very strong effect" has to do with the fact that elderly people are able to stay in touch with others and not feel so lonely.

To carry out the study, Cotten's research team looked at data collected from the Health and Retirement Survey.  This survey included over 22,000 older Americans with data being collected every two years.  More than 3,000 people were included in this particular sampling.  According to Cotten, it is "one of the largest and most comprehensive surveys of its kind."  Other smaller studies have been inconclusive about what role technology such as the Internet might play in helping depression.

The study was also different from others in that it took into account what the people's depression levels were like before they began their Internet usage.

Internet usage was no panacea, however.  Some people did remain depressed even after using it.

The team also confirmed a finding from previous studies that people who live alone experience a greater impact on their depression when they begin to use the Internet.

Cotten suggests that the effect that Internet use has on a person - whether it's positive or negative - is greatly influenced by how that person uses it.  If they use it to the point of ignoring the needs of their daily life, then it can have a negative effect on them.  However, if they take a more moderate approach and use it in  way that enhances their life it can bring about a positive effect.

The study can be found in the Journal of Gerontology: Psychological Sciences and Social Sciences.

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Parkinson's Disease Treatment in Those With Depression

Monday April 21, 2014

People with Parkinson's disease often also suffer from depression, according to scientists.  In fact, about 40 percent of those with Parkinson's will also suffer from depression.  Because of this connection, a research team at the University of Kentucky College of Medicine and the Sanders-Brown Center on Aging did a study in which they assessed cognitive function in both depressed and non-depressed individuals with with this disease.

The study involved 10 depressed and 18 non-depressed Parkinson's disease patients.  At the start of the study, they were given a battery of tests to assess both their cognitive function and the severity of their depression.  They were then tested again both with and without dopamine replacement therapy, which is the treatment that is commonly used to treat the motor symptoms of this disease.

The researchers found that there was a significant link between depression and medication status when it came to measures of verbal memory and a facial affect naming task.  In addition, those with depression did much worse while on medication than off.  However, those who were not depressed improved while on medication.

Contrary to what lead author Dr. Lee Blonder expected, the study also found that the mood of depressed patients actually worsened while they were taking dopamine replacement medications.  According to Blonder, this was the opposite of what they had hypothesized, which was that dopaminergic medications should improve the mood of the depressed patients.

Blonder cautions, however, that these results should not be used to alter treatment plans.  The study group was quite small and larger studies will be necessary before any conclusions can be drawn.

The study was published in the journal Psychiatry Research.

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http://depression.about.com/b/2013/10/02/depression-may-mean-increased-risk-for-parkinsons-disease.htm

Young Fathers at Risk for Depression Too

Monday April 14, 2014

According to a new study, young fathers may be at risk for increased depression during the early years of their children's lives.

The researchers found that during the first five years of new fatherhood the young men who were studied - who were about 25 years old at the time their children were born - had depression symptoms which increased by around 68 percent during these crucial first years of their children's lives.

Dr. Craig Garfield, who authored the study, said these results indicate that it's not just new mothers who should be screened for depression.  New fathers can be at risk too.  Since having a depressed parent or parents can have a negative effect on young children, Garfield notes that doctors need to do a better job helping both moms and dads.

Garfield says that scientists already knew that paternal depression existed and can have negative effects on children.  His team's review of the medical literature surrounding this issue reveals that fathers who are depressed are more likely to use physical punishments to discipline their children.  They are also less likely to read to them and interact with them.  As a result, the children of depressed fathers tend to have poorer language  development and more behavioral problems.  What the researchers did not know, however, was where attention should be focused to deal with this problem.

To conduct the study, the team used data that has been gathered from 10,623 men who are enrolled in the National Longitudinal Study of Adolescent Health (Add Health).  The study includes a nationally-representative sample of American adolescents and is designed to follow them over almost 20 years and they enter into young adulthood.  At each wave, their depression symptoms are scored using a well-known depression rating scale called the Center for Epidemiologic Studies Depression Scale.

During the most recent wave of the study, 33 percent of the young men, who were aged 24 to 32, had become fathers.

Of the men who had become fathers, most lived in the home with their children.  However, those who did not live with their children did not experience the same degree of worsening in their depression.  For these men, their symptoms became worse prior to fatherhood and then decreased after they became fathers.  On the other hand, those men who resided with their children had less depression before becoming fathers and more depression after.

The results of the study were published April 14, 2014 in the journal Pediatrics.

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Hypothyroidism and Depression

Sunday March 30, 2014

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.

What Is a Psychiatric-Mental Health Nurse?

Friday March 28, 2014

I thought I'd share a very informative email that I recently received from a reader.  In it, she discusses some very important treatment providers whom I have previously neglected to mention:  psychiatric-mental health nurses.  Thank you, Amy, for allowing me to share your email!

Hello Ms. Schimelpfening,

I was reading over some information contained on your depression site to find information for a research question. I actually don't have a question, but a comment. I noticed that you don't seem to discuss any type of psychiatric mental health nurses at all, even though these are individuals qualified to provide mental health services.

A psychiatric-mental health Registered Nurse is registered as a nurse with additional training and certification in providing services to this population. Clinical Nurse Specialists trained in the specialty of Psychiatric Mental Health can provide services, having obtained an advanced degree. Often they are able to provide pharmaceutical therapy (in accordance with state laws) as well as psychotherapy. Nurse Practitioners can also fall into this category. CNSs are trained at a masters level, and NPs can be trained at a masters or a doctoral level.

I am hoping that you can include these additional professionals in your information about depression and treatment providers. These individuals are trained and qualified but are largely unknown to the general public as professionals who can help. With your site being so accessible, you can help people understand they have many options for treatment and therapists.

Thank you.

Sincerely,

Amy LaValla, RN

Update: In response to my posting of Ms. LaValla's email, I also received the following feedback from Dr. Jilda Green, a licensed psychologist.  She seems to be in some disagreement with how the terminology in the original email was used; and, since I am not personally an expert in this area, I will present this information as well.

Ms. Schimelpfening:

I appreciate your attempt to include advanced nursing practitioners in your column, but would like to suggest that you get the terminology correct by speaking with the credentialing agency: ANCC (American Nursing Credentialing Committee).

Any nurse working as a psychiatric-mental health nurse fits the title you used. Now ANCC has several specialty certifications and one is a an RNC which is a basic certification for nurses (with at least a BSN) who have specialized knowledge in this field. There also was CNS certification for psychiatric-mental health nurse specialists (holding a masters degree) although they could not prescribe or diagnose officially in some states (PA being one). More and more common now are the CRNP (certified registered nurse practitioners) or Psychiatric-Mental Health Advanced Nurse Practitioner PMH-APRN (adults) and FPMH- APRN (adults and children), who can both diagnose and prescribe.

More and more of these latter two are in private practic . The advantage of advanced nurse practitioners is that they have approaches which address the entire bio-psycho-social and spiritual aspects of the persons they are working with.

Sincerely,

Dr. Jilda Green, PhD, RN

Licensed Psychologist

Spring Forward, Fall Back Into Depression?

Friday March 28, 2014

While many look forward to Daylight Saving Time and having more light at the end of the day, others, especially those with seasonal affective disorder (SAD), may find themselves slipping back into depression at this time of year.

SAD, according to experts, is caused by a disturbance in our circadian rhythm.  Light entering into the eye controls this rhythm; but, during the winter months when days are shorter we may not be exposed to sufficient light during the morning hours, throwing our circadian rhythm off-balance and creating the symptoms of SAD (depression, fatigue and a craving for sweets).

For those with SAD, the longer days of spring bring relief from depression.  The arrival of Daylight Saving Time, however, may cause a temporary return of these symptoms as you are forced to once again wake when it is still dark and may not receive adequate exposure to morning light.

The best treatment for SAD?  According to SAD researcher Dr. Michael Terman bright light therapy has the best data supporting it.  Bright light therapy involves sitting in front of a  device designed for this purpose called a light box for about 30 minutes each morning to simulate the light you would normally get by being outside in sunlight.

Do you fall into a season long slump each winter that lifts as spring approaches?  Speak with your doctor about the possibility that you may be experiencing seasonal affective disorder.

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