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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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How Do You Find Credible Health Information Online?

Friday March 28, 2014

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.

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Poll: Gender Differences in Depression

Friday March 28, 2014

Typically studies point to the fact that women will experience depression twice as often as men. Does this statistic hold true for visitors to this site? What's your gender? Click through to vote in our forum poll.

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Intimate Partner Violence Linked to Depression Symptoms

Thursday March 6, 2014

According to a new study from some Bowling Green State University researchers, teens and young adults who either fall victim to or commit what they term as "intimate partner violence" are more likely to experience increased depression symptoms.

To carry out the study into how violence within relationships might influence depression, the team examined data from the Toledo Adolescent Relationships Study.

Altogether four interviews were done, with the first being conducted in 2001.  In this first interview, the participants were aged 12 to 19.  The followup interviews were done every two years.  And, at the time of the final interview, the study participants were aged 17 to 24.

To learn about the patterns of violence in the participant's relationships, the researchers asked the participants for their own reports, including whether they were the victim or the instigator of the violence or it was mutual.  They were also asked about whether they were the victim of any earlier violence by family members or their peers.

One of the things that the researchers found during their interviews was that most did not report having a continual pattern of violence across all relationships.  It tended to be only present in one or two relationships.

The team further found that being involved in intimate partner violence, no matter whether the person was the victim or the perpetrator, was associated with increased depression symptoms.

Both men and women were affected by this depression, according to the authors.  Although generally women tend to experience more depression symptoms, intimate partner violence seems to have just as much effect on both genders.

The study authors note that while it might seem intuitive that being a victim of violence would be connected to depression, being a perpetrator of violence is also linked to worsening mental health.  The researchers suggest that this may be because the relationship has greater conflict and negativity in general.

The study authors suggest that the effects of intimate partner violence can be long-term, affecting how well people make the transition into adulthood.  It can break down a person's self-confidence and sense of self-worth, they note, affecting the life choices that they make.

They also note that repeated exposure to intimate partner violence with different partners does not appear to make depression symptoms worse.  These symptoms seems to be dependent upon the current relationship only.

The study was published in the March issue of the Journal of Health and Social Behavior (JHSB).

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Moving Out of Poor Neighbhorhood Helps Girls, Makes Boys More Depressed

Thursday March 6, 2014
A new report reveals that an anti-poverty program called "Moving to Opportunity" has yielded mixed results as far as the mental health of the children who were involved in the program.  When families were moved out of poor neighborhoods, the girls subsequently had lower rates of depression and conduct disorder.  Boys, on the other hand, had greater rates of depression, post-traumatic stress disorder and conduct disorder.

According to the study's author, Jens Ludwig, this study was a followup long-term analysis of families who participated in Moving to Opportunity.  Moving to Opportunity was a residential-mobility program sponsored by the U.S. Department of Housing and Urban Development.  It was designed to allow families to use housing vouchers in order to move out of poor areas into those with less poverty and crime.  The goal of the program was to improve both educational opportunities and economic self-sufficiency.  Altogether, HUD enrolled 4,604 low-income families from Baltimore, Boston, Chicago, Los Angeles and New York into the program, randomly assigning half of the participants to receive the vouchers.  The program was carried out between 1994 and 1998.

Ten and 15 years later, followups were conducted, making those participants who were children when the project began teenagers at the time of the followups.  The children were assessed to see how their mental health was impacted by being in the program.

The research team found that the girls who were in the program had much lower rates of depression (6.5 percent compared to 10.9 percent) and conduct disorder (0.3 percent compared to 2.9 percent) compared to the control group who had not been given housing vouchers.    The boys appeared to be affected quite differently, however.  Their rates of depression were significantly higher than the control group (7.1 percent versus 3.5 percent).  In addition, their rates of PTSD and conduct disorder were much higher (6.2 percent versus 1.9 percent and 6.4 percent versus 2.1 percent, respectively).

Ludwig says that the most surprising thing that they discovered was the size of their findings.  Not only did the move out of a high-poverty area affect girls and boys in a very different way, but the effects on the children were quite large.  He compared the effect on the boys to the type of increase in PTSD that one might see among combat veterans.  However, the decrease in depression among the girls was just as great.

"Qualitative evidence suggested these differences were due to girls profiting more than boys from moving to better neighborhoods because of sex differences in both neighborhood experiences and in the social skills needed to capitalize on new opportunities presented by their improved neighborhoods," the authors write in their report.

Ludwig believes that this study shores up the idea that scientific research is necessary in order to make informed public policy decisions.  "This work demonstrates that the effects of housing mobility interventions are more complicated than one might expect," he notes.

The study appears in the March 5, 2014 issue of the Journal of the American Medical Association.

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Cognitive Behavioral Therapy Helps Diabetes Control in Depressed Patients

Tuesday February 25, 2014

One of the most important things that people with diabetes need to do is to keep their blood sugar in good control.  Unfortunately, the symptoms of depression often make it difficult for them to comply with their doctor's recommendations.  To help these patients, a group of researchers at Massachusetts General Hospital decided to investigate the use of a cognitive behavioral therapy intervention to help with both depression as well as diabetes self-care compliance to see if it would help those with poorly-controlled diabetes.

The research team enrolled 87 adults with poorly-controlled type 2 diabetes in the study who were also suffering from clinical depression.  At the beginning of the study, these individuals met with a nurse educator to talk about goals for blood sugar monitoring.  They also met with a dietitian to discuss a plan for diet and exercise.  Finally, the spoke with a counselor to create strategies for meeting these goals.

Out of this group, 45 people were randomly selected to receive an additional intervention involving nine to 12 weeks of cognitive behavioral therapy where they worked on problem solving and mood tracking as well as discussing how well they had been meeting their treatment goals.  These sessions were tailored to the patients' needs as far as their illness.

During the year that the study was going on, all participants continue with any existing depression treatment.  If their symptoms became worse, they received a referral for additional therapy or changes in their medication regimen.

In order to track how well participants were following their diabetes treatment plan, an electronic monitoring system was used to detect when their pill bottle was opened as well as their compliance with their glucose monitoring.

Four months into the study, it was found that those receiving cognitive behavioral therapy were more successful at meeting their diabetes treatment goals.  They also exhibited better blood sugar control.  Similar success was seen at the eight- and 12-month points.

The cognitive behavioral therapy group also had faster improvement of their depression.  While both groups had similar improvement at the eight- and 12-month points, the therapy group had greater improvement in symptoms early on at the four-month assessment.

Study author Dr. Steven Safren says he is hopeful that this approach will help in other illnesses with co-existing depression as well.  He notes that it is also important to determine whether the improved blood sugar control to be gained by such an approach will bring about long-run cost savings.

Safren says that previous studies attempting to combine depression and diabetes management have had mixed results.  This particular study was an attempt to adapt an approach which had had good results in HIV/AIDS patients as far as improvement of the patients' self-management of their illness.

The study was published in the March issue of Diabetes Care.

Emotional Numbness, Suicidal Thoughts From Antidepressants More Common Than Originally Thought?

Tuesday February 25, 2014

A new study indicates that certain antidepressant side effects - such as suicidal thoughts, sexual dysfunction and emotional numbness - could actually be much more common than was once realized.

For the study, University of Liverpool researcher named John Read, surveyed 1,829 people in New Zealand who had antidepressants to treat their depression within the past five years. Each survey participant filled out a questionnaire dealing with about twenty different antidepressant side effects.  They survey also collected information about their current level of depression and asked them to discuss how they felt while using an antidepressant.

What he found was that over half of survey takers who were between the ages of 18 and 25 reported having had suicidal urges.  In addition, out of the entire sampling of people, there were a large number who reported having sexual problems (62 percent) and feeling emotionally numb (60 percent).  Other psychological effects that were commonly reported included:  "feeling not like myself" (52 percent), "reduction in positive feelings" (42 percent), "caring less about others" (39 percent) and "withdrawal effects" (55 percent).

Despite all of these negative effects, 82 percent of survey respondents did feel that the medication can helped with their depression.

Percentages for other effects included: 'feeling not like myself' (52%), 'reduction in positive feelings' (42%), 'caring less about others' (39%) and 'withdrawal effects' (55%). However, 82% reported that the drugs had helped alleviate their depression.

Read notes that while many side effects of antidepressants - like weight gain and nausea - are well-documented, the psychological effects often get ignored.  Unfortunately, they may be even more common than has previously been thought.

Read says that he feels that the medicalization of sadness has reached "bizarre levels," noting that one out of every ten people in some countries are being prescribing antidepressants each year.

Read concluded by saying that these type of psychological effects are "of major concern."  He also noted that many people are not being told about these side effects.  In addition, he said, about a third of the people taking the survey reported feel suicidal, a finding which suggests that other studies have underestimated this problem.

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