About Depression

Benefits of Antidepressants May Vary With Severity of Depression

2010-01-06T00:00:38Z

The benefits obtained from antidepressants may vary according to the severity of the patient's depression, says a new article appearing in the January 6, 2010 issue of JAMA, and they may provide little benefit at all for those with mild to moderate depression.

Jay C. Fournier of the University of Pennsylvania and his colleagues conducted a meta-analysis to estimate the benefit of antidepressant treatment vs. placebo across a wide range of initial symptom severity in patients with depression, combining data from six large-scale, placebo-controlled randomized trials including 718 adult patients.

The authors found that the efficacy of antidepressant treatment varied considerably and was dependent upon the severity of symptoms. True drug effects (defined as an advantage of antidepressant treatment over sham treatment with a non-drug placebo) were non-existent to negligible among patients with mild, moderate or even severe baseline symptoms. They were, however, large for patients with very severe symptoms.

"What makes our findings surprising," say the authors, "is the high level of depression symptom severity that appears to be required for clinically meaningful drug/placebo differences to emerge," especially since the majority of patients receiving antidepressant treatment appear to have depression below these levels.

Efforts should be made, the authors conclude, to clarify to clinicians and patients that whereas antidepressants can have a substantial effect for those with more severe depression, there is little evidence to suggest that they give much benefit for those with less severe depression.

Benefits of Antidepressants May Vary With Severity of Depression originally appeared on About.com Depression on Wednesday, January 6th, 2010 at 00:00:38.

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Few With Major Depression Get Adequate Treatment

2010-01-05T00:00:47Z

Many adults in the U.S. with major depression either do not receive treatment or the treatment they do receive is not adequate, according to a report in the January issue of Archives of General Psychiatry. The report further states that certain ethnic and racial groups are even less likely than other groups to receive adequate care for their depression.

Hector M. Gonzales and his colleagues at Wayne State University in Detroit analyzed data from the National Institutes of Mental Health's Collaborative Psychiatric Epidemiology Surveys, which combined three nationally representative studies. During these studies, face-to-face interviews were conducted with 15,762 adults between 2001 and 2003.

Of those surveyed, 8.3% had major depression, including 8% of Mexican Americans, 11.8% of Puerto Ricans, 7.9% Caribbean blacks, 6.7% African Americans and 8.5% non-Latino whites.

Overall, more than half of those with depression received at least one form of care, but only 21.3% of these received care that conformed with established treatment guidelines.

Mexican Americans and African Americans consistently had lower odds of receiving any type of care or care in alignment with established guidelines. Puerto Ricans and non-Latino whites, however, were twice as likely as Mexican Americans, Caribbean blacks and African Americans to use therapies that were in agreement with treatment guidelines.

According to the authors, these results point out the importance of breaking down larger ethic and racial groups into subcategories. "Failing to do so obscures depression care research, especially for the largest and fastest-growing segment of the U.S. population, Latino individuals, and especially Mexican American individuals."

"With the recent passing of a U.S. Mental Health Parity Act, our findings should provide guidance to better-enabled mental health to improve the depression care of all Americans and for reducing disparities among ethnic/racial minorities," the authors concluded.

Few With Major Depression Get Adequate Treatment originally appeared on About.com Depression on Tuesday, January 5th, 2010 at 00:00:47.

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More U.S. Patients Receive Multiple Psych Meds

2010-01-04T16:00:24Z

More and more U.S. patients are being prescribed multiple psychotropic medications - including antidepressants and antipsychotic medications - according to a report in the January issue of Archives of General Psychiatriy.

According to background information provided in the report, there is some evidence that combining different types of psychotropic medications may be beneficial for patients. For example, if a patient does not respond completely to a particular antidepressant, they may respond better if given a second antidepressant with a different mode of action.

In order to examine trends in this phenomena of prescribing multiple psychotropic medications, Ramin Mojtabai of Bloomberg School of Public Health, Johns Hopkins University and Mark Olafson of Columbia University Medical Center and the New York State Psychiatric Institute, analyzed data collected from a national sample of office-based psychiatric practices. The data included medications and combinations of medications prescribed during a total of 13.079 office visits made by adults between 1996 and 2006.

Overall, there was an increase in the number of psychotropic medications prescribed. Between 1996 to 1997 and 2005 to 2006, the percentage of visits during which two or more medications were prescribed increased from 42.6% to 59.8%. In addition, the percentage of visits during which three or more medications were prescribed rose from 16.0% to 33.2%. The median number of drugs prescribed at each visit increased from one to two.

Combinations of antidepressants with sedative-hypnotics were most common (23.1%), followed by combinations of antidepressants and antipsychotics (12.9%) and combinations of two antidepressants (12.6%).

The authors suggest that this growing trend should be curtailed because there is "scant data to support the efficacy of some of the most common medication combinations." In addition, there is growing evidence regarding the adverse effects of these combinations. For example, certain combinations have been associated with weight gain and increases in cholesterol levels.

"Prudence suggests that renewed clinical efforts should be made to limit the use of these combinations to clearly justifiable circumstances," the authors conclude.

More U.S. Patients Receive Multiple Psych Meds originally appeared on About.com Depression on Monday, January 4th, 2010 at 16:00:24.

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Bad Choices, Bad Habits

2009-12-30T00:00:45Z

A habit is any action that we have performed so often that it becomes almost an involuntary response. If we consider this habit to be undesirable then we may label it a "bad habit". People spend countless hours and dollars each year attempting to break these bad habits and often do not have any success. Why? Because there is no magic bullet. Change is hard work and there is no short cut to achieving it. The steps a person needs to take, however, can be very simply outlined. To effect a change in habits, one needs to bring the action back into the realm of consciousness and regain the ability to make choices. Read More

Bad Choices, Bad Habits originally appeared on About.com Depression on Wednesday, December 30th, 2009 at 00:00:45.

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Stop Procrastination--Now!

2009-12-29T15:19:51Z

Never do today what you can put off for tomorrow. Better yet, never put off 'til tomorrow what you can avoid altogether!

I don't know who coined these phrases, but they must have been a depressive. The symptoms that we face, such as fatigue and hopelessness, make it so easy to say to ourselves, "I'll just put this off until tomorrow when I feel better". Before we know it, that deadline is creeping up on us and we're starting to panic. What's the best way to deal with panic? Hide your head in the sand and hope it goes away! Not really, but procrastination an easy habit to fall into and as the panic mounts, so does the depression. The more depressed we get, the more we avoid reality. Read More

Stop Procrastination--Now! originally appeared on About.com Depression on Tuesday, December 29th, 2009 at 15:19:51.

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Change Your Life

2009-12-28T11:51:51Z

Are you contemplating making some changes in your life? Unfortunately, although most of us start out full of resolve and determination, we end up falling short of our goals. We know we can benefit from change in our lives, but how do we make those changes become lasting ones? Read More

Change Your Life originally appeared on About.com Depression on Monday, December 28th, 2009 at 11:51:51.

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Holiday Support Chat

2009-12-23T00:00:54Z

Feeling especially blue this time of year? A moderated chat room is open 24/7 at Depression Haven to support you. I know all of the moderators personally and give this site my highest recommendation.

Holiday Support Chat originally appeared on About.com Depression on Wednesday, December 23rd, 2009 at 00:00:54.

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Help Seniors Beat the Holiday Blues

2009-12-22T10:08:16Z

While the holidays are commonly thought of as a time of joy and celebration, they may be a time of a time of sadness and isolation for the elderly, especially if they have lost loved ones or are experiencing health or financial difficulties.

According to the American Geriatrics Society, there are some things that seniors can do combat holiday depression.

Get out and about. Ask friends and relatives for help in getting to parties and events or invite them to your home.
Volunteer. Volunteer work can lift your mood by taking your mind off your own troubles. Contact local schools, religious organizations or charities to learn about opportunities.
Don't drink too much alcohol. Alcohol is a depressant and can make you feel even worse.
Accept and express your feelings. There's nothing wrong with feeling blue. Talking about it can help you understand why you feel like you do.
Recognize the signs of depression. Symptoms of depression include sadness that doesn't pass; loss of interest or pleasure; changes in appetite or weight; sleeping more than normal; frequent crying; feeling restless or tired all the time; feeling worthless, helpless or guilty; slowed thinking and thoughts of death or suicide.
See your healthcare provider. If you are depressed, see your physician. Depression is very treatable and you do not have to suffer.

Many older people do not realize that they are depressed, however, and it may be up to friends and family to recognized the signs and encourage them to seek assistance. If you suspect that someone you know is depressed, there are some things you can do to help.

Invite them to do things with you. Invite them to go places with you and to holiday gatherings. Be aware that they may need help with transportation or special needs such as diet.
Help with holiday tasks. Offer to help them with holiday shopping and preparation for get-togethers in their own home.
Be a good listener. Encourage them to talk about how they are feeling and acknowledge that they may be going through a difficult time.
Encourage them to talk with their healthcare provider. Let them know that you are concerned about their well-being and that depression is a medical illness and nothing to be ashamed of. Offer to make an appointment for them and take them there.

You can learn more about depression in the elderly by visiting the Web site of the American Geriatrics Society's Foundation for Health in Aging.

Help Seniors Beat the Holiday Blues originally appeared on About.com Depression on Tuesday, December 22nd, 2009 at 10:08:16.

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When a White Christmas Makes You Blue

2009-12-21T00:00:19Z

One recent evening I was watching my neighbors put up a dazzling display of lights on their home. Judging by the wattage being consumed they had more Christmas spirit than anyone around. Suddenly I heard a barrage of angry shouts from the mother. The lights were malfunctioning and she was upset. I said to myself "something is definitely wrong with this picture". Although the Christmas holidays are supposed to be a time of peace, joy, and love, all too often we spend it angry, stressed, and blue. Why does this happen and how can we avoid it? I have a few tips to share that I think can help you have a much happier holiday.

When a White Christmas Makes You Blue originally appeared on About.com Depression on Monday, December 21st, 2009 at 00:00:19.

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Teen Pot Smokers More Prone to Depression, Anxiety

2009-12-19T05:36:14Z

Teenagers who smoke marijuana daily may be damaging their brains and making themselves more prone to depression and anxiety as adults, according to a new study out of McGill University.

The researchers at the University found that when adolescent and adult lab rats were exposed to the active ingredient in marijuana for 20 days, only the adolescent rats were adversely affected.

Changes observed in the rats included a decrease in a substance in the brain called serotonin, which is believed to play a role in depression. Increases in another substance called norepinephrine, which has been associated with anxiety, were also noted.

Although the study was carried out on rats, study author Gabriella Gobbi said the results could be extrapolated to humans.

The results suggest, according to Gobbi, that because the adolescent brain is still developing, it may be particularly vulnerable to chronic drug use.

Earlier research done by Gobbi found that marijuana can act as an antidepressant, but only in the short-term. If used long-term, the opposite effect occurs.

The new study appears in the latest issue of Neurobiology of Disease.

Teen Pot Smokers More Prone to Depression, Anxiety originally appeared on About.com Depression on Saturday, December 19th, 2009 at 05:36:14.

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