NeuroStar TMS Therapy, a Non-Drug Depres

NeuroStar TMS Therapy, a Non-Drug Depression Treatment, Demonstrates Statistically Significant Benefits on Patient-Reported Pain Outcomes http://ow.ly/jeEIE

Boost Your Satisfaction With Life By Doing A Little More Exercise

Had a bad day? Extending your normal exercise routine by a few minutes may be the solution, according to Penn State researchers, who found that people’s satisfaction with life was higher on days when they exercised more than usual.

“We found that people’s satisfaction with life was directly impacted by their daily physical activity,” said Jaclyn Maher, graduate student in kinesiology. “The findings reinforce the idea that physical activity is a health behavior with important consequences for daily well-being and should be considered when developing national policies to enhance satisfaction with life.”

The team examined the influence of physical activity on satisfaction with life among emerging adults ages 18 to 25 years because this population’s sense of well-being appears to worsen more quickly than at any other time during adulthood.

“Emerging adults are going through a lot of changes; they are leaving home for the first time and attending college or starting jobs,” said Maher. “As a result, their satisfaction with life can plummet. We decided to focus on emerging adults because they stand to benefit the most from strategies to enhance satisfaction with life.”

The researchers recruited two groups of college students at Penn State. The first group, consisting of 190 individuals, entered information into a diary every day for eight days. The second group, consisting of 63 individuals, entered information into a secure website every day for 14 days. Both groups answered questions aimed at determining participants’ satisfaction with life, physical activity and self-esteem. The personalities of all participants in the first group were assessed at the outset of the study using the Big Five Inventory short form.

For the second group (the 63 individuals who filled out questionnaires online for 14 days), the researchers wanted to further investigate whether physical activity was indeed, the cause of participants’ increased satisfaction with life rather than some other factor such as mental health, fatigue, or Body Mass Index.

“Shifts in depression, anxiety and stress would be expected to influence a person’s satisfaction with life at any given point in time,” said David Conroy, professor of kinesiology. “In addition, fatigue can be a barrier to engaging in physical activity, and a high Body Mass Index associated with being overweight may cause a person to be less satisfied in a variety of ways.”

By controlling for these variables, the researchers were able to determine that the amount of physical activity a person undertakes in a particular day directly influences his or her satisfaction with life. Specifically, the team found that by exercising just a little more than usual a person can significantly improve his or her satisfaction with life.

The results appeared online in the journal Health Psychology.

“Based on these findings, we recommend that people exercise a little longer or a little harder than usual as a way to boost satisfaction with life,” said Conroy.

Health Hero: Martha Rhodes

Martha Rhodes, a wife and mom of two grown children, had battled depression on and off since she was a teenager. In her 40s, she tried medication to help allay the debilitating symptoms. But the side effects were daunting, and after awhile, the drugs no longer worked for her.

“I had become resistant to the medication,” recalls Rhodes, a former advertising executive. “Some people just cannot tolerate the medications. I was one of them.”

Feeling increasingly depressed, she began to consume alcohol in greater and greater amounts and mixed in a few prescription medications too. In February 2009, she overdosed on a combination of Xanax® and alcohol.

“I had created the perfect storm for myself,” Rhodes recalls. “I cashed in my chips, but fortunately, I have a large family and they rescued me.”

Despite two weeks in the hospital and more treatments, she wasn’t getting better. Then, Rhodes’ sister came across an article about a little-known treatment for depression known as Transcranial Magnetic Stimulation (TMS). Neuronetics NeuroStar TMS therapy, approved in 2008, is the first (and only) therapy of its kind that has been cleared by the U.S. Food and Drug Administration (FDA). While still fairly new, as of June 2012, 418 Neurostars have been installed around the United States, and about 9,000 patients have been treated with TMS.

The non-invasive treatment, which is prescribed by a psychiatrist, uses highly focused, pulsed magnetic fields that stimulate function in particular brain regions. Only tissue that is two to three centimeters into the brain are affected. During a therapy session—which lasts for a little more than half an hour—a magnetic field is administered in short pulses to the front left part of the brain. That area, called the dorsolateral prefrontal cortex, is associated with depression. Initially, the therapy is repeated daily over four to six weeks.

Anthony Barker, MD, invented the first solid-state TMS machine in 1985 in England as he was searching for a way to map the brain areas of stroke patients. As he mapped stroke victims with the technique, the patients started to feel less depressed. Research got underway, and over time, TMS came into use to treat a variety of neuropsychiatric conditions.

After Rhodes was treated with TMS in 2010, the clouds of despair and hopelessness that had taken away her zest for life were lifted. The story of her treatment, and how she got her life back, is chronicled in an about-to-be-published book, 3,000 Pulses. In her book, Rhodes explains how the treatment helped her recover from the severe depression she lived with much of her life.

Each day for six weeks, she went for a TMS treatment. “It takes longer to get a mani-pedi than it does to have a treatment,” she said. “I didn’t have any headaches, and I didn’t feel dizzy or woozy.”

As for discomfort, Rhodes said she experienced only mild discomfort and that it stopped after a few treatments. “It felt like my brother giving me a noogie in my head,” she said. “It was like a woodpeckering in my head, and after a week, I didn’t feel it at all.”

After about 20 treatments, Rhodes says, she felt better. “I felt lighter. I started returning phone calls. I wanted to socialize again.”

Since the treatments she had in 2010, Rhodes just goes for occasional maintenance.  She also makes sure to eat a nutritious diet, get enough rest, and consciously avoid stressful situations. And she finally feels like she’s gotten her life back on track. “I have a very normal and full life, thanks to TMS,” Rhodes says.

Maternal Depression Affects Language Development in Babies

   ScienceDaily (Oct. 8, 2012) — Maternal       depression and a common class of antidepressants can alter a crucial period of language development in babies, according to a new study by researchers at the University of British Columbia, Harvard University and the Child & Family Research Institute (CFRI) at BC Children’s Hospital.

Published today in the Proceedings of the National Academy of Sciences, the study finds that treatment of maternal depression with serotonin reuptake inhibitors (SRIs) can accelerate babies’ ability to attune to the sounds and sights of their native language, while maternal depression untreated by SRIs may prolong the period of tuning.

“This study is among the first to show how maternal depression and its treatment can change the timing of language development in babies,” says Prof. Janet Werker of UBC’s Dept. of Psychology, the study’s senior author. “At this point, we do not know if accelerating or delaying these milestones in development has lasting consequences on later language acquisition, or if alternate developmental pathways exist. We aim to explore these and other important questions in future studies.”

The study followed three groups of mothers — one being treated for depression with SRIs, one with depression not taking antidepressants and one with no symptoms of depression. By measuring changes in heart rate and eye movement to sounds and video images of native and non-native languages, the researchers calculated the language development of babies at three intervals, including six and 10 months of age. Researchers also studied how the heart rates of unborn babies responded to languages at the age of 36 weeks in the uterus.

“The findings highlight the importance of environmental factors on infant development and put us in a better position to support not only optimal language development in children but also maternal well-being,” says Werker, who adds that treatment of maternal depression is crucial. “We also hope to explore more classes of antidepressants to determine if they have similar or different impacts on early childhood development.”

High resolution photos of Werker (reading to children) and co-author Tim Oberlander are available upon request.

Background

“These findings once again remind us that poor mental health during pregnancy is a major public health issue for mothers and their infants,” says co-author Dr. Tim Oberlander, a professor of developmental pediatrics at UBC and CFRI. “Non-treatment is never an option. While some infants might be at risk, others may benefit from mother’s treatment with an antidepressant during their pregnancy. At this stage we are just not sure why some but not all infants are affected in the same way. It is really important that pregnant women discuss all treatment options with their physicians or midwives.”

Previous research by Werker has found that during the first months of life, babies rapidly attune to the language sounds they hear and the sights they see (movements in the face that accompany talking) of their native languages. After this foundational period of language recognition, babies begin focusing on acquiring their native tongues and effectively ignore other languages.

The current study suggests that this key developmental period — which typically ends between the ages of eight and nine months — can be accelerated or delayed, in some cases by several months. In another recent study, Werker has found that this development period lasts longer for babies in bilingual households than in monolingual babies, particularly for the face recognition aspects of speech.

The maternal depression and language acquisition study was co-authored by UBC post-doctoral fellow Whitney Weikum at CFRI, Tim Oberlander of CFRI, UBC’s Dept. of Pediatrics and BC Children’s Hospital, and Takao Hensch, a professor of neurology at Harvard University.

This program of research was funded by agencies including the Human Frontiers Research Program (HFSP), the Canadian Institutes for Advanced Research (CIFAR), the Michael Smith Foundation, and the Canadian Institutes of Health Research (CIHR), the Social Science and Humanities Research Council of Canada (SSHRC) and the Natural Sciences and Engineering Research Council of Canada (NSERC).

Transcranial Magnetic Stimulation: Powerful integrative treatment for depression

Yet another interesting articles about Transcranial Magnetic Stimulation!!

 

(NaturalNews) With a ray of hope for those who await psychiatry’s acceptance of integrative and holistic treatments, Transcranial Magnetic Stimulation (TMS) has arrived. This MRI-strength magnetic stimulation is being used by more enlightened psychiatrists across the country to treat difficult cases of depression. I interview Philip Botkiss, MD about his experience using TMS on this week’s episode of Mental Health Exposed.

According to the Mayo Clinic: Transcranial magnetic stimulation is a procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. Transcranial Magnetic Stimulation may be tried when other depression treatments haven’t worked. 

With Transcranial Magnetic Stimulation, a large electromagnetic coil is placed against your scalp near your forehead. The electromagnet used in Transcranial Magnetic Stimulation creates electric currents that stimulate nerve cells in the region of your brain involved in mood control and depression. 

Philip Botkiss, MD, a psychiatrist practicing in San Diego, uses TMS regularly with his patients. Dr. Botkiss tells us what TMS is, how it works and the impressive yet realistic results he has seen with over 60 patients.

This information is critical for the fields of mental health and psychiatry.

As a culture we desperately need more psychiatrists to open their minds to holistic treatment options! We need to recognize and spread the word about innovators in the field like Dr. Botkiss who are leading the way toward true integrative medicine for mental health patients. Please download this episode, listen and share it with your friends. You never know whose life you may be changing – or saving.

Depression is serious.

Thousands of people with moderate to severe depression are in need of alternatives to the conventional psychiatric approach, which involves medication and even extreme measures like electro-convulsive therapy. Practitioners such as Dr. Botkiss need to be recognized.

Dr. Botkiss also embraces and practices conventional psychiatry, which makes this episode even more interesting, as I take the opportunity to ask him how he justifies treatment like ECT.

Learn more: http://www.naturalnews.com/036333_magnetic_stimulation_depression_treatment.html#ixzz28pOD30W6

Neurostar TMS Therapy for Treatment of Depression – Patient Education Video

 

Before reviewing, please note below the FDA-cleared indication for use and clinical trials data for NeuroStar TMS Therapy.

NeuroStar TMS Therapy is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode.

Efficacy for NeuroStar TMS Therapy was established in a controlled clinical trial comparing active treatment with the NeuroStar TMS Therapy system to an inactive device. Patients treated with active NeuroStar TMS Therapy received an average reduction in their depression symptom score of 22.1% compared to a 9% average reduction in patients receiving inactive treatment.

NeuroStar TMS Therapy has not been studied in patients who have not received prior antidepressant treatment. Its effectiveness has also not been established in patients who have failed to receive benefit from two or more prior antidepressant medications at minimal effective dose and duration in the current episode.

The most common side effect associated with treatment is scalp pain or discomfort at or near the treatment site – generally mild to moderate. There is a rare risk of seizure with TMS Therapy.

NeuroStar TMS Therapy is available by prescription only.

Tracking Mental Illness Among Qataris

Mental disorders are widely recognized as a major contributor to the burden of disease worldwide. In most countries, over a third of the population report sufficient criteria to be diagnosed with mental illness at some point in their life, and many people suffer from more than one mental disorder at a given time. But until now Qatar lacked a comprehensive study on the prevalence of mental disorders in the general population, despite evidence that outpatient visits to Hamad Hospital’s psychiatry unit have increased considerably over the last 10 years. A recently completed study, conducted with a US $258,000, two-year grant from QNRF, provides the first systematic look at the prevalence of common mental disorders among Qataris and identifies high risk groups in the Qatari population.

Researchers from Hamad Medical Corporation, Weill Cornell Medical College in Qatar, and the University of London found the overall prevalence of mental disorders in Qatari patients attending primary health care centers was 36.6%, which is consistent with other clinical and epidemiological surveys. According to World Health Organization estimates, nearly 25% of individuals develop one or more mental disorders at some stage in their life.

Of the studied subjects, 46.2% were males and 53.8% were females, making the female to male sex ratio 1.3:1. The most prevalent mental disorder in the Qatari population was depression (13.5%), followed by anxiety disorders (10.3%), personality disorders (7.5%) and phobia (7.3%). Phobia (p<0.001), bipolar disorder (p=0.032), and obsessive compulsive disorder (p=0.018) were significantly more prevalent among women, but schizophrenia (p=0.004) and dementia (p=0.016) were markedly higher in men. The most common mental disorders in the Qatari population — anxiety and depression — were found more frequently in the age group 18 to 34 years (43.3% and 42.9%), followed by 35-49 years (40.9% and 42.4%). The finding of a peak age for depression and anxiety disorders in midlife is in keeping with other epidemiological findings in Western countries.

The researchers who conducted the study were: Dr. Suhaila Ghuloum of Hamad Medical Corporation; Abdulbari Bener of Hamad Medical Corporation, Weill Cornell Medical College in Qatar, and The University of Manchester; and Mohammed T. Abou-Saleh of the University of London. The cross sectional study included Qatari patients aged 18 to 65 years who attended primary health care centers throughout Qatar — nine centers from urban areas and three centers from semi-urban areas — as a representative sample of the community. Qualified nurses were trained to interview the patients and complete the questionnaires. A total of 2,080 Qatari patients were approached and 1,660 patients agreed to participate in the study, with a response rate of 79.8%. The survey instrument was tested on 100 patients who visited the health centers, and subsequently validated. The questionnaire had three parts. The first part included the socio-demographic details of participants and the second part the medical and family history. The third part was the diagnostic screening questionnaire, which consisted of 79 questions about symptoms and signs of various common mental disorders.

Mental disorders are among the most burdensome of all classes of disorders because of their high prevalence and chronicity, early age of onset and possibility of functional impairment. The study findings highlight the urgent need for systematic development of community-based mental health services for the screening, early identification, and treatment of people suffering from mental disorders.

Proposal No.: NPRP 30-6-7-38
Table 1: Prevalence of Mental Disorders among studied Qatari subjects according to gender (N=1660)

Variables	Total n=1660 n (%)	Male n=767 n (%)	Female n=893 n (%)	P value
Depression	224(13.5)	105(13.7)	119(13.3)	0.829
Anxiety disorder	171(10.3)	74(9.6)	97(10.9)	0.417
Personality disorder	124(7.5)	65(8.5)	59(6.6)	0.149
Phobia	121(7.3)	8(1.0)	113(12.7)	<0.001
Bipolar disorder	71(4.3)	24(3.1)	47(5.3)	0.032
Schizophrenia	59(3.6)	38(5.0)	21(2.4)	0.004
Obsessive compulsive disorder	58(3.5)	18(2.3)	40(4.5)	0.018
Dementia	19(1.1)	14(1.8)	5(0.6)	0.016
Alcohol abuse	18(1.1)	14(1.8)	4(0.4)	0.008
Drug abuse	34(2.0)	14(1.8)	20(2.2)	0.605

Table 2: Socio-demographic characteristics of the studied Qatari subjects by gender (N=1660)

Variables		Total  n=1660 n (%)	Male  n=767 n (%)	Female  n=893 n (%)	P value
Age in yrs (mean � sd)		38.0 � 12.1	40.6 � 12.8	35.8� 11.0	0.000
Age Group
	18-34 Years	707 (42.6)	276 (36.0)	431 (48.3)
	35-49 Years	656 (39.5)	301 (39.2)	355 (39.8)	<0.001
	50-64 Years	245 (14.8)	152 (19.8)	93 (10.4)
	65+ Years	52 (3.1)	38 (5.0)	14 (1.6)
Marital status
	Single	298 (18.0)	171 (22.3)	127 (14.2)
	Married	1270 (76.5)	549 (71.6)	721 (80.7)	<0.001
	Divorced	69 (4.2)	38 (5.0)	31 (3.5)
	Widow	23 (1.4)	9 (1.2)	14 (1.6)
Educational level
	Illiterate	111 (6.7)	41 (5.3)	70 (7.8)
	Primary	141 (8.5)	81 (10.6)	60 (6.7)
	Intermediate	214 (12.9)	122 (15.9)	92 (10.3)	<0.001
	Secondary	591 (35.6)	283 (36.9)	308 (34.5)
	University	603 (36.3)	240 (31.3)	363 (40.6)
Occupation
	Not working	535 (32.2)	81 (10.6)	454 (50.8)
	Sedentary/Professional	717 (43.2)	360 (46.9)	356 (40.0)
	Manual	175 (10.5)	138 (18.0)	37 (4.1)	<0.001
	Business man	92 (5.5)	73 (9.5)	19 (2.1)
	Army/Police	141 (8.5)	115 (15.0)	26 (2.9)
Household income per month (QR)
	<5,000	113 (6.8)	41 (5.3)	72 (8.1)
	5,000-9,999	537 (32.3)	309 (40.3)	228 (25.5)
	10,000-14,999	455 (27.4)	223 (29.1)	232 (26.0)	<0.001
	>15,000	555 (33.4)	194 (25.3)	361 (40.4)
Number of bedrooms (mean�sd)		4.7 � 2.0	4.4 � 1.9	5.0 � 2	<0.001
Number of people living in house(mean � sd)		6.2 � 3.0	6.2 � 2.7	6.2 � 3.3	0.716
Consanguinity
	Yes	620 (37.3)	306 (39.9)	314 (35.2)	0.047
	No	1040 (62.7)	461 (60.1)	579 (64.8)

Courtesy: Qatar National Research Fund

‘Social stigma deterrent for Arab women seeking treatment for emotional issues’

DUBAI: According to the World Health Organisation (WHO), depression in the UAE is the second leading contributor to poor health and shorter lifespan among people between the ages of 15 and 44.

Experts at the upcoming Obs-Gyne Exhibition & Congress, taking place from April 1-3 at the Dubai International Convention & Exhibition Centre, will discuss this issue of depression among women in the Middle East, as well as appropriate screening and treatment methods for this health concern.

For the second year, Informa Exhibitions is partnering with the Arab Association of Obstetrics & Gynaecology Societies (AAOGS) drawing more than 100 regional and international speakers from around the world.

According to Dr Saliha Afridi, clinical psychologist and MD at The LightHouse Arabia, and speaker at the Obs-Gyne Exhibition & Congress, the ‘social stigma’ associated with going to see a mental health professional still acts as a strong deterrent for women seeking treatment for their emotional issues.

“The Arab and Asian world is very private with religion playing a strong mediating role in coping with mental health issues. For some, it is not considered to be acceptable to discuss family problems with an ‘outsider’.

“Women will often go to primary care physicians to report psychosomatic symptoms who will then refer them to psychiatrists or psychologists as it is much easier and more socially acceptable to admit that there is something wrong with the body than it is to admit that they need help coping with depression,” says Dr Afridi.

Lack of awareness is the main reason why women in the Arab world do not seek appropriate treatment for symptoms of depression.

“Many women are unaware of the different ways that depression can present itself, and, being away from their support systems can often leave them alone to cope with life’s challenges.

Stress is also a major issue trigger as women try to adhere to traditional gender definitions while juggling the high demands of family, work, and social responsibilities,” Dr Afridi explains.

According to Dr Afridi, prescribing antidepressants is only an effective form of treatment when the individual is treated holistically.

“Antidepressants may alleviate the symptoms of depression; however, they will not treat the life choices and patterns that the person is involved in that resulted in the depression.

“Emotional health is very important as the patient must learn how to heal their wounds, learn their relational style, achieve work-life balance, know what their impact is on those around them, take accountability for their role in their depression, and feel empowered to make life changes,” she explains.

Courtesy : Gulf Today

Education and Treatment key to preventing suicide

A string of expat suicides in the United Arab Emirates in 2011 has been cause for concern.

A recent spate of suicides in the United Arab Emirates has brought the issue to the forefront of residents’ minds, as incidents involving both UAE nationals and expatriates in recent weeks have proven that many communities are affected.

In one high-profile case, police found Indian expatriate Dubai resident Sreesha Nambiar, 29, in a bathroom of her family’s apartment in Bur Dubai with slit wrists. Her daughter, Avantika, had been suffocated and her husband hanged himself shortly after the 6-year-old had been killed, according to police reports.
A police official, Khalid Ismail, said: “We are treating this as a suicide, and at this initial stage there are no criminal suspicions because of the father’s note.”

The case has been referred to Public Prosecution, and the mother will face charges of attempted suicide. She could face murder charges if she is found to have suffocated her daughter.

Although decriminalized in many parts of the world, suicide remains a crime in many Arab states. The manner in which UAE law deals with suicide, both considered and attempted, perpetuates the problem. The crime is punishable by a short prison sentence, a Dh5,000 fine, or both.
Meanwhile, doctors who seek to treat patients who have threatened or attempted suicide must inform the authorities or face prosecution for, in essence, aiding and abetting the victim. And in doing so they breach doctor-patient confidentiality.

Anecdotes of people considering suicide being turned away by medical professionals for fear of punishment are becoming more and more common, and doctors and other medical professionals who have long criticized the fact that discussions about suicide and its causes are discouraged, increasing calls for greater safeguards and support for mental health patients.

According to statistics cited in the International Journal of Social Psychiatry, in 2011, seven times as many foreigners committed suicide in the UAE than did UAE citizens.

Of those, three-quarters were Indian nationals. According to figures released by the Indian consulate published in The National, about 100 Indian expatriates committed suicide in the UAE in 2011.

Statistics show suicides are increasingly prevalent among professional married men, debunking the lower-class single laborer stereotype as the main population affected by the issue.

The article reiterated a call from 2000 for “public education on risk factors for suicide (i.e. depression, substance abuse, previous suicide attempt) and about where to obtain help in suicidal crisis (i.e. hotlines).”

According to Dr. Yousef Abou Allaban, the medical director of the American Center for Psychiatry and Neurology in Abu Dhabi, the Middle East is “way behind in addressing such a sensitive issue.”

He said the lack of resources and awareness available to both mental health professionals and victims leads to unnecessary loss of life that could be saved through greater education within the community and wider availability of treatment.

Dr. Justin Thomas, an assistant professor of psychology at Zayed University, explained that in raising awareness of suicide, there is a danger of encouraging copycats.

However, what does need to be understood is “what to look for, in terms of depression, in your child or your spouse” and other risk factors associated with suicide.

Experts stress, however, that raising awareness about depression and conditions that could potentially lead to suicide is not a solution in and of itself.

According to Dr. Thomas, raising awareness “raises dissatisfaction and anxiety.” It is only through the two-pronged approach of raising awareness and having mechanisms in place “to deal with the potential demand that awareness could create and focusing on healthy psychologies” that suicide can be prevented.

He said there needs to be greater “awareness about what you can do to stay psychologically healthy,” and an effort to promote resilience and emotional intelligence to provide people with coping mechanisms to deal with stress, depression, anxiety and other such conditions.

According to mental health professionals, the issue of suicide must be dealt with through a joint effort of the government, religious community, and the media; each sector must educate and inform the population, joining forces to promote a greater understanding of the issue and its causes and effects.

One such method is “mindfulness”, currently being tested in schools in Australia, Canada and the UK. Dr. Thomas said that the 4-week course helps children understand that “negative moods and emotions do pass” and teaches them “to be able to relate in a less destructive way to negative emotion” and develop the skills they need to deal with difficult periods in life. Using this approach avoids the negative discussion surrounding suicide and its associated risk factors. According to Thomas, mindfulness training has cut the relapse rate for depression by 50 percent.

There is still much to be done for mental health concerns and its myriad effects, including suicide, for the issues to be effectively tackled in the United Arab Emirates. The growing number of students seeking education and training in psychiatry and clinical psychology in the country is a positive barometer of the wider audience seeking to make a difference in this field.

Ultimately, a psychologically healthier workforce will contribute to wealth creation and productivity in the country.

 

By NIAMH MCBURNEY

FOR AL ARABIYA

Depression stalks Emirati students

ABU DHABI // Nearly one in four Emirati university students may suffer from depression, a rate at the upper end of global levels, a new study shows. The two-year research project was meant to find links between thinking patterns and depression to better prevent the condition.

But while studying 450 students at Zayed University, researchers also found a “surprisingly high” rate of depression. The study found that 20 per cent of the students were likely to be suffering from “moderate” depression and three per cent showed “severe” depressive symptoms. “The results were very surprising,” said Dr Justin Thomas, an assistant professor for natural science and public health at the university, who led the study.

“Initially I had to go back to the literature because I thought, ‘This is just too high’.” Rates for depression globally range from about 1.5 per cent of the population in Taiwan to about 20 per cent in the US. Most of those surveyed in the study by Dr Thomas were under 25, the average age of onset for depression. The expectation was that the rate of depression among the students would be lower than was found, he said.

However, recent surveys in the region have also show a high prevalence of the condition. A study in Kuwait, published late last year, found 10 per cent of university students were severely depressed and 14 per cent moderately depressed. A study of Emiratis over the age of 60 published in 2004 found a depression rate of about 20 per cent. Dr Thomas said the cause of the high depression rate in the Gulf may be due to “cultural transition” and the upheavals caused by rapid development.

“I expected the UAE to be nearer the middle of the global range,” he said. “But when there’s change there’s always loss, and the rate of depression is linked to loss. In this case it may be a loss of connection to family, to tradition, to how things used to be. That’s one theory.” That theory gets some support from a survey conducted among elderly Emiratis which split the results geographically. In Dubai, the rate of depression was found to be 29 per cent, far higher than in Al Ain and Ras al Khaimah, where rates of development have been gentler.

Another unexpected result of the study was that the results were similar across gender lines; globally, rates of depression among women are usually higher. Dr Thomas said that Zayed University women might be a “biased sample” because of a sense of achievement in having reached the university. “One of the reasons hypothesised is that if in the society historically there have been limited opportunities for women to go to university, women that make it will be relatively more psychologically healthy,” he said.

The purpose of the survey was to discover if certain “thinking styles” could predict depression. Those with “dysfunctional attitudes” such as closely tying their self-worth to achievement and acceptance from others or those who respond to sadness by focusing attention on the cause of the mood, are “powerfully” linked to higher instances of depression, the research showed. Dr Thomas said because of the correlation between dysfunctional attitudes and depression, “you can identify people who think in this way” and categorise them as at-risk. “This means you can focus on prevention rather than curing depression,” he said. “The way in which people think can be changed.”

Dr Thomas argued that it was important for educators to work with the health sector to ensure young people developed healthy “thinking styles” and prevent mental illness. The Ministry of Health recently began a study to isolate psychological problems suffered by teenagers in schools. Psychologists are increasingly looking at preventive measures because the World Health Organisation predicts that by 2020 depression will be the second-leading disability-causing disease in the world.

Delegates at a mental-health conference in Dubai in June announced that 75 per cent of mental illness in the UAE is linked to depression and anxiety.

TYPES OF Depression:

TYPES OF Depression:

Depression Types
All depression types are not the same. Learn about the different types of depression, the signs and symptoms, and talk to your doctor about treatment.

Major Depression
Read about the causes and symptoms of major depression and the available treatments. Talk openly with your doctor if you have these major depression symptoms because help is available.

Chronic Depression (Dysthymia)
Chronic depression or dysthymia is a milder form of depression that affects millions. Find out if you or a loved one has chronic depression.

Atypical Depression
Many people with depression don’t have the typical symptoms. Learn about the causes and treatment of atypical depression, with symptoms that include weight gain, sleeping too much, and feeling anxious.
Postpartum Depression
Postpartum depression is increasingly common. Discover the signs and symptoms of postpartum depression and seek early medical treatment to keep it from affecting your life.

Bipolar Depression (Manic Depression)
Learn all about the mood swings of bipolar depression (manic depression) from the elated highs of mania to the major depression lows.

Seasonal Depression (SAD)
Do you get depressed during certain times of the year? Learn when seasonal affective disorder is most likely to affect people and what your doctor can do to help you manage the symptoms.

Psychotic Depression
Learn all about psychotic depression — psychosis, hallucinations, and other signs — and know when to call the doctor for a medical evaluation.

3000 Pulses: Surviving Depression with TMS

“As a senior-level New York advertising executive for 25 years living

what appeared to be a perfect life, no one could have been more surprised than I to land in a psychiatric ward after a suicide attempt. 3,000 Pulses is a memoir about my struggle with depression, ineffective medications, and my remarkable recovery with Transcranial Magnetic Stimulation therapy. It works. I’m alive, happy, and I’m here to tell the story.”

Patient Advocate Martha Rhodes wrote 3,000 Pulses: Surviving Depression with TMS with contributions by Randy Ian Pardell, MD DFAPA, to help the millions who suffer from depression find a safe, medication-free therapy that has no side effects. Rhodes and Pardell have been featured on ABC TV, Fox News, YNN, and The Daily Buzz.

 

 

 

 

 

Check out the Excerpt on the following  link : http://www.3000pulses.com/3000pulses.com/Excerpt_from_3,000_Pulses.html

Its a must Read!!!

Postpartum Depression Treatment With and Without Medications

Believe it or not, postpartum depression or post pregnancy depression is pretty common. While the abundant joy of welcoming a new baby into the world is wonderful, sometimes the mental anguish that comes with it can be debilitating. This feeling can last for weeks or months and can be treated with medication, counseling, and lifestyle changes. Coping with depression doesn’t have to be something you need to do on your own, and you will need a good, strong support system to help you through. Postpartum depression treatment is multi faceted, and without all the pieces coming together, you could be in for an uphill climb. Attacking anxiety and depression head on is the best way to rid yourself of the baby blues.

Talk to your doctor about antidepressants. They are commonly used for postpartum depression treatment, and although they enter the breast milk, most are associated with little risk while you are nursing. If your doctor prescribes medication for you, it’s important to take it as prescribed and for as long as recommended. Your doctor will help you to weigh the risks associated with taking antidepressants.

In conjunction with medical intervention, make sure that your lifestyle is conducive to promoting wellness. The sleep deprivation depression link cannot be stressed enough, and while having a newborn may make for many sleepless nights, work with your partner and helping hands to ensure that you are getting enough winks overnight. Postpartum depression treatment is nearly impossible without you taking care of yourself inside and out. Taking care of yourself also includes making sure that you are allowing for enough “you” time, and not making yourself crazy trying to take on too much or not ask for help when you need it. Additionally, make sure that your diet is working in your favor and not against you. High fat and high sugar foods might make you feel great when you’re horking them down, but long term, they will do little to benefit your mind, body or soul.

Natural depression remedies including St. John’s Wort and Omega 3 fatty acids can help boost your mood and are readily available. However, it’s important to discuss any supplements or vitamins that you are taking with your health care provider, especially if you are taking antidepressants to ensure that you are not taking anything that might interfere with your medications.

Postpartum depression treatment is a combination of many things all working together to help you in time have a more positive outlook and ability to look at each day in a new way. Combining counseling, medication, and lifestyle changes, you will be well on your way to feeling like your old self, which is a great thing because you now have someone very small who is going to demand a lot of the new you!

TMS therapy is very beneficial in the treatment of postpartum treatment. Its drug free and delivers a very focused magnetic pulses to the mood center of the brain. Thus it helps in avoiding any kind of adverse effects on the baby!!

Heavy Drinking Rewires Brain, Increasing Susceptibility to Anxiety Problems

ScienceDaily (Sep. 2, 2012) —

Doctors have long recognized a link between alcoholism and anxiety disorders such as post-traumatic stress disorder (PTSD). Those who drink heavily are at increased risk for traumatic events like car accidents and domestic violence, but that only partially explains the connection. New research using mice reveals heavy alcohol use actually rewires brain circuitry, making it harder for alcoholics to recover psychologically following a traumatic experience.

“There’s a whole spectrum to how people react to a traumatic event,” said study author Thomas Kash, PhD, assistant professor of pharmacology at the University of North Carolina School of Medicine. “It’s the recovery that we’re looking at — the ability to say ‘this is not dangerous anymore.’ Basically, our research shows that chronic exposure to alcohol can cause a deficit with regard to how our cognitive brain centers control our emotional brain centers.”

The study, which was published online on Sept. 2, 2012 by the journal Nature Neuroscience, was conducted by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and UNC’s Bowles Center for Alcohol Studies.

“A history of heavy alcohol abuse could impair a critical mechanism for recovering from a trauma, and in doing so put people at greater risk for PTSD,” said NIAAA scientist Andrew Holmes, PhD, the study’s senior author. “The next step will be to test whether our preclinical findings translate to patients currently suffering from comorbid PTSD and alcohol abuse. If it does, then this could lead to new thinking about how we can better treat these serious medical conditions.”

Over the course of a month, the researchers gave one group of mice doses of alcohol equivalent to double the legal driving limit in humans. A second group of mice was given no alcohol. The team then used mild electric shocks to train all the mice to fear the sound of a brief tone.

When the tone was repeatedly played without the accompanying electric shock, the mice with no alcohol exposure gradually stopped fearing it. The mice with chronic alcohol exposure, on the other hand, froze in place each time the tone was played, even long after the electric shocks had stopped.

The pattern is similar to what is seen in patients with PTSD, who have trouble overcoming fear even when they are no longer in a dangerous situation.

The researchers traced the effect to differences in the neural circuitry of the alcohol-exposed mice. Comparing the brains of the mice, researchers noticed nerve cells in the prefrontal cortex of the alcohol-exposed mice actually had a different shape than those of the other mice. In addition, the activity of a key receptor, NMDA, was suppressed in the mice given heavy doses of alcohol.

Holmes said the findings are valuable because they pinpoint exactly where alcohol causes damage that leads to problems overcoming fear. “We’re not only seeing that alcohol has detrimental effects on a clinically important emotional process, but we’re able to offer some insight into how alcohol might do so by disrupting the functioning of some very specific brain circuits,” said Holmes.

Understanding the relationship between alcohol and anxiety at the molecular level could offer new possibilities for developing drugs to help patients with anxiety disorders who also have a history of heavy alcohol use. “This study is exciting because it gives us a specific molecule to look at in a specific brain region, thus opening the door to discovering new methods to treat these disorders,” said Kash.

Study co-authors include Kristen Pleil, Chia Li and Catherine Marcinkiewcz of UNC and Paul Fitzgerald, Kathryn MacPherson, Lauren DeBrouse, Giovanni Colacicco, Shaun Flynn, Sophie Masneuf, Ozge Gunduz-Cinar and Marguerite Camp of NIAAA.

Video: Study Reports TMS Therapy Helps Patients With MDD

By Laurie Martin, Web Editor | May 16, 2012

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In a scientific poster presented at last week’s American Psychiatric Association (APA) meeting, new data show that patients with unipolar, non-psychotic major depressive disorder (MDD) receiving transcranial magnetic stimulation (TMS) achieved significant improvements in both depression symptoms and in quality of life measurements.¹

In an open label study of 307 participants receiving acute TMS over an average period of 5 weeks, 58% had a positive response, with 37% achieving remission from their depression. Researchers reported the most noteworthy improvement was seen in the mental component summary score measured by the Short Form 36-Item Questionnaire (SF-36). Neurostar TMS^®—the only FDA-approved TMS device—was used in the study. It is currently being studied in the treatment of postpartum depression, PTSD, OCD, and schizophrenia.

Here, Ian A. Cook, MD, an investigator in the study, briefly explains the findings. Dr Cook is Professor of Psychiatry at the Semel Institute for Neuroscience and Human Behavior at the University of California, Los Angeles.

75 % of mental illness cases in UAE are linked to depression and anxiety, reveals mental health conference

 

The recently concluded Mental Health Conference in Dubai revealed      that the average patient’s spend on mental illness treatment in the UAE exceeds Dhs20,000 per annum, with 55% of patients denying that they are ill.

It also emphasized that poor compliance leads to failed medical treatment and drug-resistant conditions.The conference, attended by patients, doctors, nurses, psychologists, social workers and members of the public, said that stigma was the first reason that prevented patients from seeking diagnosis and treatment.

It also urged people who feel the symptoms of mental illness to see a doctor, adding that while there is inadequate health insurance coverage of mental illnesses in the UAE, the treatment fees and medicines are supported by the government in local hospitals where it is free for locals and almost negligible for expatriates.

The conference, organized by AstraZeneca, revealed that 75% of the cases were linked to depression and anxiety.

Dr Bahjat Balbous, Specialist Psychiatrist, Al Amal Hospital, Dubai said:

“There are only 180 specialist psychiatrists working in the UAE. Only 10% of them are doctors know how to use hypnosis in treating patients for critical cases. Global percentages for schizophrenia are 1%, and the UAE is not far away from this percentage.”

Dr. Khalid Shirazy, Medical & Regulatory Manager, AstraZeneca Gulf added, “The major issues that face mental illness disease in the UAE includes how well patients are on drug compliance and how well a patient follows the instructions for taking the medication.”

Dr Shirazy said, “We must raise awareness of the several mental and physiological illnesses among the community. With all the pressures and the fast pace of life that the Gulf community is being subjected to, no one is immune from these illness.”

The existing strategies used for treating mental illness are still limited, in particular in the Arab world, the conference pointed out.

Dr Balbous added, “The lack of understanding by patients about the chronicity of mental illness and the need to take the medication as well as the stigma attached mental illness results in late diagnosis. This puts on us all the responsibility to put extra efforts in fighting mental illness diseases.”

A UK expatriate patient talked about his personal experience and how compliance of treatment had produced good results and helped him complete his education and pursue career growth.

Praising the expatriate patient speaking out at the conference, Dr Shirazy added that addressing public events could motivate others facing similar challenges to come out in the open.

Dr Balbous added, “Stigma is a real barrier to cure people who have a mental illness. It is by definition a negative judgment based on a personal trait. It was once a common perception that having a mental illness is dangerous. It is something we need to eliminate from the patients mind and the surrounding mind as well.”

Dr Shirazy added, “Having a mental illness doesn’t mean that someone is violent or dangerous This can lead to feelings of anger, frustration, shame and low self-esteem as well as discrimination at work, school and in other areas of the patients life which will lead that he will hide his mental illness or illness denial or treatment refusal.”

“The conference urged the outside world to treat a mentally ill people with understanding and support. We shouldn’t say that someone is bipolar rather that he has a bipolar disorder,” Dr Balbous argued.

“While the government is helping a lot, we need to increase the number of non profit agencies and programs support people who have mental health conditions,” the conference pointed out.

Dr Mona Issa Jakka, Specialist Psychiatrist, Obeid Allah Hospital, RAK, said:

“Similar to other chronic diseases such as Diabetes or Asthma, mental health disorders can be controlled and managed by early visits to a psychiatry clinic and seek treatment. Treatment helps patients to re-enjoy their family life, work and social activities. Therefore, relapse and progression of mental health disorders could be prevented by regular follow up with the psychiatrist and maintaining on taking the medication properly and continuously.”

Depression Therapy: TMS

By Linda Mays – bio | email

Birmingham, AL –

Promising news for the millions of Americans who suffer from major depression.  A remarkable new medical technology is now considered second line therapy for treating major depression.  Linda Mays reports, this is an alternative treatment when medication is not quite enough.

This image of the brain of someone who’s battling major depression shows less activity than the non-depression brain image.  Experts say major depression is a brain disease.

Dr. Paul Weir, a psychiatrist and psychoanalyst says, “Major depression is a specific form of depression. It’s an illness that’s very severe and lasts for long period of time. And there are certain signs and symptoms. Lack of zest for life, lack of interest in life. heir enthusiasm for relationships work for their hobbies sort of fade away.”

Dr. Weir offers the latest technology to treat major depression.   It is called the Neurostar TMS Therapy system.  It delivers Transcranial Magnetic Stimulation.

Weir says, “TMS is a magnetic pulse. It’s a series of magnetic pulses that delivered to executive centers of the brain. This is the left side. It makes the cells in that area of the brain wake up as it fires 3,000 times per treatment.”

Bryan Olson says he’s fought depression for a number of years with the help of therapist and anti-depressants.

Olson says, “I’ve always been functional I’m not someone who had trouble getting out of bed, working or holding down a job. That’s not me.”

Olson adds, “I could see that other people were reacting and feeling in ways I wasn’t and there was something missing, something more wrong with once that wasn’t to going to be cured by people saying hey just snap out it.”

Olson is one of several people who decided to undergo TMS therapy.

During the 40 minute treatment a small magnetic coil on the scalp targets the precise location in the brain that controls mood.

The staff and the patient wear earplugs to reduce the magnet’s knocking sound during treatment.

Olson says, “The way I ‘ve described it to people, It’s like putting on a baseball helmet and putting on a hard hat and have someone tap on the helmet while its hitting, it takes a little getting used to.”

Recommended TMS treatment is five days a week for four to six weeks.  The sessions are closely monitored.  In fact, the patient completes a self inventory of their depression symptoms weekly.

Bryan Olson’s report at the end of his TMS treatment in early March this year indicates an improvement.  Olson says, “Dr Weir helped, medication helped but, after I had TMS even a week I really felt that negative ball was gone.  I wasn’t wrestling with extra inexplicable negative part in my personality.”   Olson says he feels better and so far, the improvement continues and it’s been a few months now.

Possible side effects of TMS may include– pain at the treatment site or a headache that can be alleviated with an over the counter pain reliever.

TMS is FDA-cleared and is included in the American Psychiatric Association’s depression treatment guidelines.  Tests have shown that TMS therapy helps improve depression symptoms and in some cases patients experience remission.  Dr. Weir says, it’s a treatment and not a cure because depression is a recurring illness.  Dr. Weir’s practice is one of two sites with the TMS therapy in our area.

Magnetic Depression Treatment ‘gave me my life back’

TMS experience narrated by patient who has lived with depression for decades!! Check out the video

DENVER – For too many years to count, Terri Diem has lived with depression. Despite decades of treatment and countless courses of antidepressants, nothing ever seemed to cure Diem’s depression.

“It just never worked very well,” Diem said. “And as I am sure you can imagine, that perpetuated the depression.”

Two years ago, Diem began treatment with Dr. Daniela Stamatoiu, who determined Diem had treatment resistant depression. After even more treatment failed to garner positive results, Stamatoiu suggested a new type of therapy approved in October 2008 called transcranial magnetic stimulation, or TMS.

The NeuroStar TMS therapy system sends a series of magnetic pulses at the left, pre-frontal cortex of the brain. Psychiatrists believe this is an area where neurons need to be in balance for depression to subside. The treatment depolarizes neurons, which then discharge an action potential. In other words, brain cells needed to stave off depressive symptoms begin functioning again as they should in a patient without depression.

Patients sit in a chair resembling something you would see in the dentist’s office. A hovering hood is placed over the left side of a patient’s head before therapy begins. Treatment consists of a series of hundreds of magnetic pulses, which ‘click’ at rapid fire every minute.

The treatment is non-invasive, and patients can watch a movie or chat with the doctor or an assistant during the hour or so of treatment.

After several months of treatment, Diem says she began seeing a remarkable improvement in her own demeanor, beginning with a greater interest in doing things outside of the shrinking “bubble” felt depression had established around her.

The value of that, she says, is priceless.

“The best way I can describe it is clarity. I have a lot more energy, I enjoy things now, I’m taking on new hobbies,” Diem said. “Eventually, I realized I had a much more positive outlook on life.”

Stamatoiu believes Diem’s case is proof that the treatment works and can change lives.

“It’s what makes our profession so rewarding,” Stamatoiu said, “as we’re seeing them through the hard times and into the good times. We build significant relationships with our patients. If there’s a chance that this can, at the very least, add back another layer of who they are, then it’s worth it.”

A full course of treatment costs patients between $8,000 and $12,000, with each session costing about $400. Since the therapy system is relatively new, it is still quite expensive and not covered by many insurance plans.

Psychiatrists who advocate for the system argue that while expensive, the system actually is more effective in treating otherwise untreatable depression. Furthermore, the average cost of depression between medication and therapy ($26,000) is far greater than the $12,000 cost for a regiment of TMS.

Finally, psychiatrists argue the cost of treatment resistant depression averages about $45,000, so a potential treatment that reverses that could make the TMS treatment even more valuable than its sticker cost would suggest.

Treatments for Depression

Depression is most often treated with psychotherapy (talk-therapy) and antidepressant medications administered together. Although antidepressants can be effective for many patients, they do not work for everybody. Additionally, since antidepressants are typically taken by mouth, they circulate in the bloodstream throughout the body, often resulting in unwanted side effects.

More than 4 million patients do not receive adequate benefit from antidepressant medications and/or cannot tolerate the side effects caused by them. For these patients, non-drug treatments are available. Some of these treatments include: electroconvulsive therapy (ECT), vagus nerve stimulation (VNS) and transcranial magnetic stimulation

Medications:

A number of antidepressant medications are available to treat depression. There are several different types of antidepressants. Antidepressants are generally categorized by how they affect the naturally occurring chemicals in your brain to change your mood.

Types of antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs). Many doctors start depression treatment by prescribing an SSRI. These medications are safer and generally cause fewer bothersome side effects than do other types of antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). The most common side effects include decreased sexual desire and delayed orgasm. Other side effects may go away as your body adjusts to the medication. They can include digestive problems, jitteriness, restlessness, headache and insomnia.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications include duloxetine (Cymbalta), venlafaxine (Effexor XR) and desvenlafaxine (Pristiq). Side effects are similar to those caused by SSRIs. These medications can cause increased sweating, dry mouth, fast heart rate and constipation.
• Norepinephrine and dopamine reuptake inhibitors (NDRIs).Bupropion (Wellbutrin) falls into this category. It’s one of the few antidepressants that doesn’t cause sexual side effects. At high doses, bupropion may increase your risk of having seizures.
• Atypical antidepressants. These medications are called atypical because they don’t fit neatly into another antidepressant category. They include trazodone (Oleptro) and mirtazapine (Remeron). Both of these antidepressants are sedating and are usually taken in the evening. In some cases, one of these medications is added to other antidepressants to help with sleep. The newest medication in this class of drugs is vilazodone (Viibryd). Vilazodone has a low risk of sexual side effects. The most common side effects associated with vilazodone are diarrhea, nausea, vomiting and insomnia.
• Tricyclic antidepressants. These antidepressants have been used for years and are generally as effective as newer medications. But because they tend to have more numerous and more-severe side effects, a tricyclic antidepressant generally isn’t prescribed unless you’ve tried an SSRI first without an improvement in your depression. Side effects can include dry mouth, blurred vision, constipation, urinary retention, fast heartbeat and confusion. Tricyclic antidepressants are also known to cause weight gain.
• Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate) and phenelzine (Nardil) — are usually prescribed as a last resort, when other medications haven’t worked. That’s because MAOIs can have serious harmful side effects. They require a strict diet because of dangerous (or even deadly) interactions with foods, such as certain cheeses, pickles and wines, and some medications including decongestants. Selegiline (Emsam) is a newer MAOI that you stick on your skin as a patch rather than swallowing. It may cause fewer side effects than other MAOIs. These medications can’t be combined with SSRIs.
• Other medication strategies. Your doctor may suggest other medications to treat your depression. These may include stimulants, mood-stabilizing medications, anti-anxiety medications or antipsychotic medications. In some cases, your doctor may recommend combining two or more antidepressants or other medications for better effect. This strategy is known as augmentation.

Finding the right medication
Everyone’s different, so finding the right medication or medications for you will likely take some trial and error. This requires patience, as some medications need eight weeks or longer to take full effect and for side effects to ease as your body adjusts. If you have bothersome side effects, don’t stop taking an antidepressant without talking to your doctor first. Some antidepressants can cause withdrawal symptoms unless you slowly taper off your dose, and quitting suddenly may cause a sudden worsening of depression. Don’t give up until you find an antidepressant or medication that’s suitable for you — you’re likely to find one that works and that doesn’t have intolerable side effects.

If antidepressant treatment doesn’t seem to be working, your doctor may recommend a blood test to check for specific genes that affect how your body uses antidepressants. The cytochrome P450 (CYP450) genotyping test is one example of this type of exam. Genetic testing of this kind can help predict how well your body can or can’t process (metabolize) a medication. This may help identify which antidepressant might be a good choice for you. These genetic tests may not be widely available, so they’re an option only for people who have access to a clinic that offers them.

Antidepressants and pregnancy
If you’re pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk to your doctor if you become pregnant or are planning on becoming pregnant.

Antidepressants and increased suicide risk
Although most antidepressants are generally safe, be careful when taking them. The Food and Drug Administration (FDA) now requires that all antidepressant medications carry black box warnings. These are the strictest warnings that the FDA can issue for prescription medications.

The antidepressant warnings note that in some cases, children, adolescents and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting an antidepressant or when the dose is changed. Because of this risk, people in these age groups must be closely monitored by loved ones, caregivers and health care providers while taking antidepressants. If you — or someone you know — have suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help.

Again, make sure you understand the risks of the various antidepressants. Working together, you and your doctor can explore options to get your depression symptoms under control.

Electroconvulsive Therapy (ECT)

During electroconvulsive therapy (ECT) the patient’s brain is electrically stimulated to cause an intentional seizure. Patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants. Recovery from an ECT treatment session occurs slowly, and patients are usually closely monitored for minutes or a few hours after a treatment. Short-term confusion and memory loss are common, and long-term disruptions in memory have been shown to occur and may persist indefinitely in some people. Because of the side effects associated with ECT, a significant amount of caregiver support is required.

Vagus Nerve Stimulation (VNS)

Patients receiving vagus nerve stimulation (VNS) are required to have a medical device implanted within their chest. Through a wire, this device is attached to the vagus nerve in the neck. Electrical pulses sent from the device travel up the vagus nerve to the brain. Some risks associated with VNS include persistent voice alteration and potential nerve paralysis. Also, since VNS is an implanted device, patients face surgical risks when choosing to undergo treatment.

Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation (TMS) therapy uses a pulsed magnetic field to non-invasively stimulate the area of the brain thought to control mood. TMS is administered without medication in a physician’s office while the patient remains awake and alert. TMS is delivered in 37 minute treatment sessions given daily over 4 to 6 weeks. The most common side effects associated with TMS treatment are scalp pain or discomfort at the treatment site —generally mild to moderate and occurring less frequently after the first week of treatment. There is a remote risk of seizure with TMS, occurring in approximately 0.1% of patients.

Tests And Diagnosis

Because depression is common and often goes undiagnosed, some doctors and health care providers may ask questions about your mood and thoughts during routine medical visits. They may even ask you to fill out a brief questionnaire to help check for depression symptoms.

When doctors suspect someone has depression, they generally ask a number of questions and may do medical and psychological tests. These can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:

• Physical exam. This may include measuring your height and weight; checking your vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen.
• Laboratory tests. For example, your doctor may do a blood test called a complete blood count (CBC) or test your thyroid to make sure it’s functioning properly.
• Psychological evaluation. To check for signs of depression, your doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. He or she will ask about your symptoms, and whether you’ve had similar episodes in the past. You’ll also discuss any thoughts you may have of suicide or self-harm. Your doctor may have you fill out a written questionnaire to help answer these questions.

Diagnostic criteria for depression
To be diagnosed with major depression, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

To be diagnosed with major depression, you must have five or more of the following symptoms over a two-week period. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Symptoms can be based on your own feelings or may be based on the observations of someone else. They include:

• Depressed mood most of the day, nearly every day, such as feeling sad, empty or tearful (in children and adolescents, depressed mood can appear as constant irritability)
• Diminished interest or feeling no pleasure in all — or almost all — activities most of the day, nearly every day
• Significant weight loss when not dieting, weight gain, or decrease or increase in appetite nearly every day (in children, failure to gain weight as expected can be a sign of depression)
• Insomnia or increased desire to sleep nearly every day
• Either restlessness or slowed behavior that can be observed by others
• Fatigue or loss of energy nearly every day
• Feelings of worthlessness, or excessive or inappropriate guilt nearly every day
• Trouble making decisions, or trouble thinking or concentrating nearly every day
• Recurrent thoughts of death or suicide, or a suicide attempt

To be considered major depression:

• Your symptoms aren’t due to a mixed episode — simultaneous mania and depression that can occur in bipolar disorder
• Symptoms must be severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others
• Symptoms are not due to the direct effects of something else, such as drug abuse, taking a medication or having a medical condition such as hypothyroidism
• Symptoms are not caused by grieving, such as temporary sadness after the loss of a loved one

Other conditions that cause depression symptoms
There are several other conditions with symptoms that can include depression. It’s important to get an accurate diagnosis so you can get the appropriate treatment for your particular condition. Your doctor or mental health provider’s evaluation will help determine if your symptoms of depression are caused by one of the following conditions:

• Adjustment disorder. An adjustment disorder is a severe emotional reaction to a difficult event in your life. It’s a type of stress-related mental illness that may affect your feelings, thoughts and behavior.
• Bipolar disorder. This type of depression is characterized by mood swings that range from highs to lows. It’s sometimes difficult to distinguish between bipolar disorder and depression, but it’s important to get an accurate diagnosis so that you can get the proper treatment and medications.
• Cyclothymia. Cyclothymia (si-klo-THI-me-uh), also called cyclothymic disorder, is a milder form of bipolar disorder.
• Dysthymia. Dysthymia (dis-THI-me-uh) is a less severe but more chronic form of depression. While it’s usually not disabling, dysthymia can prevent you from functioning normally in your daily routine and from living life to its fullest.
• Postpartum depression. This is a common type of depression that occurs in new mothers. It often occurs between two weeks and six months after delivery.
• Psychotic depression. This is severe depression accompanied by psychotic symptoms, such as delusions or hallucinations.
• Seasonal affective disorder. This type of depression is related to changes in seasons and diminished exposure to sunlight.

Make sure you understand what type of depression you have so that you can learn more about your specific situation and its treatments.

Causes of Depression

It’s not known exactly what causes depression. As with many mental illnesses, it appears a variety of factors may be involved. These include:

• Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.
• Neurotransmitters. These naturally occurring brain chemicals linked to mood are thought to play a direct role in depression.
• Hormones. Changes in the body’s balance of hormones may be involved in causing or triggering depression. Hormone changes can result from thyroid problems, menopause or a number of other conditions.
• Inherited traits. Depression is more common in people whose biological family members also have this condition. Researchers are trying to find genes that may be involved in causing depression.
• Life events. Certain events, such as the death or loss of a loved one, financial problems, and high stress, can trigger depression in some people.
• Early childhood trauma. Traumatic events during childhood, such as abuse or loss of a parent, may cause permanent changes in the brain that make you more susceptible to depression.

Is depression a serious disease?

Yes. The National Institute of Mental Health maintains that, “Depressive illness can often interfere with normal functioning and cause pain and suffering not only to those who have the disorder, but to those who care about them. Serious depression can destroy family life as well as the life of the ill person.”

A national study of depression found that nearly all the respondents who reported a major depressive disorder also reported that their social and/or work lives were negatively affected by their illness. In 2000, the economic burden of depression was estimated at $83.1 billion in the US and researchers estimate that by the year 2020, depression will be the second leading cause of disability worldwide. Depression can also be a lethal disease. Each year in the US, over 30,000 people die by suicide, 60% of whom had been diagnosed with major depression.

Symptoms of Depression

Depression symptoms include:

• Feelings of sadness or unhappiness
• Irritability or frustration, even over small matters
• Loss of interest or pleasure in normal activities
• Reduced sex drive
• Insomnia or excessive sleeping
• Changes in appetite — depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
• Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
• Irritability or angry outbursts
• Slowed thinking, speaking or body movements
• Indecisiveness, distractibility and decreased concentration
• Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort
• Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren’t going right
• Trouble thinking, concentrating, making decisions and remembering things
• Frequent thoughts of death, dying or suicide
• Crying spells for no apparent reason
• Unexplained physical problems, such as back pain or headaches

For some people, depression symptoms are so severe that it’s obvious something isn’t right. Other people feel generally miserable or unhappy without really knowing why.

Depression affects each person in different ways, so symptoms caused by depression vary from person to person. Inherited traits, age, gender and cultural background all play a role in how depression may affect you.

Depression symptoms in children and teens
Common symptoms of depression can be a little different in children and teens than they are in adults.

• In younger children, symptoms of depression may include sadness, irritability, hopelessness and worry.
• Symptoms in adolescents and teens may include anxiety, anger and avoidance of social interaction.
• Changes in thinking and sleep are common signs of depression in adolescents and adults but are not as common in younger children.
• In children and teens, depression often occurs along with behavior problems and other mental health conditions, such as anxiety or attention-deficit/hyperactivity disorder (ADHD).
• Schoolwork may suffer in children who are depressed.

Depression symptoms in older adults
Depression is not a normal part of growing older, and most seniors feel satisfied with their lives. However, depression can and does occur in older adults. Unfortunately, it often goes undiagnosed and untreated. Many adults with depression feel reluctant to seek help when they’re feeling down.

• In older adults, depression may go undiagnosed because symptoms — for example, fatigue, loss of appetite, sleep problems or loss of interest in sex — may seem to be caused by other illnesses.
• Older adults with depression may have less obvious symptoms. They may feel dissatisfied with life in general, bored, helpless or worthless. They may always want to stay at home, rather than going out to socialize or doing new things.
• Suicidal thinking or feelings in older adults is a sign of serious depression that should never be taken lightly, especially in men. Of all people with depression, older adult men are at the highest risk of suicide.

When to see a doctor
If you feel depressed, make an appointment to see your doctor as soon as you can. Depression symptoms may not get better on their own — and depression may get worse if it isn’t treated. Untreated depression can lead to other mental and physical health problems or problems in other areas of your life. Feelings of depression can also lead to suicide.

If you’re reluctant to seek treatment, talk to a friend or loved one, a health care professional, a faith leader, or someone else you trust.

What is Depression?

Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.

Also called major depression, major depressive disorder and clinical depression, it affects how you feel, think and behave. Depression can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn’t worth living.

More than just a bout of the blues, depression isn’t a weakness, nor is it something that you can simply “snap out” of. Depression is a chronic illness that usually requires long-term treatment, like diabetes or high blood pressure. But don’t get discouraged. Most people with depression feel better with medication, psychological counseling or other treatment.

Depression ranges in seriousness from mild, temporary episodes of sadness to severe, persistent depression. Doctors use the term “clinical depression” to describe the more severe form of depression also known as “major depression” or “major depressive disorder.”

For a diagnosis of clinical depression, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is a guidebook used to diagnose mental illness in the United States.

Clinical depression symptoms may include:

• Depressed mood most of the day, nearly every day
• Loss of interest or pleasure in most activities
• Significant weight loss or gain
• Sleeping too much or not being able to sleep nearly every day
• Slowed thinking or movement that others can see
• Fatigue or low energy nearly every day
• Feelings of worthlessness or inappropriate guilt
• Loss of concentration or indecisiveness
• Recurring thoughts of death or suicide

To meet the criteria for clinical depression (called major depression in the DSM), you must have five or more of the above symptoms over a two-week period. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Keep in mind, some types of depression may not fit this strict definition.

Clinical depression causes noticeable disruptions in daily life, such as work, school or social activities. It can affect people of any age or sex, including children. It isn’t the same as depression caused by a loss (such as the death of a loved one), substance abuse or a medical condition such as a thyroid disorder.

Clinical depression symptoms usually improve with psychological counseling, antidepressant medications or a combination of the two. Even severe depression symptoms usually improve with treatment.