Depression and Anxiety
Written and researched by Bob Murray, PhD
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Depression Link to Heart Disease
October 7, 2001
Scientists believe that being depressed makes you more likely to suffer heart disease -- and a new project is trying to find out why.
The British Heart Foundation is funding an investigation looking at how depression and stress could damage blood vessels. Every year, tens of thousands of people in the UK and the United States are diagnosed with some form of coronary heart disease -- it remains the biggest killer.
Coronary problems begin when deposits gather on the sides of the arteries supplying the heart muscle, which eventually narrow and constrict blood flow. Experts still do not know which external and internal factors cause the deposits to form and cause this hardening of the arteries. Researchers now think that long-term stress may be causing an "over-reaction" by the body's immune system, which causes inflammation in the tissues, which can cause long-term damage.
A team at the University of Wales College of Medicine in Cardiff is looking into the theory that the body's inability to deal with stress may contribute to this problem.
Professor Michael Frenneaux, who is leading the research, said: " When the body is under stress it produces certain chemicals that, over time, may be harmful to our arteries by causing inflammation. We believe that being depressed may lead to prolonged over-activity of the body's 'stress response' and this could be why depression can increase the risk of coronary heart disease."
The British Heart Foundation's regional director for Wales, David Napier, said: "Stress in short bursts is not harmful for the heart, and is a natural part of everyday life. However, long term stress or depression is a different matter. BHF statistics show that people with less control over their work, and those who are depressed or have an angry personality, are at a greater risk of coronary heart disease."
Read more in BBC News
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Increasing Numbers of Children Harm Themselves
August 22, 2001
UK Government figures reveal that about one in 75 children under 10 has tried to kill or injured themselves. Family stress such as divorce and separation or a bereavement are seen as triggers. Rates of self-harm increase as children become teenagers. In the 11 to 15 age group the figure is one in 50. The highest rate was found among 13 to 15-year-old girls.
The study, compiled by the Office for National Statistics, found that emotionally vulnerable children who had witnessed the separation of their parents, who had suffered a serious illness or had experienced the death of a close family member were more likely to self-harm than their classmates.
The figures are highest among children from single-parent families or whose parents held unskilled jobs. Those with parents holding professional jobs were three times less likely to harm themselves than those whose parents held down an unskilled job. Researchers found that children were more likely to self-harm if they suffered from mental disorders such as behavioral problems or attention deficit disorder.
Peter Wilson, director of the children's mental health charity Young Minds, said it was vital parents understand how deeply a family problem could affect their child. "We always think children are resilient but they don't have much choice other than to keep going. What these children are saying is that it is very hard for them to keep going."
Read more in BBC News
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Seasonal Trend in Abortions Linked to Depression
August 22, 2001
Researchers in Italy have come up with the theory that a woman's decision to have an abortion may be influenced by the season. They found an annual peak in voluntary abortions in early May -- coinciding with an annual peak in female suicides.
This suggests that the same factors that push women to commit suicide might also make them more vulnerable to pressure to abort a pregnancy, they say.
"The almost complete similarity of the seasonal rhythm of female suicides and that of voluntary abortion furnishes valid support for a strong relationship between the two," say Angelo Cagnacci and Annibale Volpe at the University of Modena. Their findings were reported in the journal Human Reproduction.
"This is an interesting paper," says Anne Furedi of the British Pregnancy Advisory Service. But she adds that there could be a number of other explanations for the annual peak, such as the rise in unplanned conceptions over holiday periods.
Cagnacci and Volpe studied data on Italian women dating between 1995 and 1998. They tried to rule out any seasonal effect of conception on the abortion rate by charting the ratio of abortions to pregnancies, rather than the absolute number of abortions, for each month of the year. They found a clear pattern in abortions over the year, peaking in May.
The team also found no difference in the pattern of female suicides in the years before abortion was legalised in Italy. This suggests that the annual peak in abortions is not driving the annual peak in suicides.
If depression and abortion are indeed linked, Cagnacci and Volpe say that the measures that help reduce depression, such as support from friends and family, might also apply to voluntary abortion.
Read more in New Scientist online
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Depression The Biggest Problem
April 11, 2001
Although mental health problems are dramatically increasing throughout the world, the depression rate is the most frightening. Clinical depression (or unipolar depression) alone accounts for 36.5% of all neuropsychiatric disorders, according to the latest World Health Organization report.
This form of depression is followed a long way behind by bipolar depression (manic depressive disorder) at 10.4% and alcoholism at just over 11%. Together they account for one half of all causes of disability.
Worldwide 400 million people are mentally ill and of these 340 million suffer from unipolar disorder.
More disturbing still, 78 countries have no mental health policy at all. Even many of those that do, such as India, are swamped.
Earlier reports have shown that even in developed countries, such as the UK, under half of all doctors are able to recognize the symptoms of depression.
Read more on BBC News
Find out about the World Health Organization's Mental Health Programme
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Has Pregnancy Lost Its 'Glow?'
August 8, 2001
Pregnancy is often depicted as a special time, with the expectant mother radiant and content. Emotional problems are expected later, in 'post-partum' depression. Yet women are more likely to become depressed while pregnant than after their babies are born, research suggests. Scientists found the peak for depression was 32 weeks into pregnancy, close to birth.
The unborn child may also be affected, as for example, a rise in stress hormones could lead to low birth weight. The researchers are calling for more recognition and treatment for antenatal depression.
Dr Jonathan Evans, who led the study, told BBC News Online: "The message is 'don't be surprised if someone is depressed during pregnancy.' There is an assumption that (the pregnant woman) just blooms and it's important to recognise that might not be the case."
Though it has long been realized that up to 10% of women -- and 10% of men -- suffer from post natal depression there has been little research done on prenatal depression.
However, this latest piece of research suggests the severity and nature of depression are the same whether it occurs before or after a woman has given birth.
The study looked at over 9,000 women in the Avon area of the UK, whose babies were due between April 1 1991 and December 31 1992. Clinically approved scales for measuring depression were used to asses women at 18 weeks and 32 weeks into pregnancy, and eight weeks and eight months after their child was born. The researchers found the average scores recorded were higher during pregnancy than after the births. The proportion of women with probable depression was 11.8% at 18 weeks, rising to 13.5% at 32 weeks. That fell to 9.1% at eight weeks after the birth, and 8.1% at eight months.
This shows that antenatal depression is clearly as important as, and possibly more so, than postnatal depression.
In the paper, published in the British Medical Journal, the authors admit the women's assessment of whether they were depressed was not the same as a clinical diagnosis. But they add: "The consequences of antenatal depression are not well understood."
They say there may be benefits in screening and treating depression during pregnancy, though admit there are concerns about the widespread use of antidepressants. And they call for more work to be done on the consequences of antenatal depression for both mother and baby.
This is especially interesting in light of the fact that women's depression is now seen as stemming from the lack of support and clarity around her roles (see our depression health news special:
Why Women Are More Depressed). If she works outside the home, she will have to decide how soon, if ever, to wrench herself away from her baby and return to work. Staying at home with the baby, although emotionally and biologically fulfilling, involves for the most part isolation from other adults and giving up the social and financial benefits of status and earning an income. The encroaching birth will certainly disrupt a household, which is probably already beset by the stresses that affect most nuclear families. Many already precarious relationships crash on the shoals of pregnancy and the anticipated additional demands of children. The involvement of grandparents to ease the stresses can create just the opposite effect if their relationship with one or both members of the couple is strained. In an overcrowded world, pregnancy may not be seen by the community as the blessing it used to be perceived as. One further, and most important,!
factor is the lack of female company and support that many women have both during and after pregnancy.
How different all this is from the experience of a real hunter-gatherer woman, who brings a new life to the entire tribe, and looks forward to the celebration and support of all the other members! AF
Read more on BBC News
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Age of anxiety
February 10, 2001
An article, also from the Journal of Personality and Social Psychology, confirms something that we have been saying for some time. It details two meta-analyses, which find "that Americans have shifted toward substantially higher levels of anxiety and neuroticism during recent decades."
The article, by Jean M. Twenge at the Department of Psychology, Case Western Reserve University looks at two broad ranging studies into the effects of modern society, particularly in the areas of anxiety and neuroticism.
The problem, it seems is that there has been a great decrease in social connectedness coupled with an increase in the perception of environmental dangers. Most research into personality has focused on the effects of either genetics or the family. However we now know that genetics plays a relatively minor role in the overall shaping of personality. The role of the family, as countless studies have shown, is crucial. However the role of society at large has not been given it's proper due (except by Evolutionary Psychologists and Fortinberry Murray Practitioners -- BM).
The adults of today are markedly more anxious than their parents. They are also more isolated. We need only look at the increase in 'computer friendships', which do not at all perform the same beneficial role as primary relationships (ones where all the senses are involved), the lack of human contact in, say, grocery stores, the increasing 'home office' working environment and the dehumanizing effects of such things as voice mail. The more cut-off we are the more anxious and depressed we get. (It is, of course, exactly this lack of connectedness that the Uplift Program seeks to correct -- BM)
Examining changes in anxiety are particularly important. More people visit doctors for anxiety (and depression. According a University of Colorado study, up to 80% of all visits to the doctor are depression-related -- BM) than for colds and other 'physical illnesses'. Researchers have linked self-reports of anxiety to a wide variety of physical ailments, including asthma, coronary heart disease, irritable bowel syndrome, ulcers, and inflammatory bowel disease.
Interestingly the studies Twenge quotes seem to show that economic privation has little to do with an individual's level of anxiety (other recent studies have shown that rich people are more depressed than poor ones).
Read Dr Twenge's report online on the Journal of Personality and Social Psychology
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St John's Wort & Depression
According to a recent review of 23 trials involving 1,757 people, by Jerry Cott, PhD, chief, Adult Psychopharmacology Research Program, Adult and Geriatric Treatment and Prevention Branch, National Institute for Mental Health (NIMH), St John's Wort (hypericum) is very effective in treating mild to moderately severe depression with far fewer side-effects. St. John's Wort achieved a 64% success rate compared to the 58% success rate achieved by a variety of standard antidepressants. What's more two of the most worrying side-effects of most antidepressants -- female hair loss and loss of libido -- seem to be absent from those taking the hypericum.
Read more on BBC News.
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Exercise Halts Mental Decline and Fights Depression
January 17, 2001
According to a study reported on BBC News Online (Jan 16), which was carried out by researchers at Duke University Medical Center (one of the places we have lectured at) in Durham, North Carolina, exercise can improve mental abilities in the elderly. Researchers believe it could be linked to the fact that exercise improves the body's ability to pump blood and blood's oxygen-carrying capacity.
The implication is that exercise might be able to offset some of the mental decline that we often associate with the ageing process.
The original purpose of the study was to show how exercise affected depression. It would seem that exercise is of great benefit here as well -- something that our students and clients will not be surprised to hear. Improvements were seen "above and beyond" what was expected after the depression had lifted, say researchers. One of the key findings was that exercise had beneficial effects on functions controlled by specific areas of the brain. Memory, planning, organisation and juggling different tasks all improved under the study.
The link between exercise and depression is, of course one of the reasons we have dance and Feldenkrais-like
Repatterning Movements (RPMs) in our Uplift Program.
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Independent People at Risk for Depression
October 30, 2000
A recent study by Professor Neil Jacobson and Dr Jackie Golan at Washington University, offers new insights into preventing and predicting relapse of depressed patients. It was found that depressive people with low dependency on others were more at risk of relapse than those with moderate dependency who were more able to seek out social support. Those with aggressive, hostile styles of relating who exhibited pathological independence, may find it more difficult to make friends, making them most at risk.
Relapse rates among patients who have been successfully treated by cognitive behavioral therapy, often in conjunction with anti-depressant medication, the standard treatment for depression, are as high as 50 - 80%.
Moreover, Gollan states that "it is becoming clear that people are less at risk for relapse when they do things they enjoy rather than working on overcoming their negative thinking patterns."
This supports what the founders of the
Uplift Program, Dr Bob Murray and Alicia Fortinberry, have saying for years -- that you can't heal yourself on your own, and that whatever you do to counteract the symptoms of depression it has to be fun ! The better equipped you can become at building a network of supportive relationships, with whom you can enjoy a range of activities, the more chance you have of maintaining life-long happiness.
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Youth Depression Rates Under-estimated
October 30, 2000
New figures published by the Depression Alliance as part of Britain's National Depression Week has found that suicide is contemplated by one in eight young people, with 45% surveyed saying they knew someone their age who had contemplated, attempted or committed suicide.
With substance abuse, money worries, job problems, or difficulty with family and friends cited as the major stress factors, the pressures of modern life are exerting deadly weight on our youth.
Stigma around depression is compounding this problem, with only one in ten saying they would go to their parents or GP for help. A quarter of the 1,000 people questioned thought that depression was a sign of "mental weakness" and that sufferers should "snap out of it".
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About the Author
Dr Bob Murray is a widely published psychologist and expert on emotional health and optimal relationships. Together with his wife and long-term collaborator Alicia Fortinberry, he is founder of the highly successful Uplift Program, and author of Raising an Optimistic Child (McGraw-Hill, 2006) and Creating Optimism (McGraw-Hill, 2004).
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