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Depression and Anxiety
Written and researched by Bob Murray, PhD
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Eating Disorders Linked to Abuse
January 23, 2002
Research has shown that more than half of college women have experienced eating disorder symptoms (although most do not have full-blown anorexia or bulimia).
While the cause of eating disorders is still unknown, new research suggests that depression and difficulty expressing one's feelings may be risk factors for disordered eating in young women with a history of family problems or abuse.
Psychologists Suzanne E Mazzeo, PhD, of Virginia Commonwealth University and Dorothy L Espelage, PhD, of the University of Illinois, studied 820 undergraduate female college students to see whether certain risk factors led to disordered eating. They found that family conflict, family cohesion, childhood physical and emotional abuse and early neglect did indirectly influence whether a college student would develop problem eating behaviors.
However, they found that depression and alexithymia -- difficulty in identifying and describing one's own feelings -- more directly influences whether women from this type of background develop eating problems.
In summary: Childhood abuse leads to depression and eating disorders, and the greater the abuse, the greater the disorder.
Once again research has emphasised the direct link, which we have always maintained, between childhood abuse, depression and eating disorders. BM
Read more in Uniscience
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Depression "Boosts Fatal Stroke Risk"
January 7, 2002
Middle-aged men who have symptoms of psychological distress, such as depression and anxiety, are more than three times as likely to have a fatal stroke, research suggests.
A research project involving 2,124 middle-aged men in South Wales has shown that depression makes a man three times more likely to suffer from a fatal stroke even though psychological distress was not linked to a significantly increased risk of having a non-fatal stroke. Further there was no apparent link between mood disorders and an increased risk of the mini-strokes that sometimes precede a major attack.
Each man in the study was subjected to a battery of physical and psychological tests, and then monitored over the course of the next 14 years. In that time 137 strokes occurred, including 17 which were fatal.
In general, men who had strokes were older, heavier and had higher blood pressure levels than men who did not have strokes. The men who had strokes were also more likely to be current smokers and to have at least one other chronic disease.
However, analysis of the data also revealed that they had also reported more symptoms of anxiety and depression. This was particularly true among those who died from their stroke. The worse the depression and anxiety, the greater the risk.
Professor Robert Carney, of Washington University School of Medicine in St Louis, has examined the findings. He believes there are several possible explanations for the link between depression and fatal strokes. He said: "Depressed people often don't take medicines as prescribed so some of the men may not be taking medicines for high blood pressure, thereby increasing their risk for stroke."
However, there is also evidence to suggest that depression and anxiety has an effect on the way the autonomic nervous system works. This system regulates heart rate and the contraction of the blood vessels.
"Those changes may produce alterations that contribute to the severity of stroke or heart attack." Professor Carney said that the findings of the study should impress on both doctors and patients the need for vigilance. Depression and anxiety are often downplayed by physicians who fail to ask about psychological health and patients who are reluctant to discuss depression.
Read more in BBC News
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Placebo Treatment Works For Depression
January 7, 2002
Placebo treatment has been shown to have an impact on the brains of people with serious depression. Theoretically a placebo should be of no use at all. However, some people with depression do respond positively when they are given a placebo such as a sugar pill. It may be that simply believing that you are receiving help is enough to stimulate a positive =esponse.
Now researchers from the University of California Los Angeles have used imaging technology to show that placebo treatment can actually change the way these people's brains work.
The changes are different to those found in people who respond to recognized antidepressant medication. The researchers used a technique called quantitative electroencephalography to examine the electrical activity of the brain.
Patients who responded to placebo showed increased activity in the brain's prefrontal cortex. In contrast, those who responded to medication showed suppressed activity in that area. The prefrontal cortex has been linked to working memory, information processing, behavioral organization and attention.
Researcher Dr Andrew Leuchter said: "People have known for years that if you give placebos to patients with depression or other illnesses, many of them will get better. What this study shows, for the first time, is that people who get better on placebo have a change in brain function, just as surely as people who get better on medication. We now know that placebo is, very definitely, an active treatment condition."
The researchers believe their work could eventually help determine which treatments work best in individual patients, and also could aid development of new medications.
Dr Leuchter said: "These findings show us that there are different pathways to improvement for people suffering from depression. Medications are effective, but there may be other ways to help people get better. If we can identify what some of the mechanisms are that help people get better with placebo, we may be able to make treatments more effective."
In total, 51 volunteers with serious depression took part in the study. Overall, 10 out of the 26 patients who were given a placebo responded positively to the treatment. Thirteen out of the 25 who received a recognized antidepressant, either fluoxetine or venlafaxine, responded.
Read more in the American Journal of Psychiatry online
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One Question Questionnaire for Depression?
November 26, 2001
More and more doctors are coming to realize that depression is at the root of many so-called 'physical' illnesses from chronic pain to heart disease, to diabetes. But given the 10 minutes or so that a patient spends with a physician, how is the MD to tell whether the sufferer is one of those whose problem lies deeper than the presenting symptoms?
A paper published last year showed that under 50% of physicians were even aware of the symptoms of depression. Many of these were doling out quite inappropriate drugs to try to cure 'physical' illnesses which were, in fact, driven by mood disorders.
A study reported in the British Medical Journal seems to have the answer. The researchers developed a one-question questionnaire to be given to stroke patients on admission to the Royal Liverpool Hospital in England: "Do you often feel sad or depressed?" Those answering "yes" were classed as depressed and those answering "no" were classed as non-depressed.
With other patients the doctors had to guess whether they were depressed or not.
All patients who were admitted were also given more detailed standardized tests for depression.
The results showed that the one-question test was just as good a determinant of depression as the more detailed one (both right 91% of the time) and just over 20% better than the physicians' guesswork (right 70% of the time).
I wonder why no one thought of this before? BM
Reported in the British Medical Journal
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Acupuncture May Relieve Depression
November 26, 2001
Research by the Mental Health Foundation into acupuncture involving the ear examined the impact of this therapy on women with mental health problems.
Women involved in the study reported feeling more relaxed and calm, having improved sleep, more energy and greater confidence, and these benefits increased if the treatment was repeated regularly over a number of weeks.
Eight women volunteers with long-term mental health problems, including eating disorders, depression, anxiety and obsessive compulsive disorder, took part, receiving weekly ear acupuncture treatments for six months.
Recorded comments included: "I'd recommend it to anybody, it's the only thing that's ever worked for me" and "I feel like I'm living a better quality of life now; I'm more creative, more skilful, just because I feel good."
Another project by the same charity examined the impact of both giving and receiving massage -- and found and found these activities were also beneficial to mental wellbeing.
Vicky Nicholls, the Foundation's Strategies for Living project co-ordinator, said "This research highlights the value of creative approaches in mental and emotional health. At the moment people are most likely to be offered medication, hospitalization and, sometimes, talking therapies, but there is no one solution that works for everyone, and we need to see more therapies and services made available, so that people have a real choice."
The trouble with this study is that the numbers, eight women, are too small to be convincing. Further there was no control group. However,whatever benefits acupuncture may bring to those suffering from depression, what I want to know is what the level of relationship the acupuncturists had with their clients. Almost any treatment can work, at least in the short term, if a) the patient believes in it and/or b) there is a strong relationship between the practitioner and the patient. If "alternative" therapists spend more time with their patients, then that may be what is needed. BM
Read more in BBC News
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Depression Linked to Vision Problems
October 26, 2001
Almost every day we see research linking more so-called 'physical' illnesses to depression. The latest is age-related macular degeneration (AMD), a form of vision loss in the elderly.
The latest findings are the results from a study appearing in the October issue of Ophthalmology, the clinical journal of the American Academy of Ophthalmology.
AMD is the leading cause of vision loss worldwide, affecting one in five people over the age of 65. Researchers from the Departments of Ophthalmology, Psychiatry, and Family and Preventive Medicine, at the University of California, San Diego (UCSD) School of Medicine, interviewed 151 adults, age 60 or older, with advanced AMD.
The study participants were interviewed using measures of depression, disability and chronic medical conditions. Results showed that depression was the strongest predictor of disability, followed by visual acuity.
"Ophthalmologists and primary care doctors should be sensitive and alert for depression in their patients with macular degeneration," said Stuart I. Brown, MD, co-author of the study, chairman of UCSD's Department of Ophthalmology.
Depression in the elderly stems from their sense of uselessness in our society. In a hunter-gatherer band they would be revered and be part of the council of elders. The ultimate cure for depression among the elderly is to give them a worthwhile and ongoing role in the community. BM
Read more in Uniscience
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Recession Leads to Depression
October 26, 2001
There is a lot of psychological as well as economic truth in the old quip. A new study, reported in the New York Times, shows that recession causes a big decline in people's happiness, even among those who do not lose a job or take a pay cut.
"People really hate recessions," said Andrew J. Oswald of the University of Warwick in Coventry, England, who wrote a paper based on the study with Rafael Di Tella of Harvard and Robert J. MacCulloch of the London School of Economics.
The three, all economics professors, blame a "fear effect," the widespread worries about jobs, salaries, retirement accounts and family members that accompany a recession. Such worries may cause less panic than anthrax, but they are far more likely to materialize.
To some people, the notion of economists studying emotions like happiness seems odd, but the research is part of a growing academic movement known as behavioral economics. Its adherents examine actual human behavior, in addition to the purely rational behavior that Economics 101 textbooks predict.
Professors Di Tella, MacCulloch and Oswald considered all the variables and examined whether recessions, generally two consecutive quarters of economic contraction, affected people's happiness in ways beyond lost jobs and wages. Their answer was a clear yes.
During recessions, the study found, the number of people describing themselves as "very happy" fell about 10 percent. A society that booms and busts tends to be less happy than one that grows steadily.
Digging deeper into the satisfaction surveys, the professors say the countries least affected by recessions pay the highest unemployment benefits. In Denmark, where a typical unemployed worker receives benefits equal to 60 percent of the worker's old salary, people endure a recession better =han those in England, where the salary replacement is closer to 20 percent.
The changes that the two countries made in unemployment benefits in recent decades -- Denmark's becoming more generous and Britain's becoming less -- also had the expected effect on wellbeing, Professor Oswald said. This, he added, argues for a stronger safety net in many countries, for the wellbeing of both the employed and the unemployed.
Read more in the New York Times online, subscribers only
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Student Debt Can Cause Mental Illness
October 7, 2001
Those who worry about owing large sums after their degree are four times as likely to suffer the illness, according to a book edited by academics at Bath and Exeter universities called "Student Debt: The Causes and Consequences of Undergraduate Borrowing in the UK."
The researchers believe the replacement of grants with loans is breeding a dangerous "debt culture" among students which is having a "serious impact on student wellbeing." They say many become resigned to owing large sums while over-estimating their future earnings.
According to the book around two-thirds of students over-estimate their likely salaries and that 45% of students who did not worry about getting into debt suffered from anxiety, while among those who did the figure was 74%. Just under a third (32%) of students with existing debt problems said they were depressed, compared to only 8% of those without cash concerns.
The research suggests women are less likely to get into debt than men, owe smaller amounts, and are better at managing a budget.
Depression is unlikely to be caused by student debt alone unless there is a prior history of childhood trauma or parental debt. BM
Read more in BBC News
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Why Exercise Cheers You Up
October 7, 2001
It has long been known that exercise lifted mood and acted like an antidepressant, but until now it has not been clear why exercise has that effect.
But, doctors from Nottingham Trent University suggest the chemical phenylethylamine could play a part. Phenylethylamine is a naturally produced chemical that has been linked to the regulation of physical energy, mood and attention. An enzyme changes the chemical into phenylacetic acid. There is evidence that levels of both substances are low in the biological fluids of depressed patients.
In what are thought to be the first attempts to test the effects of exercise on levels of the chemical, the researchers found, overall, levels of the acid increased by 77% after exercise.
Twenty healthy men, with an average age of 22 were tested. All regularly did around four hours of moderate to hard aerobic and anaerobic exercise each week. Before the study began, they refrained from exercise for a day, and a urine test was done to check for levels of levels of phenylacetic acid, the most accurate measurement of the chemical.
The next day the men exercised on a treadmill at 70% of their maximum heart rate capacity for 30 minutes. Doctors chose that level because mood changes are commonly reported at that level.
The men were also asked to rate how hard they had found the exercise. When urine levels were checked, it was found phenylacetic acid levels were increased in 18 out of the 20 participants. The highest rises were seen in two out of the three who had rated the exercise as hard.
Dr Ellen Billet, who was one of the team of researchers from Nottingham Trent who carried out the research, told BBC News Online: "We felt there may be an effect of exercise on phenylethylamine. We also know that moderate exercise has these beneficial effects."
A spokeswoman for the mental health charity Mind said: "Physical exercise has a valid place in the treatment and prevention of some mental health problems. In a recent Mind survey of Cannons gym users, 75 % said they exercised to reduce their stress levels and 67% said they used exercise to maintain their mental health, like lifting 'low' moods. Mind is calling for all GPs to offer exercise sessions on prescription to patients with mental health problems, particularly as we know that most people with mental health problems don't know this non-drug 'treatment' option exists."
The Repatterning Movements (RPMs), which we use in our
Uplift Program, are very useful in raising moods. These exercises can be done by people of all ages and even those with quite severe disabilities. Some of these RPMs are available as
audio-programs. BM
Read more in BBC News
And in New Scientist online
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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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