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Beating the burnout blues

Mon, 27 Feb 2012 09:41:07 GMT

Exhaustion, depression, and anxiety attacks are just some of the debilitating symptoms of work burnout.
But preventing it isn't just a case of slowing down. It often requires something additional to offset the effects of work, such as playing sport or being part of a social circle to provide emotional balance. "Sometimes a patient will tell me that they haven't had a holiday in two or even five years," said Nadja Behling, a German doctor, who finds that many burnout patients ignore this aspect.

These workaholics run the risk of burnout to the extent of total emotional exhaustion. Studies indicate that sport has a strong anti-depressive effect, with people who take regular exercise less likely to be ill-tempered. And social contact als o helps to counter burnout. So where possible, people should play sport or meet friends twice a week. "The circle of friends does not have to be large, but there should be two or three good friends whom one can talk to about important things," Behling said.

Psychological issues are increasingly causing problems at work and are often cited as the reason for early retirement. And yet it is by no means certain that everyone who believes they are suffering from burnout - which has a fashionable ring to it these days - is actually ill. This is because burnout is not a specific ailment, rather a variable set of symptoms making it more difficult to determine when stress at work is causing illness or when the borders of burnout have been reached. "It describes total exhaustion, and can show itself alongside depression, anxiety attacks or with various physical symptoms," Behling said.

"It only gets serious when someone is unable to cope with their everyday life and their own mechanisms for dealing with crisis break down," she says. This is then true burnout and professional help is required.
Signs of burnout are when someone relaxes completely over the weekend over several weeks and still feels exhausted at the start of the next week, or if going on holiday is no longer fun, and the patient returns home as tired as ever.

Another signal is when a hobby that was once absorbing no longer provides any pleasure or a family member repeatedly loses their temper. "Once things have got this far, the symptoms clearly indicate illness and professional help should be sought," Behling advises.

Migraine increases risk of depression

Thu, 23 Feb 2012 14:41:44 GMT

A study of 36,000 women found those who had either suffered from different types of migraine in the past, or continued to experience episodes, were at a 36 per cent higher risk of developing depression over 14 years. All those who enrolled in the study, conducted by researchers at the University of California, Los Angeles (UCLA), had never being diagnosed with depression.

Over the 14 years they were followed on average, almost 4,000 developed the mental illness. The researchers found the 6,500 women with current or past migraine were at a higher risk. Those with a condition called migraine with aura appeared to be at a higher risk still (43 per cent) than those who had migraine without aura (29 per cent), although the difference was not statistically significant.

Dr Tobias Kurth, of Brigham and Women's Hospital in Boston, Mass., said: "We hope our findings will encourage doctors to speak to their migraine patients about the risk of depression and potential ways to prevent depression."

He and colleagues are to present their findings at the American Academy of Neurology's annual conference in New Orleans in April. The study could not draw any conclusions about any possible link between migraine and depression in men because it only looked at women.

Does Depression Contribute to the Aging Process?

Wed, 22 Feb 2012 11:26:26 GMT

Telomeres are protective caps on the ends of chromosomes and are indicators of aging, as they naturally shorten over time. However, telomeres are also highly susceptible to stress and depression, both of which have repeatedly been linked with premature telomere shortening.

The human stress response is regulated by the hypothalamic-pituitary-adrenal axis, or HPA axis. This axis controls the body's levels of cortisol, the primary stress hormone, and it generally does not function normally in individuals with depression- and stress-related illnesses.

Scientists of a new study published this week in Biological Psychiatry sought to bring all this prior work together by studying the relationships between telomere length, stress, and depression. They did so by measuring telomere length in patients with major depressive disorder and in healthy individuals. They also measured stress, both biologically, by measuring cortisol levels, and subjectively, through a questionnaire.

They found that telomere length was shorter in the depressed patients, which confirmed prior findings. Importantly, they also discovered that shorter telomere length was associated with a low cortisol state in both the depressed and healthy groups.

First author Dr. Mikael Wikgren further explained, "Our findings suggest that stress plays an important role in depression, as telomere length was especially shortened in patients exhibiting an overly sensitive HPA axis. This HPA axis response is something which has been linked to chronic stress and with poor ability to cope with stress."

"The link between stress and telomere shortening is growing stronger. The current findings suggest that cortisol levels may be a contributor to this process, but it is not yet clear whether telomere length has significance beyond that of a biomarker," commented Dr. John Krystal, editor of Biological Psychiatry.
Future studies will be needed to determine whether normalizing telomere length is an important component of the treatment process.

Treating Depression with the Oxytocin, the Love Hormone

Tue, 21 Feb 2012 12:47:37 GMT

When a person hugs or affectionately touches another, the brain chemical oxytocin is released, helping to strengthen social bonds, among other actions. This “hormone of love” might provide hope for those suffering with depression, according to researchers who are currently conducting a clinical trial.

“In humans, oxytocin is released when they hug or experience other pleasant physical touch, and it plays a part in the human sexual response cycle,” said Dr. Kai MacDonald, assistant clinical professor of psychiatry at UC San Diego School of Medicine.

Oxytocin seems to change the brain signals responsible for social recognition through facial expressions, says MacDonald, perhaps by changing the firing of the amygdala, the area of the brain that plays a major role in the processing of important emotional stimuli. Therefore, oxytocin in the brain may be a very strong mediator of human social behavior.

“That’s why oxytocin is sometimes called ‘the love hormone,’” said MacDonald. “It’s said that the eyes are the window to the soul… they certainly are the window to the emotional brain. We know that the eye-to-eye communication, which is affected by oxytocin, is critical to intimate emotional communication for all kind of emotions — love, fear, trust, anxiety.”

Previously, UC San Diego researchers discovered that oxytocin could help those with schizophrenia, and MacDonald and colleague David Feifel, M.D., Ph.D., professor of psychiatry, are now enrolling participants to study its role in clinical depression.

“Studies of blood levels and genetic factors in depressed patients point to the possibility that this natural hormone might play a part in helping clinical depression,” said MacDonald.

“Previously, studies of healthy individuals have shown that intranasal doses of oxytocin reduce activation of brain circuits involved in fear, increase levels of eye contact, and increase both trust and generosity,” MacDonald said. “Interestingly, people given oxytocin don’t report feeling any different, but they act differently.”

Early clinical data also indicates oxytocin may help women with anxiety disorders. “A hug or a touch that causes a release of this hormone might somehow change brain signals,” MacDonald said. “We want to see if we can harness this response to help patients who suffer from depression.”

Treating Depression: Is there a placebo effect?

Mon, 20 Feb 2012 13:05:59 GMT

Clearly many people here are posting to uphold their long held belief. Beliefs ingrained through years of training by med school founded and funded by Pharma. I am an expert by experience having lost a family member due to poly pharmacy and poisoning by Cymbalta. Many doctors are unyielding in their long held beliefs even though they know little themselves about the pharmacologic aspects relying instead on drug reps and Pharma for their education.

The FDA and Pharma are in collusion as many ex Pharma execs have held positions in the FDA and visa versa. The biggest lobby in Congress is second only to the oil lobby. This is all about the $$$$. Countless people are addicted to these toxins and don't realize it because the doctor hasn't explained the negative aspects. Family members of mine have said oh, I need the drug because if I miss a dose I go crazy. What they don't realize that is a symptom of withdrawal not a need for the addictive toxin. A danger in suddenly stopping these drugs is mania and aggression.

So when people who have gotten off their drugs commit a crime people will say it is because they stopped a needed and beneficial drug which is totally not true. Has anyone heard of the trojan horse? That is what is going on here. And to trust the pharmaceutical companies to monitor their own studies is like having a fox run a hen house. Google Traci Johnson and educate yourselves. Also go to Facebook and look at a group called Cymbalta Withdrawal Horror Stories. There is a great blog called wwwdotssristoriesdotcom. Where Rosie Meyenburg has accumulated just stories that have made the mainstream news in the last few years.

The stories are chilling. In my own life my family member's death did not make the news so he and thousands upon thousands are not counted in this list of mayhem. In my family member's situation he went to his trusted doctor because he had a backache. The doctor immediately started writing prescription after prescription for very toxic and highly addictive anti-depressants. None of these worked and my family member had terrible side effects. Not the least of these was suicidal ideation. After 5 years my family member hung himself after 3 days earlier visiting his trusted doctor and telling the doctor he was having feelings, again, of self harm.

The doctor doubled his dose and sent him on his way. 3 days later family member died due to hanging. And the thing to know here is that until the psychotropics had been introduced he had never been suicidal. The Pharma industry has made it such that legal recourse is nearly impossible because of their black box label. So, the mayhem continues because it is a billion dollar industry. Street drugs and legal drugs are very similar on a lot of levels. Google Dr. Peter Breggin. Good luck and never stop taking any psychiatric drug suddenly. I would look for a doctor specializing in chemical withdrawal. Also, poly pharmacy is another silent killer of geriatrics but that is another story.

Psychiatric 'bible' may classify the bereaved as mentally ill: journal

Fri, 17 Feb 2012 10:20:06 GMT

One of the world's most influential medical journals is warning that normal human grief could soon be classified a mental illness and routinely treated with antidepressant drugs. The Lancet, in a lead editorial published Thursday, says a proposed revision to psychiatry's official manual of mental disorders that would allow doctors to diagnose the newly bereaved with major depression two weeks after the death of a loved one "is not only dangerously simplistic, but also flawed.""The evidence base for treating recently bereaved people with standard antidepressant regimens is absent," the journal says.

"In many people, grief may be a necessary response to bereavement that should not be suppressed or eliminated."According to renowned U.S. psychiatrist Allen Frances: "This hits people where they live. Everyone who has lost a treasured loved one will run the risk of being called mentally ill."The proposal has become one of the most controversial issues in the rewriting of psychiatry's "bible" of mental illness.

The current and fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, an influential book published by the American Psychiatric Association and used by doctors the world over, excludes people who have recently suffered a loss from being diagnosed with a major depressive disorder unless his or her symptoms are extremely severe or persist beyond two months. It's known as the "bereavement exclusion", the theory being that it's normal for people to show symptoms of depression following the lost of a loved one.

But in the draft version of the next edition of the DSM, due out in 2013, "there is no such exclusion for bereavement" for a diagnosis of major depression, the Lancet notes - meaning that "feelings of deep sadness, loss, sleeplessness, crying, inability to concentrate, tiredness and no appetite, which continue for more than two weeks after the death of a loved one, could be diagnosed as depression, rather than as a normal grief reaction."Grief isn't an illness, the journal says. It's "part of being human" and time limits shouldn't be placed on mourning.

It often take six months or the first anniversary of a death until grieving "can move into a less intense phase," the authors write. While depression or "prolonged grief disorder" occasionally develops and may need treatment, "most people who experience the death of someone they love do not need treatment by a psychiatrist or indeed by any doctor," the Lancet argues. Proponents of the move say that grief-related depression is like any other depression and that other major life stressors, such as the loss of a job or end of a marriage, aren't excluded for a diagnosis of major depression. Removing the bereavement exclusion would enable people to get help sooner, they say.

Frances, a professor emeritus at Duke University who chaired the task force that wrote the current edition of the psychiatric manual, begs to differ. He said it's impossible in the short run to distinguish grief from depression unless the symptoms are severe - for example, if the bereaved person is suicidal, or falsely believes, ‘It's my fault the person died', or if they're markedly impaired and have had major depression before.

When the depression is clear cut, Frances says the current DSM is clear: "Make the diagnosis as soon as you can and start treatment."But most grief is different, he said. "It's a terrible life catastrophe, but it's not a mental illness. The price of loving and attachment is that you feel devastated and this should not be medicalized."He and others worry that if the grief exclusion is dropped from the manual vast numbers of people would be misdiagnosed as mentally ill and prescribed antidepressants, exposing them to potentially serious side effects with no benefit. "Drug companies will jump on this as a vast new market," Frances said. "Grieving people will spend seven minutes with a primary care doctor and be given medication for normal grief. It makes no sense."

Greece’s depression could prove worst in modern history

Thu, 16 Feb 2012 10:44:32 GMT

How badly is Greece hurting from its debt woes and onslaught of austerity? One World Bank official tells the paper Ekathimerini that the country is on pace to suffer the worst economic contraction in the postwar era. “On the current path — which is not sustainable in my view — we may very well see Greek GDP go down 25 to 30 percent, which would be historically unprecedented,” said Uri Dadush, a former World Bank official.

The previous records were set by Argentina — which contracted 20 percent after it defaulted on its debts in 2001 — and Latvia, whose economy shrunk 24 percent after the 2008 financial crisis. (For various reasons, economists seem to consider the break-up of the Soviet Union, which shrunk Russia’s economy 44 percent, a special case).

And Greece could well beat them all, even with the bailout it’s getting from the rest of Europe. After four years of recession, the country has contracted 16 percent, and it’s hard to see how Greece will start growing anytime soon with further sharp budget and wage cuts on the horizon, as the country struggles to rein in its debt load (which, in turn, has been exacerbated by endless recession). Typically when countries are caught in this trap, they drastically devalue their currency to shrink their debts. But as long as its tethered to the euro, Greece doesn’t have that option.

Read Howard Schneider’s report for more on Greece’s debt woes — he notes that the new three-year, $170 billion rescue package from the rest of Europe “depends heavily on Greece returning to economic growth.” But how likely is that? Meanwhile, Russell Shorto has a longer piece on how everyday Greeks are faring under the barrage of wage reductions and layoffs.

Taking depression to heart

Wed, 15 Feb 2012 10:23:42 GMT

Heart attack patients who also suffer from depression are more likely to be readmitted for cardiac events and chest pains in the future, and have 14 percent more days of hospitalization than their happier counterparts, says researcher Vicki Myers of TAU's Sackler Faculty of Medicine. Along with Dr. Yariv Gerber and other members of the Israel Study Group of First Acute Myocardial Infarction, Myers examined the association between depressive symptoms in heart attack patients and hospital admissions more than a decade after the initial attack.

These findings have long-term ramifications, says Myers. Spending more time in the hospital, these patients are a massive financial burden on health services, but an investment in extra psychiatric support may have a large positive payoff. The study was funded by the Israel National Institute for Health Policy and Health Services Research and has been published in the Journal of Psychosomatic Research.

Making better lifestyle choices
Most studies examining the connection between heart attack recovery and mental health have only included short term follow up, says Myers. To study the effect of depression on the long-term health of heart attack patients, the researchers used data collected from 632 heart attack patients under the age of 65 admitted to Israeli hospitals between 1992 and 1993, comparing their recoveries using follow-up data through 2005.

Although a large percentage of people who survive a heart attack will be re-admitted to the hospital at some point, people identified as at least "mildly depressed" during their first hospital stay were far more likely to be re-hospitalized later with further cardiac health problems. Patients with a higher depression score spent 14 percent more time in the hospital than those with a low score. Data were controlled for measures of co-morbidity, including other illnesses and risk factors such as smoking and socioeconomic status.

Making the right choices
Post-heart-attack lifestyle choices played a major role in this relationship, explains Myers. Most heart attack patients are offered rehabilitation services, and are advised to change their lifestyle to include exercise, diet, and smoking cessation programs. Depressed patients are far less likely to avail themselves of rehab services, or elect to make life changes themselves, she says. Overall, depressed patients were 20 percent less likely to be physically active after suffering a heart attack, 26 percent less likely to participate in a cardiac rehabilitation program, and 25 percent less likely to quit smoking.

"The message is that doctors cannot ignore psychological factors in patients who have had a heart attack. Patients who exhibit signs of depression need to be followed more closely, and may need extra help in following lifestyle recommendations. Ignoring this problem weighs heavily on health services," she adds.

Depressed over wife’s attempt to suicide, man ends life

Mon, 13 Feb 2012 10:38:15 GMT

A security guard allegedly committed suicide owing to depression over his wife’s attempt to commit suicide. The deceased is identified as Umesh, 30, a resident of Third Cross, Vivekananda Nagar in Hongasandra, and a native of Anekal taluk. He committed suicide by hanging allegedly because his wife Savita tried to commit suicide by consuming poison. She had undergone treatment at a private hospital on Friday.

Umesh was depressed over his wife’s attitude. On Saturday, he came home and hanged from a ceiling fan. The incident came to light on Sunday morning when his relatives came home. The reason for Savita’s suicide attempt is not known. The body was handed over to the family after postmortem. A case is registered with Madiwala police station.

Pickpocket caught
A pickpocket was caught by the public and handed over to the Madiwala police when he tried to steal money from a passenger in a BMTC bus.

John, 30, along with his associates, got into the bus, which was heading towards Electronics City from Shanthinagar and tried to steal the wallet of a man who was travelling with Rs13,000 along with his wife. However, the man noticed John’s attempt and raised an alarm. The passengers managed to catch the miscreant.

Bullying or depression - which comes first?

Thu, 09 Feb 2012 10:34:42 GMT

When a kid is repeatedly hit, insulted or picked on by another student, it’s reasonable to assume the victim may develop low self-esteem and other psychological problems. But although depressed kids are more likely to be bullied, their poor mental health is not necessarily due to abuse from their peers, CBC reports.

A new study that followed 486 children through Grade 4 to Grade 6 found little indication that being bullied increased a child’s risk for depression in later grades. For kids who are already depressed, however, the earlier grades can be dark times. Children who cry easily or go on about their problems may be bully magnets, according to the research, conducted by Karen Kochel and colleagues at Arizona State University’s school of social and family dynamics.

“Youth who are depressed really have the potential to appear vulnerable, and are easy marks for victimization,” she told CNN. It’s a matter of kick ’em while they’re down. The research, published in the journal Child Development and funded by the U.S. National Institutes of Health, confirms that depressive behaviour has a negative impact on peer acceptance.

Fourth graders with depressive symptoms were more likely than their classmates to be bullied in Grade 5, and kids who were victimized in Grade 5 were more likely to be shunned by peers in Grade 6.

The study suggests that depression came before the kids’ social difficulties, but doesn’t rule out the possibility that rejection from peers can make a depressed child even more depressed. Researchers looked at depressive symptoms based on reports from parents and teachers, which didn’t include whether students themselves had feelings of worthlessness.

Nevertheless, in an interview with CNN, Jennifer Lansford, a developmental psychologist at Duke University's Center for Child and Family Policy in Durham, N.C., described the study as “rigorous and well conducted.”

She said the findings emphasize the need for parents and teachers to identify psychological problems early and help kids before the cycle of depression and victimization starts. “Even from a pretty early age, [expressions] of sadness or … other negative emotions can lead to problems with peers,” she said. “If parents and teachers are able to work with kids to express their emotions in different ways, then they may not elicit the same maltreatment from peers.”