Archive for November, 2009

Mental health professionals tend to approach their subject from one of two quite different perspectives. Some regard mental health problems as a biological disorder or malfunction. This is the approach that is emphasized within medical models of illness, and by psychiatrists. Psychologists are more likely to look at the psychosocial and cognitive factors. So where does that leave the ‘chemical imbalance’ theory of depression?

Mind: Body Relationships and Chemical Imbalance

We are beginning to understand the ways in which the mind and body are interdependent. The consensus today is that stress and emotions can induce the biochemical changes that can be measured in depressive illness. More rarely it can work the other way round, with physical illness resulting in depressed mood.

Often it is hard to separate the two. Stress or poor diet causes us to become run down and renders us more vulnerable to physical illness. Physical illness is itself frequently a cause of stress, and so a feedback situation arises. Most experts agree that depressive illness is a two-way street.

Various diseases and conditions are thought to trigger depression in certain individuals. Depression is associated with various diseases of the nervous system and the endocrine system, for example. It can also be triggered by infections, such as glandular fever.

What Chemicals Are Implicated in Depressive Illness?

Whichever approach is adopted, there is no doubt that biochemistry is a very real factor in depressive illness and that drug treatments that alter body chemistry can be effective. Attention has focussed on hormones and neurotransmitters called monoamines.

The best-known neurotransmitter linked to depression is serotonin. Low serotonin levels are linked to depressed mood, poor appetite and sleep and other bodily functions. The stress hormone norepinephrine is another. Drugs that prevent re-uptake of these neurotransmitters increase their levels in the body and are fundamental to medical management of depression, usually together with psychological therapies.

An alteration in brain chemistry is involved in depression. Returning that imbalance to normal plays an important role in treatment.

This is one of those topics that people give close attention. It is actually empowering. When you know the causes of an illness, you are more self-aware. The power is in your hands at that point to be proactive.

Depression is an illness that mostly results from an imbalance of chemicals in the brain. These chemicals are called neurotransmitters. The ones affected are associated with neural pathways that control mood.

There isn’t just one cause for depression. In fact, finding a cause can be rather complex in its nature. Many of the causes that scientists and doctors have come up with are still being tested. Start with this list and follow up with your doctor for more in-depth information.

1. Heredity – Like other conditions such as alcoholism, you are at a greater risk if someone in your family also has the condition. Those with family members suffering from depression or who have succumbed to a depressive symptom (suicide) are more likely to develop depression according to the experts. They have not identified which types of depression that includes as yet.
2. Illness – There seems to be a correlation between illness and depression. This refers to prolonged illness like cancer, HIV/AIDS, diabetes and heart disease. If you already have been exhibiting symptoms of depression before these illnesses your risk is greater.
3. Personality type – People who exhibit low self-esteem, poor body image, inability to handle stress, feelings of isolation and negative thinking are more likely to become depressed.
4. Nutritional deficiencies – What you eat is important. When your diet lacks vitamins and minerals instrumental in brain health, depression could become a reality in your future.
5. Medications – Some medications may have side effects that can lead you to depression. If you’ve ever read the list on the bottle, prolonged use of some can increase depressive symptoms.

Are you concerned that something in your life may be a cause for depression? You won’t know for sure unless you see a professional.

Along with more traditional forms of treatment, behavioral modification has shown to help many who suffer from depression. It is a complementary therapy that many turn to as a form of self help.

The broad term for the category of therapies encompassing behavioral modification is psychotherapy. This is not something you’d see going on in the back room in one of those low-budget horror flicks. It is a form of talk therapy designed to help you to recognize your depression for what it is.

You’d be surprised how many people are in denial. They classify their depression as a bad case of sadness that will eventually pass. They don’t want to be labeled by depression.

They don’t realize that the way not to be labeled is to find help. Here are the basics of behavioral modification.

* You and your therapist will discuss your condition. They will find out your symptoms, what you feel from day to day and how you view your depression. All of the answers you give are clues to helping them to find a complementary treatment for you.
* One form of psychotherapy is cognitive behavior therapy. This therapy teaches you to recognize when you are slipping back into depression and how to use your behavior, thinking and words to influence the outcome.
* Cognitive behavior therapy involves: (1) working with your therapist to decide on what the outcome of treatment will be, (2) learning to recognize what events trigger you to relapse into depression, and (3) modifying your thoughts, words and actions from negative to positive in order to cope successfully and not relapse.

What you get out of therapy largely depends on you. Psychotherapy treatments are usually highly structured to give you the safety and confidence to keep pursuing it. Along with medical treatment, hopefully you will find a prescription for successful management.

One of the symptoms of depression is an altered mood. People, who are normally bubbly and outgoing, change and become more sullen and withdrawn. Anyone who knows you can tell that something is wrong.

Many of the symptoms of depression revolve around your attitude. There is a tendency towards insomnia or trouble staying asleep. Sleep is the time when the body recharges itself.

If you are suffering from depression, you may notice that you are more irritable than usual. That could be followed by crying spells and moments of anger. The majority of suicides have been diagnosed with some form of depression at some point in their lives.

All of these symptoms and others lead to one thing: a change in your outlook on life and your own well-being. It is a common practice for depressed people who are contemplating suicide to give away their belongings. It may not be odd to be generous but these are items that they hold dear and, under any other circumstance, wouldn’t be parted with.

For that reason, making any major life decisions is not wise at this time. If you know anyone who exhibits signs of depression, get them help right away. When people who are depressed are approached by salespersons, they can be more highly suggestible than normal. You may not have wanted to change your life insurance policy a year ago, but in light of your depressive episodes, you may be talked into changing that and more. The downside here is that your life can be totally turned upside down in those days and months when your depression went undiagnosed.

If you or someone you know is being treated for depression, ask a friend or family member to hold you accountable physically, mentally, emotionally and financially. Changes in relationship status, financial status, work status (to name a few) need to be put on hold until you are thinking more clearly.

Much has been made of ‘happy pills’, with drugs such as Prozac becoming a household name in the 1990s. Antidepressant drugs have been around for half a century, with new types regularly being developed. They are as controversial as they are widely used.

Apart from potentially unpleasant side effects, they have been described as overrated and over-prescribed. A key criticism is that they target the symptoms of depression without addressing the causes. That is certainly true, but antidepressants have their uses in modern medicine and mental health treatments, although many professionals no longer use them as a first line of defense against depressive illness.
Types of Antidepressants

Although there are many classes of antidepressants, three are most commonly used. All work in much the same way, by affecting the chemicals known as neurotransmitters. Those chemicals include serotonin, dopamine and norepinephrine (noradrenalin), which are all implicated in mood regulation.

* Tricyclic antidepressants (TCAs) are the oldest kind, dating back to the 1950s. They have largely been replaced by newer kinds with fewer side effects and lower overdose potential. Imipramine, clomipramine, trimipramine and amitryptiline are all TCAs (brand names include Anafranil, Tofranil, Surmontil). They are still occasionally prescribed when the need arises.

* Monoamine oxidase inhibitors (MAOIs). These are now rarely prescribed because of negative interactions with other drugs and with foods containing tyramine (including red wine, some cheeses, Marmite/Bovril/Vegemite).

* Selective serotonin reuptake inhibitors (SSRIs). The most used these help to build up serotonin levels in the brain. Serotonin is linked to mood as well as appetite, and low levels have been implicated in chronic pain syndromes. Well known SSRIs include fluoxetine (Prozac), paroxetine (Paxil/Seroxat) and sertraline (Zoloft).
Antidepressants are often in the headlines due to real and supposed side effects and questions about their effectiveness. Some argue that they are little better than placebos. Anyone opting for antidepressant drug therapy should discuss the pros and cons with their doctor. Antidepressants alone may not solve the problem and are often taken as one arm of a wider-ranging treatment program that can include counseling and lifestyle changes.