Tag Archives: Depression

Depression And Allergies

pollen

More and more, researchers are starting to see a connection between allergies and depression. There is evidence of relationships in both directions, so allergies exacerbate depression, while depressive symptoms and affect make allergy symptoms worse. One study found that this connection is partly responsible for an uptick in suicides as winter turns into spring. Part of this is a hope that depression is merely seasonal being dashed—people tough it out through the winter but go into a decline when spring doesn’t bring improvement—but now it appears that allergens increasing in the springtime also bears on this phenomenon.

Depression is thought of as a mental illness, but the brain is part of the body, and there’s no bright line, medically speaking, between physical symptoms and mental ones. One place where this is apparent is allergic reactions causing depressive symptoms. Allergens are normally harmless substances, such as pollen, that trigger an immune response in people who are sensitive to them. Part of this immune response is inflammation. Inflammation can lead to a low feeling called dysthymia; this is why people who are sick feel awful. Dysthymia is also a symptom of depression. Some scientists have proposed that a hitherto underestimated cause of depression itself is inflammation due to allergy.

Meanwhile, stress is both a cause and an effect of depression. Depression can be a response, in part, to stress, but t can also increase it. Stress is also intimately bound up with the immune system The stress hormone cortisol temporarily suppresses the immune system, only for it to come back turned up after the stressor has passed. That means that stress, anxiety, and depression actually make allergic reactions worse, particularly on the second day. That means not only does stress directly lead to depression, it also increases depression as a result o the inflammation from an allergy attack.

In children, scientists have also found a genetic link between allergies and depression, as well as behavioral problems. While allergies themselves exacerbate depression, and allergies and depression alike are partly responsible for children misbehaving, there is evidence that genetics is behind a predisposition to allergies, a predisposition to depression, and a tendency to act out.

Finding Depression

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Depression is a disease. It goes beyond simply being sad, or in a down mood—it is the result of chemical abnormalities in the brain. Sometimes people are born with these abnormalities, sometimes they come about due to another illness, or life experiences, and often, scientists believe it is a combination of these factors: people are born with a predisposition—which is sometimes genetic and sometimes not—to develop these abnormalities in response to events and circumstances.

Depression can be debilitating, even deadly. That’s why it’s important to identify it so appropriate treatment can be obtained. Symptoms of depression include the obvious sadness, lack of motivation, and changes in appetite—either an increase or lowered—but there can also be physical effects. Depressed people often experience otherwise inexplicable aches, and often fail to connect these to their mental state. Sleep problems are also common; as with appetite, this can take the form of insomnia or of sleeping too much. Depression might also bring anxiety, restlessness, and difficulty making decisions.

People who are exhibiting these or any other signs of depression, or who are undergoing stress but aren’t noticing symptoms, might benefit from getting screened for depression. In fact, more and more experts are recommending screening for all adults who have access to mental health care, whether or not they are showing any signs of depression. Mental illnesses in general, and depression in particular, are difficult to spot, both because they come on so gradually, and because they affect the area that notices symptoms, and screening people who thing they are health could have enormous public health benefits. Screenings are confidential and generally take less than an hour.

Now screening may be easier still. Researchers have developed a blood test that they say will help spot signs of depression as it starts to develop more easily than talk- and questionnaire-based screening techniques, and even spot people who are prone to depression before they experience it. The blood test looks for molecules in the blood that are characteristic of depression, can help differentiate types of depression, and may be able to help predict which course of treatment is likely to be most effective. Scientists say the test demonstrates that depression is an actual illness with a biochemical basis.

Risk Factors For Postpartum Depression

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The hormonal rush of pregnancy and giving birth can wreak havoc on a woman’s emotional state. The mood swings that often accompany pregnancy don’t always go away once the baby is born. As many as one in four women experience clinical depression starting around four weeks after giving birth. Postpartum depression is more than simply low mood, or the lack of energy that comes from taking care of a new baby. Like other forms of depression, it is a potentially serious mental illness.

While new motherhood brings with it a certain amount of worry, postpartum depression goes beyond that. Lasting feelings of being overwhelmed, of regret over having a child, of not feeling any connection to the newborn or to anything at all, of emotional numbness, of guilt over feeling like a bad mother, or of wanting to run away and leave the baby behind are not simply the emotional roller-coaster of new motherhood; they may be signs of a serious illness—though often a treatable one.

There are some risk factors to be aware of. A woman with a prior history of clinical depression is prone to return to that state after having a baby. Women who are pregnant in stressful situations—such as young motherhood, unplanned pregnancy, facing motherhood alone, relationship difficulties, or financial problems—are more likely to develop postpartum depression, and lack of support is the biggest single risk factor. Sometimes, depression develops as a response to a temperamental or colicky baby; it can be triggered, in part, by fear of being an inadequate mother, and a baby who is responding poorly to parenting can seriously exacerbate that fear. Smoking makes the postpartum depression risk worse, even among women who quit for the duration of the pregnancy if they resumed after.

Another risk factor is the perceived—and often real—pressure to be The Perfect Mother. Although no mother is perfect, women are often made to feel as though the tiniest misstep during the child’s infancy can ruin them for life. This results in every decision becoming fraught with worry, and new mothers may freeze up as a result. One decision that is highly anxiety-provoking in this way is weather or not to breastfeed. Interestingly, while the dire consequences commonly predicted for formula-fed infants are often exaggerated if not invented, breastfeeding does lower the mother’s risk of postpartum depression. One reason for this may be that new mothers who attempt to breastfeed but are unsuccessful are more likely to develop depression, but breastfeeding also promotes mother-child bonding.

Weight Loss and Happiness

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Although some research indicates losing weight makes people healthier, many dieters don’t cite health concerns as their reason for trying to lose weight. Instead, they say they are doing it in pursuit of a more general life improvement. Now a new study, which followed nearly 2,000 people in the Unite Kingdom over four years, reiterates that people who expect weight loss to lead to a better, happier life may well wind up disappointed, and in reality, losing weight does not make people happy.

One aspect of the problem is high expectations. Weight is only one aspect of someone’s life, an a fat person with problems who slims down is likely to end up as a thinner person with many of the same problems. Moreover, weight loss is a slow and difficult process, and there are no instant results. The researchers characterized their results as meaning that dieters should not expect instant improvement in all areas.

That doesn’t necessarily mean no one should bother. In the study, subjects who had a weight loss of at least five percent were found to have significantly improved health outcomes. Fourteen percent of study subjects achieve this level of weight loss, an average of 15 pounds each, and their physical health improved, but at the cost of mental health. Even taking unrelated averse life events into consideration, the subjects who lost weight were 50 percent more likely to be depressed than those who did not.

The researchers cite unrealistic expectations, encouraged both by the culture generally and weight loss industry advertising in particular, as one factor in this linkage. Another aspect of it is the constant temptation, also encouraged by advertising, to eat unhealthy foods and foods that might impede weight loss. In fact, many of these foods are promoted as enjoyable because they are in opposition to weight loss efforts.

The researchers say their findings are relevant not only to people considering losing weight but to their doctors. They say doctors should take mental health and well-being into account when advising patients on whether and how to lose weight. Doctors should monitor patients who are losing weight to ensure that signs of depression are promptly addressed. The study only looked at the weight loss period, an it is not known if the effect diminishes or disappears once the goal is reached and the dieter can switch focus from losing weight to keeping it off.

Suicide And Depression

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The tragic death of comedian Robin Williams has brought new focus to the problem of suicide, which kills at least 800,000 people each year. Exact numbers are difficult to determine, because people who commit suicide often try to hide the fact, but it is believed to be the worlds tenth leading cause of death. This suggests that suicidal thoughts are quite common; one danger of media coverage of the death by suicide of a prominent person is the fear that it could lead others to emulate that person.

Suicide has been called "a permanent solution to a temporary problem," but all too often the problem doesn’t feel temporary to the person suffering. One reason for this is that depression and despair can have a distorting effect on one’s perceptions; in the words of the poet Alexander Pope, "all looks yellow to the jaundiced eye." In some cases, such as terminally ill patients suffering degenerative conditions, there may be some truth to the notion that the situation is hopeless, but otherwise there is almost always a brighter future than may be visible at the time. That is why people who are feeling suicidal are urged to get help, from a doctor, or a friend, or a helpline such as the National Suicide Prevention Lifeline at 800-273-TALK.

This can be a complicated situation for the person reached out to, especially if that person is not trained. The best thing to do with a friend or relative who has expressed a suicidal feelings is to ask direct questions, though in a non-judgmental way if possible, about the person’s state of mind. Many people are reluctant to do this for fear it will be the final push, but generally it’s the opposite. Often people become suicidal when they feel they have no room to express these feelings. Someone to talk to, someone who encourages them to open up, can be tremendously helpful. If someone is talking about suicide, this is not a sign they won’t do it; although suicide is frequently an impulsive act, someone thinking and talking about suicide often is more likely to go through with it.

Serotonin And Serotonin Syndrome

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A neurotransmitter—a type of chemical used by the nervous system to carry signals from one place to another—called serotonin is synthesized out of a nutrient called tryptophan, which is part of proteins in the brain and in the intestines. Most of it, as much as 90 percent, is in the gut, where it is a part of the digestive process. Serotonin regulates appetite and is responsible for the body's response to poisons and other things that are not fit to eat.

The rest, the serotonin produced and used in the brain, is separate. The blood-brain barrier keeps serotonin in the brain from going to the gut, and vice-versa; the level in one is not effected by the level in the other. Serotonin in the brain is related to mood balance and social behavior. The two functions are not unrelated; among humans, social status is a part of how well one eats. Even in civilization, social occasions often involve food. Culture recognizes the link between interaction and appetite.

Serotonin is also associated with clinical depression. Depression often includes poor motivation and low libido and sexual response, and depressed people have low levels of serotonin in the brain, where it regulates those things. It is not clear whether low serotonin causes depression or depression reduces serotonin levels, but it seems that the low serotonin in turn affects libido and motivation.

That's why depressive patients are advised to eat healthy and get exercise and sunlight, all of which boost serotonin production. It's also why treatment for depression includes a class of medications called selective serotonin reuptake inhibitors. These SSRIs prevent serotonin produced in the brain from being reabsorbed after it is used. With more serotonin around, these symptoms often diminish.

However, an excess of serotonin can also cause problems, specifically, a condition called serotonin syndrome. This condition, which is almost always a result of SSRIs or other medications that cause serotonin to accumulate, can result in nausea or diarrhea as well as restlessness, confusion, twitching, perspiration, shivering, and goose bumps. In severe cases it can cause fever, irregular heartbeat, and seizures. The symptoms usually go away when the medication is stopped or adjusted, but can be fatal if ignored.

Dealing With The Winter Blues

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Between the cold weather, the short days and long nights, and the after-holiday crash, the early months of the year are often a downer for people. For some, in fact, the winter blues can reach the level of full-blown depression, reaching its nadir in the depths of winter. Mental health experts call it seasonal affective disorder, and it affects as many as 20 percent of people in some parts of the country.

Seasonal affective disorder is considered a type of clinical depression—the fact that it fades as spring approaches does not mean it is any less serious. However, many sufferers feel that the temporal, and temporary, nature of the condition marks it as not worthy of treatment, or as something that can’t be treated. Seasonal affective disorder can occur in people who have no symptoms of depression at other times of the year, or people who are depressed can find it worsening in the fall and winter.

It most likely happens because people, like a lot of animals, go into a sort of shutdown mode in the wintertime. Humans don’t hibernate as thoroughly as bears do, but a general cutting back on activity saves energy during a time of year when our ancestors may have found food relatively scarce. In addition, the changes in the amount of sunlight affects the circadian rhythm—the body’s sleep-wake cycle. This affects the levels of chemicals in the brain that regulate mood, making people broodier in the wintertime. This can be exacerbated by other factors. For example, the cold weather means most leisure time is spent in isolation at home. Residual holiday stress may linger, no longer balanced by the distractions of holiday festivities, and paying for it adds another layer of worry.

Whatever the cause, it’s important not to let seasonal depression keep you down. Spend low-impact time—coffee, bowling, something indoors and inexpensive—with friends you may not have seen during the holidays. Keep up your exercise habits, or the habits you resolved to develop. If you’re already in therapy for depression, make sure to make and keep appointments during the winter. A doctor may be able to help you get a light therapy box, a special light designed to offset the effects of winter darkness on mood. Even without a light box, getting as much light as you can will help smooth things out, as can fresh air.

Alcohol And Health

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People who drink moderate amounts of alcohol are actually healthier than the general population, with better cardiovascular function and a lower risk of death than teetotalers. Now researchers can add immune system benefits to that list. According to researchers at from Oregon Health & Science University, alcohol—in moderation—can help fight off infection.

"It seems that some of the benefits that we know of from moderate drinking might be related in some way to our immune system being boosted by that alcohol consumption," Kathy Grant, Ph. D., the senior author on the paper, said in a statement. While the research showed that heavy drinkers had poorer immune function than non-drinkers, immunity to infection was actually enhanced in the moderate-drinking group.

This ties in with observational evidence of the benefits of alcohol. People have long fought colds with Bourbon and brandy, and a component of red wine, called reservatrol, has been found to have beneficial effects on heart health. Reservatrol is an antioxidant, meaning it helps slow the decay of cells and tissue within the body that is responsible, at least in part, for most of the major diseases that primarily affect older people. In addition, alcohol is a blood-thinner, preventing clotting that can lead to stroke. It also helps lower cholesterol and blood pressure. All these effects, researchers have found, are due to the alcohol itself, regardless of other lifestyle factors, and are consistent across drinkers.

In fat, a nutrition guide developed by Harvard University researchers recommends moderate alcohol consumption except for people who are specifically likely to be harmed by it or who have had or are prone to problems with substance abuse. Diseases that have been found to be reduced in drinkers include duodenal ulcer, gallstones, kidney stones, rheumatoid arthritis, osteoporosis, dementia, type 2 diabetes, hearing loss, and angina pectoris. Furthermore, the ability of alcohol to reduce feelings of stress mean less depression and stress-related physical problems.

Postpartum Depression And Your Kids

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New research on depression suggests that depressed pregnant women have children who are themselves depressed. Depression is a medical condition that is related to hormones, which is an important reason women are particularly prone to become depressed during pregnancy and postpartum, even if they do not otherwise show symptoms, and it now appears that the hormonal disturbance that causes this tendency also affects the fetus.

This is in addition to the known hereditary component of the mental illness, and it supports the understanding that in many cases, the seeds of mental illness exist before the disease develops or the patient shows any symptoms—a finding with important implications for diagnosis, treatment, and prevention. In particular, experts say, it might be particularly helpful to provide intervention and support to the children of depressed mothers in an effort to stop the condition before it starts. The study found that the children of less educated mothers with postpartum depression are more likely to become depressed, and would particularly benefit from intervention.

This is important because, if unchecked, depression can be a lifelong, debilitating condition. In addition to a general lowering of quality of life, the illness can exacerbate physical illnesses. The nearly 8 million diabetics who also have major depressive disorder, for example, have a 20 percent higher risk of dying from cardiovascular disease and a 50 percent higher overall mortality rate. Depression makes the sort of self-care needed to manage diabetes difficult, and there are known links both between depression and obesity and, in turn, obesity and diabetes; depressed people have lower levels of physical activity, which can prevent diabetes.

Smoking, too is associated with both depression and diabetes, and a study published last month found that treating depression can help people quit smoking. This isn’t, the first suggestion of a link; the antidepressant Wellbutrin has been used for some time as a stop-smoking drug, and depressed people are more likely to smoke. The study found that smokers who are depressed have worse smoking-related medical problems, but that therapy for depression makes it easier for them to quit.

Diabetes And Depression

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Psychiatrists and other doctors treating depression are being advised to be judicious about prescribing antidepressants to patients at risk for type 2 diabetes, in the wake of new findings suggesting a link between the medications and likelihood of developing diabetes. The mechanism is unclear; while some antidepressants are known to cause weight gain, which is a diabetes risk factor, some of the studies researchers looked at showed a connection even when accounting for weight and other risk factors. The results even held when accounting for the diabetes risk factors, such as inactivity, poor diet, and smoking.

"While depression is an important clinical problem and antidepressants are effective treatments for this debilitating condition, clinicians need to be aware of the potential risk of diabetes, particularly when using antidepressants in higher doses or for longer duration," said Richard Holt, one of the researchers involved in the latest study, in a statement. "When prescribing antidepressants, doctors should be aware of this risk and take steps to monitor for diabetes and reduce that risk of diabetes through lifestyle modification."

Other risk factors include a family history of diabetes, being over 45, having developed gestational diabetes during pregnancy, or having given birth to a baby over nine pounds. People who are black, Hispanic, or of Asian or Pacific Island decent are also more prone to type 2 diabetes. Some health conditions tend to lead to diabetes also. People with high blood pressure, low levels of HDL cholesterol, or high triglyceride levels are likely to develop the conditions. People with these conditions should be cautious about taking antidepressants for a long time or at high doses.

In contract, the hormone melatonin, often taken in supplement form as a sleep aid, might help prevent diabetes. A study in Boston found that people with lower levels of melatonin in their blood are more than twice as likely to develop diabetes. This only raises the possibility that raising a person;s level of the hormone will prevent diabetes, but it is known that melatonin can prevent or reduce weight gain, lowering diabetes risk that way.