Categories
Depression Tic Disorders

Depression and Tourette’s Syndrome

Depression is one of the most common mood disorders in the United States that affects all ages. There are several different kinds of depressive disorders including persistent depressive disorder, postpartum depression, psychotic depression, and seasonal affective disorder. Common signs and symptoms of all these forms of depression include feeling persistent sadness, hopelessness, and irritability. There is also a loss of interest and pleasure in hobbies, as well as restlessness, aches and pains, heachaches, cramps, digestive problems, difficulty sleeping, and difficulty concentrating. Not all people affected by depression experience the same symptoms, and some individuals may experience only a few of these symptoms while others experience multiple ( NIMH » Depression ). Causes behind depression may include changes within the brain, function and effect of neurotransmitters, and hormonal balance. Research has demonstrated that depression tends to be more common in individuals who have a family history of the mood disorder. Additionally, there can be multiple risk factors of depression including low self-esteem, traumatic or stressful events, family history of depression, having a past medical history of other mental health disorders, drug or alcohol abuse, serious to chronic physical illnesses, and certain medications’ side effects. Some prevention methods or treatments for depression can include healthy stress management strategies, medications such as antidepressants, and psychotherapy, all of which should be discussed beforehand with a medical professional (Depression (major depressive disorder) – Symptoms and causes). 

Tourette’s Syndrome is a neurodegenerative disorder that causes individuals to experience tics, which are sudden twitches, movements, or sounds that are done or made repetitively and can be difficult to voluntarily stop. Tics usually begin in children around the ages of five to ten, and the frequency and types of tics a person may experience could change a lot overtime. It has been commonly demonstrated that tics tend to decrease into adolescence and early adulthood, or may even completely disappear. Although a decline in tics in adulthood is common, some people may experience tics worsening into adulthood. Although there is no cure for Tourette’s syndrome, there are multiple methods to manage tics such as medication or behavioral therapy ( What is Tourette Syndrome? ). 

Many studies have found that there is an association between Tourette’s Syndrome and depression. One study had found that in a form of Tourette’s, Gilles de la Tourette’s syndrome (GTS), depression is common amongst these patients and is significantly associated with GTS patients, depending on factors such as tic severity, comorbidity with ADHD, and the presence of coexistent anxiety (Rizzo, Gulisano, Martino & Robertson, 2017). Another study had similar results, and found that screening for depression amongst patients with Tourette’s Syndrome was higher in adolescents, children, and adults with severe tics (Marwitz & Pringsheim, 2018). This association between Tourette’s syndrome and depression indicates that there is a need to emphasize the importance of routinely screening for depression amongst Tourette’s syndrome patients to implement appropriate screening. Additionally, it is important that patients with Tourette’s syndrome who have comorbidity of ADHD, anxiety, and severe tics, should receive proper care and treatment for these comorbidities and severe tics, so that the patient does not pose a greater threat of experiencing depression. Fortunately, such results from these two studies indicate that there is greater hope that future patients with Tourette’s syndrome will have better care that incorporates mental health. 

 

References

NIMH » Depression. (2021). Retrieved 13 April 2021, from https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145396

Depression (major depressive disorder) – Symptoms and causes. (2021).Mayo Clinic. Retrieved 13 April 2021, from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

What is Tourette Syndrome?.(2021). CDC. Retrieved 13 April 2021, from https://www.cdc.gov/ncbddd/tourette/facts.html

Marwitz, L., & Pringsheim, T. (2018). Clinical Utility of Screening for Anxiety and Depression in Children with Tourette Syndrome. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie canadienne de psychiatrie de l’enfant et de l’adolescent, 27(1), 15–21.

Rizzo, R., Gulisano, M., Martino, D., & Robertson, M. (2017). Gilles de la Tourette Syndrome, Depression, Depressive Illness, and Correlates in a Child and Adolescent Population. Journal Of Child And Adolescent Psychopharmacology, 27(3), 243-249. doi: 10.1089/cap.2016.0120

Depression. (2018). [Image]. Retrieved from https://i0.wp.com/digitallyliterate.net/wp-content/uploads/2018/05/180510-depression-al-1509_8b5188e45e5aed500291d9c30689f57f.focal-1000×500.jpg?fit=1000%2C500&ssl=1

Categories
Depression

Journaling and Depression

Treatment for depression normally consists of a combination of psychotherapy and medication such as antidepressants. But what are some daily activities that can help manage the symptoms of depression? Mental health experts have found evidence that journaling can help. 

How can something as simple as journaling help alleviate depression? There are several theories as to how writing down your thoughts can have a positive impact on mood. Journaling can help you become more aware of your thoughts, according to psychotherapist Cynthia McKay. Expressing yourself in a journal can bring your thoughts and feelings to the surface. Many people are surprised by what they write (Robinson, 2017). Clinical psychologist Perpetua Neo says that journaling allows you to take control, “when we write things down, they feel more manageable.” Taking the time to write out your thoughts on paper forces you to put things into perspective, and can help put a damper on feelings of worthlessness and bring you back to reality (Robinson, 2017). 

Journaling truly allows the patient to take an active role in their own treatment; it’s something you can do for yourself that in return makes you feel better. Charlynn Ruan, a licensed clinical therapist, says she often uses gratitude and affirmation journaling techniques with her clients in order to reinforce positive thinking and self-talk. Ruan also says that “writing about happy memories is especially powerful because depression tends to bring up negative feelings. It’s like retraining your brain” (Robinson, 2017). 

Being able to recognize patterns in your moods is another benefit of journaling. A journal is essentially a way to track your symptoms and pinpoint your triggers. By looking back at past entries, you’re able to analyze what triggered your feelings and how to better handle stressful situations. For example, you may notice by reading your entries that you tend to have a more depressed mood when your work schedule is jam-packed and you have several important deadlines coming up. By recognizing this, you can better prepare yourself for these stressful times by planning some self-care time into your nightly routine or treating yourself to dinner from your favorite spot.

Depression is considered a mental illness that results from distorted thinking, meaning you may over analyze situations or jump to the worst conclusions without knowing the full story (Journaling for Anxiety, 2019). Recording your thoughts, feelings, and emotions in a journal allows you to see patterns in distorted thinking and correct the thoughts to be more positive and realistic. 

A journal can be used as a tool during therapy sessions too. The journal should be brought to sessions and used to jot down any key points you address during the session. Entries from the previous week can be discussed, finally, keeping a section in your journal with questions for your therapist can be helpful (Journaling for Anxiety, 2019). Being able to look back on past entries and realize how much you’ve grown and improved since you began treatment is another motivating factor to start journaling. Having written proof of recovery, better times, and happy memories can be helpful to look back during rough days or relapses in depression

Overall, it is clear that keeping a journal is an effective way to help manage depression on your own. However, it is still important to seek help from a mental health professional if you think you’re struggling with depression. Journaling is a tool to alleviate symptoms of depression, not cure them. Medication and psychotherapy used in conjunction are still proven to be the most effective forms of treatment for depression. Journaling gives you the opportunity to explore your own feelings, thoughts, and emotions on a deeper level and analyze your own thought patterns in order to help improve your depression. 

 

References

Journaling for anxiety treatment and depression treatment. (2019, February 18). Retrieved April 05, 2021, from https://shermanconsulting.net/journaling-anxiety-depression/ 

Robinson, K. (n.d.). How to manage depression by writing in a journal. Retrieved April 05, 2021, from https://www.webmd.com/depression/features/writing-your-way-out-of-depression

Categories
Depression

Atypical Depression

With depression being one of the most prevalent mental illnesses in America, it’s likely you’ve heard of the various types of depression. Perhaps these sound familiar: major depression, chronic depression, and postpartum depression. But have you ever heard of atypical depression? Despite its name, atypical depression actually is not uncommon or abnormal; it’s just the way the depression presents itself is not typical for other depressive disorders (Atypical Depression, 2018). People with atypical depression differ in the fact that they tend to feel temporary relief from their symptoms when receiving sympathy or having a friend or family member visit.

Atypical depression, just like chronic or major depression, can take a toll on your daily life by negatively impacting your mood and feelings (Symptoms of Depression, 2019). Those suffering from atypical depression still exhibit typical signs of any form of depression, including fatigue, trouble concentrating, feelings of worthlessness, loss of interest in things that were once pleasurable, sleeping too much or too little, overeating or undereating, and possibly suicidal thoughts or ideation (Symptoms of Depression, 2019). 

Some of the distinct characteristics that cause atypical depression to be its own form of depression were researched and discovered by Harvard Medical School. Scientists found patients struggling with what is now classified as atypical depression. Patients complained of many physical symptoms, one of which was a feeling of heaviness in the arms and legs (Harvard Health, 2014). They also found that these patients had a tendency to oversleep and overeat, never the opposite way around. These patients also tended to feel worse in the evening time rather than in the morning. The biggest distinction, however, was the inconsistency of their depressed mood and feelings. The scientists at Harvard said the patients with atypical depression differed in the sense that it was easier to lift their moods; “they were not sad all the time but able to cheer up at least momentarily in response to sympathy, compliments, or a visit from a child” (Harvard Health, 2014).

The scientists also noted that the majority of those classified with atypical depression tend to be highly sensitive to what they regard as rejection by lovers and others. They also tend to have many phobias, panic attacks, and severe premenstrual symptoms (Harvard Health, 2014). These symptoms are unusual because most patients are more constantly sad, wake up early rather than oversleep, feel worse in the morning rather than the evening, and eat less rather than more (Harvard Health, 2015). 

The exact cause of atypical depression is still unknown. Doctors have inferred that neurotransmitters play a key role, similar to other forms of depression. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When these chemicals are abnormal or impaired, the function of nerve receptors and nerve systems change, leading to depression (Symptoms of Depression, 2019). Besides the biological aspect, trauma, childhood neglect, and environmental stressors can all contribute to the onset of depression. 

Treatment for atypical depression is similar to other forms of depression. A combination of psychotherapy and medication together seem to be most successful. Doctors are not sure exactly why, but the type of medication that seems to be most effective in treating atypical depression belongs to one of the oldest classes of antidepressants: monoamine oxidase (MAOs). MAOs can have potentially severe side effects, which is why they are prescribed sparingly and never without extreme caution. Experts feel that MAOs, especially phenelzine (Nardil), can be effective for atypical depression. They may also help with anxiety, panic, and other specific symptoms (Atypical Depression, 2018). A strict diet must be followed while taking MAOs to prevent specific food interactions from occurring with food or medications, such as decongestants and certain herbal supplements. MAOs also can not be combined with selective serotonin reuptake inhibitors (SSRIs) (Atypical Depression, 2018). The interactions that can occur between MAOIs and certain substances can be severe or even deadly. Caution must be taken when prescribing these medications in order to produce the most desired results.

Overall, it’s essential that people understand there are different forms of depression and not all of them exhibit the same symptoms or respond to the same treatments. Those struggling with atypical depression should not feel ostracized or different just because their depression may not present itself in the same way that other typical depressive disorders do. If you or someone you know thinks they may be suffering from atypical depression, please do not hesitate to reach out to a mental health care professional for help.   

 

References

Atypical depression. (2018, August 28). Retrieved March 21, 2021, from https://www.mayoclinic.org/diseases-conditions/atypical-depression/symptoms-causes/syc-20369747 

Publishing, H. (n.d.). Atypical depression. Retrieved March 21, 2021, from https://www.health.harvard.edu/newsletter_article/Atypical_depression 

Signs of clinical depression: Symptoms to watch for. (n.d.). Retrieved March 21, 2021, from https://www.webmd.com/depression/guide/detecting-depression

Categories
Depression

Depression: Deeper Than the Surface

You’ve likely heard of diseases and disorders being genetic, meaning they are passed to you through your parent’s genes. But have you ever considered that mental illnesses like depression could also be genetic? 

First, it’s important to understand what it means for a disease to be genetic. In order to determine that genes play a role in causing depression, scientists looked at family medical histories and made note of illnesses that seemed to pop up frequently. By doing this they were able to estimate the illness’s “heritability,” or roughly what percentage of its cause is genetic (Levinson, M.D., 2021). 

In order to find out if depression is hereditary, scientists and doctors normally begin by studying twins, since they share so much of the same genetic material. Identical twins share 100% of their genes while fraternal twins share 50% of their genes. One twin being studied will already be diagnosed with clinical depression, while scientists try to determine the other twin’s genetic chance of developing the same disorder. 

Scientists at Stanford Medicine did just that and concluded that heritability for depression to be around 40-50%. This could mean that in most cases of depression, around 50% of the cause is solely genetic and the other 50% is a result of personal stressor or trauma (Levinson, M.D., 2021). In order to further prove that depression can be genetic, the same scientists looked at adopted individuals and found that if either of the biological parents had suffered from depression, the chances their child would also be affected increased. 

Now you may be thinking, I don’t have a twin with depression but other people in my family do. Am I at a higher risk for developing depression? If someone has a parent or sibling with depression, that person has a two or three times greater risk of developing depression compared with the average person. With a family history of depression present, the chances of developing the disorder are around 20-30%, while if there were no family history the chance would be only around 10% (Levinson, M.D., 2021). However, there are other factors that may increase the chances of a child developing depression. A British research team found that a child who watches a depressed parent or sibling may learn to mimic that person’s behavior under certain conditions. For example, a child who sees a parent spend days in bed may not think it unusual (Faris, 2017). 

Diseases like Huntington’s, cystic fibrosis, and forms of muscular dystrophy are all passed on through one specific gene. Things like depression and high blood pressure are still considered genetic but are not passed through one gene, rather a group of genes. There is no single depression gene, and depression cannot be inherited from a specific parent. All individuals inherit unique combinations of genes, some of which predispose them to depression (Levinson, M.D., 2021). 

Interestingly enough, the British research team recently isolated a chromosome, 3p25-26, that was found in more than 800 families with histories of depression (Faris, 2017). Although scientists were able to isolate that chromosome, much more research needs to be done before it can actually be concluded that it is the “depression gene”, considering there is currently no single gene responsible for causing depression. Another study was conducted and found that women are at higher risk for inheriting depression, with a 42% chance, while men have only a 29% chance. (Faris, 2017). 

Understanding that depression has genetic links may bring comfort to those suffering in silence, wondering where all their pain came from. Perhaps they cannot recall any traumatic event that caused their depression, or any major event. Knowing that they could just be predisposed to the disease may ease the anxiety of wondering why they feel depressed. Sometimes genetics really are a factor. If you or anyone you know is struggling with depression, never hesitate to reach out to family or friends for help. You are never alone. 

 

References

Faris, S. (2017, July 25). Is Depression Genetic? Retrieved March 2021, from https://www.healthline.com/health/depression/genetic#genetics 

Levinson, D. (n.d.). Major depression and genetics. Retrieved March 07, 2021, from https://med.stanford.edu/depressiongenetics/mddandgenes.html 

Categories
Depression

A Shocking Treatment for Severe Depression

Perhaps you have a loved one who struggles with depression. Hopefully, they are seeking the treatment they rightfully deserve. However, what happens if the “typical” forms of treatment are not effective enough? What if they have already tried multiple forms of therapy, cocktails of medications, all with little to no success?

Typical forms of treatment for depression include psychotherapy, specifically cognitive behavioral therapy (CBT), and/or antidepressants. However, a study was conducted where 100 clinically depressed patients were given antidepressants, and only about 40 to 60 of the individuals reported an improvement in their symptoms within six to eight weeks. CBT has been found to effectively help eliminate symptoms in around 55 to 75% of depressed patients, which may seem pretty effective. But what about the people who are not relieved by these treatments? Severe depression can feel suffocating, and when no treatments seem to provide enough relief, individuals may begin to feel even more hopeless. When this happens, and all other forms of treatment have failed, a procedure called electroconvulsive therapy (ECT) may be suggested. 

Focusing just on it’s name, electroconvulsive therapy sounds like an intimidating experience. Nevertheless, it’s important to understand how ECT works, who it treats, when it is used, and how successful it can truly be. Electroconvulsive therapy is a medical treatment most commonly used in patients with severe major depression or bipolar disorder who have not responded to other typical treatments (“What is ECT”, 2018). When the therapy is taking place, the patient will be under general anesthesia. Small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry, which may ease symptoms of mental health disorders such as depression and bipolar disorder (“Electroconvulsive”, 2018). Although doctors are not exactly sure how inducing a seizure helps relieve depressive symptoms, researchers at Johns Hopkins have recently found that new brain cells develop in the brain’s hippocampus after ECT, which is likely to contribute to the treatment’s success (“How ECT Relieves”, 2018).   

Hearing that ECT causes the brain to have a seizure may sound terrifying to some, and deter them from seeking this treatment. However, the entire procedure only lasts around 10 minutes. The patient is given the anesthesia and a muscle relaxant to dull the physical convulsions of the seizure. A blood pressure cuff is placed around the patient’s ankle, blocking the muscle relaxant from entering the foot. Rhythmic movement of the limb is the only visible sign that the seizure has occurred. Even though the outward signs of ECT are minimal, the procedure causes brain activity to skyrocket. A test called an electroencephalogram (EEG) records the electrical signals in the patient’s brain. Sudden increases in activity indicate a seizure. When they level off, the seizure has ended and that treatment session is over (“Electroconvulsive”, 2018). 

The amount of ECT sessions a patient will need completely depends on the severity of their depression or other mental disorder. Doctor’s base treatment length on how the patient reports feeling, and the number of depressive symptoms that still linger. Generally, the patient should expect to receive treatment two to three times weekly for three to four weeks for optimal results (“Electroconvulsive”, 2018). 

With this all being said, it is still important to understand and recognize that ECT is not a cure, but a treatment. To prolong its effect, it is common for patients to continue psychotherapy or to continue taking antidepressants after ECT is over. Again, ECT is only recommended for those who have already tried medication and therapy and failed to see improvement in depressive symptoms. A combination of psychotherapy and antidepressants are successful in treating around 75% of cases of mild to moderate depression. ECT is seen as an option for the remaining 25% of individuals who are not helped with the traditional treatments. Clinical evidence indicates that for individuals with severe major depression not treated by antidepressants, ECT will produce substantial improvement in approximately 80% of patients (“What is ECT”, 2018). 

American novelist and poet, Sylvia Plath, suffered from severe depression for the majority of her life and actually received ECT treatment in the 1950’s when the procedure was still experimental; without anesthesia, she was completely awake and aware the entire time. Ernest Hemingway, another American writer, also suffered from depression and other mental conditions. Hemingway also tried ECT in hopes for some relief. Modern day ECT has promising results with sessions improving depression in 70 to 90 percent of patients. Perhaps Plath and Hemingway could have had a happier ending if they had the procedure today and continued treatment with a combination of psychotherapy and medication. 

 

References

CH;, K. (n.d.). Electroconvulsive therapy (ect) IN literature: Sylvia Plath’s the Bell Jar. Retrieved February 20, 2021, from https://pubmed.ncbi.nlm.nih.gov/24290484/ 

Electroconvulsive therapy (ect). (2018, October 12). Retrieved February 20, 2021, from  https://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/about/pac-20393894 

What is electroconvulsive therapy (ect)? (n.d.). Retrieved February 20, 2021, from https://www.psychiatry.org/patients-families/ect 

How ect relieves depression. Retrieved March 01, 2021, from https://www.hopkinsmedicine.org/news/articles/how-ect-relieves-depression 

Categories
Bipolar Disorder Depression

The Winter Blues Disguised in SADness: Seasonal Affective Disorder

As we make our way into the cold and dark winter season, it is fairly common to see a change in people’s mood and experience a form of the ‘winter blues’. Winter can be a difficult season to experience as the days become shorter, colder, and limited in the amount of sunlight available. One is more likely to spend time indoors and may not participate in the same activities one was able to in the warmer months. It is quite common to see many feeling lethargic and down more than often. Can someone experience a more serious form of the winter blues? Can the winter months get you down more than you think? Yes. It’s called seasonal affective disorder, also known as SAD.

SAD is more than just the winter blues. Seasonal affective disorder (SAD) is known as a mood disorder characterized by the predictable depressive onset in the colder fall and winter months and hypomanic or manic episodes during the spring and summer months. A distinct feature that stems from this kind of mood disorder is that the symptoms tend to appear during the same months when seasons change. For example, an individual who tends to experience feelings of SAD during the colder months, can start to see symptoms emerge late fall to the early days of December. SAD has been studied to be linked to a biochemical imbalance in the brain produced by less daylight hours and sunlight in the winter. It may be rare, but SAD can be experienced in the summer months. 

Symptoms of SAD vary among seasons. Typical symptoms of SAD in the cold winter months consist of hypersomnia and increased appetite (specifically additional cravings of carbohydrates) (Ghaemi, 2020). When a study was conducted to see correlations between seasonal affective disorder and bipolar disorder, a 24 year-old woman shared her symptoms of SAD. “She craves bread, pasta, and sweets and reports increased appetite in winter compared with summer. Fatigue and difficulty concentrating are causing her problems at work and school.” (Roecklein, Rohan, & Postolache, 2010). The study concludes how different symptoms appear in the colder months compared to the warmer months. Several describe their symptoms of SAD during the winter months to be a period of hibernation where they rather be trapped away in their homes. Other symptoms can include feelings of no motivation, loss of interest, and decreased levels of energy (Team, 2020). 

A striking difference between experiencing this mood disorder between the colder and warmer months is people who are struggling with SAD during the spring and summer months tend to have a loss of appetite and insomnia. It is common between these warmer months where an individual will tend to have hypomanic or manic episodes. However, a similarity between the seasons is that an individual will experience a typical form of depressive symptoms. A dive into typical depressive symptoms are feelings of worthlessness and hopelessness, withdrawal from family and friends, agitation, and a sluggish mood (Borenstein, 2019). SAD depressive symptoms can lead to suicidal thoughts which are distinctive of major depression. 

One may ask what exactly causes SAD? There are three major causes to this condition. The first apparent cause is a disruption in the body’s circadian rhythm which is referred to as the body’s biological clock. Due to the reduced amount of sunlight in the fall and winter months, the body recognizes this disruption in its internal clock that may lead to the winter onset of SAD and introduction to depressive symptoms. This shift in the body’s internal clock is what can lead an individual to step outside of their daily schedule (Torres, 2020). The neurotransmitter called serotonin, responsible for mood regulation and stabilizing feelings of happiness and well-being, is noticeably reduced in individuals diagnosed with SAD. Another probable cause of SAD onset would be the over-production of the hormone melatonin in the body, which contributes to an individual feeling more tired and having lower levels of energy. 

Because SAD is categorized as a mood disorder and demonstrates cyclic seasonal patterns of depressive or manic symptoms, it exhibits commonalities with bipolar disorder. According to the National Institute of Mental Health (NIMH), initial studies were conducted on 29 patients which revealed that 93% of them had bipolar illness. Through many experimental studies, it has been discovered seasons affect mood even more for individuals with bipolar disorder compared to individuals with depression (Shin, 2005). The rebirth of spring and longer days can contribute to symptoms of mania in individuals with bipolar disorder. The relationship between seasons and mood can play a major impact on bipolar disorder and have the potential for triggering symptomatic behavior. 

If you feel that you are experiencing symptoms of SAD and these symptoms are invading other parts of your life, it is important to seek out professional help, especially if you feel down for more than a couple of days at a time. There are many types of treatment options for SAD, consisting of light therapy, psychotherapy, and medication. Light therapy is considered a form of phototherapy where an individual will sit in front of a light therapy box emitting a very bright light for approximately 20-60 minutes. Many people will tend to see improvements within the first two weeks of light therapy. The concept behind light therapy is to replenish the amount of sunlight that gets diminished from the fall and winter months. It is recommended that light therapy be used in the early fall to prevent symptoms from occurring.   

Cognitive behavioral therapy (CBT) is a type of psychotherapy that has been effective for individuals combating SAD. CBT is recognized as a talk therapy where individuals can improve and develop coping skills for the seasons (Rohan, 2013). As the name suggests, there are two components to this form of therapy, cognitive and behavioral, that individuals work on equally. The cognitive component is composed of learning to access and deal with the negative emotions and thoughts when experiencing SAD symptoms.The behavioral aspect consists of identifying and scheduling pleasurable everyday activities during the winter months to offset the lethargic feelings developed in SAD. To counteract the decreased levels of serotonin in the body, the most common type of medication used for SAD are selective serotonin reuptake inhibitors (SSRIs), which are a type of antidepressant. 

The most integral part of dealing with SAD is to take care of your general health. This can consist of eating a proper diet, getting enough sleep, and spending time with friends and loved ones. One of the key aspects to offset SAD is to embrace the joys of winter and enjoy the season in order to get through the difficult months of the year. The winter season is a time of the holidays and bringing others together. The winter months may not share the same activities one may enjoy in the summer months. However, you can pick up a pair of skates with a friend and go ice skating. You can bring loved ones closer together by making a comforting and cozy meal. One should not feel the cold of the winter alone, so it is important to try to be as occupied as you can. It is very possible to stay active, healthy and happy and combat the grueling symptoms of SAD one can face.  

 

References

Borenstein, J. (2019, December 31). The Winter Blues or Seasonal Affective Disorder. Brain & Behavior. https://www.bbrfoundation.org/blog/winter-blues-or-seasonal-affective-disorder

Ghaemi, S. N. (2020, January 28). Seasonal Affective Disorder (SAD) : Facts and Misconceptions. https://reference.medscape.com/slideshow/seasonal-affective-disorder-6007256

Levitan, D. (2007, September 1). The chronobiology and neurobiology of winter seasonal affective disorder. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202491/

Roecklein, K., Rohan, K., & Postolache, T. (2010, February). Is seasonal affective disorder a bipolar variant? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874241/

Rohan, K. (2013). Pardon Our Interruption. American Psychological Association. https://www.apa.org/news/press/releases/2013/02/seasonal-disorder

Shin, K. (2005, May 1). Seasonality in a community sample of bipolar, unipolar and control subjects. ScienceDirect. https://www.sciencedirect.com/science/article/abs/pii/S0165032704004380

Team, B. A. S. (2020, September 30). What’s the Difference Between the ‘Winter Blues’ and Seasonal Affective Disorder (or SAD)? Health Essentials from Cleveland Clinic. https://health.clevelandclinic.org/whats-the-difference-between-the-winter-blues-and-seasonal-affective-disorder-or-sad/

Torres, F. (2020, October). What is Seasonal Affective Disorder?  https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder

Categories
Depression Post Traumatic Stress Disorder

Still in Neverland: Childhood trauma and Interpersonal impact

In any given year, there are 3 million reports of child abuse in the United States alone. Many of these reports are made after these children reached maturity, and their confessions are no less sobering. 28.3% of adults report having experienced physical abuse during their childhood, and 20.7% of adults reported sexual abuse during their childhood. Based on the statistics, that translates 849,000 cases of physical child abuse and 621,000 cases of sexual child abuse. To put that in perspective, the University of Central Florida, the school with the largest undergraduate of on-campus enrollment, has 56,972 students. Imagine entire college campuses, in every dorm, in every classroom, in every lecture hall, with 2 floors of seats, packed by students who have gone through something unspeakable.

 

This is the state of child abuse in America.

 

Why don’t we talk about it?

 

Children are often victims of abuse. Childhood trauma and its well-studied effects on interpersonal issues. After child abuse shakes the foundations of their world, people with childhood trauma generally have trouble trusting others and battling their own emotions.

 

It is commonly known to psychologists that interpersonal trauma, or trauma inflicted with a target and intention, are more psychologically damaging than those cast without. In short, the accidental death of a loved one is a non-interpersonal trauma, while getting raped by a family member as a child is an interpersonal trauma. Both are terrible, but one is more likely to cause difficulties in regulation, changes in attention and consciousness, a manifestation of mental strain into physical problems, disruptions in self-identity, and harmful behaviors.

 

In addition to the above list of symptoms, one of the most noticeable impacts of childhood abuse is the way it affects how people perceive the world around them. Those who’ve experienced childhood abuse often have a hard time making and maintaining personal relationships. There’s little information about the specific nature of these interpersonal difficulties, but those who’ve experienced child abuse often feel vulnerable, ashamed, guilty, hopeless, and worthless.

 

In a recent case study by Dr. Kimberly and her team, a patient with an abusive background was evaluated for depressive symptom with the BDI-II and interpersonal ability with the IIP-32. Both tests consisted of inventory questions that sorted patients on a scale of severity. For example, the scale of someone with minimal to none depressive symptoms scored from 0-13. The patient scored 30 on her BDI-II and 57 on her IIP-32. Her score showed definite signs of severe depression and above average problems with interpersonal aspects of her life. She had expressed that her father’s abusive aggression and her mother’s lack of intervention has left her with feelings of shame, anger, and she did not know how to let go. This bled into her personal life, as she felt the need to be in control and was unable to express herself.

 

As part of the study, the patient underwent Short Term Psychodynamic Psychotherapy, otherwise known as STPP, for 20 weeks. STPP is designed to focus on undermining feelings and thoughts that disrupt one’s ability to communication, work, and maintain relationships. Post-therapy, the patient has shown drastic improvements in her depressive symptoms and interpersonal problems, with a score of 2 on her BDI-II and an 8 on her IIP-32. A year later, her score remained relatively low, with a score of 8 on her BDI-II and a 13 on her IIP-32.

 

Children abuse and therapy are one of those problems that people just don’t talk about.

 

Sometimes, it’s exactly what we don’t talk about that is the problem.

 

What we refuse to talk about, refuse to make a part of our reality, are an undeniable part of someone else’s.

 

You can help, there is a list of organizations that support and advocate those who experienced child abuse.

 

If you’d like to learn more about resources for you or someone in your life that has gone through childhood abuse, the Academy of Child and Adolescent Psychiatry has a page dedicated to research and common questions for your understanding.

 

If you need someone to listen, here is a guide to help find the right therapist for you.

References:

Barkham, M., & Hardy, G. E. (n.d.). The IIP-32: A short version of the inventory of interpersonal problems. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.2044-8260.1996.tb01159.x

Beck depression inventory-II (BDI-II). (n.d.). Retrieved from https://www.commondataelements.ninds.nih.gov/doc/noc/beck_depression_inventory_noc_link.pdf

Lindsay, S. (n.d.). The 37 biggest colleges in the united states. Retrieved from https://blog.prepscholar.com/the-biggest-colleges-in-the-united-states

Short-Term dynamic psychotherapy. (n.d.). Retrieved from https://www.apa.org/pubs/videos/4310903

Myths-about-child-abuse.jpg [Photograph]. (n.d.). Retrieved from

    https://www.paperrevolution.org/wp-content/uploads/2015/07/

    myths-about-child-abuse.jpg

Van Nieuwenhove, K. (n.d.). Interpersonal features in complex trauma etiology, consequences, and treatment: A literature review. Journal of Aggression, Maltreatment, and Trauma. Retrieved from Taylor and Francis Online database.

Van Nieuwenhove, K., Truijens, F., Meganck, R., Cornelis, S., & Desmet, M. (n.d.). Working through childhood trauma-related interpersonal patterns in psychodynamic treatment: An evidence-based case study. Retrieved from PsycARTICLES database.

What is Child Abuse? (n.d.). Retrieved from https://www.childhelp.org/child-abuse/

 

 

Categories
Depression

Depression and Insomnia

We all know what it is like after a bad night’s sleep. You wake up feeling groggy and 10 years older. No matter how many cups of coffee you down, the way you sleep stays with you for the rest of your day. In a fast paced, modernized society, a good night’s sleep can be hard to come by. For those with depression, sleep is a battle rarely won. While most of us hear that those with depression tend to sleep more than the average person, often we do not hear about the people who struggle with depression and insomnia.

 

According to WedMD, the medical definition for insomnia is the inability to fall or stay asleep. Since the quality of our sleep is a vital determinant of the quality of your waking hours, insomnia can be quite debilitating to one’s health and daily life. In addition to anxiety and intense emotional burdens, it is well documented that insomnia is often linked to someone’s sleep reactivity, also known as the tendency and to have disturbances in their sleep. One of the common factors that determine someone’s sleep reactivity is something that is often out of our control: stress. Generally speaking, sleep reactivity is not a characteristic unique to insomnia and could be associated and indicative of other disorders. For instance, studies have shown that insomnia has extremely high comorbidity and tend to co-occurrence with depression. If sleep reactivity can be a predictor of insomnia, what if it can be a predictor of depression? While there are lots of studies that confirm the association between sleep reactivity and insomnia, a lab in Michigan set to find more about the link between sleep reactivity and depression.

 

At the University of Michigan, a study by Dr. Vargas looked to find the link between sleep reactivity and depressive symptoms. To do this, he conducted a survey on 2,250 participants with insomnia and asked questions about their sleep disturbances and mental health. When he studied the results, Dr. Vargas found that the association between depressive symptoms and sleep reactivity was statistically significant. Therefore, the results of his data were not just caused by chance, there is an association between the way you sleep and how you feel. So, what exactly is the link? Dr. Vargas thinks that stress plays a big part. A lot of what keeps us up at night is the stress of our working hours. Stress is a universal emotion, but it impacts us all differently. Compared to an average individual, people with depression tend to have more stress and fewer tools to cope with it. Thus, they are more likely to have higher sleep reactivity and not get enough sleep. This would generate additional stress and create a vicious cycle of reciprocal sleep debt.

 

Before sleep reactivity is utilized for assessing risk for depression, Dr. Vargas thinks that there should be more research done. He believes that insomnia, a disorder closely associated with sleep reactivity and depression, could have been the real cause of the strong association between sleep reactivity and depressive symptoms. This means that the reason sleep reactivity may be more strongly associated with depression symptoms purely because of its strong ties to insomnia. Thus, we need more research before sleep reactivity can be accurately used to predict and treat depression. Evidently, sleep is a big factor in how we manage stress. With more time and sleep-focused research, scientists like Dr. Vargas can look forward to utilizing the link between sleep and other stress-rooted disorders to provide earlier detection and treatment. 

References:

Lawrence Robinson, Melinda Smith, M.A., and Robert Segal, M.A.  (2018) Insomnia. (n.d.) https://www.helpguide.org/articles/sleep/insomnia-causes-and-cures.htm/

 

Vargas, I., Friedman, N. P., & Drake, C. L. (2015). Vulnerability to stress-related sleep disturbance and insomnia: Investigating the link with comorbid depressive symptoms. Translational Issues in Psychological Science, 1(1), 57–66. https://doi-org.proxy.library.stonybrook.edu/10.1037/tps0000015

Categories
Depression Eating Disorders

Eating Disorders: The Consequences

Eating disorders are a set of widespread and life threatening conditions.  According to a new study published in Biological Psychiatry based on the largest national sample of U.S. adults of 36,309 people, around “0.8 percent of adults will be affected by anorexia nervosa in their lifetime; 0.28 percent will be affected by bulimia nervosa; and 0.85 percent will be affected by binge eating disorder” (Udo & Grilo, 2018).  Furthermore, eating disorders affect people of every age, sex, gender, race, ethnicity, and socioeconomic group and could have severe consequences on a person’s emotional and physical health (“Risk Factors”, 2018).

Eating disorders affect every organ system in a person’s body, including the brain.  Because of this there are many health consequences associated with having an eating disorder.  By consuming fewer calories, the body starts to break down muscle and tissue for fuel. Due to this, the heart has fewer cells and less fuel to pump blood with and pulse and blood pressure begin to drop and the risk of heart failure increases (“Health Consequences”, 2018).  In the case of orally purging the body of food, the body is losing electrolytes which “can lead to irregular heartbeats and possible heart failure and death” (“Health Consequences”, 2018). Not only does purging cause electrolyte imbalances in the body, it has severe consequences on the gastrointestinal system.  Purging can lead to a deteriorated esophagus and stomach problems such as blocked intestines from undigested food, bacterial infections, constipation, intestinal perforation and in severe cases stomach ruptures (“Health Consequences”, 2018). In addition, purging and malnutrition can cause of pancreatitis or an inflammation of the pancreas (“Health Consequences”, 2018).

Neurologically, due to the restriction of calories in the body, the brain will not receive enough nutrients to function and could lead to a toxic cycle of obsessing about food and difficulties concentrating (“Health Consequences”, 2018).  Furthermore, not eating enough can create difficulties falling or staying asleep, numbness and tingling in the extremities of the body due to damage to the neuronal insulations, seizures and muscle cramps due to electrolyte imbalance, and fainting or dizziness (“Health Consequences”, 2018).  Even more alarming, in the endocrine system sex hormones decrease and can increase bone loss and starvation can cause high cholesterol levels (“Health Consequences”, 2018).

However, the consequences of eating disorders are not merely confined to the physical body.  There are many cognitive and emotional effects associated with restrained eating. People suffering from eating disorders have their cognitive performance and function disrupted by thoughts of food and/or weight (Polivy, 1996).  People with a history of dieting were also found to have more difficulty concentrating than their peers and experience feelings of irritability and negative emotionality and heightened affective responsiveness (Polivy, 1996). Self-harm, suicide attempts and death constitutes as some of the highly associated risks with eating disorders (Keski-Rahkonen & Mustelin, 2016) .  

In fact, according the the National Association of Anorexia Nervosa and Associated Disorders, eating disorders have the highest mortality rate of any mental illness.  One in five people with anorexia die by suicide (“Eating Disorder Statistics”, n.d.). This statistic does not include those that die due to pure self-starvation. The Standard Mortality Ratio, how likely one is to die over the study period compared to same aged peers of the general population, is 5.86 times more likely for people suffering from anorexia nervosa and 1.93 times more likely for people suffering from bulimia nervosa (“Eating Disorder Statistics”, n.d.).  

As eating disorders are complex in nature, the risk factors of eating disorders involves an interaction between a range of biological, psychological and sociocultural factors (“Risk Factors”, 2018). Eating disorders are extremely prevalent and consequential and with more information, education, and funding for research there can be more support for those fighters and survivors of eating disorders.   

References

Eating Disorder Statistics • National Association of Anorexia Nervosa and Associated Disorders.

(n.d.). Retrieved February 10, 2019, from

https://anad.org/education-and-awareness/about-eating-disorders/eating-disorders-statistics/

Health Consequences. (2018, February 22). Retrieved February 10, 2019, from

https://www.nationaleatingdisorders.org/health-consequences

Keski-Rahkonen, A. & Mustelin, L. (2016). Epidemiology of eating disorders in Europe. Current

Opinion in Psychiatry, 29(6), 340–345. doi: 10.1097/YCO.0000000000000278.

Polivy, J. (1996). Psychological Consequences of Food Restriction. Journal of the American

Dietetic Association,96(6), 589-592. doi:https://doi.org/10.1016/S0002-8223(96)00161-7

Risk Factors. (2018, August 03). Retrieved February 10, 2019, from

https://www.nationaleatingdisorders.org/risk-factors

Udo, T., & Grilo, C. M. (2018). Prevalence and Correlates of DSM-5–Defined Eating Disorders

in a Nationally Representative Sample of U.S. Adults. Biological Psychiatry,84(5),

345-354. doi:https://doi.org/10.1016/j.biopsych.2018.03.014

 

Categories
Depression

Art Therapy: Art as Medicine

Depression is a mental disorder that affects the way we feel, think, and act. It can become an obstacle in life becoming debilitating enough that individuals struggle just to get out of bed. There are many treatments for depression, from medication to psychotherapy. However, one type of sub-therapy is quickly gardening popularity. Art therapy is an expressive form of treatment that uses the creativity of making art to improve an individual’s well-being. It has been utilized as a unique approach to treat depression.

Art therapy isn’t a new thing, however. It became a recognized form of therapy in 1969 when the American Art Therapy Association was established. Creative art therapists are said to be trained in both art and therapy (Iliades). Under the supervision of a trained therapist, creative activities can complement or enhance other depression treatments.

Art therapy allows individuals to express and learn about themselves. It can be used to identify and change negative feelings associated with depression. It can be beneficial for individuals who may find it difficult to open up to strangers about their darkest emotions. Furthermore, people with depression may have adapted to suppress their emotions. In art therapy, words are not always required. Simple scribbles can express a depressive thought. Art therapy can provide support when words are not enough. In turn, it can also assist in coming to terms with a person’s underlying expressed feelings (Iliades).

Cancer patients have been found to be more vulnerable to depression. A study conducted in the Journal of Psychological, Social and Behavioral Dimensions of Cancer, found that anthroposophical art therapy provided a benefit treatment of cancer patients with depression or fatigue during chemotherapy treatment (Bar-Sela). Another study published in the Journal of Arts in Psychotherapy revealed the positive effects of art therapy for prison inmates. It demonstrated positive deviations in mood and locus of control for both male and females (Gussak).

There are several types of creative arts that include: Art therapy (drawing, painting, and sculpting), Dance or movement therapy, Drama therapy (acting, improv, and storytelling), and Music therapy (playing and writing music). The healing process that comes from these creative arts has shown to help the depressed individual by contributing to the release of brain chemicals that fight depression (Iliades). Dopamine is a neurotransmitter that aids in the feeling of pleasure when released. Another benefit of creative therapy is that it gives a product that an individual could learn from, while group therapy can support a connection with others. Creative art therapy is offered in many hospitals, outpatient centers, and private practices as a cooperative form of depression treatment. It allows you to express yourself, be creative, and explore your emotions. Most of all, it’s an excellent way to de-stress, and can be helpful to anyone!

References:

Bar-Sela, G., Atid, L., Danos, S., Gabay, N. and Epelbaum, R. (2007), Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. Psycho-Oncology, 16: 980–984. doi:10.1002/pon.1175

Gussak, D. (2009). Comparing the effectiveness of art therapy on depression and locus of control of male and female inmates. The Arts In Psychotherapy, 36202-207. doi:10.1016/j.aip.2009.02.004

Iliades, C. (2012, Augst 30). The Healing Power of Creative Therapy for Depression. Retrieved from https://www.everydayhealth.com/hs/major-depression/creative-therapies/