Depression (Clinical)

[Michaelangelica]

A meta-analysis of 14 studies in a variety of research and real-world settings by Bair et al.4 found that, overall, 65% of patients with MDD reported painful physical symptoms.

The diffuse nature of physical symptoms is the hallmark of major depression, which, in addition to the aforementioned painful symptoms, can also include symptoms such as

• weakness,
• muscle soreness,
• chilly hands and feet,
• dizziness,
• numbness,
• trouble with vision or hearing,
• and a lump-in-throat feeling.5
• The most commonly reported symptom according to a recent study (N = 2191) by Vaccarino et al.5 was “feeling fatigued, weak, or tired all over.”

This symptom had a high correlation (r = 0.50) with patients’ overall scores on the Hamilton Rating Scale for Depression (HAM-D).
at least half of the patients with major depression in primary care were initially misdiagnosed and received no treatment for depression. A majority of patients with MDD presented with only somatic symptoms.

The more physical symptoms the patient reports, the greater the likelihood that the patient has a mood or anxiety disorder (AV 3).
Chronic pain and physical symptoms are common in patients with mood symptoms, and the presence of painful physical symptoms makes the recognition of mood symptoms more difficult

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[Michaelangelica]

STEPHEN FRY: THE SECRET LIFE OF THE MANIC DEPRESSIVE
ABC1, 9:35pm Monday, 16 February 2009
Stephen Fry looks at the different treatments available for manic depression, talking to experts and sufferers alike, and ponders whether he is willing, after all this time, to take that route himself.
Stephen Fry: The Secret Life Of The Manic Depressive - ABC1 Television Guide

How come so many extremely funny people suffer from depression eg Spike Mulligan, Peter Cook, Robin Williams. . . any others?

or are alcoholics, or reformed alcoholics and therefore still alive- eg Billy Connelly, R. Willims (dugs&AL?)- both brave people.

Maybe they need to slow down a racing mind that makes continual bizarre connections and observations..

Keith Allen, the Sheriff of Nottingham BBC TV Robin Hood series, had the funniest story about Stephen Fry which he told on Parkinson.(Allen does not seem depressed at all)
It was a V ERY funny interview.
I love Stephen Fry especially in Absolute Power where he plays an amoral adverting executive (nmed?)

[Michaelangelica]

This would help a lot of people, empty a lot of hospital wards and save a lot of marriages if it can be done.

Study suggests new test to predict postpartum depression risk

Changes in levels of corticotropin-releasing hormone (CRH) at around 25 weeks' gestation both predict and explain the development of postpartum depression (PPD), according to a longitudinal study in this month's Archives of General Psychiatry.

The report urges routine use of a blood test for CRH in mid-pregnancy to predict risk of PPD, as well as research into preventive strategies.

Apparently the rate of change of CRH levels in mid-pregnancy is the crucial factor, although assessment of depressive symptoms at this time may increase its predictive power.

During pregnancy, the placenta increasingly releases CRH, reaching levels that correspond to acute stress according to previous studies. Sudden removal of CRH in late pregnancy may create a withdrawal syndrome.

Medical News: Placental Hormone Levels May Foretell Postpartum Depression - in Psychiatry, General Psychiatry from MedPage Today
See also other papers:-
Results For "postpartum depression CRH" - SearchMedica - Professional Medical Search


Hamilton Rating Scale for Depression

NOTE: This search delivers articles about the Hamilton Rating Scale for Depression. But you can find the scale itself by un-clicking "Prioritize results by publication date" just beneath the search box. Several other scales are available from Psychiatric Times if you use this option.

[Michaelangelica]

Understanding Depression

Depression is not a weakness or a character flaw—it is a real medical illness. People who suffer from depression may experience long periods of feeling very sad and lose interest in social and daily activities. Anyone, regardless of gender, race or socioeconomic status, can suffer from depression.

* An estimated 19 million American adults suffer from depression every year.
* With proper treatment, four out of five people with depression will improve.

Depression often occurs simultaneously with other conditions. In fact, as many as 90% of people who've been diagnosed with depression also have symptoms of anxiety. (This does not necessarily mean these patients have generalized anxiety disorder (GAD)). Learn more about the connection between depression and GAD.
Common Symptoms of Depression

You don't need to experience all of the signs and symptoms listed below to be diagnosed with depression. Symptoms of depression will vary from person to person.

1. Depressed or irritable mood most of the day

2. Loss of interest or pleasure in activities (such as hobbies, work, sex or being with friends) most of the day

3. A sudden change in weight (weight loss without dieting, gaining more than 5% of body weight in one month) or a change in appetite

4. Inability to sleep or sleeping too much

5. Agitation or restlessness (observed by others)

6. Constant fatigue or loss of energy

7. Frequent feelings of worthlessness or inappropriate guilt

8. Difficulty concentrating or making decisions

9. Physical symptoms such as digestive problems, headaches or muscle aches

10. Frequent thoughts of death or suicide (or a suicide attempt or plan)

Important note: you or someone you know has thoughts of suicide, seek professional help immediately, or contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

What Causes Depression?

Depression is often triggered by events such as:

* Divorce, death of a spouse, loss of a job or serious financial problems
* Abuse of alcohol or other drugs
* Certain medications and diseases
* Hormonal changes in women associated with childbirth or menopause
* A family history of depression
* In older adults, health problems and functional limitations associated with aging

Whatever the triggers, depression is believed to be caused by an imbalance of certain chemicals in the brain, such as serotonin. These "chemical messengers" help nerve cells communicate with one another by sending and receiving messages. In the case of depression, the available supply of the chemical messengers is low, so nerve cells may not be able to communicate effectively. This can result in symptoms of depression.
How Is Depression Treated?

Depression and Anxiety Treatment Center: Understanding Depression (Sponsored)

[Michaelangelica]

Mental Health: It's Life, Not Depression
Friday, March 13, 2009 by: Dr. Julian Whitaker, MD, citizen journalist
Mental Health: It's Life, Not Depression


Salt May Be An Antidepressant - Which Would Also Explain Why It's Addictive
http://www.scientificblogging.com/ne..._its_addictive

[paigetheoracle]

I've realized that there is a kind of psychological cycle like manic-depression or bipolar disease but it is based on conscious frustration, trying to reach your goal and disappointment when you do (distance and unattainability versus attainment and proximity: Snippet in give away paper, Metro, stated that researchers in America had discovered a link between masculinity and distance in fruit flies). This is also the basis of energy and lack of it (depression and going nowhere, and elation, through having a goal to move (inspire) you into action).

[Michaelangelica]

Originally Posted by paigetheoracle

I've realized that there is a kind of psychological cycle like manic-depression or bipolar disease but it is based on conscious frustration, trying to reach your goal and disappointment when you do (distance and unattainability versus attainment and proximity: Snippet in give away paper, Metro, stated that researchers in America had discovered a link between masculinity and distance in fruit flies). This is also the basis of energy and lack of it (depression and going nowhere, and elation, through having a goal to move (inspire) you into action).

Manic Depressive psychosis or now "Bi-polar" disease is treated differently from Clinical Depression
It is what Stephen Fry has; but he has decided to live with it rather than medicate. I think he feels it is so much a part of his creative energy that he will castrate his personality with dugs. He is frightened, possibly righly so. Fortunately he has the money to indulge some of the bizarre behaviours of the manic depressive (his, fortunately, is "shopping") Some feel the high is wort the low and suffer in silence
Lithium is still used to treat Bi Polar and, when it works, it works dramatically and well.



i ment to add this atraing programme for Docs or anyone else who says they are docs. (my vet!)

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AV 1: Suicide Rates in 2005 for Selected Age Groups (00:12)
Differential Diagnoses and Assessment of Depression in Elderly Patients
Gary W. Small, MD

The consequences of depression in older people include a high rate of suicide compared with suicide rates in all other age groups (See AV 1). Participate in this activity to learn about the differential diagnoses of depression in the elderly and to review methods for assessing your patients with this diagnosis.

Part of the multi-activity "Depression in the Elderly" series in J Clin Psychlopedia and independently developed by the CME Institute of Physicians Postgraduate Press, Inc., and the American Society of Clinical Psychopharmacology.

1 Credit

For more free CME activities, visit the CME Institute at Psychiatrist.com. If you are having trouble reading this E-Lert, see www.psychiatrist.com/elerts/cme043009b/

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An online curriculum integrating the basics with the latest research.

AV 2: STAR*D Study Remission Rates (00:15)
Treating Major Depression: Antidepressant Algorithms
Michael E. Thase, MD

Clinicians have the best chance of getting a patient into remission during the first treatment trial (See AV 2). Read this J Clin Psychlopedia activity to learn how treatment algorithms can help you successfully treat patients with complicated major depression.

Part of the multi-activity "Complicated Major Depressive Disorder" series in J Clin Psychlopedia and supported by educational grants from Eli Lilly and Company and Bristol-Myers Squibb Company and Otsuka America Pharmaceutical, Inc.

1 Credit

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Other free J Clin Psychlopedia CME activities:

Helping Patients With Depression Achieve Wellness

Mark Hyman Rapaport, MD

1 Credit

Initial Treatment Approaches for Patients With Major Depressive Disorder

George I. Papakostas, MD

1 Credit

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[paigetheoracle]

Funnily enough I was at technical college with him (he was in the same campus hostel but on the floor above). I also visited his website after seeing the program he did on manic-depression or bipolar disease (saw the second part but missed the first).

Doesn't Lithium give some people uncontrollable, long term shakes? This I believe is the reason he gave up on the drug and decided shopaholicism was preferable (Please correct me if I'm wrong because although I knew him then, he doesn't want to know me know...along with my brother, an aunt, a cousin...)

[paigetheoracle]

Moderators - I must apologize for the above post as it would have been more appropriate in the recent thread on Bipolar disease but alas work load of new job meant I stuck it where I could, rather than where I should (Kids are tiring - I work as a classroom assistant).

[Michaelangelica]

Originally Posted by paigetheoracle

Funnily enough I was at technical college with him (he was in the same campus hostel but on the floor above). I also visited his website after seeing the program he did on manic-depression or bipolar disease (saw the second part but missed the first).

Doesn't Lithium give some people uncontrollable, long term shakes? This I believe is the reason he gave up on the drug and decided shopaholicism was preferable (Please correct me if I'm wrong because although I knew him then, he doesn't want to know me know...along with my brother, an aunt, a cousin...)

I think he was frightened. He did not want to be "born again' into a new person even if that person had no pain. He may have been concerned that the depression was a source of his creativity and inspiration and skill. It may well be, given with so many famous comics suffering from it (Peter Cook, Spike Milligan, etc). He would be aware of this too. He is a very talented, intelligent man. If he was dumber, and less gifted, he might be happier?
I would suggest you reach out to him and try and reconnect. Depressed people don't reach out; they try to stay isolated. Don't recoil if he at first rejects you; that may be the disease Just try again much later; leave him with your contact details.

Can you expand on your previous post I didn't understand it.
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The Type of exercise you do when depressed may be important. Most suggest walking but according to this psychiatrist that may not be the best thing

Maria Tickle: The most common mental disorder in Australia is depression, and its personal and economic cost to society is enormous. It’s responsible for more than half of all suicides and recent research has indicated depression doubles your chances of having a heart attack. Last year alone through the PBS the government spent more than $155-million on antidepressants such as Zoloft and Arapax.

While the effectiveness of antidepressants has been well documented, so have their potential side-effects, especially in the elderly.
According to researcher Nalin Singh, from Sydney’s Balmain Hospital, this group are less likely to stick to their drug regime than younger patients, and the antidepressants can affect their balance, causing them to fall.

Dr Singh believes the key to treating depression is exercise. This isn’t news; there have been many studies showing the effectiveness of exercise in reducing depression, but those results were based on aerobic exercise, such as running, and generally involved younger participants. What’s different about Dr Singh’s work isn’t that he’s sending our senior citizens for a run around the block (that’s not possible for a frail 80-year-old, for obvious reasons) but instead to the gym to do weights – and heavy muscle-building weights at that.

At the clinic, which is within the Balmain Hospital, his patients are prescribed specific exercises and are heavily supervised by trained staff. 72-year-old David Lewis is one of Singh’s patients, and says in three months the program has changed, if not saved, his life

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Web Archive Copy: Sports Factor: The Mozart Maulers

If you get a chance read also Mozart's Maulers if nothing else it will make you laugh

Dorian Mode: His idea was for me to externalise my anger, he felt that anxiety is really a symptom of something wrong. It’s like a volcano, it’s something bubbling underneath that’s not quite resolved within yourself.

My psych professor, from whom I learnt very little, did leave me with the concept that depression is "anger tuned inwards". There may be a component of that in my depression as I had a very aggressive dad and aggression frightens me.
Certainly self mutilation and suicide may be an example of this. Spike Milligan makes the wonderful comment that "Killing yourself only gets rid of you--not the disease"!

More from Dorian Mode (who lives locally and teaches music and may even coach football?)

So he wanted me to somehow get that out, somehow bring that to the surface. So he suggested that I start boxing, this was his idea. So I joined the Sydney University boxing team, and I think I had about 16 fights and got knocked out about 18 times. In fact Mundine’s Management of Contact did me for a fight. So that was pretty hopeless, and I was turning up to my piano lessons I remember with my teacher, Mike Knock, with big black eyes and things, and he’s saying, ‘Hey, have you thought about music? Try music.’

Maria Tickle: What was your physical state like at that time?

Dorian Mode: Well I was like a corpse with a faint pulse, and I was so painfully thin, I was a vegetarian so I was a pleasant shade of green, and I really had no stamina at all, I was just weak. Just a weak, snivelling little wimp. Not a lot has changed, really.

Maria Tickle: You described yourself as a psychiatric guinea pig with internal bleeding. So next was fencing. How did you go with that?

Dorian Mode: Well fencing was really quite sort of middle-class and prissy. You know, I mean the problem with fencing is it’s all over in a nanosecond. I’m sure it was very exciting in the middle ages. So I gave away fencing for the simple reason it was quite non-confrontational. The boxing was confrontational, and was a great release for the anger.

Maria Tickle: And that was the idea, wasn’t it; it was to get you into a sport that was confrontational, that could release this anger that you had inside you related to your childhood and your relationship with your parents.

Dorian Mode: That’s right, and that I was turning on myself, essentially. Yes, I think most kids blame themselves for marriage breakups on some level, and I really took it squarely on the shoulders I suppose. My father was married three times. So I was back to the psychiatrist’s and looking for new cures, hoping that he’d just give me the goddamned pills and let me get out of there quite frankly. But he’s the only psychiatrist who took Medicare and I had to keep seeing him. So he then suggested that the boxing had been a disaster, the fencing had been a waste of time, so then he suggested Rugby League, and it was at this time that I thought he was dipping into his own medication.

Maria Tickle: Didn’t you throw your shoe at him?

Dorian Mode: I did, yes I threw my shoe at him. He ducked. And I decided OK, I’ll give the Rugby League a go just to satisfy him and then get my goddamned pills and leave.

Web Archive Copy: Sports Factor: The Mozart Maulers