Study Finds Even Preschoolers Can Be Depressed

Children can and do suffer from depression, however, even very small children can suffer from depression a new study has found. The researchers discovered that preschoolers who suffer from depression are also likely to experience a recurrence of their depressive symptoms throughout childhood.

Most childhood depression studies carried out to date have focussed on school age children of around 6 years old and older. Now, according to this recent study by L. Luby et al, from the Department of Psychiatry, Washington University School of Medicine, even 3 year olds can show signs of suffering from major depression.

The study published in the American Journal of Psychiatry involved around 250 preschool children between the ages of 3 and 5 who were regularly assessed for signs of depression over a period of 6 years.

Of the 74 children diagnosed with depression at the start of the trial, around 50 percent went on to meet the criteria for depression 6 years later compared to only 24 percent of those who were not depressed at the start of the study.

The study also involved evaluating the relationship between the child and their parents/caregivers through two way mirrors and asking the children’s’ parents/caregivers questions on the child’s moods, emotions, playtime activities, and appetite and sleep patterns.

Children whose mother’s suffered from depression were more likely to suffer from depression themselves later on. However, the biggest risk for suffering from depression in childhood was being diagnosed with depression as a preschool child.

“Preschool depression predicted school-age depression over and above any of the other well-established risk factors” Luby said.

“Those children appear to be on a trajectory for depression that’s independent of other psychosocial variables.”

Difficult and Challenging

However, diagnosing depression in very young children is a lot more difficult and challenging than diagnosing depression in older children or adults, mainly because very young children either cannot articulate exactly how they are feeling or they find it difficult to find the words to express themselves accurately. Diagnosing depression is extremely important though because the earlier it is identified the more successful the treatment.

The biggest challenge with childhood depression is really recognising it in the first place. This is because not all children who are suffering from depression appear sad and unhappy and not all children who are sad and unhappy are suffering from depression. The symptoms may also differ depending on the age of the child and whether the child is able to speak or not.

Symptoms of depression in older children

Although it is still challenging diagnosing depression in older children, it is still easier than recognising it in very young children. The following is not an exhaustive list but these symptoms can be an indication of depression.

 

  • Poor performance at school
  • Self depreciating and feeling unworthy
  • Think they are unlovable and unloved
  • May speak of or be preoccupied with themes of death or dying
  • May intentionally hurt themselves
  • Frequent bouts of unexplained illness
  • Low moods and appears sad most of the time
  • No longer enjoying activities they used to
  • Sensitivity to criticism
  • Anxiety and excessive worrying
  • Emotional outbursts and crying frequently
  • Permanently bored
  • Defiant behaviour
  • Poor conduct
  • Major changes to appetite with weight gain or weight loss
  • Major changes to sleep patterns with sleeping to much or too little

Symptoms of depression in preschool children

This is much more difficult, not just to correctly diagnose depression but also because a lot of mental health professionals don’t acknowledge that depression can exist in a very young child as it still isn’t accepted in mainstream psychiatric circles. According to Luby it definitely does exist although she recognises that it isn’t common at about 1 or 2 percent.

Luby says an exceptionally ‘good’ child may actually be a depressed child as kids as young as this “are not disruptive in their environment” and she described them as “the wheel that’s not squeaky.”

A young child who is suffering from depression may also look sad and generally unhappy and show an inability to enjoy activities that most other preschool children are able to enjoy.

Guilt is another indicator, in that if something goes wrong, the child feels as though they are somehow to blame and it is their fault.

If these sorts of symptoms persist for longer than a week or two, then it is time to seek help says Luby.

Treatment for preschool depression

Medication combined with cognitive therapy is the standard treatment for children and adults suffering from major depression, however, this isn’t the case for very young children. Luby recommends psychotherapy in the form of play therapy and she is currently developing a treatment that will involve parent/child interaction therapy.

Medication is absolutely not the way forward she says as the drugs given to older children haven’t been tested in very young children.

 

TMS for when drugs don’t work

Most people suffering from depression are likely to be offered Antidepressants as a first treatment when they visit their doctor for help. Although this isn’t ideal, sometimes it is the only option available as lengthy waiting lists along with a lack of resources means that other types of therapies such as cognitive therapy might not be immediately available.

 

Although antidepressants are effective for many, one of the main problems with them is that any relief they do offer, comes with the price of suffering some unpleasant side effects, including nausea, dizziness, sleep disturbances, headaches, loss of libido, agitation, and erectile dysfunction in men.  Another problem is that in some people, antidepressants will have no effect on the symptoms of depression whatsoever. No one really understands why this is the case and it isn’t possible to predict which people will benefit and which won’t.

 

Now, a new study has highlighted an innovative therapy that is fast gaining recognition as a possible maintenance treatment for major depression in people who either couldn’t tolerate antidepressants or found that the antidepressant drugs didn’t work.

 

Magnetic pulses

 

Transcranial magnetic stimulation or TMS as it is known is a treatment involving magnets placed on the head to send magnetic pulses to the parts of the brain responsible for regulating mood.

 

Neurostar Inc is the company that has come up with Neurostar TMS machine which apparently carries very few, if any, side effects. The most common is a mild headache after treatment.

 

Pilot Study

 

In a pilot study carried out by Neurostar, the researchers treated half of the patients with TMS for a period of six weeks and the other half were observed monthly. After the six week period they found that 61.2 percent of those treated with TMS had experienced a remission of depression symptoms and after three months the figure was 62.5 percent compared to 43.8 percent of those who didn’t receive TMS therapy.

 

“This pilot study supports the notion that maintenance TMS may be useful in the prevention of recurrence of major depression and is an important step in learning what the optimum treatment parameters will be” said Dr. Scott Aaronson, director of Clinical Research Programs and associate medical director at Sheppard Pratt, in a statement.

 

“This preliminary information will help define an approach to TMS as a maintenance therapy as we extend our understanding of the long-term usefulness of TMS in the treatment of people with this debilitating illness.”

 

Neurostar Inc revealed the results of their study at the 167th American Psychiatric Association Annual Meeting in New York. According to the company, the treatment is safe.

 

Unlike ECT (Electroconvulsive therapy) patients do not require sedating prior to treatment. TMS can be carried out in the doctor’s surgery and is typically given daily for a period of four to six weeks.

 

Effective for more than 50 percent

 

The results of another study released in May 2014, showed that after one year, more than 50 percent of patients suffering from major depression and treated with Neurostar TMS either had no symptoms of depression or very mild symptoms. After the same period of time the figure is only 38 percent for antidepressants.

 

Dr Amit Anand from the Center for Behavioural Health at Cleveland Clinic thinks that TMS could be a useful addition to the treatments already available at the Clinic.

“It’s a way to treat depression directly, with few side effects” said Anand, who was not involved in the Neurostar study.

 

“Other research has shown only a small percentage of people respond to it, but I think if even a quarter of those people respond, it’s a benefit.”

 

Expensive

 

One disadvantage, however, is that TMS is more expensive than drugs, costing between 7,000 and 10,000 dollars. However, if you consider that the treatment isn’t likely to be ongoing in the same way that medication is, then the cost is more viable. Some insurance companies in the US are starting to fund TMS treatment.

 

TMS in the UK

 

In the UK and indeed in Europe, TMS is available in very few places. The National Institute for Health and Clinical Excellence (NICE) says that doctors can only offer this treatment in the UK on the NHS as part of a research study.

 

Conflicting results

 

Not much is currently known about the way it works and indeed there have been conflicting results as to whether it works as well as some reports have indicated. In one analysis of 11 studies involving 197 people, there was an improvement after two weeks but not after that.  In another analysis of 33 studies involving 877 patients there was no real difference between TMS and a placebo. In yet another study comparing TMS with ECT, 10 out of 20 people having TMS responded to the treatment with 2 of them cured compared to 6 out of 15 having ECT where 3 were cured.

 

Anything that helps alleviate the symptoms of depression is welcome and TMS could well find its place as a further option, especially where previous treatment has failed.

 

New Study finds Depression is as deadly as smoking

The results of a brand new study carried out by researchers at Oxford University is telling us that mental health problems can be just as deadly as smoking twenty or more cigarettes a day. This is shocking news considering that one in four of us will experience a mental health problem at some point.

 

Shortened life expectancy

 

According to the researchers, people who smoke twenty cigarettes a day shorten their lives by about eight to ten years, and if we compare this to what the Oxford study found, people with recurrent depression have a shortened life expectancy of between seven and eleven years. It’s worse for other types of mental illness. People with Bipolar disorder have a reduction in life expectancy of between nine and twenty years, and between ten to twenty years for Schizophrenia. By far the worst result was for people with drug and alcohol problems; their life expectancy was reduced by up to 24 years.

 

The report stated that people with mental health problems in the UK have a similar life expectancy to people living in North Korea or Bangladesh. So why is this?

 

Ineffective Care

 

Dr John Williams, Head of Neuroscience and Mental Health at the Wellcome Trust suggests that people with mental health problems may not be getting access to the care they need.

 

“People with mental health problems are among the most vulnerable in society” said Dr Williams.

 

“This work emphasises how crucial it is that they have access to appropriate health care and advice, which is not always the case. We now have strong evidence that mental illness is just as threatening to life expectancy as other public health threats such as smoking.”

 

The researchers looked at data from 20 separate studies covering all sorts of mental health problems as well as drug and alcohol abuse. The information came from data on more than 1.7 million people and included approximately 250,000 deaths. This information was then compared to data on heavy smoking.

 

The author of the Oxford study, Dr Seena Fazel of the Department of Psychiatry at Oxford University explains why there might be a drop in life expectancy.

 

“There are likely to be many reasons for this. High risk behaviours are common in psychiatric patients, especially drug and alcohol abuse, and they are more likely to die by suicide.”

 

Dr Fazel also highlighted the need for appropriate care.

 

“The stigma surrounding mental health may mean people aren’t treated as well for physical health problems when they do go to see a doctor” said Dr Fazel who explained that one problem is the tendency to separate mental illness from physical illness.

 

“Many causes of mental health problems also have physical consequences and mental illness worsens the prognosis of a range of physical illnesses, especially heart disease, diabetes and cancer. Unfortunately, people with serious mental illnesses may not access healthcare effectively” said Fazel, who also believes that it doesn’t have to be like that.

“All of this can be changed” explained Fazel.

 

It can be done

 

“There are effective drug and psychological treatments for mental health problems. We can improve mental health and social care provision. That means making sure people have straightforward access to health care and appropriate jobs and meaningful daytime activities. It’ll be challenging, but it can be done”.

 

No one would deny that smoking is a huge health problem and that many measures have been put in place by governments and media campaigns to reduce the number of people smoking and that these have been on the whole quite effective. Currently it is estimated that around twenty percent of the population smoke and statistics are starting to show that smoking related deaths are on the decline. However, just under half of the people who smoke have some sort of mental health problem.

 

The study does show how important it is that professionals pay particular attention to the physical health of people with mental health problems and not to focus on the mental health symptoms alone.

 

“Psychiatrists have a particular responsibility as doctors to ensure that the physical health of their patients is not neglected” said Dr Fazel.

 

“De-medicalization of psychiatric services mitigates against that” he added.

 

“What we do need is for researchers, care providers and governments to make mental health a much higher priority for research and innovation. Smoking is recognised as a huge public health problem. There are effective ways to target smoking, and with political will and funding, rates of smoking-related deaths have started to decline. We now need a similar effort in mental health”.

 

The study was funded by the Wellcome Trust and has been published in the Journal World Psychiatry.

 

 

Suicidal behaviour in young adults on SSRIs

Newly published research is calling for doctors to be careful when handing out prescriptions to treat depression in teens and young adults, and when they do they should monitor the youngsters closely, particularly if they are on an elevated dose, due to an increased risk of suicidal behaviour and self harm.

 

Twice as likely

 

The research, which was published in the Journal JAMA Internal Medicine at the end of April 2014, found that those between the ages of 10 and 24 receiving very high doses of drugs known as SSRI antidepressants (Selective Serotonin Reuptake Inhibitors) were twice as likely to try to harm themselves as those receiving lower or the recommended doses of these drugs.

 

The risk also appeared to be age dependent with those under the age of 25 and on higher than normal doses the most at risk. The risk was also highest during the first three months of taking the drugs. The same risk was not found in older people on high doses of these drugs.

 

SSRIs nearly 70 percent of all prescriptions

 

The study was led by Dr. Matthew Miller from the Harvard School of Public Health and involved over 162,000 people aged between 10 and 64 who had been treated for depression with one of three different types of SSRI drugs; citalopramhydrobromide, sertraline hydrochloride, and fluoxetine hydrochloride. These drugs are also sold under the trade names of Celexa, Zoloft and Prozac and were chosen for the study because these are the drugs that account for nearly 70 percent of all prescriptions initially issued to treat depression.

 

The researchers compared those who were taking an average or recommended dose of these drugs with those who were receiving higher than normal doses between 1998 and 2010.

They checked at intervals of one month, quarterly and a year after initially being prescribed these drugs for evidence of attempted suicide or incidents of deliberate self harm.

 

After analysis of the results, they found that one out of every 150 patients who were treated with high dose antidepressants deliberately self harmed.

 

“If I were a parent, I definitely wouldn’t want my child to start on a higher dose of these drugs” said Dr. Miller.

 

Alarm bells

 

It isn’t the first time alarm bells have been rung because of the risk of suicidal behaviour when taking antidepressants. Back in October 2004 after a government review the FDA issued a warning about the risk of self harm in children prescribed SSRIs. The FDA directed manufacturers to add a ‘black box’ warning to the healthcare professional labelling of all antidepressant medications to describe this risk and emphasize the need for close monitoring of patients started on these medications.

 

However, one research study published inJournal of the American Medical Associationin 2007 concluded that the benefits of prescribing antidepressants to young people suffering from depression far outweighed the risks. Yet another study published in the American Journal of Psychiatry in the same year found that suicide rates in the young had increased despite a drop in the number of SSRI prescriptions issued. Some researchers reckon that this is evidence that SSRIs actually offer some protection against suicidal behaviour.

 

However, no studies have ever looked at the dosages of these antidepressants and the risks of suicidal behaviour and self harm like this most recent US study did.

 

Unanswered questions

 

There are still questions that remain unanswered though. For example, it’s not clear exactly why high doses lead to an increased risk of suicide in younger people. It is also not clear why some people are affected and not others or why some types of drugs carry a greater risk than others. We also don’t know if the same risks apply when treatment is started at the average or recommended dose and is increased progressively afterwards.

 

The results also don’t explain why some people in the study were prescribed very high doses of these antidepressants in the first place. The requirement was that those included in the study shouldn’t have been prescribed an antidepressant in the previous year, however, that didn’t preclude people who may have been prescribed them prior to that. It could be that these people had different circumstances than those newly prescribed antidepressants.

 

Regardless, it would seem clear that doctors should look for other alternatives than starting children and young adults on very high doses of these drugs.

 

Official Recommendations

 

According to NICE (National Institute for Health and Clinical Excellence) the CHMP (Committee for Human Medicinal Products) noted that suicidal behaviour and hostility were seen more frequently in clinical trials where children and adolescents were treated with these antidepressants compared to those treated with a placebo and advised that SSRIs “shouldn’t be used in children and adolescents except in their approved indications – usually not depression”.

 

However, doctors can make a decision based on the individual needs of a patient. In these cases, CHMP recommends that patients are monitored carefully, especially at the beginning of treatment, for signs of suicidal behaviour, self harm and/or hostility.

 

 

 

 

 

 

Antidepressant Link with Preterm Birth and Autism

According to research published online ahead of print in March 2014, women who take antidepressants during pregnancy are more likely to deliver their babies prematurely than women who don’t take them.

Increased fourfold

Lead author of the study Krista Huybrechts, MS PhD from the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital and Harvard Medical School said the number of women using antidepressants whilst pregnant has increased over the past twenty years.

 

“Preterm birth is a major clinical problem throughout the world and rates have been increasing over the past two decades. At the same time, rates of antidepressant use during pregnancy have increased approximately four-fold,” said Dr Huybrechts.

41 papers studied

According to senior Author Dr Adam Urato, they found a link between antidepressants and preterm birth.

“We studied 41 papers on this topic and found that the available scientific evidence is becoming clearer that antidepressant use in pregnancy is associated with preterm birth”.

Could depression be the culprit?

Apparently not!

“The complication of preterm birth does not appear to be due to the maternal depression, but rather it appears likely to be a medication effect” said Dr Urato.

SSRIs and autism link

A study by John Hopkins Bloomberg School of Public Health revealed that when antidepressants called SSRIs are taken during pregnancy, there is a higher risk of autism and developmental delays.

SSRI’s or Selective Serotonin Reuptake Inhibitors work by increasing the levels of Serotonin (a feel good hormone) in the brain by inhibiting the mechanisms that naturally absorbs serotonin.

The autism link, which was published in the online Journal Pediatrics, involved researchers looking at almost 1,000 children, most of them boys, who had Autism and developmental delays and also children with typical development.

Boys affected more

 The researchers found gender differences in the effect of prenatal exposure to anti depressants with boys being more likely to be affected than girls.

“We found prenatal SSRI exposure was almost three times as likely in boys with autism spectrum disorders relative to typical development, with the greatest risk when exposure is during the first trimester,” said study co-author Li-Ching Lee, an associate scientist in the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, in Baltimore.

Should women stop taking their meds?

No, say some experts, as the risks are low and it’s important to treat depression in pregnant women. Others aren’t so sure. Although medication may be the only option for severe depression, other safer alternatives may be a better option for milder cases.

What about whilst breastfeeding?

Research presented at the 18th Perinatal Society of Australia and New Zealand annual conference in Perth, explained that women are more likely to continue breastfeeding if they continue taking their antidepressants.

Research carried out by Adelaide University found that 67 percent of women stopped taking antidepressants before becoming pregnant or when they started to breastfeed. The remaining 33 percent continued to take their antidepressant medication throughout pregnancy and while breastfeeding and they breastfed for longer.

“These women were much more successful at maintaining breastfeeding up to and beyond the recommended 6 months” explained Dr Luke Grzeskowiak who led the research.

Dr Grzeskowiak and his colleagues maintain that women should be supported and encouraged by health care providers, as well as family and friends to continue with their medication.

Conflicting information

Unfortunately there isn’t an exact science to weigh up the benefits of taking antidepressant medication during pregnancy and whilst breastfeeding, against the risks to the baby.  Of the numerous studies carried out, many carry conflicting results leaving women and even some doctors unsure of whether medication is really safe.

According to a research study by Filomina Fortinguerra et al and published in Pediatrics in October 2009, the main concern about taking SSRIs whilst breastfeeding, is whether long term exposure may have long term neurobehavioural effects as most of the studies carried out so far have been short term studies.

This research report also said that Fluoxetine (Prozac) was contraindicated whilst breastfeeding. However, another research study by Professor Louis Appleby et al and published in the British Medical Journal found Prozac to be an effective treatment for women with Post Natal Depression.

Just to confuse the matter even more, NICE (National Institute for Health and Care Excellence) advises that Prozac is not recommended whilst breasting unless a woman has already been taking it without any problems during pregnancy.

Best for baby

The most important thing for anyone suffering from depression or considering medication options whilst pregnant or breastfeeding is to discuss their case and all their symptoms with a qualified health care provider. Some women with severe depression will almost certainly need to take medication to keep their depression under control and in these cases this would be in the best interests of the baby too.

However, for many, particularly those with mild depression, it may be that with support and possibly alternative treatments like psychotherapy or natural remedies that the depression is completely manageable without antidepressants and this would be ideally be the best option for baby.

The “cuddle ” Hormone For Depression ??

People suffering from depression could in future be given a “cuddle hormone” to encourage them to reach out to others for support.

Scientists believe that treating those in distress with oxytocin, a hormone linked to emotional bonding in childbirth and breastfeeding, could help to stop them withdrawing from the help of their friends and family.

New research has shown that the hormone can increase people’s trust in others following social rejection.

In an experiment, 100 students were given either oxytocin or a placebo via a nasal spray. They were then engaged in a staged conversation in which researchers disagreed with, interrupted and ignored them.

The participants were asked to fill out mood and personality questionnaires, which showed that those who were particularly distressed after being snubbed by the researchers reported feeling greater trust in other people if they had sniffed oxytocin beforehand.

By contrast, the hormone had no effect on those who were not emotionally affected by the social rejection, according to the research, which was published in the journal Psychoneuroendocrinology.

Dr Mark Ellenbogen, from Concordia University in Montreal, Canada, who carried out the study, said: “That means that instead of the traditional ‘fight or flight’ response to social conflict, where people get revved up to respond to a challenge or run away from it, oxytocin may promote the ‘tend and befriend’ response, where people reach out to others for support after a stressful event.

“That can, in turn, strengthen social bonds and may be a healthier way to cope.”

People with depression might benefit in particular from being given oxytocin because they naturally tend to withdraw even though seeking help can aid their recovery.

Co-researcher Christopher Cardoso said: “If someone is feeling very distressed, oxytocin could promote social support seeking, and that may be especially helpful to those individuals.”

Reactions to the hormone appear to depend more on individual differences and contextual factors than most other drugs, so learning more about how it works will help scientists understand how it could be used in future treatment.

Mr Cardoso said: “Previous studies have shown that natural oxytocin is higher in distressed people, but before this study nobody could say with certainty why that was the case.

“In distressed people, oxytocin may improve one’s motivation to reach out to others for support. That idea is cause for a certain degree of excitement, both in the research community and for those who suffer from mood disorders.”

Oxytocin is the hormone the body releases to trigger labour and which helps in the bonding process with the newborn child. It has also been called the love hormone as it is released at orgasm.

Previous research has found that being given oxytocin causes men with wives or long–term partners to keep a greater distance from an attractive woman but has no effect on bachelors.

Although those in relationships did not judge the woman to be any less attractive, they began to feel uncomfortable more quickly when approached by the woman and asked her to remain further away.

A separate study found that the hormone can make men as sensitive as women.

It is thought that oxytocin could prove valuable in the treatment of autism and other conditions characterised by difficulty in connecting with others and in reading emotions.

Is Depression In Teens Linked To Fear Response?

A new study carried out by researchers at Weill Cornell Medical College has given us an interesting insight into a possible reason why depression, anxiety, and stress related problems peak during adolescence. Could a reduced ability to let go of fear lie at the root of at least some of the mental health problems experienced during this time?

 

The study involved a group of volunteers, a computer screen, headphones and sweat meters, and the results showed that when the teenagers were faced with a perceived threat, it triggered an emotional response that the youngsters couldn’t seem to suppress even after the threat was no longer present.

 

“This is the first study to show, in an experiment, that adolescent humans have diminished fear extinction learning” said Dr Siobhan Pattwell, lead author and postdoctoral fellow at Weill Cornell.

 

The study

 

The researchers asked a group of children, adolescent, and adult volunteers to look at a computer screen which showed a sequence of images consisting of blue or yellow squares. Associated with one of the squares was an unpleasant sound, for example, half of the time, one of the coloured squares consistently triggered the sound. The participants all wore headphones and skin sweat meters whilst viewing the images. If an individual acquired a fear of the sound, they perspired more when they saw that same image that had been associated with the unpleasant noise.

 

Adults and children responded differently to teens

 

The following day, the same group once again viewed a sequence of yellow and blue square images but this time there was no unpleasant noise associated with any of the images. This is where it gets interesting.

 

Those in the 12 to 17 age group didn’t show a decrease in their fear response whereas adults and children didn’t have this problem. The children and adults participating in the experiment appeared to quickly learn that neither the yellow nor the blue square was linked to an unpleasant sound and their fear response rapidly decreased.

 

“Teenagers didn’t decrease their fear response, and maintained their fear throughout subsequent trials when no noise was played” says Dr Pattwell.

 

“Our findings are important because they might explain why epidemiologists have found that anxiety disorders seem to spike during adolescence or just before adolescence. It is estimated that over 75 percent of adults with fear-related disorders can trace the roots of their anxiety to earlier ages.”

 

Standard exposure therapy may not work

 

According to Dr Francis Lee, Professor of Pharmacology and Psychiatry at Weill Cornell Medical College and senior co investigator in the study, the standard desensitization techniques (exposure therapies) may not be effective on adolescents.

 

“If adolescents have a more difficult time learning that something that once frightened them is no longer a danger, then it is clear that the standard desensitization techniques from fear may not work on them”.

 

More personalized approaches needed

 

According to Dr Lee, personalized approaches to treatment of fear and anxiety disorders in teens needs to be investigated.

 

“It is essential that we find a way to help teenagers become more resilient to the fear they experience during adolescence to prevent it from leading to a lifetime of anxiety and depression.”

 

The study was published on September 17th in the early online edition of the Proceedings of the National Academy of Sciences (PNAS),

 

Adolescent Depression

 

Depression and anxiety related disorders can be difficult to diagnose in teenagers simply because teens often experience emotional ups and downs and this is considered perfectly normal. However if a teenager’s behaviour changes radically and they are showing symptoms and signs of depression that lasts for two weeks or more and it’s affecting the child’s ability to function on a day to day basis then speak to a doctor or health care provider.

 

What to look out for:

 

  • Persistent low moods
  • Negative thinking
  • Loss of interest in activities they used to enjoy
  • Constant fatigue
  • Difficulty making decisions
  • Anxiety and fear
  • Complaining of aches and pains without an obvious cause
  • Changes in appetite
  • Difficulty concentrating
  • Emotional instability
  • Changes in sleep patterns
  • Outbursts of anger
  • Agitation or Irritability
  • Withdrawal from family and/or friends
  • Irrational or bizarre behaviour
  • Poor performance at school or college
  • Loss of interest in appearance and poor personal hygiene
  • Use of alcohol or substance abuse
  • Suicidal thoughts or talking about death

 

If a teen is experiencing any of these symptoms it doesn’t necessarily mean they are definitely suffering from depression but a doctor will be able to rule out other possible causes. The teenage years are difficult enough for many children without the added burden of depression and anxiety, which if left untreated, is likely to persist into adulthood.

 

Depression In Children May Be Contagious

 

We all know that kids can catch infectious childhood illnesses from each other but who would have thought that depression could be passed on? Many studies have already revealed that peer group pressure can influence children and that if a child is particularly disruptive he or she can influence other children, but now a recent study has found that depression and anxiety can be contagious too.

 

The study was run by Rebecca Schwartz-Mette at the Department of Psychological Sciences at the University of Missouri. A total of 274 same sex friendship pairs were involved in the study, which took place over a six month period. There were two separate age groups, younger children from Grades 3 and 5 and adolescents from grades 7 and 9. The kids completed measures of depressive and anxiety symptoms, co-rumination, and self disclosure.

 

The researchers found that depression was contagious amongst them all and anxiety was contagious amongst girls and older boys.

 

Co-rumination a major factor

 

Further analysis of the data identified that co-rumination had a major influence on the contagious effect. Rumination literally means to chew something over for an extended period of time so co-rumination basically means discussing negative or depressive feelings in depth with someone else. The results suggest that over time, children who are exposed to persistent rumination somehow internalize these feelings.

 

“These finding highlight a previously unstudied risk factor for the development of internalizing symptoms in childhood” said Schwartz-Mette.

 

“Most important, a mechanism that helped to account for depression and contagion was identified”.

 

Home environment irrelevant

 

What this suggests is that regardless of a child’s home environment and whether it’s a stable and happy one or not, if they are constantly analyzing and discussing negative feelings, anxieties and emotions with their friends, their mental health may suffer as a result.

 

It is normal for children to have fears, worries and anxieties at certain times, however, when these symptoms become so severe that it is distressing enough to affect a child’s daily life then it’s time to seek help. For example, if a child is so anxious that they are terrified to go out, fall asleep, or be on their own, or if they become excessively clingy and tearful and there is no obvious reason for this, then it may be an idea to seek professional help.

 

Anxiety and depression in children

 

According to the Royal College of Psychiatrists, there are around 3,000 youngsters suffering from an anxiety disorder in the UK alone. However, this isn’t the whole picture as there are many more that say nothing and basically suffer in silence.

 

Anxiety disorders are the most common mental health problem to affect children. There are several different types of anxiety disorders and these are:

 

  • General Anxiety Disorder – constant worry about anything and everything – not specific to one thing

 

  • Separation Anxiety Disorder – anxiety related to being away from home or separate from parents or loved ones

 

  • Obsessive Compulsive Disorder – obsessive thoughts which may result in irrational compulsive rituals in order to deal with these thoughts, for example, obsessing about cleanliness and constantly hand washing

 

  • Social Phobia – intense fear of social situations, speaking in front of other people, participating in group events etc.,

 

  • Panic Disorder – recurring panic attacks

 

  • Post Traumatic Stress Disorder (PTSD) – symptoms such as flashbacks, nightmares, avoidance techniques that can develop some time after an intensely traumatic event was experienced or witnessed.

 

Depression can affect anyone at any age including children. It’s shocking that as recent as thirty years ago, many mental health professionals believed that children were not able to suffer from depression because it was believed they were not emotionally mature enough to feel hopeless. We now know this is simply not true.

 

There is no single reason as to why anxiety and depression affects one child and not another but there are some pointers. For example, youngsters who are less confident socially may worry more. Children who have experienced a traumatic event or situation may feel more anxious. If a child is having difficulty at school or is being bullied they may feel isolated and depressed.

 

Most children cope very well with their fears and anxieties but for some, the feelings can become disabling and if not dealt with may persist into adulthood. Also, a child who is anxious is more likely to become depressed and a child who is already suffering from depression is more likely to suffer from anxiety too.

 

Childhood is supposed to be a happy time but unfortunately, this is not always the case. However, help is available if a child is suffering from depression and/or anxiety and it doesn’t necessarily mean taking prescription drugs. Talking Therapies are proving to be highly effective as they help a child make positive changes to the way they think and view a situation, which in turn helps them to cope with their fears and anxieties.

 

 

Stress Can Literally Shrink Your Brain

Sustained stress over a period of time can play havoc with our health, we all know that. It reduces our ability to function effectively and eventually takes its toll on the body. Stress is involved to some extent in every single ailment or disease known to man. Now we know it can shrink the brain too.

 

There has already been an association seen between stress and smaller brain size. In a study published in January in the journal Biological Psychiatry, researchers found that people who were under stress were found to have less grey matter in the prefrontal cortex part of the brain. Now, a recent study published in August in the journal Natural Medicine, a “direct connection” has been identified between anxiety, major depression disorder and a reduction in brain size.

 

Circuits normally involved in emotion, as well as cognition, are disrupted

 

In the most recent study, researchers from Yale University are the first to discover the genetic transcription that actually causes the brain to shrink. They analyzed the brain tissue of both depressed and non-depressed patients to identify differences in gene activation. What they found was that in the brains of people who were depressed, there were lower levels of expression genes that are needed for the function and structure of the brain.

 

“We wanted to test the idea that stress causes a loss of brain synapses in humans” said Ronald Duman, senior author on the study and Professor of Psychiatry and Professor of Neurobiology and Pharmacology.

 

“We show that circuits normally involved in emotion, as well as cognition, are disrupted when this single transcription factor is activated”.

 

Transcription Factor GATA1

 

According to Lead author H. J. Kang, at least five of the genes could be regulated by a single transcription factor called GATA1 as laboratory studies have indicated that this transcription factor is involved both in the loss of brain connections and in the symptoms of depression.

 

Professor Duman reckons that identifying variations in GATA1 could also identify people who are more at risk from depression or who are more sensitive to the effects of stress and more effective treatments can be found.

 

“We hope that by enhancing synaptic connections, either with novel medications or behavioral therapy, we can develop more effective antidepressant therapies” said Duman.

 

This study was funded by the National Institutes of Health and the Connecticut Department of Mental health and Addiction Services.

 

Healthy individuals under stress

 

Earlier in the year, a study also by researchers from Yale, found that stress can reduce brain size and brain function in individuals who were otherwise completely healthy. The researchers asked 103 healthy participants (after prescreening for substance abuse, head injuries and other factors that might have an impact on the brain) to take part in a cumulative adversity interview that was designed to estimate the level of stress in their lives. Participants were asked questions about recent traumatic events such as divorce, financial problems, and other stress inducing factors.

 

MRI scans confirmed reduction

 

After the interviews, participants underwent MRI (Magnetic Resonance Imaging) scans to see how the results of the interviews compared to the brains of these individuals. The scans revealed that those who were under high levels of stress also had a reduction in brain tissue in the prefrontal cortex part of the brain.

 

This study was the first to show the effect of stress on the brain in otherwise healthy individuals. Bearing in mind that these individuals were not suffering from any depressive illness the findings are significant as it could pinpoint individuals who may in the future be at risk of a mental health problem.

 

“The accumulation of stressful life events may make it more challenging for these individuals to deal with future stress, particularly if the next demanding event requires effortful control, emotion regulation, or integrated social processing to overcome it” said Emily Ansell, assistant professor of psychiatry at the Yale School of Medicine and author of the study.

 

“These key regions are the regions we believe regulate our emotions, help us control our impulses and help us process our daily experience. They also control our physiology. These regions have implications for long-term health.”

 

Summary

 

Back in January, researchers from Yale found that people with no mental health problems but who were experiencing a significant amount of stress, had smaller brains than those who had less stress in their lives. Then another study identified what may be the genetic triggers that are involved in the loss of connections between neurons and a reduction in brain size. The implications are enormous.

 

If it is possible to identify those who are more at risk of a major depressive disorder or more susceptible to the effects of stress, then it may be possible to prevent problems too, either by taking steps to reduce the amount of stress or by earlier intervention with therapy.

 

 

 

Brighter Outlook For SAD Sufferers

Following on from a successful pilot programme carried out in Cornwall in 2008/2009, the UK Met Office may soon be offering help to those suffering from Seasonal Affective Disorder or SAD as it is more commonly known.

 

If it goes ahead, the plan is, they will provide advice and send out text messages or email alerts when gloomy weather is on the way to give people a couple of days notice to use their light boxes or to take other appropriate action.

 

Do you suffer?

 

The symptoms of SAD are mainly lethargy, sleep disturbances, carbohydrate cravings and weight gain, loss of libido and depression and anxiety.  SAD also causes the immune system to weaken which of course means more colds, flu, and more misery. The symptoms usually appear gradually as the winter months approach and the amount of sunlight reduces, only to disappear again in spring.

 

For some people with SAD, the symptoms can be so severe they are disabling and make the winter months a living nightmare. It is estimated that around 2 million people in the UK alone suffer from SAD, however, no one knows the true number of people suffering from SAD because for many, the symptoms are no more than a mild inconvenience and these people are unlikely to associate their winter blues with something that can be alleviated or avoided.

 

Subsyndromal SAD may be more common than we think

 

There’s a very mild form of the winter blues where the sufferer feels lethargic and has some sleep problems, and they may also crave carbohydrates and eat more, but they don’t experience any symptoms of depression or anxiety – this is known as Subsyndromal SAD. So, there are many people who could be suffering from this mild form of SAD who don’t even know it.

 

SAD is rare around the equator

 

SAD is very rare in those living around the equator where the sun is high in the sky and the length of the days and nights are roughly equal. That’s not the case for those living in the Northern Hemisphere where the sun remains very low in the sky during the winter months.

 

Melatonin levels increase

 

Some reckon that SAD is caused by changes in melatonin production. Melatonin is basically a hormone that helps to regulate our circadian rhythm or body clock. As the sun goes down, melatonin production increases and we start to feel sleepy and at the same time Serotonin levels drop. Serotonin is the feel good hormone.

 

Vitamin D levels to drop

 

Others say that SAD is caused by Vitamin D deficiency. Vitamin D is often called the sunshine vitamin. This is because we get most of the Vitamin D we need from the sun shining on our skin. Most people are quite unaware if they are deficient in vitamin D as doctors don’t routinely check vitamin D levels. So, it’s quite simple; the main cause of SAD is lack of sunlight.

 

According to the Daily Express, anyone living 52 degrees North cannot produce enough Vitamin D during the winter months To put this in perspective, this is anyone living north of Birmingham.

 

A Brighter Outlook for all

 

Back in 2008/2009 the Met Office in the UK ran a pilot programme (Brighter Outlook) in Cornwall in order to ascertain the feasibility and benefit of delivering an innovative weather-based alert service as part of a care package for people with Seasonal Affective Disorder.

 

Those who participated in the programme were all given a light box and a self-help booklet. To measure how effective the Brighter Outlook care package was the participants each had three sessions with a mental health worker where a Patient Health Questionnaire was completed. Each participant was also asked to evaluate the programme at the end of the study.

 

The results showed that there was a marked improvement in symptoms after only 4 weeks on the programme, and overall, the service was considered highly effective, with the vast majority claiming the service should be promoted and more widely available.

 

The Met Office are now considering rolling out the service to the wider public to offer advice and support for those suffering from SAD, just as they currently offer advice and help to those suffering from Hay Fever or Asthma, or how to deal with heat waves or particularly cold spells.

 

According to the Telegraph, Patrick Saychon, the health business manager at the Met Office, said the Met Office was in talks with the NHS, the manufacturers of lightboxes and private health experts about the “Brighter Outlook” service.

 

“We are talking to a different number of people” he said, reported the Telegraph.

 

“If we deliver a service that warns sufferers about the period of gloomy weather and provides them with materials, it will help them improve their mental health.”

 

In the meantime, anyone who feels they may be suffering from SAD should seek advice from their doctor.