Category Archives: Depression

Hungry Hormone May be Barrier to Stress Induced Depression

March 25, 2011

Field mice placed on a calorie controlled diet as part of a major piece of US based research have allowed researchers to discover ‘ghrelin.’ This is a hormone that appears to increase when we don’t eat, and in its finding may be the key to fighting symptoms of anxiety and depression brought about through stress.
Senior author Dr Jeffrey Zigman led the study, he is the assistant professor of internal medicine and psychiatry at the University of Texas (UT) southwestern Medical Center in Dallas. The research has been published in the journal Nature Neuroscience. There is one unfortunate draw back and side effect according to the doctor of this line of research. That is the increased food intake and body weight that comes with combating the symptoms by this means.

Another of the lead authors of the study a Dr Michael Lutter has stated; “Our findings support the idea that these hunger hormones don’t do just one thing; rather, they coordinate an entire behavioral response to stress and probably affect mood, stress and energy levels.”

It was already known that the process of not eating, does cause the production of ghrelin, the result is that a great many hunger signals are sent to the brain by the hormone. Suggestions have been made in the past that a blocking of this hormone may be useful in implementing weight control. Doing such a thing, it has been uncovered by this study would play and interfere with the natural rhythm of the body, and the means by which the body handles stress and anxiety.

The study team placed ‘wild type’ (i.e. natural and non-genetically modified) mice on a diet that was calorie restricted. The diet was to go on over a period of 10 days. In this period four times the regular amount of ghrelin was produced by the mice. It was evident that as a consequence of the elevated levels when the mice were forced to swim and take on stressful mazes they showed reduced symptoms of anxiety, than did their counterparts who had not had their diet restricted.

Mice which were altered genetically were then bred. These mice had bodies that would not show a response to this ‘hungry hormone,’ they too were placed on the restricted diet. It was evident when they were put through the same stressful mazes and swims that the levels of stress and anxiety leading to depression that they experienced, were at normal levels. It was found that there wasn’t the same anti depressing effect in the mice where ghrelin had no effect.

A third test was also conducted, its fundamental was in researching and exploring social stress, here they used both the ‘wild type’ and the genetically engineered mice. Instead of making them swim and run mazes they introduced both types of mice to other aggressive mice every day, the bullying effects of these aggressive mice is quite similar in how humans are effected, and the symptoms we produce as a result are also similar.
The amount of ghrelin produced by both sets of mice was elevated to a point where it lasted for more than a month when the ‘bullying’ was finished. It was in the genetically modified mice where social avoidance symptoms began to show. Much of their activities from that point on showed symptoms of depression like reduced food intake.

The explanation offered by the scientists is the ‘survival advantage’ that has developed in animals through evolution. This advantage allows us to take in enough food to stave off death. Back on the human front it has been determined that nature would see it fit for us to be calm and collected creatures ,as this ability goes hand in hand with being a hunter gatherer.

It has been extrapolated that ghrelin when induced through hunger brings about the anti anxiety in order to give us the edge when it was needed most. There have been deductions made that this may be what happens in sufferers of anorexia nervosa also.

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Finding the Trigger – to Shoot Dead the Culprit

March 24, 2011

How does this whole thing work, and how indeed have you come upon this writing? It is a complex thing, the mind. I don’t hold a PHD in Psychology, but maybe that is a good thing. All I have to give you in this blog is the personal, and from my personal I believe you can find, your personal.

I think in life we strive to stave off the negative, if sitting at home all day playing computer games was enough to give us a happy life then we would do that, wouldn’t we? It is simple enough when you think about it. Input is equal to, and rarely is it greater than the output. If what we do and what we put into our existence makes us happy then indeed we are happy, or at least we should be.

The problem of ‘should be’ I like to break down in Economic terms, it is about ‘utility derived,’ about how much satisfaction we get out of things. Unfortunately this utility derived wanes over time. If a chocolate bar will make you happy as a kid, eating one as an adult may not have the same profound effect on your mood. Would eating ten chocolate bars then give the same effect? Maybe, maybe not, but we will try out everything we can until we are sick to the stomach with trying and attempting to find resolution to our problems.

You are here because there is a problem, maybe in yourself or maybe in those around you. Maybe you are here because you think, but are unsure there is a problem, perhaps in seeing the symptoms for depression outlined in print you will see that indeed, it is depression you or your loved one is suffering from. Depression is like a white elephant, it stands out a mile. Some may tell you that it is difficult to see, but my experience in this domain, both from seeing it in myself, and seeing it in those around me to both positive and detrimental affect, it really is there to be seen. Symptoms for depression are obvious when you know what you are looking for.

Is appetite down? Is the person failing to get the good out of things? Do they speak when they speak only of the negative, (We often see this, don’t confuse negative people with depressed people, the depression stats would be way beyond what they actually are if that was the case) but in their negativity to they self deprecate to the extreme? Do they talk in a different tone than they used to, a tone which reflects a person deeply unsatisfied?

Being unsatisfied and being depressed do not go hand in hand. Being unsatisfied leads us, guides us, and pushes us to get more out of life. But in their being unsatisfied, do they speak as though there is no other way to be? Symptoms for depression if allowed to fester and go unchecked lead to the giving up on hopes and aspirations. Has the individual’s demeanor changed? Have they stopped showing interest in the things from which they used to derive ‘utility?’ It may not be the case that you can see depression in the face, but it is always there lurking just below the surface.

Does the person become teary, just to the brink of tears at the mention of a particular thing? If you have noticed this, then you may now look at that as a ‘Eureka’ moment, this is a very positive thing a weapon for the battle that is to come.

The raw nerve may in fact be the trigger in itself that is causing the depression. If you can get to this root and weed it out you can bring the person out of their dilemma. If this person is you, then read on, here is the key to solving your problem. Once we know what the problem is, of course it will usually be the impact of a whole host of other ‘weeds’ i.e. problems, but if we can get just one thing sorted that is causing the depression, then in that we hold a solution to the problem.

Changing our lives, is the way that we can change our frame of mind. With love and our need to be loved such a major part of our lives, in this we find both the problem and the solution that both causes, and can bring us out of depression. It is often the trill of the chase that keeps our mind eager for the possibilities that may arise. The chase may not be successful, but the chase itself gives us motivation and being motivated towards anything will keep the thoughts that the mind imparts to us when it is full of depression ‘weeds’ at bay. Focusing on anything other than the negative thoughts themselves, brings reprieve from the symptoms and with reprieve comes better times.

Taking on one core problem is possible, whereas tacking everything at once is not. By ‘chunking’ it down, by finding the source of one of the things that has sent us over the edge and removing its power, we can beat the state in its entirely. Once beaten, it will often be that the other issues take care of themselves. One small element of positivity is enough to keep depression at bay.

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If words could only drive the demon out

March 24, 2011

My best mate came to the defense of his sister one day. He is an artistic writer type of person, and so perhaps he has the ability to see a little deeper then most. He told me how he had gone to the home of his sister where an ex boyfriend had managed to weasel his way in, and refused to leave, awaiting her return.

My mate turned up and tried to kick him out, he is a small lad and found a broken piece of wood with a sharp edge as both a means of attack and to defend. The family had never approved of the relationship, his sister saw in that guy maybe someone who needed her that she could help. He was a guy with problems, and those problems were right there, evident for my mate to see the day he barged into his sister’s home to confront this trespasser.

“His skin was kind of green”…”There was a pathetic look in his eyes, a desperate look, he loved her, he couldn’t just let her go.” Not one to fight really, my mate endeavored to talk him down, trying to relate and deal with it, trying to get this guy a few years his sister’s senior to see that there was more out there, plenty of fish and all that, but nothing was stirring. No words can undo the power of a malevolent force in the mind that castrates a man’s humanity and vision.

Of course words can have impact, there are motivational speakers a plenty, who do great work out there, in a world where communication, despite our technological progressions is still a little wayward from time to time. Words can’t have an immediate impact, and it is only through timely reflection that these words can be used to ‘fix’ what is broken. My mate told me how he felt deeply sorry for this guy, his ‘patheticness’ brought about this emotion, my mate could see he was depressed. See he was suffering inside, and that in my mate’s sister he found a crutch, someone who he could depend on, hold him close and feel something other than misery.

His depression was ruling him, controlling his actions, what my friend would recount to me was that this guy just wasn’t ‘himself.’

‘Himself’ or ‘herself,’ it doesn’t matter the gender, when we allow symptoms of depression to take hold of our being we are really no longer ourselves, we are the entity that the emotional state dictates, we are what this mental malaise, what this mental illness dictates that we should be. The feelings are of ‘patheticness,’ and therefore we are pathetic in our actions.

Now what happened to my friend and how he chose to deal with it is not the normal state of affairs. Another man would have used that stick and bet the individual, but depression when the symptoms take control of our actions cannot be beaten out of us, we will self inflict, we will self harm and it does us no good. It only exacerbates the problem, it isn’t a fix, it is no solution. Nor is the solution in words, and we have seen from research that only in the most serious instances of depression is the solution in medication. How can we achieve an emotional state, coming back from the brink of the abyss that is a depression plunge, almost impossible to lift ourselves out of, a vortex of self damning self induced affliction?

The assistance of those around us in diagnosing the symptoms of depression is as important as the dealing with it. Once recognised it can be the little things once again, those little things that have begun to garner no emotion, that can give us that little pick me up to get us through, and little step at a time get us on the road to recovery.

Recovery cannot begin without the aid of those around us, one cannot recover from anything until they recognise that there is something that needs recovery from. My mate told me lately that he had seen that the young man who had brought the conflict by allowing his symptoms of depression to take root and control his actions, is now ‘a different person.’ That term ‘different’ is a reflection not of the different person he was, but perhaps the person he always was minus the problem of his diseased mind.

Maybe the words of my mate had a profound effect that day. My mate had told him there was a problem, and had advised on how to get out of it. When the mind is a place that holds us tightly inward, tells us only the negative, the words of those outside this inner sanctum of turmoil can pick us up, and help us in lifting ourselves out of it.

It takes time, time is a wonderful thing, but the realisation must come first that depression symptoms are not normal, they are not meant to be, and should not be allowed the oxygen we give them to respire to grow and fester.

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What is Hidden Behind that Fake Smile?

March 24, 2011

What we see in ourselves when we look deep down and inward, so deep that we find ourselves we can often miss out on what lies upon the surface. At skin surface all seems normal, hey its normal to let the facial muscles sag downwards, its normal because it takes so much effort to smile, and even holding those muscles to keep the mouth showing an emotional state of normality ‘nothing’ with a horizon shaped mouth that takes effort, doesn’t it?

The symptoms of depression are for all to see really, but the most important thing is that you see them in yourself. Admitting there is a problem however isn’t as easy at it would appear to be, there is much greater effort in ‘faking’ a smile than in seeing something in ourselves we don’t want to see. Waking up in the morning and just wishing that you could go back to sleep, wishing that the day anew would just go away, for twelve hours and take you back to the state of night, a night where the day does not have to be faced that is a symptom, that is a telltale sign that there is something severely wrong.

Who has the luxury though of being able to just throw those covers back over your head hiding you in a cocoon, an inner sanctum away from the apparent troubles that lurk in living life and returning you alone to deal all alone with the self, that thing that damned thing that wants to keep you all to yourself. Now is it bi-polar disorder or is it just the blues? So difficult to diagnose any difference, the doctors get it wrong all of time which is why second opinions of depression diagnosis are often so important. Not wanting to face the day, not getting any satisfaction out of the little things, those little shared moments and laughs that what life is all about, that is a symptom.

When you recognise the symptoms, that is when something should be done about it, but so often it is too late at that point, depression has already taken control. It is so hard to help ourselves because we don’t want to help ourselves. When depression takes hold we feel that this depression as it is the only thing we know, is somehow the right thing for us. It is right for us to feel like shit because we are shit, we only deserve to feel pathetic because we are in fact pathetic. When we can no longer get satisfaction from our taste of food, when our senses are utterly numbed to the good that they experience, moreover ‘used’ to experience in everything, these are symptoms of depression.

When the sun shine is something to be avoided, when the rain and wind somehow seems to outwardly express how we feel inside, that is a symptom, and as a depression symptom when we realise what it indeed is, then it is a call to action. But where do we find help? When everything is insular, when the internal dialogue that runs in our minds tells us that we are utterly alone in this life, it is only normal then that we cant find help anywhere but within ourselves. When all we want to do is hurt ourselves, enjoying those banging our fists against cement, no longer wincing when our head hits against the pillar, when the pain is just a reflection of our emotional state that is a symptom of depression.

Symptoms of depression in others are simple enough to spot, people put on a brave face, but if we look hard enough we can see behind the fake smile and witness in the eyes the inner turmoil that is going on behind those eyes. Seer into their soul and see they are not feeling how they appear in fact to be. When the individual is no longer connecting in the way that they once were, when school friends work colleagues, when acquaintances are no longer sought out and the individual pulls away from the world, removes themselves from the part in it that they used to play, those are symptoms.

When they fail to wash and take pride in their appearance, if they used to take great pride then there is a sign here that something is up, something serious is underlying, is crushing their motivation to be a part of the world. Something has taken a hold of them and it is important that an intervention is made. That intervention is best to come from within, but when there is not the determination within to do something, when the drive has been driven out, you need to act, act fast and act smart. You need to come to their assistance before it is too late.

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Ghosts of Depression

March 24, 2011

Sometimes it is just too late before we recognise what was there in front of us all that time. I’ve seen too many of those around me let it take hold and let it take control of the implement of its inevitable winning out, if it goes unnoticed by those around you. The term inevitable in particular refers to the weak, those that shouldn’t be left to face this battle.

Last year, I as a journalist in a large town in Ireland was doing a simple photo op on a Saturday afternoon, I wasn’t supposed to be working, but I needed a little colour snapshot, some smiling faces to contrast against a very serious and possibly distressing page 10 news story. I always tried that, I never wanted my words and my decisions about what was to go on the pages to influence the mood of my 50,000 readers in a negative way.

What would happen would disturb me, and I would feel so crap about myself for not going on to take a ‘Lifeguard’ course which was being offered by Depression Battlers in my town, people who I had met, interviewed, people who had loved and lost in the battles against depression, people who had lost people very close to them. They had offered me the chance to take this ‘Lifeguard’ course and one of the main words which would haunt me when I would think back after that Saturday afternoon was that it would teach how to recognise the symptoms of depression.

Its purpose was to recognise and arm with tools that could be used to help the other person, help them through ourselves, or go about and get the assistance and err the individual towards that professional assistance. It bloody haunts me still, but I was too busy, busy doing nothing, when I should have done one of the most important things that I would ever do.

That Saturday afternoon I went along to find this photo op, nothing major just a bunch of hairdressers clubbing together in a little wooden hut in the main shopping centre. They were dishing out haircuts in aid of the Haiti earthquake relief effort. 10 quid a piece, good value, good cause and all that, you might laugh at how this might have been ‘news,’ but I’m a good photographer, and spoke to one of the girls to help me out in organising the shot.

The girl I spoke to was a blond, a big girl but a pretty girl all the same. I don’t know why I think that is important to say it is just that I didn’t know her, I’m not going to print her name, I wonder how her parents would feel about that. We would all be left to wonder why, I spoke to her and I was so engrossed in getting a shot worthy of my page ten that I didn’t see the weepiness, I looked past the low voice as though she was almost too timid to be proud of having one. I didn’t see in her face behind those eyes that there was something severely troubling her. I didn’t know that my taking that shot she helped me in setting up what may have been a nail in the coffin.

Yeah coffin, I took the shot everyone smiled, held up their charity buckets, I went back to this fine blonde young woman and asked her to tell me the names of everyone in the shot. I recorded her words into my camera using the video record function to take in the sound. On Monday afternoon as I got the paper ready for print, all was as usual frenzied in the office before Tuesday’s print. I uploaded the video file from my phone and set my hands over the buttons of my keyboard to type straight in the names. Name after name of some eight persons in the shot I think, but when it came to her name the recording was ghostlike, I say that and I mean that. I don’t believe in anything supernatural but having been so close to that, it unnerves me now and my arm hair is standing on edge as I recount this to you. It was like the voice with her name didn’t really exist anymore, a whisper that just faded out, no problem with the technology, I couldn’t make out the name and like the bad Editor I was under pressure I went to print without it.

Tuesday just after the paper was ‘put to bed’ we got a call from one of the hairdressers asking us if the photo had made it to the paper, telling us that one of the girls in the paper was no longer with us, having done something stupid to herself over the weekend. I immediately knew who she was talking of, I wish I had known then what I should have known then, I wish I had the power to do something for her and that power was in being able to see the symptoms of depression.

I should have seen them I should have made an impact on that girl’s life, I probably did in hindsight and in that photo whatever way she felt about her image at that time, its going to be in front of the faces of 50,000 people who she ‘knew’ would be judging her on this appearance. Did that put the next nail in?

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Getting to the Point of OK

March 24, 2011

Young life, the time that according to poetry we were thought in school was supposed to have been easier than all of this. Innocence of childhood and all of that nonsense was the way it was supposed to be. Innocent, free, and happy that is how we are represented in these poems, just going out there and enjoying the best years of a so called life. I wonder though, that if someone had said that to me at the time, I wonder how I would have taken it.

Hey if this was the best of times, the best time of my life then there really was no point in going on now, was there? There is an equation going on with our everyday, I’m no mathematical scientist, but I think that the reality of what we experience directly impacts on how we feel. Add up the good against the bad and your end result, the way you feel is down to these factors. If the good outweighs the bad then you feel good, if bad then bad.

If OK then that is how you come out. An Aunt of mine knew I was feeling low, I don’t think that she knew just how low, but it was low enough to cause her to go out and get me a book called “I’m OK you are OK” one of those self help books that equated our view on others as the equation in which we would find how we felt about ourselves. The fact that I was reading this type of material wasn’t something that you would go out and tell the world. Being depressed suffering from The Depression isn’t something that you want others to know, it is not that you are hiding it, in fact at every juncture, every time you barely manage to hold back the tears when a raw nerve is struck in conversation you are really trying that whole cry for help thing.

Big boys don’t cry however and I think I held in more tears than will ever flow back then. I had the depression, it wasn’t diagnosed, when my parents looked to take me into the doctor I lied through my teeth acted out a brave face, once there they were alongside me. They were putting me in this place I didn’t want to be, and I was damned if I was going to try and put sense and words to order how indeed I was feeling at that time in front of them, in front of a professional. I’m older now, bigger than the big boy who wouldn’t allow himself to cry, the January blues still kick in, I find myself constantly shifting and deriving the manic highs as away to get through things, trying to find a means to store the fake positivity to get through it.

Depression does not begin and end, it is always with you from where I stand, where I have unfortunately made my bed in which to lie. Holding it all in hurts from time to time, all untold, living through it and rising to get to the next day that is where the hard inches are won out against The Depression. It is a show of strength, a show of resilience just to make it through, to try and impose a mantra that will dictate that the depression will not affect your mood this day, and then just hope for the best that you won’t feel that way tomorrow.

Yes there is limited responsibility when we are young, yes it would seem that our problems are so trivial when compared against the problems we are going to face in adulthood, but try telling that to the ‘Big Boy,’ (I wasn’t all that big, but I was physically strong) try saying to him ‘snap out of it’ as my parents would say. Depression can’t be beaten with such a ‘snap,’ I’ve heard of doctors that attempt to use this device, but I never heard of it working.

The Depression just like alcoholism can only be beaten one step at a time, one moment to the next we suffer how it speaks to us, putting words into our mind which tell us just how unimportant we are, how pathetic we are. It is listening to this words that torment and letting them control us however that is the real pathetic thing as we journey on and we struggle (If we have the guts) not to let The Depression win.

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Personality Speaking Antidepressants Work

March 23, 2011

A new antidepressant treatment study now suggests that it is in personality, and in the changes to that personality through taking particular antidepressant medications like paroxetine (Paxil) that bring about improvement in the patient.

The study shows that it may not be down to the medications ability to lift mood, but may actually be born out of the direct effect of the drug, and by this means depression is lifted.

Where neuroticism is evident in a person, whereby they are more prone to experience negative emotions, and mood swings it is in these people where depression is likely to emerge. This neuroticism is just one of 5 traits of personality which scientists are now using in order to organise the understanding of personality. On the list also are openness, agreeableness, conscientiousness, and extraversion.

Whilst it has become evident that levels of neuroticism decrease when a patient undergoes antidepressant treatment, also reported is an increase in extraversion levels and a lifting of depression symptoms. It was up to this point assumed that these personality traits change was more the result of the lifting of the depression and not the cause.

It is out of studies in twins that evidence has emerged how to a large extent those very same genetic factors underlie risk of both depression and neuroticism. It has also been concluded through research how the neurotransmitter that is serotonin, does play a role in both neuroticism and extraversion expression. The serotonin reuptake inhibitors actually cause an increase to the neurotransmitters availability.

Investigator Tony Tang set about a course of investigation to test out the relationship that exists between SSRIs and the personality of the patient. Tony and colleagues of his at Northwestern University, Evanston, IL, the University of Pennsylvania in Philadelphia, and Vanderbilt University in Nashville, TN, made a random assignment of people suffering from disorders like (MDD) Major Depressive Disorder. These persons were then treated with paroxetine, placebo and cognitive therapy. It was one or the other, with 120 of the 240 individuals in the study using the drug.

The study shows how the placebo didn’t have the effects of the cognitive therapy and the drug. After eight weeks of study this was determined and along with that fact it was seen that the measure of neuroticism in the patient who received these two treatments also dropped. There was an increase in these two sets of patients with regard to rises in extraversion also. The changes were described as ’striking’ by the scientists.

There were small changes with regard to both character traits in the placebo taking patients, but with those who were actually taking the drugs the results showed a change by as much as a factor of eight.  Whilst the degree of improvement in the actual depression may have been the same for the placebo and the drug taking groups, there was a much higher rate of personality change on the drug taking patient. The suggestion from this research is that it is not the result of the drugs lifting depression that brings the personality change but the drug itself.

There were also decreases in depression levels amongst those treated by CT, these persons experienced a heightening in their levels of extraversion, however their levels of neuroticism were not affected.

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New Antidepressant Boosts Brain Connections Fast

March 23, 2011

It has been found that a new and experimental drug has the ability to eradicate depression in mere hours. Its working are based around stimulating the connections between cells in the brain, it is called ketamine and triggers a key enzyme useful in treating depression by quickly generating new synapses.

Dr Ronald Duman who led the research team is a Yale University man. Their findings have been released and published in the journal Science. Dr Ronald has stated, “Discovery of this cellular mechanism helps point the way to development of a ketamine-like agent that could become a practical, rapid-acting treatment for depression.”

With the antidepressants currently on offer not working for 40% of those who are depressed, and slow to commence working, the dramatic effects of ketamine are quite astounding. Studies have found to this point that with ketamine use in the treatment of both bipolar depression and depressive disorder, that 70% of patients who had been treatment resistant in the past showed a dramatic improvement just a day after receiving their first dose.

The drug must be administered through the veins of the patient, and there are significant side effects possible out of its use, as a result the doctors have concluded that ketamine is not a practical treatment in itself, but it has moved researchers into hunt mode for similar agents that might work by the same means as ketamine.

It was the research of these scientists which have now managed to ascertain the means by which the drug works. Whilst those drugs which are currently prescribed, work through the chemical messengers of the brain with regards to serotonin release, ketamine works through another system, the glutamate system. The Serotin drugs work by triggering events stimulating the creation of new neurons, and by this means establishing new connections (synapses) with other neurons, and thereby improving activity in the brain circuitry, this explains the delay in working.

Ketamine on the other hand offers speedy results using the glutamate system which acts more directly, in a way it works with those elements of the brain that are at the root of the problem. Whilst it was a known that ketamine does a blocking job on the binding of glutamate with receptor proteins on the membranes of the cell (NMDA receptor) the team took an approach of determining the pathway the signal takes when triggered by the blockade of the receptor.

When research was conducted with rats, the researchers found that in the rats prefrontal cortex (front of the brain) when a low level of ketamine was introduced it activated activity of the enzyme. This then went on to make proteins, which in turn went quickly on to form new connections (synapses) between neurons. Its activities are determined to be different than those of normal antidepressants or ECT treatment.

It has been found that depression and stress produce in the body the very opposite of what ketamine achieved. These mental ailments cause the synapses to shrivel. The ketamine however boosts the creation of these synapses in as little as two hours. In rats it was found that the drug reduces symptoms of depression brought about courtesy of stress in a day and the effects are ongoing for at least seven days.

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Relapse Risk for Recovered Hard to Treat Depression Teens

March 23, 2011

Those young people, who get to the remission stage by the time six months have passed, are still at risk of relapse according to new research now published in the Journal of Clinical Psychiatry.

These teens are ones who are dealing with hard to treat depression; the data which backs up the relapse prognosis is from long term analysis from a NIMH-funded study. The end result of the research is a reiteration that there is a need for highly aggressive treatment needed for teenagers who have stubborn hard to eradicate depression.

The name of the study was: Treatment of Resistant Depression in Adolescents (TORDIA) study. Those young people who had shown no signs of improvement from their depression in the initial action when serotonin uptake inhibitor antidepressants were used, were given a random assigning to the study. Four different interventions were possible, each of which would last for 12 weeks.

There was the opportunity to switch to a different drug of this nature (SSRI) or to a serotonin reuptake inhibitor, so too the patients could have had their drug treatment changed to venlafaxine plus CBT.

After a six month period, four in ten of the subjects experienced total remission from their depression. At that point they were removed from the study and directed to continue with their care within their own community, with their only return booked in for a year and a half down the line.

Out of 334 young people who had commenced the study more than 60% had reached the point of remission by the year and a half period. There were some patients who even at this point still complained of experiencing residual symptoms, these symptoms included low self esteem, fatigue, and irritability.

If there was more severe depression evident at this ‘baseline’ point of a year and a half those individuals were less likely to arrive at remission at the end point, whilst those who were early responders perhaps within the first month and a half of treatment were more likely to get to the point of remission. The drugs applied in the initial treatment it was evident, didn’t influence the time at which remission occurred or the rate of remission.

The study found that whilst 130 participants had show remission by the six month mark, more than a quarter of these had a relapse by the year and a half point. It was noted that whites stood a smaller chance of relapse than ethnic minorities.

It was concluded by the study authors that effective interventions are needed early in the process of treatment, this was needed as more than a third of the teenagers in the study did not recover at all, and the quarter of all relapses was a very high stat. The authors also determined from the study that there is a need for new methods to make an accurate identification of who will and who will not, respond early to treatment.

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A Second Opinion may be Needed for Depression Diagnosis

March 23, 2011

Taking on a case study to provide example we will now demonstrate the reality of the need for a second opinion in this regard as was made evidential from new research conducted by Wake University Researchers.

Taking an individual who has struggled for decades with a form of depression that left him to the point of despondence more often than not, it had never occurred to this individual to get a second opinion.

He felt that he had ownership of his own body and his health. With regards to the body, and if there is a diagnosis which he wasn’t so sure of or didn’t like then yes for the body he would seek out a second opinion, for the mental health issue however there is a different reasoning.

It was only after many years, decades in fact of suffering through non functioning relationships, suicidal thoughts and the highs and lows of manic excess that a second diagnosis was achieved. His depression was now diagnosed as bipolar II mixed.

Our case study had slipped through the net, and had his symptoms misinterpreted as this for of bipolar disorder is very difficult to diagnose, with it the affected person is still capable of being very productive and high functioning. The mood swings that are inherent are, whilst uncontrollable, sometimes misinterpreted for happiness, when the manic high kicks in.

It has been determined by this research that almost 70% of the first diagnosis of bipolar disorders were wrong, which shows that second opinions in this area are very important. The main problem with misdiagnosis is that the medication used if wrong can be very damaging for the patient, the meds can make a depression deeper or make the manic highs and lows come quicker.

Our case study outlines how the individual would have been very unlikely to have sought out a second opinion off his own back. As a result the research finds that it is medical professionals themselves who should be seeking to get second opinions on their own prognosis in this area.

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