Category Archives: Depression

Brain Changes in Youth with Depression

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youth brainJoining the quest to discover the brain basis for depression, a group of scientists recently published results from a study of youth (ages 4-24) with clinical depression (*).  The scientists compared the brain activity of 250 depressed youth to brain activity of a non-depressed group.

The study suggests that over-activation of two brain areas (Cingulate gyrus and thalamus) lead to “hypervigilance toward emotional stimuli”.  In other words the youth could not stop themselves from focusing on negative emotional ideas – this despite an increased activation of the dorsolateral prefrontal cortex (an area of the brain responsible for logical control of emotion).

While not offering final answers to the question, “What happens to the brain of people with depression?”, the article does provide evidence that brain malfunctions associated with depression can start in childhood.  The findings might also compel us to more urgently get help for children with depression, not to simply excuse depressive behaviors as a phase of childhood or something they can work out on their own.

(*)  Chris Miller and others. Meta-analysis of Functional Neuroimaging of Major Depressive Disorder in Youth, Journal of the American Medical Association -Psychiatry.  Published online September 2, 2015.

Shrinking Brain – Cause or Effect of Depression

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brainNew research provides evidence that long-term depression is associated with a shrinking brain (1).  The study, published last week, suggests that shrinkage in the hippocampus is a consequence of long-term depression.

Scientists compared brain imaging of 1700 patients with clinical depression to brain images of control subjects with no history of depression.  The hippocampus, a region responsible for memory function, was smaller in patients with long-term depression.  Hippocampus shrinkage was not seen in patients who had only experienced one depressive episode.   From this finding, scientists concluded that brain shrinkage comes after, not before, the onset of clinical depression.

In Breaking Through Depression (2), my book on causes and treatments of depression, I explain how stress can lead to brain cell injury.  Being depressed is certainly a stressful experience, one that might lead to brain cell injury. Breaking Through Depression also explains how this brain cell damage appears to be reversed by successful treatment.  Whether brain cell loss is a cause or consequence of depression remains to be conclusively determined but the point is made stronger by new research: stress and depression can damage the brain.

Do what you can to un-do depression.  Find healthy ways to relax and take care of yourself.  Exercise: huff and puff and break a sweat.  Hang-out with good friends for a while.  Engage your spirituality through prayer, meditation, or reading something inspirational.  If these self-care steps don’t lift your mood, then seek professional counseling and consider talking with a physician about medication.  Depressive illness comes with brain cell injury that can be reduced and reversed.

1. Molecular Psychiatry advance online publication 30 June 2015

2. Breaking Through Depression: A Biblical and Medical Approach to Emotional Wholeness. Harvest House Books

Emotionally Healthy Spirituality

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IMG_3905For many people, faith is indispensable to mental health. Religious beliefs and practices strengthen their emotional resiliency in the face of hassles and stressors.

Healthy spirituality can infuse  emotion and intellect with hope and clarity.  Awareness of the Holy Spirit lessens the sense of aloneness  and imparts wise counsel.  Reading of religious texts, with focus on scriptures that emphasize God’s love and grace, can correct cognitive distortions regarding low self-worth or helplessness.

Looking inward, prayer provides a structure in which to list problems and to facilitates a mental state of receptivity to new solutions.  Going deeper into a meditative state, while contemplating God as creator of the universe yet intimate companion,  enlightens the mind to a bigger-picture image of life that causes worries to melt.

Clearly spiritual belief can support mental health.   People tell me this, in one way or another, most days.

It is also true that spiritual belief can become emotionally unhealthy.  People also remind me of this on a regular basis.  A woman with obsessive compulsive disorder tells me of crippling obsessions over past sins.  Victims of clergy-abuse describe long-lasting wounds.

And so, healthy and unhealthy beliefs can be intimately interwoven in the mind.  Disentangling these beliefs can be hard and the process of uprooting unhealthy spiritual beliefs can be psychologically traumatic.  Often, it is better to start with cultivating spiritual wellness through the practices noted above.   In time, emotionally healthy spirituality will begin to yield fruits of improved mental fitness.

Too Many Antidepressants?

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photo (13)Over 10% of the US population use antidepressants each year, according to a recent study.   Researchers at the National Center for Health Statistics*, also found that antidepressant use rose nearly 400% between approximate years of 1998-2008.

Clearly antidepressants can be over-prescribed.  Doctors may rush to treatment  when they hear complaints of  “I’ve been feeling a bit depressed lately”.  Visits to the doctor tend to brief encounters and quick answers may appear necessary.  It takes a little longer to explain that talking therapy or better self-care may be the better choice for relieving sad and worried moods.

On the other hand, many people who could benefit from medication are not getting the help they need.  This can lead to job loss, broken relationships, and social isolation.  Some people refuse to see the problem.  Others refuse to consider medication as a solution.

Yes, there a lot of people taking medications.  Some should be using psychotherapy, exercise, or another health-promoting alternative instead.  Still many others should recognize that the brain develops chemical imbalance just like any other body part and consider medication. Most people using antidepressants have been properly diagnosed with some form of depression or anxiety disorder.  These people should continue using antidepressants under the care of a medical professional.

So yes, antidepressant medications are over-prescribed.  But they are also under-prescribed.  A thoughtful discussion with a psychiatrist or other mental health professional can usually identify who is who and what is what is this dilemma.

 

* National Center for Health Statistics.  Health, United States, 2010.  Hyattsville, MD. 2011.

Easter Spirituality: Christ’s Views on Good and Evil

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IMG_1984Believers of Jesus Christ as the incarnate son of God view the Easter weekend as a time of tragedy and triumph.  Orthodox, Catholic, and Protestant churches will open their doors to the curious and the devout and proclaim a message of good overcoming evil.

Like followers of Christ two thousand years ago, it is easy to get focused on the evil around us.  Early Christians watched Christ arrested, humiliated, and killed by men consumed by evil.

But Christ said, “Hey wait a minute.  Don’t be so short sighted.  Evil is coming for me but it has no power over me.  I am willing – no wait – looking forward to glorifying my father in obedient sacrifice, with the full assurance that I am headed to heaven.  It’s actually a good thing.  And, by the way, I am going back to heaven to prepare a place for you… got a room reserved for you in my father’s house.” (paraphrased from John 13).

Nowhere else in history is recorded such a story of bruising tragedy and ultimate fulfillment as in the historical events of Easter.  Whether you tend to get overwhelmed by worry or struggle with depression, may God refresh and bless you, with a new peace and perspective that surpasses human understanding.

See the Bible, John Chapter 13, for Christ’s perspective on evil, goodness, and his understanding of eternity.

Thawing Your Heart With Gratitude – Guest Post

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photo_4 (1)Hearts can become cold after months of freezing temperatures.  As we pass the time waiting for warmer days, now is a good time thaw our frozen hearts with gratitude.

Gratitude is an attitude, a habit of being thankful for the little things.  Research shows that gratitude and dark moods cannot rest in the same mind at the same time.

Studies have found that college students who wrote down things they were thankful for 9 weeks exhibited fewer physical illness symptoms than those who recorded hassles or neutral events.  Time focused on positive events kept them healthier.

In a study of subjects with a neurological illness, participants who counted their blessings daily for 21 days were found to sleep better than those in the control group.  Counting blessings appears to foster a sense of ease and contentment.

A final piece of research I will mention reports on a sample of 82 adults receiving treatment for hypertension.  Here, scientists found that participants who received a 10-week gratitude intervention, as well as their regular treatment, experienced greater decreases in blood pressure than the control. Gratitude can reduce symptoms of high stress, including high blood pressure.

For a few moments each day, be grateful.  Your blood pressure may drop and your sleep may improve.

Angela Hall., MA.  Resident in Counseling, Riverside Counseling Center

Winter Blues and SAD

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photo (33)Cloudy and cold, with a chance of freezing rain – this forecast is heard too often between December and February every year.  Dark days may stifle moods.  People often feel a touch of, what might be called, the winter blues.  Then, if the blues become intense, Seasonal Affective Disorder (SAD) develops.

SAD is a type of depression.  It affects 1-10% of people in the US.  The rates of SAD vary depending on how far north you live.  Residents in Alaska are at greatest risk for SAD due to shorter periods of daylight in the winter.

In my practice, people start showing up with SAD in September and October each year.  SAD comes with the same symptoms seen in more common forms of depressive illness. More days are spent feeling down on self and down on life.  Few days are experienced with feeling good about themselves and good about life. Like a bear retreating to a cave, people with SAD tend to isolate themselves and wait for the sunnier days of spring.

Treatment of SAD may include counseling, stress management (e.g. limiting expectations during holiday period), and more focus on self-care (e.g. rest and recreate when you can).  Many people benefit from increasing exposure to sunlight by taking a trip to a sunnier locale.   ‘Light-box’ therapy has also become popular.  Several companies now carry light therapy lamps.  If these measures do not help, medication may offer relief.  Wellbutrin is a popular medical treatment for Seasonal Affective Disorder.

SAD is, by definition, a time-limited illness.  Thankfully, moods begin to lighten with brighter days of March and April.  But if depressive symptoms are robbing you of joy in relationships or productivity at work, the season to seek help is now.

Five Tips to Reduce Anxiety and Depression

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0561. Develop a healthy habit. Growing a healthy habit may help to displace an unhealthy one.
2. Be open-minded about the benefits of medication to reduce worry or irritability, especially if your moods are creating conflicts in relationships or problems at work.
3. Consider counseling as way to unpack and examine your deeper feelings, ones that are not discussed in most day-to-day relationships.
4. Strengthen your social ties. Call an old friend or have breakfast with someone in the family.
5. Make a goal to grow spiritually over the next year. Then meditate on how your behavior may reflect that change.

Comfort in Grief – Spiritual Perspectives

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photo (57)In times of grief, a view of heaven may help.  Here are three images of God that illustrate the comfort that awaits the children of God.

The prophet Isaiah’s view of heaven included a vision of God as a kingly figure sitting on a throne, with flowing robes filling the temple and angels surrounding him with praises of his holiness (Isaiah 6:1-3).  How amazing it must be to dwell in his presence.

The apostle Mark described the presence of Jesus with children: ”And he took them in his arms and blessed them…” (Mark 10:16).  Jesus, as God among us, provided a glimpse of eternal heavenly compassion.

In my own mind, I like to imagine God as a loving father, sitting on his throne, with flowing robes billowing off of his shoulders and filing a heavenly temple.  I like to imagine all of his children sitting on his lap (it’s a big lap).  Our heavenly father looks down into the eyes of each one of us, in a way that fills our minds with amazement at his love and eternal provision for our souls.

Energy Balance in Depression and Anxiety

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photo (54)Two things I ask nearly every patient on every visit: “How are you sleeping” and, “Are you getting some exercise.”

If the answers are fine and yes, then I begin to relax in the belief that things are going pretty well for this person.  It’s a remarkably sensible formula: Rest + Exercise = Improved Health.

Our bodies were made to do things; and then, to rest in order to more things the next day.  People have been getting physical exercise since the time we lived in caves and hunted for dinner.  In modern times, we spend less time foraging through the woods for dinner and more time standing in front of the microwave oven.

Exercise researchers have shown that regular exercise is good for your mind and body.  It can even be a remedy for mild depression (see earlier blog).  The huffing and puffing of exercise blows off the emotional steam that comes with anxiety.  It is one of the few documented factors that help to reduce the risk of dementia and heart attacks.  Need I say more about the need to make some time for exercise?

Sleep researchers recommend 6-10 hour s of sleep.  Most people need about eight.  Some of us do better with nine.  Very few people function well with less than six.

In many ways, sleep seems like one of the easiest things to do with our time.  It is not.  A healthy sleep pattern takes discipline.  Reduce or eliminate caffeine if you sleep poorly.   Good sleep hygiene also requires that you spend the last hour or so of your day unwinding – not finishing a work or school project, not watching an adventure movie or reading a scary book. Let your mind and body relax.

Then make yourself go to bed.  Your mother does not control your bedtime anymore, so tell your own self “It’s time to go to bed so I can get up in the morning and exercise.”