Article Examining Depression

The article mentions standards such as medication and counseling, but perhaps the best way to reduce high depressive rates in the population is to restructure society to make it much better for most people than it is currently.

Clinical depression has surged to epidemic proportions in recent decades, from little-mentioned misery at the margins of society to a phenomenon that is rarely far from the news. It is widespread in classrooms and boardrooms, refugee camps and inner cities, farms and suburbs.

At any one time it is estimated that more than 300 million people have depression – about 4% of the world’s population when the figures were published by the World Health Organization (WHO) in 2015. Women are more likely to be depressed than men.

Depression is the leading global disability, and unipolar (as opposed to bipolar) depression is the 10th leading cause of early death, it calculates. The link between suicide, the second leading cause of death for young people aged 15-29, and depression is clear, and around the world two people kill themselves every minute.

While rates for depression and other common mental health conditions vary considerably, the US is the “most depressed” country in the world, followed closely by Colombia, Ukraine, the Netherlands and France. At the other end of the scale are Japan, Nigeria and China.

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Things have improved since people with mental illness were believed to be possessed by the devil and cast out of their communities, or hanged as witches. But there remains a widespread misunderstanding of the illness, particularly the persistent trope that people with depression should just “buck up”, or “get out more”.

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The WHO estimates that fewer than half of people with depression are receiving treatment. Many more will be getting inadequate help, often focused on medication, with too little investment in talking therapies, which are regarded as a crucial ally.

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There have been positive experiments with both ketamine and psilocybin, the active ingredient in magic mushrooms. Further hopes for a new generation of treatments have been raised by recent discoveries of 44 gene variants that scientists believe raise the risk of depression. Another controversial area of research is treatment for low immunity and mooted links between depression and inflammation.

Countries are increasingly recognising the need to train more psychologists to replace or complement drug treatments.

And perhaps most importantly, there is a cultural movement to make it easier for people to ask for help and speak out about their illness.

Link Between Depression and Increased Brain Aging in Older Adults Found

The new research shows another reason to take mental health problems seriously. Suboptimal cognitive function in older adults both decreases general welfare and leads to worse outcomes via less informed decisions in political democracy.

Psychologists at the University of Sussex have found a link between depression and an acceleration of the rate at which the brain ages. Although scientists have previously reported that people with depression or anxiety have an increased risk of dementia in later life, this is the first study that provides comprehensive evidence for the effect of depression on decline in overall cognitive function (also referred to as cognitive state), in a general population.

For the study, published today, Thursday 24 May 2018, in the journal Psychological Medicine, researchers conducted a robust systematic review of 34 longitudinal studies, with the focus on the link between depression or anxiety and decline in cognitive function over time. Evidence from more than 71,000 participants was combined and reviewed. Including people who presented with symptoms of depression as well as those that were diagnosed as clinically depressed, the study looked at the rate of decline of overall cognitive state — encompassing memory loss, executive function (such as decision making) and information processing speed — in older adults.

Importantly, any studies of participants who were diagnosed with dementia at the start of study were excluded from the analysis. This was done in order to assess more broadly the impact of depression on cognitive ageing in the general population. The study found that people with depression experienced a greater decline in cognitive state in older adulthood than those without depression. As there is a long pre-clinical period of several decades before dementia may be diagnosed, the findings are important for early interventions as currently there is no cure for the disease.

Lead authors of the paper, Dr Darya Gaysina and Amber John from the EDGE (Environment, Development, Genetics and Epigenetics in Psychology and Psychiatry) Lab at the University of Sussex, are calling for greater awareness of the importance of supporting mental health to protect brain health in later life.

Dr Gaysina, a Lecturer in Psychology and EDGE Lab Lead, comments: “This study is of great importance — our populations are ageing at a rapid rate and the number of people living with decreasing cognitive abilities and dementia is expected to grow substantially over the next thirty years.

“Our findings should give the government even more reason to take mental health issues seriously and to ensure that health provisions are properly resourced. We need to protect the mental wellbeing of our older adults and to provide robust support services to those experiencing depression and anxiety in order to safeguard brain function in later life.”

44 Genomic Variations Linked to Major Depression in New Research

Genetic variations (variants) are the roughly 0.5% share of DNA that makes individuals unique, as about 99% of human DNA is shared across humans. The word genome represents the entire set of genetic material someone’s made of. With that being said, this research is important because major depressive disorder can be a really crippling affliction, and the more that’s known about it, the more effectively it can be treated or prevented.

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A new meta-analysis of more than 135,000 people with major depression and more than 344,000 controls has identified 44 genomic variants, or loci, that have a statistically significant association with depression.

Of these 44 loci, 30 are newly discovered while 14 had been identified in previous studies. In addition, the study identified 153 significant genes, and found that major depression shared six loci that are also associated with schizophrenia.

Results from the multinational, genome-wide association study were published April 26 in Nature Genetics.

The study was an unprecedented global effort by over 200 scientists who work with the Psychiatric Genomics Consortium. Co-leaders of the study are Patrick F. Sullivan, MD, FRANZCP, Yeargen Distinguished Professor of Psychiatry and Genetics and Director of the Center for Psychiatric Genomics at the University of North Carolina School of Medicine; and Naomi Wray, PhD, Professorial Research Fellow at the University of Queensland in Australia.

“This study is a game-changer,” Sullivan said. “Figuring out the genetic basis of major depression has been really hard. A huge number of researchers across the world collaborated to make this paper, and we now have a deeper look than ever before into the basis of this awful and impairing human malady. With more work, we should be able to develop tools important for treatment and even prevention of major depression.”

“We show that we all carry genetic variants for depression, but those with a higher burden are more susceptible,” Wray said. “We know that many life experiences also contribute to risk of depression, but identifying the genetic factors opens new doors for research into the biological drivers.”

“This pioneering study is incredibly important, for two reasons,” said Josh Gordon, MD, PHD, Director of the U.S. National Institute of Mental Health. Dr. Gordon was not an author on this paper.

“First, it reaffirms the value of large-scale collaborations, particularly in identifying the complex genetics underlying psychiatric illness. Second, it confirms the genetic roots for depression, offering important biological clues that we hope will lead to new and better treatments.”

“Major depression represents one of the world’s most serious public health problems,” said Steven E. Hyman, MD, former director of the U.S. National Institute of Mental Health who is now Director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard. Dr. Hyman was not an author on this paper. “Despite decades of effort there have been, until now, only scant insights into its biological mechanisms. This unfortunate state of affairs has severely impeded treatment development, leaving the many people who suffer from depression with limited options. This landmark study represents a major step toward elucidating the biological underpinnings of depression,” Hyman said.

Other findings of the study include:

  • The results can be used for improved therapies — targets of known antidepressant medications were enriched in the genetic findings
  • The genetic basis of depression overlaps importantly with other psychiatric disorders like bipolar disorder and schizophrenia
  • Intriguingly, the genetic basis of depressive disorder also overlaps with that for obesity and multiple measures of sleep quality, including daytime sleepiness, insomnia and tiredness

Ketamine Nasal Spray Shows Effectiveness at Treating Major Depression and Suicidal Thoughts

There’s definitely something to be said about ketamine’s apparent effectiveness at immediately making many suicidal people no longer want to end their lives. The importance of caution in using it should be noted though.

A nasal spray formulation of ketamine shows promise in the rapid treatment of symptoms of major depression and suicidal thoughts, according to a new study published online today in The American Journal of Psychiatry (AJP).

The double-blind study compared the standard treatment plus an intranasal formulation of esketamine, part of the ketamine molecule, to standard treatment plus a placebo for rapid treatment of symptoms of major depression, including suicidality, among individuals at imminent suicide risk. The study involved 68 participants randomly assigned to one of two groups — either receiving esketamine or placebo twice a week for four weeks. All participants continued to receive treatment with antidepressants throughout. The researchers looked at effects at four hours after first treatment, at 24 hours and at 25 days.

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The results of the study support nasal spray esketamine as a possible effective rapid treatment for depressive symptoms in patients assessed to be at imminent risk for suicide, according to the authors. Esketamine could be an important treatment to bridge the gap that exists because of the delayed effect of most common antidepressants. Most antidepressants take four to six weeks to become fully effective.

This study was a proof-of-concept, phase 2, study for esketamine; it must still go through a phase 3 study before possible FDA approval. It was funded by Janssen Research and Development, LLC.

The authors caution that more research is needed on the potential for abuse of ketamine. That caution is also the focus of an accompanying AJP editorial also published online today. In the editorial, AJP Editor Robert Freedman, M.D., along with members of the AJP Editorial Board, note the known potential for abuse and existing reports of abuse of prescribed ketamine. They discuss the need for additional research relating to the abuse potential of ketamine during phase 3 trials, such as monitoring of patients’ craving and potential ketamine use from other sources.

While it is the responsibility of physicians to provide a suicidal patient with the fullest range of effective interventions, the AJP Editor’s note, “protection of the public’s health is part of our responsibility as well, and as physicians, we are responsible for preventing new drug epidemics.” The Editors suggest the need for broad input in the development of effective controls on the distribution and use of ketamine.

Raw Fruits and Vegetables May Provide Better Mental Health Outcomes

Mental health problems are a really significant undercurrent issue in countries across the world today, and so even more minor studies like this can be helpful at addressing them.

Seeking the feel good factor? Go natural.

That is the simple message from University of Otago researchers who have discovered raw fruit and vegetables may be better for your mental health than cooked, canned and processed fruit and vegetables.

Dr Tamlin Conner, Psychology Senior Lecturer and lead author, says public health campaigns have historically focused on aspects of quantity for the consumption of fruit and vegetables (such as 5+ a day).

However, the study, just published in Frontiers in Psychology, found that for mental health in particular, it may also be important to consider the way in which produce was prepared and consumed.

“Our research has highlighted that the consumption of fruit and vegetables in their ‘unmodified’ state is more strongly associated with better mental health compared to cooked/canned/processed fruit and vegetables,” she says.

Dr Conner believes this could be because the cooking and processing of fruit and vegetables has the potential to diminish nutrient levels.

“This likely limits the delivery of nutrients that are essential for optimal emotional functioning.”

For the study, more than 400 young adults from New Zealand and the United States aged 18 to 25 were surveyed. This age group was chosen as young adults typically have the lowest fruit and vegetable consumption of all age groups and are at high risk for mental health disorders.

The group’s typical consumption of raw versus cooked and processed fruits and vegetables were assessed, alongside their negative and positive mental health, and lifestyle and demographic variables that could affect the association between fruit and vegetable intake and mental health (such as exercise, sleep, unhealthy diet, chronic health conditions, socioeconomic status, ethnicity, and gender).

“Controlling for the covariates, raw fruit and vegetable consumption predicted lower levels of mental illness symptomology, such as depression, and improved levels of psychological wellbeing including positive mood, life satisfaction and flourishing. These mental health benefits were significantly reduced for cooked, canned, and processed fruits and vegetables.

“This research is increasingly vital as lifestyle approaches such as dietary change may provide an accessible, safe, and adjuvant approach to improving mental health,” Dr Conner says.

* The top 10 raw foods related to better mental health were: carrots, bananas, apples, dark leafy greens such as spinach, grapefruit, lettuce, citrus fruits, fresh berries, cucumber, and kiwifruit.

Research Into Certain Psychedelics Alleviating Mental Health Difficulties

Psilocybin mushrooms, ketamine and LSD all show interesting results at alleviating mental difficulties such as depression. The pharmaceutical industry is of course largely against this positive evidence on those drugs, but this is as their synthetic antidepressants don’t work well enough and can even have their own downsides. New approaches are needed (with microdosing perhaps) for these widespread problems of mental suffering, including different policy decisions than what’s mostly been done in the last four decades of upwards redistribution to the richest class.

In recent years, scientists have been uncovering potential therapeutic benefits of psychedelic substances like psilocybin and lysergic acid diethylamide (LSD) – it looks like they can ‘reset’ the brain in people with mental health conditions.

Now a new study has revealed exactly what’s going on inside our brains when we take LSD, uncovering a connection that might explain why it relieves the symptoms of disorders such as PTSD and chronic depression.

Research led by the Center for Brain and Cognition at the Universitat Pompeu Fabra in Barcelona has discovered a process of ‘harmonising’ across areas of the brain that don’t usually work together.

Referred to by the team as ‘repertoire expansion’, it suggests psychedelic substances like LSD could be encouraging the brain to develop certain patterns of activity.

The team thinks these patterns could help compensate the disordered connections that can cause mental suffering.

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For one thing, after half a century of being stigmatised as dangerous recreational drugs, it’s still slow going to build up the evidence base supporting the healing potential psychedelic pharmaceuticals.

The studies are piling up, though. Which is good news for those dealing with ill mental health.

Self-Compassion May Help Protect People from the Harmful Effects of Perfectionism

Perfectionism has increased among young people since 1980, as has been shown recently. Perfectionism does have a healthier strain, but it should be noted that it can also be quite unhealthy. The self-compassion must allow people to more easily forgive themselves for not always being perfect.

perfectionism-and-compassion

Relating to oneself in a healthy way can help weaken the association between perfectionism and depression, according to a study published February 21, 2018 in the open-access journal PLOS ONE by Madeleine Ferrari from Australian Catholic University, and colleagues.

Perfectionistic people often push themselves harder than others to succeed, but can also fall into the trap of being self-critical and overly concerned about making mistakes. When the perfectionist fails, they often experience depression and burnout. In this study, Ferrari and colleagues considered whether self-compassion, a kind way of relating to oneself, might help temper the link between perfectionist tendencies and depression.

The researchers administered anonymous questionnaires to assess perfectionism, depression, and self-compassion across 541 adolescents and 515 adults. Their analyses of these self-assessments revealed that self-compassion may help uncouple perfectionism and depression.

The replication of this finding in two groups of differently-aged people suggests that self-compassion may help moderate the link between perfectionism and depression across the lifespan. The authors suggest that self-compassion interventions could be a useful way to undermine the effects of perfectionism, but future experimental or intervention research is needed to fully assess this possibility.

“Self-compassion, the practice of self-kindness, consistently reduces the strength of the relationship between maladaptive perfectionism and depression for both adolescents and adults,” says lead author Madeleine Ferrari.

The increases in perfectionism among young people since 1980 are probably caused by the policies of neoliberalism, which began to be implemented much more around 1980 and basically represent undermining mechanisms of social solidarity in society. Also, this is what I wrote when addressing perfectionism and neoliberalism last month: “I have thought for years now that there is generally too much competition and not enough cooperation in society today, which is part of the reason I advocate for reforms such as increasing the use of democratic co-operatives.”

My other advice to people who have struggled with unhealthy variants of perfectionism in the past — as I have — is to simply try to first do well, but maybe not quite to the highest standard you know you’re capable of, and then after that decide if you want to improve what you were doing any further. There are times when it’s much better to do something at 80 to 90 percent of your potential instead of not doing it at all. Experiences (and doing something at 80 to 90 percent rather than not at all is an experience) can be immensely valuable, and based on the findings that show a lot of millennials are prioritizing experiences over traditional gifts, there should be an improving understanding of this.