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September 29, 2006 19:09 - Inflammation May Contribute to Depression

Another study has found that the bodies of depressed people function differently than the bodies of nondepressed people. Those with major depression have more inflammation in response to psychological stress.

The study was conducted at Emory University School of Medicine. Researchers Andrew Miller, MD, and Christine Heim, PhD, exposed a group of 28 medically healthy males to moderately stressful situations for 20 minutes. Half of the men had been diagnosed with depression; the other half had no depression.

Blood from each research subject was tested for indicators of inflammation every 15 minutes starting before the stressful situations and continuing for an hour and a half after the stress. The results showed that both groups experienced increased inflammation in response to the stress. However, the depressed group had more inflammation before and during the stress situation.

Inflammation is one way that the body's immune system fights bacterial and viral infections. Like other immune system activities, the inflammation becomes harmful if it is too great or continues for too long. Such exaggerated responses may contribute to medical problems including heart disease, cancer, and diabetes.

This study suggests that the increased inflammation may be a cause of depression. Furthermore, these results may explain why heart disease, cancer, and diabetes seem to be related to depression. The common link could be the inflammation.

It is interesting that the researchers also found that the depressed men had a history of more early life stressful experiences. These early stressful events seemed to make it more likely that a person will develop depression when older.


My Two Cents Worth

Again we see that people who experience depression often have depressing lives. The difficult stressful situations that they encounter do damage both physically and emotionally.

When a person becomes healthier physically the impact of the physical damage is minimized. Factors such as exercise, good nutrition, sufficient sleep improve the overall condition and lessen the health related problems of those who have medical problems such as heart disease, cancer, and diabetes.

Likewise, becoming healthier psychologically can help minimize the impact of depression. Thus, learning and developing good coping skills is important for a depressed person. By doing so the person with depression can better weather stress as it comes into his or her life.

For help in developing coping skills, click here.

For source, click here.

September 29, 2006 21:37 - Better Care Can Save the Life of a Depressed Elderly Person

Depression is high among the elderly. These individuals also report a high rate of suicidal thoughts and behaviors.

A program developed by the University of Washington School of Medicine in Seattle has been found to be helpful in addressing these problems. Dr. Jurgen Unutzer and colleagues evaluated the effectiveness of two approaches to caring for depressed elderly men and women.

One approach -- called usual care -- involved having the patient's primary care physician provide psychotherapy and antidepressant medication when indicated.

The other approach involved having a psychologist or nurse work with the primary care doctor to manage depression care. They discussed treatment options such as antidepressant medication and therapy with the patient. In addition, a four to eight session problem-solving training program was offered. This second option was called IMPACT (Improving Mood: Promoting Access to Collaborative Treatment).

In the study, 1801 people 60 years old or older were randomly assigned to one treatment approach or the other. They received treatment for one year.

After six months of treatment the IMPACT program resulted in a decrease in the number of patients reporting suicidal thoughts from 15.3 percent to 7.5 percent. The usual care treatment group's suicidal thinking dropped from 13.3 percent to 12.1 percent. After one year of treatment the IMPACT group reported 9.8 percent having suicidal thoughts compared to 15.5 percent in the usual care group.

One year after treatment ended the IMPACT group still reported less suicidal thinking.

The patients received other benefits from the IMPACT approach including less physical pain, less emotional upset, and better physical functioning.


My Two Cents Worth

Is it realistic to expect a primary care physician to provide patients with psychotherapy?

Primary care physicians are not trained to provide psychotherapy. Most physicians that I know spend only a few minutes with each patient. How much psychotherapy can be provided in five minutes?

The physicians in this study may have had special training in providing psychotherapy, but in the real world psychotherapy provided by primary care physicians is not likely to happen. If other mental health professionals are not involved in the process, the patient will simply not receive the services.

Nevertheless, there is no doubt that psychotherapy and problem-solving training can help depressed people of all ages -- including the elderly. With suicide rates being as high as they are, such treatment will save lives.

If you or someone you know is depressed and/or suicidal, don't look only to your primary care physician for help. You may need antidepressant medication and your physician can help you with this. But you also need psychological help. Find a psychologist to address your counseling needs. By doing so you will receive more beneficial help.

For information about how to find professional help for you depression, click here.

For source, click here.

September 30, 2006 23:28 - Burnout and Depression May Cost You Your Life

Burnout and depression can threaten your life. This is especially true if it is your physician that is burned out and depressed.

A recent study conducted by Mayo Clinic and led by Tait Shanafelt, M.D., has found that physicians who are experiencing symptoms of depression or burnout are more likely to make medical errors. Furthermore, having made an error often results in increased depression and anxiety for the physician. This is an improtant issue because over 100,000 patients die each year in the US because of preventable medical errors.

The study followed 184 residents in the Mayo Clinic Rochester Internal Medicine Residency program questioning them about possible errors and screening them for depression and burnout. Those residents who reported making errors scored higher on measures of burnout. They were more than three times more likely to be experiencing depression according to screening tests.

When found to be experiencing burnout or depression, the physicians were also more likely to make future errors. Thus, it is important that physicians attend to their own mental health needs. Taking better care of themselves may make a life or death difference for their patients.


My Two Cents Worth

The importance of your physician being in the best mental shape possible when treating you is obvious. But this study has implications for nonphysicians as well.

How many driving errors resulting in serious automobile accidents are caused by burnout and depression? How many industral accidents are cause by burnout, depressed employees? Could burnout, depressed airline pilots be a contributing factor to airplane crashes? Etc., etc., etc.

I think you get the point. It is very important that we all take good care of ourselves psychologically. Not only is our happiness at stake. Our lives and the lives of others are at stake as well.

For more information about depression and burnout, click here.

For source, click here.

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