Depression

Being aware of a Whole person. Pernicious anaemia

Until recently I was unaware of pernicious anaemia or a vitamin B 12 deficiency and its symptoms.

I took my daughter to the doctors as she was suffering from headaches, felt dizzy at times, she had trouble concentrating, was very tired despite good sleep and an excellent balanced diet.
She was told she had tension headaches. After a few weeks and doing all we were told she still felt awful and that diagnosis didn’t  ring true to either of us.
We were then told she had anxiety. Perhaps I’d like to give my 15 year old anti anxiety drugs? My daughter said no thanks and explained that was confusing as she didn’t feel anxious not particularly extraordinarily stressed. I asked for blood tests.
After a few months of pushing she was given a blood test to find that she actually had very low iron, B12 etc.
Eventually she was given B 12 jabs that she will have to have for the rest of her life as its an auto immune condition that would have made her very ill.
Since doing some research, those with a B12 deficiency can present as anxious or depressed. Also older people will often have a B 12 deficiency and benefit from jabs. In these cases diet changes will  not work as an intrinsic factor is missing.
I then met an older client presenting similar issues. While I am not qualified to, nor would I ever diagnose anyone, I encouraged him to see his GP. His result was a B12 deficiency. After jabs he felt better and we could work on his issues without the physical symptoms masking the real issue.
My point in this article is look at everything, see the whole person and trust your instincts. Get checked out always in all ways available.
http://www.pernicious-anaemia-society.org/

Depression and what we eat

For the past couple of years, when people come to see me with depression I also look at their diet. I have long believed it is a contributory factor.  The age old tidy house tidy mind also has some bearing.  Healthy eating and sleep patterns matter.

As figures of depression and prescriptions soar there are longer waiting lists for counselling on the nhs.  Private therapy can’t be afforded by everyone.  There are however some dietary basics we can all look at. This post makes for very interesting reading?

Could it be chicken and egg? Which came first? Lack of dietary factors or depression.

 

http://www.huffingtonpost.co.uk/mobileweb/glen-matten/depression-food-cases-of-depression-soar-_b_1977632.html

 

An analysis of NHS figures, released this week  (http://www NULL.ssentif NULL.com/archive/12_oct2012 NULL.shtml)by data experts SSentif, revealed that the number of people living with depression in England has soared by nearly half a million in the last three years, with the total number standing at almost 5 million.
Inevitably, this has been accompanied by a large increase in the number of prescriptions for anti-depressant drugs. With official figures such as these likely to be merely the tip of the iceberg, just quite how much worse the actual situation is, is anyone’s guess.
Am I surprised? Not in the slightest. The writing was already on the wall and this is just more evidence of the growing burden of mental health problems society faces. As discussed recently in Nature  (http://www NULL.nature NULL.com/nature/journal/v477/n7363/full/477132a NULL.html), across 30 European countries, in a typical year, it’s estimated that around 165 million people – 38% of the population of these countries – will have a fully developed mental illness. When it comes to major depression, across these 30 countries, the estimated number of people affected was 30 million — making it the single greatest burden of all human diseases.
Certainly, mental health problems, and depression in particular, are undoubtedly complex, multi-factorial conditions. But the bit I’m interested in – and think more people should take seriously – is the extent to which our modern day diets are messing with our brains. To offer a window into this paradigm of thinking, I’m going to make reference to a particular constituent of our diet – omega-3 fish oils. Firstly (and famously), there’s a strong correlation between a nation’s fish consumption and the prevalence of depression [1], meaning countries with a high intake of fish (for example, Japan) have much lower rates of depression than countries with a low intake (such as the UK).
Whilst tantalising, this type of data is mere correlation, subject to any number of ‘confounders’. However, the fact that omega-3 fish oils (EPA and DHA) are critical for the structure and function of the brain, and play a role in how neurotransmitters work, does add biological plausibility. Then, we find that patients with depression have lower levels of omega-3 [2], and not only that, the lower the level of omega-3, the worse the depression [3].
Whilst the plot thickens, we need harder evidence, the sort that can only come from well-conducted randomised controlled trials (or RCTs), and that’s a bit of quagmire, as we find a mixture of both positive and negative studies on the role of omega-3 fish oils in depression. But to cut a long story short (for those wanting the whole story, we spell it out in The Health Delusion), when you put all these studies together into a ‘meta-analysis’, supplements containing the omega-3 fish oil EPA (rather than DHA) appear to be effective in improving symptoms of depression [4]. Whilst most of us would do well to eat more oily fish generally, for those suffering with depression, there is a persuasive, if not yet conclusive, argument for considering a supplement of 1g per day of EPA (but not DHA) as part of a comprehensive treatment approach (but always to be discussed with the doctor first).
Alongside omega-3 fish oils, we could make similar (if less strong) arguments for a potential role of other nutrients in supporting our mood and mental health, such as zinc [5] and folate [6]. We could even extend that to the removal of deleterious dietary factors, such as trans fats, which have recently been implicated in exacerbating our mental health woes (more about that here  (http://healthuncut NULL.com/2012/03/trans-fats-are-irritating-literally/)).
With burgeoning rates of depression, and our modern day diets in a pretty woeful state, is it time we started integrating nutritional strategies into the prevention and treatment of depression? It’s not as if the pharmaceutical solutions are a holy grail, given the significant numbers who either derive little or no benefit from them, or are afflicted by side effects.
Surely this is food for thought?
[1] Hibbeln JR (1998) Fish consumption and major depression Lancet 351(9110):1213
[2] Lin PY et al (2010) A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression Biol Psychiatry 68(2):140-7
[3] Edwards R et al (1998) Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord 48(2-3):149-55
[4] Sublette ME et al (2011) Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry 72(12):1577-84
[5] Cope EC, Levenson CW (2010) Role of zinc in the development and treatment of mood disorders Curr Opin Clin Nutr Metab Care 13(6):685-9
[6] Papakostas GI et al (2012) Folates and s-adenosylmethionine for major depressive disorder. Can J Psychiatry 57(7):406-13

Talking, diet and sporting against depression

I work with clients with depression.

Some move and change some develop a different thinking, some work through. It all depends on the person. I do know however that I feel it is a privilege to be part of their journey and look at why, their life story and ways forward and or to change.

The two articles following argue that drugs don’t work and or that talking therapies are over looked.

I believe that talking to your doctor about taking medication is great, see what is right for you and also go get a therapist too, use both as an option. Reading can help, talking can help. A focused session where you have a set time concentrating on you is an opportunity. I also look at diet, exercise, social patterns and how you are as part of what I do.

 

 

  1. How to beat depression – without drugs
  • Jake Wallis Simons (http://www NULL.guardian NULL.co NULL.uk/profile/jake-wallis-simons)
  • The Guardian (http://www NULL.guardian NULL.co NULL.uk/theguardian), Monday 19 July 2010

Up to 20% of the UK population will suffer from depression – twice as many as 30 years ago, says Steve Ilardi. Photograph: Rob Lewine/Getty/Tetra

Dr Steve Ilardi is slim and enthusiastic, with intense eyes. The clinical psychologist is 4,400 miles away, in Kansas, and we are chatting about his new book via Skype, the online videophone service. “I’ve spent a lot of time pondering Skype,” he says. “On the one hand it provides a degree of social connectedness. On the other, you’re still essentially by yourself.” But, he concludes, “a large part of the human cortex is devoted to the processing of visual information, so I guess Skype is less alienating than voice calls.”

Social connectedness is important to Ilardi. In The Depression Cure, he argues that the brain mistakenly interprets the pain of depression as an infection. Thinking that isolation is needed, it sends messages to the sufferer to “crawl into a hole and wait for it all to go away”. This can be disastrous because what depressed people really need is the opposite: more human contact.

Which is why social connectedness forms one-sixth of his “lifestyle based” cure for depression. The other five elements are meaningful activity (to prevent “ruminating” on negative thoughts); regular exercise; a diet rich in omega-3 fatty acids; daily exposure to sunlight; and good quality, restorative sleep.

The programme has one glaring omission: anti-depressant medication. Because according to Ilardi, the drugs simply don’t work. “Meds have only around a 50% success rate,” he says. “Moreover, of the people who do improve, half experience a relapse. This lowers the recovery rate to only 25%. To make matters worse, the side effects often include emotional numbing, sexual dysfunction and weight gain.”

As a respected clinical psychologist and university professor, Ilardi’s views are hard to dismiss. A research team at his workplace, the University of Kansas, has been testing his system – known as TLC (Therapeutic Lifestyle Change) – in clinical trials. The preliminary results show, he says, that every patient who put the full programme into practice got better.

Ilardi is convinced that the medical profession’s readiness to prescribe anti-depression medication is obscuring an important debate. Up to 20% of the UK population will have clinical depression at some point, he says – twice as many as 30 years ago. Where has this depression epidemic come from?

The answer, he suggests, lies in our lifestyle. “Our standard of living is better now than ever before, but technological progress comes with a dark underbelly. Human beings were not designed for this poorly nourished, sedentary, indoor, sleep-deprived, socially isolated, frenzied pace of life. So depression continues its relentless march.”

Our environment may have evolved rapidly but our physical evolution hasn’t kept up. “Our genome hasn’t moved on since 12,000 years ago, when everyone on the planet were hunter- gatherers,” he says. “Biologically, we still have Stone Age bodies. And when Stone Age body meets modern environment, the health consequences can be disastrous.”

To counteract this Ilardi focuses on the aspects of a primitive lifestyle that militate against depression. “Hunter- gatherer tribes still exist today in some parts of the world,” he says, “and their level of depression is almost zero. The reasons? They’re too busy to sit around brooding. They get lots of physical activity and sunlight. Their diet is rich in omega-3, their level of social connection is extraordinary, and they regularly have as much as 10 hours of sleep.” Ten hours? “We need eight. At the moment we average 6.7.”

So we should all burn our possessions and head out into the forest? “Of course not,” Iladi shudders. “That would be like a lifelong camping trip with 30 close relatives for company. Nobody would recommend that.”

Instead we can adapt our modern lifestyle to match our genome by harnessing modern technology, such as fish oil supplements to increase our intake of omega-3. All well and good. But I can’t escape the feeling that the six-step programme seems like common sense. Isn’t it obvious that more sleep, exercise and social connectedness are good for you?

“The devil is in the detail,” replies Ilardi. “People need to know how much sunlight is most effective, and at which time of day. And taking supplements, for example, is a complex business. You need anti-oxidants to ensure that the fish oil is effective, as well as a multivitamin. Without someone spelling it out, most people would never do it.” Ilardi practises the programme himself. He’s never been depressed, he tells me, but it increases his sense of wellbeing and reduces his absentmindedness (his college nickname was “Spaced”).

It all makes sense, but will I try it myself? I don’t suffer from depression, but wellbeing sounds nice. I’m not so sure about the fish oil, but I might just give it a go.

Enjoy the sunshine, get plenty of sleep – and be sociable

▶ Take 1,500mg of omega-3 daily (in the form of fish oil capsules), with a multivitamin and 500mg vitamin C.

▶ Don’t dwell on negative thoughts – instead of ruminating start an activity; even conversation counts.

▶ Exercise for 90 minutes a week.

▶ Get 15-30 minutes of sunlight each morning in the summer. In the winter, consider using a lightbox.

▶ Be sociable.

▶ Get eight hours of sleep

 

 

2.Psychotherapy as Treatment Option for Depression Often Overlooked

By American Psychological Association

American Psychological Association

Last modified: 2012-10-10T19:01:21Z

WASHINGTON, Oct. 10, 2012 /PRNewswire-USNewswire/ — As mental health advocates observe and blog about World Mental Health Day today, the American Psychological Association (APA) is drawing attention to psychotherapy as an effective treatment option for depression and other mental health issues.

“Even though countless studies show that psychotherapy helps people living with depression and anxiety, drug therapy has become the most popular course of treatment,” says Katherine C. Nordal, Ph.D., APA executive director for professional practice.

APA launched a psychotherapy awareness initiative this Fall to educate consumers about psychotherapy’s effectiveness and encourage them to talk with their physicians about treatment options. APA’s efforts include resources about psychotherapy to help people understand how it works and a video series that illustrates the value of psychotherapy as a treatment option.

“Research shows that psychotherapy works. It is an effective way to help people make positive changes in their lives,” Dr. Nordal said. “We hope people will explore their treatment options to create a plan that gives them the skills they need to manage their condition.”

Mental health problems are one of the top three reasons why Americans seek medical treatment. In the United State alone, one in ten adults report having depression, which is being treated more frequently with medication — since the 1990s, the number of prescriptions for antidepressants more than doubled from 55.9 million to 154.7 million.

SOURCE American Psychological Association
Read more here: http://www.sacbee.com/2012/10/10/4899574/psychotherapy-as-treatment-option.html#storylink=cpy

HOW you ask yourself why am I depressed really does matter

 

I recently read an article that interested me as it is something I have noticed with clients with depression. HOW you ask yourself a question, look at what’s going on and why, REALLY does matter. To distance yourself from what’s going on, be able to ask why am I feeling what I am, what’s happened, when, with whom in an analytical way IS, it seems more effective at breaking that cycle of negative thoughts, behaviours and feelings.
Talking therapy can really enable you to recognise that pattern of negativity and open up different ways of asking questions of yourself and looking at yourself. The fact that the study showed that people with even major depression can choose to distance really matters too. Choice used as a word doesn’t sit with clients at first, yet is an important part of the process, even if that original choice to react in a certain way was effective when the decision was first made. It isn’t any more, hence people email, phone or text and ask for therapy. People with depression will often share that they are drowning, to accept that ‘self emersion’ is a possibility and to work with choice is a great goal for anyone with depression. Please note i do use the word goal as most people with depression reading this will state categorically there I have no choice, which I totally understand.
It’s an interesting article based on incredibly experience proving research!

http://www.goodtherapy.org/blog/self-distancing-depression-emotions-0713122

Distancing Oneself from Negative Emotions Decreases Depressive Symptoms
July 13th, 2012 |
Rumination is a key characteristic of depression. Individuals with depression have high levels of negative affect and tend to recycle negative thoughts and emotions. This behavior of ruminating on negative experiences perpetuates the cycle of depression and increases the severity and length of depressive symptoms. How individuals approach their negative emotions has been the subject of much research on depression. In a recent study, Ethan Kross of the Department of Psychology at the University of Michigan looked at two different ways in which people view negative thoughts in order to determine if one increased depressive symptoms more than the other.
In the study, Kross evaluated 51 individuals with major depressive disorder (MDD) and 45 individuals with no history of depression as they analyzed their emotions in relation to a negative life event. The participants were instructed to view their feelings using either a self-distanced approach or a self-immersed approach. Kross gauged how these two perspectives affected negative affect, avoidance, and emotional content and discovered several interesting findings.  First, Kross found that both the MDD and non-MDD participants were able to self-distance. This is a key finding because many depressed individuals do not automatically choose to use this perspective when in the midst of troubling feelings but may be inherently capable of doing so. Kross said, “Second, depressed participants who analyzed their feelings from a self-distanced perspective displayed lower levels of depressive thought accessibility and negative affect than their self-immersed counterparts.” These same individuals also gained more awareness of the negative situations and achieved a sense of closure that the self-immersed group did not.
Kross did not find any differences in the levels of avoidance, regardless of how the participants viewed their negative events. Overall, the research demonstrated that individuals with depression do not always have negative outcomes when they question the circumstances that led to the negative emotions. Rather, their emotional outcome is predicted more by how they ask the questions. Specifically, a self-distanced approach of analyzing emotions seems to lead to a more adaptive and positive outcome than a self-immersed approach, which appears to contribute to further rumination and negative emotions.
Reference:
Kross, E., Gard, D., Deldin, P., Clifton, J., Ayduk, O. (2012). ‘Asking why’ from a distance: Its cognitive and emotional consequences for people with major depressive disorder.” Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0028808

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