Depression: Why Life Can Feel Out Of Control

Depression: Why Life Can Feel Out Of Control

People with depression often feel their life is out of control. It can evoke feelings that their life is pointless or by merely existing bad things can happen. Research funded by the Economic and Social Research Council (ESRC) suggests that these feeling may be caused by subtle changes in the way depressed people perceive time and process their surroundings.

Experiments by Dr Rachel Msetfi, psychology researcher, University of Limerick and Dr Robin Murphy, University of Oxford, used a computer-based task to explore how healthy as well as depressed volunteers responded to simple tasks in which they had varying levels of control.

They were asked to test the reliability of a remote controller in different rooms of a virtual house. The remote would switch on the hi-fi in each room with a certain level of reliability; sometimes the music would come on immediately, sometimes with a slight delay and sometimes it would start even when the volunteer decided not to use the remote.

The experiment was designed so that in different rooms the volunteers had different levels of control. In some rooms pressing the remote control worked well. In other rooms the remote was less reliable, giving the volunteers less control. After many goes at using the remote controller in a room each participant was asked about how much control they felt they had using the remote, and the extent to which the behaviour of the hi-fi was governed by the room, not them pressing the button.

Dr Msetfi's analysis showed that when there were longer delays, either between opportunities to press the remote button or between pressing the button and the music turning on, depressed people responded differently than others. Interestingly, with these longer delays, their judgements were actually more realistic than those of the healthy volunteers.

This finding supports other studies which suggest that people with depression experience time as passing more slowly; they also tend to process cues from their environment and context differently to people without depression.

"When depressed people have more time to process information about cause and effect, due to their slower perception of time they tend to take more notice of their environment which is often beyond their control, hence their feelings of helplessness," says Msetfi. "We see that contrary to the cognitive theory of depression, which emphasises the effects of irrational thought, here very subtle changes in perceptions have a strong knock on effect on other cognitive processes and feelings of control."

Msetfi also suggests that her research may also help to explain why mindfulness therapy is so successful in treating depression and preventing relapse. "Mindfulness is about paying more attention to what is happening right now. If time moves more slowly for people with depression and makes them oversensitive to their surroundings, mindfulness may work because it recalibrates their perceptions to find a better balance."

Additional

References

Citations

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our depression section for the latest news on this subject.

1. This release is based on early findings from “Feelings of control: The effects of depression, context and contingency learning” funded by the Economic and Social Research Council and carried out by Rachel Msetfi at the University of Limerick, Ireland and the University of Oxford in the UK.

2. This part of the project included four experiments that involved 352 volunteers who were asked to participate in a computer simulation to ‘test’ the reliability of the remote controller in different rooms in a house. They could choose to press, or not press, the button on the remote (using the keyboard space bar) and observe the outcome. There were a total of forty such tests (trials) per room. The variables in the study included the inter trial interval (the time between each opportunity to press or not press the remote button) and the inter stimulus interval (the time between pressing the button and the music turning on). Each participant completed the Beck Depression Inventory as well as other measures of mood state to assess their level of depression and categorise them as mildly depressed or not depressed.

Identify the Indicators of Depression and Get Timely Cure for It

Everyone goes through ups & downs in life and there are times when you might feel low and miserable. Life is full of struggles and whenever you have a setback, you tend to react bitterly and become sad. Such feelings form a part of routine life and are nothing to be alarmed about. However, when the feelings of hopelessness overpower your life and you experience desolation for a prolonged time, it indicates a serious problem. Continued feelings of emptiness and worthlessness of life are symptoms of depression.

Often, people use the word 'depression' to mean that they are sad. However, depression is more than occasional unhappiness. It gets you into a constant state of hopelessness and helplessness. It interferes with your daily life, making it tough to attend to routine activities such as eating, sleeping, working, studying, etc. If not recognized and treated in time, depression can worsen, making it difficult to go through life and a person suffering from depression may even develop suicidal tendencies.

Though every person is different, depression does have a few key indicators. These include:

The most common sign of depression is a feeling of despair. The sufferer feels as if all is lost and nothing can be done to improve his/her condition. He/she finds life meaningless and purposeless.

The patients generally lose their appetite or else start impulsive eating. As such, abnormal weight variations, whether loss or gain, are seen in them.

It is quite common to find depressed people lose interest in going through their daily activities. They resent being asked to do anything and refuse to accept and fulfill their responsibilities.

Disturbed sleep patterns are also a symptom of depression. The sufferer either has problem in falling asleep or tends to over sleep.

The patients feel exhausted at all times and may also have recurring aches all over the body. They have problems in concentrating and are unable to accomplish even ordinary tasks.

A general feeling of sorrow engulfs such people. They do not find pleasure in anything and lose interest in hobbies, etc.

They avoid socializing and tend to be irritable, easily angered and abusive.

No matter how overwhelmingly depressed you might feel, you can certainly get out of it and resume a normal life. The most important thing to make this happen is to recognize the signs and symptoms of depression and accept that you are suffering from it. If it is necessary, you should also not hesitate in getting professional help in treating the problem.

Coping With the Suicide of a Loved One

My father passed away from suicide when I was 14 years old. I was the one to find him. I suffered for many years with depression of my own and also what I felt was the humiliation of having a parent who committed suicide.

Clinging to relationship after relationship and, in the meantime, abandoning friends before they could abandon me, I spent years struggling inwardly while on the surface making it appear that everything was fine. Suppressing my emotions, people pleasing, and a feeling of shame created physical ailments for me such as migraines, high blood pressure, and acne.

Suicide has such a stigma to it in our society that, from my perspective, it would have been a totally different situation if my dad died from a heart attack or cancer. I spent years holding a resentment towards him for his suicide and also the depression and moodiness that I consistently was surrounded by as a child.

I am now in my 30's and no longer feel the animosity or sadness that I felt for years about his suicide. I can't really say that it even bothers me so much anymore and I have very loving feelings towards my dad. What's great is that you don't have to spend 20 years hurting like I did before you begin to heal. The healing process can begin today, in this very moment.

One of the first areas to start with is forgiveness. I wouldn't even call it forgiveness, but something much more powerful, compassion.

When I really looked at the situation and realized just how much pain my dad was in, how he suffered in his childhood, and ultimately could not escape the madness of his mind, I feel a sense of deep love and compassion for him. He was simply doing the best that he could have at the time with what he knew. If he knew better, he would've acted differently.

What he did wasn't personal against me or anyone else. He was in so much pain and felt that there was no other way out. When I came to that awareness, my anger began to fade away, and love and compassion for him took over.

I also stopped seeing myself as a victim and a victim of circumstance. I did this through the letting go of the preconceived notions that I had about myself, the story. I thought for so long that I was my story, that I was my past, that I was my fears, that I was all those things that happened in my life. In fact, those are all just a collection of experiences that make up a life situation.

They aren't really who I am in my true essence, which is something much more divine than anything anyone of us could ever imagine. The more that I accepted myself as a soul, as a spiritual being, and the more that I began to view myself as something grander than any life story, a surrendering took place. A surrendering to what is, to what was, and to what will come, set me free.

I surrendered to all that had happened in my life involving my dad, his depression, and ultimate suicide. For so long, I insisted that it should not have occurred, that things should have been different, and I am a victim because of it. Really? Is that true? Things happened the way that they happened and me trying to change that, or act like it should have been otherwise only causes more suffering for me.

Acceptance of his suicide helped me to discover true freedom. Acceptance doesn't mean that we necessarily condone things, but that we stop telling ourselves that the past should be different than what it was.

I was no longer an ashamed little girl with this victim story. I am a beautiful soul who is on this earth at this time with a purpose. We all are, every single one of us. We have just forgotten this and have gotten a little sidetracked.

When you begin to view yourself and others in this way, compassion for them is much more possible. After my father's death, I made an internal decision to never talk about it as much as I could help it. I eventually did start talking about it, though, about 15 years later.

It has been truly healing for me to see my father in this new, more compassionate light. I feel as though I have a new friend on the other side and all is forgiven. On a deeper level, there is nothing to forgive because we are all doing the best we can with what we know. When I put myself into his shoes, I can honestly say that I understand, and it is okay.

Might You Be Suffering From Depression?

What is depression?

Depression can mean different things to different people. For some, it's often a word used to describe periods of feeling sad or low, but for others it can mean an illness that lasts a long time and interferes with the way they live their life. In the most serious cases, depression can be life-threatening, as it can lead to suicidal thoughts.

Depression is very common. Anyone can suffer from it and over the course of a lifetime it's estimated that you have a one-in-five chance of experiencing a period of depression. The good news is that depression is treatable and most people who experience it can live normal and happy lives.

There are also specific types of depression, including seasonal affective disorder (SAD), postnatal depression and bipolar disorder (also known as manic depression). Each type of depression affects the sufferer in a different way and it's important to remember that getting depressed is not a sign of weakness or the fault of the person suffering from it.

What are the symptoms of depression?

At the moment there is no single test to determine whether a person is suffering from depression, but there are a number of symptoms that can be used to help doctors make a diagnosis.

Depression can cause people to feel sad or low-spirited for long periods of time. Negative thoughts become common and many sufferers have feelings of hopelessness or inadequacy. It can also make people irritable, restless or easily upset. Another symptom is a disinterest in things that you would normally enjoy doing. If you are avoiding activities you would normally participate in, or have cut yourself off from friends or family, it's possible you may be depressed.

Sufferers often have difficulty communicating with others and find themselves feeling isolated and alone. Depression can also have physical symptoms. Lethargy and tiredness are common indicators, as is a loss of appetite or an increase in the use of tobacco, drugs or alcohol. More seriously, some sufferers have the desire to self-harm or have suicidal thoughts.

Depression can also present itself in different ways. Some people may experience severe anxiety or panic attacks, while people who are severely depressed may have psychotic episodes. In order to diagnose depression, a doctor will often look for a combination of symptoms, but each case is different and generally speaking a diagnosis will be made if a person experiences symptoms that significantly affect their day-to-day life.

Does Hypnosis Work for Depression? Get Hypnotherapy for Stress and Anxiety Relief

It is understandable that hypnosis is one of the most misunderstood field of study, even at that it is still one of the oldest forms of psychotherapy especially in the Western world. So the question: does hypnosis work for depression? Is still debatable even among medical experts but I know it works but might not be effective for everyone.

Although meditation can be a tool to reducing anxiety and depression, another effective method is Hypnosis -- or hypnotherapy for stress and anxiety. With hypnosis, you can easily bring depression and anxiety under control.

This is achieved using intense concentration and relaxation techniques thereby creating a state of awareness called trance or a kind of hypnotize sleep. With the help of a trained hypnotherapist (hypnotherapy anxiety expert), you can meditate deeper and focus your attention on specific thoughts or tasks. Every activity around you will be temporary shut out from your awareness.

Your mind is focused on positive mental imagery using hypnotize techniques but first of all, you have to trust what you are about to do or the therapist then fully concentrate your mind using relaxation and imagery.

When you fully focused or self hypnotize yourself on a particular thing, you eliminate distractions. The same is with hypnotherapy for stress, anxiety and depression. Your mind will be open to different treatment suggestion while you are being hypnotized. This is when you gain access to the treatment process gradually.

This process can also prove effective when you combined it with cognitive behavioral therapy (one of the most common clinical depression treatment method). It will help patients to reduce anxiety or depression. That way there can focus their attention, relax, access solution and follow through the helpful suggestions recommended.

Recently, a lot of study had shown that hypnosis can help reduce blood pressure and anxiety level in patients. This is done before surgery. It will also help the patient to recover fast and counter complications like nausea and vomiting.

Patients who are anxious to enter the operation room are advice to pass through this process. Their anxiety level can be reduced up to 60%. Although there is no much medical evidence to using hypnosis in the treatment of depression, it has been used severally to help people in depressed or anxious mood.

This hypnotherapy anxiety and depression relief technique is induced through a kind of suggestion therapy. It enable the patient to alter his or her perception and sensation about a particular state through positive affirmation and be more open to discussion and treatment suggestion.

This suggestive therapy had been applied effectively in the treatment of pain, phobia, fears, stress, depression and anxiety, post-trauma anxiety, grief and loss, sleep disorder etc.

UF Researchers Show Brain's Battle For Attention

UF Researchers Show Brain's Battle For Attention

We've all been there: You're at work deeply immersed in a project when suddenly you start thinking about your weekend plans. It happens because behind the scenes, parts of your brain are battling for control.

Now, University of Florida researchers and their colleagues are using a new technique that allows them to examine how parts of the brain battle for dominance when a person tries to concentrate on a task. Addressing these fluctuations in attention may help scientists better understand many neurological disorders such as autism, depression and mild cognitive impairment.

Mingzhou Ding, Ph.D., a professor of biomedical engineering, and Xiaotong Wen, Ph.D., an assistant research scientist of biomedical engineering, both of the University of Florida; Yijun Liu of the McKnight Brain Institute of the University of Florida and Peking University, Beijing; and Li Yao of Beijing Normal University, report their findings in the current issue of The Journal of Neuroscience.

Scientists know different networks within the brain have distinct functions. Ding, Wen and their colleagues used a brain imaging technique called functional magnetic resonance imaging and biostatistical methods to examine interactions between a set of areas they call the task control network and another set of areas known as the default mode network.

The task control network regulates attention to surroundings, controlling concentration on a task such as doing homework, or listening for emotional cues during a conversation. The default mode network is thought to regulate self-reflection and emotion, and often becomes active when a person seems to be doing nothing else.

"We knew that the default mode network decreases in activity when a task is being performed, but we didn't know why or how," said Ding, a professor of biomedical engineering in the J. Crayton Pruitt department of biomedical engineering. "We also wanted to know what is driving that activity decrease.

"For a long time, the questions we are asking could not be answered."

In the past, researchers could not distinguish between directions of interactions between regions of the brain, and could come up with only one number to represent an average of the back-and-forth interactions. Ding and his colleagues used a new technique to untangle the interactions in each direction to show how the different brain regions interact with one another.

In their study, the researchers used fMRI to examine the brains of people performing a task that required concentration. The scientists can see the activity in certain areas of the brain at the same time a person is performing a given task. They can see which parts of the brain are active and which are not and correlate this to how successful a person is at a given task. They then applied the Granger causality technique to look at the data they saw in the fMRI. Named for Nobel Prize-winning economist Clive Granger, this technique allows scientists to examine how one variable affects another variable; in this case, how one region of the brain influences another.

"People have hypothesized different functions for signals going in different directions," Ding said. "We show that when the task control network suppresses the default mode network, the person can do the task better and faster. The better the default mode network is shut down, the better a person performs."

However, when the default mode network is not sufficiently suppressed, it sends signals to the task control network that effectively distract the person, causing his or her performance to drop. So while the task control network suppresses the default mode network, the default mode network also interferes with the task control network.

"Your brain is a constant seesaw back and forth," even when trying to concentrate on a task, Ding said.

The Granger causality technique may help researchers learn more about how neurological disorders work. Researchers have found that the default mode network remains unchanged in people with autism whether they are performing a task or interacting with the environment, which could explain symptoms such as difficulty reading social cues or being easily overwhelmed by sensory stimulation. Scientists have made similar findings with depression and mild cognitive impairment. However, until now no one has been able to address what areas of the brain might be regulating the default mode network and which might be interfering with that regulation.

"Now we are able to address these questions," Ding said.

Additional

References

Citations

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our neurology / neuroscience section for the latest news on this subject.

What Are Endorphins, and More Importantly How Do We Get Them?

Endorphins are known as mood enhancers, and these brain chemicals can put us in a better mood and for some even a euphoric state. Knowing what can set off these mood enhancers without taking drugs or medication will be much better for our long-term health. Exactly what are they? Breaking down the word, endorphin means "morphine-like substance produced by the body".

The reason humans developed this ability to create endorphins is not to get into a euphoric state, but as a stress mechanism to reduce our perception of pain. So when we exercise over a long period of time, such as running a marathon (known as a "runners high"), endorphins are released in response to the pain. This endorphin release varies among people. Studies have shown that there are other ways to stimulate endorphin secretion, such as acupuncture and message therapy. The practice of meditation has also been used by some people.

There is one other way that has been known to produce levels of endorphins in some people: food. These are some of the foods that are known to release endorphins.

1. Chocolate. Some people really crave this during times of stress, and chocolate has long been considered the best food to cause the release of certain neurotransmitters. These are the molecules that transmit signals between neurons in the brain. Is what makes chocolate special is a unique neurotransmitter that is released by chocolate called phenylethylamine. This is known to cause feelings of excitement as it works as an amphetamine. Fortunately it will increase our mood and diminish depression without causing addiction.

2. Oranges. Because they are high in vitamin C, they are a great endorphin producer. They also are excellent sources of antioxidants, the B vitamins and flavonoids.

3. Chili peppers. They actually release endorphins and the hotter the better. It is thought that it is because of the pain factor with hot peppers. (Remember, endorphin release is a response to pain).

To further complicate things, we will bring up another term: serotonin. What is the relationship between this and endorphins? Serotonin and endorphins are two of six main neurotransmitters produced naturally by the brain. Both are known to boost emotions, but endorphins are more intense. Endorphins are more likely to be triggered by physical exercise, along with the foods mentioned above. Serotonin release is more food-based.

There are many more foods that will produce the comforting effects caused by serotonin. Complex carbohydrate consumption has been known to improve serotonin levels, so some people have been known to unconsciously crave high-carb foods when they need rest. Instead of eating refined sugars, opt for complex carbohydrates like starchy vegetables, oatmeal, whole-grain cereals and legumes.

One must be very careful not to eat foods for a "serotonin effect" en masse, as they can become habit-forming and lead to overweight. Even chocolate, which has a reputation for producing the endorphin high, must be consumed in moderation to prevent unwanted side effects. In tests, it was found that the amount of chocolate for optimum health is a very small amount. To give a visual of how much chocolate is the right amount, it is about one square of chocolate a day or half of a small chocolate Easter egg in a week's time. Obviously, more isn't better.

Is Medication Always The Answer?

Students are more commonly depressed these days than people even imagine. Some will say society is to blame, that students lives are much more complex and challenging than they used to be, while others will turn the blame onto doctors saying they just give medication away.

The argument that children's lives are more complex and challenging these days holds up better than accusing the doctors. In certain situations it very well may be a doctor is looking to promote a certain drug, or may just be careless in who and why they give medication out to. But more often than not these days doctors do not want to prescribe medication, especially to children. Depending on the severity of the child's problem, maybe medication is not the answer. There are many ways a student can channel their anger or sadness, such as joining a team or club, or finding other healthy interests to occupy their time with. Some things can be more effective than a drug, because what do most drugs do to a child anyway? Mask the problem. Parents, along with the help from other outside resources, need to find what the root of their child's problem is in order to help them instead of just sweeping it under the rug.

Sometimes parents are the ones partially to blame for their child's depression, because they don't want to deal with it. As a parent it is easier to pretend the problem isn't there, or to have someone else deal with it because it is easier, or the parent is too stressed or busy. But often times it could be something so simple. If we just take the time to talk to our students or children to find out exactly how they feel and what is bothering them we can find a way to deal with it together, and not have to mask them with medications to put them at ease. Some other alternatives could be signing them up for a sports team so they can be apart of something, helping them find a club at school that catches their interest, taking them to talk to a therapist without prescription medications. It could be something as simple as the child just needs to talk. Getting them involved with other kids their own age could be a positive spin to their lives. If they have someone they can relate and talk to that may ease some of their own stress and pressure.

There are just so many different outlets available for kids these days, I think it is a bad decision to automatically jump to medications to fix their problems. Whether we want to face the facts or not, children's lives are more difficult these days, coming out of divorced homes, only having one parent in their lives, parents that work too much which forces the oldest child to raise their siblings, drugs, alcohol; so many stressors around their lives daily that they don't have any control over. But, we need to teach them, they do have control over themselves, and there are ways to be positive that don't involve medications. They just need the proper help and guidance from loved ones surrounding them to show the healthy way.

Lower Your Cholesterol: Drugs or Natural Remedies?

Everyone will agree that good health is a blessing that should be cherished more than all the achievements and material possessions that one may have amassed through the course of life. However, equally true is the fact that there are very few people in this world who can claim to enjoy perfect health. The fast-paced life that everyone leads today has made them adopt incorrect lifestyles and harmful dietary habits. As a result, physical as well as mental diseases are on an increase all over the globe.

High cholesterol is one of the most rampant problems, affecting the young and the old alike. It is not very uncommon to see people who are barely in their late thirties resorting to medications to lower their cholesterol levels. However, not many of them are aware that these cholesterol lowering drugs (they are called statins because the names of all the drugs in this group end with 'statin') are reported to have mood altering effects. The statins block a key enzyme that is involved in cholesterol production in the body. At the same time, the medications are also thought to affect serotonin, which is a neurotransmitter that helps maintain your good mood. The cholesterol reducing drugs are even thought to lower the brain's polyunsaturated essential fatty acids. These fatty acids are vital for the health of the brain and for ensuring your good mood. Therefore, their reduction translates into increased feelings of unhappiness and depression.

As people are becoming aware of the potential side effects of the medical drugs, they are turning towards natural cures and holistic treatments. Actually, all the aspects of your life are inter-linked and your overall well-being cannot be ensured by treating any element in isolation. The combination of healthy diet, proper exercise and relaxed lifestyle can work wonders in treating most of the common ailments. The experts of naturopathy claim that even a problem like high cholesterol can be quite effectively treated with the help of such natural remedies.

To reduce cholesterol, you should avoid saturated fats and consume high-fiber, omega-3 rich food. Quality proteins such as nuts, beans, seeds, lean animal protein, etc. should be included in the diet. Good sleeping habits are also essential. Daily exercise like walking, cycling, dancing, aerobics, weight lifting, and other moderate intensity activities are beneficial in reducing the cholesterol levels up to 20%. Moreover, exercising offers the added advantage of improving your good cholesterol level!

Now, what you prefer to lower your cholesterol- medication or healthy diet and lifestyle changes?

Increase in Diabetic Complications With Coexisting Depression

Diabetes in itself would rather have been less problematic if it did not create complex health issues combining with other minor health problems and finally leading to serious complications. As per a study published by NIMH, type 2 diabetes when combined with depression, may lead to serious health problems. Depression is one of the silent side effects that diabetes may have. Mental anguish and depression due to the disease are seldom spoke about or even considered in the treatment process. Rather, insulin management and blood sugar control is given the priority.

If you diabetic and often remain depressed, talking about it to your doctor is as important as you consider any other serious symptom related to the disease. A simple antidepressant can make you feel better but unless you get yourself disclosed in front of the doctor they can't be able to help you out. You can also try to ease off yourself on personal level. Avoid cutting yourself off from the society. Spend time with your family and friends. Try being merry and enjoy your life. Every person may have some type of health and therefore thinking about it every moment would do no good. Have proper sleep and enough rest from work so that you remain fresh both mentally and physically. It will prevent any stress development.

Depression is mostly associated with diabetes. These two health issues when present together may increase the symptoms of both the diseases. Such individuals may need to take extra care and medical treatment in comparison to those who only have diabetes but no depression. A study was conducted by medical researchers from Group Health Research Institute and University of Washington, in which they examined 4,623 patients who were enrolled for a group health plan in Washington. They were first interviewed in 2000 and 2002 and later on again interviewed in 2005 and 2007. The micro vascular and macro vascular complications of the patients were tracked. Micro vascular complications refer to end stage kidney diseases, blindness, kidney failure deaths and amputations. Macro vascular complications include strokes, heart attacks, cardiovascular problems and death due to these issues.

The Study

In the interview conducted during the in initial phase it was observed that 14% of the participants had developed greater micro vascular complication and 24% of them developed severe macro vascular complication. After the five years tenure of the study, patients suffering from depression along with diabetes were observe to have developed 36% higher risk of developing micro vascular complications and 25% of greater risk of macro vascular complications comparing those who were not having depression.

Conclusion from the Study

As a result of the study it was concluded that patients suffering from depression along with diabetes were more susceptible to serious or even fatal health issues. This made the medical professionals to get aware that diabetes treatment should not only be concentrated to proper working of insulin or its proper secretion but treating depression is also a factor to be considered in the treatment process.

Future Needs for Treatment Advancement

Further research has to be done to find out the exact reason what brings such a relation between the two health issues. A treatment process is to be developed that tackles both these issues simultaneously. A proper screening process is to be developed so that a diabetic patient can be identified if he/she is at risk of developing serious depression or any other related health complications that may make the treatment process even more tedious.

Work and Rest and Being Depressed

"Noble deeds and hot baths are the best cures for depression."
~Dodie Smith (1896-1990)

The author of One Hundred and One Dalmatians, Smith, states a rather simplistic suggestion, but one worthy of some thought, especially from the unfortunate vantage point of helpless desperation. There may just be something in what seems a throwaway line.

There are many forms of depression, as well as many stimuli to it, so simplistic answers are generally an anachronism of sense; they don't help. Instead they infuriate and polarise the sufferer from their seemingly dispassionate world.

But let us entertain this throwaway line to see if it helps; let us move cautiously in the direction of a solution, even if a temporary solution, which, for depression, is generally the case in any event.

THE SOLUTION OF NOBLE WORK

Many times part of the source of depression may be due to a lack of purpose. Two general causes are in view: a lack of purpose and achievement (task-caused) and a lack of relational satisfaction (relationship-caused). Work can help with both these ends, given that we can work for a purpose, achieve our objectives, and, in combination, it can be a perfect outlet to relate with other people in the completion of our tasks in non-threatening ways.

Work is work, but it has a complete other dimension when that work takes on real tangible meaning; when work is done for a higher purpose or higher calling.

Such a thing as noble work, like serving others in love, by giving them what they cannot get without us, may not be the perfect solution, but it has some positive effect.

THE SOLUTION OF SUITABLE REST

Sometimes fatigue plays too big a part in our lives, and many depressions are caused by burnout.

Perhaps it is no coincidence that those who suffer from depression may also suffer anxiety-related problems - they may tend to worry or find it hard to relax. Some of this anxiety is unconscious to the individual. There may be worry and tension underneath without so much as a clue within the grasp of conscious control.

Finding the opportunity, then, to take a hot tub, to get away alone, to have the senses massaged somehow; these and many more are good ideas to explore; anything to escape in healthy ways.

***

Sometimes, just sometimes, depressed occasions and seasons can be aided by a noble deed or timely restful encounter. These simplistic solutions don't always work, but often what we need is something rather simple; the challenge is finding just what.

Doing something worthwhile - whether it is work or rest - may just be what's needed.

© 2013 S. J. Wickham.

Adults With Diabetes And Limited Health Literacy Less Likely To Adhere To Prescribed Antidepressants

Adults With Diabetes And Limited Health Literacy Less Likely To Adhere To Prescribed Antidepressants

Adult patients with diabetes who don't understand basic health information are significantly less likely to take newly prescribed antidepressant medication, according to a new Kaiser Permanente study in the Journal of General Internal Medicine.

In this study conducted by the Kaiser Permanente Division of Research and the University of Washington School of Medicine, 72 percent of the 1,366 study participants had limited health literacy, and had significantly poorer adherence to newly prescribed antidepressants, compared to patients with no limitations.

"Research shows that those with health literacy limitations are more likely to have poor control of their chronic medical conditions such as diabetes, congestive heart failure and HIV," said Andrew Karter, PhD, research scientist at Kaiser Permanente and senior author on the study. "However, this is the first study to examine the association between health literacy and antidepressant adherence among patients with diabetes. This type of research gives our health care systems important feedback because, as providers, we often remain unsure whether the critical health information we convey to our patients is fully understood."

The Institute of Medicine defines health literacy as the capacity for patients to "obtain, process, and understand basic health information and services needed to make appropriate health decisions." Because nearly 90 percent of Americans have some difficulty using routine health information, the U.S. surgeon general has identified the improvement of health literacy as a national priority.

Adequate adherence for antidepressants is particularly important for patients with diabetes and other chronic medical conditions. Depression occurs twice as frequently among adults with diabetes compared to adults without diabetes, and has been associated with an increased risk of the serious diabetic complications, dementia and mortality.

In the study, health literacy was based on a self-reported scale in which participants with type 2 diabetes responded to three questions:

How often do you have problems learning about your medical condition because of difficulty understanding written information?

How confident are you filling out medical forms by yourself?

How often do you have someone like a family member, friend, hospital or clinic worker or caregiver, help you read health plan materials?

The study examined medication nonadherence during the 12 months after the initial antidepressant prescription, and researchers found that many patients failed to adhere to their treatment. Although most patients filled the prescription at least once, 43 percent failed to fill the prescription a second time, and nearly two-thirds had discontinued the antidepressant by the end of the 12-month period.

Poor adherence to antidepressant medications has been described previously, but what was not known is that those with health-literacy limitations were significantly less likely to take their antidepressant medications. In fact, diabetes patients with limited health literacy were much less likely to refill their antidepressant medications in a timely fashion than patients with no limitations. These patterns were not explained by other factors known to be associated with medication nonadherence, including age, race/ethnicity, English proficiency and income, which were accounted for in the study.

Depression in adults with diabetes is frequently chronic, suggesting the need for long-term antidepressant therapy. "The high rates of early discontinuation that were observed among adults with diabetes who had any health literacy limitation suggest that few of these individuals received an adequate course of antidepressant therapy. Getting that sufficient treatment is critical in preventing relapse and recurrence of depression," said lead author Amy Bauer, MD, of the University of Washington School of Medicine. "Physicians should be aware of this. For antidepressant treatment to succeed, patients with limited health literacy may require more intensive counseling and clearer explanations about use of antidepressant medications and closer follow-up."

The researchers said the study findings underscore the importance of national efforts to address healthy literacy, simplify health communications regarding treatment options, improve public understanding of the importance of depression treatment, and monitor antidepressant adherence.

Additional authors on the study include Wayne Katon, MD, University of Washington; Dean Schillinger, MD, University of California, San Francisco Division of General Internal Medicine; Melissa Parker, MS, Alyce Adams, PhD, and Howard H. Moffet, MPH, Kaiser Permanente Northern California Division of Research; and Nancy Adler, PhD, University of California, San Francisco Center for Health and Community.

This research was supported by funding from the National Institutes of Health.

Additional

References

Citations

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our depression section for the latest news on this subject.