Bipolar Disorder Brain - What Changes Does Manic Depression Cause in the Brain?

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With modern day brain imaging, it becomes clear that bipolar is not a disorder, but a brain illness, as real as cancer or a cold. While science is nonetheless investigating the differences between the brain of a regular individual and the brain of a bipolar individual here are four differences in between the two.

1.) Ventral Striatum

The ventral striatum permits the brain to procedure rewards, such as feeling pleased after consuming or having sex. If a person suffers from bipolar, this component will be overactive and have a 30% loss in the amount of gray matter.

The ventral striatum also aids in judgment, such as what is regarded as typical or moral. Because bipolar persons suffer a reduction in this portion of the brain, they will be prone to overspending or sexual promiscuity, in particular when manic.

two.) Prefrontal Cortex

The prefrontal cortex allows the brain to approach and regulation emotion, an critical component of impulse control. For example, when 1 feels angry, they don't go out and hit the 1st individual they see.

In those with bipolar disorder, there is a 20% to 40% reduction in gray matter material in the prefrontal cortex, causing rash behavior and anger control issues.

3.) Amygdala

The amygdala controls facial expressions and tones of voice. For example, if you see a person you like on the method, neural transmissions will occur in your brain, telling you to smile. In the bipolar brain, there is a loss of gray matter in this region, causing a delay reaction in facial expressions.

four.) Hippocampus

In those with bipolar disorder, the hippocampus has lost branches that connect neurons, leading to a loss of an capability to tell the difference in between danger and reward, causing a state of anxiety.

13 Tips for Dating with Depression

Dating presents a challenge when one is depressed and has difficulty feeling or expressing joy. About 18 million Americans suffer from depression, with another 20 million worldwide using dating sites on the web each month according to On Line Dating Magazine. In fact at least 20 per cent of American women and 10 per cent of men experience major depression sometime in their lives. Therefore the question on looking for relationship during the mild to moderate depression episode is quite a common situation in the modern world.

Regarding depressed people and dating, Helen Friedman, PhD, a clinical psychologist in private practice in St. Louis says, “Sometimes when you don’t feel like smiling, but are in a situation where you’re expected to be happy, that can make you feel even worse.”

Meeting a new person, however, can also be a source of great joy.

Following these ten tips might make the prospect of dating a little easier for depressed individuals:

Remember, you can be happy!

It is important to remember that everyone has something in their past that they are less than proud about, and depression is nothing to feel ashamed of. Everyone has something in their past that can be cast in a negative light, as none of us are perfect. Try to remember that your depression does not define who you are. If you have suffered from depression and have overcome it, you are likely a stronger and more compassionate person because of your experiences. If you are still struggling with depression, anyone worth being with will accept your illness along with all the positives you offer them.

Depression is a serious illness but it's a treatable one, and it doesn't mean that all your potentially great relationships are doomed. "It is absolutely possible for two people to have a relationship when one of them lives with depression," says Heather Cobb, spokesperson for the National Mental Health Association (NMHA). "Most people who seek treatment do get better."

Consider professional help

If a person is not already receiving treatment for his/her depression, getting professional help is advised. When depressed, dating might potentially magnify some symptoms, such as fatigue, irritability, low self-esteem and decreased libido. According to Mental Health America, 80% of those who seek treatment get relief; therapy and medications are successful in most cases.

Time it right

Despite the urging of family and friends, if a depressed individual does not feel up to dating, it is best to postpone. Taking care of oneself is priority in order to care of someone else in a relationship. Maintain positive thoughts, consistently take medications and attend therapy sessions, keep company with others who are supportive and upbeat in order to be at your best when dating opportunities occur.

Don’t tell on first date

It is not necessary to bare your soul, or your depression on a first date. Before confiding in another, ensure that person is someone who is going to be a constant in your life; someone for whom you genuinely care about and with whom you wish to have a prolonged relationship.

When Should I Tell?

The time to tell someone about your depression is either when your condition gets in the way of the relationship or the partnership starts to become serious. So, if you get knocked on your ass by depression and have to cancel a Friday night date, tell him or her what's going on. But do it in person, not via email or over the phone, as this lets them know that you are serious about the relationship. Equally, if you are shacking up or getting married, best to come clean about the depression, even if you haven't experienced any bouts since you started dating, as there may be times when your partner will need to stand by and support you, and they have a right to know what they are signing up for.

How to talk about it

When you are ready to reveal your medical condition, avoid blurting it out. Preface your conversation with comments about having something important to discuss and you are doing so only because the person in whom you are confiding is important to you. Share that you have been diagnosed and are receiving treatment. Conclude by reiterating how important this person is to you and that you are telling about your depression, in order to be completely honest and forthright.

Accept assistance

It is important to let your partner know how he/she can help you, according to Sheela Raja, PhD, clinical psychologist and assistant professor at the University of Illinois at Chicago. For example, if daily exercise is part of your treatment regimen, invite your partner to join you taking walks or working out. Consider couples counseling so that your significant other might learn other ways to be helpful.

Be patient

Dating when depressed might not fit the stereotype of men taking the initiative and women being joyful at being catered to by another. A male partner might not always feel up to making plans and a female might not always be smiling and upbeat in response to her partner’s catering. With raised awareness, these deviations to normal expectations can be coped with more easily.

Low libido

It is common for depressed persons to lose interest in sex. Sometimes medications keep the disposition in balance, but decrease the libido. Talk to your doctor about alternative medications, if this is the case. In any event, it is possible to display affection in other ways when the mood is not right due to depression issues.

Do not take personally

If someone backs off after you reveal this, DO NOT TAKE IT PERSONALLY. We fear what we don’t know. Some people just do not have any experience with these situations or don’t understand. The stigma attached to these conditions is diminishing because it is more and more common in the modern society, and people are feeling more comfortable discussing these topics and revealing their own battles.

Don’t repeat mistakes

If you made the mistake of investing time with someone who made you feel bad, or worse yet, rejected you, talk it over with a therapist and move on. With practice, you will be able to recognize the signs and discern early on the level of maturity and compassion in prospective dates.

On line dating

Many individuals nowadays indulge in internet dating. There are special sites especially geared to those with depression or other mental and physical issues, such as nolongerlonely.com. It is not necessary to limit one’s exposure to such as this site, however, as mainstream dating sites might also be effective ways to meet suitable dating prospects.

Acceptance

Most importantly, if you want to be accepted by others, accept yourself. All people have baggage of one type or another; weight issues, acne or a difficult past can be as challenging as suffering from depression. When the right person comes along, depression will not be a deal breaker.

In conclusion, do not allow the fact that you are battling with depression to preclude a satisfactory dating life. Use these thirteen tips as a guide for lessening the challenges and increasing the joy of dating.

Source and Additional Information:

http://www.helium.com/items/2093882-dating-with-depression-10-tips

http://click.lavalife.com/dating/feature/article/Dating-With-Depression/rHSA/568986/p1

http://andthatswhyyouresingle.com/2010/12/09/how-do-i-tell-people-that-i-take-meds/

http://www.steadyhealth.com/articles/3_Tips_for_Dating_with_Depression_a1628.html

http://datingwithdepression.com/

Alexander Technique for Depression and Stress

Background

The Alexander technique is an educational program that aims to change habitual patterns of movement and posture that are thought to be harmful. Teachers of the Alexander technique guide clients ("students") through various movements using verbal directions and light touch. The goal of these sessions can be to improve coordination and balance, reduce tension, relieve pain, decrease fatigue, improve various medical conditions or promote well-being. Students are encouraged to use what they learn in everyday life. Actors, dancers and athletes use the Alexander technique to improve performance.

F.M. Alexander, an Australian-English actor, developed the Alexander technique. He believed that poor head and neck posture was the cause of his recurrent voice loss. He suggested that people be trained to alter harmful movement patterns and positions.

In 1964, the American Center for the Alexander Technique was founded to provide teaching certification. The certification process generally involves 1,600 hours of training over three years in an approved program. The North American Society of Teachers of the Alexander Technique was established in 1987 to educate the public and to maintain standards for certification of teachers and training courses in the United States. The Alexander technique is taught at wellness centers, through health education programs and by individual teachers.

Theory

Basic beliefs underlying the Alexander technique are that musculoskeletal movements and relationships can directly affect other aspects of health or function and that beneficial movement patterns can be reinforced through repetition. The position of the head and spine is thought to be important in this approach. Many physiologists and behavioral scientists are advocates of musculoskeletal techniques similar to the Alexander technique, although there are few scientific studies of the Alexander technique specifically.

Method

The Alexander Technique is a way of becoming more aware of your balance and how you move. It's based on the premise that most people have bad postural habits that, over time, stop us using our bodies as easily and comfortably as we should be able to. Wrongly used muscles contract and pull down, giving rise to the classic sign of bad use: head tipped back at the start of any movement, especially sitting down or standing up. As well as the long-term damage to joints and cramped internal organs, poor posture causes a lot of tension, most commonly felt as chronic backache or stiff shoulders. It's also linked with respiratory ailments: people develop round shoulders from hunching protectively around their painful chests as they cough and wheeze, which in turn restricts their airways still further.

Frederick Matthias Alexander believed modern living gives rise to our bad postural habits: shoulders raised and stiffened by stress, neck poked forward over desk work, tired bodies slumped into saggy armchairs. Soon we've lost all sense of how we really are, so that what feels natural (because it's habitual) is wildly out of line. That's why it's very hard to correct our own posture without expert help.

The Alexander Technique aims to re-educate each body into moving more easily - relearning the natural grace all children have till they go to school and start slouching over desks.

It's based on what Alexander teachers call 'good use of the body' - allowing the spine to regain its natural curves, holding the head effortlessly in the easiest position and distributing weight evenly over your feet. The bonus is that you look taller and feel two stone lighter.

It's a hands-on teaching method, though you don't undress; after three years' full-time training Alexander teachers can 'read' people's muscles through layers of clothes with their fingertips. To start with, you and the teacher observe your stance and movements for some time, and the first shock is seeing how asymmetrical you are when you think you're standing up straight. Then you're gently moved into a healthier position when you're sitting, standing and lying down.

As part of the relearning process, you stop and think before plunging into a habitual move, then make the movement mindfully. It feels odd to practice getting up or walking with someone's hand lightly holding the back of your neck, and even odder for the first few days when you keep making conscious efforts to do it the way you've learnt. If you're used to standing with your pelvis jutting further forward than your toes, for example, you feel as though you're going to fall over backwards when you tuck your tailbone in and bring your weight nearer a point above your heels. But your legs, no longer struggling to hold you at a slant, now carry you effortlessly. You may be noticeably taller. Walking upstairs feels like levitating. The idea is that this soon becomes second nature.

The Technique's basic idea is that when the neck muscles do not overwork, the head balances lightly at the top of spine.  The relationship between the head and the spine is of utmost importance.  How we manage that relationship has ramifications throughout the rest of the body.  As the boss -- good or bad -- sets the tone for an organization, the head / spine relationship -- compressed or free -- determines the quality of the body's overall coordination.  Our neuromuscular system is designed to work in concert with gravity.  Delicate poise of the head sparks the body's anti-gravity response: a natural oppositional force in the torso that easily guides us upward and invites the spine to lengthen, rather than compress, as we move.  Instead of slouching or holding ourselves in a rigid posture, we can learn to mobilize this support system and use it wherever we go -- in the car, at the computer, in the gym.

And the homework couldn't be easier: for 20 minutes a day you lie on your back on the floor, with just enough books under your head to keep your neck parallel to the floor (so you can swallow comfortably), knees raised and hands on abdomen. Keep your mind on the Alexander mantra: 'Let the neck be free so the head can move forwards and upwards and the back can lengthen and widen.'

Young children have this natural poise. If you watch a toddler in action, you will see an erect spine, free joints and a large head balancing easily on a little neck.  A healthy child walks and plays with regal posture.  Barring birth defects, we all began that way.  But over the years, we often lose that spontaneity and ease.

Using the Alexander Technique, you can learn to strip away harmful habits, heighten your self-awareness, and use your thought process to restore your original poise.  In a way, you are learning something that, deep down, your body already knows.  With the Alexander Technique, you come to understand much more about how your body works, and how to make it work for you.  You can tap more of your internal resources, and begin on a path to enhancing your comfort and pleasure in all your activities. 

Self-Help

Begin observing yourself in a mirror. A full length one is best. Pay special attention to the relationship of your whole head (not just your face) to the rest of your body. Notice how this relationship changes as you perform simple activities like talking, walking or raising an arm or leg.

How does what you see in the mirror correspond to what you think you're doing, and what do you feel you're doing? Which do you think is more accurate? Take plenty of time to explore and compare your experiences with Alexander's.

Experiment with changing the relationship of your head to your body, perhaps tilting it a little forward or backward from the top of your neck and observe what difference these shifts make to your movements and to your breathing.

Alexander found that the most useful change he could make was to mentally direct his neck to be free so that his head, followed by his body, could release in an upward direction - delicately, without any stiffening or undue effort.

Try this. What do you notice? Does anything look or feel different?

Now, try doing the opposite. Stiffen your neck a little as you gently push your head down towards the rest of your body. What effect does this have on your ability to breathe, speak and perform simple activities?

What happens when you just leave yourself alone? Is there a relationship between your head and your body that you tend automatically to go back to? 'Exaggerate yourself' for just a moment. Notice what happens to your head/body relationship when you do this.

Feel free to experiment in other ways that occur to you. Pay close attention to the results of your experiments. Remember that you are both the experimenter and the object of the experiments. So you are always going to have to be careful that you are not deceiving yourself. Continue comparing what you see with what you're thinking about and what you feel.

After you've experimented in front of the mirror long enough to have made for yourself some of the same kinds of observations that Alexander wrote about, extend your self-study to your daily round of activities. Can you sense how your body reacts to stressful situations, for example? How about pleasant experiences? Does the presence of some people act as a stimulus to tighten your neck? Do others seem to encourage freedom and expansion in your body?

Notice the effects of sound on your physical mechanism. Experiment with scanning your auditory 'horizon' and noting the effects of actively listening to the highest pitched sounds available to you. These could be high musical notes, the chirping of birds, even the sound of wind blowing through the branches of a tree. Then, shift your conscious attention to the lowest-pitched sounds you can hear - drum beats, the sounds of heavy machinery, for example. What effect does this shift have on the way you're using your body?

Keep in mind that Alexander's purpose in performing his investigations was to improve the quality of his performance. So begin to observe other people--and animals and small children--with a view toward becoming a good judge of quality of movement. Keep a look out for particularly good examples of ease, balance and co-ordination. Look also for particularly bad examples. Can you make any generalizations about quality of movement and the nature of the head/body relationship?

Potential Dangers

Instruction or practice of the Alexander technique has not been associated with reports of severe complications. However, safety has not been studied systematically. Some practitioners believe that this technique may be less beneficial in people with mental illness or learning disabilities. Safety during pregnancy has not been established scientifically, although the Alexander technique has been used by pregnant women and during delivery without reports of complications.

Do not rely on the Alexander technique alone as an approach to treat medical conditions. Speak with your health care provider if you are considering using the Alexander technique.

Summary

The Alexander technique has been used to address several health issues, but there is still no overwhelming scientific evidence that it has been proven effective for any specific condition. Do not rely on the Alexander technique alone to treat a potentially severe medical condition. Speak with your health care provider if you are considering using the Alexander technique.

Sources and Additional Information:

http://www.healthyplace.com/alternative-mental-health/treatments/alexander-technique-for-depression-stress/menu-id-1017/

http://www.alexandertechnique.com/jwright.htm

http://www.timesonline.co.uk/tol/life_and_style/health/traineo/exercise/article3773825.ece

http://www.alexandertechnique.com/at/

http://www.ati-net.com/articles/dm-rrick.php

Depression Signs Detection through Computer Software Analysis

New technologies are investigating new methods of the Depression signs identification without visiting a therapist by the potential patient. No matter how much successful these approaches appear, the computerized system absolutely cannot replace the personal communication. It is a common knowledge that only 10% of the communication is verbal. Therapist reviews multiple signs and makes the conclusion based on multiple factors, and what patient is saying, is just one of them. However, every possibility to give a heads-up and detect dangerous signs in the individual’s mental well-being should be encouraged. Yes, that should be a first screening test, which will require more detailed therapist assessment, but for some people it might catch the disease before it becomes major health impairment.

In this post, we will review two new techniques, both under development, for early detection of the depression signs: one through voice recognition, another – through posted text analysis (which might be very useful for fellow bloggers).

Software detecting depression signs through Voice Recognition

It's a common complaint in any communication breakdown: "It's not what you said, it's how you said it." For Professor Sandy Pentland and his group at MIT's Media Lab, the tone and pitch of a person's voice, the length and frequency of pauses and speed of speech can reveal much about his or her mood.

While most speech recognition software concentrates on turning words and phrases into text, Pentland's group is developing algorithms that analyze subtle cues in speech to determine whether someone is feeling awkward, anxious, disconnected or depressed.

Cogito Health, a company spun out of MIT based in Charlestown, MA, is building on Pentland's research by developing voice-analysis software to screen for depression over the phone.

For years, psychiatrists have recognized a characteristic pattern in the way that many people with clinical depression speak: slowly, quietly and often in a halting monotone. Company CEO Joshua Feast and his colleagues are training computers to recognize such vocal patterns in audio samples.

Tool Could Help Manage People with Chronic Disease

Feast says the software could be a valuable tool in managing patients with chronic diseases, which often lead to depression.

As part of certain disease-management programs, nurses routinely call patients between visits to ask if they are taking their medication. However, symptoms of depression are more difficult for nurses to identify. Feast says voice analysis software could provide a natural and noninvasive way for nurses to screen for depression during routine phone calls.

"If you're a nurse and you're trying to deal with a patient with long-term diabetes, it's very hard to tell if a person is depressed," says Feast. "We try to help nurses detect possible mood disorders in patients that have chronic disease."

A few years ago, the pharmaceutical giant Pfizer developed voice-analysis software to detect early signs of Parkinson's disease. Pfizer scientists designed the software to recognize tiny tremors in speech. Such tremors offered clues to help gauge patients' response to various medications.

Software Detects Patterns in Vocal Recordings

In much the same way, Cogito Health's software detects specific patterns in vocal recordings. For example, the researchers have developed mathematical models to measure a speaker's consistency in tone, fluidity of speech, level of vocal energy, and level of engagement in the conversation (for example, whether someone responds with "uh-huh's" or with silence).

"It listens to the pattern of speech, not the words," says Pentland, a scientific advisor to the company. "By measuring those signals in the background, you can tell what's going on."

The company is conducting a large-scale trial of the software by collecting hundreds of routine phone conversations between nurses and patients, with consent from both parties. After performing follow-up questionnaires to see which patients are depressed, the researchers tested the software, to see if it could accurately identify these patients.

Vocal Cues Can ID Deception, Anger, Signs of Intoxication

Mark Clements, a professor of electrical and computer engineering at the Georgia Institute of Technology, has analyzed vocal patterns associated with clinical depression. His lab also uses vocal cues to identify deception and anger, as well as early signs of intoxication.

Clements says the benefit of Cogito Health's approach is that it could help untrained professionals detect signs of depression.

"A trained listener could detect these types of things in a person's voice, but it's difficult to teach a novice," he says. "But things that are hard to hear can be detected by a computer, and have correlations with various emotional and even physical states."

Carl Marci, director of Social Neuroscience at the Massachusetts General Hospital's Department of Psychiatry, and another a scientific advisor to the company, says such technology could help monitor a patient's long-term progress.

Software detecting depression signs through blogs and websites postings

Israeli researchers have developed a software program that can detect depression in blogs and online texts. The software is capable of identifying language that can indicate a writer's psychological state, which could serve as a screening tool.

Developed by a team headed by Yair Neuman, associate professor of education at Ben-Gurion University (BGU) of the Negev, Israel, the software was used to scan more than 300,000 English language blogs posted on mental health websites. The program identified what it perceived to be the 100 "most depressed" and 100 "least depressed" bloggers.  A panel of four clinical psychologists reviewed the samples and concluded that there was a 78 per cent correlation between the computer's and the panel's findings.



"The software program was designed to find depressive content hidden in language that did not mention the obvious terms like depression or suicide," Neuman said.  "A psychologist knows how to spot various emotional states through intuition. Here, we have a program that does this methodically through the innovative use of 'web intelligence'."

For example, the program spots words that express various emotions, like coolers that the writer employs to metaphorically describe certain situations. Words like "black" combined with other terms that describe symptoms of depression, such as sleep deprivation or loneliness, will be recognized by the software as "depressive" texts.

Originally conducted for academic purposes, the findings could potentially be used to screen for would-be suicides. The software provides a screening process that raises an individual's awareness of his or her condition, enables mental health workers to identify individuals in need of treatment and can recommend they seek professional help.

The software isn’t designed to replace human judgment, said Neuman. And it’s not sophisticated enough to analyze intention or detect those who may be more likely to write when they’re feeling sad. But given the large number of people suffering from depression, it can be an effective screening tool, especially if combined with other technologies, such as voice recognition or new algorithms that can detect sarcasm, Neuman said. “It has the power to screen for depression in an economical, proactive and quick way,” said Neuman. “The language we use tends to shape our thoughts in a very deep sense.”

Sources and Additional Information:

http://abcnews.go.com/Technology/AheadoftheCurve/software-listens-hints-depression/story?id=9017304&page=1

http://economictimes.indiatimes.com/articleshow/6086463.cms

http://featuresblogs.chicagotribune.com/features_julieshealthclub/2010/06/program-helps-detect-depressed-bloggers.html

Cyclothymia (cyclothymic disorder)

Cyclothymia (si-kloh-THIGH-me-uh), also called cyclothymic disorder, is a mild form of bipolar disorder. Like bipolar disorder, cyclothymia is a chronic mood disorder that causes emotional ups and downs.

With cyclothymia, you experience periods when your mood noticeably fluctuates from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.

Compared with bipolar disorder, the highs and lows of cyclothymia are less extreme. Still, it's critical to seek help managing these symptoms because they increase your risk of bipolar disorder. Treatment options for cyclothymia include psychotherapy, medications, and — most important — close, ongoing follow-up with your doctor.

Symptoms

Cyclothymia symptoms include an alternating pattern of emotional highs and lows. The highs of cyclothymia are characterized hypomanic symptoms, which resemble those of mania, but are less severe. The lows consist of mild or moderate depressive symptoms.

Cyclothymia symptoms are generally similar to those of bipolar disorder, but they're less severe. When you have cyclothymia, you can typically function in your daily life, though not always well. The unpredictable nature of your mood shifts may significantly disrupt your life because you never know how you're going to feel — and you can't just will yourself to live life on an even keel.

Cyclothymic Disorder

Hypomanic phase of cyclothymic disorder

Signs and symptoms of hypomanic episodes of cyclothymia may include:

• Unusually good mood or cheerfulness (euphoria)


• Extreme optimism


• Inflated self-esteem


• Poor judgment


• Rapid speech


• Racing thoughts


• Aggressive or hostile behavior


• Being inconsiderate of others


• Agitation


• Increased physical activity


• Risky behavior


• Spending sprees


• Increased drive to perform or achieve goals


• Increased sexual drive


• Decreased need for sleep


• Tendency to be easily distracted


• Inability to concentrate

Depressive phase of cyclothymic disorder

Signs and symptoms of depressive episodes of cyclothymia may include:

• Sadness


• Hopelessness


• Suicidal thoughts or behavior


• Anxiety


• Guilt


• Sleep problems


• Appetite problems


• Fatigue


• Loss of interest in daily activities


• Decreased sex drive


• Problems concentrating


• Irritability


• Chronic pain without a known cause

When to see a doctor

If you have any symptoms of cyclothymia, seek medical help as soon as possible. Cyclothymic disorder generally doesn't get better on its own. If you're not sure where to start with treatment, see your primary health care provider. He or she may refer you to a mental health provider with experience in cyclothymia or bipolar disorder.

If you're reluctant to seek treatment, try to work up the courage to confide in someone, whether it's a friend or loved one, a health care professional, a faith leader, or someone else you trust. He or she can help you take the first steps to successful treatment.

If you have a loved one you think may have symptoms of cyclothymia, have an open and honest discussion about your concerns. You can't force someone to seek professional help, but you can offer encouragement and support and help your loved one find a qualified doctor or mental health provider.

Suicidal thoughts

If you're considering suicide right now, call 911 or your local emergency services number. If you just can't make that call, pick up the phone and reach out to someone else — immediately:

• Contact a family member or friend.


• Contact a doctor, mental health provider or other health care professional.


• Contact a minister, spiritual leader or someone in your faith community.


• Go to your local hospital emergency room.


• Call a crisis center or hot line.

If you have a loved one who has harmed himself or herself, or is seriously considering doing so, take him or her to the hospital or call for emergency help.

Diagnostic Criteria

Diagnostic criteria are as follows:

- Symptoms present for at least 2 years, the patient has had periods of hypomanic symptoms and periods of low mood that don't fulfill the criteria for Major Depressive Disorder.

- The longest period the patient has been free of mood swings is 2 months.

- During the first 2 years of this disorder, the patient has not fulfilled criteria for Manic, Mixed, or Major Depressive Episode.

- Schizoaffective disorder doesn't explain the disorder better, and it isn't superimposed on Schizophrenia, Delusional Disorder or Psychotic Disorder Not Otherwise Specified.

- The symptoms are not directly caused by a general medical condition or the use of any substances, including prescription medications.

- These symptoms cause the patient clinically important distress or impair work, social or personal functioning.

Causes

It's not known specifically what causes cyclothymia. As with many mental disorders, research shows that it may result from a combination of:

• Heredity — cyclothymia tends to run in families. One is 2-3 times more likely to have the disorder if someone in the immediate family has it or if an identical twin has it. In a study by Bertelsen, Harvard, and Huage (1977), if an identical twin had depression, 59% of the identical twins had it also. Heritability for women ranges from 36-44%; for men, 18-24%.


• Your body's biochemical processes, such as changes in brain chemistry. Serotonin: Serotonin regulates other hormones like norepinephrine and dopamine, so when serotonin is low, the other chemicals may fluctuate, causing irritability, impulsivity and mood irregularities such as dysthymia and depression. Cortisol: Depressed individuals can have high cortisol levels. Cortisol is a stress hormone, and mood disorders often occur during stressful points in one’s life. Elevated stress hormones can affect functioning of the hippocampus, an important centre for memory and cognitive processes. Overproducing cortisol can also impair the brain’s ability to regenerate neurons in the hippocampus.


• Environment and stressful events, as perceived by the individual. Job loss, relationship failure, identity change, natural disaster, learned helplessness and hopelessness, extreme feelings, negative thinking patterns.


• Parenting styles.

Risk factors

Cyclothymia is thought to be relatively rare. But true estimates are hard to pin down because people may be undiagnosed or misdiagnosed as having other mood disorders, such as depression.

Cyclothymia typically starts during adolescence or young adulthood. The condition affects about the same number of men and women.

Tests & diagnosis

The person's own description of the behavior usually leads to diagnosis of the disorder.

Prognosis

This disorder usually has an insidious onset in adolescence or early adult life. It often develops with prolonged periods of cyclical, often unpredictable mood changes (e.g., the person may be regarded as temperamental, moody, unpredictable, inconsistent, or unreliable). This disorder usually has a chronic course, and has a 15%-50% risk that the person will eventually develop Bipolar I or II Disorder.

Most people do not need long-term therapy.

Treatment

The most important first step in the treatment of this disorder is to prevent alcohol or illicit drug abuse. Medication often is ineffective when the individual is still abusing alcohol or illicit drugs.

A combination of antimanic drugs, antidepressants, or psychotherapy are used to treat cyclothymic disorder. Medications used to treat this condition are called mood stabilizers.

• Lithium. Lithium has been used for years in patients with bipolar disorder, and it may also help patients with cyclothymic disorder.


• Antiseizure drugs. Valproic acid (Valproate), carbamazepine (Tegretol), oxcarbazepine (Trileptal), and lamotrigine (Lamictal) are the most established antiseizure drugs. Other antiseizure drugs used for bipolar disorders include gabapentin (Neurontin), zonisamide (Zonegran), and topiramate (Topamax).


• Antipsychotics.


• Antidepressants are not recommended because they can trigger a manic episode.

It has been repeatedly demonstrated that physical exercise can help with mood regulation and emotional stability

Patients may not respond to medications as strongly as do patients with bipolar disorder.

Sources and Additional Information:

http://www.mayoclinic.com/health/cyclothymia/ds00729

http://en.wikipedia.org/wiki/Cyclothymia

https://health.google.com/health/ref/Cyclothymic+disorder

http://www.mentalhealth.com/dis/p20-md03.html

http://www.psychnet-uk.com/dsm_iv/cyclothymic_disorder.htm

Youth Suicide: Risk Factors and Prevention

Facts and Statistics

Teenagers attempt suicide roughly 10 times more frequently than adults, although their fatality rate of 11.1 per 100,000 people is about the same as adults'. This is the third leading cause of death among 15-19 year-olds. For this age group, there were 5,174 motor-vehicle deaths in 1994, compared to 1,948 suicides.

According to U.S. national data released in September 1991, about one million teens (out of about 25 million) attempt suicide each year, of which an estimated 276,000 sustained injuries serious enough to require medical treatment.

Some other estimates (these are total, not per-year) are considerably higher: 3% of elementary-school, 11% of high-school, and 17% of college students. However, "Most were low-lethality attempts for which medical or other attention was not sought. Accordingly, the vast majority of [these] suicide attempts will not be uncovered by investigations dealing solely with clinical or medically identified populations." Thus, estimates or calculations of teenage suicide-attempt rates are particularly unreliable.

About four times more girls than boys make suicide attempts, but boys are much more likely to die: about 11% of (reported) males' attempts were fatal, compared to 0.1% of females', a ratio of more than 100:1. This also gives a ballpark average of about 50 attempts for every fatality in this age group.

This low fatality rate might be taken to mean that most of these adolescents don't want to kill themselves (true) and that there is generally one or more "warning" attempts before a lethal one (not true). In a study from Finland, only 30 percent of male, and 68 percent of female suicides 13 to 22 years old had made a previous (known) suicide bid. This suggests that many of these lethal first-time-attempters intended to die.

Compared to those of older people, adolescents' suicide-attempt statistics show two significant differences. First the fatality rate for boys is a hundred times that of girls, a much greater gender difference than with any other age group. The immediate reason is clear enough: most teenage girls use relatively low-lethality methods like drugs and wrist cuts, while a substantial number of boys use guns and hanging. The reasons behind these choices are not known.

Second, the fatality rate among adolescents, less than 2%, is much lower than that among the elderly, variously reported to be between 25% and 50%. This may be because the young, however miserable, usually have more reason for optimism about the future than do the old, who are too often without friends, family, job, and health.

Nevertheless, their suicide rate is increasing, and approaching the national average.

This corresponds to about 2000 suicides among 15-19 year-olds per year. While it's true that the suicide rate is substantially higher among old people, suicide is a relatively more frequent cause of death in the young, who have few deaths from illness. That's why it's the third leading cause of death among 15-24 year-olds, but ranks ninth or tenth for those 55-74.

The reasons for this rise are also in dispute. Besides the usual social rationales (e.g. higher divorce rates), "Some statistics indicate that suicide attempts among younger persons have not increased, but the methods and means they are using are more lethal, making the attempts more successful," says CDC's [centers for Disease Control] Dr. Alexander E. Crosby.

Risk Factors Related to Adolescent and Youth Suicide

Mental health professionals have identified those factors that pose the greatest risk to adolescents and youth suicides. Youths who attempt and commit suicide generally have several risk factors, which are combined with the ready availability of a lethal means and the lack of suitable sources of help.

Social and economic environments

The family is one of the earliest and most significant influences in a young person's development. There have been numerous studies of family troubles associated with youth suicidal behavior, including early parental loss, parental mental health problems, parental abuse and neglect, and a family history of suicide. In addition to chronic family troubles, there are usually precipitant events closer in time to a suicide attempt, many of which involve the family. These precipitants include serious conflicts with family members or divorce of parents, perceived rejection by one's family, and failure of family members to take an adolescent's talk about suicide seriously.

The school constitutes an important influence on youth. It is therefore not surprising that a history of school problems and the stress of disruptive transitions in school are potential risk conditions for youth suicidal risk behavior, as well as failure, expulsion, and overwhelming pressure to succeed.

Bullying is an extremely serious problem in schools and can result in the victims becoming depressed and suicidal, and even taking their own lives.

The influence of peers on young people's behavior can sometimes be greater than that of family and school. There is a risk of copycat suicidal behavior in adolescents who have been exposed to a peer's suicide. This contagion effect is most pronounced for vulnerable youths who tend to identify strongly with someone who has committed suicide in their environments or in mass media. Common precipitating events in youth suicidal behavior include rejection from peers, the breakup of a significant relationship, or the loss of a confidant. Furthermore, adolescents and young people who fail to act when confronted with a suicidal peer, by dismissing it as insignificant or failing to inform an adult, can increase the risk of suicide.

Poverty in children and youth heightens the risk conditions for suicide, including school problems and failures, psychiatric disorders, low self-esteem, and substance abuse, all of which can increase vulnerability to suicide and suicidal behavior.

Physical environment

Having immediate and easy access to lethal means to kill oneself increases the risk that a suicide will occur. Firearms are common methods of male suicides in the United States, and young women are increasingly using guns to kill themselves. Having such an instantly lethal method available increases the risk that vulnerable young people may kill themselves impulsively.

Additional risk factors

The researcher Jerome Motto suggested that the increased use of alcohol and drugs might have been a significant factor related to the rise of youth suicide since the 1970s. According to David Brent, at least one-third of adolescents who kill themselves are intoxicated at the time of their suicide and many more are likely to be under the influence of drugs.

A history of previous suicide attempts and the presence of a psychiatric disorder are among the most important and well-established risk factors for youth suicidal behavior. As many as 10 percent of suicide attempters eventually die in a later suicide attempt. Depression is a major mental health problem associated with suicide. In addition, impulsive behavior, poor problem-solving and coping skills, alcoholism, and homosexual orientation also increase the likelihood of suicidal behavior.

Prevention

No single risk factor alone is sufficient to result in a suicide. Youths who attempt and commit suicide generally have several risk factors that are combined with the ready availability of a lethal means and the lack of suitable sources of help.

Primary prevention consists of actions to prevent suicidal behavior before people develop a high-risk or a suicidal crisis. Most youth and adolescent suicide prevention programs have focused on school-based activities where adolescents receive training in identifying signs of suicide risks and how to best react to suicidal peers. Some programs also identify resources to help with suicide and encourage young people to talk with adults if they feel that they or their friends are feeling suicidal. Young people are specifically encouraged not to keep a "secret" confession of suicidal intentions to themselves. Controversy surrounds the usefulness and effects of school-based suicide prevention programs. Few programs have been the subject of rigorous evaluations and not all programs have had positive results. Research indicates that programs that provide a variety of resources within the school and community, including specially trained teachers, mental health services and counselors, and information and training for parents, may be of more benefit in preventing suicidal behavior.

In addition to school-based programs, many primary prevention approaches have focused on key persons who may come in contact with potentially suicidal youth. These persons, called "gatekeepers," include school staff, child welfare workers, community volunteers, coaches, police, family doctors, and clergy members. Training usually involves information on taking suicide threats seriously and asking specific questions to assess suicide risk, identifying behavior changes that may indicate increased suicide risk, better identification and treatment of depression and other mental health problems, and providing information about resources to help with suicide and other community youth problems.

Emergency Help

If you or someone you know is in immediate danger because of thoughts of suicide

Please call 911

There is help for you. Stay on the phone with the operator and wait for help to arrive.

Do not hesitate to call. Your life is extremely valuable, and people care about you.

Please reach out for help. Never act on your thoughts of suicide. Never… Remember, when you die, you cannot change your mind. And if your attempt fails, you might become physically or mentally impaired for all your remaining life!

Sources and Additional Information:

http://www.deathreference.com/Sh-Sy/Suicide-over-the-Life-Span.html

http://www.a1b2c3.com/suilodge/facovr1b.htm

http://www.suicide.org/bullying-and-suicide-information.html

http://www.suicide.org/teen-suicide-and-youth-suicide.html

http://www.cdc.gov/ncipc/dvp/suicide/youthsuicide.htm

Mindfulness Based Cognitive Therapy (MBCT) in clinical depression treatment

Clinical Research

The research, just published in the Journal of Consulting and Clinical Psychology, found that the group-based psychological treatment called Mindfulness Based Cognitive Therapy (MBCT) was as good or better as treatment with anti-depressants like Prozac in preventing a relapse of serious depression -- and the non-drug therapy was more effective in enhancing quality of life. What's more, the study concluded MBCT is cost-effective in helping people with a history of depression stay well for the long term.

The research team, which included British investigators from the Mood Disorders Center at the University of Exeter and the Center for Economics of Mental Health (CEMH) at the Institute of Psychiatry at King's College in London, looked at 123 people who had suffered repeated episodes of clinical depression. In a randomized control trial, the research subjects were assigned to one of two groups. Half continued their on-going drug treatment with anti-depressants and the rest participated in an MBCT course and were also given the option of stopping their anti-depressant medications.



MBCT focuses on targeting negative thinking and helps people who are at risk for recurring depression to stop their depressed moods from spiraling out of control into a full episode of depression. During the eight-week trial, groups of between eight and fifteen people attended meetings with a therapist who taught them a range of meditation exercises that they could continue to practice on their own once the course ended. The MBCT exercises were primarily based on Buddhist meditation techniques and helped the study participants learn to focus on the present, rather than dwelling on the past or worrying about future tasks.



Although the meditation exercises worked in a different way for each person, many reported more control over their negative thoughts and depressed feelings. Over the 15 months after the trial ended, about 47% of the group following the MBCT course experienced a relapse -- but those who continued normal treatment with anti-depressant drugs experienced a much higher, 60 percent relapse rate. In addition, the group practicing the mindfulness meditation techniques learned in the MBCT program reported a far better quality of life, more overall enjoyment and better physical well-being.



In a statement to the media, Professor Willem Kuyken of the University of Exeter, who headed the research, explained that people treated with anti-depressants are highly vulnerable to relapse when they stop their prescription drug therapy. "MBCT takes a different approach – it teaches people skills for life. What we have shown is that when people work at it, these skills for life help keep people well. Our results suggest MBCT may be a viable alternative for some of the 3.5 million people in the UK known to be suffering from this debilitating condition. People who suffer depression have long asked for psychological approaches to help them recover in the long-term and MBCT is a very promising approach. I think we have the basis for offering patients and GPs an alternative to long-term anti-depressant medication. We are planning to conduct a larger trial to put these results to the test and to examine how MBCT works," Kuvken said.

About MBCT

Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them. MBCT was developed by Zindel Segal, Mark Williams and John Teasdale, based on Jon Kabat-Zinn's Mindfulness-Based Stress Reduction program at the University of Massachusetts. Kabat - Zinn's work shows that for these people who have had little success with conventional pain management, the internal work of mindfulness practice substantially helped in dealing with pain.



So the authors of MBCT worked with Kabat - Zinn in specifying the MBSR for training chronic sufferers of depression in skills that prevent relapse. Their own research shows in people with 3 or more episodes, MBCT cut the relapse rate in half (over the 60 week follow-up period).



MBCT consists of a mix of mindfulness practice, of practicing a mere noticing of sensation (vipassana practice), as well as certain thought-tracking techniques from cognitive therapy. It is taught as an 8 week class that focuses on skill acquisition, rather than on psychotherapy per se. Groups are from 8-12 people, a size that tends to pull away from the tendency for it to become group therapy. It's really about learning and practicing skills.

MBCT addresses unwanted beliefs, feelings and body sensations. People are then taught to change the way their mind normally responds to negative events and thoughts. This helps to create a more positive outlook. The goal is to provide skills for life to help prevent chronic depression.

How does MBCT help?

MBCT works by keeping the mind from being caught in old habits that can create a downward spiral of negative thinking. The therapy is based on concepts that teach you to:

• Get to know the workings of your mind


• Notice small beauties and pleasures around you instead of living in your head


• Not drive yourself to meet impossible goals


• Accept yourself as you are, without judgment


• Recognize unhelpful thoughts and how they affect your mood


• Break the link between negative mood and the negative thinking that could lead to a relapse


• Learn to stay in touch with the present moment, and not obsess about the past or future

MBCT helps you to see more clearly the patterns of your mind; and to learn how to recognize when your mood is beginning to go down. It helps break the link between negative mood and the negative thinking that might normally have escalated into a relapse. You develop the capacity to mindfully disengage from distressing mood, and negative thoughts. You find that you can learn to stay in touch with the present moment, without having to ruminate about the past, or agonize about the future.

MBCT can be used on its own. It may also be combined with antidepressants or other types of therapy. Studies are looking into whether MBCT can reduce or eliminate the need for antidepressant medication in some people.

What to expect

MBCT is used by health care professionals who have had specific training in this approach. It is usually taught in a group with eight weekly classes. Each person is also asked to do "homework," using CDs with guided meditations that support what they learn in class.

The exercises work in a different way for each person. But many report greater acceptance of - and more control over - negative thoughts and feelings.

Most sessions involve:

• Simple breathing techniques, meditations and yoga stretches to increase awareness of the present moment. This includes getting in touch with moment-to-moment changes in the mind and the body.


• Education about depression and anxiety.


• Group discussion about using these practices at home.


• Advice on how to deal with any problems that came up.

MBCT can be cost-efficient, as group sessions cost less than individual therapy. Also, some people may be able to reduce their medication in lieu of therapy.

Case studies

Case study 1: Di

Di Cowan of Sampford Peverell, East Devon, has suffered from depression since he was in his late teens, though it was not diagnosed until much later. Now 53, he has been taking anti-depressant drugs for more than 15 years and has had no previous psychological treatment.

It is now two years since he completed the eight-week MBCT trial and Di practices the meditation techniques learned during the trial four or five times a week, for up to an hour each time. He plans to continue doing this for the rest of his life.

Di explains how the techniques learned on the trial have helped him in his daily life: "It's helped me immensely. It's given me the ability to come up against something that would have previously thrown me, think it through, come up with a solution and then move on. It's helped me deal with recurrent thoughts."

Shortly after completing the trial, Di was diagnosed with bone cancer and had to undergo treatment, including a major spinal operation, which has left him less mobile than he was before. Despite this set-back, he feels he is managing his depression using the techniques learned on the MBCT trial.

He says: "My view of the world has changed and I look at life in a new light. I'm much more cheerful and positive. Other people noticed a change. My friends and family were very quick to comment that I was showing an improvement."

Di concludes: "It was very worthwhile and I would highly recommend it to anyone who has similar problems. It's a very sound way of combating mental illness and promoting mental health."

Originally from Manchester, Di has lived in Devon for 28 years. He is a retired Math teacher and is married with two boys, aged 19 and 11.

Case study 2: Stephen

Stephen hopes that MBCT will be "the final piece in the jig-saw" in learning to cope with a tendency towards severe depression that he has suffered since his teens. Now 56, he experienced severe episodes between 2000 and 2002, involving hospitalization. Having already tried a number of alternative therapies, and talking cures, as well as anti-depressant drugs, he finally agreed to try the mood-stabilizer, Lithium.

Soon afterwards, he embarked on a course of cognitive behavioral therapy, and it was via this route that he heard of MBCT. "It was the right thing at the right time", he says. Sufficiently "stabilized" by Lithium, he was able to benefit fully from the techniques taught, which he now practices on a daily basis, some six years later.

The group context of MBCT was important for him. Not only did participants share their individual experiences of depression, and find common ground in symptoms suffered and warning signs to heed, they also helped keep each other "on track" with the practical homework involved. Stephen believes that, in addition to the group's support, self-discipline helped him complete the eight week course and has been essential for him to continue regular practice at home. He says: "Persistence and determination are necessary during the course and become even more vital when you're on your own."

Stephen, who lives in Exeter, is realistic enough to suspect that, without Lithium he could not have reaped the benefits of MBCT. However, he says: "Mindfulness gave me added insight into the way I function and respond to people, and helped me become more accepting. Along the way I have gained an understanding that, much of the time, life may not be as I would like it, but an awareness – particularly a body awareness – of such situations can lead to easier acceptance of them, and sometimes to beneficial change. Maybe, one day, I'll have gained sufficient insight not to need the Lithium any more".

Sources and Additional Information:

http://www.naturalnews.com/024986_meditation_depression_health.html

http://www.sciencedaily.com/releases/2009/04/090423210055.htm

http://www.myoptumhealth.com/portal/Information/item/Suffering+from+Depression%3F+Mindfulness+

http://www.sciencedaily.com/releases/2008/11/081130201928.htm

http://www.wellsphere.com/depression-article/review-of-mbct-mindfulness-based-cognitive-therapy-for-depression/404596

Historical retrospectives of depressive disorder

Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time.

Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.

In the 1950s and 60s, depression was divided into two types, endogenous and neurotic. Endogenous means that the depression comes from within the body, perhaps of genetic origin, or comes out of nowhere. Neurotic or reactive depression has a clear environmental precipitating factor, such as the death of a spouse, or other significant loss, such as the loss of a job.

The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classification, and has become widely used since. The general term depression is often used to describe the disorder, but as it can also be used to describe other types of psychological depression, more precise terminology is preferred for the disorder in clinical and research use. Major depression is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, approximately 3.4% of people with major depression commit suicide, and up to 60% of people who commit suicide have depression or another mood disorder.

Major Depressive Disorder

In the 1970s and 80s, the focus of attention shifted from the cause of depression to its effects on the afflicted people. That is to say, whatever the cause in a particular case, what are the symptoms and impaired functions that experts can agree make up a depressive disorder? Although there is some argument even today (as in all branches of medicines), most experts agree that:

1. A depressive disorder is a syndrome (group of symptoms) that reflects a sad and/or irritable mood exceeding normal sadness or grief. More specifically, the sadness of depression is characterized by a greater intensity and duration and by more severe symptoms and functional disabilities than is normal.


2. Depressive signs and symptoms are characterized not only by negative thoughts, moods, and behaviors but also by specific changes in bodily functions (for example, crying spells, body aches, low energy or libido, as well as problems with eating, weight, or sleeping). The functional changes of clinical depression are often called neurovegetative signs. This means that the nervous system changes in the brain cause many physical symptoms that result in diminished activity and participation.


3. Certain people with depressive disorder, especially bipolar depression (manic depression), seem to have an inherited vulnerability to this condition.


4. Depressive disorders are a huge public-health problem, due to its affecting millions of people.

·         The statistics on the costs due to depression in the United States include huge amounts of direct costs, which are for treatment, and indirect costs, such as lost productivity and absenteeism.

·         In a major medical study, depression caused significant problems in the functioning of those affected more often than did arthritis, hypertension, chronic lung disease, and diabetes, and in two categories of problems, as often as coronary artery disease.

·         Depression can increase the risks for developing coronary artery disease, HIV, asthma, and some other medical illnesses. Furthermore, it can increase the morbidity (illness/negative health effects) and mortality (death) from these conditions.

5. Depression is usually first identified in a primary-care setting, not in a mental health practitioner's office. Moreover, it often assumes various disguises, which causes depression to be frequently under-diagnosed.


6. In spite of clear research evidence and clinical guidelines regarding therapy, depression is often undertreated. Hopefully, this situation can change for the better.

Major Depressive Disorder

Sources and Additional Information:

http://www.medicinenet.com/

http://en.wikipedia.org/wiki/Major_depressive_disorder