May Physical Exercises Ease Depression?

In many cases of depression, although they may seem like a torture, exercises may be the right treatment technique for recovery.  It is very common for people who used to be very active in their life to become couch addicted during their depression episodes.

Exercises' most dreadful enemy are the fatigue and low energy symptoms of depression and can create overwhelming feelings of worthlessness for those who watch their body changing proportions.

A depressed person's health and activity level are damaged by their condition. Although, the mood disorder and poor physical condition are not so tightly related as a Duke University Medical Center in Durham , N.C. study has shown. Exercising may ease depression just as well as medication.

Antidepressants or exercises

As it was shown in a late 1999 study, the exercises play an important role in relieving short – term depression and their effect can be compared to that of medication. Three groups of people were given different therapies for comparison. The first group practiced physical exercises, the second one was given medication therapy and the third group had a combined therapy of both medications and exercises. The results have shown that the exercises therapy was as effective as the other two groups' treatments.

The results were even better according to a follow – up study that continued monitoring the subjects for an additional 6 months. Even more, they showed that exercising therapy prevents the depression to relapse. The more an individual practices exercises, the less predisposed he is to re – experience depression episodes.

An interesting observation was that those who used combined treatments of medications and exercises did not do as well as those who only worked out. This effect was blamed by some researchers on the more active role that people had in exercise groups that gave them a proper motivation.

Although these results are very useful for those who suffer from depression, further research is required to establish the exact connection with the physical exercising and what kinds of depressions are best treated with this kind of treatment.

First Steps

Only by taking the first step, one can make progress possible.  Small, singularly focused steps are the key of success into starting an uneasy physical exercises therapy as Teri Jo Oetting, a community dietitian at the University of Missouri Health and Science Center is persuading her patients.

Keep things simple and focus on one area at the time. It will be a lot easier than seeing a whole objective.

People who suffer from depression would rather stay home than go out and mix with other people. They close the door to an endless number of possibilities of being happy. Oetting tells her patients to go out and if they refuse, go out at night. Still being alone but outside. Find the moon and take a few deep breaths. Oetting admits that some patients accuse her of silly methods but she achieves the goal of taking them beyond the door. Small steps well focused that increase in time and provide more happiness, well – being and a more sociable behavior that is the way to cure.

How do I get started — and stay motivated?

Starting and sticking with an exercise routine can be a challenge. Here are some steps that can help. Check with your doctor before starting a new exercise program to make sure it's safe for you.

• Identify what you enjoy doing. Figure out what type of physical activities you're most likely to do, and think about when and how you'd be most likely to follow through. For instance, would you be more likely to do some gardening in the evening or go for a jog in the pre-dawn hours? Go for a bike ride or play basketball with your children after school? Do what you enjoy to help you stick with it.


• Get your mental health provider's support. Talk to your doctor or other mental health provider for guidance and support. Discuss concerns about an exercise program and how it fits into your overall treatment plan.


• Set reasonable goals. Your mission doesn't have to be walking for an hour five days a week. Think realistically about what you may be able to do. Tailor your plan to your own needs and abilities rather than trying to meet unrealistic guidelines that you're unlikely to meet.


• Don't think of exercise as a chore. If exercise is just another "should" in your life that you don't think you're living up to, you'll associate it with failure. Rather, look at your exercise schedule the same way you look at your therapy sessions or medication — as one of the tools to help you get better.


• Address your barriers. Figure out what's stopping you from exercising. If you feel self-conscious, for instance, you may want to exercise at home. If you stick to goals better with a partner, find a friend to work out with. If you don't have money to spend on exercise gear, do something that's virtually cost-free, such as walking. If you think about what's stopping you from exercising, you can probably find an alternative solution.


• Prepare for setbacks and obstacles. Give yourself credit for every step in the right direction, no matter how small. If you skip exercise one day, that doesn't mean you can't maintain an exercise routine and may as well quit. Just try again the next day.

What Are the Psychological Benefits of Exercise With Depression?

Improved self-esteem is a key psychological benefit of regular physical activity. When you exercise, your body releases chemicals called endorphins. These endorphins interact with the receptors in your brain that reduce your perception of pain.

Endorphins also trigger a positive feeling in the body, similar to that of morphine. For example, the feeling that follows a run or workout is often described as "euphoric." That feeling, known as a "runner's high," can be accompanied by a positive and energizing outlook on life.

Endorphins act as an analgesic, which means they diminish the perception of pain. They also act as sedatives. They are manufactured in your brain, spinal cord, and many other parts of your body and are released in response to brain chemicals called neurotransmitters. The neuron receptors endorphins bind to are the same ones that bind some pain medicines. However, unlike with morphine, the activation of these receptors by the body's endorphins does not lead to addiction or dependence.

Regular exercise has been proven to help:

• Reduce stress and take your mind of worries.


• Ward off anxiety and feelings of depression.


• Boost self-esteem and gain confidence.


• Improve sleep.


• Release feel-good brain chemicals that may ease depression (neurotransmitters and endorphins).


• Reduce immune system chemicals that can worsen depression.


• Increasing body temperature, which may have calming effects.

Exercise also has these added health benefits:

• It strengthens your heart.


• It increases energy levels.


• It lowers blood pressure.


• It improves muscle tone and strength.


• It strengthens and builds bones.


• It helps reduce body fat.


• It makes you look fit and healthy.

Are Particular Types of Exercise That Are Better for Depression?

It appears that any form of exercise can help depression. Some examples of moderate exercise include:

• Biking


• Dancing


• Gardening


• Golf (walking instead of using the cart)


• Housework, especially sweeping, mopping, or vacuuming


• Jogging at a moderate pace


• Low-impact aerobics


• Playing tennis


• Swimming


• Walking


• Yard work, especially mowing or raking


• Yoga

Because strong social support is important for those with depression, joining a group exercise class may be beneficial. Or you can exercise with a close friend or your partner. In doing so, you will benefit from the physical activity and emotional comfort, knowing that others are supportive of you.

How long will it take to feel better?

People suffering from major depression have experienced a boost in emotional well-being and energy from as little as a single 30-minute workout, according to a small study published in the journal Medicine & Science in Sports & Exercise. But for the best results, the exercise program should last at least two months, according to the Harvard Mental Health Newsletter.

Does the exercise have to be vigorous?

No, any kind will help. In a study published in 2005, researchers tested the effects of a three-month exercise program on people with mild to moderate depression. They divided 80 participants into five groups, with one of them exercising vigorously three days a week and another five days a week; two groups doing "low-dose" exercise three and five days a week, and another (the control group) doing only stretching.

Symptoms of depression dropped in all five groups, but they did take the biggest tumble in the rigorous exercise program, falling by an average of 47 percent. That means that the program of vigorous exercise was about as effective as antidepressant medication and cognitive therapy, the two main treatments for depression.

Sources and Additional Information:

http://www.throughdepression.com/exercises_ease_depression_medications.htm

http://www.webmd.com/depression/guide/exercise-depression

http://www.ahealthyme.com/topic/exdepression

http://psychcentral.com/news/2010/04/06/exercise-therapy-for-depression/12627.html

http://www.mayoclinic.com/health/depression-and-exercise/MH00043

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

Post Partum Depression for New Moms and Dads

The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression.

Many new moms experience the baby blues after childbirth, which commonly include mood swings and crying spells and fade quickly. But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme form of postpartum depression known as postpartum psychosis develops after childbirth.

Postpartum depression isn't a character flaw or a weakness. Sometimes postpartum depression is simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms — and enjoy your baby.

Symptoms

Signs and symptoms of depression after childbirth vary depending on the type of depression.

Baby blues symptoms

Signs and symptoms of the baby blues — which last only a few days or weeks — may include:

• Mood swings


• Anxiety


• Sadness


• Irritability


• Crying


• Decreased concentration


• Trouble sleeping

Postpartum depression symptoms

Postpartum depression may appear to be the baby blues at first — but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to care for your baby and handle other daily tasks. Postpartum depression symptoms may include:

• Loss of appetite


• Insomnia


• Intense irritability and anger


• Overwhelming fatigue


• Loss of interest in sex


• Lack of joy in life


• Feelings of shame, guilt or inadequacy


• Severe mood swing


• Difficulty bonding with the baby


• Withdrawal from family and friends


• Thoughts of harming yourself or the baby

Untreated, postpartum depression may last for a year or more.

Postpartum psychosis

With postpartum psychosis — a rare condition that typically develops within the first two weeks after delivery — the signs and symptoms are even more severe. Signs and symptoms of postpartum psychosis may include:

• Confusion and disorientation


• Hallucinations and delusions


• Paranoia


• Attempts to harm yourself or the baby

When to see a doctor

If you're feeling depressed after your baby's birth, you may be reluctant or embarrassed to admit it. But it's important to call your doctor if the signs and symptoms of depression:

• Don't fade after two weeks


• Are getting worse


• Make it hard for you to care for your baby


• Make it hard to complete everyday tasks


• Include thoughts of harming yourself or your baby

Getting early treatment for postpartum depression can speed your recovery.

If you suspect that you're developing postpartum psychosis, seek medical attention immediately. Don't wait and hope for improvement. Postpartum psychosis may lead to life-threatening thoughts or behaviors.

Causes

There's no single cause for postpartum depression. Physical, emotional and lifestyle factors may all play a role.

Physical changes

The postpartum period is a time of great changes in the body. These changes can affect a woman’s mood and behavior for days or weeks.

Levels of the hormones estrogen and progesterone decrease sharply in the hours after childbirth. This change may trigger depression in the same way that much smaller changes in hormone levels can trigger mood swings and tension before menstrual periods. Some women are more bothered by these changes than others. They may be more likely to have postpartum blues or depression.

Hormone levels produced by the thyroid gland also may decrease sharply after birth. If these levels are too low, the new mother may have depression-like symptoms, such as mood swings, nervousness, fatigue, trouble sleeping, and tension.

Many women feel very tired after giving birth. It can take weeks for a woman to regain her normal strength. Some women have their babies by cesarean birth. Because this is major surgery, it will take them longer to feel strong again.

Also, new mothers seldom get the rest they need. In the hospital, sleep is disturbed by visitors, hospital routine, and the baby’s feedings. At home, the baby’s feedings and care must be done around the clock, along with household tasks. Fatigue and lack of sleep can go on for months. They can be a major reason for depression.

Emotional factors

Many emotional factors can affect a woman’s self-esteem and the way she deals with stress. This can add to postpartum depression.

Feelings of doubt about the pregnancy are common. The pregnancy may not have been planned. Even when a pregnancy is planned, 40 weeks may not be enough time for a couple to adjust to the extra effort of caring for a baby.

The baby may be born early. This can cause changes in home and work routines that the parents did not expect. If the baby is born with a birth defect, it may be even harder for the parents to adjust.

Having a baby who must stay in the hospital after birth can cause sadness and guilt. A woman may feel guilty that she did something wrong during pregnancy. Sadness about coming home without the baby is very common.

Mixed feelings sometimes arise from a woman’s past. She may have lost her own mother early or had a poor relationship with her. This might cause her to be unsure about her feelings toward her new baby. She may fear that caring for the child will lead to pain, disappointment, or loss.

Feelings of loss are common after having a baby. This can add to depression. The loss can take many forms:

• Loss of freedom. This can include feelings of being trapped and tied down.


• Loss of an old identity. The mother may be used to someone else taking care of her or of being in control.


• Loss of prepregnancy shape and feelings of having sex appeal.

Lifestyle influences

A major factor in postpartum depression is lack of support from others. The steady support of a new mother’s partner, other family members, or friends is a comfort during pregnancy and after the birth. It helps when others can assume household chores and share in child care. If a woman lives alone or far away from her family, support may be lacking.

Breast-feeding problems can make a new mother feel depressed. New mothers need not feel guilty if they cannot breast-feed or if they decide to stop. The baby can be well nourished with formula. Your partner or other supportive person can help with some of the feedings, giving you more time for yourself or for rest.

The Role of Myths

Women who have an idea of the “perfect mother” are more likely to feel let down and depressed when faced with the needs of day–to–day mothering. Three myths about being a mother are common:

Myth No. 1: Motherhood Is Instinctive. First-time mothers often believe that they should just know how to care for a newborn. In fact, new mothers need to learn mothering skills just as they learn any other life skill. It takes time and patience. It takes reading child care books, watching skilled child caregivers, and talking with other mothers. As a mother’s skills grow, she will become more sure of herself.

Mothers also may believe that they must feel a certain way toward their newborns or they are not “maternal.” In fact, some women feel very little for their infants at first. Mother love, like mothering skills, does not just happen. Bonding often takes days or even weeks. When the special feelings of motherhood begin to emerge, they should be nurtured.

Myth No. 2: The Perfect Baby. Most women dream about what their newborns will look like. When the baby arrives, it may not match the baby of their dreams.

Also, babies have distinct personalities right from birth. Some infants are easier to care for. Others are fussy, have upset stomachs, and are not easy to comfort. A new mother may find it hard to adjust to the baby.

Myth No. 3: The Perfect Mother. For some women, being perfect is a never-ending goal. A mother may think she is not living up to the ideal. She may feel that she is a failure.

Of course, no mother is perfect. It is not true that every woman can “have it all.” Most women have trouble finding a balance between caring for a new baby and keeping up with household duties, other children, and a job. They often feel this way even with a lot of support.

Risk factors

Postpartum depression can develop after the birth of any child, not just the first. The risk increases if:

• You have a history of depression, either during pregnancy or at other times


• You had postpartum depression after a previous pregnancy


• You've experienced stressful events during the past year, including illness, job loss or pregnancy complications


• You're having problems in your relationship with your spouse or significant other


• You have a weak support system


• You have financial problems


• The pregnancy was unplanned or unwanted

The risk of postpartum psychosis is higher for women who have bipolar disorder.

Complications

Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems. Children of mothers who have untreated postpartum depression are more likely to have behavioral problems, such as sleeping and eating difficulties, temper tantrums and hyperactivity. Delays in language development are more common as well.

Untreated postpartum depression can last up to a year or longer. Sometimes untreated postpartum depression becomes a chronic depressive disorder. Even when treated, postpartum depression increases a woman's risk of future episodes of major depression.

Treatments and drugs

Treatment and recovery time vary, depending on the severity of your depression and your individual needs.

Baby blues

The baby blues usually fade on their own within a few days to weeks. In the meantime, get as much rest as you can. Accept help from family and friends. Connect with other new moms. Avoid alcohol, which can make mood swings worse. If you have an underactive thyroid, your doctor may prescribe thyroid medication.

Postpartum depression

Postpartum depression is often treated with counseling and medication.

• Counseling. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health professional. Through counseling, you can find better ways to cope with your feelings, solve problems and set realistic goals. Sometimes, family or relationship therapy also is helpful.


• Antidepressants. Antidepressants are a proven treatment for postpartum depression. If you're breast-feeding, it's important to know that any medication you take will enter your breast milk. However, some antidepressants can be used during breast-feeding with little risk of side effects for your baby. Work with your doctor to weigh the potential risks and benefits of specific antidepressants.


• Hormone therapy. Estrogen replacement may help counteract the rapid drop in estrogen that accompanies childbirth, which may ease the signs and symptoms of postpartum depression in some women. Research on the effectiveness of hormone therapy for postpartum depression is limited, however. As with antidepressants, weigh the potential risks and benefits of hormone therapy with your doctor.

With appropriate treatment, postpartum depression usually goes away within a few months. In some cases, postpartum depression lasts up to a year. It's important to continue treatment after you begin to feel better, however. Stopping treatment too early may only lead to a relapse.

Postpartum psychosis

Postpartum psychosis requires immediate treatment, often in the hospital.

When your safety is assured, a combination of medications — such as antidepressants, antipsychotic medications and mood stabilizers — may be used to control your signs and symptoms. Sometimes electroconvulsive therapy (ECT) is recommended as well. During ECT, a small amount of electrical current is applied to your brain to produce brain waves similar to those that occur during a seizure. The chemical changes triggered by the electrical currents can reduce the symptoms of depression, especially when other treatments have failed or when you need immediate results.

Treatment for postpartum psychosis can challenge a mother's ability to breast-feed. Separation from the baby makes breast-feeding difficult, and some medications used to treat postpartum psychosis aren't recommended for women who are breast-feeding. If you're experiencing postpartum psychosis, a team of health care providers will help you work through these challenges.

Lifestyle and home remedies

Postpartum depression isn't generally a condition that you can treat on your own — but you can do some things for yourself that build on your treatment plan. In fact, taking good care of yourself can help speed your recovery.

• Make healthy lifestyle choices. Include physical activity, such as a walk with your baby, in your daily routine. Eat healthy foods, and avoid alcohol.


• Focus on little things to look forward to during the day. This might be a hot shower, relaxing bath, walk around the block, or visit with a friend.


• Read something uplifting. Since depression may make it difficult to concentrate, choose something light and positive that can be read a bit at a time.


• Indulge in other simple pleasures. Page through a magazine, listen to music you enjoy, sip a cup of tea.


• Rest. Give your child a quiet place to sleep, and try to rest when the baby does.


• Set realistic expectations. Don't pressure yourself to do everything. Scale back your expectations for the perfect household. Do what you can and leave the rest. Ask for help when you need it.


• Make time for yourself. If you feel like the world is coming down around you, take some time for yourself. Get dressed, leave the house, and visit a friend or run an errand. Or schedule some time alone with your partner.


• Avoid isolation. Talk with your partner, family and friends about how you're feeling. Ask other mothers about their experiences. Ask your doctor about local support groups for new moms or women who have postpartum depression.


• Be patient. Know that it may take time to feel better and take one day at a time.


• Be optimistic. Try to think of small things you're grateful for.

Remember, the best way to take care of your baby is to take care of yourself.

Prevention

If you have a history of depression — especially postpartum depression — mention it to your doctor as soon as you find out you're pregnant. Your doctor will monitor you closely for signs and symptoms of depression. Sometimes mild depression can be managed with support groups, counseling or other therapies. In other cases, antidepressants are recommended — even during pregnancy.

After your baby is born, your doctor may recommend an early postpartum checkup to screen for signs and symptoms of postpartum depression. The earlier postpartum depression is detected, the earlier treatment can begin. If you have a history of postpartum depression, your doctor may recommend antidepressant treatment immediately after delivery.

Post Partum Depression for Male

Although many people know that new moms are at increased risk of depression following the birth of a child, new research suggests that about 10 percent of new dads experience the "baby blues," too.

What's more, the researchers found that if the mother experiences postpartum depression, the father is more apt to be depressed also, which puts the baby at a significantly greater risk of developing emotional, behavioral and developmental problems later on, according to the study.

"Pre- and postnatal depression in men is real. The overall rate of depression in fathers was 10.4 percent in our analysis, about twice what we would expect in the general population of men," said the study's lead author, James Paulson, an associate professor and clinical psychologist at Eastern Virginia Medical School in Norfolk.

Sources and Additional Information:

http://www.mayoclinic.com/health/postpartum-depression/DS00546

http://www.nlm.nih.gov/medlineplus/news/fullstory_98910.html

http://kidshealth.org/parent/emotions/feelings/ppd.html

http://www.emedicinehealth.com/postpartum_depression/article_em.htm

http://www.acog.org/publications/patient_education/bp091.cfm

Adlerian Therapy against Depression

Overview

Adlerian psychotherapy was founded by Alfred Adler (an ex-associate of Freud who rejected Freud's notion that sex is the root of all psychological problems.) It takes a positive view of human nature: We are all goal-oriented creatures who are striving for social connectedness, and we are in control of our destiny. Many personal difficulties, Adler believed, stem from feelings of inferiority-he in fact coined the term "inferiority complex."

An Adlerian therapist will identify, explore, and challenge a client's current beliefs about their life goals. He or she will gather family history and will use information about a client's behavior patterns to help the client set new, socially satisfying, and attainable goals. These could relate to any realm of life and could include developing parenting or marital skills, or ending substance abuse. Once these healthier objectives are set, the therapist may also assign homework, set up contracts with the client, and make suggestions on how the client can reach his or her new goals.

Probably, the most influential contribution Adler has made was his emphasis on birth order and sibling relationships. This emphasis propelled him to focus his therapeutic approach in family relationships. This approach was labeled “family constellation”, which gathers information on the client’s immediate family member, such as parents, brothers and/or sisters, and others living in their house. A summary and interpretation of this information portrays how the client interacts with the social world.

The Adlerian therapy focuses on spotting concerns or issues revolving around unrealistic ambitions or lack of confidence. The therapist also discovers the successes and failures the client has gone through and how these experiences have affected him or her. The diagnostic tool of early recollections is also practiced. With this method, the client narrates early childhood incidents that keep on happening again and again. According to Adler, these recollections describe how an individual sees himself or herself and what he or she envisions for the future. After gathering this information, the therapist then develops a lifestyle assessment, or the main targets of therapy.

It is a guideline for Adlerian therapists to guide the client in exploring his or her strength, rather than revealing his or her weaknesses. Therapists use an objective interview that inquires about the beginning of the client’s problems, the client’s medical history, the client’s purpose for engaging in therapy, and the person’s coping mechanisms. Indeed, based on this approach, therapists or counsellors are “lifestyle investigators”.

Questions about family environment have likewise been included in the techniques. The family issues include the client’s similarity or dissimilarity with the parents and other siblings, parents’ treatment of the children and discipline in the home. Early recollections are also practiced, commonly starting with the line, “Tell me something that happened one time.” This narration is further interpreted by the therapist, according to the client’s perception of the event. Personality priorities are also interpreted based on the four behavioral patterns of superiority, control, comfort, and aim to please.

Adlerian Therapy Focus for Depression Treatment

- Emphasis is placed on the importance of the feelings of self that arise from conflicts and interactions

- The sense of self being the central core of personality is also stressed

- The relationship of ego being the core personality of a person is another focus of the therapy

- It starts from psychoanalysis

- Great emphasis is placed on motivation and social interaction 

How Adlerian Therapy works?

The goal of Adlerian Therapy is to challenge and encourage the clients' premises and goals, to encourage goals that are useful socially and to help them feel equal. These goals may be from any component of life including, parenting skills, marital skills, ending substance abuse, and most anything else.

The Adlerian therapist provides a supportive, accepting environment that can help you build trust, hope and confidence. This can be achieved in a non-judgmental, non-labeling context where the client is stimulated (or irritated) into thoughts and actions which strive for a positive, balanced, connected, competent and creative approach to self and others. The therapists may also assign homework, setup contracts between them and the client, and make suggestions on how the client can reach their goals.

Adlerian Play Therapy

Adlerian Play Therapy is a component of the complete program of Adlerian Therapy. Although Adlerian Play Therapy may work a little different because it is geared to appeal to children, the concept is the same. In Adlerian Therapy sessions, the therapist will focus on and examine the lifestyle of the client and try to form a mutual respect and trust with the client. They will then mutually set goals as the therapist provides encouragement and makes suggestions on how the client can reach those goals. The therapist will also provide the encouragement for the client to make the changes that will assist him or her in attaining the goals that have been set.  

In the case of children, they are not always perceptive to opening up and talking about their feelings, and without this very important part of lives being revealed, it’s difficult for a therapist to help solve the problem that may be plaguing the child. As a result, a systematic approach to therapy was developed called Adlerian Play Therapy and is used in combination with the Adlerian Therapy. Children, being as they are, do not like the idea of anyone trying to find out why they act a certain way, or what happened to make them the way they are. They are very timid little creatures when it comes to the way they feel inside and why they feel that way. I am sure many parents have heard their children say, “I’m not saying anything. I don’t like talking to strangers.” It becomes difficult for a parent who is trying to get to the root a problem with her child’s behavior or the way her child thinks. 

What is the solution and how do you help a child who refuses to open up? That’s where the concept of Adlerian Play Therapy steps in. Your child doesn’t want to talk to a stranger, and no matter what you do, he or she just won’t open up and talk. With the Adlerian Play Therapy concept, the child is “fooled” into opening up because the session is conducted during a course of playtime with the therapist. By playing together and developing a sense of being on the child’s level, he or she opens up without even realizing it.

Methodology

Adler taught that a client’s life-style can be viewed as a personal mythology. These mythologies are true for the individual and so the individual acts accordingly. These mythologies are “truths” and “partial truths,” but they can also be myths that one confuses for truths. Adler calls these basic mistakes. Look at common overgeneralizations, such as “people are hostile”, “life is dangerous” as well as misperceptions of life, “life doesn’t give me any breaks”, are all myths that one confuses for truth. These mythologies or life-styles are expressed in the client’s physical behavior, language, dreams, interpretations, etc. The intervention in Adlerian therapy is reeducation and reorientation of the client to myths that work “better”.

Concept of Change/Development According to Adler's theory of change, the therapist uses a variety of strategies that help the client to identify his specific needs. The client is unique; therefore, the technique used must fit the situation of the client. Thinking, feeling, emotion and behavior can only be understood as subordinated to the individual's style of life, or consistent pattern of dealing with life. The individual is not internally divided or the battleground of conflicting forces. Adler believed that humans possess the freedom to act, determine our fate, determine our personality, and affect our style of life.

The goal of the therapy is to stimulate cognitive, affective and behavior change. Although the individual is not always fully aware of their specific goal, through analysis of birth order, repeated coping patterns and earliest memories, the psychotherapist infers the goal as a working hypothesis. The client approaches control of feelings and emotions. First, the client recognizes what kind of feeling he or she is having (angriness, sadness, frustration, etc). Once the client sees and knows the feeling; then he or she will try to imagine or think of something pleasant that had happened to him or her, replacing the bad feeling for a good one. By doing this, the client is in control of his or her emotions and can change the mood only by thinking differently. It is believed by Adlerians that thinking different thoughts can effectively change mood states.

The client is helped by the therapist to see life from another perspective. The client tries to put him or herself into another role. Change occurs when the client is able to see his or her problem from another view, so he or she can explore and practice new behavior. As the therapist explores the thinking, feeling and acting of the client, he or she directs the client into a new philosophy of life. Thus, the client is able to think about a new philosophy of life. He or she makes decisions and conclusions about his or her own life.

Adlerian psychotherapy can be broken down into three basic phases: 1) Understanding he specific style of life of the patient, 2) Explaining the patient on himself or herself, and 3) Strengthening the social interest in the patient. It attempts to bring each individual to an optimal level of personal, interpersonal, and occupational functioning. The objective of therapy is to replace exaggerated self-protection, self-enhancement, and self-indulgence with courageous social contribution.

Tools and Techniques Once the initial analysis has been completed and goals for treatment have been set, Adlerians employ a variety of techniques to encourage individuals to move forward and elicit change. Most of the techniques are action-oriented, focusing on facilitating life-style changes while working to help the individual learn to counteract discouragement, enhancing self-efficacy and increasing self-esteem. Treatment may occur in the form of multiple psychotherapy (whereby several therapists treat a single patient), individual psychotherapy, and/or group therapy.

Within the therapeutic relationship, the therapist is said to represent values the patient may attempt to imitate. In serving as models for their patients, Adlerian therapists therefore characterize themselves as “being for real”- genuine, fallible, and able to laugh at themselves. An emphasis on humor as an important asset is frequently utilized in treatment since “if one can occasionally joke, things cannot be so bad”. Other verbal techniques include giving advice while taking care to discourage dependency; frequent use of encouragement and support; and utilizing language that avoids moralizing by referring to behaviors as “useful” and “useless” as opposed to “good” and “bad”.

Some of the more action-oriented techniques include creative and dramatic approaches to treatment such as role-play, the empty-chair, acting “As if”, and psychodrama. Other techniques include task setting, creating images, catching oneself, and the Push-Button Technique. Dramatic techniques such as Role-play, the Empty Chair, and Acting “as if”, are all utilized to help the patient practice useful skills and behaviors as they “try on” new roles and styles of living. While these techniques provide valuable opportunities for patients to rehearse new life-skills, they also allow for the patient to make choices as to which roles they wish to discard, and which they wish to use in their everyday life. Psychodrama is technique that occurs exclusively in a group setting, whereby the internal struggles of a single patient (or “protagonist”) are worked though dramatically. The process occurs with the active participation (and support) of other members of the group who are employed by the protagonist to represent challenging aspects of his or her inner life, while he or she attempts to move “successfully” through it.

Creating images is another technique utilized by Adlerians in eliciting change. Based on the premise that “one picture is worth a thousand words”, patients are given (or generate) images to describe themselves. Use of this technique maintains that remembering this image, the patient can remember goals, and in later stages, can learn to use the image to laugh at oneself.

The Push-Button Technique also utilizes the patients’ own imagination in service of therapeutic goals. After being instructed to call upon two specific life experiences- one pleasant experience and one unpleasant experience- patients are encouraged to focus on the feelings each of these incidents evoke. This process is utilized to teach patients that they can create whatever feeling they wish by deciding what they think about. As a result, the patient finds that he is the creator, not the victim of his emotions, and the power of self-determination is enhanced.

Sources and Additional Information:

http://therapists.psychologytoday.com/rms/content/therapy_methods.html

http://www.healthster.co.uk/adlerian-therapy/

http://www.depression-guide.com/adlerian-therapy.htm

http://www.depression-doctor.com/adlerian-therapy.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

Robert Sapolsky Lecture on Depression

We've all felt a little blue, down in the dumps, or just plain sad. But when a serious depression sets in, it could be weeks, months or even years before the feeling lifts. It is your enemy, and consider your fight with depression seriously. Learn more about the illness, learn more about yourself, and you will be able to develop an action plan of how to win the fight and become healthier, happier, and in harmony with your soul and body.

During a recent workshop presented by Stanford's Faculty and Staff Help Center, biologist Robert Sapolsky talked about the biological and psychological causes of depression, how to recognize its symptoms and how to handle the disease.

Robert Sapolsky on Depression

Depression is the world's fourth leading cause of disability and is on track to be second only to obesity-related disorders by 2025, Sapolsky said.

"Depression is incredibly pervasive and thus important to talk about," he said. "Depression is like the worst disease you can get. It's devastating."

Lecture on Depression from Stanford University

About

Robert Maurice Sapolsky (born 1957) is an American scientist and author. He is currently professor of Biological Sciences, and Professor of Neurology and Neurological Sciences, and by courtesy, Neurosurgery, at Stanford University. In addition, he is a research associate at the National Museums of Kenya.

Chocolate against Stress and Depression

Researchers have found that chocolate can make some people who are prone to depression less anxious and less irritable. There is a downside, as the chocolate is laden with fat and sugar. Several recent studies provided the scientific background to the common knowledge that chocolate has a definite upside as an anti-depressant.

A study of 3,000 people by the Black Dog Institute found 45 per cent of people with depression craved chocolate. "Of those 45 per cent, 60 per cent found that the chocolate improved their mood when they were depressed," Joanne Crawford, study co-author said.

Researchers found that among the depressed, those who were anxious or worriers were more likely to benefit from the sweet treats. They believe it is the endorphins and opoids in chocolate which make people feel more relaxed. "The opoids are morphine-like and lower pain and that also flows through into mental wellbeing," Professor Gordon Parker from the Black Dog Institute said.

Swimming star John Konrads battled depression, often turning to chocolate when he felt low. "I thought it was a pick-me-up, almost like a cup of coffee, but to hear that it's a soother makes sense to me with hindsight," he said.

While it is too early for doctors to start prescribing chocolate for depression, this study does prove that it has tangible benefits in fighting mood disorders. "I think this will be reassuring to many people who will say this just merely confirms what I have found out over the years," Professor Parker said.

The only caveat is that even as an anti-depressant, when it comes to chocolate, moderation is the key.

Another study showed  that 40 grams of dark chocolate per day reduces the urinary excretion of the stress hormone cortisol and it almost normalizes the stress related differences in energy metabolism and gut microbial activities between participants with low and high anxiety traits. Already after one week metabolic changes were evident in the metabolic profiles of participants compared to the baseline analyses. This became more significant after two weeks of dark chocolate at 40 grams per day. The metabolic changes in both endogenous and gut microbial metabolism were evident.

Comparing the groups with low and high anxiety traits revealed a decreased level of urinary stress hormone levels in the participants with high level trait anxiety after two weeks of dark chocolate. This study strongly suggests potential beneficial implications of dark chocolate consumption for reduction of mental and/or physical stress and improvement of the metabolic response to stress. 

How Can Chocolate Really Help Depression Symptoms?

The carbohydrates in chocolate increase neurotransmitters, such as: serotonin, dopamine and phenylethylamine, which alleviate depression, and give general feelings of well-being. Cocoa also contains M A O inhibitors (monoamine oxidase inhibitors) which help prolong the benefits of neurotransmitters. Cocoa also raises endorphins, which increase pleasure and lessen pain.

The vitamins found in cocoa are:

- Vitamins B1,2,3,5, and 11 which, in conjunction with other vitamins, help release energy from food, and aid the formation of the body's defenses.

- Vitamin D which helps the uptake of calcium and phosphorus, good for teeth and bones.

- Vitamin E has antioxidant properties, helps build muscle, and promotes the production of red blood cells, and protects cell walls.

All these benefits come from pure cocoa, or dark chocolate, the higher cocoa percentage, the better. Chocolate with 80% cocoa, or higher, is perfect. Though of course, the higher the cocoa percentage, the more bitter the taste.

This pure chocolate, and Cocoa itself, will give you all these benefits. Although to the real chocolate lover, even milk chocolate will give them a good feeling. Just its texture, the smooth silkiness in the mouth, will give feelings of pleasure.

Limitations

Most of the studies concluded that the chocolate’s advantages on mood are thought to be short-lived, a momentary band-aid to a bigger difficulty. While chocolate may lift up your mood at first, it rapidly wears off. So, be careful to increase your dose to get the better anti-depressant effect. Otherwise, the positive influence of this “happy food” can be converted for the significant harm to your health.

Sources and Additional Information:

http://www.abc.net.au/news/stories/2007/10/02/2049304.htm

http://www.shockmd.com/2010/03/16/chocolate-against-stress/

http://hubpages.com/hub/chocolateanddepression

http://generalmedicine.suite101.com/article.cfm/chocolate-a-mood-food-that-eases-depression

http://www.healblog.net/medical/can-be-chocolate-linked-to-depression/