1. B vitamins. This is crucial. The B vitamins are for your mental health. When you are deficient, you will suffer. B1 (thiamine) turns glucose into fuel. If you lack B1, you will suffer with fatigue- which can turn to depression. B3 (niacin)- a defeciency of B3 can cause Pellegra which produces psychosis and dementia. It can also cause extreme anxiety. B5 (pantothenic acid) assists in the uptake of amino acids to the brain. A lack of this vitamin will cause severe depression. B6 (pyrodoxine) is needed to process seratonin (the chemical that produces the 'happy feeling'), melatonin (the chemical that assists in sleeping), and dopamine (essential for the normal functioning of the nervous system). B12- This one is near and dear to me. Being a vegetarian makes it much harder for me to get enough B12 and so it is basically necessary for me to take a supplement (which I haven't been doing lately and now I'm extremely bitchy- I'm off to the drug store at lunch!). B12 deficiency causes pernicious anemia. The symptoms are mood swings, paranoia, dizziness, irritability, hallucinations, dementia, mania, appetite loss, heart palpatations, shortness of breath, and tingling extremeties. This is a VERY important vitamin. In addition to your important B vitamins- I would also advise an uptake in vitamin C, Iron, Zinc, Potassium, Calcium, and Manganese.
2. Drink MORE WATER!!! I think the majority of the population is dehydrated. Dehydration can cause fatigue, decreased brain activity (your brain is 85% water), and it can also cause severe headaches. The one thing that throws me into depression easily is fatigue. I am the sort of person that wants to be going going going. When I am fatigued, I feel absolutely useless. Being dehydrated increases your level of fear and anxiety.People often mistake being 'hungry' when they are actually 'thirsty'. When you are thirsty- your body is craving water. People tend to overeat when they are dehydrated which can cause you to be overweight. People who are overweight have a higher chance of dealing with depression.I would say a good rule is if you're not going #1 six times a day, you should probably drink some more water.
3. Listen to uplifting music! When you are in a funk, listening to sad music is just going allow you to wallow in your sorrow. Which brings me to...
4. Dance! Dancing around your living room in your pjs is just going to make you laugh at yourself. You can't be sad then ; )
5. Get plenty of exercise. Taken from MayoClinic:"Research suggests that it may take at least 30 minutes of exercise a day for at least three to five days a week to significantly improve symptoms of depression. However, smaller amounts of activity — as little as 10 to 15 minutes at a time — have been shown to improve mood in the short term. "So, small bouts of exercise may be a great way to get started if it's initially too difficult to do more," Dr. Vickers-Douglas says.Just how exercise reduces symptoms of depression and anxiety isn't fully understood. Researchers believe that exercise prompts changes in both mind and body.Some evidence suggests that exercise postively affects the levels of certain mood-enhancing neurotransmitters in the brain. Exercise may also boost feel-good endorphins, release tension in muscles, help you sleep better and reduce levels of the stress hormone cortisol. It also increases body temperature, which may have calming effects. All of these changes in your mind and body can improve such symptoms as sadness, anxiety, irritability, stress, fatigue, anger, self-doubt and hopelessness."When I was dealing with horribly severe anxiety, exercize helped me tremendously. I got to the point where I was becoming agoraphobic (wouldn't leave the house unless absolutely necessary), and I was also struggling with falling asleep at night. I would lay in bed and have tremors and anxiety attacks until I would eventually pass out from sheer exhaustion, only to have to wake up a couple hours later for work. This is no way to live people!!! When I began my exercise routine (which I should get back on top of!), I slowly began to fall asleep more easily. That with the help of valerian root tea got me back on track.
6. BELIEVE in the power of positive thinking. It is a very real, and very powerful thing. YOU can make things happen and change your life, and knowing you have that control is very uplifting. You need to change the way you're looking at your current situation and change the way you're processing your thoughts. Let's have a couple of examples:During my extreme anxiety, I was always afraid I was going to have an anxiety attack, and I was afraid they were never going to go away. These thoughts crossed my mind many times throughout a day. Everytime I was thinking these thoughts, I was just confirming that they were indeed going to happen. I suffered for 4-5 years because of this. Towards the end, I got to the point where I just REFUSED to live like that any longer. I started telling myself, I DO NOT SUFFER FROM ANXIETY ANY MORE. I WILL NOT SUFFER FROM ANXIETY ANY MORE. I told myself that it was all in my head, and that everything is ok (because it was, and it is!). By replacing my fear of anxiety with the affirmation that I do not suffer from anxiety, I banished my attacks. I have not suffered in about 2 years now. It is gone. Let's use a depression example:Perhaps your significant other has left you. This is a big one for everyone, so I thought it would be a good example. It's bound to at best upset you, at worst send you into a depression. Change is so hard sometimes, but you need to look at it in a positive light (even something as 'negative' and hard as a significant other leaving). As cliche as it sounds, I really enjoy the saying 'everything happens for a reason'. You have to believe this with unwaivering faith. Everything does happen for a reason, and I'm sure your s.o. left because your soul mate is right around the corner. What if you missed him/her because you were in the wrong relationship??!!! See how easy that was? ; )Affirmations are always good as well. Pick a mantra and repeat it over and over. Perhaps (for this example):* I enjoy being independent and having the freedom to always do what I want to do. Isn't that a great positive spin?? And better yet, it's true!
7. Keep a gratitude journal. This is sort of an add on to #6...Enter in your journal every night 10 reasons why you are blessed and grateful. This will remind you of the good things you're not focusing on when you're looking at the things that are making you sad.
8. Get out in the sun!!! Try to get outside and go to the beach, walk to the park, go hiking, go boating, go camping... Anything to get some fresh air and some sunlight. If it's winter, try skiing, snowboarding, snow shoe-ing (how the hell do you spell that???), intertubing, ice skating... Being outdoors even during cloud cover still gives you the benefits of being in the sun. This often times also goes hand in hand with #5.
9. Spend some time with a good friend. Do something fun, even if you don't think you feel like it. Try to find something that wont allow you to focus on anything upsetting. My votes are going for pie at a hole in the wall restaurant and having a good chat, go out dancing (this covers #3, #4, #5!), go to a great concert, see if there are any listings for local theatre (I mean live theatre, not movie theatre- which I don't suggest personally), go get tattoos!!!!, treat yourself to a spa facial or massage (or both!).
10. If you feel the need, try out a good herbal supplement for depression/anxiety before going head-first into using anti depressants. I highly suggest 5-HTP (which I had a Dr. confirm as 100% safe, and I found 100% effective), St. John's Wart (never worked for me, but some people swear by it), melatonin supplements (aid in falling asleep and also a mood elevator- try not to take right before work!), Valerian root extract (Valium was patterned after valerian root...just a little fun fact for the day!)
I hope this is beneficial for someone. Depression and anxiety can literally ruin your life, so don't let it any longer! I feel for people on anti depressants thinking that it is going to cure them. I've never seen a single person cured by anti depressants (or honestly even helped much), and that's because they're not a cure. They don't attack the root cause of your depression. Find the root cause and fix it! Your life is worth enjoying!
from http://questioning--everything.blogspot.com/
Tuesday, March 13, 2007
Depression Treatment: Cannabis
Decreased Depression In Cannabis Users, Study Says
Los Angeles, CA: Adults who use cannabis report suffering from less severe incidents and/or symptoms of depression than non-users, according to survey data published last month in the journal Addictive Behaviors.
Researchers at the University of Southern California analyzed survey results from 4,400 adults who had completed The Center for Epidemiologic Studies Depression scale (a numerical, self-report scale designed to assess symptoms of depression in the general population). Authors compared "depression scores" among those who consumed cannabis daily, once a week or less, or never in their lives.
"Despite comparable ranges of scores on all depression subscales, those who used once per week or less had less depressed mood, more positive affect, and fewer somatic (physical) complaints than non-users," authors wrote. "Daily users [also] reported less depressed mood and more positive affect than non-users."
Authors further noted that a separate analysis of medical cannabis users versus recreational users "demonstrated that medical users reported more depressed mood and more somatic complaints than recreational users, suggesting that medical conditions clearly contribute to depression scores and should be considered in studies of marijuana and depression.
"These data suggest that adults apparently do not increase their risk for depression by using marijuana," researchers concluded.
from http://www.norml.org/
Los Angeles, CA: Adults who use cannabis report suffering from less severe incidents and/or symptoms of depression than non-users, according to survey data published last month in the journal Addictive Behaviors.
Researchers at the University of Southern California analyzed survey results from 4,400 adults who had completed The Center for Epidemiologic Studies Depression scale (a numerical, self-report scale designed to assess symptoms of depression in the general population). Authors compared "depression scores" among those who consumed cannabis daily, once a week or less, or never in their lives.
"Despite comparable ranges of scores on all depression subscales, those who used once per week or less had less depressed mood, more positive affect, and fewer somatic (physical) complaints than non-users," authors wrote. "Daily users [also] reported less depressed mood and more positive affect than non-users."
Authors further noted that a separate analysis of medical cannabis users versus recreational users "demonstrated that medical users reported more depressed mood and more somatic complaints than recreational users, suggesting that medical conditions clearly contribute to depression scores and should be considered in studies of marijuana and depression.
"These data suggest that adults apparently do not increase their risk for depression by using marijuana," researchers concluded.
from http://www.norml.org/
Depression Treatment: Drugs (Marijuana & Psychedelics)
much respect for you, the shaman of the next generation. I have an EXTREME fascination w/ psychedelics and have done acid and shrooms a good amount of times. at first, when i was young, i had fun. now i always get caught in that grey, quiet, depressive state where all feels absolutely HOPELESS. i also have short bursts of this intense hoplessness feeling when sober now(spilt-second flashback?). i smoke weed everyday and am caught up in the "should i be smokin everyday" loop of depression. i guess my question is this. I have a good amount of problems, is it realistic to try and deal w/ these problems w/ psychedelic use? or should i deal w/ the depression through yoga and meditation? Should i quit weed while working on the self, or at least cut down? Does marijuana perpetuate my depression? Will psychedelics do more bad than good while you are depressed?
i am 20, and have probably been depressed for about 5-6 years. i have social anxiety disorder and have not responded to prozac, but haven't been very proactive in dealing with my problems. Any advice you can give me about depression that isn't well known would be very helpful. I'd also like to know if salvia is worth trying. thank you very much.moonchild
Moonchild,
Cannabis and psychedelic drugs are NOT anti-depressants, and should NOT be used to solve emotional problems. And yes, they can make things worse. You say you've been depressed for 5-6 years. Have you been smoking pot that long? If so there might be a connection!
Everyday use of marijuana really gets you in a rut, and the more you use, the deeper the rut. Get it? You can get so low you can't even see above the ditch you've dug. So why not stop? Any change of mind will probably be a big improvement. Oh you might get a little more depressed for a couple of days when you first stop, but then, THEN, you'll start feeling more alive than you have in a long time. This is the point at which you must be careful. I've learned that when you start to "feel good" naturally, it's like getting high, but that often kicks in a "I feel great, let's get high" syndrome that starts you smoking again. That's the hard one to get beyond. But once you do, you may find yourself with more energy and more motivated than usual. Then you must focus that energy on something fun and productive. So plan out what you're going to do when you get straight, and psyche yourself to do it! Either go back to school, or get a new job, or take that trip, whatever, just take advantage of your newfound zest. Then you won't need the crutch of drugs to define your daily life.
Yoga and meditation are excellent for improving your mental and physical condition, which could be a large part of your depression.
If you can manage that, and learn how to keep yourself straight when you need or want to be straight, then perhaps you can approach cannabis again as a therapeutic or recreational drug, not as a dependency.
If you cannot manage the above prescription, then you really should seek outside help (as you've just done by writing me!). Why be miserable, when you should be enjoying life?
I highly recommend you DON'T use salvia until your depression is cleared up! It won't help!
Wishing you Health & Happiness,The Old Hippy
from http://www.hippy.com/
i am 20, and have probably been depressed for about 5-6 years. i have social anxiety disorder and have not responded to prozac, but haven't been very proactive in dealing with my problems. Any advice you can give me about depression that isn't well known would be very helpful. I'd also like to know if salvia is worth trying. thank you very much.moonchild
Moonchild,
Cannabis and psychedelic drugs are NOT anti-depressants, and should NOT be used to solve emotional problems. And yes, they can make things worse. You say you've been depressed for 5-6 years. Have you been smoking pot that long? If so there might be a connection!
Everyday use of marijuana really gets you in a rut, and the more you use, the deeper the rut. Get it? You can get so low you can't even see above the ditch you've dug. So why not stop? Any change of mind will probably be a big improvement. Oh you might get a little more depressed for a couple of days when you first stop, but then, THEN, you'll start feeling more alive than you have in a long time. This is the point at which you must be careful. I've learned that when you start to "feel good" naturally, it's like getting high, but that often kicks in a "I feel great, let's get high" syndrome that starts you smoking again. That's the hard one to get beyond. But once you do, you may find yourself with more energy and more motivated than usual. Then you must focus that energy on something fun and productive. So plan out what you're going to do when you get straight, and psyche yourself to do it! Either go back to school, or get a new job, or take that trip, whatever, just take advantage of your newfound zest. Then you won't need the crutch of drugs to define your daily life.
Yoga and meditation are excellent for improving your mental and physical condition, which could be a large part of your depression.
If you can manage that, and learn how to keep yourself straight when you need or want to be straight, then perhaps you can approach cannabis again as a therapeutic or recreational drug, not as a dependency.
If you cannot manage the above prescription, then you really should seek outside help (as you've just done by writing me!). Why be miserable, when you should be enjoying life?
I highly recommend you DON'T use salvia until your depression is cleared up! It won't help!
Wishing you Health & Happiness,The Old Hippy
from http://www.hippy.com/
Depression Treatment: Alcohol
A lot of people when faced with chronic stress, anxiety and depression try to cope with these health problems by using alcohol to find relief from their suffering. While alcohol may aid relaxation in small amounts and used in the short term, in the long term it is one of the worst things you could do, for in the end it can actually increase the severity of the symproms of stress, anxiety and depression. You end up having to consume ever higher and higher amounts of alcohol in order to sustain its effects and as a result excess alcohol can cause or exacerbate a wide range of psychological and physiological health problems besides the inital stress, anxiety and depression.
A report published by the Institute of Alcohol Research said that nearly two million people in the UK have an alcohol problem and can't get through a day without consuming alcohol. Alcohol is regarded as being socially acceptable to consume but in reality it is a drug and has widespread negative effects on our biochemistry when consumed in excess levels. Ask many people and they will cite that they are concerned over the level of drug abuse in modern society, yet twice as many people are addicted to alcohol compared to other drugs.
Research indicates that consuming excess alcohol can be a factor in causing health problems like chronic stress, anxiety and depression. So in order to recover our optimal psychological health it is absolutely vital that we reduce our alcohol to currently recommended limits. If you are consuming excess levels it would be wise to contact one of the alcohol organisations to help you to withdraw.
In the final analysis alcohol doesn't solve problems, in fact it creates more problems that you have to deal with. Consuming alcohol to help us deal with our problems is the equivalent of pouring petrol onto a fire in order to put the fire out. You don't have to totally abstain from alcohol but its vital for wellbeing to keep consumption to within safe limits.
NEGATIVE EFFECTS OF ALCOHOL ON BRAIN AND BODY BIOCHEMISTRY
Alcohol can and does have a potentially powerful and mostly negative effect on brain and body biochemistry if consumed in excess amounts causing or exacerbating stress, anxiety and depression. Alcohol is a chemical stressor and causes the body to release stress hormones like cortisol and if you already have heightened levels of these stress hormones, the alcohol will make them higher. It does this by stimulating the sympathetic nervous system and the adrenal glands.
Alcohol can temporarily raise mood enhancing chemical levels like those of serotonin, this is how it can improve mood, but in excess alcohol makes these serotonin levels fall and lowers mood, increasing depression.
Certain nutrients are needed by the body in order for it to manufacture chemicals that dampen anxiety. Alcohol causes depletion of vitamin B6 and Folic acid, the very nutrients needed for us to be in optimum psychological health enabling us to cope with stress. It also stimulates the release of the stress hormone adrenaline and interferes with the amino acid tryptophan which is used to manufacture serotonin. Serotonin is a chemical involved in sleep and mood regulation.
ALCOHOL AND ANXIETY
Alcohol in small amounts can have a relaxant, anti-anxiety effect and this is why a lot of people use it, however, if you use it in this way you have to consume ever larger amounts to achieve the same effects, as your body gets used to the alcohol, and research has shown that alcohol in excess in the long term can significantly increase our anxiety. Alcohol acts by mimicking the activity and function of the chemicals already present in the brain that help us to relax.
In her book, "Molecules of Emotion", Dr Candace Pert says alcohol binds to GABA receptors in the brain which are used by tranquilizing brain chemicals that have the effect of reducing our anxiety levels, but only in the short term, when we consume alcohol it competes with the natural chemicals that are meant to bind with the GABA receptors, often flooding them and thereby causing them to decrease in sensitivity and/or number and causing them to signal a decrease in peptide secretion. The physiological effects resulting from substance abuse are reversible but it can be a very slow process before the receptors return to their original sensitivity and number and the corresponding peptides get back into body wide production and flow.
Another way in which alcohol can increase anxiety is by its effect on lactic acid. Research indicates that increased lactic acid levels may be an underlying factor in anxiety and panic attacks. The aim is to prevent the conversion of pyruvic acid to lactic acid the the conversion of lactic acid back to pyruvate. Nutrition appears to play a key role according to Dr Melvyn Werback MD, author of Nutritional Influences on Mental Illness, who says that alcohol can be a factor in causing elevated lactate or lactate to pyruvate levels.
ALCOHOL AND DEPRESSION
Alcohol in the short term can boost our serotonin but in the long term excess can actually lower these levels. Excess alcohol can cause or exacerbate depression, it interferes with the amino acid tryptophan which the body needs to produce the mood enhancing chemical called serotonin. Alcohol is also laden with refined sugar which is how it can cause obesity. Research has indicated that high levels of refined sugar can be a factor in causing depression.
Alcohol in excess amounts can lower our mood. A large number of alcoholics have symptoms of depression. As many as 25% of untreated drug and alcohol abusers eventually commit suicide. The late KGB spy Kim Philby once said that drunkeness was the least painful method of suicide. Excess alcohol doesn't solve our problems, it causes more problems for us to deal with, so in order to ease depression it is vital we control our alcohol intake.
ALCOHOL AND PANIC ATTACKS
Some people with panic attacks resort to alcohol to help them cope. Alcohol in the short term can reduce panic symptoms. As many as 10 - 20% of panic sufferers may have an alcohol problem and research has indicated that more than 30% of alcohol abusers had a panic disorder or social phobia before they began to use alcohol in order to find relief from their psychological health problem.
HOW MUCH ALCOHOL IS SAFE?
You don't have to be an alcoholic for alcohol to be a cause of health and social problems in your life. In order to help assess whether you have an alcohol problem, Clinical Psychologist Dr Kevin Gourney in his book, Stress Management, a Guide to Coping, has devised these questions you should ask yourself. You must be honest with yourself when answering them, because its only yourself you will be fooling. Almost 50% of men and 20% of women drink more than the recommended levels. Alcohol can be a very addictive chemical.
1. Do you drink alcohol daily?
2. Has your alcohol tolerance changed, are you drinking more than before to get the same effect?
3. Do you feel guilty because of your drinking?
4. Do you have memory gaps?
5. Do friends comment on the amount you drink?
6. Do you exceed safe drinking limits?
7. Do you sometimes feel shakey after a heavy drinking session?
THE HEALTH EDUCATION AUTHORITY CURRENT GUIDELINES FOR THE LEVEL OF MAXIMUM CONSUMPTION OF ALCOHOL IS:
- 21 units per week for men.
- 14 units per week for women, (But no alcohol if pregnant).
A UNIT OF ALCOHOL REPRESENTS:
- Half a pint of ordinary beer (not strong)
or
- A pub measure of spirit
or
- A normal size glass of wine.
It is important to spread these alcohol units out throughout the week. Some people go on a massive binge and use up the 21 units of alcohol recommended per week, over a day or two, which research has shown to be harmful. If you do feel you have an alcohol problem then you could reduce the impact on stress, anxiety, depression, insomnia by cutting down your intake to current recommended drinking limits.
DISEASES RELATED TO EXCESS ALCOHOL CONSUMPTION
Excess alcohol consumption can cause or worsen a great many pschological, physical and social health problems. Alcohol related disease is such a problem that it has been estimated that up to 20% of all beds on Medical Units in the NHS are taken up by people suffering alcohol related medical health problems. Almost 50% of men and 20% of women drink alcohol to deal with stress, 1:20 people in the UK, that's nearly 2 million people have an alcohol problem and 1:4 people cannot get through the day without alcohol so you are not alone. It is nothing to be ashamed of, excess alcohol is a very treatable problem and there are alternative, safer and more effective ways of dealing with stress, anxiety and depression.
CAUTION
You should always check with your pharmacist if it is safe to consume alcohol with the medication you are on because the side effects can be lethal. It is never wise to consume alcohol and medication because the alcohol can interfere with the effectiveness of some types of medication.
ALCOHOL WITHDRAWL
If you have been using excess alcohol you should not suddenly stop your drinking because if you do it can cause temporary health problems like DTs, exacerbation of your anxiety symptoms and even fits. See your doctor for guidance on withdrawl. By gradually reducing your intake you help to avoid withdrawl symptoms.
from http://stresshelp.tripod.com/
A report published by the Institute of Alcohol Research said that nearly two million people in the UK have an alcohol problem and can't get through a day without consuming alcohol. Alcohol is regarded as being socially acceptable to consume but in reality it is a drug and has widespread negative effects on our biochemistry when consumed in excess levels. Ask many people and they will cite that they are concerned over the level of drug abuse in modern society, yet twice as many people are addicted to alcohol compared to other drugs.
Research indicates that consuming excess alcohol can be a factor in causing health problems like chronic stress, anxiety and depression. So in order to recover our optimal psychological health it is absolutely vital that we reduce our alcohol to currently recommended limits. If you are consuming excess levels it would be wise to contact one of the alcohol organisations to help you to withdraw.
In the final analysis alcohol doesn't solve problems, in fact it creates more problems that you have to deal with. Consuming alcohol to help us deal with our problems is the equivalent of pouring petrol onto a fire in order to put the fire out. You don't have to totally abstain from alcohol but its vital for wellbeing to keep consumption to within safe limits.
NEGATIVE EFFECTS OF ALCOHOL ON BRAIN AND BODY BIOCHEMISTRY
Alcohol can and does have a potentially powerful and mostly negative effect on brain and body biochemistry if consumed in excess amounts causing or exacerbating stress, anxiety and depression. Alcohol is a chemical stressor and causes the body to release stress hormones like cortisol and if you already have heightened levels of these stress hormones, the alcohol will make them higher. It does this by stimulating the sympathetic nervous system and the adrenal glands.
Alcohol can temporarily raise mood enhancing chemical levels like those of serotonin, this is how it can improve mood, but in excess alcohol makes these serotonin levels fall and lowers mood, increasing depression.
Certain nutrients are needed by the body in order for it to manufacture chemicals that dampen anxiety. Alcohol causes depletion of vitamin B6 and Folic acid, the very nutrients needed for us to be in optimum psychological health enabling us to cope with stress. It also stimulates the release of the stress hormone adrenaline and interferes with the amino acid tryptophan which is used to manufacture serotonin. Serotonin is a chemical involved in sleep and mood regulation.
ALCOHOL AND ANXIETY
Alcohol in small amounts can have a relaxant, anti-anxiety effect and this is why a lot of people use it, however, if you use it in this way you have to consume ever larger amounts to achieve the same effects, as your body gets used to the alcohol, and research has shown that alcohol in excess in the long term can significantly increase our anxiety. Alcohol acts by mimicking the activity and function of the chemicals already present in the brain that help us to relax.
In her book, "Molecules of Emotion", Dr Candace Pert says alcohol binds to GABA receptors in the brain which are used by tranquilizing brain chemicals that have the effect of reducing our anxiety levels, but only in the short term, when we consume alcohol it competes with the natural chemicals that are meant to bind with the GABA receptors, often flooding them and thereby causing them to decrease in sensitivity and/or number and causing them to signal a decrease in peptide secretion. The physiological effects resulting from substance abuse are reversible but it can be a very slow process before the receptors return to their original sensitivity and number and the corresponding peptides get back into body wide production and flow.
Another way in which alcohol can increase anxiety is by its effect on lactic acid. Research indicates that increased lactic acid levels may be an underlying factor in anxiety and panic attacks. The aim is to prevent the conversion of pyruvic acid to lactic acid the the conversion of lactic acid back to pyruvate. Nutrition appears to play a key role according to Dr Melvyn Werback MD, author of Nutritional Influences on Mental Illness, who says that alcohol can be a factor in causing elevated lactate or lactate to pyruvate levels.
ALCOHOL AND DEPRESSION
Alcohol in the short term can boost our serotonin but in the long term excess can actually lower these levels. Excess alcohol can cause or exacerbate depression, it interferes with the amino acid tryptophan which the body needs to produce the mood enhancing chemical called serotonin. Alcohol is also laden with refined sugar which is how it can cause obesity. Research has indicated that high levels of refined sugar can be a factor in causing depression.
Alcohol in excess amounts can lower our mood. A large number of alcoholics have symptoms of depression. As many as 25% of untreated drug and alcohol abusers eventually commit suicide. The late KGB spy Kim Philby once said that drunkeness was the least painful method of suicide. Excess alcohol doesn't solve our problems, it causes more problems for us to deal with, so in order to ease depression it is vital we control our alcohol intake.
ALCOHOL AND PANIC ATTACKS
Some people with panic attacks resort to alcohol to help them cope. Alcohol in the short term can reduce panic symptoms. As many as 10 - 20% of panic sufferers may have an alcohol problem and research has indicated that more than 30% of alcohol abusers had a panic disorder or social phobia before they began to use alcohol in order to find relief from their psychological health problem.
HOW MUCH ALCOHOL IS SAFE?
You don't have to be an alcoholic for alcohol to be a cause of health and social problems in your life. In order to help assess whether you have an alcohol problem, Clinical Psychologist Dr Kevin Gourney in his book, Stress Management, a Guide to Coping, has devised these questions you should ask yourself. You must be honest with yourself when answering them, because its only yourself you will be fooling. Almost 50% of men and 20% of women drink more than the recommended levels. Alcohol can be a very addictive chemical.
1. Do you drink alcohol daily?
2. Has your alcohol tolerance changed, are you drinking more than before to get the same effect?
3. Do you feel guilty because of your drinking?
4. Do you have memory gaps?
5. Do friends comment on the amount you drink?
6. Do you exceed safe drinking limits?
7. Do you sometimes feel shakey after a heavy drinking session?
THE HEALTH EDUCATION AUTHORITY CURRENT GUIDELINES FOR THE LEVEL OF MAXIMUM CONSUMPTION OF ALCOHOL IS:
- 21 units per week for men.
- 14 units per week for women, (But no alcohol if pregnant).
A UNIT OF ALCOHOL REPRESENTS:
- Half a pint of ordinary beer (not strong)
or
- A pub measure of spirit
or
- A normal size glass of wine.
It is important to spread these alcohol units out throughout the week. Some people go on a massive binge and use up the 21 units of alcohol recommended per week, over a day or two, which research has shown to be harmful. If you do feel you have an alcohol problem then you could reduce the impact on stress, anxiety, depression, insomnia by cutting down your intake to current recommended drinking limits.
DISEASES RELATED TO EXCESS ALCOHOL CONSUMPTION
Excess alcohol consumption can cause or worsen a great many pschological, physical and social health problems. Alcohol related disease is such a problem that it has been estimated that up to 20% of all beds on Medical Units in the NHS are taken up by people suffering alcohol related medical health problems. Almost 50% of men and 20% of women drink alcohol to deal with stress, 1:20 people in the UK, that's nearly 2 million people have an alcohol problem and 1:4 people cannot get through the day without alcohol so you are not alone. It is nothing to be ashamed of, excess alcohol is a very treatable problem and there are alternative, safer and more effective ways of dealing with stress, anxiety and depression.
CAUTION
You should always check with your pharmacist if it is safe to consume alcohol with the medication you are on because the side effects can be lethal. It is never wise to consume alcohol and medication because the alcohol can interfere with the effectiveness of some types of medication.
ALCOHOL WITHDRAWL
If you have been using excess alcohol you should not suddenly stop your drinking because if you do it can cause temporary health problems like DTs, exacerbation of your anxiety symptoms and even fits. See your doctor for guidance on withdrawl. By gradually reducing your intake you help to avoid withdrawl symptoms.
from http://stresshelp.tripod.com/
Depression Medication (List)
Medication
Medication that relieves the symptoms of depression has been available for several decades. These drugs are listed in order of historical development. Typical first-line therapy for depression is the use of an selective serotonin reuptake inhibitor, such as citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). Under some circumstances, medication and psychotherapy may be more effective than either treatment separately.
Monoamine oxidase inhibitors (MAOIs) such as Nardil may be used if other antidepressant medications are ineffective. Because there are potentially fatal interactions between this class of medication and certain foods and drugs, they are rarely prescribed anymore. MAOI's are used to block the enzyme monoamine oxidase which breaks down neurotransmitters such as serotonin and norepinephrine (noradrenaline). MAOI's are as effective as tricyclics, if not slightly more effective. A new MAOI has recently been introduced. Moclobemide (Manerix), known as a reversible inhibitor of monoamine oxidase A (RIMA), follows a very specific chemical pathway and does not require a special diet.
Tricyclic antidepressants are the oldest and include such medications as amitriptyline and desipramine. Tricyclics block the reuptake of certain neurotransmitters such as norepinephrine (noradrenaline) and serotonin. They are used less commonly now because of their side effects, which include increased heart rate, drowsiness, dry mouth,constipation, urinary retention, blurred vision,dizziness, confusion, and sexual dysfunction. Most importantly, they have a high potential to be lethal in moderate overdose. However, tricyclic antidepressants are still used because of their high potency, especially in severe cases of clinical depression.
Selective serotonin reuptake inhibitors (SSRIs) are a family of antidepressant considered to be the current standard of drug treatment. It is thought that one cause of depression is an inadequate amount of serotonin, a chemical used in the brain to transmit signals between neurons. SSRIs are said to work by preventing the reabsorption of serotonin by the nerve cell, thus maintaining the levels the brain needs to function effectively, although two researchers recently demonstrated that the advertised connection between seratonin deficiency and symptoms of depression is a marketing technique rather than a scientific portrayal of how the drugs actually work. [4]. Recent research indicates that these drugs may interact with transcription factors known as "clock genes", which may be important for the addictive properties of drugs of abuse and possibly in obesity.
This family of drugs includes fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro), citalopram (Celexa), and sertraline (Zoloft). These antidepressants typically have fewer adverse side effects than the tricyclics or the MAOIs, although such effects as drowsiness, dry mouth, nervousness, anxiety, insomnia, decreased appetite, and decreased ability to function sexually may occur. Some side effects may decrease as a person adjusts to the drug, but other side effects may be persistent.
Norepinephrine (noradrenaline) reuptake inhibitors (NRIs) such as reboxetine (Edronax) act via norepinephrine (also known as noradrenaline). NRIs are thought to have a positive effect on concentration and motivation in particular.[citation needed]
Norepinephrine-dopamine reuptake inhibitors such as bupropion (Wellbutrin, Zyban) inhibit the neuronal reuptake of dopamine and norepinephrine (noradrenaline)[8].
Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) and duloxetine (Cymbalta) are a newer form of antidepressant that works on both noradrenaline and serotonin. They typically have similar side effects to the SSRIs, although there may be a withdrawal syndrome on discontinuation that may necessitate dosage tapering.
Noradrenergic and specific serotonergic antidepressants (NASSAs) form a newer class of antidepressants which purportedly work to increase norepinephrine (noradrenaline) and serotonin neurotransmission by blocking presynaptic alpha-2 adrenergic receptors while at the same time minimizing serotonin related side-effects by blocking certain serotonin receptors. The only example of this class in clinical use is mirtazapine (Avanza, Zispin, Remeron).
Dietary supplements
5-HTP supplements are claimed to provide more raw material to the body's natural serotonin production process. There is a reasonable indication that 5-HTP may not be effective for those who haven't already responded well to an SSRI because of their similar function: SSRIs allow the brain to use its serotonin more effectively, while 5-HTP induces production of more serotonin.
S-adenosyl methionine (SAM-e) is a derivative of the amino acid methionine that is found throughout the human body, where it acts as a methyl donor and participates in other biochemical reactions. It is available as a prescription antidepressant in Europe and an over-the-counter dietary supplement in the United States. Clinical trials have shown SAM-e to be as effective as standard antidepressant medication, with fewer side effects; however, some studies have reported an increased incidence of mania resulting from SAM-e use compared to other antidepressants. Its mode of action is unknown.
Omega-3 fatty acids (found naturally in oily fish, flax seeds, hemp seeds, walnuts, and canola oil) have also been found to be effective when used as a dietary supplement (although only fish-based omega-3 fatty acids have shown antidepressant efficacy).
Dehydroepiandrosterone (DHEA), available as a supplement in the U.S., has been shown to be effective in small trials.
Chocolate improves mood, probably by raising serotonin. Indeed, chocolate contains serotonin and there are case reports of interactions between chocolate and antidepressant drugs.
Magnesium supplementation has gathered some attention as a possible treatment for depression. Some case reports demonstrate rapid recovery from major depression using magnesium treatment. "The possibility that magnesium deficiency is the cause of most major depression and related mental health problems including IQ loss and addiction is enormously important to public health and is recommended for immediate further study."
St John's Wort [Hypericum perforatum] Traditionally used by 'wise women' and midwives for hundreds of years, to 'chase away the devil' of melancholia and anxiety. It is a mood-enhancing herbal substance which acts like an antidepressant and increases the availability of serotonin, norepinephrine and dopamine at the neuron synapses. Also popular for treating insomnia, mood swings, fatigue, PMS and menopause. Except under medical supervision, St. John's Wort should not be used with SSRIs or MAOIs due to the risk of serotonin syndrome.
Ginkgo Biloba Effective natural antidepressant said to stabilise cell membranes, inhibiting lipid breakdown and aiding cell use of oxygen and glucose - so subsequently a mental and vascular stimulant that improves neurotransmitter production. Also popular for treating mental concentration (such as for Alzheimer's and stroke patients).
Siberian Ginseng [Eleutherococcus senticosus] Although not a true panax ginseng it is a mood enhancement supplement against stress. Also popular for treating depression, insomnia, moodiness, fatigue, poor memory, lack of focus, mental tension and endurance.
Zinc has had an antidepressant effect in an experiment.
Biotin: a deficiency has caused a severe depression. The patient's symptoms improved after the deficiency was corrected.
Vitamin B-12: Symptoms of a vitamin B-12 deficiency can include depression and other psychiatric disorders.
The amino acids phenylalanine and tyrosine have also a favorable effect on easy forms of depression. They enhance the neurotransmitters dopamine and noradrenalin.
Both Kava Kava and Valerian Root are said to contain naturally occurring properties which help to promote a natural cure for depression.
Cannabis has also been shown to reduce the symptoms of depression.
Tryptophan. For some time, tryptophan was available in health food stores as a dietary supplement. Since 2002, L-Tryptophan has been sold again in its original form. Many people found tryptophan to be a safe and reasonably effective sleep aid, probably due to its ability to increase brain levels of serotonin (a calming neurotransmitter when present in moderate levels) and/or melatonin (a sleep-inducing hormone secreted by the pineal gland in response to darkness or low light levels). A biological path or precursor to 5-HTP.
Augmentor drugs
Some antidepressants have been found to work more effectively in some patients when used in combination with another drug. Such "augmentor" drugs include tryptophan (Tryptan) and buspirone (Buspar).
Tranquillizers and sedatives, typically the benzodiazepines, may be prescribed to ease anxiety and promote sleep. Because of their high potential for fostering dependence, these medications are intended only for short-term or occasional use. Medications often are used not for their primary function but to exploit what are normally side effects. Quetiapine fumarate (Seroquel) is designed primarily to treat schizophrenia and bipolar disorder, but a frequently reported side-effect is somnolence. Therefore, this drug can be used in place of an antianxiety agent such as clonazepam (Klonopin, Rivotril).
Antipsychotics such as risperidone (Risperdal), olanzapine (Zyprexa), and Quetiapine (Seroquel) are prescribed as mood stabilizers and are also effective in treating anxiety. Their use as mood stabilizers is a recent phenomenon and is controversial with some patients. Antipsychotics (typical or atypical) may also be prescribed in an attempt to augment an antidepressant, to make antidepressant blood concentration higher, or to relieve psychotic or paranoid symptoms often accompanying clinical depression. However, they may have serious side effects, particularly at high dosages, which may include blurred vision, muscle spasms, restlessness, tardive dyskinesia, and weight gain.
Antidepressants by their nature behave similarly to psychostimulants. Antianxiety medications by their nature are depressants. Close medical supervision is critical to proper treatment if a patient presents with both illnesses because the medications tend to work against each other.
Psycho-stimulants are sometimes added to an antidepressant regimen if the patient suffers from anhedonia, hypersomnia and/or excessive eating as well as low motivation. These symptoms which are common in atypical depression can be quickly resolved with the addition of low to moderate dosages of amphetamine or methylphenidate (brand names Adderall and Ritalin, respectively)as these chemicals enhance motivation and social behavior, as well as suppress appetite and sleep. These chemicals are also known to restore sex drive. Extreme caution must be used however with certain populations. Stimulants are known to trigger manic episodes in people suffering from bipolar disorder. They are also easily abused as they are effective substitutes for Methamphetamine when used recreationaly. Close supervision of those with substance abuse disorders is urged. Emotionally labile patients should avoid stimulants, as they exacerbate mood shifting.
Lithium remains the standard treatment for bipolar disorder and is often used in conjunction with other medications, depending on whether mania or depression is being treated. Lithium's potential side effects include thirst, tremors, light-headedness, and nausea or diarrhea. Some of the anticonvulsants, such as carbamazepine (Tegretol), sodium valproate (Epilim), and lamotrigine (Lamictal), are also used as mood stabilizers, particularly in bipolar disorder.
from wikipedia
Medication that relieves the symptoms of depression has been available for several decades. These drugs are listed in order of historical development. Typical first-line therapy for depression is the use of an selective serotonin reuptake inhibitor, such as citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). Under some circumstances, medication and psychotherapy may be more effective than either treatment separately.
Monoamine oxidase inhibitors (MAOIs) such as Nardil may be used if other antidepressant medications are ineffective. Because there are potentially fatal interactions between this class of medication and certain foods and drugs, they are rarely prescribed anymore. MAOI's are used to block the enzyme monoamine oxidase which breaks down neurotransmitters such as serotonin and norepinephrine (noradrenaline). MAOI's are as effective as tricyclics, if not slightly more effective. A new MAOI has recently been introduced. Moclobemide (Manerix), known as a reversible inhibitor of monoamine oxidase A (RIMA), follows a very specific chemical pathway and does not require a special diet.
Tricyclic antidepressants are the oldest and include such medications as amitriptyline and desipramine. Tricyclics block the reuptake of certain neurotransmitters such as norepinephrine (noradrenaline) and serotonin. They are used less commonly now because of their side effects, which include increased heart rate, drowsiness, dry mouth,constipation, urinary retention, blurred vision,dizziness, confusion, and sexual dysfunction. Most importantly, they have a high potential to be lethal in moderate overdose. However, tricyclic antidepressants are still used because of their high potency, especially in severe cases of clinical depression.
Selective serotonin reuptake inhibitors (SSRIs) are a family of antidepressant considered to be the current standard of drug treatment. It is thought that one cause of depression is an inadequate amount of serotonin, a chemical used in the brain to transmit signals between neurons. SSRIs are said to work by preventing the reabsorption of serotonin by the nerve cell, thus maintaining the levels the brain needs to function effectively, although two researchers recently demonstrated that the advertised connection between seratonin deficiency and symptoms of depression is a marketing technique rather than a scientific portrayal of how the drugs actually work. [4]. Recent research indicates that these drugs may interact with transcription factors known as "clock genes", which may be important for the addictive properties of drugs of abuse and possibly in obesity.
This family of drugs includes fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro), citalopram (Celexa), and sertraline (Zoloft). These antidepressants typically have fewer adverse side effects than the tricyclics or the MAOIs, although such effects as drowsiness, dry mouth, nervousness, anxiety, insomnia, decreased appetite, and decreased ability to function sexually may occur. Some side effects may decrease as a person adjusts to the drug, but other side effects may be persistent.
Norepinephrine (noradrenaline) reuptake inhibitors (NRIs) such as reboxetine (Edronax) act via norepinephrine (also known as noradrenaline). NRIs are thought to have a positive effect on concentration and motivation in particular.[citation needed]
Norepinephrine-dopamine reuptake inhibitors such as bupropion (Wellbutrin, Zyban) inhibit the neuronal reuptake of dopamine and norepinephrine (noradrenaline)[8].
Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) and duloxetine (Cymbalta) are a newer form of antidepressant that works on both noradrenaline and serotonin. They typically have similar side effects to the SSRIs, although there may be a withdrawal syndrome on discontinuation that may necessitate dosage tapering.
Noradrenergic and specific serotonergic antidepressants (NASSAs) form a newer class of antidepressants which purportedly work to increase norepinephrine (noradrenaline) and serotonin neurotransmission by blocking presynaptic alpha-2 adrenergic receptors while at the same time minimizing serotonin related side-effects by blocking certain serotonin receptors. The only example of this class in clinical use is mirtazapine (Avanza, Zispin, Remeron).
Dietary supplements
5-HTP supplements are claimed to provide more raw material to the body's natural serotonin production process. There is a reasonable indication that 5-HTP may not be effective for those who haven't already responded well to an SSRI because of their similar function: SSRIs allow the brain to use its serotonin more effectively, while 5-HTP induces production of more serotonin.
S-adenosyl methionine (SAM-e) is a derivative of the amino acid methionine that is found throughout the human body, where it acts as a methyl donor and participates in other biochemical reactions. It is available as a prescription antidepressant in Europe and an over-the-counter dietary supplement in the United States. Clinical trials have shown SAM-e to be as effective as standard antidepressant medication, with fewer side effects; however, some studies have reported an increased incidence of mania resulting from SAM-e use compared to other antidepressants. Its mode of action is unknown.
Omega-3 fatty acids (found naturally in oily fish, flax seeds, hemp seeds, walnuts, and canola oil) have also been found to be effective when used as a dietary supplement (although only fish-based omega-3 fatty acids have shown antidepressant efficacy).
Dehydroepiandrosterone (DHEA), available as a supplement in the U.S., has been shown to be effective in small trials.
Chocolate improves mood, probably by raising serotonin. Indeed, chocolate contains serotonin and there are case reports of interactions between chocolate and antidepressant drugs.
Magnesium supplementation has gathered some attention as a possible treatment for depression. Some case reports demonstrate rapid recovery from major depression using magnesium treatment. "The possibility that magnesium deficiency is the cause of most major depression and related mental health problems including IQ loss and addiction is enormously important to public health and is recommended for immediate further study."
St John's Wort [Hypericum perforatum] Traditionally used by 'wise women' and midwives for hundreds of years, to 'chase away the devil' of melancholia and anxiety. It is a mood-enhancing herbal substance which acts like an antidepressant and increases the availability of serotonin, norepinephrine and dopamine at the neuron synapses. Also popular for treating insomnia, mood swings, fatigue, PMS and menopause. Except under medical supervision, St. John's Wort should not be used with SSRIs or MAOIs due to the risk of serotonin syndrome.
Ginkgo Biloba Effective natural antidepressant said to stabilise cell membranes, inhibiting lipid breakdown and aiding cell use of oxygen and glucose - so subsequently a mental and vascular stimulant that improves neurotransmitter production. Also popular for treating mental concentration (such as for Alzheimer's and stroke patients).
Siberian Ginseng [Eleutherococcus senticosus] Although not a true panax ginseng it is a mood enhancement supplement against stress. Also popular for treating depression, insomnia, moodiness, fatigue, poor memory, lack of focus, mental tension and endurance.
Zinc has had an antidepressant effect in an experiment.
Biotin: a deficiency has caused a severe depression. The patient's symptoms improved after the deficiency was corrected.
Vitamin B-12: Symptoms of a vitamin B-12 deficiency can include depression and other psychiatric disorders.
The amino acids phenylalanine and tyrosine have also a favorable effect on easy forms of depression. They enhance the neurotransmitters dopamine and noradrenalin.
Both Kava Kava and Valerian Root are said to contain naturally occurring properties which help to promote a natural cure for depression.
Cannabis has also been shown to reduce the symptoms of depression.
Tryptophan. For some time, tryptophan was available in health food stores as a dietary supplement. Since 2002, L-Tryptophan has been sold again in its original form. Many people found tryptophan to be a safe and reasonably effective sleep aid, probably due to its ability to increase brain levels of serotonin (a calming neurotransmitter when present in moderate levels) and/or melatonin (a sleep-inducing hormone secreted by the pineal gland in response to darkness or low light levels). A biological path or precursor to 5-HTP.
Augmentor drugs
Some antidepressants have been found to work more effectively in some patients when used in combination with another drug. Such "augmentor" drugs include tryptophan (Tryptan) and buspirone (Buspar).
Tranquillizers and sedatives, typically the benzodiazepines, may be prescribed to ease anxiety and promote sleep. Because of their high potential for fostering dependence, these medications are intended only for short-term or occasional use. Medications often are used not for their primary function but to exploit what are normally side effects. Quetiapine fumarate (Seroquel) is designed primarily to treat schizophrenia and bipolar disorder, but a frequently reported side-effect is somnolence. Therefore, this drug can be used in place of an antianxiety agent such as clonazepam (Klonopin, Rivotril).
Antipsychotics such as risperidone (Risperdal), olanzapine (Zyprexa), and Quetiapine (Seroquel) are prescribed as mood stabilizers and are also effective in treating anxiety. Their use as mood stabilizers is a recent phenomenon and is controversial with some patients. Antipsychotics (typical or atypical) may also be prescribed in an attempt to augment an antidepressant, to make antidepressant blood concentration higher, or to relieve psychotic or paranoid symptoms often accompanying clinical depression. However, they may have serious side effects, particularly at high dosages, which may include blurred vision, muscle spasms, restlessness, tardive dyskinesia, and weight gain.
Antidepressants by their nature behave similarly to psychostimulants. Antianxiety medications by their nature are depressants. Close medical supervision is critical to proper treatment if a patient presents with both illnesses because the medications tend to work against each other.
Psycho-stimulants are sometimes added to an antidepressant regimen if the patient suffers from anhedonia, hypersomnia and/or excessive eating as well as low motivation. These symptoms which are common in atypical depression can be quickly resolved with the addition of low to moderate dosages of amphetamine or methylphenidate (brand names Adderall and Ritalin, respectively)as these chemicals enhance motivation and social behavior, as well as suppress appetite and sleep. These chemicals are also known to restore sex drive. Extreme caution must be used however with certain populations. Stimulants are known to trigger manic episodes in people suffering from bipolar disorder. They are also easily abused as they are effective substitutes for Methamphetamine when used recreationaly. Close supervision of those with substance abuse disorders is urged. Emotionally labile patients should avoid stimulants, as they exacerbate mood shifting.
Lithium remains the standard treatment for bipolar disorder and is often used in conjunction with other medications, depending on whether mania or depression is being treated. Lithium's potential side effects include thirst, tremors, light-headedness, and nausea or diarrhea. Some of the anticonvulsants, such as carbamazepine (Tegretol), sodium valproate (Epilim), and lamotrigine (Lamictal), are also used as mood stabilizers, particularly in bipolar disorder.
from wikipedia
Manic Depression: Symtoms, Causes, Treatment, etc
Bipolar disorder, also known as manic-depression, is a psychiatric diagnosis referring to a mental health condition defined by periods of extreme, often inappropriate, and sometimes unpredictable mood states.
Bipolar individuals generally experience mania, hypomania or mixed states alternating with clinical depression and euthymic or normal range of mood over varied periods of time. There are many variations of this disorder. A person with bipolar disorder generally tends to experience more extreme states of mood than other people. Moods can change quickly (many times a day) or last for months. Bipolar individuals tend to have very 'black and white' thinking, where everything in life is either a positive aspect or a negative. Mood patterns of this nature are associated with distress and disruption, and a relatively high risk of suicide. Bipolar disorder is also associated with a variety of cognitive deficits, in particular, difficulty in organizing and planning. The disorder may also skew the ability to judge others' emotion, and alter sense of awareness. Bipolar individuals can be overly observant and analytical of their environment, and in some cases paranoid of others.
Bipolar disorder is usually treated with medications that help to stabilize mood, and/or therapy and counselling.
Some studies have suggested that while bipolar disorder alters emotion, there may be a correlation between creativity and bipolar disorder, although it is unclear what the relationship is between the two.
Aspects of bipolar disorder
Bipolar disorder is commonly categorised as either Bipolar Type I, where an individual experiences full-blown mania, or Bipolar Type II, in which the hypomanic "highs" do not go to the extremes of mania. The latter is much more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing depression. Psychosis can occur, particularly in manic periods. There are also 'rapid cycling' subtypes. Because there is so much variation in the severity and nature of mood-related problems, the concept of a bipolar spectrum is often employed, which includes cyclothymia. There is no consensus as to how many 'types' of bipolar disorder exist (Akiskal and Benazzi, 2006). Many people with bipolar disorder experience severe anxiety and are very irritable (to the point of rage) when in a manic state, while others are euphoric and grandiose.
The Depressive Phase
Signs and symptoms of the depressive phase of bipolar disorder include (but in no way are limited to): persistent feelings of sadness, anxiety, guilt, anger, isolation and/or hopelessness, disturbances in sleep and appetite, fatigue and loss of interest in usually enjoyed activities, problems concentrating, loneliness, self-loathing, apathy or indifference, depersonalization, loss of interest in sexual activity, shyness or social anxiety, irritability, chronic pain (with or without a known cause), lack of motivation, and morbid/suicidal ideation].
Mania
People having a manic episode of mood can be elated, euphoric, irritated and/or suspicious. There will be an increase in physical and mental rate and quality. Increased energy and over-activity is common; speech can become racing. The need for sleep is reduced. Attention span is low and easily distracted. Unrealistic, grandiose or over optimistic ideas may be voiced or attempted. Social skills are impaired, and impractical ideas may lead to financial and relationship indiscretions.
Hypomania
Hypomania is generally a less destructive state than mania, and people in the hypomanic phase generally experience less of the symptoms of mania than those in a full-blown manic episode. The duration is usually also shorter than in mania. This is often a very 'artistic' state of the disorder, where there is a flight of ideas, extremely clever thinking, and an increase in energy.
Mixed state
In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously (for example, agitation, anxiety, aggressiveness or belligerence, confusion, fatigue, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, racing thoughts, restlessness, and rage).
Mixed episodes can be the most volatile of the bipolar states, as moods can easily and quickly be triggered or shifted. Suicide attempts, substance abuse, and self-mutilation may occur during this state.
Rapid cycling
Rapid cycling, defined as having four or more episodes per year, is found in a significant fraction of patients with bipolar disorder. It has been associated with greater disability or a worse prognosis, due to the confusing changeability and difficulty in establishing a stable state. Rapid cycling can be induced or made worse by antidepressants.
Cognition
Numerous studies show that bipolar disorder involves certain cognitive deficits or impairments, even in states of remission. Deborah Yurgelun-Todd of McLean Hospital in Belmont, Massachusetts has argued these deficits should be included as a core feature of bipolar disorder. According to McIntyre et al. (2006), "study results now press the point that neurocognitive deficits are a primary feature of BD; they are highly prevalent and persist in the absence of overt symptomatology. Although disparate neurocognitive abnormalities have been reported, disturbances in attention, visual memory, and executive function are most consistently reported."
Creativity
A number of recent studies have observed a correlation between creativity and bipolar disorder, although it is unclear in which direction the cause lies, or whether both conditions are caused by some third, unknown, factor. It has been hypothesized that temperament may be one such factor.
Suicide risk
Although many people with bipolar disorder who attempt suicide never actually complete it, the annual average suicide rate in males and females with diagnosed bipolar disorder (0.4%) is 10 to more than 20 times that in the general population
Individuals with bipolar disorder tend to become suicidal, especially during mixed states such as dysphoric mania and agitated depression. Persons suffering from Bipolar II have high rates of suicide compared to persons suffering from other mental illnesses, including Major Depression. Major Depressive episodes are part of the Bipolar II experience, and some have speculated that sufferers of this disorder spend much of their life in the depressive phase of the illness.
Divorce rate
According to Psychology Today, the divorce rate for couples where at least one spouse is bipolar is 90%. For comparison purposes, the general divorce rate is commonly held to be about half as much (around 50%), implying that this illness causes substantial additional burdens on married life.
Diagnosis
Diagnostic criteria
Flux is the fundamental nature of bipolar disorder. Both within and between individuals with the illness, energy, mood, thought, sleep, and activity are among the continually changing biological markers of the disorder. The diagnostic subtypes of bipolar disorder are thus static descriptions—snapshots, perhaps—of an illness in continual change, with a great diversity of symptoms and varying degrees of severity. Individuals may stay in one subtype, or change into another, over the course of their illness. The DSM V, to be published in 2011, will likely include further and more accurate sub-typing (Akiskal and Ghaemi, 2006).
There are currently four types of bipolar illness. The Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR) details four categories of bipolar disorder, Bipolar I, Bipolar II, Cyclothymia, and Bipolar Disorder NOS (Not Otherwise Specified).
For a diagnosis of Bipolar I disorder according to the DSM-IV-TR, there requires one or more manic or mixed episodes. A depressive episode is not required for the diagnosis of Bipolar I disorder but it frequently occurs.
Bipolar II, which occurs more frequently is usually characterized by at least one episode of hypomania and at least one depression.
A diagnosis of Cyclothymic Disorder requires the presence of numerous hypomanic episodes, intermingled with depressive episodes that do not meet full criteria for major depressive episodes. The main idea here is that there is a low-grade cycling of mood which appears to the observer as a personality trait, but interferes with functioning.
If an individual clearly seems to be suffering from some type of bipolar disorder but does not meet the criteria for one of the subtypes above, he or she receives a diagnosis of Bipolar Disorder NOS (Not Otherwise Specified).
Although a patient will most likely be depressed when they first seek help, it is very important to find out from the patient or the patient's family or friends if a manic or hypomaniac episode has ever been present, using careful questioning. This will prevent misdiagnosis of Depressive Disorder and avoids the use of an antidepressant which may trigger a "switch" to hypomania or mania or induce rapid cycling. Recent screening tools such as the Hypomanic Check List Questionnaire (HCL-32) have been developed to assist the quite often difficult detection of Bipolar II disorders.
Treatment lag
The behavioral manifestations of bipolar disorder are often not understood by patients nor recognized by mental health professionals, so people may suffer unnecessarily for over 10 years in some cases before receiving proper treatment.
That treatment lag is apparently not decreasing, even though there is now increased public awareness of the illness in popular magazines and health websites. Recent TV specials, for example the BBC's The Secret Life of the Manic Depressive, MTV's True Life: I'm Bipolar, talk shows, and public radio shows, and the greater willingness of public figures to discuss their own bipolar disorder, have focused on mental illnesses thereby further raising public awareness.
Despite this increased focus, individuals are still commonly misdiagnosed.
Children
Main article: Bipolar disorder in children
Children with bipolar disorder do not often meet the strict DSM-IV definition. In pediatric cases, the cycling can occur very quickly (see section above on rapid cycling).
Children with bipolar disorder tend to have rapid-cycling or mixed-cycling. Rapid cycling occurs when the cycles between depression and mania occur quickly, sometimes within the same day or the same hour. When the symptoms of both mania and depression occur simultaneously, mixed cycling occurs.
Often other psychiatric disorders are diagnosed in bipolar children. These other diagnoses may be concurrent problems, or they may be misdiagnosed as bipolar disorder. Depression, ADHD, ODD, schizophrenia, and Tourette syndrome are common comorbid conditions.
Misdiagnosis can lead to incorrect medication. Incorrect medications can trigger mania and/or suicidal ideation and attempts.
Treatment
Main article: Treatment of bipolar disorder
Currently, bipolar disorder cannot be cured, though psychiatrists and psychologists believe that it can be managed.
The emphasis of treatment is on effective management of the long-term course of the illness, which usually involves treatment of emergent symptoms. Treatment methods include pharmacological and psychotherapeutic techniques.
Prognosis and long-term treatment
A good prognosis results from good treatment which, in turn, results from an accurate diagnosis. Because bipolar disorder continues to have a high rate of both under-diagnosis and misdiagnosis, it is often difficult for individuals with the illness to receive timely and competent treatment.
Bipolar disorder is a severely disabling medical condition. However, with appropriate treatment, many individuals with bipolar disorder can live full and satisfying lives. Persons with bipolar disorder are likely to have periods of normal or near normal functioning between episodes.
Ultimately one's prognosis depends on many factors, which are, in fact, under the individual's control: the right medicines; the right dose of each; a very informed patient; a good working relationship with a competent medical doctor; a competent, supportive, and warm therapist; a supportive family or significant other; and a balanced lifestyle including a regulated stress level, regular exercise and regular sleep and wake times.
There are obviously other factors that lead to a good prognosis, as well, such as being very aware of small changes in one's energy, mood, sleep and eating behaviors, as well as having a plan in conjunction with one's doctor for how to manage subtle changes that might indicate the beginning of a mood swing. Some people find that keeping a log of their moods can assist them in predicting changes.
The goals of long-term optimal treatment are to help the individual achieve the highest level of functioning while avoiding relapse.
Relapse
Even when on medication, some people may still experience weaker episodes, or have a complete manic or depressive episode. In fact, a recent study found bipolar disorder to be "characterized by a low rate of recovery, a high rate of recurrence, and poor interepisodic functioning." Worse, the study confirmed the seriousness of the disorder as "the standardized all-cause mortality ratio among patients with BD is increased approximately 2-fold." Bipolar disorder is currently regarded "as possibly the most costly category of mental disorders in the United States."
The following behaviors can lead to depressive or manic relapse:
Discontinuing or lowering one's dose of medication, without consulting one's physician.
Being under- or over-medicated. Generally, taking a lower dosage of a mood stabilizer can lead to relapse into mania. Taking a lower dosage of an antidepressant, may cause the patient to relapse into depression, while higher doses can cause destabilization into mixed-states or mania.
Taking hard drugs—recreationally or not—such as cocaine, alcohol, amphetamines, or opiates. These can cause the condition to worsen.
An inconsistent sleep schedule can destabilize the illness. Too much sleep (possibly caused by medication) can lead to depression, while too little sleep can lead to mixed states or mania.
Caffeine can cause destabilization of mood toward irritability, dysphoria, and mania. Anecdotal evidence seems to suggest that lower dosages of caffeine can have effects ranging from anti-depressant to mania-inducing.
Inadequate stress management and poor lifestyle choices. If unmedicated, excessive stress can cause the individual to relapse. Medication raises the stress threshold somewhat, but too much stress still causes relapse.
Relapse can be managed by the sufferer with the help of a close friend, based on the occurrence of idiosyncratic prodromal events That is, by noticing which moods, activities / behaviours or thinking process / thought content typically occur at the outset of their episodes. They can then take planned steps to slow or reverse the onset of illness, or take action to prevent the episode causing damage to important aspects of their life.
Research findings
Heritability or inheritance
The disorder runs in families. More than two-thirds of people with bipolar disorder have at least one close relative with the disorder or with unipolar major depression, indicating that the disease has a genetic component.
Studies seeking to identify the genetic basis of bipolar disorder indicate that susceptibility stems from multiple genes. Scientists are continuing their search for these genes, using advanced genetic analytic methods and large samples of families affected by the illness. The researchers are hopeful that identification of susceptibility genes for bipolar disorder, and the brain proteins they code for, will make it possible to develop better treatments and preventive interventions targeted at the underlying illness process.
Genetic research
Bipolar disorder is considered to be a result of complex interactions between genes and environment.
The monozygotic concordance rate for the disorder is 70%. This means that if a person has the disorder, an identical twin has a 70% likelihood of having the disorder as well. Dizygotic twins have a 23% concordance rate. These concordance rates are not universally replicated in the literature; recent studies have shown rates of around 40% for monozygotic and <10% for dizygotic twins (see Kieseppa, 2004 and Cardno, 1999).
In 2003, a group of American and Canadian researchers published a paper that used gene linkage techniques to identify a mutation in the GRK3 gene as a possible cause of up to 10% of cases of bipolar disorder. This gene is associated with a kinase enzyme called G protein receptor kinase 3, which appears to be involved in dopamine metabolism, and may provide a possible target for new drugs for bipolar disorder.
Ongoing research
The following studies are ongoing, and are recruiting volunteers:
The Maudsley Bipolar Twin Study, based at the Institute of Psychiatry in London is conducting research about the genetic basis of bipolar disorder using twin methodology. Currently recruiting volunteers: identical and non-identical twins pairs, where either one or both twins has a diagnosis of bipolar I or II.
The MRC eMonitoring Project, another research study based at the Institute of Psychiatry and Newcastle Universities, is conducting novel research on electronic monitoring methodologies (electronic mood diaries and actigraphy) for tracking bipolar symptom fluctuations in Bipolar individuals who are interested in self-managing their condition.
Medical imaging
Researchers are using advanced brain imaging techniques to examine brain function and structure in people with bipolar disorder, particularly using the functional MRI and positron emission tomography. An important area of neuroimaging research focuses on identifying and characterizing networks of interconnected nerve cells in the brain, interactions among which form the basis for normal and abnormal behaviors. Researchers hypothesize that abnormalities in the structure and/or function of certain brain circuits could underlie bipolar and other mood disorders, and studies have found anatomical differences in areas such as the prefrontal cortex and hippocampus.
Better understanding of the neural circuits involved in regulating mood states, and genetic factors such as the cadherin gene FAT linked to bipolar disorder, may influence the development of new and better treatments, and may ultimately aid in early diagnosis and even a cure
New treatments
In late 2003, researchers at McLean Hospital found tentative evidence of improvements in mood during echo-planar magnetic resonance spectroscopic imaging (EP-MRSI), and attempts are being made to develop this into a form which can be evaluated as a possible treatment.
NIMH has initiated a large-scale study at 20 sites across the United States to determine the most effective treatment strategies for people with bipolar disorder. This study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), will follow patients and document their treatment outcome for 5-8 years. For more information, visit the Clinical Trials page of the NIMH Web site.
Transcranial magnetic stimulation is another fairly new technique being studied.
from wikipedia
Bipolar individuals generally experience mania, hypomania or mixed states alternating with clinical depression and euthymic or normal range of mood over varied periods of time. There are many variations of this disorder. A person with bipolar disorder generally tends to experience more extreme states of mood than other people. Moods can change quickly (many times a day) or last for months. Bipolar individuals tend to have very 'black and white' thinking, where everything in life is either a positive aspect or a negative. Mood patterns of this nature are associated with distress and disruption, and a relatively high risk of suicide. Bipolar disorder is also associated with a variety of cognitive deficits, in particular, difficulty in organizing and planning. The disorder may also skew the ability to judge others' emotion, and alter sense of awareness. Bipolar individuals can be overly observant and analytical of their environment, and in some cases paranoid of others.
Bipolar disorder is usually treated with medications that help to stabilize mood, and/or therapy and counselling.
Some studies have suggested that while bipolar disorder alters emotion, there may be a correlation between creativity and bipolar disorder, although it is unclear what the relationship is between the two.
Aspects of bipolar disorder
Bipolar disorder is commonly categorised as either Bipolar Type I, where an individual experiences full-blown mania, or Bipolar Type II, in which the hypomanic "highs" do not go to the extremes of mania. The latter is much more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing depression. Psychosis can occur, particularly in manic periods. There are also 'rapid cycling' subtypes. Because there is so much variation in the severity and nature of mood-related problems, the concept of a bipolar spectrum is often employed, which includes cyclothymia. There is no consensus as to how many 'types' of bipolar disorder exist (Akiskal and Benazzi, 2006). Many people with bipolar disorder experience severe anxiety and are very irritable (to the point of rage) when in a manic state, while others are euphoric and grandiose.
The Depressive Phase
Signs and symptoms of the depressive phase of bipolar disorder include (but in no way are limited to): persistent feelings of sadness, anxiety, guilt, anger, isolation and/or hopelessness, disturbances in sleep and appetite, fatigue and loss of interest in usually enjoyed activities, problems concentrating, loneliness, self-loathing, apathy or indifference, depersonalization, loss of interest in sexual activity, shyness or social anxiety, irritability, chronic pain (with or without a known cause), lack of motivation, and morbid/suicidal ideation].
Mania
People having a manic episode of mood can be elated, euphoric, irritated and/or suspicious. There will be an increase in physical and mental rate and quality. Increased energy and over-activity is common; speech can become racing. The need for sleep is reduced. Attention span is low and easily distracted. Unrealistic, grandiose or over optimistic ideas may be voiced or attempted. Social skills are impaired, and impractical ideas may lead to financial and relationship indiscretions.
Hypomania
Hypomania is generally a less destructive state than mania, and people in the hypomanic phase generally experience less of the symptoms of mania than those in a full-blown manic episode. The duration is usually also shorter than in mania. This is often a very 'artistic' state of the disorder, where there is a flight of ideas, extremely clever thinking, and an increase in energy.
Mixed state
In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously (for example, agitation, anxiety, aggressiveness or belligerence, confusion, fatigue, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, racing thoughts, restlessness, and rage).
Mixed episodes can be the most volatile of the bipolar states, as moods can easily and quickly be triggered or shifted. Suicide attempts, substance abuse, and self-mutilation may occur during this state.
Rapid cycling
Rapid cycling, defined as having four or more episodes per year, is found in a significant fraction of patients with bipolar disorder. It has been associated with greater disability or a worse prognosis, due to the confusing changeability and difficulty in establishing a stable state. Rapid cycling can be induced or made worse by antidepressants.
Cognition
Numerous studies show that bipolar disorder involves certain cognitive deficits or impairments, even in states of remission. Deborah Yurgelun-Todd of McLean Hospital in Belmont, Massachusetts has argued these deficits should be included as a core feature of bipolar disorder. According to McIntyre et al. (2006), "study results now press the point that neurocognitive deficits are a primary feature of BD; they are highly prevalent and persist in the absence of overt symptomatology. Although disparate neurocognitive abnormalities have been reported, disturbances in attention, visual memory, and executive function are most consistently reported."
Creativity
A number of recent studies have observed a correlation between creativity and bipolar disorder, although it is unclear in which direction the cause lies, or whether both conditions are caused by some third, unknown, factor. It has been hypothesized that temperament may be one such factor.
Suicide risk
Although many people with bipolar disorder who attempt suicide never actually complete it, the annual average suicide rate in males and females with diagnosed bipolar disorder (0.4%) is 10 to more than 20 times that in the general population
Individuals with bipolar disorder tend to become suicidal, especially during mixed states such as dysphoric mania and agitated depression. Persons suffering from Bipolar II have high rates of suicide compared to persons suffering from other mental illnesses, including Major Depression. Major Depressive episodes are part of the Bipolar II experience, and some have speculated that sufferers of this disorder spend much of their life in the depressive phase of the illness.
Divorce rate
According to Psychology Today, the divorce rate for couples where at least one spouse is bipolar is 90%. For comparison purposes, the general divorce rate is commonly held to be about half as much (around 50%), implying that this illness causes substantial additional burdens on married life.
Diagnosis
Diagnostic criteria
Flux is the fundamental nature of bipolar disorder. Both within and between individuals with the illness, energy, mood, thought, sleep, and activity are among the continually changing biological markers of the disorder. The diagnostic subtypes of bipolar disorder are thus static descriptions—snapshots, perhaps—of an illness in continual change, with a great diversity of symptoms and varying degrees of severity. Individuals may stay in one subtype, or change into another, over the course of their illness. The DSM V, to be published in 2011, will likely include further and more accurate sub-typing (Akiskal and Ghaemi, 2006).
There are currently four types of bipolar illness. The Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR) details four categories of bipolar disorder, Bipolar I, Bipolar II, Cyclothymia, and Bipolar Disorder NOS (Not Otherwise Specified).
For a diagnosis of Bipolar I disorder according to the DSM-IV-TR, there requires one or more manic or mixed episodes. A depressive episode is not required for the diagnosis of Bipolar I disorder but it frequently occurs.
Bipolar II, which occurs more frequently is usually characterized by at least one episode of hypomania and at least one depression.
A diagnosis of Cyclothymic Disorder requires the presence of numerous hypomanic episodes, intermingled with depressive episodes that do not meet full criteria for major depressive episodes. The main idea here is that there is a low-grade cycling of mood which appears to the observer as a personality trait, but interferes with functioning.
If an individual clearly seems to be suffering from some type of bipolar disorder but does not meet the criteria for one of the subtypes above, he or she receives a diagnosis of Bipolar Disorder NOS (Not Otherwise Specified).
Although a patient will most likely be depressed when they first seek help, it is very important to find out from the patient or the patient's family or friends if a manic or hypomaniac episode has ever been present, using careful questioning. This will prevent misdiagnosis of Depressive Disorder and avoids the use of an antidepressant which may trigger a "switch" to hypomania or mania or induce rapid cycling. Recent screening tools such as the Hypomanic Check List Questionnaire (HCL-32) have been developed to assist the quite often difficult detection of Bipolar II disorders.
Treatment lag
The behavioral manifestations of bipolar disorder are often not understood by patients nor recognized by mental health professionals, so people may suffer unnecessarily for over 10 years in some cases before receiving proper treatment.
That treatment lag is apparently not decreasing, even though there is now increased public awareness of the illness in popular magazines and health websites. Recent TV specials, for example the BBC's The Secret Life of the Manic Depressive, MTV's True Life: I'm Bipolar, talk shows, and public radio shows, and the greater willingness of public figures to discuss their own bipolar disorder, have focused on mental illnesses thereby further raising public awareness.
Despite this increased focus, individuals are still commonly misdiagnosed.
Children
Main article: Bipolar disorder in children
Children with bipolar disorder do not often meet the strict DSM-IV definition. In pediatric cases, the cycling can occur very quickly (see section above on rapid cycling).
Children with bipolar disorder tend to have rapid-cycling or mixed-cycling. Rapid cycling occurs when the cycles between depression and mania occur quickly, sometimes within the same day or the same hour. When the symptoms of both mania and depression occur simultaneously, mixed cycling occurs.
Often other psychiatric disorders are diagnosed in bipolar children. These other diagnoses may be concurrent problems, or they may be misdiagnosed as bipolar disorder. Depression, ADHD, ODD, schizophrenia, and Tourette syndrome are common comorbid conditions.
Misdiagnosis can lead to incorrect medication. Incorrect medications can trigger mania and/or suicidal ideation and attempts.
Treatment
Main article: Treatment of bipolar disorder
Currently, bipolar disorder cannot be cured, though psychiatrists and psychologists believe that it can be managed.
The emphasis of treatment is on effective management of the long-term course of the illness, which usually involves treatment of emergent symptoms. Treatment methods include pharmacological and psychotherapeutic techniques.
Prognosis and long-term treatment
A good prognosis results from good treatment which, in turn, results from an accurate diagnosis. Because bipolar disorder continues to have a high rate of both under-diagnosis and misdiagnosis, it is often difficult for individuals with the illness to receive timely and competent treatment.
Bipolar disorder is a severely disabling medical condition. However, with appropriate treatment, many individuals with bipolar disorder can live full and satisfying lives. Persons with bipolar disorder are likely to have periods of normal or near normal functioning between episodes.
Ultimately one's prognosis depends on many factors, which are, in fact, under the individual's control: the right medicines; the right dose of each; a very informed patient; a good working relationship with a competent medical doctor; a competent, supportive, and warm therapist; a supportive family or significant other; and a balanced lifestyle including a regulated stress level, regular exercise and regular sleep and wake times.
There are obviously other factors that lead to a good prognosis, as well, such as being very aware of small changes in one's energy, mood, sleep and eating behaviors, as well as having a plan in conjunction with one's doctor for how to manage subtle changes that might indicate the beginning of a mood swing. Some people find that keeping a log of their moods can assist them in predicting changes.
The goals of long-term optimal treatment are to help the individual achieve the highest level of functioning while avoiding relapse.
Relapse
Even when on medication, some people may still experience weaker episodes, or have a complete manic or depressive episode. In fact, a recent study found bipolar disorder to be "characterized by a low rate of recovery, a high rate of recurrence, and poor interepisodic functioning." Worse, the study confirmed the seriousness of the disorder as "the standardized all-cause mortality ratio among patients with BD is increased approximately 2-fold." Bipolar disorder is currently regarded "as possibly the most costly category of mental disorders in the United States."
The following behaviors can lead to depressive or manic relapse:
Discontinuing or lowering one's dose of medication, without consulting one's physician.
Being under- or over-medicated. Generally, taking a lower dosage of a mood stabilizer can lead to relapse into mania. Taking a lower dosage of an antidepressant, may cause the patient to relapse into depression, while higher doses can cause destabilization into mixed-states or mania.
Taking hard drugs—recreationally or not—such as cocaine, alcohol, amphetamines, or opiates. These can cause the condition to worsen.
An inconsistent sleep schedule can destabilize the illness. Too much sleep (possibly caused by medication) can lead to depression, while too little sleep can lead to mixed states or mania.
Caffeine can cause destabilization of mood toward irritability, dysphoria, and mania. Anecdotal evidence seems to suggest that lower dosages of caffeine can have effects ranging from anti-depressant to mania-inducing.
Inadequate stress management and poor lifestyle choices. If unmedicated, excessive stress can cause the individual to relapse. Medication raises the stress threshold somewhat, but too much stress still causes relapse.
Relapse can be managed by the sufferer with the help of a close friend, based on the occurrence of idiosyncratic prodromal events That is, by noticing which moods, activities / behaviours or thinking process / thought content typically occur at the outset of their episodes. They can then take planned steps to slow or reverse the onset of illness, or take action to prevent the episode causing damage to important aspects of their life.
Research findings
Heritability or inheritance
The disorder runs in families. More than two-thirds of people with bipolar disorder have at least one close relative with the disorder or with unipolar major depression, indicating that the disease has a genetic component.
Studies seeking to identify the genetic basis of bipolar disorder indicate that susceptibility stems from multiple genes. Scientists are continuing their search for these genes, using advanced genetic analytic methods and large samples of families affected by the illness. The researchers are hopeful that identification of susceptibility genes for bipolar disorder, and the brain proteins they code for, will make it possible to develop better treatments and preventive interventions targeted at the underlying illness process.
Genetic research
Bipolar disorder is considered to be a result of complex interactions between genes and environment.
The monozygotic concordance rate for the disorder is 70%. This means that if a person has the disorder, an identical twin has a 70% likelihood of having the disorder as well. Dizygotic twins have a 23% concordance rate. These concordance rates are not universally replicated in the literature; recent studies have shown rates of around 40% for monozygotic and <10% for dizygotic twins (see Kieseppa, 2004 and Cardno, 1999).
In 2003, a group of American and Canadian researchers published a paper that used gene linkage techniques to identify a mutation in the GRK3 gene as a possible cause of up to 10% of cases of bipolar disorder. This gene is associated with a kinase enzyme called G protein receptor kinase 3, which appears to be involved in dopamine metabolism, and may provide a possible target for new drugs for bipolar disorder.
Ongoing research
The following studies are ongoing, and are recruiting volunteers:
The Maudsley Bipolar Twin Study, based at the Institute of Psychiatry in London is conducting research about the genetic basis of bipolar disorder using twin methodology. Currently recruiting volunteers: identical and non-identical twins pairs, where either one or both twins has a diagnosis of bipolar I or II.
The MRC eMonitoring Project, another research study based at the Institute of Psychiatry and Newcastle Universities, is conducting novel research on electronic monitoring methodologies (electronic mood diaries and actigraphy) for tracking bipolar symptom fluctuations in Bipolar individuals who are interested in self-managing their condition.
Medical imaging
Researchers are using advanced brain imaging techniques to examine brain function and structure in people with bipolar disorder, particularly using the functional MRI and positron emission tomography. An important area of neuroimaging research focuses on identifying and characterizing networks of interconnected nerve cells in the brain, interactions among which form the basis for normal and abnormal behaviors. Researchers hypothesize that abnormalities in the structure and/or function of certain brain circuits could underlie bipolar and other mood disorders, and studies have found anatomical differences in areas such as the prefrontal cortex and hippocampus.
Better understanding of the neural circuits involved in regulating mood states, and genetic factors such as the cadherin gene FAT linked to bipolar disorder, may influence the development of new and better treatments, and may ultimately aid in early diagnosis and even a cure
New treatments
In late 2003, researchers at McLean Hospital found tentative evidence of improvements in mood during echo-planar magnetic resonance spectroscopic imaging (EP-MRSI), and attempts are being made to develop this into a form which can be evaluated as a possible treatment.
NIMH has initiated a large-scale study at 20 sites across the United States to determine the most effective treatment strategies for people with bipolar disorder. This study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), will follow patients and document their treatment outcome for 5-8 years. For more information, visit the Clinical Trials page of the NIMH Web site.
Transcranial magnetic stimulation is another fairly new technique being studied.
from wikipedia
Depression Treatment: Massage
MASSAGE, IT'S ROLE IN MANAGEMENT OF STRESS, ANXIETY AND DEPRESSION
Massage is one of the oldest healing techniques used to help us overcome psychological and physical health problems. It has probably been used since the dawn of human evolution and has been found to have been used in countries all over the world and in the early part of this century was still used in orthodox medical hospitals and clinics, but fell out of favour when high tech. medicine began to dominate our health care system.
BENEFICIAL BIOCHEMICAL EFFECTS OF REGULAR MASSAGE
Research indicates that massage can be of value in helping reduce stress, anxiety and depression. Massage causes the body to release many therapeutic mood and health enhancing chemicals, it increases dopamine and serotonin and reduces the stress hormones cortisol and adrenaline. It increases the relaxation alpha brain waves and also increases pain relieving levels of endorphins. Massage lowers noradrenaline and lowers the stress hormone ACTH (Adrenocorticotrophic hormone). Massage boosts the immune system, stabilises blood sugar levels, improves lung function and peak air flow, it generally reduces the number of visits to the doctor whilst increasing work productivity.
MASSAGE AND ANXIETY
Regular massage can help to reduce our anxiety levels. Research by Tiffany Fields, at the Touch Research Institute at the University of Miami School of Medicine in the USA looked into the therapeutic value of massage in reducing anxiety and depression. The data from this study indicated that massage produced marked reductions in anxiety and depression in people who were massaged, but not in a control group who were not massaged. Mood and sleep patterns also improved they slept more soundly and for longer periods of time. The subjects massaged were found to have lower levels of cortisol stress hormone in their saliva and depressed people also had lower levels of urinary cortisol and noradrenaline which increase in times of stress. Other studies have confirmed this research. Adults with chronic anxiety problems, people with muscle tension, aches and pains etc, who did not improve after being given anti-anxiety medication/antidepressants, muscle relaxants and relaxation training, were given a course of massage. Afterwards most reported less tension, pain and need for medication.
MASSAGE AND DEPRESSION
Andrew Vickers, a researcher formerly with the Research Council for Complementary Medicine who carried out research into the value of complementary medicine's in psychological health problems which was published in the journal "Psychiatry in Practise", said it's far too simplistic to say massage can cure depression or other diseases, but it can help us to cope better and improve the quality of life.
HOW MASSAGE WORKS
Our skin is full of many millions of nerve receptors that are linked to our nervous system. When the skin is massaged it causes stimulation and release of chemicals in the brain like serotonin that help reduce stress, anxiety and depression. It's known that the skin and nervous system are intimately connected. A single part of the developing foetus known as the neuroectoderm gives rise to both.
HEAD MASSAGE
You don't have to have a full body massage to obtain the benefits of massage, you can massage the head and shoulders to induce relaxation, you don't even have to get undressed or use massage oils. You can visit a qualified head massage therapist but it can work out expensive. The best philosophy is to be as self sufficient as possible. Many Adult Education Centres now run relatively low priced courses in head massage with reduced fees for those on DSS benefits.
CONDITIONS HELPED BY MASSAGE
Massage has been shown to be beneficial in many physical and psychological health problems such as Stress, Anxiety, Depression, Anaemia, Pain, Back Pain, Insomnia, Pregnancy, High Blood Pressure, Asthma, Infertility, Eating Disorders, Diabetes Mellitus, Human Defficiency Virus, to name but a few.
CAUTION
If you have a chronic health problem it is wise to check with your GP that it is okay for you to receive massage. In a small minority of cases, massage may have to be used with caution in people who suffer epilepsy. Be careful when using head and neck massage if you have skeletal, neck problems. Don't massage wounds, lumps, infected or damaged/diseased areas of skin. Finally, research has indicated that not only the person being massaged benefits from massage, the person applying the massage also gains health benefits. A study at the Touch Research Institute, in the USA found that people who gave shoulder massages to their relatives reported feeling less depressed.
from http://stresshelp.tripod.com/id8.html
Massage is one of the oldest healing techniques used to help us overcome psychological and physical health problems. It has probably been used since the dawn of human evolution and has been found to have been used in countries all over the world and in the early part of this century was still used in orthodox medical hospitals and clinics, but fell out of favour when high tech. medicine began to dominate our health care system.
BENEFICIAL BIOCHEMICAL EFFECTS OF REGULAR MASSAGE
Research indicates that massage can be of value in helping reduce stress, anxiety and depression. Massage causes the body to release many therapeutic mood and health enhancing chemicals, it increases dopamine and serotonin and reduces the stress hormones cortisol and adrenaline. It increases the relaxation alpha brain waves and also increases pain relieving levels of endorphins. Massage lowers noradrenaline and lowers the stress hormone ACTH (Adrenocorticotrophic hormone). Massage boosts the immune system, stabilises blood sugar levels, improves lung function and peak air flow, it generally reduces the number of visits to the doctor whilst increasing work productivity.
MASSAGE AND ANXIETY
Regular massage can help to reduce our anxiety levels. Research by Tiffany Fields, at the Touch Research Institute at the University of Miami School of Medicine in the USA looked into the therapeutic value of massage in reducing anxiety and depression. The data from this study indicated that massage produced marked reductions in anxiety and depression in people who were massaged, but not in a control group who were not massaged. Mood and sleep patterns also improved they slept more soundly and for longer periods of time. The subjects massaged were found to have lower levels of cortisol stress hormone in their saliva and depressed people also had lower levels of urinary cortisol and noradrenaline which increase in times of stress. Other studies have confirmed this research. Adults with chronic anxiety problems, people with muscle tension, aches and pains etc, who did not improve after being given anti-anxiety medication/antidepressants, muscle relaxants and relaxation training, were given a course of massage. Afterwards most reported less tension, pain and need for medication.
MASSAGE AND DEPRESSION
Andrew Vickers, a researcher formerly with the Research Council for Complementary Medicine who carried out research into the value of complementary medicine's in psychological health problems which was published in the journal "Psychiatry in Practise", said it's far too simplistic to say massage can cure depression or other diseases, but it can help us to cope better and improve the quality of life.
HOW MASSAGE WORKS
Our skin is full of many millions of nerve receptors that are linked to our nervous system. When the skin is massaged it causes stimulation and release of chemicals in the brain like serotonin that help reduce stress, anxiety and depression. It's known that the skin and nervous system are intimately connected. A single part of the developing foetus known as the neuroectoderm gives rise to both.
HEAD MASSAGE
You don't have to have a full body massage to obtain the benefits of massage, you can massage the head and shoulders to induce relaxation, you don't even have to get undressed or use massage oils. You can visit a qualified head massage therapist but it can work out expensive. The best philosophy is to be as self sufficient as possible. Many Adult Education Centres now run relatively low priced courses in head massage with reduced fees for those on DSS benefits.
CONDITIONS HELPED BY MASSAGE
Massage has been shown to be beneficial in many physical and psychological health problems such as Stress, Anxiety, Depression, Anaemia, Pain, Back Pain, Insomnia, Pregnancy, High Blood Pressure, Asthma, Infertility, Eating Disorders, Diabetes Mellitus, Human Defficiency Virus, to name but a few.
CAUTION
If you have a chronic health problem it is wise to check with your GP that it is okay for you to receive massage. In a small minority of cases, massage may have to be used with caution in people who suffer epilepsy. Be careful when using head and neck massage if you have skeletal, neck problems. Don't massage wounds, lumps, infected or damaged/diseased areas of skin. Finally, research has indicated that not only the person being massaged benefits from massage, the person applying the massage also gains health benefits. A study at the Touch Research Institute, in the USA found that people who gave shoulder massages to their relatives reported feeling less depressed.
from http://stresshelp.tripod.com/id8.html
Depression Treatment: Banana
I write a market report for a local produce company that I used to work at full time prior to attending culinary school. It’s a quick job that takes me a couple of hours on Wednesday afternoons and pays me just enough to keep me from feeling like a total slacker. I get first-hand knowledge of all things produce related from the guys in the company buying office, sometimes including free samples of things. One of the buyers, Mark, sent me this article about the nutritional power of the Banana, and I loved it. You must read it too, if only for the funny part at the end about the monkeys. Thanks Mark! I do want some of that organic chevre too!
Facts About Bananas
Never, put your banana in the refrigerator!!!
This is interesting. After reading this, you’ll never look at a banana in the same way again.Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world’s leading athletes. But energy isn’t the only way a banana can help us keep fit. It can alsohelp overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.
Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier.
PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood.
Anemia: High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia.
Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit’s ability to reduce the risk of blood pressure and stroke.
Brain Power: 200 students at a Twickenham (Middlesex) school were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert.
Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives.
Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system.
Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief.
Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness
Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation.
Nerves: Bananas are high in B vitamins that help calm the nervous system.
Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high- pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady.
Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over- chronicler cases. It also neutralizes over-acidity and reduces irritation by coating thelining of the stomach.
Temperature control: Many other cultures see bananas as a “cooling” fruit that can lower both the physical and emotional temperature of expectant mothers. In Thailand, for example, pregnant women eat bananas to ensure their baby is born with a cool temperature.
Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan.
Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, and B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal.
Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body’s water balance. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack.
Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%!
Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape!
So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is oneof the best value foods around So maybe its time to change that well-known phrase so that we say, “A banana a day keeps the doctor away!”PS: Bananas must be the reason monkeys are so happy all the time! I willadd one here; want a quick shine on our shoes?? Take the INSIDE of thebanana skin, and rub directly on the shoe…polish with dry cloth. Bananas….Amazing fruit !!
from http://cooknkate.wordpress.com/
Facts About Bananas
Never, put your banana in the refrigerator!!!
This is interesting. After reading this, you’ll never look at a banana in the same way again.Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world’s leading athletes. But energy isn’t the only way a banana can help us keep fit. It can alsohelp overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.
Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier.
PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood.
Anemia: High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia.
Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit’s ability to reduce the risk of blood pressure and stroke.
Brain Power: 200 students at a Twickenham (Middlesex) school were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert.
Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives.
Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system.
Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief.
Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness
Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation.
Nerves: Bananas are high in B vitamins that help calm the nervous system.
Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high- pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady.
Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over- chronicler cases. It also neutralizes over-acidity and reduces irritation by coating thelining of the stomach.
Temperature control: Many other cultures see bananas as a “cooling” fruit that can lower both the physical and emotional temperature of expectant mothers. In Thailand, for example, pregnant women eat bananas to ensure their baby is born with a cool temperature.
Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan.
Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, and B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal.
Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body’s water balance. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack.
Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%!
Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape!
So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is oneof the best value foods around So maybe its time to change that well-known phrase so that we say, “A banana a day keeps the doctor away!”PS: Bananas must be the reason monkeys are so happy all the time! I willadd one here; want a quick shine on our shoes?? Take the INSIDE of thebanana skin, and rub directly on the shoe…polish with dry cloth. Bananas….Amazing fruit !!
from http://cooknkate.wordpress.com/
Treat Depression with Video Games!
Contrary to popular belief, the lives of gamers aren't necessarily all lame and depressing. In fact, recent studies from the US National Institute of Mental Health shown that depressed people pwn less than non-depressed people in video games that test spatial memory. Depression has been associated with a shrunken hippocampus, a part of the brain that influences spatial memory performance. USNIMH researchers have developed a video game based on scenes from Duke Nukem where players navigate around a virtual town trying to hit up as many landmarks as possible in a limited amount of time. The depressed players averaged at 2.4 locations in comparison to "healthy" players with 3.8 locations. Players suffering from deeper depressions yielded lower scores -- an indicator that these tests may someday lead to quantitatively measuring different levels of depression. Of course, it's hard to quantify how much a continued lack of Duke Nukem Forever might have tainted these results.
from www.engadget.com
from www.engadget.com
Ways to Overcome Depression - Do's & Dont's
DO: Get Plenty of Sunshine
And by sunshine, I mean by going outdoors and having sunlight fall directly on your skin, for at least 10-15 minutes a day, preferably early in the day but late afternoon is good too. This makes a tremendous difference to my productivity level and mood during the day. Opening the shades to get natural light in my office helps too, but not nearly as much as getting outside does.
The body has plenty of hormones whose activity is regulated by sunlight. Sunlight is also a factor in the production of vitamin D.
DO: Move around
You don't have to work out, you just have to get out. Take a walk. Bend over and pick stuff up off the floor. Bounce on a trampoline. Your heart isn't the only muscle that pumps blood, and for that matter, blood isn't the only vital fluid that moves through your body. The lymph system, for example, depends on movement and deep breathing, which brings us to...
DO: Breathe deeply
Depressed people look down and breathe shallowly. Don't do that. Look up, so that your throat opens up and you can breathe deeply without effort. Combine this with moving around in the sunlight outdoors, and you're almost set.
...
Read the rest at dirtsimple.org
And by sunshine, I mean by going outdoors and having sunlight fall directly on your skin, for at least 10-15 minutes a day, preferably early in the day but late afternoon is good too. This makes a tremendous difference to my productivity level and mood during the day. Opening the shades to get natural light in my office helps too, but not nearly as much as getting outside does.
The body has plenty of hormones whose activity is regulated by sunlight. Sunlight is also a factor in the production of vitamin D.
DO: Move around
You don't have to work out, you just have to get out. Take a walk. Bend over and pick stuff up off the floor. Bounce on a trampoline. Your heart isn't the only muscle that pumps blood, and for that matter, blood isn't the only vital fluid that moves through your body. The lymph system, for example, depends on movement and deep breathing, which brings us to...
DO: Breathe deeply
Depressed people look down and breathe shallowly. Don't do that. Look up, so that your throat opens up and you can breathe deeply without effort. Combine this with moving around in the sunlight outdoors, and you're almost set.
...
Read the rest at dirtsimple.org
Monday, March 12, 2007
How to manage the depression independently?
Contemporary person, in particular, that lives in the megapolis, with his idols makes to quarry, success, the vital timetable, where each step, each workday, any visit toward the doctor, marches into the gymnasium, the bells and the encounters with the close ones and the relatives and all the remaining components of our life are painted literally on the minutes. We learned briefly to talk on the cell phones: only main thing, only basic "on business, in the essence". Even our leisure is frequently planned in good time and in it also there is a timetable. We rush in the rabid rhythm, conquering to ourselves right to leisure and happiness, sometimes losing their meaning itself, lichen ourselves happiness simple to live. At some moment "happiness of life" it becomes the prize, which can be obtained only by the price of improbable efforts and steady determination. We begin to reject to ourselves everything, to load ourselves excessively, strashas' not to have time. The success of our career swiftly grows, external achievements frequently strike with spread, but us increasingly more strongly gnaws of inferiority complex and vague dissatisfaction. But, possibly, somewhere in the program did occur failure? And key to happiness is the most direct - this is its obtaining? In our everyday everyday language of word the "hedonism" and "pleasure", became almost abusive. But meanwhile ancient (which were, probably, wiser us) they knew how to delight in by life and to value its pleasures. The tendency of people, which experience difficulties and stress also is not by chance to search for the methods to be scattered and to be distracted for itself. But it is important so that the minutes of pleasure not would be overloaded by unrealistic expectations or provoked by a feeling of desperation, since then they worsen the matter, causing feeling of guilt and reduction in the self-appraisal, and simply subjecting the organism of excessive of that not expected let and to the pleasant load (indeed it cannot be month been fasted, and then at once eaten entire cake). But it means, pleasures must be dosed, practiced regularly, to make by their standard of its life, but not to attempt to squeeze into painted on the hours weekly "leisure". And in order to make the first step they approach the simplest and even free things: To find in the park bench, to sit down and to observe life. Lying at the hammock, to contemplate the celestial sphere. To rock on the waves in the ocean. To go, where eyes look. In the complete silence to read the book. To snooze on solnyshke. To accept bath with the spark plugs. To sleep, to sleep and to sleep to the exhaustion. To look the film of French director. To pomassirovat' sole. To study love in the rain. To dance dirty dances. To sit in the silence. To without restraint begin to laugh.
Suicides and the depression
Is only one properly serious philosophical problem - problem of suicide. To a. kamyu (1990. s. 24 - 25)
The World Health Organization separates the problem of suicides to one of the important medico- social problems of contemporary society. In many countries the suicides are located among the first 10 reasons for mortality, and among the adolescents and the youthful population they occupy the third place. Yearly, from its own hand die about half million of people; moreover these data, undoubtedly, are underestimated. Only in the last decade in Russia is noted an increase in the prevalence of suicides before 45-56 cases by 100 thousand populations per year, and in the separate regions and the population groups - to 90 and more, which is combined with the parallel growth of the frequency of depressions and abuse of alcohol. Depression - reason 70% for all perfect suicides. Many authors are agreed in the opinions that the large number of suicides, which we have, is connected with the inadequate treatment of depression. Depressive disorders, in turn, are one of the most frequently meeting psychopathological states. The approximately each tenth inhabitant of planet transfers during his life depression, and in each twentieth it is repeated. Thus, for the preventive maintenance of suicides, is necessary early taking of adequate diagnostic measures for the purpose of timely development and treatment of depressive disorders.
The World Health Organization separates the problem of suicides to one of the important medico- social problems of contemporary society. In many countries the suicides are located among the first 10 reasons for mortality, and among the adolescents and the youthful population they occupy the third place. Yearly, from its own hand die about half million of people; moreover these data, undoubtedly, are underestimated. Only in the last decade in Russia is noted an increase in the prevalence of suicides before 45-56 cases by 100 thousand populations per year, and in the separate regions and the population groups - to 90 and more, which is combined with the parallel growth of the frequency of depressions and abuse of alcohol. Depression - reason 70% for all perfect suicides. Many authors are agreed in the opinions that the large number of suicides, which we have, is connected with the inadequate treatment of depression. Depressive disorders, in turn, are one of the most frequently meeting psychopathological states. The approximately each tenth inhabitant of planet transfers during his life depression, and in each twentieth it is repeated. Thus, for the preventive maintenance of suicides, is necessary early taking of adequate diagnostic measures for the purpose of timely development and treatment of depressive disorders.
Treatment of depression by the light
The treatment of depression for the elongation more than twenty years try to achieve with the aid of the light, designing for a change in the disrupted biological rhythms of sick person. It was experimentally proven that a change of the biological rhythms in the human organism occurs with his illumination by the luminous source of enhanced intensity. Were undertaken attempts at warning the seasonal aggravation of depression by "lengthening of the day period of twenty-four hours" with the aid of the artificial lighting and the deprivation of sleep. It is assumed that the bright and prolongedly influencing light influences in the centers of circadian rhythms, suppresses in the epiphysis (gland of internal secretion, the partly regulated activity of other organs of endocrine system) the secretion of melatonin, is produced a change of the concentration of hydrocortisone and ACTH in the blood of patient, it changes the synthesis of catecholamines, it possesses sympathicotonic and parasympathicotonic (due to the thermal effect) action. In the final analysis, these changes lead to the treatment of depression. For obtaining the therapeutic effect is necessary the illumination of accomodation not less than 2600 and not more than 8000 lux. The necessary illumination is achieved by the application of incandescent lamps, located on the ceiling of chamber at the height of approximately 2,5 it is meter. Usually are used 27 incandescent lamps on 200 W noted, that the effectiveness of treatment by light rises during painting of therapeutic accomodation in the white or green color, and also with the maximum (more than 25%) nakedness of body. Thoroughly they inspect before beginning the therapy by the light of patient. The treatment of depression by light can be conducted at any time of twenty-four hours both daily and from two - by three-day interruptions. During the therapeutic session the patients, whom they request not to only shut eye, can freely be moved through the room. The majority of specialists the positive effect of the therapy by light relates with strengthening of the cerebral cortex regulating functions, and also with the normalization of the activity of vegetative system. It is interesting to note sensitivity to the therapy by the light of patients with the manifestations of anxiety. To a lesser degree to this form of therapy react the patients with the symptoms of melancholy and apathy. Speaking about the mechanism of the therapeutic effect of this therapy should be noted the thermal effect of light. By general contra-evidence to the treatment of the depression and other mental disorders light are oncologic diseases and pathology of eyes. At present for treating the depression with the aid of the light special table instruments are developed.
Psychotherapy of the depression
Depression cannot be treated without psychotherapy and patients themselves strive for this form of medical and psychological aid. They for a long time are not decided to resort to the method of preparations and, after beginning the method of antidepressants, they sufficiently frequently rapidly cease drug treatment. In view of helplessness and constant doubts, the patients are usually suggested and, reading annotation to these or other medicines, they easily reveal in itself side effects already during the first days of treatment. Furthermore, patients, who suffer depression, have the functional disorders of internal organs and in view of this are actually sensitive to the side effects of preparations. Many patients experience false alarm with respect to a constant dependence on the antidepressants. The substantial part of the patients, who suffer depression, relates to the placebo - reactors, i.e., to people, which easily react to the method even the "empty tablets", which not at all contain what - or active medicinal substance. Entire above-enumerated determines the increased interest of such patients in psychotherapy. Those experimental data are the serious argument, which testifies about the role of psychotherapy in the treatment of depression, which speak about the value of psychological factors in the formation of the therapeutic stability of depression to the medicines. The effective course of psychotherapy in the long-term outlook is useful possible, than pharmacotherapy, since it trains patient. The latter acquires the habits of overcoming depression, it learns to recognize its approximation, to prevent the development of its relapse. As the results of many studies showed, the normalization of endocrine indices in the process of the therapy of depression is achieved not only in the process of treatment with antidepressants, but also with psychotherapy. Moreover the influence of psychotherapy on the endocrine indices is observed both in the case of its combination from the psycho-pharmacological therapy and in the case of use it as the only method of treatment. In a number of cases psychotherapy gives the possibility to patients to be adapted to the real life with the preservable disturbances of affective sphere, thinking and installations. Possessing independent therapeutic effect, psychotherapy contributes to the optimum collaboration of patient and doctor, increases the effectiveness of drug treatment, improves family relations and professional status of patient. The frequent beginning of depression after sharp mental injury or protracted state of stress they lead to the persistent searches for the psychological reasons for its appearance. This circumstance, strengthens the tendency of patients toward the psychological aid. However, the superfluous overestimation of its possibilities, unfortunately, can lead to the complete refusal of the psychotropic means, the formation of the resistance and protracted versions of the flow of depression, the appearance of its early aggravations. From the point of view of doctor psychotherapy of depression must be first of all directed toward the elimination of its symptoms. Some of them prove to be more sensitive to psychotherapy, others comparatively with difficulty be subject to its effect. It is customary to assume that with the heavy depressions of the possibility of psychotherapy it is more than ogranichenny, than in the mild cases of disease. The disorders of mood, thinking, behavior, motivational and physiological symptoms are separated as the targets of psychotherapeutic action with the depression. Among the affective symptoms - grief, the feeling of guilt and shame and especially anxiety it is especially sensitive to the psychotherapeutic action. It is possible to isolate the number of the general principles of the work of psychotherapist with the patient, who suffer depression. The control of doctor on its own feelings with respect to the patient is here important, since is possible the appearance a feeling of void, irritation, superfluous sympathy and fatigue. Psychotherapist not only sympathizes to patient, but also attentively he controls it, preserving the specific distance. In the process of therapy it is necessary to strictly regulate the time of contact with the patient, to support the structure of forward motion to the recovery. The active setting of the goal-directed questions, confidence in the diagnosis, assignment of real hope relate to the fundamental rules of the treatment of depression. Studies showed that the hope obtained from the doctor is retrospectively evaluated by patients as important aid in the process of overcoming the depression. By the special feature of the work of psychotherapist with the patient with depression appears not so much mutual anxiety, as understanding state and, in particular, possibility of the appearance of the episodes of negative changes in the mood. Frequently the patient attempts "it to be sultry" psychotherapist with his infinite expectation of aid, and the latter commits error, being released into the theoretical explanations and the searches for the psychological reasons for depression. In reality the psychotherapist must approach that so that the patient would focus attention on himself and would search for the ways of the adequate perception of his situation. Conversation with the patient about the symptoms of his state is especially undesirable, to it is much more important emphasize the dependence of their manifestation on different situations, to conduct conversation about the special features of nature and interrelations with the surrounding people. The compassion of psychotherapist usually strengthens in patient the expectation of aid, the attempt to weaken the manifestation of symptoms leads to their strengthening, comfort - to the depression. It is important to lead patient to the need for self-help, but not to comfort him, to show it importance to accept itself as such, such as it there is. For treating the depression different methods of psychotherapy were proposed: Psychoanalysis. Client- centered therapy. Existential therapy. Interpersonal therapy. Cognitive therapy. Therapy by recollections. Change of the projection with time. Relaxation training. Therapy of the solution of social problems and other methods of psychotherapy. Including its mixed or eclectic versions. In the opinion of the majority of researchers the cognitive therapy, which is focused on the correction of the special features of thinking patients, who suffer depression, is most effective with the treatment of depression.
Treatment of the depression
The determination of depression depression - is the disease, which can take man away from the emotional equilibrium for a long time and considerably worsen the quality of his life (working activity, personal relations, leisure, etc.). Depression can arise as response reaction to the previous psychological injury or the negative event (death of close person, release from the work, etc.), however, frequently it is developed without the visible reason. It is important to know that: Depression yields well to treatment, as a result of which complete recovery begins. To speak about its problem - means to make the first step on the way of recovery from the depression. Typical symptoms of the depression: Melancholy, grief, anxiety or irritability. Difficulties of falling asleep, the repetitive awakenings at night or too early awakening. Loss of interest in the work, the food, the sexual life. Feeling of guilt and its own inferiority, hopelessness with respect to future. Difficulties of concentration and a constant fatigue. Decrease in weight or, on the contrary, addition in the weight. Headaches, pain in the region of heart, back (without the organic reasons). Superfluous preoccupation by its own health. Thoughts about suicide and death. Man depression depression in men frequently will recognize with difficulty. This is caused, from one side, by the widespread erroneous opinion what to tell others about its problems and not to know how very to manage them - this is the sign of the weakness of man, but from other side, fact that the men often hide their depression for the aggressive behavior and/or for the abuse of alcohol. Alcohol - not only means, with the aid of which they attempt to facilitate depression or to disguise it. Withdrawal with the head into the work, the active occupation by sport or enthusiasm by such forms, which are connected with the risk or the extreme situations, and also enthusiasm by the game of chances - all this can testify about the depression in men. Typical symptoms of depression in the men: Reduction in the stability to the stress. Soyavleniye of uncertainty in decision making. Aggressive and hostile behavior. Abuse of alcohol, alcoholic dependence. Syndrome of "burnout". Manifestation of impulsive behavior. Enthusiasm by the extreme forms of sport, the intentional excessive physical activity. Thoughts about suicide and death.
Women Depression
Depression in the women "female nature" or special predisposition to the disease? The unhealthy state, which is manifested by characteristic symptoms, is called depression. Depression in no way is the manifestation of the weakness of nature. This is the serious disease, which is accompanied by the disturbances of all mental and even solid (sleep, appetite, the weight of body and others.) the functions of man. Loss or reduction in the volitional qualities - one of the symptoms of depressive disease. Therefore one ought not to advise person, who suffers depression, "to take itself in the hands" - it will not be able to overcome disease without the medical aid. Depression substantially is reflected in the fitness for work, the studies, the social life, the interrelations with others, including close ones. Is there a connection of depression with the feminine sex? To doctors it is well known that the women suffer the depression of more frequent than men. This fact is reliably confirmed by the results of numerous large epidemiological studies in the different countries, including in Russia. The frequency of depressions in women is 2-3 times higher than in men. In contemporary medicine feminine sex relates to the number of factors, which predispose to the development of depression. With which is connected the predisposition of women to the depression? Depression in many respects is connected with the changes in the hormonal background, which occur in the female organism at childbearing age. The so-called reproductive (genital) cycle passes a number of stages, beginning from the appearance of monthly and concluding by their disappearance: menstrual cycle, pregnancy, kinds, preclimacteric and climacteric periods. On each of these stages in the composition and quantity of hormones occur the significant changes, which are accompanied by physiological changes in all functions of female organism, including mental sphere. Therefore such changes in the hormonal background are connected with an increase in the risk of the development of depression. How is manifested depression in women? As has already been spoken, the risk of depression rises for each of the stages of reproductive cycle. In clinical medicine the different versions (syndromes) of the depressions, characteristic for each of the stages of reproductive cycle, are separated, premenstrual syndrome, depressive syndrome of pregnant females, syndrome of "melancholy of parturients", postpartum depressions and depressions in the preclimacteric and climacteric periods. The manifestations of depression can be different. Depressive mood can be manifested by the depression, depression and apathy as well as increased irritability, tearfulness, anxiety, feeling of internal stress. A change in the mood is usually accompanied by reduction in the activity, by feeling of the loss of energy, increased by fatigue, by the absent-mindedness of attention. Depressions in women are frequently accompanied by the diverse somatical disturbances: by changes in the sleep (insomnia or the increased sleepiness), the appetite (reduction in the appetite or its increase). Can appear the discomfort of stress and a feeling of pain in the mammary glands, headaches, pain in the joints and the muscles, the pain into the heart and the periodic sensations of palpitation, weakness in of tele-, the fluctuation arterial pressure, etc. The duration of the depressions, connected with the reproductive cycle, can be different. Premenstrual depressive syndrome usually short-term, approximately 2 weeks (1 week to even 1 week after menses), but has the relapsing nature with the corresponding to menstrual cycle monthly aggravations. Postpartum depressions and depressions of climacteric period can be more protracted and continue on several weeks and even months. How it is possible to treat depression? Depression - curable disease. With the condition for the correct selecting of the corresponding medicine and its dose the most complete possible deliverance from the symptoms of depression. The treatment of depression is conducted only with the aid of the special medicines, which are called antidepressants. Doctor must prescribe the treatment of depression only. It is necessary to remember that in each person the depression has its special features, connected both with the degree of gravity of disease, and with his clinical manifestations. The correct selection of the means of treatment in each specific case requires the estimation of many special features of the state of patient. Correct to reveal, to estimate and qualify such special features can only doctor. On no account should be come running to the councils of close ones or familiar either selected the means of treatment independently, on the basis of the fact that one or other preparation or another helped someone, whom you know. This rule it is necessary to soblyudat', especially if a change in the mood is accompanied by the expressed changes in the general health, by the disturbances of solid functions and by pains, which is most characteristic for the depressions, connected with the reproductive cycle. In such cases only the doctor can correctly estimate nature of symptoms, determine the real state of internal organs and select the medicine, which will be not only effective, but also safe. Categorically one should not independently assume antidepressants during the pregnancy and breast feedings. Today there is a large quantity of antidepressants. All contemporary preparations of this class are effective and safe means. However, each of the preparations has their distinctive special features, connected both with the therapeutic action, and the methods of its method, dosing. The treatment of depression requires time. One ought not to await complete recovery already during the first days of the method of preparation. It is necessary to remember that all contemporary antidepressants begin to affect depression not earlier than 1 -2 weeks after the beginning of treatment. The selection of the necessary dose of preparation also is accomplished during this period. The cancellation of antidepressant, just as its designation, must be carried out only by doctor. Even after the complete disappearance of all symptoms of depression it is necessary to continue the method of antidepressant during the specific period of time. This is connected with the fact that the risk of the aggravation of depression in the case of the premature cancellation of therapy is very high - to 60-80%. Moreover, aggravation of depression, connected with the premature curtailment of treatment, as a rule, it more complexly yields to therapy. The duration of this additional period of the treatment, whose purpose - preventive maintenance aggravation, determines only doctor on the basis of the specific features of each patient. You remember that even if you decide to end treatment ahead of time, which determined the doctor, it is necessary compulsorily to confer with it.
Self-diagnostics of depression
Now depression advances all other mental frustration on a degree of damage for work capacity and accordingly on a share of the years lost for a high-grade life. The significant share of patients with depressive frustration addresses for the help in общесоматическую a network. Thus only in 10-30 % of cases depression is distinguished(recognized) in due time. In the present(true) test(dough,father-in-law) symptoms of depression and an estimation of its(her) weight are brought into accord with criteria of the International classification of illnesses of 10-th revision but filled by the concrete maintenance(contents) from our personal medical practice.
Typical (basic) symptoms of depression:
The mood bad, suppressed, nasty, gloomy, disgusting, decadent, melancholy, " is lovely nothing ", " boredom on a shower(soul) ", " all is grey for me ".
" There is no bent for to business ": you postpone performance of any plans or affairs, or long adjust(set up) yourself on their performance. There is no desire to penetrate in essence of a business problem, maintenance(contents) of the important conversation - know, that it should be made, but do not do(make). Industrial decisions, business acquaintances also postpone on "tomorrow". Nothing interests, it would not be desirable anything to do(make), and know what to do(make) it is necessary. Pleasures are not present such as before - " All became somehow all the same ". For a long time it is forgotten, when with something were pleased.
Get tired at once, even after insignificant physical effort, or in the evening after returning from work on what there are no forces. The sensation of constant weariness is possible(probable). It seems, that had never a rest. It would be desirable to dump(reset) from itself duties on the house, on work - to have a rest, gain strength. However, short-term rest does not improve a condition, and entertainments quickly lose the appeal.
Other symptoms of depression:
It is difficult to concentrate at presence of the irritator(for example, the TV, radio, conversation in the next room works); because of "parallel" ideas - " I Read, and I think of other ". In dialogue it became difficult to select words, to catch a string of conversation; at reading books, magazines, the business documentation the sense read through is hardly caught, it is necessary to re-read pages anew.
There was unusual to you an indecision, constant doubts in performance of ordinary household and well familiar professional duties, after the made decision. The confidence of - " Suddenly not was gone so I shall tell, not so I shall make ".
The critical estimation of all last life - " Everything is possible(probable), that was in the past senseless, it was necessary to be engaged in another ". You test burdensome feeling of "burden" in family, " the superfluous person " on work. Reproach itself with the irresponsible attitude(relation) to the filial or affiliated duties, insufficient attention to other close relatives.
You are overcome with gloomy reflections that you are "loser", cannot solve in a life the problems; ascertaining of full professional bankruptcy, finish (" I have fulfilled the a resource "). Gloomy and pessimistic vision of the future can be filled and rather concrete household circumstances.
From time to time there are ideas - " Can be is easier die, as all badly, badly, badly... ", hopelessly, it is not visible prospects and, in general, the life for you has ceased to be something significant, has lost the sense.
Frustration of a dream are various enough. It is the complicated period засыпания; reduction of hours of a night dream because of frequent awakenings; awakenings in 3-4 one o'clock in the morning or 5 o'clock in the morning with the subsequent sleeplessness. At all variants of frustration of a dream after final awakening there is no feeling of freshness (rest) in the morning.
Appetite is lowered (" I Can be limited for a day to a glass of tea "), or appetite is absent at all, is possible(probable) even with disgust for a kind and a smell of food.
Self-diagnostics of depression
In the event that you do not type(collect) any 3 symptoms (the basic and additional list), you do not have depressive frustration of mood according to criteria МКБ-10.
Easy(Light) depressive frustration
Presence any 2 typical symptoms of depression and even 2 symptoms from the list "and". You are concerned by the condition. Experience the certain difficulties in performance of usual work and social activity.
The moderate depressive frustration
Presence any 2 typical symptoms of depression and not less than 3 (it is preferable 4) from the list "and". There are значитель-th difficulties in performance of social duties, house affairs and continuation of professional work.
Heavy depressive frustration
Presence of all of 3 typical depressive symptoms and 4 or more from the list "and". Social and house activity can be carried out very much ограниченно or its(her) performance is improbable.
At presence of depressive frustration of mood according to the resulted(brought) criteria your condition can be aggravated with a number(line) of additional painful(unhealthy) displays:
You would like to be to one (one), from all to be fenced off; desire " to creep as a snail in a bowl - that nobody touched you, to not answer questions ".
Relatives notice, that you became unusually silent; the smile has disappeared from the person(face).
The attitude(relation) with relatives in family, employees on work become complicated unusual for you early the raised(increased) irritability reaching at times before aggression.
Heavy feeling in a breast (" As a stone on heart ", " As the elephant has come(stepped) ") or ноющая a pain in the left half of breast, or sensation of burning behind a brest.
There was a sluggishness unusual for you in movements, or, on the contrary, impellent excitation, anxiety, restlessness (" I can not find to myself a place ").
During depression the sexual inclination - " considerably(much) decreases As cut off, I do not think at all of it(this) "
Especially badly you feel yourselves in the morning and in the afternoon. By the evening the state of health improves (a typical daily rhythm of depressive frustration of mood a little.
Attempt to improve the state of health to remove(take off) sincere discomfort reception of alcohol brings only temporary and unstable effect.
In case you will find at yourselves or at a member of the family of the basis for self-diagnostics of depressive frustration of mood, it is necessary to address for the psychotherapeutic help.
Typical (basic) symptoms of depression:
The mood bad, suppressed, nasty, gloomy, disgusting, decadent, melancholy, " is lovely nothing ", " boredom on a shower(soul) ", " all is grey for me ".
" There is no bent for to business ": you postpone performance of any plans or affairs, or long adjust(set up) yourself on their performance. There is no desire to penetrate in essence of a business problem, maintenance(contents) of the important conversation - know, that it should be made, but do not do(make). Industrial decisions, business acquaintances also postpone on "tomorrow". Nothing interests, it would not be desirable anything to do(make), and know what to do(make) it is necessary. Pleasures are not present such as before - " All became somehow all the same ". For a long time it is forgotten, when with something were pleased.
Get tired at once, even after insignificant physical effort, or in the evening after returning from work on what there are no forces. The sensation of constant weariness is possible(probable). It seems, that had never a rest. It would be desirable to dump(reset) from itself duties on the house, on work - to have a rest, gain strength. However, short-term rest does not improve a condition, and entertainments quickly lose the appeal.
Other symptoms of depression:
It is difficult to concentrate at presence of the irritator(for example, the TV, radio, conversation in the next room works); because of "parallel" ideas - " I Read, and I think of other ". In dialogue it became difficult to select words, to catch a string of conversation; at reading books, magazines, the business documentation the sense read through is hardly caught, it is necessary to re-read pages anew.
There was unusual to you an indecision, constant doubts in performance of ordinary household and well familiar professional duties, after the made decision. The confidence of - " Suddenly not was gone so I shall tell, not so I shall make ".
The critical estimation of all last life - " Everything is possible(probable), that was in the past senseless, it was necessary to be engaged in another ". You test burdensome feeling of "burden" in family, " the superfluous person " on work. Reproach itself with the irresponsible attitude(relation) to the filial or affiliated duties, insufficient attention to other close relatives.
You are overcome with gloomy reflections that you are "loser", cannot solve in a life the problems; ascertaining of full professional bankruptcy, finish (" I have fulfilled the a resource "). Gloomy and pessimistic vision of the future can be filled and rather concrete household circumstances.
From time to time there are ideas - " Can be is easier die, as all badly, badly, badly... ", hopelessly, it is not visible prospects and, in general, the life for you has ceased to be something significant, has lost the sense.
Frustration of a dream are various enough. It is the complicated period засыпания; reduction of hours of a night dream because of frequent awakenings; awakenings in 3-4 one o'clock in the morning or 5 o'clock in the morning with the subsequent sleeplessness. At all variants of frustration of a dream after final awakening there is no feeling of freshness (rest) in the morning.
Appetite is lowered (" I Can be limited for a day to a glass of tea "), or appetite is absent at all, is possible(probable) even with disgust for a kind and a smell of food.
Self-diagnostics of depression
In the event that you do not type(collect) any 3 symptoms (the basic and additional list), you do not have depressive frustration of mood according to criteria МКБ-10.
Easy(Light) depressive frustration
Presence any 2 typical symptoms of depression and even 2 symptoms from the list "and". You are concerned by the condition. Experience the certain difficulties in performance of usual work and social activity.
The moderate depressive frustration
Presence any 2 typical symptoms of depression and not less than 3 (it is preferable 4) from the list "and". There are значитель-th difficulties in performance of social duties, house affairs and continuation of professional work.
Heavy depressive frustration
Presence of all of 3 typical depressive symptoms and 4 or more from the list "and". Social and house activity can be carried out very much ограниченно or its(her) performance is improbable.
At presence of depressive frustration of mood according to the resulted(brought) criteria your condition can be aggravated with a number(line) of additional painful(unhealthy) displays:
You would like to be to one (one), from all to be fenced off; desire " to creep as a snail in a bowl - that nobody touched you, to not answer questions ".
Relatives notice, that you became unusually silent; the smile has disappeared from the person(face).
The attitude(relation) with relatives in family, employees on work become complicated unusual for you early the raised(increased) irritability reaching at times before aggression.
Heavy feeling in a breast (" As a stone on heart ", " As the elephant has come(stepped) ") or ноющая a pain in the left half of breast, or sensation of burning behind a brest.
There was a sluggishness unusual for you in movements, or, on the contrary, impellent excitation, anxiety, restlessness (" I can not find to myself a place ").
During depression the sexual inclination - " considerably(much) decreases As cut off, I do not think at all of it(this) "
Especially badly you feel yourselves in the morning and in the afternoon. By the evening the state of health improves (a typical daily rhythm of depressive frustration of mood a little.
Attempt to improve the state of health to remove(take off) sincere discomfort reception of alcohol brings only temporary and unstable effect.
In case you will find at yourselves or at a member of the family of the basis for self-diagnostics of depressive frustration of mood, it is necessary to address for the psychotherapeutic help.
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