Depression is quite common. In fact, depressed mood is the fourth most common symptom that patients complain of when they see their primary care physician. About 10% to 25% of women will have have major depression at some point during their lifetime and they will be especially vulnerable during their reproductive years. Mood disorders like depression worsen the morbidity and mortality rates of other medical disorders. In addition, untreated depression has the potential to lead to suicide. It is important for women to understand depression and how it affects their lives…read more

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According to the U.S. Preventive Services Task Force, which sets guidelines for doctors on a wide variety of health issues, nearly 2 million teens suffer from depression, but most go undiagnosed.

Because depression leads to lingering sadness, social isolation, school problems and even suicide, screening and early treatment of depression is crucial, said the task force.

The group further recommends that all teens be screened, not just those in high risk groups, because depression is so common.

Task force chairman Dr. Ned Calogne emphasized that the panel does not want its advice to lead to drug treatment alone, especially with antidepressants which have been linked to increased suicidal thoughts in teens. The group recommends that screening should be done only if psychotherapy is also available.

More information about the task force and its recommendations is available though the Agency for Healthcare Research and Quality web site.

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Cognitive behavioral therapy, or CBT, is just one of many types of talk therapy that can be used effectively to treat depression as well as anxiety and other mental illnesses. In my last blog post, I went over five specific types of thinking errors that can worsen mood, including all or none thinking, over generalization, mental filter, rejecting the positive and jumping to conclusions.

In this post, I will discuss five other thinking errors. These include:

Magnification or minimizing. You magnify (blow out of proportion) your own human errors and others’ successes. Alternatively, you minimize (discount) your successes and good qualities while minimizing other’s mistakes.Should statements. This leads to anger, guilt, frustration and resentment. Attempting to motivate yourself by saying should or shouldn’t is like saying you have/need to be punished in order to do something. “I should have done more to help,” does you no good in the long run.Emotional reasoning. If you fell a certain way then that means it is true. “I feel bad, so it must be true and I am a bad person.”Labeling and mislabeling. An even more extreme form of over generalizing. Saying “I’m a loser” after making one mistake is attaching an inaccurate label to oneself. Mislabeling could be calling another person “lazy” when describing their behavior.Blame and personalization. This is when you take personal responsibility for something that is not in your control. An example could be blaming oneself for a spouse’s medical illness by saying, “I am to blame, if only I had made he/she exercise more.”

As you can see, these thinking errors can contribute to worsening mood. Things didn’t get to this point overnight, so it will take some time to change your thinking. Cognitive behavioral therapy is a powerful tool. It’s not for everyone but is effective in treating depression. Work with a trained health professional to determine the best type of therapy and treatment plan for you. Best of luck to you all and please share your experiences.

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The researchers found with brain scans that there was a 28% thinning in the right cortex (the outer layer of the brain) in those with a family history of depression.

The findings were based on imaging studies of 131 people aged 6 to 54 with a family history of depression, as well as 54 people without.

Interestingly, those who had a predisposition to depression but had never been depressed had thinning on the right side, while those who actually had depression also showed thinning on the left side.

The researchers also gave the participants memory and attention tests and found that the thinning in the right cortex was associated with a worse performance on the tests.

“Our findings suggest,” said study author Dr. Bradley Peterson, “that if you have thinning in the right hemisphere of the brain, you may be predisposed to depression and may also have some cognitive and inattention issues.” Peterson further said that these brain changes may increase the risk of depression by disrupting a person’s ability to decode and remember social and emotional cues from other people.

Peterson suggests that medications used to treat attention problems, such as stimulants, might be helpful in treating depression in some patients.

The study appears in the Proceedings of the National Sciences Academy.

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Symbyax, which combines the ingredients of the antipsychotic Zyprexa (olanzapine) with the antidepressant Prozac (fluoxetine), is approved for patients with major depression who have not responded to two separate trials of different antidepressants.

It was originally approved by the FDA in 2003 for the treatment of bipolar disorder and is now the first medication approved for the treatment of treatment-resistant depression.

Lilly has also updated the labels for Symbyax and Zyprexa to include information about weight gain, hyperglycemia and hyperlipidemia following the FDA’s review of clinical trial data submitted between August 2007 and July 2008.

More information about Sybyax is available through the official Symbyax website.

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Cognitive distortions can be so ingrained that they become “core beliefs” that you live by. An example is “I have never been successful at anything, so why even try?”

Some specific examples of cognitive distortions are:

All or none thinking. You see things in black and white. If you don’t finish something perfectly, then you’re a complete failure. Things in life are either wonderful or terrible.Over generalization. You may conclude that since a single negative event occurred in the past that it will occur over and over again. Say you have a disagreement with someone important in your life and you conclude that this person doesn’t understand or care about you. You then over generalize by assuming that this person never cared, never will and then may conclude that no one every will understand or care.Jumping to conclusions. You interpret something negatively (incorrectly) even though you have no facts or evidence to support the conclusion. One way to reconcile this would be to check out the situation and gather information instead of assuming.Mental filter. You focus on one negative detail so intently that your whole outlook on the situation is negative. If you make a good meal and overcook the bread, then you only focus on the “bad” bread instead of the rest of the meal that was enjoyed.Rejecting the positive. You reject positive experiences and hold firmly that they “don’t count” for one reason or another. You don’t allow yourself to enjoy positive feelings as you tell yourself that a bad or negative feeling is sure to follow. You end up feeling bad about feeling good.

In my next blog post, I’ll conclude with five other thinking errors that can worsen mood.

Do you identify with any of the examples above? If so, cognitive behavioral therapy may be a tool that can help you to effectively manage your depression. Discuss this option with your health care provider. Depending on the severity of your depression, medication or other types of treatments may be recommended in addition to or other than therapy. And please share with the group if you’ve found cognitive behavioral therapy helpful.

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Seasonal affective disorder, or SAD, is a mood disorder, characterized by symptoms like increased sleep and appetite, weight gain, irritability, sensitivity to rejection and heaviness in the limbs, which occurs when the circadian rhythms of the body are disrupted. The winter months, when we may be stuck indoors during the daylight hours and not getting enough exposure to sunlight, are prime time for seasonal affective disorder.

If you’ve been feeling depressed all winter, but are finding yourself feeling much better now, speak with your doctor about the possibility that you may have seasonal affective disorder.

Related Articles:

What Is SAD?What Are the Symptoms of SAD?The Latest on SAD ResearchBefore You Buy a Light Box

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The Associated Press reported last month that the Justice Department had filed a complaint against Forest Laboratories alleging that they had been promoting the off-label use of Lexapro in children. This charge was filed before the FDA approval and the drugmaker has denied any wrongdoing.

The approval of Lexapro was supported by two placebo-controlled trials. In the first study, 12-17 year old patients showed statistically significant greater average improvement from baseline when compared to placebo. In the second study, which involved patients from 7-17 years of age taking Celexa (citalopram), the patients treated with the antidepressant again had statistically significant improvement compared to the placebo group.

The drug company said that the FDA extrapolated from the Celexa study to approve Lexapro based upon the similarity of the two drugs.

Maintenance efficacy was not evaluated in the two studies, but the FDA concluded that that Lexapro is also appropriate for maintenace therapy, based upon adult data.

Lexapro was generally well-tolerated, Forest Laboratories said, with adolescents experiencing adverse reactions similar to those seen in adults, which are described in the current prescribing information.

A press release from the drug maker noted that antidepressants increase the risk of suicidal thoughts and behavior in children, adolescents and young adults in short-term studies of major depression and that anyone considering using Lexapro in an adolescent or child should balance this risk with the clinical need to treat depression. Patients should be closely observed during the first few months of therapy as well as anytime they go thorugh a dose change.

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On Sunday, his sister Frieda told The Times that Hughes had hanged himself on March 16 at his Alaskan home after a long battle with depression.

Hughes was 47, unmarried and had no children. He was a professor of fisheries and ocean sciences at the University of Alaska Fairbanks.

He was just a baby when his mother killed herself in response to her husband, poet Ted Hughes, having left her for the wife of another poet. Plath, as a struggling single mother of two young children. eventually went through a mental collapse and committed suicide. Rather ironically, Hughes’ mistress, Assia Wevill, also gassed herself and her child six years later.

Could Hughes’ death have been due to an inherited tendency towards depression and suicidal urges? Research does indicate that depression is, at least in part, due to genetic inheritance, so Hughes may well have inherited his tendency towards depression from his mother. One has to wonder though what effect his environment – having a mother who died by her own hand while he was just a baby – might have had on him.

Related Articles:

Book Review: The Bell JarIs Depression Genetic?

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For example, say you are talking with a group of other people. Your mood is good and you have been experiencing a positive day overall. The subject turns to a complaining session regarding work. Others chime in about how awful their job is, how they’re overworked, etc. Soon your mood sours and you’re angry and upset, too. You add your two cents about how horrible your job is. When the conversation is over, you’re starting to dwell on other negative aspects of your life. You return to your work area with a scowl on your face and another co-worker asks you what’s wrong.

The same thing that happened in this situation can happen in your head when you are alone. You may start focusing on your depression and have a thought such as, “I got up late this morning, so now my whole day is ruined.” This thought can be the spark that gets the fire burning. Fuel is added by thinking, “I can’t even get up on time, what use am I to myself or others?” The negative thoughts feed on themselves. You continue to talk negatively to yourself and, ultimately, you feel more depressed.

The thoughts can also be inaccurate. Inaccurate thoughts are also called “cognitive distortions.” These negative and inaccurate thoughts can be so ingrained that they become “core beliefs” that you live by. An example is, “I’ve never been successful at anything, so why even try?”

Over the next couple of weeks, I will go through specific examples of cognitive distortions that can worsen depression. Working with a trained cognitive behavioral therapist is the best way to learn CBT and to apply it effectively to your life. Depression and anxiety can be effectively treated with CBT. Cognitive behavioral therapy alone may not be enough, depending on the severity of your depression. Medication may be recommended along with CBT. Cognitive behavioral therapy is just one type of talk therapy. There are numerous other effective types. Talk with your health care provider to find the best type for you. And if you’ve had any experience with cognitive behavioral therapy you’d like to share, please do.

See AlsoCognitive behavioral therapy

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