Psychotherapy and antidepressants treat only about one-third of patients who suffer depression, but a magnetic therapy is promising, a U.S. researcher said. Dr. Murali Rao of Loyola University Medical Center in Maywood, Ill., said nearly 300 U.S. centers offer the treatment, called transcranial magnetic stimulation, a treatment that sends short pulses of magnetic fields to the brain.

At Loyola, about two-thirds of Rao's transcranial magnetic stimulation patients reported their depression has significantly lessened or gone away completely. In 2009, the U.S. Food and Drug Administration approved transcranial magnetic stimulation for patients who have major depression and have failed to experience improvement from at least one antidepressant.

One transcranial magnetic stimulation system, NeuroStar, made by Neuronetics, has the patient recline in a comfortable padded chair. A magnetic coil is placed next to the left side of the head that sends short pulses of magnetic fields to the surface of the brain, producing currents that stimulate brain cells, Rao said.

The currents, in turn, affect mood-regulatory circuits deeper in the brain. The resulting changes in the brain appear to be beneficial to patients who suffer depression, Rao said. Each treatment lasts 35 to 40 minutes. Patients typically undergo three treatments per week for four-to-six weeks, Rao explained. The treatments do not require anesthesia or sedation, and a patient can immediately resume normal activities, including driving.

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You may have heard recently that ketamine, an anesthetic medication, may be a promising treatment for depression. There have been no new drugs that treat depression in a unique way in decades, but ketamine works in a different way in the brain than traditional antidepressants.

Ketamine blocks a chemical called glutamate in the brain, which is different from the action of many antidepressants. Most antidepressants work on the neurotransmitters, of which serotonin is the most well known. Ketamine can help put a patient to sleep for surgery or relieve a patient who is in pain by placing them in a kind of trance called ‘dissociative anesthesia’. For this reason, the drug can also be abused, helping those who wish to leave reality; the drug can also cause hallucinations similar to PCP.

Small studies of 6-33 patients receiving low-dose ketamine have shown impressive results in reducing depression and suicidal thinking. One study showed improvements in depression within 40 minutes! Others showed improvement within hours to days, which is much shorter than the weeks to months traditional antidepressants or psychotherapy can take to have an effect. The effect lasted 7-10 days in some trials.

Studies in animals have shown increases in hormones and neurotransmitters that promote growth of brain cells. This is similar to how traditional antidepressants are thought to work, but it appears to happen much more quickly with ketamine. Ketamine may activate areas of the brain that are slowed in depression by increasing blood flow and consumption of blood sugar.

Larger, more rigorous studies are needed and are currently being conducted. One study hopes to compare ketamine with another anesthetic in 72 persons and should be completed later this year. Patients will be followed for up to 8 weeks. Although the research is preliminary, and abuse concerns are real, ketamine appears to have a bright future.

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Nadi Weather Office - Duty Forecaster Steven Meke says to expect strong winds with average speeds of up to 45km- 80km per hour for the Fiji group. He adds another depression which was lying over the Coral Sea is now moving towards Vanuatu and does not pose any threat.

"The tropical depression that was lying over the Coral Sea is now a cyclone. The cyclone name is Jasmin. It is still in the Coral Sea and is moving North East at around 7 knots. It is expected to move in outwards and will be affecting mainly Vanuatu. Once it reaches Vanuatu, it is likely to move South."

Meke is urging mariners to be cautious while out at sea. "We still have a strong wind warning out for the mariners. The wind that would be expected out there is around 25 to 30 knots gusting to 45 knots. We expect rough to very rough seas and North West swells as well."

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A blood test may eventually help diagnose depression, according to a new study published in the journal Molecular Psychiatry.  In the study, which was  funded by Ridge Diagnostics, the firm that developed the blood test,  researchers at Massachusetts General Hospital in Boston analyzed the levels of nine biomarkers that could  distinguish patients who had a major depressive disorder from those who did not.

The biomarkers analyzed were associated with inflammation, neuron development and stress response in brain structures. The blood test results were then scored on a scale that researchers created for the study.

“Traditionally, diagnoses of major depression and other mental disorders had been made based on patients’ reported symptoms, but the accuracy of that process varies a great deal, often depending on the experience and resources of the clinician conducting the assessment,” Dr. George Papakostas, lead author of the study, said in a statement.” Adding an objective biological test could improve diagnostic accuracy and may also help us track individual patients’ response to treatment.”

The pilot study included 36 adults who had been diagnosed with major depression, and 43 healthy control study subjects.  The test accurately pinpointed depression in  90 percent of previously diagnosed depressed patients.

Many patients deny they are depressed because of the stigma associated with depression, said Dr. Harold Koenig, a professor of psychiatry and behavioral sciences at Duke University Medical Center, so the test could be useful in taking away the shame of the disease and getting more people  treated, he said.

But a blood test diagnosis can come with a big downside. “[Some] patients might truly have depression and have a negative test, and then their symptoms might be discounted by family members and by health professionals, since depressive symptoms or emotional feelings are entirely subjective and there  is no way to verify these symptoms,” said Koenig.  “This could place a huge burden on patients who are already suffering, and be told that they really don’t have depression because they had a low score on a less than perfect test.”The biomarkers could also be influenced by other disease patterns, said Cynthia Kuhn, a  professor of pharmacology at Duke University Medical Center. “It will be important to see if [the blood test] can discriminate depression from related disorders,” said Kuhn. “It is unlikely that the blood test alone would be appropriate.”

It is important that physicians focus on patients’ symptoms, along with biologic and genetic factors, said Dr. Carol Bernstein, associate professor of psychiatry at the New York University School of Medicine.
“Patient-centered care should be exactly that and outside of specific diseases that have clear genetics … medicine cannot be reduced to simple tests,” said Bernstein. “Disease states are complex and depression is no exception.”

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Grieving the loss of a friend, family or loved one may soon be considered a form of depression. While many doctors acknowledge that grief is a very normal part of losing someone close to us, they also acknowledge that it’s important to deal with that grief.

Speaking to the New York Times one doctor explains why turning grief into a depression diagnosis could end up hurting those people suffering from some for of grief. “This would pathologize them for behavior previously thought to be normal.” says one doctor.
Opponents to the diagnosis also say to could lead many people with short term grief receiving drug treatments that would normally be unnecessary outside of depression symptoms.

Supporters of the bill say it’s not about misdiagnosing patients but rather helping those people who’s grief has become debilitating. In those cases doctors argue that many grief stricken people don’t get help because they are told their extreme cases of grief are “normal” and therefore require no treatment.

Under the current definition/criteria for depress doctors have listed such cases as sleep loss, loss of concentration and other signs, however grieving was never included. If approved the new diagnosis would appears in the Diagnostic and Statistical Manual of Mental Disorders.

Also under consideration would be a tightening of the definition of Autism, a disorder many doctors now believe may be prescribed too often for children who are just socially awkward or still developing but at a slower pace then peers of the same age.

Do you think the act of grieving should be diagnosed as a form of depression or have doctors taken the definition too far outside of it’s original diagnosis?

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A clinical trial of ''magic mushroom therapy'' could take place in the UK within a year following two ground-breaking studies. Doctors plan to treat depressed patients who cannot be helped by modern drugs or behaviour-based psychotherapy with the active ingredient in hallucinogenic mushrooms. Psilocybin would slowly be infused into their bloodstreams while they receive a carefully tailored ''talking therapy''.

The controversial trial is planned by Professor David Nutt, from Imperial College London, who three years ago was sacked as the Government's chief drug adviser. Prof Nutt, former chairman of the Advisory Committee on the Misuse of Drugs (ACMD) clashed with then Home Secretary Alan Johnson after criticising the decision to toughen the law on cannabis.

The move to investigate psilocybin as a possible treatment for serious depression is linked to results from two far-reaching scientific studies. In one, volunteers were given psilocybin infusions while undergoing functional magnetic resonance imaging (fMRI) brain scans.

The findings, reported today in the journal Proceedings of the National Academy of Sciences, showed the drug disconnected two key ''hub'' regions of the brain with multiple connections to other areas. One of these regions, the medial prefrontal cortex (mPFC) is known to be hyperactive in people with depression. The other, the posterior cingulate cortex (PCC) at the back of the brain, is thought to play a role in consciousness and self-identity.

The second study, soon to be published in the British Journal of Psychiatry, found that the magic mushroom chemical enhanced memories associated with positive emotions. Scans showed that the memory experience was very ''real''. Activity was increased in brain regions that processed vision and other sensory information.

Speaking to journalists in London, Prof Nutt said the findings were ''a revelation''. ''Psychedelics are thought of as 'mind-expanding' drugs so it has commonly been assumed that they work by increasing brain activity, but surprisingly, we found that psilocybin actually caused activity to decrease in areas that have the densest connections with other areas. ''These hubs constrain our experience of the world and keep it orderly. We now know that deactivating these regions leads to a state in which the world is experienced as strange.''

It is the first time serious research has been carried out on the effects of ''psychedelic'' drugs for more than 50 years. In the 1950s and 1960s, scientists investigating drugs such as LSD and psilocybin carried out studies on around 40,000 patients and published 1,000 papers. Such work was brought to an abrupt halt when the drugs came to be seen as social evils and were made illegal.

''They got banned because they could be society changing,'' said Prof Nutt. ''There was great concern about that. Since then they've been virtually impossible to research.''He said finding support for the new studies had been ''damned difficult''. Neither the Medical Research Council (MRC) nor the Wellcome Trust, Britain's biggest research charity, had been willing to fund them. And both Nature and Science, the two most prestigious scientific journals, refused to publish the findings. Now the MRC is said to be showing interest in the planned clinical trial, which Prof Nutt believes could be undertaken this year with sufficient backing.

Twenty six patients with a history of serious depression which cannot be treated with drugs or cognitive behavioural therapy (CBT) are expected to take part. Half will be treated with psilocybin while trained psychotherapists prompt them to recollect happy memories and think positively. Findings from the earlier research suggest the positive effects of the drug might be long-lasting, or even permanent.

After the treatment, the patients' progress will be monitored for a year. Their responses will be compared with those of a ''placebo group'' of another 13 patients given infusions of a salt solution containing no psilocybin.

For safety reasons, both the PNAS and British Journal of Psychiatry studies involved healthy volunteers unaffected by mental problems. All had also taken hallucinogenic drugs in the past without reacting badly to them.

Thirty participants took part in the PNAS study and ten in the British Journal of Psychiatry study. Volunteers had a range of vivid and ''dreamlike'' experiences including seeing geometric patterns, an altered sense of time, and the ''Alice in Wonderland'' sensation of being either very big or very small.

They also underwent ''mystical'' transformations of the sort reported by Buddhist monks who practise deep meditation. This has been described as the ''ego dissolving'' and becoming ''one with the universe''.
One volunteer described the effect of psilocybin as being like ''kneeling before God''. Prof Nutt stressed that people should not be tempted to conduct their own experiments with magic mushrooms. ''This is a research tool which may give us insights into how to treat depression,'' he said. ''I would strongly resist people self-medicating.''

Dr Kevin Healy, who chairs the Royal College of Psychiatrists' Faculty of Medical Psychotherapy, described the British Journal of Psychiatry study as ''interesting'' but added: ''We are clearly nowhere near seeing psilocybin used regularly and widely in psychotherapy practice. ''Although this study found that psilocybin enhanced autobiographical recollection in 10 healthy volunteers, we have no evidence that it would enhance a therapeutic response in patients, where the experienced relationship between patient and therapist is central to the therapeutic work.''

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Patients with depression and type 2 diabetes showed more improvement when they received simultaneous treatment for both conditions, researchers report.

Their 12-week study of 180 patients found that nearly 61 percent of those who received integrated care combined with a brief program to help them adhere to their medication regimens achieved improved blood sugar test results, and almost 59 percent had a reduction in depression symptoms.

Among patients who received usual primary care for the two conditions, nearly 36 percent had improved blood sugar test results and about 31 percent had a reduction in depression symptoms, said the researchers at the Perelman School of Medicine at the University of Pennsylvania.

The study appears in the January/February issue of the journal Annals of Family Medicine.

There is a link between depression and diabetes, the researchers noted. Depression is a risk factor for diabetes, and diabetes also increases the risk of depression. Depression is common in diabetes patients and contributes to poor adherence to diabetes medication regimens, which can lead to poorer diabetes management.

In the integrated treatment group, care managers worked with participants to increase their adherence to both diabetes and depression medications, addressing barriers such as medicine costs and lack of social support.

“Though research demonstrates the link between depression and diabetes, few integrated programs is being implemented in practice,” study lead author Dr. Hillary Bogner, an assistant professor of Family Medicine and Community Health in the Perelman School of Medicine, said in a university news release.

“Our results demonstrate that integrated treatment for both conditions, combined with a brief program focused on adherence for primary care patients with type 2 diabetes and depression can result in a significant improvement in clinical outcomes. We hope the findings will encourage the adoption of adherence programs aimed at improving outcomes,” Bogner added.

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PEOPLE who battle severe depression should seek professional help to manage stress and prevent extreme acts such as suicide, said a leading clinical psychologist. It follows the suicide of Bahraini Badriya Ali, who died last week after pouring kerosene on her body and setting herself alight.

The 59-year-old was said to have been suffering from psychological problems. Such people need a strong support system at home to help them monitor their medication and manage daily life challenges to put them on the right road to recovery, said Al Dana Consultation Centre general manager and clinical psychologist Dr Banna Bu Zaboon.

She said lifestyle changes, stress and the breakdown of family unit can all contribute to the development of depression. However, it is important for those in stressful situations or jobs to take programmes that teach them how to manage and understand their stress to prevent becoming anxious.

It would also prevent people developing severe depression and related health problems. Dr Bu Zaboon, who conducts a five-day stress-related programme for institutions and companies, urged people to seek help from clinical psychologists to avoid depression and teach them self-reliance.

"Anyone can become depressed in their life and although they might not die they can lose interest in their life, family, health and job," said Dr Bu Zaboon. "We have a problem in our world, we don't recognise our feelings, so many patients feel restless and don't like to eat, but they don't realise they are having depression.

"We need people to identify how they are feeling. Some people think their problems are physical and will go to the doctor with back pain, restlessness, weight loss, unable to sleep and so on. "Some doctors will recognise that they are suffering from depression and refer them to a psychiatrist but some don't go.

"Depression can be hereditary and these people should take care. "If anyone feels they are becoming depressed they should seek medical attention quickly."According to the World Health Organisation (WHO) depression affects 121 million people worldwide and is among the leading causes of disability worldwide.

Severe depression affects five to 10 per cent of the global population, but almost all will experience feelings of depression at some point in their life. Dr Bu Zaboon said severe depression like other mental illnesses can lead to suicide if left untreated. She said medication combined with cognitive behavioural therapy was the best way to tackle severe depression.

Most people who commit suicide have not been taking their medication properly and are not receiving the care and support they need. "When you are very depressed you don't think properly and you can't control yourself and you think 'why live', someone like this is in severe pain, their coping system is zero and they can collapse in a minute," she explained.

"Anyone can feel for a moment that life is black but a normal person will quickly overcome these feelings, but a depressed person has a chemical imbalance in the brain and if they are not taking their medication properly and not going for psycho therapy it can be very dangerous for them. "Medication alone is not enough. They need cognitive behavioural therapy because it helps them think positively and to rely on themselves."

Dr Bu Zaboon said depressed people need a strong support system to regulate their medication to avoid a possible overdose. She said therapy might be necessary for the family of a depressed person as they were also affected by this condition.

"It's not easy to live with a severely depressed person, it affects the whole family because they become like a child and need to be looked after all the time," she said. "They need someone to take them to their appointments and make sure they take their medication and receive cognitive behavioural therapy.

"Families need to support patients who are severely depressed because they may try to end their lives, they can't feel happy, can't smile or taste their food."Following Ms Ali's suicide, Psychiatric Hospital chairman Dr Adel Al Offi said citizens and residents with psychological problems could receive free treatment at the Psychiatric Hospital in Salmaniya.

He said there was also a 24-hour Health Ministry hotline (39425525) for people suffering from psychological problems, but more needed to be done by civil societies, organisations and the ministry to support people with mental problems.

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A past suicide attempt is the best predictor of a future attempt, says psychiatrist and director of the Ottawa Psychopharmacology Clinic Dr. David Bakish. In addition, he says, "the risk of suicide is higher in someone who has a family history of suicide. Suicidologists from the 1900s on recognized that there was a familial tendency."

Bakish, who previously taught at the University of Ottawa and worked at the Royal Ottawa Hospital, notes that when profiling patients in the emergency room, "we would look at those with that weight towards suicide very carefully before discharging them. And in my clinical practice now, we treat patients who have had a previous suicide attempt and have someone in the family who had a suicide attempt much more aggressively."

Gene screening indicates that people with "suicidal ideation seem to have a bigger number of a specific serotonin receptors. So there definitely seems to be a linkage with serotonin."He adds that the genetic connection becomes more complex with time.

For example, he says, negative events in childhood could change serotonin sensitivity and could result in an individual being prone to overreact in some situations, "sometimes by a cry for help through suicidal gestures."

"There are many other reasons for suicidal thoughts," says Bakish. "You can have the person who is perfectly well, then blows the family fortune and jumps out of a window. There is also a whole body of literature on drugs that may or may not induce suicide."

However, the biggest problem of all, he says, is that "people don't see depression as an illness. They see it as a failure of their psyche and are embarrassed because there is a stigma and people - particularly males - come for help too late. People should accept that depression is an illness, that treatment and medication can help and that suicidal ideation is a danger sign."Almost all suicides are preventable, he says. "The easiest way to decrease the suicide rate is to get the patients who have depression treated."

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Marcus Trescothick, the former England cricketer, and Jonny Wilkinson, England’s 2003 Rugby World Cup winner, are supporting the campaign to get more people to talk openly about mental health problems. The Department of Health has provided £16 million for the Time to Change campaign, aimed at children in schools and youth clubs and via social networking websites.

Nick Clegg, the Deputy Prime Minister, said: “This is particularly important as young people suffering with a mental illness are particularly vulnerable to the stigma surrounding it. They can be bullied, marginalised, left to suffer alone, too afraid to talk about what they are going through. This is a tragedy.” Government figures suggest one in four people will experience mental health problems during their lives. Trescothick, who has spoken about his own battle with depression, urged more people to “speak out about their mental illness, just like I did”. In a blog for the campaign, Wilkinson has described his “obsessiveness” and “dark” thoughts that led him to self-harm.

It comes a year after the Coalition launched its mental health strategy, which was designed to improve access to psychological therapies. More than 500,000 people have entered treatment for mental illnesses between July 2010 and September 2011, while 24,000 were able to move off sick pay and benefits after receiving therapy for their problems, the Government said.

A salesman who lost his job after telling his boss he was depressed yesterday won the backing of MPs and business groups after posting his letter of dismissal on Twitter. Roy Ward tweeted: “Dear Twitter, I just opened up to my boss about my depression and she’s indicated she might have to fire me. Erm, help?” Within a few hours thousands of users began contacting him to offer their support and advice, including Louise Mensch, the Tory MP, Alastair Campbell, Tony Blair’s former spin doctor, and the Chartered Institute of Personnel and Development.

 

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