by Robert T. Gonzales / io9.com
Why do people get depressed during winter? Odds are you’ve heard of seasonal affective disorder, or you’ve experienced it for yourself. Fittingly abbreviated “SAD,” this periodic melancholy is most often seen in Northern latitudes with the long nights and short days of nature’s coldest season.
But what’s really going on when your body catches a case of wintertide doldrums?
Winter-onset seasonal affective disorder was first described by researchers at the National Institute of Mental Healthin 1984, but people have been suffering from winter’s depressive touch since long before the syndrome had a name. Nowhere is this more evident than the work of writers and poets, who throughout history have described winter as something to be endured, a season marked by perseverance in the face of soul-sapping chill and darkness.
“Every mile is two in winter,” wrote 17C English poet George Herbert, pithily encapsulating winter’s physical, psychological and emotional toll. The Mayo Clinic provides a more clinical description of SAD’s symptoms, which include hopelessness, lethargy, social withdrawal, oversleeping and weight gain.
Of course, the hallmark symptom of SAD is that its effects tend to give ground during spring and summer, only to return on the heels of autumn. With this in mind, it’s tempting to write off many of SAD’s signature characteristics as emergent features of weather and culture. Winter, after all, can be a cruel, cold bitch; at what point does the desire to remain indoors, curled up beneath an electric blanket, come to constitute social withdrawal as opposed to, say, a completely rational preference for warm, dry conditions? Also, winter is the season of feasting; between Thanksgiving, New Year’s and assorted holiday gatherings, doesn’t everyone put on pretty serious wintertide poundage? (Actually, while answering the first question can be somewhat tricky, the widely held notion that the average person gains tons of weight during the holidays is a big, fat lie.) Perhaps not surprisingly, SAD was regarded skeptically by experts for many years — but more recently, several studies have helped validate the disorder.
Most research identifies changes in daylength, or “photoperiod,” as SAD’s primary cause. Its commonness, for example, tends to vary by latitude. Epidemiological studies have shown that its prevalence in the adult population ranges from 1.4 percent in Florida to 10 percent in places likeNew Hampshire and Alaska.
by Emily Allen / Daily Mail
Scientists have finally discovered how one of psychiatry’s most controversial treatments can help patients with severe depression.
Researchers at Aberdeen University have discovered that ECT – or electro-convulsive therapy - affects the way different parts of the brain involved in depression ‘communicate’ with each other.
They found that the treatment appears to ‘turn down’ an overactive connection between areas of the brain that control mood and the parts responsible for thinking and concentrating.
This stops the overwhelming impact that depression has on sufferers’ ability to enjoy normal life and carry on with day-to-day activities.
This decrease in connectivity observed after ECT treatment was accompanied by a significant improvement in the patient’s depressive symptoms.
The ECT treatment, which is 75-years-old, involves an electric shock being passed through the cortex of a severely-depressed patient to ‘cure’ them.
Its graphic portrayal in the 1975 film One Flew Over the Cuckoo’s Next won Jack Nicholson an Oscar.
The controversial treatment was introduced in 1938 by an Italian neurologist Ugo Cerletti, who was allegedly inspired by watching pigs being stunned with electric shock before being butchered in Rome. The animals would go into seizures and fall down, making it easier to slit their throats.
At the time psychiatric orthodoxy held – wrongly – that schizophrenia and epilepsy were antagonistic and one could not exist in the presence of the other.
Deciding to try the stunning technique on his patients, Dr Cerletti found electric shocks to the head caused his most obsessive and difficult mental patients to become meek and manageable.
Later the treatment was found to be effective in treating severe depression but its mode of action has remained until now a complete mystery.
The study involved using MRI to scan the brains of nine severely depressed patients before and after ECT, and then applying entirely new and complex mathematical analysis to investigate brain connectivity.
Professor of Psychiatry at the university Ian Reid, who is also a consultant psychiatrist at the Royal Cornhill Hospital, Aberdeen, said: ‘We believe we’ve solved a 70 year old therapeutic riddle.
‘ECT is a controversial treatment, and one prominent criticism has been that it is not understood how it works and what it does to the brain.
‘For all the debate surrounding ECT, it is one of the most effective treatments not just in psychiatry but in the whole of medicine, because 75 per cent to 85 per cent of patients recover from their symptoms.
‘Over the last couple of years there has been an emerging new perspective on how depression affects the brain.
‘This theory has suggested a ‘hyper-connection’ between the areas of the brain involved in emotional processing and mood change and the parts of the brain involved in thinking and concentrating.
‘Our key finding is that if you compare the connections in the brain before and after ECT, ECT reduces this ‘hyper-connectivity’.
‘For the first time we can point to something that ECT does in the brain that makes sense in the context of what we think is wrong in people who are depressed.’
Although ECT is extremely effective, it is only used on people who need treatment quickly: those who are very severely depressed, who are at risk from taking their own lives, and perhaps cannot look after themselves, or those who have not responded to other treatments.
Professor Reid said: ‘The treatment can also affect memory, though for most patients this is short-lived.
‘However if we understand more about how ECT works, we will be in a better position to replace it with something less invasive and more acceptable.
‘At the moment only about 40 per cent of people with depression get better with treatment from their GP.
‘Our findings may lead to new drug targets which match the effectiveness of ECT without an impact on memory.’
Professor Christian Schwarzbauer, chair in neuroimaging at Aberdeen, who devised the maths used to analyse the data, said: ‘We were able to find out to what extent more than 25,000 different brain areas ‘communicated’ with each other.
‘The method could be applied to a wide range of other brain disorders such as schizophrenia, autism, or dementia, and may lead to a better understanding of underlying disease mechanisms and the development of new diagnostic tools.’
The team’s findings are published in the journal Proceedings of the National Academy of Sciences.
By Lisa Esposito / HealthDay Reporter
MONDAY, Feb. 20 (HealthDay News) — New studies show that children struggling with their gender identity also face higher risks for abuse and mental health problems, including post-traumatic stress disorder.
Children with gender identity disorder show a strong, persistent discomfort with their biological sex. They identify with and display behaviors usually seen in the opposite sex.
One study, from Children’s Hospital Boston, looked at the emotional and behavioral problems of children and teens referred to its specialty clinic for evaluation and possible medical treatment.
“The study only focuses on kids who experience profound distress or [sadness] with their changing bodies, so the psychiatric manifestations of that distress include much higher risks for self-injurious behavior, depression, suicide attempts and anxiety,” said Dr. Scott Leibowitz, a pediatric psychiatrist affiliated with the hospital’s Gender Management Service.
Ninety-seven patients younger than 21 were included, 43 born as males and 54 as females. Forty-three patients already had psychiatric symptoms, 20 reported self-mutilation and nine had attempted suicide.
The studies appear online and in the March issue of the journal Pediatrics.
Dr. Walter Meyer III, author of an accompanying journal editorial, said many problems arise from the reactions these children face at home and in school.
“These kids are really normal — they just want to be the other gender,” said Meyer, a psychiatrist who works with transgender patients at the University of Texas Medical Branch, in Galveston. “The ones who are well-adjusted and well-accepted by their families and at school don’t have the psychiatric issues.”
The other study, from the Harvard School of Public Health, looked at long-term data on nearly 10,000 young adults, average age 23. Those who rated high for childhood gender nonconformity were more likely to report physical, psychological and sexual abuse as children. They were almost twice as likely to have post-traumatic stress disorder as young adults.
“Gender conformity” relates to how children express themselves — through their clothes, their interests, their mannerisms — and how these behaviors mesh with what’s typical for their biological sex.
One expert said the study is “important,” and that it helps tease out why these kids have trouble coping.
It “tests one of the key proposed factors — childhood abuse,” said Stephen Russell, a professor of family studies at the University of Arizona. “There has been concern that parents may react to gender nonconformity in harsh ways. This is perhaps the first study to show evidence of that and of the lasting implications for health.”
Fear of the unknown is part of the problem.
“We’ve seen in studies of gender nonconforming LGBT [lesbian, gay, bisexual, transgender] youth that what most people think of as abuse comes from a place of concern and fear on the part of parents — that is, they think they can help their kid by ‘toughening them up’ or teaching them to ‘fit in,’ ” Russell said. “Many parents literally have no framework for understanding gender nonconformity in children.”
Meyer, meanwhile, said he sees signs of growing awareness and acceptance, spurred by the media. Once parents are onboard, treatment can begin, sometimes quite early, he said.
“At age 5 or 6, treatment is mainly psychotherapy and working with family to help them [kids] adjust,” Meyer said. “Sometimes that means reassuring them and letting them dress up at home. Some might start school taking on a new gender.”
Pent-up need for treatment appears to exist.
Since Children’s Hospital Boston established a Gender Management Service in 2007, the population of gender nonconformists seeking treatment quadrupled.
“By having clinical services that are specialized and interdisciplinary, you’re providing an avenue for parents to come and present for treatment,” Leibowitz said. “That brings a lot of people out of their closets, so to speak, and shows this is a less stigmatized issue, so that people can get the appropriate assessments and treatments that they deserve.”
Some children receive treatment to delay puberty and buy them time while deciding whether to proceed with a gender change.
Puberty blockers, which are not covered by insurance, are expensive. “Injections can cost upwards of $1,000 a month.” Leibowitz said. Newer implants cost about $3,400 for two years.
Blocking irreversible changes of puberty has advantages for those who eventually opt for full gender transition, through cross-sex hormones or sexual reassignment surgery, Leibowitz said. “In their bodies and appearance, they will be perceived by society as the gender they affirm and thus have healthier outcomes,” he explained.
“We as individuals who do not experience an incongruence between our minds and bodies take for granted how easy life is,” Leibowitz added. “You just need to meet one child and one family to see how this impacts their lives.”
by Stephanie Pappas / livescience.com
Kids who are distressed because they feel their physical body doesn’t match their gender suffer from high rates of psychiatric symptoms, such as depression and suicide attempts, a new study finds.
In a sample of children and adolescents treated at the Endocrine Division at Children’s Hospital Boston, young people who experienced distress about the “mismatch” between their body’s sex and their mental gender had high rates of psychiatric complications (before any gender treatment). Kids who don’t get treatment, whether for financial reasons or because their parents aren’t supportive, likely have higher rates of psychiatric problems, said study researcher Scott Leibowitz, a psychiatrist at Children’s Hospital Boston.
“Individuals who are not transgender take for granted what life must be like when our minds and bodies are incongruent with one another,” Leibowitz told LiveScience. “Personally, I’ve seen so many kids who experience such high levels of distress with their changing bodies that it impairs their emotional and social functioning,” he said.
Transgender people — people who feel that their biological sex does not reflect their true gender — have astonishingly high rates of mental health problems: A 2010 survey found that 41 percent of transgender people in the U.S. have attempted suicide.
Researchers attributed those rates to discrimination and stigma, as well as a lack of laws protecting transgender people from employment discrimination. Poor insurance coverage of hormones and other treatments to help a transgender person transition to their desired gender also account for the rates, the researchers found. [5 Myths About Gay People]
But the mismatch between mind and body alone can be a major source of psychological pain, Leibowitz said. Of 97 patients who came to the Endocrine Division for hormones and other treatments related to gender identity disorder between January 1998 and February 2010, 44.3 percent had significant mental health histories. Twenty percent had self-mutilated, and 9.3 percent had attempted suicide at least once. About 37 percent were taking psychiatric medication.
Treating gender identity
Growing up, many children experiment with cross-gender behaviors, but very few of them will grow up to experience distress about their biological sex. Persistent gender identity disorder is rare: In the Netherlands, where gender-treatment programs are well- established, only about 1 in every 10,000 to 30,000 people seeks treatment.
When young people start puberty and experience serious distress about their bodies developing into a gender they don’t identify with, there are solutions, Leibowitz said. The medical standard established by the Endocrine Society and the World Professional Organization for Transgender Health call for treatment with hormones that suppress puberty in teens who have not yet undergone major physical changes. These treatments “buy time,” Leibowitz said, preventing the development of secondary sex characteristics such as breasts or an Adam’s apple while kids mature mentally enough to make decisions about whether they’d like to transition to a new gender. These treatments are reversible.
Older teens, ages 16 or 17, can begin to make decisions about taking estrogen or testosterone to promote the sexual characteristics of the gender they feel they are. Puberty-suppressing treatments are also used at this stage to lessen the doses — and thus side effects — of these hormones. The effects of cross-sex hormone therapy are partially reversible.
At every step of the way, Leibowitz said, families and children are counseled and evaluated to be sure they’re ready for treatment. Doctors counsel young children and their families, but do not treat them with drugs or hormones unless their gender identity distress persists at puberty.
The cost of not treating can be high, as the new study, published today (Feb. 21) in the journal Pediatrics, highlights.
“Without treatment, a lot of these kids are prone to psychiatric disorders, including depression, suicide, self-mutilation, anxiety,” Leibowitz said.
by Jonah Lehrer / Wired.com
Sigmund Freud gets a bad rap from modern science. (The immunologist Peter Medawar summarized the feeling of many with his remark that psychoanalysis is the “most stupendous intellectual confidence trick of the twentieth century.”) Sure, Freud’s theories mangled a lot of details — we no longer worry about penis envy or the Oedipus complex — but he was shockingly prescient on the big themes. In recent years, it’s become clear that, as Freud always insisted, the unconscious is the dominant force in our mental life. (What Freud called the id is now a network of brain areas associated with emotion, such as the amygdala and nucleus accumbens.) He was mostly right about the logic of dreams, which often regurgitate those parts of experience we store in long-term memory. And he was basically correct to imagine the mind as a set of conflicted drives, with reason competing against the urges of the passions. We expend a lot of neurotic energy holding ourselves back.
But there’s another Freudian theme that deserves a little 21st century appreciation: his obsession with the mother-child relationship and the way it shadowed people throughout life. Freud saw this parental bond as a dominant motive for behavior, influencing both our development as children and our happiness as adults. (The super-ego, for instance, begins to form when the incestuous desires of the child are thwarted by the father.) Although many of Freud’s particular claims feel like cultural relics, modern attachment theory has confirmed the crucial importance of the maternal bond. As Harry Harlow put it, “You’ve got learn how to love before you can learn how to live.” And it’s our mothers who often first teach us how to love. (Thankfully, human parenting is slowly becoming much more gender neutral. But this a recent cultural innovation.)
A new paper in PLoS ONE expands on this Freudian theme. The study involved a team of scientists at Columbia University, Beth Israel Medical Center and Albert Einstein Medical Center who performed fMRI scans on 28 female subjects between the ages of 18 and 30, half of whom were suffering from unipolar depression. (The patients were evaluated using the Beck Depression Inventory II.) While lying in the scanner, the volunteers looked at pictures of their mothers, a few friends and a selection of strangers. The scientists focused their attention on the left anterior paracingulate gyrus (aPCG), a brain area that plays an important role in the regulation of social emotion. Previous studies have linked the bit of cortex to error and conflict resolution and the understanding of intentionality.
By looking at the differential brain responses of depressed and control subjects after viewing those various faces, the scientists came up with an impressive diagnostic tool. In fact, the fMRi scans were able to predict the presence of depression in nearly 90 percent of subjects; the correlation between actual BDI scores and the predicted BDI scores based on fMRI results was 0.55, which is quite strong. Out of the 28 subjects, the fMRI diagnosis generated one false positive and two false negatives.
by Helen Hill MFT
The holidays can be a very lonely time of year for anyone who, because of their uniqueness, finds himself or herself without family, and sometimes, friends. Sharing the time with others can be a salve for those who are tolerated or accepted. But for those of us who are unique, whether transsexual, gay, lesbian, bisexual, or suffering from some physical malady, and we find ourselves alone, it can be a challenge to just get through the holidays.
Families are defined by blood. Often, that is a mistake. Sometimes there are those relatives (by blood) whose views and outlooks would be offensive and cruel to any outsider — to any kind and compassionate soul. The challenge is to surround ourselves with a family we choose, who love us and accept us for who we are, rather than for what we are not.
If family during the holidays is defined by accepting only those people like themselves, then we have learned nothing about tolerance, acceptance, and compassion. Let us not make the same mistakes as those poor souls who live in fear of what they do not understand, and the resulting cruelty that manifests itself in the name of “family.”
What I would emphasize to all gender-variant individuals is that the holidays are NO TIME to be making major decisions about one’s life, one’s circumstances, one’s issues, or one’s family. Suicide is never good any time. But the holidays have a way of making us, what I like to call, “temporarily isolated” or “temporarily inconsolable.” The emphasis, though, should be on the word TEMPORARY.
During this tough economic time, many are suffering. And even in good economic times, during the holidays, there are so many people who find themselves spending the holiday alone, whether transgendered or not. And then there are those who do spend the holidays with their relatives and come back even more depressed and/or vulnerable than before they left.
Family and holidays can be very difficult even in the best of times. No matter what, whether spending holidays with friends and family, or spending them alone, I would recommend that no one make major life changing, irreversible decisions.
For those who find themselves depressed or alone during the holidays, the secret to success is to just get through them!
Survival is success!
The sun will come out tomorrow. There will be a chance for a new day and new beginnings. And hope does not take a raincheck during holidays. It is still there, even if it seems harder to grasp.
As you have doubtless heard many times before, even if you don’t feel like doing something, DO SOMETHING! A walk, a movie, reading a good book, or an activity. Invite another friend over for tea, or meet for a lunch or dinner. Some online support forums can be quite helpful during these times as well.
Solution Focused Therapy provides three very simple, yet effective, suggestions:
- If it is not broken, don’t fix it
- It it is working, do more of it
- If it is NOT working, change it
Lastly, don’t be afraid to ask for help. It is not a character flaw or a weakness to ask for help. On the contrary, it is one of the healthiest things a person can learn to do – knowing when to ask for help. This link http://gendersanctuary.com/resourceshelp.htm lists a number of resources that can be helpful during difficult times.
Make the time less about the holiday, and more about self-care.
But most of all, never use a temporary situation to make a permanent, unalterable decision. Never.
Hope and peace are always in season.
by Annalee Newitz
It’s possible that depression could be cured by reducing mild swelling in your brain. Neuroscientists have linked depression to brain inflammation before, and now a new study suggests further evidence for this theory. Here you can see the distinctive signature of a glial cell responding to swollen tissue in a brain — the cell’s center is elongated, and it has many more branching fibers than a typical glial cell.
Neurologist Susana Torres-Platas and colleagues recently discovered that this type of glial cell also shows up in the brains of people who killed themselves. Are we witnessing the distinctive neuroanatomy of depression?
Writing in Nature Neuropsychopharmacology, the researchers write that they dissected the brains of 10 people who had committed suicide and died after suddenly becoming depressed. They found noticeable differences between fibrous astrocytes, or star-shaped glial cells, in the brains of depressed people and a control group. Fibrous astrocytes are cells that provide support to neurons in the brain by aiding in their growth as well as neurotransmission, or chemical communication between neurons. There are two kinds of astrocytes in the brain, and the fibrous type is mostly in your brain’s white matter.
Write Torres-Platas and colleagues:
It can be hypothesized that the hypertrophic fibrous astrocytes described here in depressed suicides reflect local inflammation in the white matter. Strong lines of evidence support the neuroinflammatory theory of depression. In particular, it has been well documented that patients suffering from depression have significantly higher levels of circulating pro-inflammatory cytokines.
In other words, these super-active and enlarged astrocytes are likely a response to small areas of inflammation in the brain’s white matter. This suggests yet another way that depression can be caused by physical changes to the brain itself. It may also help to explain why people who have suffered concussions are depressed afterwards — their brains are literally swollen.
Read the full scientific paper via Nature Neuropsychopharmacology
In a new study just released it appears that living in a Big City has the effect of making people be less tolerant of others. In other words, people get on each other’s nerves faster!!!!
In the AP article, “Big City Got You Down? Stress Study May Show Why?” by Malcolm Ritter, he reports that
Imaging scans show that in city dwellers or people who grew up in urban areas, certain areas of the brain react more vigorously to stress. That may help explain how city life can boost the risks of schizophrenia and other mental disorders, researchers said.
The study, sponsored by the Central Institute of Mental Health in Mannheim, Germany, looked at people from urban settings and was published in the latest issue of “Nature.”
For more on the study: