Antidepressants rapidly alter brain architecture, study finds []



A single dose of a popular class of psychiatric drug used to treat depression can alter the brain’s architecture within hours, even though most patients usually don’t report improvement for weeks, a new study suggests.

More than 1 in 10 adults in the U.S. use these drugs, which adjust the availability of a chemical transmitter in the brain, serotonin, by blocking the way it is reabsorbed. The so-called Selective Serotonin Reuptake Inhibitors, or SSRIs, include Prozac, Lexapro, Celexa, Paxil and Zoloft.

The findings could be a first step toward figuring out whether a relatively simple brain scan might one day help psychiatrists distinguish between those who respond to such drugs and those who don’t, an area of mystery and controversy in depression treatment.

Researchers at the Max Planck Institute in Leipzig, Germany, used a magnetic resonance imaging machine to compare connections in the gray matter of those who took SSRIs and those who did not. They were particularly interested in what goes on when the brain is doing nothing in particular.

“We just tell them to let their minds wander and not think of anything particularly dramatic or upsetting,” said neuroscientist Dr. Julia Sacher, a co-author of the study published online Thursday in the journal Current Biology.

They created 3-D maps of connections that “matter” to gray matter: interdependence, not just anatomical connection. They relied on a discovery in the late 1990s that low-frequency brain signaling during relative inactivity, such as daydreaming, is a good indicator of functional connectivity.

When more serotonin was available, this resting state functional connectivity decreased on a broad scale, the study found. This finding was not particularly surprising — other studies have shown a similar effect in brain regions strongly associated with mood regulation.

But there was a two-fold shock: Some areas of the brain appeared to buck the trend and become more interdependent. And all the changes were evident only three hours after the single dosage.

“It was interesting to see two patterns that seemed to go in the opposite direction,” Sacher said. “What was really surprising was that the entire brain would light up after only three hours. We didn’t expect that.”

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Why Solitary Confinement Is The Worst Kind Of Psychological Torture []

by George Dvorsky /

There may be as many as 80,000 American prisoners currently locked-up in a SHU, or segregated housing unit. Solitary confinement in a SHU can cause irreversible psychological effects in as little as 15 days. Here’s what social isolation does to your brain, and why it should be considered torture.

There’s no universal definition for solitary confinement, but the United Nations describes it as any regime where an inmate is held in isolation from others, except guards, for at least 22 hours a day. Some jurisdictions allow prisoners out of their cells for one hour of solitary exercise each day. But meaningful contact with others is typically reduced to a bare minimum. Prisoners are also intentionally deprived of stimulus; available stimuli and the fleetingly rare social contacts are rarely chosen by the prisoners, and are are typically monotonous and inconsiderate of their needs.

As for the jail cell itself, it typically measures 6′ x 10′. Nearly all scenarios for human contact, such as a guard, or medical and family visits, are done through a metal mesh, behind glass partitions, or in hand- and leg-cuffs.

Writing in Wired, Brandon Keim describes the conditions in the cells:

What’s emerged from the reports and testimonies reads like a mix of medieval cruelty and sci-fi dystopia. For 23 hours or more per day, in what’s euphemistically called “administrative segregation” or “special housing,” prisoners are kept in bathroom-sized cells, under fluorescent lights that never shut off. Video surveillance is constant. Social contact is restricted to rare glimpses of other prisoners, encounters with guards, and brief video conferences with friends or family.

For stimulation, prisoners might have a few books; often they don’t have television, or even a radio. In 2011, another hunger strike among California’s prisoners secured such amenities as wool hats in cold weather and wall calendars. The enforced solitude can last for years, even decades.

These horrors are best understood by listening to people who’ve endured them. As one Florida teenager described in a report on solitary confinement in juvenile prisoners, “The only thing left to do is go crazy.”

Prisoners in low and medium security jails are often thrown in the SHU for “just” a few days. But in maximum security prisons, individuals in solitary are held on average for five years, and there are thousands of cases of prisoners who have been held in solitary confinement for decades. Some countries, including the United States, employ the use of Super Maximum Security Prisons, or “Supermax Prisons,” in which solitary confinement is framed as a normal, rather than exceptional, practice for inmates.

Exact statistics are not known, but a 2011 study suggested that 20,000 to 25,000 prisoners in the United States are held in this way. Keim claims that that California holds some 4,500 inmates in solitary confinement, and that there are as many as 80,000 prisoners held in solitary across the United States — more than any other democratic nation.

Lasting Effects

Human beings are social creatures. Without the benefit of another person to “bounce off of,” the mind decays; without anything to do, the brain atrophies; and without the ability to see off in the distance, vision fades. Isolation and loss of control breeds anger, anxiety, and hopelessness.

Indeed, psychologist Terry Kupers says that solitary confinement “destroys people as human beings.” A quick glance at literature review studies done by Sharon Shalev (2008) and Peter Scharff Smith (2006) affirms this assertion; here are some typical symptoms:

  • Anxiety: Persistent low level of stress, irritability or anxiousness, fear of impending death, panic attacks
  • Depression: Emotional flatness/blunting and the loss of ability to have any “feelings”, mood swings, hopelessness, social withdrawal, loss of initiation of activity or ideas, apathy, lethargy, major depression
  • Anger: Irritability and hostility, poor impulse control, outbursts of physical and verbal violence against others, self, and objects, unprovoked angers, sometimes manifested as rage
  • Cognitive disturbances: Short attention span, poor concentration and memory, confused thought processes, disorientation
  • Perceptual distortions: Hypersensitivity to noises and smells, distortions of sensation (e.g. walls closing in), disorientation in time and space, depersonalization/derealization, hallucinations affecting all five senses (e.g. hallucinations of objects or people appearing in the cell, or hearing voices when no one is speaking
  • Paranoia and psychosis: Recurrent and persistent thoughts, often of a violent and vengeful character (e.g. directed against prison staff), paranoid ideas (often persecutory), psychotic episodes or states, psychotic depression, schizophrenia
  • Self-harm: self-mutilation and cutting, suicide attempts

In California, it has been shown that inmates are 33 times more likely to commit suicide than other prisoners incarcerated elsewhere in the state. Disturbingly, solitary confinement beyond 15 days leads directly to severe and irreversible psychological harm. But for some, it can manifest in even less time. What’s more, a significant number of individuals will experience serious health problems regardless of specific conditions of time, place, and pre-existing personal factors.

In terms of prevalence, somewhere between 8% and 19% of American prisoners will experience significant psychiatric or functional disabilities, while another 15% to 20% will require some form of psychiatric intervention during their incarceration. Figures in Europe are comparable. The American Psychiatric Association says that up to 20% of all prisoners are “seriously mentally ill” whereas up to 5% are “actively psychotic at any given moment.” About 4% of inmates have schizophrenia or some other psychotic disorder, nearly 19% suffer from depression, and around 4% have bipolar disorder (Abramsky and Fellner 2003).

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Alone During the Holidays? Make No Major Decisions

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, different, eclectic, marching to a different drummer, 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 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.  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:

  1. If it is not broken, don’t fix it
  2. It it is working, do more of it
  3. 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 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.


Why Does Winter Make You Sad? []

by Robert T. Gonzales /

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.

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How Electro-Shock Therapy Affects the Brain and Depression []

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.

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