Have you ever had a telehealth video session with a clinician?

My hospital, Evergreen Hospital (Kirkland, WA), was the first in the United States to identify the infection on 20 February 2020.

Telehealth video medicine became popular in my oncology clinic during the COVID-19 pandemic.

A substantial minority of patients still prefer the approach.

Telehealth Benefits for Physical Conditions

Studies suggest telehealth can:

• Reduce opioid overdose deaths
• Improve patient satisfaction for rheumatologic conditions
• Provide valuable care for those with cardiovascular disease
• Help manage movement disorders (such as Parkinson’s disease)

However, there’s a wrinkle.

While telehealth has benefits, some of my colleagues in healthcare are unsure about its effectiveness and safety for treating depression and other behavioral health issues.

My Goals

You just read about some conditions for which telemedicine provides benefits.

But what about mental health issues?

Are telehealth practices efficacious?

We’ll examine the potential advantages of telehealth for depression treatment and the concerns raised by some practitioners.

First, let’s look at the depression statistics.

Depression: The Numbers

Here’s a breakdown of depression prevalence according to recent estimates from the U.S. Centers for Disease Control:

• Overall: Nearly four percent of the global population experiences depression.
• Adults: Depression affects 5 percent of adults, with a slightly higher rate among women (6 percent) compared to men (4 percent). Age matters a bit, as seen in the chart above.

• Age: The rates of depression were 21, 18, 18, and 17 percent for those ages 18 to 29, 45 to 64, and over 65, respectively.
• Global Impact: An estimated 280 million people worldwide struggle with depression.
• Pregnancy & Postpartum: More than 10 percent of pregnant women and new mothers experience depression.

Other Factors Influence Depression Risk

Some factors can increase the risk, such as:

• Life Experiences: People who have faced abuse, significant losses, or ongoing stress are more likely to develop depression.
• Gender: Women are statistically more prone to experience mild, moderate, or severe depression than men.
• Race: Non-Hispanic Asian adults are least likely to experience depression compared with Hispanic, non-Hispanic white, and non-Hispanic black adults.

One in Five Actively Experience Depression

According to the U.S. Centers for Disease Control (CDC), nearly one in five adults in the United States reported experiencing some symptoms of depression within the past two weeks.

These problems ranged from mild feelings of sadness to more severe symptoms.

The good news is that depression is treatable.

Approximately 70 to 80 percent of people with major depression can significantly improve with proper treatment.

The Devastating Impact of Suicide

Sadly, depression is linked to a significant number of suicides each year.

Over 700,000 people die by suicide globally, making it the fourth leading cause of death among young adults aged 15 to 29.

Remember: Depression is a treatable condition. If you or someone you know is struggling, please ask for help. There are resources available to support you on the road to recovery.

Telehealth

The COVID-19 pandemic has dramatically changed how we access healthcare, and mental health services are no exception.

Telehealth, which uses technology like video conferencing and secure messaging, has become increasingly popular for delivering therapy sessions.

This virtual approach lets patients connect with mental health professionals remotely, offering convenient access to consultations, interventions, and secure information exchange.

Telehealth for Depression Management

Researchers analyzed a collection of studies (meta-analysis) to see if online therapy (telemedicine) could help people with mild to moderate depression.

They found strong evidence that telemedicine improved the following:

• Depression symptoms: People felt better overall.
• Quality of life: Daily life felt more manageable.

There wasn’t enough data to definitively say how telemedicine impacts work and social functioning, but at least one study showed promising results — people also experienced significant improvements in these areas.

Overall, this research suggests that online therapy can be an effective tool for managing depression and improving well-being.

Telemedicine versus Face-to-Face

Researchers compared studies on depression treatments, both in-person and online (telehealth), that involved cognitive therapy (talk therapy).

They found some interesting things about the people who participated in these studies:

• Telehealth Patients: People who used telehealth tended to have had depression symptoms for a longer time compared to those in in-person therapy studies. However, a smaller percentage of them had received treatment before. This finding suggests that telehealth attracts people who haven’t sought help earlier.
• Severity of Symptoms: Despite the longer duration of symptoms, the telehealth group didn’t experience worse depression compared to the in-person group. This observation was surprising, as researchers initially thought patients with more severe (untreated) depression might be more likely to choose telehealth.
• Age: There wasn’t a significant difference in age between the groups using telehealth and in-person therapy.

These findings suggest that people who haven’t received prior treatment for depression might be more open to trying telehealth. More research is needed to understand these trends fully.

Non-Westerners May Benefit Most

A recent study published in JAMA looked at the effectiveness of mental health apps for people with moderate to severe depression.

People from non-Western ethnicities seemed to benefit more from these apps than those from Western backgrounds.

The researchers suggest this difference might be linked to the stigma surrounding mental health in some cultures.

People from non-Western cultures might feel more comfortable using an anonymous app to access treatment.

This fascinating finding highlights the potential of mobile apps for making mental healthcare more accessible, especially for those who might face social barriers.

Good News All Around

The study also found some positive things about how well the app worked:

• Reduced Depression: People who used the app, regardless of whether they were already getting therapy or medication, experienced a decrease in depression symptoms.
• Boost from Combo Treatment: Those who used the app alongside therapy or medication saw the most significant improvement in their depression.

These findings suggest that mobile apps could be a valuable tool or an extra support system for traditional treatments.

Apps May Work for Both Diagnosed and Self-Reported Depression

The study also found that the app seemed to be equally helpful for people with a formal diagnosis of depression and those who self-reported symptoms.

These results suggest that mobile app interventions could be useful for a wider range of people seeking help with depression.

Important Note: While the app showed promise, it’s crucial to remember that it shouldn’t replace professional mental healthcare.

If you’re struggling with depression, please reach out to a qualified mental health professional for proper diagnosis and treatment.

My Thoughts: Is Telehealth A Solution?

The rise of telehealth offers a convenient and potentially effective approach to managing depression.

Research shows that online therapy can significantly improve many individuals’ symptoms and quality of life.

While some uncertainties remain regarding its effectiveness for specific patient groups, telehealth has the potential to expand access to mental healthcare, particularly for those who may face social barriers or have had difficulty seeking help in the past.

Mobile apps also show promise as supplementary tools, offering additional support and potentially reducing stigma for those in cultures where mental health issues carry a heavy social burden.

Remember, depression is a treatable condition. If you’re struggling, don’t hesitate to reach out for help.

Whether you choose traditional in-person therapy, explore telehealth options, or utilize a mental health app, resources are available to support your recovery journey.

The post Feeling Blue? Maybe There’s an App for That: Exploring Telehealth for Depression appeared first on Medika Life.

I often wonder how much walking I need to do to combat the blues. It turns out that even small volume increases in physical activity can reduce your depression risk or symptoms.

A new research study demonstrates that even small increases in physical activity can reduce your risk or symptoms of depression.

“Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say, “My tooth is aching” than to say, “My heart is broken.” ― C.S. Lewis, The Problem of Pain.

Let’s briefly look at how movement can help us feel better. First, though, let’s pivot to the origins of the word “blues.”

The Blues

African Americans created the blues, a secular folk music, in the early 1900s, primarily in the American South.

Although instrumental accompaniment is nearly universal in the blues, it is essentially a vocal form.

Blues songs are usually lyrical rather than narrative because expressing feelings is foremost.

As a musical style, the blues is characterized by expressive “microtonal” pitch inflections (blue notes), a three-line textual stanza of the form AAB, and a 12-measure form.

Initial Use of “Blues”

But we need to go back to find the initial use of the term blues.

In the 1800s, the English phrase “blue devils” meant upsetting hallucinations precipitated by severe alcohol withdrawal.

“Blue devils” was later shortened to the blues, describing states of depression and upset.

Now that you have kindly indulged me in exploring the origin of the term “blues,” let’s move on to the new research findings.

The Mood-Boosting Minimum

I always feel better after walking for 30 minutes during my lunch hour. Could this be enough to provide a mood boost?

Scientists recently analyzed over 4000 individuals in the Republic of Ireland over a decade. The subjects were at least 50 years old.

The researchers wanted to know the minimal dose of moderate to vigorous physical activity (MVPA) associated with a reduced risk of depression and depressive symptoms in older adults with and without chronic disease.

Key Findings

Can you walk your way to a better mood? The answer is yes, and with fewer steps than you might think.

Researchers from the University of Limerick and Trinity College Dublin discovered the following:

A physical activity dose equivalent to 20 minutes a day (five days a week) of moderate-intensity physical activity, like brisk walking, was linked with less risk of depressive symptoms and odds of major depression.

About 400 MET minutes (MET = metabolic equivalent task) — about 100 minutes of low-intensity exercise (think a walk) or approximately 50 minutes of moderate-intensity exercise — provides significant mind protection.

Moreover, the more exercise you perform, the less likely you are to experience depressive symptoms. But you begin to accrue benefits with very little physical activity.

The presence of chronic disease did not affect the findings.

Dose-Response Curve

The investigators discovered a dose-response relationship between exercise volume and the risk of depression.

More moderate-to-vigorous physical activity was linked to greater depression protection.

Thirty minutes of exercise was associated with a small (seven percent relative risk reduction) improvement in the chances of developing depressive symptoms. However, the odds of major depression dropped by nearly one-half (44 percent).

Doses equivalent to 60 minutes daily of physical activity were associated with a 16 percent lower chance of depressive symptoms and 41 percent lower odds of major depression.

Finally, those getting 120 minutes of daily exercise were linked to a 23 percent lower probability of depressive symptoms and a halving (49 percent) of the odds of major depression.

Study Details

The team used ten years of Irish Longitudinal Study On Ageing data.

The scientists analyzed more than 4,000 older individuals over ten years.

The database included information on depression, moderate-to-vigorous physical activity, and other key health-related variables such as disease, lifestyle factors, and socio-economic status.

They controlled for health-related factors, including age, biological sex, alcohol and smoking use, obesity, and antidepressant use.

My Take

There is growing evidence that physical activity promotes neuroplasticity, your brain’s ability to adapt and reprogram.

Many depressed individuals have psychological inflexibility, which occurs when they get stuck in a feedback loop of negative thoughts and emotions.

Exercise, and you may re-route neural pathways. The result? More positive emotions, improved stress resilience, and less anxiety.

Physical activity at lower doses than World Health Organization recommendations for health appears to offer protection against depressive symptoms and Major Depression.

Aim for 20 minutes daily of moderate-intensity activity at least five days per week. Do more to get even more benefits.

Do you feel better after a short bout of exercise?

The post Unleash the Happy Hormones: The Surprising Magic of Just 2 Hours a Week to Beat the Blues appeared first on Medika Life.

Teenagers and young kids use their smartphones a lot to browse social media, particularly Facebook, Instagram, and Twitter. The average age of first use is decreasing to 12 to 13 years, indicating the necessity of establishing a personal social identity before using social networks. Due to their screen size, interactive features, and capacity to stream information like video games, films, photographs, and applications, smartphones are gradually replacing desktop computers as the devices of choice for younger people.

When we consider that the brains of children are not fully formed until about the age of 25, we can appreciate that teens and younger children are not equipped to see the risk of excessive media devices like smartphones. If parents discourage this abuse, especially around bedtime or in the morning when they arise or during school hours, it may not address the “addiction” to the media. And the word “addiction” is being used, but is it really the proper word to use?

The risk factors of excessive use of social media are numerous. They include overuse, uncontrollable behaviors like checking for alerts all the time, mental health issues including sadness and anxiety, and physical issues. Even the physical problems are a result of this behavior. When using cell phones, youth with smartphone addiction had considerably flexed cervical posture and reduced cervical range of motion, according to measurements made using an inclinometer.

10,000 questionnaires in total in Italy were filled out for a study on cell phone use. Youngsters reported using their phones for more than 3 hours (41%), more than 2 hours (29%), more than 1 hour (21%), and less than 1 hour (9%) per day. Children using the devices right before bed (38%), during class (24%), and right when they wake up in the morning (21%), were found to be using them problematically.

Fourteen percent of teenagers had addictions that had been recorded. Low academic results, impaired concentration (24%), neck and back pain (12%), insomnia (10%), and mood changes (7%) were among the effects that were noted. The results, therefore, confirmed that there are both psychological and physical issues associated with the excessive use of these digital devices. This was true in other European countries where research has been initiated, such as Croatia, the Czech Republic, Germany, Estonia, Italy, Lithuania, Norway, Poland, Portugal, Romania, and Serbia, where over 80% of children aged 9–16 use a smartphone to access the Internet at least once a day. One problem with most of these studies, however, is that they are based on self-report, a potentially highly biased means of research.

Is there any positive use of cell phones by adolescents? Teenage boys and girls are nearly equally likely to say they use their gadgets frequently or occasionally to interact with others (85% vs. 83%, respectively), pass the time (both 90%), or learn new things (79% vs. 87%), according to a survey. But it may also be a means of avoiding face-to-face communication, and we have to wonder what might be behind that. Fifty-four percent of the girls in this survey said that they use phones to avoid physical interactions, while boys use the phone in this way a bit more than thirty percent. Half of the sample believed they used cell phones too much and wanted to cut back. But in a culture that is heavily geared toward their use, is it possible to cut back? When more than half of the teens said they used the phones to avoid feeling lonely or anxious, especially girls, it presented challenges for them.

University students, too, expressed heavy use of cell phones. They, too, have both physical and mental difficulties associated with it, complaining of chronic neck and back pain, eye strain, weight gain, depression, and loneliness. The alternatives recommended were more physical activities planned for students and activities that could cut down on the use of phones. In a world of more than 6.5 billion users, one has to wonder how the decreased use of phones might play out when stress and loneliness appear to drive their use.

How can parents, guardians, or schools help to offer solutions to excessive cell phone use? Hobbies, social interactions, and physical activity can all influence a more balanced lifestyle for teens and younger children. Urge the young person to take part in social activities, make genuine connections with friends, and spend time with family in person.

A cell phone can be an important tool in our worldwide culture, but it can also disrupt lives in negative ways in terms of mental health, isolation, and physical problems, too.

The post Unhappy or Depressed Teens and Social Media’s Involvement Isn’t So Simple appeared first on Medika Life.

The following was excerpted with permission from Healing Honestly: The Messy and Magnificent Path to Overcoming Self-Blame and Self-Shame 2023 Berrett-Koehler Publishers www.bkconnection.com

Now I get to introduce you to a friend of mine, Anna Holtzman, LMHC, who has helped me so much on my chronic pain journey. Anna is a licensed therapist and chronic pain expert whose expertise is at the intersection of chronic pain and trauma. She is also a childhood sexual trauma survivor, and you know we love survivor-to-survivor wisdom!

A year ago, I was dealing with chronic migraines. At my request, Anna sent me information about how chronic pain works in the body, along with resources like guided imagery and journaling prompts. One of the coolest things I learned was that research shows that simply learning about how chronic pain works can in and of itself be an effective treatment for pain. So many fellow CSA survivors struggle with physical pain, like shoulder/neck/ back pain, migraines, and pelvic pain the way I have. It isn’t a coincidence, and it certainly isn’t our fault.

WITHOUT GETTING TOO PHILOSOPHICAL ON YOUR ASS, WE ARE GOING TO ASK OURSELVES, “WHAT IS PAIN?”

Anna explained to me, “Pain is nothing but a danger signal and triggered by fear. Sometimes the danger is physical, like a broken leg; sometimes the danger is emotional, like emotional abuse.” She continued, “Pain is a danger alarm created in our brains when our nervous systems feel unsafe. This is a process that doesn’t happen consciously, nor is it based on decisions we make.”

There are loads of examples of how this mind-body connection works. If we are nervous about a job interview, having a difficult conversation, or awaiting results of an important test, we may get stomach pains, nausea, loss of appetite, tightness in our neck and back. Or, if you’re me, you get the nervous bubble gut and you’re just grateful to make it through without pooping your pants. We don’t decide to get an upset stomach or back pains during these high-stress experiences; they are things that happen subconsciously.

There are these one-off stressful experiences, “but when you are dealing with chronic stress or chronic trauma, it can cause chronic pain. We can see examples around us, like having a super stressful job, which is an everyday experience, which may lead us to have headaches or back pain most days,” said Anna.

It all sounds too simple, right? Well, that’s kind of the point, she said. “This is all actually very simple. We all intuitively understand the connection between pain and trauma and our mind and body. But we’ve been conditioned to distrust our own knowledge of our own emotional and physical experience. We have been gaslit into believing our emotional feelings are not valid.”

While the world outside of us tells us that physical and emotional pain are completely different things, one being considered “real” and provable and the other constantly invalidated and dismissed, they are interwoven inside of us.

Anna explained, “Physical pain and emotional pain are created in very similar parts of the brain, so the two are inextricably connected. They are coordinated aspects of stress response, so we cannot divorce one from the other, not ever. Even if you have pain from a bone, there’s an emotional response to that from the physical sensation of the broken bone.” I can personally attest to that as someone who, as a kid, all on separate occasions, broke her leg, three toes, one finger, and an arm (from literally, I shit you not, napping on the couch while watching Baywatch reruns and slowly rolling over onto the floor, landing on my arm. Yes, it was just a regular couch.)

Anna continued, “Chronic pain is a result of the chronic tension between the part of us that wants to fight back and the part of us that has learned to be afraid to fight back, probably for good reasons, at least in childhood or before you had allies to support you.”

To illustrate the point, she offered us this prompt:

• First, let’s imagine lots of angry energy inside of you, the kind of fury of fighting back against all that is wrong. Tap into the anger and fury that is a part of each of us.
• Now that you’ve tapped into that feeling of righteous anger, try suppressing all that fighting energy with all of your might.
• What does your body feel like when you try to suppress your anger and fighting energy? It may feel pretty tense and tight in your body. If each of us sustained that for a while, we might start to feel some pain.
• Now that this little experiment is over, give your limbs a light shake or do some deep exhalations to release all that tension and discomfort, because that isn’t a pleasant feeling!

Presumably, if we continued to suppress and silence the natural fight response in us for long periods of time, say our whole childhood, we can see how some pain would start to develop. So this prompt is helping us understand a little better how chronic pain comes from this tension of suppressing our healthy natural emotional selves. Whether the prompt was illuminating to you or not, that’s okay; we have more to learn together!

COMMON SURVIVAL BEHAVIORS THAT CAN PERPETUATE CHRONIC PAIN (NONE OF WHICH ARE ANYTHING FOR US TO FEEL ASHAMED OF!)

In further exploring the chronic pain and CSA survivor relationship, Anna explained to me that there are some common survival behaviors that we survivors engage in that can perpetuate chronic pain.

1. Vigilance and preparing for the threat of danger.
   Many survivors experience hypervigilance as a part of their trauma. I feel I am often on high alert, playing worst-case scenarios in my head as a way to anticipate danger and prepare for ways to deal with the fallout. Do you observe yourself being constantly on high alert? No shame if you do! This was developed for good reasons!
   
   “The habit of vigilance perpetuates chronic pain because it keeps our danger alarm on high alert all the time. Pain is a danger signal, so when we fear we are in danger, our body sends us pain as a message, Anna explained. If we spend a lot of time with our danger alarms going off, this can continue our cycles of pain.
2. People pleasing and suppressing anger.
   Many of us can relate to being conditioned to suppress anger, because if we tried expressing it when we were younger, we may have received explicit or implicit signals that it wasn’t safe for us to be angry. Have you observed any people-pleasing/appeasing tendencies within yourself? Again, no shame if you have! This was developed for good reasons! (Yes, I will repeat this again because it is worthy of repetition!)
   
   “The people-pleasing/appeasing/suppressing anger survival behaviors perpetuate chronic pain in a few ways, including that when we have the urge to fight back but have to suppress it, it is as though our internal gas pedal and brake pedal are being slammed on simultaneously, which causes physical tension,” Anna explained.
3. Perfectionism and self-criticism (I am the best at this one!)
   My therapist says I am the best at criticizing myself for things that aren’t my fault — which also fulfills my perfectionist tendencies, so take that. We can be so hard on ourselves in hopes that it prevents us from “inviting” (we never actually invite abuse from someone, hence the quotation marks) abuse from someone else. Do you join me in having a lot of perfectionism and self-criticism tendencies too?
   
   When I asked Anna how this survival behavior contributes to chronic pain, she explained, “When we are perfectionists and intense self-critics, we are terrorizing ourselves all day long, and that turns on our danger alarms and sends signals of pain within us.” I did a true, honest-to-God spit-take when she said this last one, because it was so real to me that my only option was to hysterically laugh.

It’s no wonder so many of us deal with chronic pain! Look at all the coping strategies we had to develop just to try to stay safe and function in the world as survivors. Those same things can cause us pain. Thinking about all this together fills me up with a deep feeling of compassion for all of us.

HOW PAIN CAN SHOW UP DELAYED FOR US, LIKE A FUN SURPRISE FROM HELL!

A really important aspect of pain for us CSA survivors is that sometimes danger is a present-time threat, like touching a hot stove, but other times danger can be a conditioned response that reminds us of past danger or abuse. We can be going about our days and then get a headache or back pain and not know why, but it could be because we smelled or heard or saw something that subconsciously reminded us of our abuse. Anna explained that this can be a confusing part of pain, especially if we are trying to explain it to people who don’t know what it’s like to have trauma and experience triggers.

“An example I like to use is that when we get near a flame, our body automatically recoils from it because we know It’s dangerous. How do we know it’s dangerous? We aren’t consciously thinking about how fire is dangerous, so we must move our hand. We aren’t thinking about the first time we learned fire is dangerous. We may not consciously remember how and when we learned fire was dangerous, but our nervous system remembers fire is dangerous to touch, so our nervous system is recoiling our hand from the flame,” Anna said.

For some of us, we experienced chronic pain throughout our childhood. For others, we didn’t experience it until adulthood. Sometimes people ask, “Why now?!” to their pain who didn’t experience pain in their childhood.

“Often with chronic pain, we experience the pain when our bodies are safe enough to relax our survival mechanisms a bit and we determine, in a subconscious place, that it’s safe enough for us to fully feel the pain connected to the stress,” Anna explained.

WE CALL BULLSHIT ON THE NOTION THAT OUR EMOTIONS ARE “TOO BIG” TO FEEL

I’ve heard some people imply that we have chronic pain because our emotions are too big, or too hard, for our minds to process, so our bodies store them. When I asked Anna about this, she told me that every one of her trauma teachers has said that people suppress their feelings because they are too overwhelming, and that’s what leads to chronic pain.

“In my opinion, that is bullshit,” I was surprised to hear her say. “I don’t think we are unable to handle big feelings. Or that there are feelings too big for our nervous systems to handle. But rather, it’s that we can’t handle big feelings in isolation. We need companionship in order to safely process our feelings.”

We weren’t born suppressing our emotions. We learned to suppress our emotions because we learned from the people around us that we were not going to receive empathy and companionship with our feelings. Expressions of our feelings were met with silence, criticism, denial, and even punishment. Bad f — -ing things. At the same time, we learned that our physical pain would be taken seriously and met with some sympathy and support. So our bodies brilliantly channeled all our pain and emotions into the parts of us that would receive care and support when hurt. Fancy, smart moves from our bodies.

“We feel physical pain because it has a greater chance of being socially validated than emotional pain, and we stuff emotional pain down because we know we aren’t going to get empathy for it and the world around us has shown us it isn’t safe to process it,” Anna shared. Are there ways you’ve seen your physical pain garner more support and empathy than your emotional pain throughout your life?

The good news is that, as adults, we can seek out empathetic witnesses to our pain, like a trusted friend or a good therapist, who can offer us companionship that allows us to safely express our big feelings.

“Feeling our feelings without the presence of compassion makes our nervous system freak the f — – out because it feels exposed and vulnerable to potential threats. But feeling our feelings in the presence of compassion makes our nervous system feel safe,” Anna told me.

What is most important is for each of us to know we aren’t alone in our pain. “You are not crazy, and none of this is your fault. It is possible for you to find relief, and while you can never prevent all pain, it absolutely can get better,” Anna offered.

I know that was a lot of information about chronic pain and trauma! What kinds of emotions, including potentially unpleasant ones, does all of this bring up for you? However you feel, it is totally normal.

Want to read more? Grab a copy of the book, Healing Honestly: The Messy and Magnificent Path to Overcoming Self-Blame and Self-Shame!

The post Overcoming Self-Blame and Self-Shame appeared first on Medika Life.

Persistent sadness, hopelessness, and a loss of interest or pleasure in daily activities characterize MDD.

There has been growing interest in exploring alternative treatment approaches in recent years. These tools include probiotic supplementation to alleviate anxiety and depression symptoms.

A pilot randomized trial published in JAMA Psychiatry provides valuable insights into the potential benefits of probiotic supplementation as an adjunctive treatment for individuals with a major depressive disorder who do not achieve a complete remission with antidepressants.

We will examine the study findings and discuss the implications for clinical practice.

Depression is Common

Major depression is quite common, with around 264 million people globally experiencing this debilitating disorder, according to the World Health Organization.

According to The National Institute of Mental Health, 17.3 million (7.1 percent of adults) have had at least one major depressive episode in the United States.

The National Institute of Mental Health explains that of adults, 17.3 million (7.1 percent of the adult population) have had at least one major depressive episode in the United States.

The prevalence of major depression varies across different countries and populations, but it is a significant public health concern.

Major depression affects individuals from all walks of life, irrespective of age, gender, socioeconomic status, or cultural background. It is not limited to a specific demographic group and can occur in children, adolescents, adults, and older adults.

Women may be more likely to experience major depression than men. The reasons for this gender difference are not fully understood.

Despite its commonality, major depression is often underdiagnosed and undertreated. Many individuals suffering from depression do not seek professional. Reasons include stigma, lack of awareness, and limited access to mental health services.

Addressing the prevalence of major depression requires increased awareness. We also need improved mental health literacy and enhanced accessibility to appropriate treatments and support systems for those affected.

Depression (major depressive disorder) – Symptoms and causes

www.mayoclinic.org

Anxiety is common

Anxiety disorders are among the most common mental health conditions worldwide, affecting a significant portion of the global population. The condition is the most common mental illness globally and has a striking impact on the global disease burden.

Anxiety is a normal and adaptive response to stress or danger, but it can be classified as an anxiety disorder when it becomes chronic, excessive, and interferes with daily functioning.

Approximately 284 million individuals experience an anxiety disorder, making it a widespread concern.

It is important to note that anxiety disorders are not exclusive to any particular demographic group and can affect people from all backgrounds and age groups.

Anxiety disorders can manifest in various forms, such as generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, specific phobias, and post-traumatic stress disorder (PTSD).

Anxiety-related conditions can significantly impact an individual’s quality of life, relationships, and overall well-being.

Similar to major depression, anxiety disorders are often underdiagnosed and undertreated. Many anxious individuals don’t seek professional help due to stigma, lack of awareness, or fear of judgment.

Furthermore, some individuals may not recognize that their distressing symptoms indicate an anxiety disorder. Addressing the prevalence of anxiety requires promoting mental health awareness, reducing stigma, and ensuring access to appropriate diagnosis, treatment, and support services for those in need.

Anxiety disorders – Symptoms and causes

www.mayoclinic.org

Probiotics, Anxiety, and Depression

The randomized trial investigated the effects of probiotic supplementation as an adjunctive treatment for anxiety and depression symptoms in patients with MDD.

The study included 120 participants already receiving treatment with antidepressant medication but had not achieved full remission.

They were randomly assigned to receive either a widely-available, 14-strain probiotic supplement or a placebo. Subjects took the supplement or placebo four times daily for eight weeks.

Researchers assessed the severity of anxiety and depression symptoms using standardized measures at the beginning and end of the study.

The trial results revealed:

A significant drop in anxiety and depression symptoms among those who received probiotic supplementation (versus a placebo).

This finding suggests that probiotic supplementation may benefit mental health outcomes in individuals with MDD who do not experience complete relief from antidepressants alone.

Importantly, the use of probiotics as an adjunctive treatment did not interfere with the efficacy of the antidepressant medication, emphasizing its potential as a complementary therapeutic approach.

Probiotics mechanism

The mechanisms underlying the observed effects of probiotic supplementation on anxiety and depression symptoms are not yet fully understood.

However, there are several plausible explanations based on current scientific understanding. One hypothesis is that probiotics may modulate the gut-brain axis, bidirectional communication between the gastrointestinal and central nervous systems.

Emerging evidence suggests that alterations in gut microbiota composition and function are associated with mood disorders. Probiotics help restore a healthy balance of gut bacteria, improving mental well-being.

Furthermore, probiotics exert anti-inflammatory effects and regulate the production of neurotransmitters, such as serotonin, which play a crucial role in mood regulation.

Dysfunction in the serotonergic system is implicated in the pathophysiology of anxiety and depression. By influencing serotonin levels, probiotics may help alleviate depressive symptoms and promote a more positive mood state.

Probiotics: What is it, Benefits, Side Effects, Food & Types

Probiotics are a mixture of live bacteria or yeast in your body.

my.clevelandclinic.org

Clinical Trial Implications

The findings of this pilot trial have important implications for clinical practice, particularly for individuals with MDD who do not achieve full remission with antidepressants alone.

Adding probiotic supplementation as an adjunctive treatment may offer a valuable and safe option to enhance therapeutic outcomes. Given probiotics’ relatively low cost and minimal side effects, it could be a feasible and accessible intervention for many patients.

Study Limitations

However, it is essential to recognize the limitations of this study. First, the trial had a relatively small sample size, and we need to interpret the findings cautiously until replicated in larger, more diverse populations.

Secondly, the specific probiotic strain, dosage, and treatment duration used in this trial may not be generalizable to all available probiotic products. We need additional research to identify the most effective probiotic strains and optimal treatment protocols for managing anxiety and depression symptoms in patients with MDD.

Third, adherence was evaluated through capsule count, which, while the most commonly used method in clinical trials, can lead to overreporting.

In conclusion, the pilot randomized trial published in JAMA Psychiatry suggests that probiotic supplementation used as an adjunctive treatment holds promise in reducing anxiety and depression symptoms in patients with a Major Depressive Disorder (MDD) who do not experience full relief from antidepressants alone.

Gut-Brain Axis

The study’s findings support the hypothesis that probiotics may positively influence the gut-brain axis and modulate key neurochemical pathways involved in mood regulation.

Sugar, the Gut, and Obesity: Revealing Findings You Should Know About.

medium.com

We need more study

Although further research is warranted, these results provide a stepping stone for future investigations in larger populations to establish the efficacy and safety of probiotics as adjunctive treatments for anxiety and depression in MDD.

Incorporating probiotics into the treatment landscape may broaden the options available to clinicians and improve outcomes for individuals struggling with MDD.

The randomized clinical trial used the equivalent colony-forming unit of a single serving of kombucha.

Conflicts of Interest

The Medical Research Council Industrial CASE Ph.D. funded the study. Studentship with ADM Protexin (supplier of the probiotics) as the industry partner and additional support from Freya Green.

Study author Dr. Nikolova has received grants from the Medical Research Council and ADM Protexin during the conduct of the study as well as personal fees from Janssen outside the submitted work.

The post Surprising Link Between Probiotics, Anxiety, and Depression appeared first on Medika Life.

High blood pressure.

High cholesterol.

Excess weight.

These are the risk factors for heart disease that your doctor typically talks to you about.  Yet, there is a risk factor that most doctors never discuss that can have as much impact as the ones I just listed — Depression.

Your mood plays a significant role in whether or not you get heart disease.  Study after study shows that the biological changes involved with depression– increased cortisol, elevated adrenaline, and decreased serotonin – causes changes in how well your heart functions.  It directly impacts how well your heart pumps as well as how much plaque develops in your arteries. Intense emotions and acute anxiety can literally change the shape of the heart. It’s a condition called Takotsubo cardiomyopathy and often referred to as “broken heart syndrome.”

Why is no one talking about this?

Even though we have made progress in recent years around the mind-body connection, we often don’t implement it in clinical practice. We create silos with physical health managed by physicians trained in internal and family medicine and mental health largely managed by psychiatry.  We need to be integrating and acknowledging there is no physical health without mental health, and there is no mental health without physical health.  It doesn’t make sense to only address risk factors such as blood pressure, cholesterol and weight – and then have mood as some time of afterthought.

If you follow some of my writing, you know I’m a big fan of risk calculators. Perhaps it’s time to update those that help calculate risk of cardiovascular disease and add depression/anxiety in the calculation of the risk score. That might force folks to be more explicit and proactive about managing mood as part of a primary prevention program.

Like many other aspects of heart disease, we wait until someone has a heart attack to adequately address it.  We talk about the need to reduce stress after patients experience chest pain – we should be talking about mood before they get to that point!

We have made amazing advances in the treatment of heart disease but sometime still dies of a heart attack every thirty- five seconds. Given the mental health challenges that many people have experienced during the past two years, I expect deaths from heart disease will increase unless we take proactive steps in reducing risk.  Addressing depression and other mental health conditions must be an important part of plan.

The post Heart Disease and Depression appeared first on Medika Life.

Cannabis has gained popularity as a potential management tool for depression. But the available evidence regarding its efficacy is not robust.

Now comes an observational study that hints at the promise of cannabis for treating depression and insomnia.

“When you smoke the herb, it reveals you to yourself.”
― Bob Marley

Cannabis and depression

Some clinical studies hint that marijuana smokers (especially regular or heavy users) are diagnosed with depression more frequently than non-users. However, there is no good evidence that marijuana directly causes depression.

On the other hand, there are probably environmental or genetic factors related to depression and marijuana use. Some with depression may use marijuana to detach from their symptoms.

Marijuana use is also associated with other mental health conditions. The Mayo Clinic (USA) reminds us that substance use may trigger schizophrenia or other forms of psychosis (detachment from reality) in those with a higher baseline risk of these conditions.

There also are associations between marijuana and mental health conditions. Marijuana use may trigger schizophrenia or detachment from reality (psychosis) in people at higher risk of psychosis. The symptoms of diagnosed psychotic illness may be aggravated if marijuana use continues.

Finally, limited evidence shows that teens who attempt suicide may be more likely to have used marijuana than those not making a suicide try.

Cannabis and depression — A new study

British researchers conducted an observational case series review. The study included 129 individuals with depression, identified through the UK Medical Cannabis Registry.

Here are the outcomes based on changes in the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Sleep Quality Scale, and EQ-5D-5L from baseline to months one, three, and six:

There were significant improvements (at all time points) in each survey tool. Anxiety and depression subscores improved. There were 153 adverse events, including mild (50 percent of side effects), moderate (37 percent), and severe (13 percent).

The biggest study limitation? The study is observational. It cannot establish a causal relationship between marijuana use and improvements in sleep, depression, and overall quality of life.

The post Cannabis and Depression appeared first on Medika Life.

Think tanks such as the Pew Research Center have shown that social media now provides political and cultural news to one-half of Americans. The topics, whether seemingly benign or graphically serious in nature, stick with us, and that’s where the damage may begin. This is especially true when it comes to highly serious issues related to the Covid pandemic.

Political media news also affects children, and teen icons are rising up to address these issues. For example, Greta Thunberg, a teen environmental activist, and David Hogg, a gun ownership activist and survivor of a school attack, and Malala Yousafzai, another school shooting survivor.

The presence of upsetting politics in our lives can damage our mental and physical health. Anxiety, sadness, sleep disturbances, and even heart disease have all been linked to political stress.

Unpredictability and resulting chronic stress are the most difficult aspects of political life. Our emotional well-being can take a hit when we have no control over these circumstances. Will there be another shutdown of the federal government? Do you think there will be another major shooting? How likely is a nuclear assault from a foreign country? Will a recession cost me my job, and we’ll lose our home?

The emotional toll of being subjected to constant bad news is significant. When we hear about violence, lies, and corruption all the time, it’s easy to feel powerless and even suspicious.

There’s also the persistent prodding to pick a side. It appears impossible to be impartial in today’s political climate. You are for or against someone, for or against gun control, and for or against issues like abortion, healthcare, taxes, school lunches, or other social programs, and even Medicare and Social Security. We know that stress affects our decision-making, so we must help ourselves.

What can we do to help ourselves remain on an even keel and protect our mental and physical health? Researchers are looking for answers and some are now coming forth. This isn’t rocket science, but it makes good sense.

One solution is to limit our exposure to upsetting or completely biased news. Stop yourself from “doomscrolling,” the constant seeking out of media detailing the pandemic or other disturbing news. One expert named this “headline stress disorder” and even “election stress disorder.” He believes this erodes our resilience to maintain stress under our control.

The intent here is not to leave yourself devoid of information and to become a pawn in any way. You need to keep abreast of government affairs and how they affect you and your community. But excessively zeroing in solely on political discussions and news does not provide only pertinent material; it provides material.

Dead air on TV is verboten, just as newspapers, magazines, and internet blogs or publications need to fill their designated spaces with copy. Is it always something that provides you with needed information? How could it possibly do that?

A second means of handling this stress is to take action and not give in to feelings of helplessness. We’ve seen many ads encouraging people to vote, write letters to the editor, or make phone calls about issues that affect them socially, financially, or emotionally. Action is a good way to stay healthy.

Third, focus on what you can do and devote yourself to a pleasurable activity, such as a hobby or a group (social service, church, environmentalists, etc.). Volunteer in your area. In fact, research on charitable works for others has shown that it benefits the volunteer just as much as the person or group receiving the help.

What other ways can you help yourself in stressful, politically uncertain times? Take a journal and start writing things down and how you might counter the stress they cause. Track how successfully you’ve met your daily goals. And remember, accentuate the positive.

The post Paying a High Cost in Personal Health for Politics appeared first on Medika Life.

Once tested, they could be sent off to schools for these individuals. Was this for their benefit or that of society, and were the initial tests by Binet genuinely valid? The test had 30 questions.

Translated and revised to become an American test by Herbert Goddard, this original Binet-Simon test and a puzzle test provided a way to separate immigrants at Ellis Island and direct the “feeble-minded” to low-level jobs. One of the reasons? Racism and bias ran rampant.

Italian and Irish immigrants had little to no schooling, and many couldn’t read and were, therefore, of low intellect as rated by those in charge. How many of us could pass an I.Q. test administered in Russian and printed out in the Cyrillic alphabet? Could we even know what to do with a puzzle if the directions were spoken in a language we were unfamiliar with?

One current, widely used I.Q. test for kids displayed (maybe still?) a lack of cultural understanding and rated against some children. The test of judgment was one where a specific problem existed, and the child was scored on what they said they’d do in that situation.

When I read the question, I knew what a child in a poor neighborhood would do, and I wouldn’t have scored against them for what I saw as a smart action. To my mind, that portion of the test is culturally biased. Remember that call for “culture-free testing” or “culture-fair testing?” Who missed this one? Schools all over the U.S. use this test and others for school placement.

The question of intelligence has been one where many psychologists have attempted to devise one test to measure everything. Howard Gardner believed there wasn’t a singular intelligence, but multiple intelligences (Linguistic, Logical/Mathematical, Spatial, Bodily-Kinesthetic, Musical, Interpersonal, Intrapersonal, and Naturalist), and each should be measured. Gardner outlined these intelligences in his book Frames of Mind. Some forms of intelligence, he noted, could be enhanced by exposure to learning and culture.

Other psychologists, for example, Alexander Luria, studied neurologic aspects of psychology with his Luria-Nebraska battery of tests. One caveat most psychologists never hear is that Luria cautioned that it would take several years to become proficient in administering the test.

I do not know if the battery was normed on a diverse cultural sample. However, today we may turn to neurologic imaging for answers to individual deficits/difficulties.

I.Q. tests aren’t the only ones that are not sensitive to cultural considerations. Tests to assess depression have come under the research microscope, and we find them wanting, especially with Black women, an understudied group. An analysis of depressive symptoms in Black mothers found: In this sample of A.A. women with increased cardiometabolic burden, increased stress was associated with depressive symptoms that standard screening tools may not capture.

One reason depression may not be adequately assessed is the stereotype of the “strong black woman” (SBW), where self-silencing is one of the cardinal features. Seeking out or admitting to a need for mental health services does not mesh well with this image. The question for researchers is how to best devise tests of emotion for groups other than the usual white samples.

Any medical or psychological test must acknowledge the inherent factors of discrimination, culture, and bias. As in artificial intelligence algorithms, psychological test construction can have bias unacknowledged and unstudied by those who create and validate the tests.

Much work remains for everyone involved in providing care for all who come to them, and reliable, valid tests are a mandate for everyone.

The post Depression Scales and IQ Measures Fail Some Who Need Help the Most appeared first on Medika Life.

Do you enjoy sugary-sweet drinks? Packaged snacks or reconstituted meat products? They are convenient and easy to prepare.

I would be lying if I told you that I did not enjoy eating processed foods, at least in the past. I remain imperfect, but if I indulge, you can catch me eating a freshly made chocolate croissant or a delicious recently prepared piece of chocolate (of course) cake.

What are ultra-processed foods?

Let’s begin with some basics about processed foods before we pivot to the new study linking ultra-processed foods and mood.

What Are Ultra-Processed Foods?

CAN ULTRA-PROCESSED FOODS HURT YOUR HEALTH? Some studies indicate the answer is yes.

medium.com.

In the Harvard Health Blog, Katherine McManus, MS, RD, LDN, offers her take:

“Unprocessed or minimally processed foods are whole foods in which the vitamins and nutrients are still intact. The food is in its natural (or nearly natural) state. These foods may be minimally altered by removal of inedible parts, drying, crushing, roasting, boiling, freezing, or pasteurization, to make them suitable to store and safe to consume.”

The Academy of Nutrition and Dietetics defines processed food as “food that has been cooked, canned, frozen, packaged or changed in nutritional composition with fortifying, preserving or preparing in different ways.”

Please note that not all processed foods are unhealthy; rather, it depends on the amount of processing.

Ultra-processed foods, depression, and anxiety

Some studies point to a connection between ultra-processed food consumption and feeling blue. The evidence regarding other mental health symptoms, such as anxiety, remains lacking.

Enter a new study exploring whether people who consume higher amounts of ultra-processed food have more adverse mental health symptoms.

Researchers measured ultra-processed food consumption as a percentage of total energy intake in kilo-calories. They took a representative sample from the United States National Health and Nutrition Examination Survey between 2007 and 2012, including 10,359 people ages 18 and older.

They categorized the foods and drinks consumed as unprocessed or minimally processed, processed culinary ingredients, processed foods, or ultra-processed foods. They reported each food type as a percentage of daily calories.

The investigators examined measures of depression and mentally unhealthy or anxious days to see if those who ate more ultra-processed foods appeared more likely to report symptoms each month.

Here are the results, as published in Public Health Nutrition:

Individuals consuming the most ultra-processed foods (compared with those consuming the least) had significant increases in mild depression, “mentally unstable days,” and “anxious days.”

The high consumers of ultra-processed foods also reported significantly lower rates or reporting zero “mentally unhealthy days” and zero “anxious days.”

Ultra-processed foods and mental health — My take

Individuals with higher intakes of ultra-processed food consumption appeared significantly more likely to report mild depression, more mentally unhealthy and anxious days, and less likely to report zero mentally unhealthy or anxious days.

This study, while admittedly observational, adds to a growing scientific literature suggesting a connection between what we consume and mental health and well-being.

We need more analytic epidemiologic research to prove the hypotheses generated by studies such as the current one.

The study findings align with basic research showing that food additives in ultra-processed foods (such as artificial sweeteners and emulsifiers) can cause biological changes associated with mental health symptoms.

With a poor diet, the study authors remind us that we can have impaired glucose (blood sugar) tolerance, increases in inflammation, neuroinflammation, nerve cell mitochondrial (the cell’s powerhouse or energy station) function, and more.

Ultra-processed foods — Action plan

Unfortunately, many Americans consume copious amounts of ultra-processed foods. Here are some things we can do better (I am trying with you):

• Get more whole foods in your diet. You’ll reap the benefits in terms of nutrition that ultra-processed foods lack. I find whole foods more filling, perhaps because they tend to have more water and fiber. As a result, I snack less.
• Start with a piece of fruit as a snack. You can always find grapes sitting in my office.
• Add fresh (or even frozen) vegetables to your meals. I had to start small, as I am not naturally inclined to eat a lot of plants.
• Limit your ultra-processed food consumption. You knew I had to incorporate that tip! I mean the soft drinks (the easiest ultra-processed food for me to ditch), hot dogs, packaged cookies (that one was more challenging for me), and sweetened breakfast cereals.

Thank you for joining me today in this brief look at ultra-processed foods and anxiety and depression. As I write to you, I am pleased to report that I am eating some of my precious grapes. What is your go-to healthy snack?

The post Feeling Anxious or Blue? Might Be Your Diet appeared first on Medika Life.