25 Ways to Find Joy and Balance During the Holidays

Feeling down during the holidays can be tough, especially since you seem so out of step with the world. Everyone else seems to be beaming, ruddy-cheeked, bursting with holiday spirit. You’re feeling wretched and exhausted.

But here’s something to cheer you up the next time you’re stuck in a room of revelers at a holiday party: Plenty of them are probably unhappy, too.

“I think a lot of people would say that the holidays are the worst time of the year,” says Ken Duckworth, MD, medical director of the National Alliance on Mental Illness. “They’re just straight up miserable, and that’s not only for people with clinical depression.”

So if the family gatherings, the endless parties, and the shopping get you down, you’re hardly alone. But people with depression -- or who have had depression in the past -- need to be especially careful when coping with holiday stress. While it might take some conscious effort on your part, you can reduce stress -- and maybe even find some holiday joy, too. Here are some tips.

Finding the Holiday Spirit: Emotions

1. Keep your expectations modest. Don’t get hung up on what the holidays are supposed to be like and how you’re supposed to feel. If you’re comparing your holidays to some abstract greeting card ideal, they’ll always come up short. So don’t worry about holiday spirit and take the holidays as they come.

2. Do something different. This year, does the prospect of the usual routine fill you with holiday dread rather than holiday joy? If so, don’t surrender to it. Try something different. Have Thanksgiving at a restaurant. Spend Christmas day at the movie theater. Get your family to agree to skip gifts and instead donate the money to a charity.

3. Lean on your support system. If you’ve been depressed, you need a network of close friends and family to turn to when things get tough, says David Shern, PhD, president and CEO of Mental Health America in Alexandria, Va. So during the holidays, take time to get together with your support team regularly -- or at least keep in touch by phone to keep yourself centered.

4. Don’t assume the worst. “I think some people go into the holidays with expectations so low that it makes them more depressed,” says Duckworth. So don’t start the holiday season anticipating disaster. If you try to take the holidays as they come and limit your expectations -- both good and bad -- you may enjoy them more.

5. Forget the unimportant stuff. Don’t run yourself ragged just to live up to holiday tradition. So what if you don’t get the lights on the roof this year? So what if you don’t get the special Christmas mugs from the crawl space? Give yourself a break. Worrying about such trivial stuff will not add to your holiday spirit.

6. Volunteer. Sure, you may feel stressed out and booked up already. But consider taking time to help people who have less than you. Try volunteering at a soup kitchen or working for a toy drive. “You could really find some comfort from it,” says Duckworth, “knowing that you’re making a small dent in the lives of people who have so little.”

Finding the Holiday Spirit: Family

7. Head off problems. Think about what people or situations trigger your holiday stress and figure out ways to avoid them. If seeing your uncle stresses you out, skip his New Year’s party and just stop by for a quick hello on New Year’s Day. Instead of staying in your bleak, childhood bedroom at your stepfather’s house, check into a nearby hotel. You really have more control than you think.

8. Ask for help -- but be specific. See if your spouse will lug out the decorations. Ask your sister to help you cook -- or host the holiday dinner itself. Invite a friend along on shopping trips. People may be more willing to help out than you expect; they just need some guidance from you on what to do.

9. Don’t worry about things beyond your control. So your uncle and your dad get into a fight every holiday dinner and it makes you miserable. But remember your limits. You can’t control them. But you can control your own reaction to the situation.

10. Make new family traditions. People often feel compelled to keep family holiday traditions alive long past the point that anyone’s actually enjoying them. Don’t keep them going for their own sake. “Start a new holiday tradition instead,” says Gloria Pope, Director of Advocacy and Public Policy at the Depression and Bipolar Support Alliance in Chicago. “Create one that’s more meaningful to you personally.”

11. Find positive ways to remember loved ones. Holidays may remind you of the loved ones who aren’t around anymore. But instead of just feeling glum, do something active to celebrate their memory. For instance, go out with your sisters to your mom’s favorite restaurant and give her a toast.

Finding the Holiday Spirit: Parties

12. Don’t overbook. “The holidays last for weeks and weeks,” says Pope. “People really need to pace themselves or they’ll get overwhelmed.” So don’t say yes to every invitation willy-nilly. Think about which parties and you can fit in -- and which ones you really want to attend.

13. Don’t stay longer than you want. Going to a party doesn’t obligate you to stay until the bitter end. Instead, just drop by for a few minutes, say hello, and explain you have other engagements. The hosts will understand that it’s a busy time of year and appreciate your effort. Knowing you have a plan to leave can really ease your anxiety.

14. Have a partner for the party. If the prospect of an office party is causing holiday stress, talk to a friend and arrange to arrive -- and leave -- together. You may feel much better knowing you have an ally and a plan of escape.

Finding the Holiday Spirit: Shopping

15. Forget about the perfect gift. If you’re already feeling overwhelmed, now is not the time to fret about finding the absolute best gift ever for your great aunt or your mailman. Remember: everybody likes a gift certificate.

16. Shop online. Save yourself the inconvenience, the crowds, and the horrors of the mall parking lot by doing the bulk of your shopping online.

17. Stick to a budget. The cost of holiday shopping mounts quickly and can make people feel out of control and anxious. So draw up a budget long before you actually start your shopping and stick to it.

18. Stay on schedule. As much as you possibly can, try to stick with your normal routine during the holidays. Don’t stay too late at parties. Don’t pull an all-nighter wrapping presents. Disrupting your schedule and losing out on sleep can make your mood deteriorate.

19. Exercise. While you may not feel like you have the time to exercise during the holidays, the benefits are worth it. “We know that exercise has a pretty strong anti-anxiety, anti-depression effect,” says Duckworth. You can work physical activity into your errands. When you’re shopping, take a few extra laps around the mall. Walk your Christmas cards to the post office instead of driving.

20. Eat sensibly. When you’re facing a dozen holiday parties and family gatherings between now and New Year’s, it’s hard to stay committed to a sensible diet. But try. Eating healthy may keep you feeling better -- physically and emotionally. On the other hand, don’t beat yourself up if you go overboard on the cookie platter in the break room. It’s not a big deal. Just get back on track the next day.

21. Don’t rely on holiday spirits (or other substances.) “The holidays are a time of heavy drinking,” says Duckworth. “It’s a common strategy for getting over anxiety about holiday parties or having the boss as your Secret Santa.” Remember that alcohol is itself a depressant and abusing it will leave you feeling worse. It also may not be safe for people taking antidepressant medication, says Pope.

22. Try a sun lamp. As the daylight grows shorter, lots of people find their mood gets gloomier. While some have diagnosed seasonal affective disorder (SAD), even people who don’t may still have a seasonal aspect to their depression. Talk to your doctor about trying a sun lamp. It could improve your mood.

23. If you take medication, don’t miss doses. In the hustle of the holidays, it’s easy to slack off and miss medication, says Pope. Don’t let that happen. Make sure that you’re up-to-date on your refills, too

24. If you see a therapist, have extra meetings. To stay grounded, plan ahead and schedule some extra sessions during the holiday season. Or you could ask about the possibility of doing quick phone check-ins.

25. Give yourself a break. “The holidays can make some people dwell on their imperfections, their mistakes, the things they’re not proud of,” Duckworth tells WebMD. But try to cut yourself some slack. “This is not an easy time of year for a lot of people,” Duckworth says. “Be gentle with yourself.”It is the season of kindness and forgiveness, after all. Save some of it for yourself.

Source:  http://www.webmd.com/depression/features/25-ways-find-joy-balance-during-holidays

Dissolve stress naturally

We get stressed when our nervous system is unable to get the special quality of rest it needs to recover completely from everything life throws at us.

If we are deprived of anything natural, there are eventually serious consequences. Severe sleep loss leads to the brain taking mini-sleeps when we are awake. And that can be disastrous. If we are deprived of dream, such as when sleeping pills are taken long term, we begin to hallucinate during the day.

When the nervous system doesn't get a profound state of restful alertness, we get stressed. We become unhappy. We don't sleep well. We lose our cool. The body begins to complain and life becomes a struggle.
Yet it is possible to access a source of vitality within which makes life easier, more enjoyable and rewarding. And rise above stress.

The fourth state of consciousness

Accessing a fourth natural state of consciousness of which we are ordinarily deprived – a deeply settled, restful, yet conscious state – is a universal human ability. It allows the brain to de-fragment, reset, and become more functional.

In this state, mental chatter ceases and new pathways are able to form in the brain. We are handicapped without it. Like walking around without shoes. Is it any wonder we have, as a species, endemic mental ill-health, delinquency, crime, open conflict, runaway birth rates and global poverty?
Call it the simplest state of human awareness, call it transcending, call it connecting with the body's innate intelligence, realising your essential nature, communing with universal consciousness – the outcome is the same, and it's measurable.

Transcendental Meditation

Transcendental Meditation (TM) is a simple and reliable way of freeing the mind from the vicious circle of activation. That is all that is needed - give the mind a break. The mind needs short periods of silence, regularly.
Different kinds of meditation are as different as different types of medication. Some techniques discipline the mind, some explore new avenues of understanding, some monitor the present stream of consciousness. None of theses involve transcending. They don't allow the mind to go beyond sensation, beyond thought, beyond activity altogether.
You don't have to learn a new skill. You don't have to be able to sit still or keep your mind focused or empty of thought. Even children learn Transcendental Meditation. It's easy from the first day.

Stress-free life

Transcendental Meditation has profound effects. Health care costs have been found to be 55% less after 6 years. Blood pressure is likely to stay within safe limits, anxiety decreases, war veterans and refugees recover from years of emotional numbness following trauma. Relationships heal, and elderly practitioners have outlived their matched controls.

Source:  http://uk.tm.org/web/clpgg/stress?leadsource=CRM1784&gclid=CJDI7taU3MwCFagy0woddu0NVg

How to Deal with a Depressed Spouse

When one spouse is depressed, a marriage is depressed. This illness erodes emotional and sexual intimacy and suffuses a relationship with pessimism and resentment, anger and isolation. Even the sunniest, most capable partner can be pulled into depression’s strong undertow: You may be overwhelmed by extra household chores that your partner is too lethargic to finish, resentful because your spouse won’t just snap out of it, or feel that you’re somehow to blame for the illness itself. You may feel alone yet unwilling to tell anyone there’s depression in your household, or you may simply wonder when the sparkle and joy, the humor and fun seeped out of your relationship. If there’s depression in your marriage, it’s time to act—for your partner and yourself. Waiting increases the chances that your relationship won’t last; depressed couples are nine times more likely to divorce. And trying to fight or make peace with this often misunderstood illness on your own raises risks for both of you. The longer a nondepressed spouse lives with a depressed partner, the higher his or her own risks for depression. The deeper a depressed spouse sinks, the tougher it may be to finally treat the depression—and the greater the risk for alcoholism, drug abuse, violence, and even suicide. The stakes are high, but the odds are that things will improve.
Remember, you’re not alone. An estimated 19 million Americans are currently going through depression. In the Reader’s Digest Marriage in America Survey, 42 percent of respondents named depression as a major challenge in their relationships. It’s not surprising that most said this insidious illness had a negative effect on them. But there was an unexpected ray of hope: One in four said depression had a positive outcome for their marriages. “Getting diagnosed and treated makes all the difference,” says Emily Scott-Lowe, Ph.D., an assistant visiting professor of social work at Pepperdine University, who leads workshops across the country about depression and marriage with her husband, Dennis Lowe, Ph.D., a psychologist and director of Pepperdine’s Center for the Family. “Just 33 percent of people with depression seek and get help. But when you do, your chances for significant improvement are 80 to 90 percent. Almost everyone gets some relief.”
Depression isn’t a choice or a little case of the blues. It’s a physical illness as serious and life-altering as diabetes, heart disease, or arthritis. A depressed spouse can’t just “snap out of it” or “get on with life.” The reason: Depression is marked by dramatic shifts in brain chemistry that alter mood, thoughts, sleep, appetite, and energy levels. Genetics usually make many of us susceptible to depression; any number of factors can trigger the slide, including prolonged or severe stress, financial problems, a big loss or change in your life, the birth of a child, parenthood, and even some health conditions and prescription drugs. Marriage itself even raises your risk: Up to 1 in 10 brides experience “postnuptial depression” in the months after the wedding. And up to half of all women and men in unhappy marriages may be depressed, perhaps due to marriage problems (though some experts suspect that undiagnosed depression is behind the problems).
If you think your partner may be depressed, your first step is to pay attention to the clues—and help him or her get a diagnosis and treatment. These steps can help.

 Be alert to small changes. Depression can come on slowly, almost imperceptibly. “You look for all types of other explanations—we just had a new baby, it’s a tough time at work, it’s a phase,” Emily Scott-Lowe notes. “It can take a while to see the pattern or to be ready to accept that depression might be the cause.”
Often it’s up to the nondepressed spouse to take the lead: The illness itself often prevents depressed people from recognizing that something’s wrong or seeking help. They may feel too lethargic or withdrawn or may think they can fix it alone.
If you notice that your spouse isn’t acting, feeling, or thinking as he or she normally does, ask yourself if it could be depression, but don’t stop there. Depression may be the reason your spouse is working extremely long hours, drinking too much, using recreational drugs, or looking for thrills in risky activities. It can also look different in men and women.
Don’t wait for your spouse to hit bottom. Letting a depressed person sink low before offering help is an old-school approach borrowed from the early days of alcohol- and drug-addiction treatment. But the reasoning behind it is flawed and dangerous. Long-term depression is harder on your marriage, tougher to treat, and more likely to recur, and it leaves its victim in despair. The most chilling risk: It leaves open the very real possibility of suicide. About 60 percent of people who attempt suicide have major or minor depression or another mood disorder—and depressed men are four times more likely than depressed women to take their own lives.
Break the ice gently yet firmly. If you suspect your partner is depressed, don’t blurt out a layperson’s diagnosis: “You’re depressed!” or announce: “You better get help!” In order to begin the process of healing, approach your spouse with concern and with an action plan. You might say, “I’m concerned about how feeling tired and losing your appetite are affecting you. You deserve to feel better. Our doctor may be able to help you, and I’d like to arrange a time when we can meet with him. Next week, I can go on Wednesday or Friday. What’s good for you?”
Get a diagnosis—together. Dozens of health conditions—including heart disease, diabetes, lupus, viral infections, and chronic pain—can trigger the same symptoms as depression. So can scores of prescription medications, including some birth-control pills and drugs that treat acne, herpes, high blood pressure, high cholesterol, and cancer. Your family doctor can rule out underlying causes and decide whether or not it’s really depression.
Ask your spouse if it’s okay for you to attend this evaluation. “When you’re down that low, you may not be able to express what’s going on or even realize what all your symptoms are,” Emily Scott-Lowe notes. “And you may not be able to concentrate on the treatment recommendations your doctor is making. You need an ally in the room.”
Know that the odds are in your favor. As we noted, the success rate of depression treatment is as high as 90 percent. Usually the road back is relatively simple: antidepressants, counseling, or a combination of the two. That said, recovery may take time and patience. There may be an initial trial-and-error period while you try various antidepressants or see whether various therapy techniques, such as cognitive behavioral therapy and interpersonal counseling, are helpful. The results are worth it.
 Find a mental-health counselor for the two of you. Depression affects both of you—and your whole family. The Lowes suggest finding a therapist or counselor who has worked with depression in couples. “You may have issues to deal with individually as the depressed person, and the two of you may have issues to deal with that stem from coping with depression,” Dennis Lowe says. “We found it very helpful to have a counselor we could see together at times and separately at other times.”
Keep on learning about depression. Read books, check out websites, ask your doctor about advances in treatment and understanding of this illness. The more you know, the better you can cope and fight.
Be alert for relapses. About half of all people who suffer a bout of major depression will have a relapse; 75 percent of those will have another relapse; and 90 percent of those will have yet another. Once a first episode passes, many doctors prescribe a maintenance dose of antidepressants to prevent a relapse. Both spouses should also stay alert for signs that the illness is returning.
Caring for a depressed spouse can be lonely, overwhelming, and emotionally draining. You may blame yourself, feel helpless, grow pessimistic, lose your sense of humor, and even consider leaving. It’s easy for the nondepressed spouse to become angry and frustrated with an irritable, lethargic mate who’s pessimistic and critical, who can’t unload the dishwasher or get the kids ready for bed anymore—let alone make love, ask how you’re doing, or acknowledge that you’ve been holding things together for weeks, months, or years.
“This starts a cycle that burns you out and doesn’t help your partner at all,” Emily Scott-Lowe notes. “I did this with Dennis—I would become extremely angry with him. Then I would feel really guilty and try to make up for it by taking on more and more around the house. Then I would get angry all over again. This wasn’t helping Dennis, of course, and it was wearing me out emotionally and physically.”
These steps can help the nondepressed spouse stay well—and protect your marriage and your family while helping a depressed partner.
Admit that you cannot cure your partner’s depression. Your spouse needs your love, support, and concern. But these important qualities can’t reverse depression any more than they can control blood sugar, ease arthritis pain, or clear out clogged arteries. Just as you wouldn’t rely on love alone to cure a medical condition—or withdraw love because it didn’t—don’t expect that your feelings or attention will be able to alter your spouse’s off-kilter brain chemistry. Use your love to get help and to remind your partner of his or her intrinsic worth during this challenging time.
See depression as an intruder in your marriage. Like any other illness, depression is an outside force—an unwelcome visitor wreaking havoc with your spouse’s health, your marriage, and your home life. Seeing it this way can allow both of you to talk about its effects without blame or shame. “Once we started talking about it as a third party—as ‘the depression’—we could express our frustrations constructively,” Emily Scott-Lowe says. “If Dennis was really doubting his worth, I could say, ‘That’s just the depression talking. It’s not you. When you’re not depressed, you don’t think this way. It’s feeding you lies.'”
This shift in thinking can clear the air. “It was a relief for me,” Dennis Lowe says. “I felt Emily was walking on eggshells sometimes, not wanting to tell me how she was feeling. Depression was the elephant in the room that no one wanted to talk about, and I felt even guiltier. Seeing it as the intruder was an accurate perspective. It helped me see why I felt the way I did and let me accept reassurance because it acknowledges what’s going on instead of denying it.”

 Find support. Admitting there’s depression in your marriage can be tough. So can accepting help. Choose a trusted friend to confide in—preferably someone who’s experienced depression in their own life or within their family. And if you’re overwhelmed by extra household duties because your spouse can’t do his or her share, say yes when others offer assistance. “At one point, I was crying at church, when my friend shook me and said, ‘Emily, people here at church are lined up waiting to help you.’ I kept saying we didn’t need help until she shook me into reality. We had people bringing us dinner several nights a week. One neighbor took our sons to spend the night, and it was so nice to know they were having fun. Depression can suck the energy right out of a household.”
Monitor your own moods and thinking. Enduring barrages of negative comments, holding the household and family together, and losing the sweetest, most supportive aspects of your marriage isn’t easy. Over months and years, the nondepressed spouse may give in to confusion, self-blame, demoralization, and resentment, notes Anne Sheffield, author of Depression Fallout: The Impact of Depression on Couples and What You Can Do to Preserve the Bond. You may conclude that you must leave to save yourself. If this sounds familiar, get help for yourself—and insist that your mate do the same. “Depression separates couples with surgical skill and is a major home-breaker,” Sheffield notes in her book.
Conquer depression before you try to work on your marriage. Depression can wreak major havoc in your marriage. You may be tempted to fix what seem like smaller issues before tackling the illness head-on (it may be easier to ask your partner to communicate more effectively than it is to say “It’s time to get help,” for example). It’s reasonable to ask your spouse to help all he or she can around the house, to be responsible and treat you well. But looking for major changes while your spouse is under the influence of depression may simply create more frustration. Focus on lifting depression first.
Respect your own needs. If your spouse has depression, you still deserve everyday niceties—a neat house, regular meals, a calm family environment—as well as friendships, a social life, and time to pursue meaningful interests. As much as possible, pursue these things. It’s easy to spend your time dealing with your spouse’s needs and issues. But don’t sacrifice your own joys and goals needlessly. As we noted, you are susceptible to depression too. Pursuing your personal pleasures will not only help prevent that but also better prepare you for aiding your spouse.

Source:http://www.rd.com/health/wellness/how-to-cope-with-a-depressed-spouse/4/ 

Rose Polge: Junior doctor had 'work-related anxiety', says sister

A junior doctor whose body was found in the sea suffered from "work-related anxiety", her sister has said.

Dr Rose Polge, 25, who worked at Torbay Hospital in Devon, was found off Portland Bill, Dorset, in April.
Hazel Polge, who said her sister worked long hours, has set up a fundraising campaign to help "prevent such a tragedy" happening again.
Torbay and South Devon NHS Foundation Trust refused to comment about Dr Polge's health or work situation.

'Never be forgotten'

More than £4,000 in donations has been raised for mental health charity Mind and Dartmoor Search and Rescue, which helped look for the missing junior doctor.
Dr Polge's car and hoodie were found near Anstey's Cove, Torbay in February.
Writing on a fundraising website, Miss Polge said: "All Rose's colleagues are missing her hard work, friendliness and approachability.

"Her stunning smile, infectious enthusiasm, kindness and inquisitive nature made her popular with all people she met."
She said she was a "sweet, beautiful, kind, loving woman" and "she will never be forgotten".
Regarding the fundraising, she added: "Even if just one person was saved, to their family that would be everything."
Dr Rob Dyer, medical director at the hospital trust, said: "Our thoughts continue to be with Rose's family and loved ones as they struggle to come to terms with her loss.
"I believe they are entitled to privacy and I do not wish to comment publicly about Rose's health or work circumstances.
"I know from experience just how challenging the demands of the role [training as a junior doctor] can be [and] at Torbay Hospital, we take our duty of care to staff very seriously."
The BBC understands a note found in Dr Polge's car related mainly to personal issues, but included a passing reference to Health Secretary Jeremy Hunt.

Timeline of events

Friday 12 February - Rose Polge's car is found in a car park near Ansteys Cove in Torbay
Saturday 13 February - The family and boyfriend of Dr Polge join more than 100 people searching the area around Ansteys Cove
Sunday 14 February - Torbay Hospital confirms that Rose Polge works there as a junior doctor.
Monday 15 February - Colin Smith of Royston Hockey Club, where Dr Polge played, said: "We just don't know what we can do."
Tuesday 16 February - Dr Polge's family release a statement saying they are "overwhelmed" by the support from her friends and colleagues
Friday 19 February - Police announce hunt for Dr Polge has been scaled down, saying there is "no structured search going on"
Friday 1 April - A woman's body is recovered from the sea east of Portland Headland in Dorset
Monday 11 April - Police announce the discovery and say relatives of Dr Polge have been informed
Monday 18 April - Police confirm the body is that of Dr Polge

Source:  http://www.bbc.co.uk/news/uk-england-devon-36236629

Vanderbilt scientists discover potential new way to treat anxiety

Chemically modified inhibitors of the COX-2 enzyme relieve anxiety behaviors in mice by activating natural “endocannabinoids” without gastrointestinal side effects, Vanderbilt University scientists will report next week.
Endocannabinoids are natural signaling molecules that activate cannabinoid receptors in the brain, the same receptors turned on by the active ingredient in marijuana.

Lawrence Marnett, Ph.D., left, Sachin Patel, M.D., Ph.D., and colleagues are studying the COX-2 enzyme's potential role in relieving anxiety. (Stephen Doster/Vanderbilt University)

These receptors are also found in the gastrointestinal system and elsewhere in the body, and there is evidence that they play a role in wide range of physiological and pathological processes, in addition to modulating stress and anxiety.
If the “substrate-selective” COX-2 inhibitors developed at Vanderbilt also work in humans without side effects, they could represent a new approach to treating mood and anxiety disorders, the researchers conclude in a paper to be posted online Sunday in the journal Nature Neuroscience.
Clinical trials of some of these potential drugs could begin in the next several years, said Lawrence Marnett, Ph.D., director of the Vanderbilt Institute of Chemical Biology and the paper’s co-senior author with Sachin Patel, M.D., Ph.D.
The Vanderbilt scientists are pursuing other potential applications of activating endocannabinoids by substrate-selective COX-2 inhibition, including relieving pain, treating movement disorders, and possibly preventing colon cancer.
“The door is really wide open,” said Patel, assistant professor of Psychiatry and of Molecular Physiology & Biophysics. “We’ve just scratched the surface.”
Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and inflammation by blocking either or both of the cyclooxygenase (COX) enzymes, which produce pro-inflammatory prostaglandins.
It has been known for several years that COX-2 inhibition also activates endocannabinoids.
Because the “substrate selective” inhibitors developed at Vanderbilt increase endocannabinoid levels in the mouse without blocking prostaglandin production, “we think (they) will not have the gastrointestinal and possibly cardiovascular side effects that other NSAIDs do,” said Marnett, University Professor and Mary Geddes Stahlman Professor of Cancer Research.
“We thought we knew everything there was to know about (COX-2 inhibitors) until about five years ago when we discovered the substrate selective inhibition,” he added. The approach used by the Vanderbilt team “is a really powerful way to help design the next generation of drugs.”
Daniel Hermanson, a graduate student in Chemistry, was first author of the paper. Other co-authors were Nolan Harley, Joyonna Gamble-George, Naoko Brown, Brian Shonesy, Ph.D., Phillip Kingsley, Roger Colbran, Ph.D., and Jeffrey Reese, M.D.
The three-year-long study was supported by National Institutes of Health grants CA089450, GM015431, NS064278, DA031572, HL096967, HL109199, MH063232, NS078291 and MH065215.

Source:  http://news.vanderbilt.edu/2013/08/vanderbilt-scientists-discover-potential-new-way-to-treat-anxiety/

Depression symptoms that steadily increase in later life predict higher dementia risk, study shows

Depression symptoms that steadily increase in older adults are more strongly linked to dementia than any other types of depression, and may indicate the early stages of the disease, according to the first ever long-term study to examine the link between dementia and the course of depression, published in The Lancet Psychiatry journal.

Symptoms of depression are common in people with dementia, but previous studies have often looked at single episodes of depression, failing to take into account how depression develops over time. The course of depression varies greatly between individuals -- some might experience depressive symptoms only transiently, followed by full remission, others might have remitting and relapsing depression, and some might be chronically depressed. Different courses of depression may reflect different underlying causes, and might be linked to different risks of dementia.
The study included 3325 adults aged 55 and over, who all had symptoms of depression but no symptoms of dementia at the start of the study. The data was gathered from the Rotterdam Study, a population-based cohort study of various diseases in the Netherlands which allowed the authors to track depressive symptoms over 11 years and the risk of dementia for a subsequent 10 years.
Using the Center for Epidemiology Depression Scale (CES-D) and the Hospital Anxiety and Depression Scale-Depression (HADS-D), the authors identified five different trajectories of depressive symptoms -- low depression symptoms (2441 participants); initially high symptoms that decreased (369); low starting scores that increased then remitted (170); initially low symptoms that increased (255); and constantly high symptoms (90).
Of the 3325 participants, 434 developed dementia, including 348 cases of Alzheimer's disease. Among the group with low symptoms of depression, 10% (226/2174) developed dementia. The researchers used this as the benchmark against which to compare other trajectories of depression -- the study did not compare the risk of dementia following depression with the risk of dementia for adults in the general population (without depression).
Only the group whose symptoms of depression increased over time was at an increased risk of dementia- 22% of people (55/255) in this group developed dementia. This risk was particularly pronounced after the first 3 years. Individuals with remitting symptoms of depression were not at an increased risk of dementia compared to individuals with low depressive symptoms. The authors say that this suggests that having severe symptoms of depression at one point in time does not necessarily have any lasting influence on the risk of dementia.
The authors say their findings support the hypothesis that increasing symptoms of depression in older age could potentially represent an early stage of dementia. They also say that the findings support previous suggestions that dementia and some forms of depression may be symptoms of a common cause. They say that at the molecular levels, the biological mechanisms of depression and neurodegenerative diseases overlap considerably including the loss of ability to create new neurons, increased cell death and immune system dysregulation.
According to Dr M Arfan Ikram, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands, "Depressive symptoms that gradually increase over time appear to better predict dementia later in life than other trajectories of depressive symptoms such as high and remitting, in this study. There are a number of potential explanations, including that depression and dementia may both be symptoms of a common underlying cause, or that increasing depressive symptoms are on the starting end of a dementia continuum in older adults. More research is needed to examine this association, and to investigate the potential to use ongoing assessments of depressive symptoms to identify older adults at increased risk of dementia."
Writing in a linked Comment, Dr Simone Reppermund from the Department of Developmental Disability and Centre for Healthy Brain Ageing at the University of New South Wales, Sydney, Australia, says: "In conclusion, several factors can contribute to the development of both depression and dementia. The questions are if, and how, the presence of depression modifies the risk for dementia. The study by Mirza and colleagues provides an answer to the first question: depression, especially steadily increasing depressive symptoms, seems to increase the risk for dementia. However, the question of how the presence of depressive symptoms modifies the risk of dementia still remains. More studies of depression trajectories over a long period, with inclusion of biological measures, are necessary to understand the link between depression and dementia, in particular the underlying mechanisms. A focus on lifestyle factors such as physical activity and social networks, and biological risk factors such as vascular disease, neuroinflammation, high concentrations of stress hormones, and neuropathological changes, might bring new treatment and prevention strategies a step closer."
Source:  https://www.sciencedaily.com/releases/2016/04/160429192926.htm

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