Five-year-olds treated for depression and anxiety

Children as young as five are being referred for treatment for depression and anxiety, the BBC has found.

Figures showed mental health teams in Sussex are working with more than 1,000 under-18s while in the Solent 324 young people were referred for therapy.
Prescriptions for Fluoxetine, more commonly known as Prozac, have risen 26% in Oxfordshire and 13% in Berkshire from April to September last year.
MPs recently announced an extra £22m to tackle child mental health treatment.
Experts said children are coming under increasing stress because of unemployment, financial problems and substance abuse among their parents.
In February, the NHS Children and Adolescent Mental Health Service (CAMHS) in Sussex estimated it was working with about 330 under-11s and about 830 12 to 18-year-olds with anxiety and/or depression.
While in Dorset, 212 young people were diagnosed with depression and/or anxiety disorder with 118 of them being under 16 at the date of referral.
Plastic animals With the approval of health professionals and his family, the BBC was given access to a therapy room in Sussex, where eight-year-old "Jack" was receiving treatment for anxiety.
Having developed a deep-seated fear of leaving his mother he has been seeing child behaviour experts since he was 18 months old.
"The anxieties, I think started probably very soon after he was born," said child psychologist Jo Russell.
"There were other difficulties in the family, some stresses around employment and finances, and then his parents separated when he was just a toddler."

During his therapy "Jack" dangles his toys from a window, 30ft from the ground

During his therapy, the BBC observed "Jack" wind up a large ball of sticky tape around his hand and tie up his toy plastic animals with string before dangling them out of the window, 30ft above the ground.
"In his mind he's putting that little creature in a position of insecurity," Ms Russell said.
"Will that little creature manage to get to the ground or not? Through that play, this little boy and I have been able to think and talk about how people cope with feeling very insecure."
Jack's mother "Joy" said she knew her son, who has thrown things at her and put holes through doors, was "different" from other children at a young age.
"He gets very like a spring, he gets wound up and explodes," she said.
"He can be very loving and caring and when it's like that it's absolutely amazing but you have the other side which goes along."
After several years of therapy, his mother said "Jack" had improved, but could still be "up and down."
NHS Solent, which covers Southampton and Portsmouth, saw 324 young people with a problem of depression referred to it between September 2010 and August 2011, the youngest of whom was five years old.
It also revealed 378 patients, aged 16 and under, were referred for a range of mental health therapies not just for depression, including cognitive behaviour therapy, anxiety management and art and play therapy.
'Entrenched problems' Its youngest patient, a two-year-old, was referred for specialist child psychotherapy.
Barbara Inkson, child clinical psychology at Solent NHS Trust, said it was seeing an annual rise of about 10% in referrals.
However, its database can only record a reason for referral and not subsequent diagnosis.
"What is clear is that levels of emotional disorders, including depression as well as anxiety disorders and obsessive-compulsive disorders, are rising in line with other referrals to CAMHS here in the city," she said.

Child psychologist Jo Russell said difficulties within the family can cause stress in children

The charity, Young Minds, said it wants more treatments based in school and the community rather than in mental health units, which it says can be intimidating for children.
The government recently announced an extra £22m funding to tackle child mental health over three years, to expand state-of-the art psychological therapies and extend training for community workers.
Nationally, one in 10 children aged between five and 16 years old has a clinically diagnosable mental health problem and of adults with long-term mental health problems, half will have experienced their first symptoms before the age of 14.
Sarah Brennan, chief executive of Young Minds, said: "Intervening early when a child or young person starts struggling to cope is proven to reduce the likelihood of that young person developing much more severe and entrenched mental health problems.
"It is vital that we invest in children and young people's mental health in order to prevent a generation of children suffering entrenched mental health problems as adults."
Source: http://www.bbc.co.uk/news/uk-england-18251582

Does Facebook make YOU miserable? Wasting time on the social network is linked to low self-esteem

Next time you're in a bad mood, don’t turn to Facebook to cheer you up.
Research has revealed that the longer you spend procrastinating on the social networking site, the more miserable you will become.
This is because we recognise we're wasting our time on the site, and this lowers our self-esteem.

Researchers from University of Innsbruck in Austria asked 300 English and German Facebook users to take a series of tests. The first asked how much time they had spent on Facebook, and to rate their mood. The second asked some participants to spend 20 minutes on the social network

The research contradicts Facebook’s own controversial study, published last month, which revealed posts on the site can have a positive and negative effect.

LONELY PEOPLE MORE LIKELY TO OVERSHARE ON FACEBOOK

Australian researchers from Charles Sturt University in New South Wales, Australia studied the profiles of 608 female Facebook users.
According to the researchers, ‘half (308) were categorised as “connected” and the remaining 308 users were categorised as “lonely”; based on clearly stating this feeling in their latest wall posting.’
The study then monitored the publicly available aspects of the profile to see if there was a relationship between loneliness and self-disclosure.
Half of those who were categorised as lonely were more likely to include more personal information on their accounts.
This ranged from their relationship status to their address and phone number.
One in eight lonely users also listed their favourite book and film. 

For the more recent experiment, a total of 300 English and German-speaking participants were asked by researchers from the University of Innsbruck to take two tests to see how Facebook affected their mood.
In the first, they were asked how much time they had spent on Facebook that day, before being asked to rate their mood.

The second study asked some of the participants to spend 20 minutes on Facebook doing typical things such as checking their news feed and updating their status.
A second group browsed the web, but did not use social networks, while a third was given no instructions.
All three groups were asked to rate how ‘meaningful’ their overall experience had been.
The findings revealed that in both experiments, people said they felt worse about themselves after using Facebook, because they did not feel it was a good use of their time.
Lead researcher Christina Sagioglou of the University of Innsbruck in Austria said: ‘The meaningfulness actually accounts for the mood effects.

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A second group browsed the web, but not social networks, while a third was given no instructions. The findings revealed that all participants said they felt worse about themselves after using Facebook because they did not feel it was a good use of their time

‘It’s not surprising that if you do something you don’t consider very meaningful, you’re not in a good mood afterward.’
Previous studies have found Facebook can make people feel more jealous and lonely.
Australian researchers from Charles Sturt University in New South Wales discovered that female Facebook users who are categorised as lonely are more likely to include more personal information on their accounts.
This ranged from their relationship status, to their address and phone number, while one in eight lonely users also listed their favourite book and film.

Facebook’s own study was heavily criticised when it emerged the company manipulated the news feeds of 700,000 people in 2012 to see what would happen - without telling them first.

Source: http://www.dailymail.co.uk/sciencetech/article-2697572/Does-Facebook-make-YOU-sad-Wasting-time-social-network-linked-low-self-esteem.html

Smoking cannabis DOES increase the risk of anxiety and depression

Smoking cannabis does increase the risk of depression and anxiety, a new study has concluded.

U.S. researchers found the brains of users were less able to react to dopamine - the feel-good chemical that inspires a spirit of get-up-and-go.

The study adds to previous research suggesting marijuana can lead to people becoming withdrawn, lethargic and apathetic.

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Danger: The brains of cannabis users were less able to react to the feel-good chemical dopamine 

What are the physical effects of smoking Cannabis/Marijuana

Psychiatrist Dr Nora Volkow, of the National Institute on Drug Abuse in the U.S., used the stimulant Ritalin to see the effect cannabis had on the brain.

Like cocaine, Ritalin raises levels of dopamine in the brain.This made it ideal for the study, published in the journal Proceedings of the National Academy of Sciences.

Of the 48 people in the study, half received the drug - while the other half acted as a control group.

Personality and brain scans showed the cannabis users had significantly blunted dopamine responses compared with the controls who had never taken the drug.

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Previous research has suggested a lack of dopamine makes people lazy

This could contribute to drug-craving and negative emotions, a tendency towards depression and anxiety which are hallmarks of cannabis addiction.

Dr Volkow said the phenomenon cannot be unequivocally attributed to reductions in dopamine release.

They believe there is a downstream effect later in the process in an area of the brain called the striatum - the reward and motivation region.

Indeed, last year a study from Imperial College London found that long-term use of cannabis destroys dopamine.

Levels in the striatum - found towards the side of the brain - were lower in regular cannabis users.
Dr Michael Bloomfield, of Imperial College London, said: 'Dopamine is involved in telling the brain when something exciting is about to happen - be it sex, drugs or rock ‘n roll.
'Our findings explain why cannabis has a tendency to make people sit around doing nothing'

Commenting on the new study, the U.S. researchers said: 'Moves to legalise marijuana highlight the urgency to investigate effects of chronic marijuana in the human brain.'

Source: http://www.dailymail.co.uk/health/article-2691837/Smoking-cannabis-DOES-increase-risk-anxiety-depression.html

Individual Cognitive Behavioral Therapy Treatment

What is Cognitive Behaviour Therapy?

Cognitive behavioural therapy (CBT) is evidence based short-term psychological treatment.

It is a way of helping people solve problems and improve the way we think and feel.

Cognitive Behavioural therapy is based on 2 principles:

1. Our thoughts and beliefs are connected to our behaviours, moods and physical experiences and to the events in our lives.
2. The perception of an event affects our emotional, behavioural and physiological
   responses to that event.

CBT also concentrates on ideas that are unrealistic as these often undermine our self confidence and make us feel depressed and anxious. CBT looks at how problems from the past are maintained in the “here and now”. It helps people to learn new methods of coping and problem solving which can be used for the rest of their lives.

Cognitive Behavioural Therapy is evidence based which means that it has been clinically proven to work. Research has shown CBT to be highly effective and is the treatment of choice for a number of mental health issues as indicated in the government backed NICE clinical guidelines.

Research demonstrates that only pure CBT is effective, CBT blended into other therapy modalities (I.e. counselling, psychotherapy, hypnotherapy) is not proven. Our London CBT therapists only provide pure formulation driven CBT.

Source: http://londoncognitivebehaviouralpsychotherapy.co.uk/therapy/what-is-cognitive-behaviour-therapy/

Does depression require hospitalization?

A study published in the current issue of Psychotherapy and Psychosomatics has analyzed the difference between day hospital and inpatient stay in depression. Depending on the severity of depression, patients may be treated at different levels of care with psychotherapy and/or antidepressant medication. While several previous studies compared the efficacy of different levels of care for psychotherapy of personality disorders, sufficient data is lacking for the comparison of day-clinic and inpatient psychotherapy for depression. The current pilot study evaluates the feasibility of randomization in a routine hospital setting and compares preliminary efficacy for day-clinic and inpatient psychotherapy for depression.

Of 144 incoming patients who met inclusion criteria, 44 patients agreed to participate. Of these, 97.7% had a major depressive episode, 1 patient was primarily diagnosed with dysthymia. Comorbid diagnoses included anxiety (45.5%), somatoform (13.6%), obsessive-compulsive (6.8%), and personality disorder (33.3%).
After the initial assessment, patients were randomized to either the day-clinic or inpatient setting and treated for 8 weeks with multimodal psychotherapy. The therapy unit combines inpatient and day-clinic treatment, therapeutic staff is the same for both treatment arms. Both groups received equal amounts of psychotherapeutic interventions. The psychopharmacological antidepressant treatment followed the German national treatment guidelines for depression. In order to be representative for routine clinical practice, no further specifications with regard to psychopharmacological medications were made for the study.
At admission, 22 patients (50%) were taking antidepressant medication. Within the completer sample, 11 patients (31.4%) had a change in antidepressant medication during treatment. Antidepressants were reduced or terminated for 6 patients (17.2%) and increased or started for 4 patients (11.4%). One patient had a change of drug class. At termination, 51.4% of completer patients were taking antidepressant medication. There were no differences between groups for change during therapy or medication at termination. Change of medication was not related to initial depression severity and beginning or increasing medication was not significantly related to symptom reduction.
Depression severity decreased from baseline to the 4-week follow-up. There were no differences between day-clinic and inpatient psychotherapy concerning change over time. In addition, response and remission rates are reported descriptively. Eight inpatients (50% of completers) and 6 day-clinic patients (35.3% of completers) were classified as responders. In both groups, 3 patients (16.7% of inpatients, 17.7% of day-clinic completers) reached remission.
These results may encourage the incorporation of a scientific evaluation in routine clinical settings. Also, the findings suggest that it may be beneficial to consider different levels of care for the treatment of severe depression. Finally, the results call for further research in larger samples in order to test for moderator effects. As inpatient psychotherapy is more expensive than day treatments, it will be crucial to find out who benefits more in each setting.

Source: http://www.sciencedaily.com/releases/2014/07/140706083943.htm

Depression Also called: Clinical depression, Dysthymic disorder, Major depressive disorder, Unipolar depression

Depression is a serious medical illness that negatively affects how you feel, the way you think and how you act. Depression has a variety of symptoms, but the most common are a deep feeling of sadness or a marked loss of interest or pleasure in activities. Other symptoms include:

• Changes in appetite that result in weight losses or gains unrelated to dieting
• Insomnia or oversleeping
• Loss of energy or increased fatigue
• Restlessness or irritability
• Feelings of worthlessness or inappropriate guilt
• Difficulty thinking, concentrating, or making decisions
• Thoughts of death or suicide or attempts at suicide



Depression is common. It affects nearly one in 10 adults each year—nearly twice as many women as men. It’s also important to note that depression can strike at any time, but on average, first appears during the late teens to mid-20s. Depression is also common in older adults. Fortunately, depression is very treatable.

How Depression and Sadness Are Different

The death of a loved one, loss of a job, or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such stressful situations. Those experiencing trying times often might describe themselves as being “depressed.” But sadness and depression are not the same. While feelings of sadness will lessen with time, the disorder of depression can continue for months, even years. Patients who have experienced depression note marked differences between normal sadness and the disabling weight of clinical depression.

Causes

Depression can affect anyone—even a person who appears to live in relatively ideal circumstances. But several factors can play a role in the onset of depression:

Biochemistry
Abnormalities in two chemicals in the brain, serotonin and norepinephrine, might contribute to symptoms of depression, including anxiety, irritability and fatigue. Other brain networks undoubtedly are involved as well; scientists are actively seeking new knowledge in this area.

Genetics
Depression can run in families.

Personality
People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be vulnerable to depression.

Environmental factors
Continuous exposure to violence, neglect, abuse or poverty may make people who are already susceptible to depression all the more vulnerable to the illness. Also, a medical condition (e.g., a brain tumor or vitamin deficiency) can cause depression, so it is important to be evaluated by a psychiatrist or other physician to rule out general medical causes.


Treatment

For many people, depression cannot always be controlled for any length of time simply by exercise, changing diet, or taking a vacation. It is, however, among the most treatable of mental disorders; the majority of people with depression eventually respond well to treatment, and almost all patients gain some relief from their symptoms.

Before a specific treatment is recommended, a psychiatrist should conduct a thorough diagnostic evaluation, consisting of an interview and possibly a physical examination. The purpose of the evaluation is to reveal specific symptoms, medical and family history, cultural settings and environmental factors to arrive at a proper diagnosis and to determine the best treatment.

Medication
Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, “uppers” or tranquilizers. Neither are they habit-forming. Generally antidepressant medications have no stimulating effect on those not experiencing depression.

Antidepressants may produce some improvement within the first week or two of treatment. Full benefits may not be realized for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist will alter the dose of the medication or will add or substitute another antidepressant.

Psychiatrists usually recommend that patients continue to take medication for six or more months after symptoms have improved. After two or three episodes of major depression, long-term maintenance treatment may be suggested to decrease the risk of future episodes.

Psychotherapy
Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, it is often used in combination with antidepressant medications. Psychotherapy may involve only the individual patient, but it can include others. For example, family or couples therapy can help address specific issues arising within these close relationships. Group therapy involves people with similar illnesses. Depending on the severity of the depression, treatment can take a few weeks or substantially longer. However, in many cases, significant improvement can be made in 10 to 15 sessions.

Depression is never normal and always produces needless suffering. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, see your family physician or psychiatrist, describe your concerns and request a thorough evaluation.

Electroconvulsive therapy (ECT)
Electroconvulsive therapy is a medical treatment most commonly used in patients with severe major depression or bipolar disorder that has not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. 

Source:http://www.psychiatry.org/depression

Depression linked to higher heart disease death risk in younger women

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Women 55 and younger are twice as likely to suffer a heart attack, die or require artery-opening procedures if they're moderately or severely depressed, according to new research in the Journal of the American Heart Association.

"Women in this age group are also more likely to have depression, so this may be one of the 'hidden' risk factors that can help explain why women die at a disproportionately higher rate than men after a heart attack," said Amit Shah, M.D., M.S.C.R., study author and assistant professor of Epidemiology at Emory University in Atlanta, Ga.
Investigators assessed depression symptoms in 3,237 people with known or suspected heart disease (34 percent women, average age 62.5 years) scheduled for coronary angiography, an X-ray that diagnoses disease in the arteries that supply blood to the heart. After nearly three years of follow-up, researchers found:

• In women 55 and younger, after adjusting for other heart disease risk factors, each 1-point increase in symptoms of depression was associated with a 7 percent increase in the presence of heart disease.
• In men and older women, symptoms of depression didn't predict the presence of heart disease.
• Women 55 and younger were 2.17 times as likely to suffer a heart attack, die of heart disease or require an artery-opening procedure during the follow-up period if they had moderate or severe depression.
• Women 55 and younger were 2.45 times as likely to die from any cause during the follow-up period if they had moderate or severe depression.

"All people, and especially younger women, need to take depression very seriously," Shah said. "Depression itself is a reason to take action, but knowing that it is associated with an increased risk of heart disease and death should motivate people to seek help."
"Providers need to ask more questions. They need to be aware that young women are especially vulnerable to depression, and that depression may increase the risk to their heart," Shah said.

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"Although the risks and benefits of routine screening for depression are still unclear, our study suggests that young women may benefit for special consideration" remarked Viola Vaccarino, M.D., Ph.D., senior author of the study and Wilton Looney Chair of Epidemiology at Emory University. "Unfortunately, this group has largely been understudied before."
In 2008, the American Heart Association issued a scientific statement recommending that depression be formally considered as a risk factor, like diabetes or hypertension, for increased heart disease risk. "Our data are in accordance with this recommendation, but suggest that young/middle aged women may be especially vulnerable to depression as a risk factor," Vaccarino added."
The research group is examining whether women have more cardiovascular changes than men in response to a short-term mental stress, such as giving a public speech.

Source: http://www.sciencedaily.com/releases/2014/06/140618165107.htm