Don't let the debt control you

"The biggest mistake people make is to allow problems with debt to control their lives, rather than controlling their debt," Alecock says. "The most important first step the debt-distressed can take is to admit that they have a problem. That's actually a very tough thing to do for many of us," he says.

If you need someone to help you come to terms with this, Reidenberg says speaking to a therapist is a good first step, though meeting with a member of the clergy may be more helpful for some people. The next step is to determine the level of your debt problems, Alecock says, by writing down take-home pay, all your monthly expenses including debt and the payments you owe every month.

"It sounds obvious, but you need to take a cold, hard look at whether what is going out each month is exceeding what you take in. If it does, it's time to take further steps to get back in control of your debt," Alecock says.

Whether you crunch those numbers yourself or want someone to help you, calling a debt counseling service is another step in the right direction. A counselor will help you prioritize your way out of debt, Reisenberg says.

He adds: "When things are spinning that far out of control, before they emotionally start becoming drained, they need to talk to someone who can help them gain control of the situation."

Alecock, who sees the benefits of credit counseling every day, says, "A responsible nonprofit credit counseling agency will provide you with a free and honest assessment of your debt problem, and a determination of what you can really afford to pay back each month." The agency will provide you with every possible option to get out of debt, possibly including a debt management plan, in which the credit counselor negotiates an arrangement with your creditors to pay off your debt over time with less if any penalties.

Alecock's agency has dealt with a suicidal debtor before, and he wants people to know that it is possible to set yourself free in a safe way. "People need to know there are many options available today to get back in control of their debt - there's credit counseling, shifting debt to lower interest cards, negotiating with your creditors directly, or in a worse case, even bankruptcy," Alecock says.

Support and crisis help

If you find yourself in a position where you fear you may harm yourself, call the National Suicide Prevention Lifeline at 1-800-273-TALK. While you can call them in a crisis, the operators also act as a general resource and referral line. "The way it is designed, it automatically routes your call to their closest call or crisis center in your area," Reidenberg says. "They have local resources for you. Those can be from credit counseling to debt management to a therapist to social workers to doctors to free clinics." They will help you figure out where to start on the path of debt freedom.

"If someone is really starting to struggle with anxiety and depression, and they go to a source that can give them a sense of, 'OK, I can get help, I can get control over this, there are resources available to me,' there is a much better likelihood that you can prevent them from taking that next step to planning a suicide attempt or dying," Reidenberg says.

While Alecock strongly believes in the help a credit counseling agency can offer to those in debt, he also encourages people considering suicide to call a suicide prevention hotline first.

People experiencing severe depression from debt may feel as if no one understands what they are going through. Fortunately, many support groups exist where you can meet people in similar circumstances. On the site MeetUp.com, you can find local meetings for credit workshops, sessions for foreclosure help, debt-proof living and bankruptcy support groups. They are not necessarily anonymous, but you do not have to reveal your name if you choose not to.

For those who have compulsive spending problems, there is Debtors' Anonymous, a 12-step program that provides direct support and financial guidance. "We are debtors, and this ranges from housewives to executives to people who are homeless. It's there to benefit anybody," says Donna D., a leader of the Austin, Texas, chapter of Debtors' Anonymous.

People "usually come in because of credit card debt, but it's also other forms of unsecured debt - the ongoing family and friend loans; friends and family bailing them out of financial disasters. Just living on that revolving unsecured credit and never being able to make ends meet, always in an obsession about financial survival," she says.

The group members help each other by recording everything they spend, discussing financial fears and sharing suggestions. They also help each other create spending plans, which are similar to budgets, and have sponsors who act as mentors and talk about their visions for the future. Most importantly, it is anonymous. 

If you do not feel comfortable sharing your problems in person, consider online support groups. iVillage, a Web site for women, has a major message board section with many debt categories, including a debt support group where people share their stories and receive advice and encouragement.

Don't wait to get help

While suicide may sound like the easy route when you are sinking under thousands of dollars of debt, its effects are permanent and will monumentally affect those who care about you. If you are feeling hopeless, remember that it is possible for things to get better. 

Don't wait until you hit rock bottom to begin seeking resources. "People feeling overwhelmed by debt need to talk to somebody and do it sooner rather than later," Reidenberg says. "There are many resources available and they should take advantage of them, because they can get through this."

Published: September 8, 2008

source site: click here I thought you'd like to know that this article was found at www.creditcard.com! :)

Other Affective or "Mood" Disorders

     Click here to read about other "Affective" or "Mood Disorders"

Depression and anxiety are the most common psychiatric disorders seen in primary-care practice;1 the symptoms of both are familiar to primary-care practitioners.

Unfortunately, fewer than 50% of the people who have depression actually ask for help, according to the National Mental Health Association.

July 2006

Major depression (or Depressive Illness)

A serious mental illness that can lead to:

• Disinterest in usual activities

• Extreme fatigue

• Sleep problems

• Feelings of guilt and helplessness

• Likely to lose touch with reality

• Delusions or hallucinations

• Inability to function

• Suicide

• Depressed mood

• Difficulty performing simple daily tasks

The most common time of onset is early middle age. Until recently it wasn't recognized as such a problem within our senior citizen population.

Depression can be a reaction to:

• The facts of growing older
• The death of a spouse or friends
• Physical limitations of age
• The impending confrontation with death

Elderly widowers are particularly susceptible to suicide. The highest percentage of suicide in the US is in elderly men. Difficult life transitions can trigger the onset of anxiety or depression.

It's truly alarming!!

The nearly 2/3 of depressed people that don't get proper treatment:

Being honest with your primary care physician about your symptoms is a first step in recognizing that you need help. Remember you have nothing to be ashamed of. Mental illness is a medical disorder.

• Convey your concern that perhaps your symptoms are those of depression or anxiety or another mental illness.

Signs & Symptoms

While it's normal for most people to feel "down in the dumps" on occasion, a person with major depression feels significantly depressed for a prolonged period of time, has difficulty enjoying acts that were once pleasurable and experiences at least 5 of the following symptoms for 2 weeks or more:

Symptoms of Depression & Mania

Not everyone who's depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.

Depression

• Persistent sad, anxious or "empty" mood

• Feelings of hopelessness, pessimism

• Feelings of guilt, worthlessness, helplessness

• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex

• Decreased energy, fatigue, being "slowed down"

• Difficulty concentrating, remembering, making decisions

• Insomnia, early-morning awakening or oversleeping

• Appetite and/or weight loss or overeating and weight gain

• Thoughts of death or suicide; suicide attempts

• Restlessness, irritability

• Persistent physical symptoms that don't respond to treatment, such as headaches, digestive disorders and chronic pain

Mania

• Abnormal or excessive elation

• Unusual irritability

• Decreased need for sleep

• Grandiose notions

• Increased talking

• Racing thoughts

• Increased sexual desire

• Markedly increased energy

• Poor judgment

• Inappropriate social behavior

Factors that predispose someone toward depression.

Many of us struggle for many years to overcome depression. At one end of the spectrum of prolonged depression are people whose depression is mild - they just consider themselves "not very happy."

At the other end are people who are often severely depressed and frequently consider suicide. Has this been a problem for you or someone you care about? What are some of the factors that predispose someone to feel depressed over a long period of time?

First, remember that these factors work by causing the person to frequently be in a state of under-challenged and under-aroused.  These factors keep them from harmonious functioning. Important values and parts of themselves aren't being engaged at a challenging, fun level or they aren't being satisfied at all.

The person may often be in a goal-less, "meaningless" mental state. These factors are dealt in other chapters, but this is the only place that they're summarized as a whole. I'll briefly discuss them and their solutions.

1. Low internal control, coping skills, or assertiveness. People who are habitually depressed often lack internal control & assertiveness. Often assertion training can help them not only become more successful w/others, but can help them get out of their depression. People who are habitually depressed also often lack self-direction, initiative, or self-management skills.

Emotional coping skills is another area frequently lacking in people who are habitually depressed.

2. Negative world views & self views often cause depression. Depression may not be so much that you're really so inadequate or have too high expectations. It may be caused by how you view yourself or the world. If you view yourself as bad or stupid no matter what you do, then you'll feel depression.

If you view the world (or other people) as so negative, hostile, or different from you, that you "don't have a chance" to succeed, then you'll feel depressed.

3.Too much self-denial can cause depression. A woman I saw was a cardiac nurse. She knew the signs of a heart attack. She started getting those signs - such as excruciating chest pains -  3 days before her daughter's wedding. Yet she didn't tell anyone or see a doctor; because she knew it was so bad, he would hospitalize her.

She feared it would disrupt her daughter's wedding. While she was dancing at the reception, her chest pains were so bad, she thought she would probably die right there.

That is self-denial - putting her own life at risk to make sure her daughter's wedding was undisturbed. What would you do in a similar circumstance?

When we make choices that deny important parts of ourselves -important biological needs, values, or goals - it can cause those parts to feel depressed and lower our overall motivation and happiness (even when other parts may feel happy).

People may habitually choose self-denial when they put all their energy into meeting long-term goals such as working exceptionally long hours to get a college degree or obtain career success.

Another cause of habitual self-denial is a belief system that puts too high a value on sacrificing ones own values and happiness for others. Many parents teach their children that their children's needs aren't important or teach them that they "don't deserve" to be happy.

These children may grow up believing a dark cloud follows them; they're so "bad" or incompetent that they don't deserve anything good. Therefore, they automatically feel guilty whenever they think about something fun for themselves and often choose to not pursue such "selfish" goals. The result is a life of self-deprivation and depression.

What if you're one of these people? What do you do about it? The solution is to confront the original belief systems that cause the self-denial and strengthen belief systems (such as the Higher Self) that support personal happiness.

Focus on areas of greatest deprivation (sex? fun? play? artistic interests? spending money on yourself? taking time to be alone? etc.) Then make practical goals and plans for leading a more personally rewarding life. Schedule these new activities into your daily and weekly and monthly plans.

Depression Intensifies From One Generation to the Next

Children with family history more than twice as likely to develop mood disorders, study finds

WEDNESDAY, Jan. 12 (HealthDayNews) - Depression intensifies from one generation to the next, says a study in the January issue of the Archives of General Psychiatry.

The study found that nearly 60% of children whose parents and grandparents suffered depression experienced anxiety disorders during their prepubescent years and developed depression as they became adolescents.

That's more than double the number of children (about 28%) with no family history of depression who developed anxiety and depression.

Researchers from Columbia University Medical Center (CUMC) and the New York State Psychiatric Institute (NYSPI) began studying 47 first-generation family members in 1982 and interviewed 86 of their children as they grew into adulthood.

They then collected data from 161 members of the third generation, average age 12.

"We have shown that the risk of depression is carried through several generations and that it intensifies as more generations are affected," study author Myrna Weissman, a professor of psychiatry and epidemiology at CUMC and chief of the department of clinical and genetic epidemiology at NYSPI, said in a prepared statement.

"Children with a two-generation family history of depression develop anxiety disorders earlier than other children and tend to experience more impairment," she said.

"Children of parents and grandparents with depression are at extremely high risk for mood and anxiety disorders even when they're very young. They should be considered for treatment if they develop anxiety disorders, or at least monitored very closely," Weissman said.

More information

The U.S. National Institute of Mental Health has more about depression (www.nimh.nih.gov ).

Are you at risk for depression? A quick family history could tell

Wed July 8, 2009 By Anne Harding

CNN Health

If you're feeling down, it can be hard to tell if you're experiencing a temporary case of the blues or a serious depression. Now a group of researchers say there's a relatively easy way to figure out whether some young adults are at greater risk of psychiatric problems or drug abuse -- just ask about their family.

It turns out that the more family members you have who have been found to have major depression, anxiety disorders, or drug or alcohol dependence, the greater the chances that you will too, according to Terrie E. Moffitt, Ph.D., a professor of psychology and neuroscience at Duke University's Institute for Genome Sciences & Policy, and colleagues, whose study was published in the Archives of General Psychiatry.

The bottom line? The researchers recommend that doctors ask a few quick questions to determine a patient's family history of psychiatric problems. People who have a strong family history should be closely monitored if they become depressed and should be treated promptly if they meet the criteria for clinical depression because they are at risk for more serious, ongoing problems. Health.com: Booze, drugs, and bipolar disorder

"It may help save their lives ultimately," says Douglas E. Williamson, Ph.D., of the University of Texas Health Science Center in San Antonio, who was not involved with the new study. Health.com: Why there's a link between depression and diabetes

Moffitt and her team looked at 981 New Zealanders born in 1972 and 1973; from age 3, their mental and physical health had been tracked by researchers, although they were in their early 30s at the time of Moffitt's study. The researchers used a simple family-history screening test with questions that identified the severity and persistence of major depression, anxiety disorder, and alcohol or drug dependence. (The question format is nearly identical to the one your doctor uses to find out whether you have a family history of heart disease or breast cancer.) They calculated family-history scores by looking at three generations of each study participant's family, including his or her grandparents, parents, and siblings over the age of 10. The test typically takes less than 30 minutes to administer.

The researchers found that the more relatives a person had with major depression, anxiety disorder, or alcohol or drug dependence, the more likely he or she was to have that condition too. And the stronger that family history, the greater a person's risk of having recurrent bouts of the condition and to report that it impaired his or her ability to function. These individuals were also at greater risk of being hospitalized for that condition, and to take medication to treat it.

The simple test was developed and published in 2000 by Myrna Weissman, Ph.D., a professor of epidemiology in psychiatry at Columbia University Medical Center, in New York City, and the director of the Division of Epidemiology at the New York State Psychiatric Institute, and her colleagues. Health.com: Change one thing, change your life: A primer for improving your mood

People who have a family history of depression have long been known to be at greater risk of the mental illness themselves, probably for both genetic and environmental reasons, Weissman says. "The reason that I developed that instrument is because I think that family history is one of the most important predictors of outcome," she says. "The family history scales that were available were very lengthy and they weren't suitable for just ordinary screening."

Weissman thinks doctors in general practice should use the test. All too often, physicians ask about family history of cancer, heart disease, or diabetes, but not mental illnesses that can have a serious impact on all facets of life, she says. Health.com: My life as a bipolar mom

"People who are depressed don't do well in school, don't do well in their work, and they often don't do well in their marriages and interpersonal relationships, and those things have a whole cascade of effects," she says.

source site: click here

Pain Affects Black Women More Intensely

Men & Women with Depression

• Men are less likely to suffer from depression than women, although there are 3 to 4 million men in the US who're affected by the illness.

• Men are less likely to admit to or seek help for depression and doctors are less likely to suspect it

• Men often mask depression by self medicating with alcohol or drugs

• Men work excessively long hours (become workaholics) hiding their depression in a socially acceptable manner

• Feelings of hopelessness and helplessness aren't usual indicators for men, instead they project as being irritable, angry and discouraged

• Men are also less willing than a woman to seek help, although they do realize that they're depressed

• They have extreme difficulty in asking anyone for help because they would have to openly admit to being depressed

• Men tend to believe that depression is a character weakness instead of a "mental illness."

• Support and encouragement from family and friends can make a difference

Campaign Seeks to Educate Hispanic Men About Depression  An estimated 54% suffer at least one major episode in their lifetime

Women are at elevated risk for depression in young adulthood.

A new study of young women during the 5-year transition from high school to early adulthood found that a substantial proportion experienced one or more episodes of major depressive disorder (MDD) during the study period.

The risk that depression would recur was substantial for all the women, particularly those whose illness began relatively early prior to their senior year in high school.

Women who had experienced psychiatric disorders other than depression also were more likely to have depressive episodes during the post-high school period.

Substance abuse disorders (SUD) affected 9.5% of the women during the 5-year period. MDD & SUD co-occurred frequently during the adolescent & early adult years. People w/SUD had an increased risk of MDD over time, but the reverse wasn't true.

Even after controlling for the effects of MDD on social adjustment, SUD was associated w/significantly impaired school functioning.

Gender differences in stress pathways may have implications for treating depression.

NIMH investigators have shown that the brain's stress pathways (the HPA axis) are generally more sensitive to stress hormones in normal men than in normal women.

However, this effect reverses w/age: older women have a higher HPA stress response than men of the same age. This finding suggests that despite their elevated rates of depression, pre-menopausal women may have protective stress adaptive mechanisms that depend on the body's natural estrogens.

It also has implications for treating depression because at core this disease is thought to involve alterations in the brain's stress adaptive mechanisms. This potential protective phenomenon may provide an avenue for developing new treatments for depression in both sexes across the life span.

Depression destroys our relationships

Depression within a family can be a devastating ruling factor. In a marriage, depression can change what you, your spouse views a marriage should be, or how you react to certain choices.

Other behaviors or symptoms of depression to watch out for include:

• Continuous boredom in your married life and nothing seems to be exciting

• Increased agitation or anger with your spouse

• When a spouse is depressed, the compromises and the commitment from both people tends to become less focused on each other and becomes a focus upon themselves, individually

Couples can overlook depression for a long period of time, but it doesn't help the marriage. Depression will eventually rule the marriage and drastic measures will be needed to help, so don't prolong getting help if this is what both of you determine that you and your spouse are going through. More signs for depression affecting your marriage are:

• Feeling that the depressed spouse is pulling the non-depressed parent under and this interferes w/the other spouse's ability to function rationally and normally

• The non-depressed spouse will often sleep less in order to get more done. The depressed spouse will sleep mostly more.

• Bickering together becomes the norm. The bickering doesn't seem to escalate into fully-fledged fights so there's no solution ever realized to the argument... there's more arguing and less communication.

• The depressed spouse will feel like the non-depressed spouse is rejecting them, creating the chaos and fears of the spouse leaving or finding someone else. This also prompts the depressed spouse to look for someone that understands who they really are....

• Anger develops more in the depressed spouse and the non-depressed spouse is left in a daze of confusion

• The non-depressed spouse will often begin to think of the future and what it holds for he/she. The depressed spouse usually can't think of anything but present and of their past

• The non-depressed spouse begins at some point to think of divorce; whether it's a 1 time thing or a continuous thought

Parenting While Experiencing Depression...

• During pregnancy, an estimated 10 to 12 % of mothers experience chronic depression

click here to read about the mother's stress being carried to the unborn child

Depressed Moms Raise Risk for Kids' Behavioral Woes

Depression during toddler years linked to antisocial tendencies

Tuesday, Feb. 8 (HealthDay News) - A mother's depression may raise the risk for antisocial behavior in her child, especially when depression occurs early in her child's development, British researchers say.

Researchers at King's College, London studied 1,116 sets of twins and found much higher levels of antisocial behavior in 7 year-old kids whose mothers had suffered depression during the child's first 5 years of life.

The greatest risk for problem behaviors occurred in children whose mothers suffered from depression and also showed symptoms of antisocial personality disorder.

A family history of antisocial behavior "accounted for approximately 1/3 of the observed association between maternal depression and children's antisocial behavior," the study authors explained in a prepared statement.

They say the study findings also suggest a strong environmental component linking exposure to a mother's depression with behavioral problems in her offspring.

The UK team believe a combination of 3 factors might explain the association between antisocial behavior in children and depression in mothers:

• First, depressed women are more likely to have antisocial personality traits related to depression

• Second, they're more likely to have children with men who also display antisocial behaviors

• Third, children of depressed mothers may simply be genetically predisposed to antisocial disorders.

Depressed mothers have:

• Elevated stress hormones

• Brain activity suggestive of depression

• Show little facial expression 

• Loss of appetite and sleep

When these infants are born they mirror the depressive symptoms that their mothers exhibit," concludes Researcher Tiffany Field, Ph.D.

Though the term "depression" can describe a normal human emotion, it also can refer to a psychiatric disorder. Depressive illness in children and adolescents includes a cluster of symptoms, which have been present for at least 2 weeks.

In addition to feelings of sadness and/or irritability, a depressive illness includes several of the following:

• Change of appetite with either significant weight loss (when not dieting) or weight gain

• Change in sleeping patterns (such as trouble falling asleep, waking up in the middle of the night, early morning awakening, or sleeping too much)

• Loss of interest in activities formerly enjoyed

• Isolation from family and friends

• Loss of energy, fatigue, feeling slowed down for no reason, "burned out"

• Feelings of guilt and self blame for things that are not one's fault

• Inability to concentrate and indecisiveness

• Feelings of hopelessness and helplessness

• Dizziness, Apathy and Social Withdrawal

• Recurring thoughts of death and suicide, wishing to die or attempting suicide

• Drug abuse or alcohol use, a drop in school performance, difficulty in concentrating

The primary types of depression include:

Major depression:  5 or more symptoms must be present; an episode must last at least 2 weeks, but tends to continue for 20 weeks. (A mood disorder is classified as minor depression if less than 5 depressive symptoms are present for at least 2 weeks.)

Dysthymia: a chronic, generally milder form of depression; symptoms are similar to major depression but more mild in degree Atypical depression accompanied by unusual symptoms, such as hallucinations, delusions & physical rigidity

Other common forms of depression include:

Postpartum depression is experienced by 8% to 20% of women following delivery

Premenstrual dysphoric disorder (PDD) experienced by 3% to 8% of women; depressive symptoms occur 1 week prior to menstruation & disappear following menstruation

• Sleep disturbances: at least 90% of people with depression have either insomnia (sleeplessness) or hypersomnia (excessive sleeping)

• Feelings of hopelessness

Men with stay at home partners less likely to be depressed

A new study shows that a partner's employment status may be more of a factor in depression than once thought. In an ESRC-funded study at the Dept. of Psychiatry at Queen Mary's School of Medicine researchers found that middle aged men whose partners worked part-time or who were at home caring for the family had lower depression scores than those whose partners worked full time.

Similarly men whose partners moved from caring for the family to full time work had higher depression scores.

The project was part of the Whitehall II study, a longitudinal study of over 10,000 middle aged male and female civil servants whose focus has been to try and explain the gradient of increasing ill health between high grade and low grade employees.

'We were trying to understand whether aspects of work and social life explain the employment grade differences in depression and identify the importance of different types of stress and social support in relation to depression' explains Professor Stephen Stansfeld, one of the authors of the report.

The project looked at the contribution of work and home based factors in the explanation of the social class gradient in mental ill health. What the research turned up was that both men and women in high grade positions have plenty of material and social resources which contribute directly to their quality of life and help them to cope with stress.

In the workplace, control over work, opportunities for use of skills and variety of work were important factors explaining why higher-grade employees had lower rate of depression than lower grade employees.

'Social networks were confirmed as an important resource. Stay at home partners in particular were perceived as particularly beneficial taking responsibility for the family and developing community ties' says Dr Vicky Cattell, one of the authors of the report.

Certain workplace stress factors more common in lower grade jobs include a huge sense of frustration at lack of promotion or feeling overburdened by demands whilst having little freedom of choice in the matter.

A cohesive work group could be protective however: 'We found that when new tasks or additional demands were combined with a disruption of the work group people were especially vulnerable to the effects of stress' explains Professor Stansfeld. 'Experiencing stress at both home and work could be particularly damaging for mental health' he adds.

Women in the lowest or middle employment grades who reported little control over their environment either at work or home were at most risk for depression. Men in middle grades with little control at work were also at risk whilst men in the middle and higher grades who felt powerless at home were also at risk for depression.

'We also found that women whose partner became unemployed were more at risk of depression whereas having a partner who moved from work into retirement had no effect on their depression score' says Professor Stansfeld.

'One of the key findings of our research is that stress factors which lead to mental illness may be on a sliding scale which correlates with social class. It's also highlighted the complex and cumulative nature of influences on mental health and wellbeing.

We need to do more research which explores the pathways linking social class, stress, resources, physical and mental illness' adds Professor Stansfeld.

it's good to be aware of....

Types of Eating Disorders

Anorexia Nervosa

Anorexia nervosa is a dangerous condition in which people can literally starve themselves to death. People w/this disorder eat very little even though they're already thin. They have an intense & overpowering fear of body fat & weight gain, repeated dieting attempts & excessive weight loss.

This particular eating disorder affects from 0.5% to 1% of the female adolescent population w/an average age of onset between 14 & 18 years.³

Anorexia is identified in part by refusal to eat, an intense desire to be thin, repeated dieting attempts & excessive weight loss. To maintain an abnormally low weight, people w/anorexia may diet, fast, or over exercise.

They often engage in behaviors such as self-induced vomiting or the misuse of laxatives, diuretics, or enemas. People w/anorexia believe that they're overweight even when they're extremely thin. Often, the beginning of illness will occur after a stressful life event such as initiation of puberty or moving out of the parents' home.

Those w/anorexia are often characterized as perfectionists & overachievers who appear to be in control. In reality, they suffer from low self-esteem & confidence & overly criticize themselves. They are also very concerned about pleasing others.

Complications - Most medical complications attributed to bulimia nervosa result from electrolyte imbalance & repeated purging behaviors.

Loss of potassium due to vomiting, e.g., damages heart muscle, increasing the risk for cardiac arrest. Repeated vomiting also causes inflammation of the esophagus & possible erosion of tooth enamel as well as damage to the salivary glands.

Some individuals w/bulimia struggle w/addictions such as drugs & alcohol & compulsive stealing. Like those w/anorexia, many people w/bulimia suffer from clinical depression, anxiety, obsessive-compulsive disorder & other psychiatric illnesses.

Binge Eating Disorder (BED)

Binge eating disorder (BED) is the newest clinically recognized eating disorder. BED is primarily identified by repeated episodes of uncontrolled eating.

The overeating or bingeing doesn't typically stop until the person is uncomfortably full. Unlike anorexia nervosa & bulimia nervosa, however, BED isn't associated w/inappropriate behaviors such as vomiting or excessive exercise to rid the body of extra food.

The illness usually begins in late adolescence or in the early 20s, often coming soon after significant weight loss from dieting. Some researchers believe that BED is the most common eating disorder, affecting 15% - 50% of participants in weight control programs.

In these programs, women are more likely to have BED than males. Current findings suggest that BED affects 0.7% - 4% of the general population.³

To the lay person, BED can be difficult to distinguish from other causes of obesity. However, the overeating in individuals w/BED is often accompanied by feeling out of control & followed by feelings of depression, guilt, or disgust.

Complications - People w/BED are often overweight because they maintain a high calorie diet w/out expending a similar amount of energy.

Medical problems for this disorder are similar to those found w/obesity such as increased cholesterol levels, high blood pressure & diabetes, as well as increased risk for gallbladder disease, heart disease & some types of cancer.

Researchers have shown that individuals w/BED also have high rates of depression.

Eating Disorder not Otherwise Specified (ENDOS)

The Eating Disorder Not Otherwise Specified (EDNOS) category is for disorders of eating that don't meet the criteria for any specific eating disorder.

In EDNOS, individuals engage in some form of abnormal eating but don't exhibit all the specific symptoms required to diagnose an eating disorder.

Treatment & Recovery

Eating disorders are most successfully treated when diagnosed early. The longer abnormal eating behaviors persist, the more difficult it is to overcome the disorder & its effects on the body. In some cases, long term treatment & hospitalization is required. Families & friends offering support & encouragement can play an important role in the success of the treatment program.

Treatment

Presently, there is no universally accepted standard treatment for anorexia nervosa, bulimia nervosa, or binge eating disorder. Ideally, an integrated approach to treatment would include the skills of nutritionists, mental health professionals, endocrinologists & other physicians.

Various types of psychotherapy may be employed, including cognitive-behavioral therapy, interpersonal therapy & family & group therapy. Self-esteem enhancement & assertiveness training may also be helpful. Antidepressants & other drugs have been part of some therapeutic regimes.

The status of eating disorders as curable diseases has been controversial, since relapse rates for disturbed eating patterns can be very high.

Etiology

No exact cause of eating disorders has yet been found. However, some characteristics have been shown to have influence in the development of the illnesses.

Personality Factors

Most people w/eating disorders share certain personality traits:

• low self-esteem
• feelings of helplessness
• a fear of becoming fat

In anorexia, bulimia & binge eating disorder, eating behaviors seem to develop as a way of handling stress.

Genetic & Environmental Factors Eating disorders appear to run in families, w/female relatives most often affected. However, there's growing evidence that a girl's immediate social environment, including her family & friends, can emphasize the importance of thinness & weight control.

i.e., regular discussion of weight & dieting may normalize societal pressure to be thin. Weight related teasing by peers & family is related to low body esteem & eating disturbances in young girls.

The National Institute of Mental Health (NIMH) reports that girls who live in families that tend to be strict & place strong emphasis on physical attractiveness & weight control are at an increased risk for inappropriate eating behaviors.⁴

Additionally, people pursuing professions or activities that emphasize thinness - like modeling, dancing, gymnastics, wresting & long distance running - are more susceptible to the problem.

Body Image

The idealization of thinness has resulted in distorted body image & unrealistic measures of beauty & success. Cultural & media influences such as TV, magazines & movies reinforce the belief that women should be more concerned w/their appearance than w/their own ideas or achievements.

Body dissatisfaction, feelings of fatness & drive for thinness has led many women to become overly concerned about their appearance. Research has shown that many normal weight & even underweight girls are dissatisfied w/their body & are choosing inappropriate behaviors to control their appetite & food intake.

The American Association of University Women found that adolescent girls believe physical appearance is a major part of their self-esteem & that their body image is a major part of their sense of self.⁶

Biochemistry

Recent studies have revealed a connection between biological factors associated w/clinical depression & the development of anorexia nervosa & bulimia nervosa.

Stress hormones such as cortisol are elevated in those w/eating disorders, while neurotransmitters such as serotonin may not function correctly. Research continues to better understand this relationship.

Population Differences

Gender Differences

Eating disorders are much more prevalent in females than in males. However, recent studies have shown that incidence & prevalence rates are increasing among males. Currently, there's approximately 1 male case to 10 female cases.

Further, up to 1 in 4 children referred to an eating disorders professional for anorexia is a boy. Many boys w/eating disorders share the same characteristics as their female counterparts, including:

• low self-esteem
• the need to be accepted
• an inability to cope w/emotional pressures
• family & relationship

Males w/eating disorders are most commonly seen in specific subgroups. e.g., males who wrestle show a disproportionate increase in eating disorders, rates 7 to 10 times the normal.

Additionally, homosexual males have an increased rate of eating disorders.⁷

Cultural Variation

Eating disorders are often perceived to be an affliction of Caucasian girls & young women in middle & upper socio-economic classes. Nevertheless, increasing numbers of cases are being seen in men & women of all different ethnic & cultural groups.³

Girls & women from all ethnic & racial groups may suffer from eating disorders & disordered eating. The specific nature of the most common eating problems, as well as risk & protective factors, may vary from group to group, but no population is exempt.

Research findings regarding prevalence rates & specific types of problems among particular groups are limited, but it's evident that disturbed eating behaviors & attitudes occur across all cultures.

Age

While eating disorders tends to peak between adolescence & early adulthood, the incidence & prevalence has shown an increase in all age groups. e.g., eating disorders are increasing rapidly among pre-pubertal girls.

Disordered eating habits & weight concerns are beginning at earlier ages & concerns of body weight & image emerge in girls as young as 9 years of age. A recent study found that 70% of 6th grade girls surveyed report that they first became concerned about their weight between the ages of 9 & 11.⁸

Eating disorders are also becoming more common among elderly women. This is in part due to patients maintaining their illness into old age. Also, elderly women have been shown to initiate weight control practices, such as bingeing & purging.⁹

Prevention

Increasing interest & concern about eating disorders has been demonstrated in both the public & private sectors but research into prevention has been limited. Although many risk factors for developing eating disorders have been identified, efforts at prevention have so far been disappointing.

A few studies have attempted to intervene in high-risk groups w/ mixed results.

Attitudes that lay the groundwork for developing eating disorders occur as early as 4th or 5th grade or younger, making prevention a major challenge. Better success has been accomplished in early detection & treatment of individuals w/eating disorders.

Brain Response May Explain Why Women Prone to Eating Disorders

Women may be more likely than men to suffer from eating disorders because women's brains process information differently, says a Japanese study.

Hiroshima University researchers found that women's & men's brains show different responses when viewing words linked to body image, BBC News Online reported.

The study included 13 women & 13 men who were shown a set of unpleasant words that described body image & another set of neutral words. Magnetic resonance imaging was used to scan the volunteers' brains while they scanned the words.

The results showed that in women, the unpleasant words triggered a response in the amygdala, an area of the brain believed to become active when a person feels threatened.

There was little amygdala activity in the men. Their response to the unpleasant words was seen in the medial prefrontal cortex, a brain region associated with rationalizing information, the researchers said.

"Our results suggest men processed the words more cognitively than emotionally. On the other hand, women processed them more emotionally," the authors noted.

Women are 10 times more likely than men to develop anorexia & Bulimia, the researchers said.

The study appears in the British Journal of Psychiatry.

Reactivate Relationships, Interests

If you've withdrawn from the social arena, you should take small steps toward getting back into it. Don't expect to show up at a party & command the room, but do try to get out & see some people. Meet with someone briefly for coffee, or maybe drop in on a friend to return something you borrowed.

It can help to talk about your problems with someone close to you. "I urge daily contact, at least over the telephone, with a confidant," Aikens says. This person shouldn't act like a therapist. He or she needs only to listen. It shouldn't be someone who might make you feel worse by getting irritated with you or giving you harsh advice.

A support group may help, too. Joining one, says Lea Ann Browning, a spokeswoman for the National Mental Health Association, based in Alexandria, Va., need not be a long-term commitment. "A lot of people can benefit from a support group for 6 or 8 weeks," she tells WebMD.

Also think about things you used to enjoy or find satisfaction in doing, but no longer do. Starting with small steps, begin to get back into doing them.

"Don't expect to enjoy it to begin with," Bilsker says. Like taking your medicine, do it because it's good for you.

If, for instance, a painter hasn't worked on a painting in a long time, she might start by taking out her materials & setting them up. Then she could commit to making a sketch & so forth.

"You can think of it as 'loosening up' the depression," Aikens says. "You're maintaining & extending your psychological range of motion."

Walk Away From Depression

Motivation to exercise may be scarce when you're feeling well, let alone when you're depressed, but try to do it anyhow.

"The typical things that we all know are important to taking care of ourselves become that much more important when you're dealing with depression," Browning says.

Exercise is a proven tonic for depression. For decades studies have been showing that aerobic exercise improves mood in people who are depressed.

Researchers recently found that the amount of aerobic exercise recommended by the CDC for general good health -- equivalent to 30 minutes of moderate-intensity exercise at least five days a week -- can bring about big improvements in depression.

The study, published in the January 2005 issue of American Journal of Preventive Medicine, involved people with mild-to-moderate depression who did various amounts of exercise for 12 weeks.

All groups in the study, including those in the control group, who only did stretches, had some improvement, but those who exercised as much as the CDC recommends fared best. In that group, 46% of the people reduced their symptoms by one-half, as rated on a scale of depression severity & 42% no longer qualified as depressed when the study ended.

It's important to start slowly with exercise. Decide what you can do & as Aikens suggests, do a little bit less than that. If you think you could manage a 20-minute brisk walk, try 15 minutes first & don't be discouraged if you don't feel better afterward.

"A person shouldn't have high expectations," Aikens says. "They shouldn't expect to necessarily feel cheerful or completely undepressed after going for a walk."

Seek Clarity

When you're depressed, you likely have all sorts of negative thoughts about yourself & your life - that you're a stupid failure beyond all hope, for example.

Should you transform your worldview & self-image by "positive thinking" instead? Scratch that, Aikens & Bilsker say. What you need when you're depressed is to get back to clear thinking.

"Our aim isn't to give you some other kind of distortion," Bilsker says. "We just want you to think about yourself in a fair way & a realistic way."

Of course, you're not stupid or a failure & there's hope for you yet. Right?

"You can encourage the return of accurate thinking by asking yourself questions," Aikens says, such as:

• How can I test whether this idea is valid or not?
• Was this always true?
• Are there any exceptions?
• What's the missing part of the picture?

Actions to Avoid

Depression sometimes drives people to drink & sometimes alcohol abuse leads to depression. In any case, drowning your sorrows now will not help you feel better later. The same goes for other kinds of substance abuse.

Also don't rashly make major life changes while you're still feeling depressed, like leaving your job or your spouse, unless the situation is really dicey. A bad job or relationship may very well be making you depressed, however, you could be taking a bleak view.

"When you're deeply depressed, you're not in a good position to make this judgment. You need your symptoms to lift so that you can see these situations more clearly," Aikens says.

That's not to say depression renders you incapable of making any decisions for yourself.

"You're just as smart when you have depression," Browning says. "But make sure you're not reacting to symptoms."

Published Aug. 22, 2005.

A country which stands for the pursuit of happiness? Should we really believe such an unfounded statement that at least 6 million men are - depressed?

Absolutely not. Because the history of the NIMH is questionable. The Citizens Commission on Human Rights (CCHR) is an international psychiatric watchdog.

Their booklet, "Documenting Psychiatry: A Human Rights and Global Failure" tells us, "In 1963, the US psychiatric research body National Institute of Mental Health, under psychiatrist Robert Felix, implemented a Community Mental Health Heath program which relied heavily on the use of mind-altering psychiatric drugs.

Spawning an international trend, it sent drugged patients homeless and incapable into the streets. After more than 47 billion spent on it between 1969 and 1994 alone, the program is an abject failure."

Now, seemingly, NIMH is targeting groups in this country, spending taxpayer dollars trying to convince the targeted group - they're depressed.

If depression and its dangerous drugs aren't being pushed in America, why has a federal task force recommended all adults be screened for depression during regular visits with their doctors? The U.S. Preventitive Services Task Force has the audacity to say as many as half of all cases are missed and others are mistreated.

Making matters worse, the American Psychiatric Association (APA) says America loses 70 billion a year because of lost productivity and absenteeism due to " not treating mental illness." This assertion is surely as surreal as the alphabet soup plethora of mental disorders listed in the APA's bible, the Diagnostic and Statistical Manual for Mental Disorders.

Perhaps such nonsense is why in 1998 noted psychiatrist Loren R. Mosher resigned after decades of membership in the APA. In his letter of resignation, he wrote, "Biologically based brain diseases are convenient for families and practitioners alike. It's no fault insurance against personal responsibility."

The colorful tapestry of a mental disorder for every American - stirred up by depression awareness campaigns for "real men" - have a horrific effect on children as well. Not surprisingly, the FDA recently approved Prozac for allegedly depressed children. Then the maker of Prozac, Eli Lilly, has the gall to say "it didn't intend to market Prozac for children." Okay, who is peppermint Prozac for? Real men? Or innocent little kids?

In the interest of our genuine mental health, we must stop selling depression and its drugs. Real men (& all other human beings) must "do" things to ward off depression. Real depression is rare. More likely, is the bastion of mental disorders and drugs that do nothing for real emotional behavioral concerns. Depression is sold to us cradle to grave. Why?

I often wonder if there's a connection between glossy depression awareness campaigns and antidepressants. In 2001, 12.2 billion dollars worth of antidepressants were sold. I just don't think we're nearly as depressed as the APA & NIMH would have us believe.

Real men, along with real women and children, have the capability to reach for the best within themselves. Depression awareness campaigns and your primary care doctor giving you and your child a free sample packet of Paxil to get through the bad days does nothing positive for the furthering of mental health. Stop the madness.

Young gay men are anxious, depressed & ignorant of their HIV status

And whilst they're aware of health warnings, the majority have had unprotected sex & few know their current HIV/AIDS status, says the study led by Dr Debra Bekerian of the University of East London's School of Psychology.

Based on preliminary analyses, the report also suggests that young gays who claim to have been traumatized in the past, perhaps thru loss of a friend, abuse or violence, are less likely to engage in unsafe sexual practices once they know their current HIV status.

This suggests that trauma may have a protective effect on health behavior.

Most of those interviewed for the study, in youth clubs & groups in London & East Anglia, considered current health messages to be too clinical & irrelevant to situations in which young gays have sex. They suggested improvements, including use of the Internet.

The 1980's saw an unprecedented number of gay men dying of HIV and AIDS-related illnesses and a subsequent hard-hitting education campaign from the Government and health authorities.

Response from the gay community was positive and reports of sexually transmitted infections fell rapidly.

The new study, however, comes against recent evidence of an increase in reported infections among young gay males between the ages of 18 and 29, with occasional high-risk sex also spreading.

Gay males are becoming sexually active as early as 14 years of age and may not have the experience or assertiveness to adopt safer sex, i.e., by using a condom, says the report.

So there is a fair chance of getting an infection right from the start.

The report points out that little formal education is offered to support young gays to behave responsibly, as the Local Government Act prevents any explicit promotion of homosexuality in schools.

There is also less general interest in AIDS and HIV than there was 20 years ago, with little mass media coverage given to the topic, so that young gays assume these are diseases relevant to an older generation.

Other research also suggests they feel it's "who you are" and not "what you do" which decides levels of personal risk.

Said Dr Bekerian: "To the extent that these findings are a representative sample, they suggest that young gays are suffering from serious negative affect and mental health issues and that some formal attention needs to be given to this problem."

It is worrying, says the report, that whilst most gays questioned reported having had unprotected sex at least once, they appeared complacent about possible effects on their health.

According to the research, young men who experienced some sort of trauma were less likely to have engaged in sex in the past 6 months than those who claimed never to have been traumatized.

Said Dr Bekerian: "These preliminary findings have serious implications for educators, health practitioners and policymakers who seek to promote safer sexual behavior in young gays.

"Future research needs to establish whether these findings are representative of young gay males exclusively, or whether they reflect trends in an entire generation of young people."

While the amygdala is involved in current emotional responses, it's also heavily involved in emotional memory, notes psychology professor Larry Cahill, University of California, Irvine. It gives a "critical boost for long-term memory of emotional events," he says, also noting that men's and women's amygdalas respond differently to emotional situations.

The brain images of women and men were recorded while they were shown emotionally upsetting films, such as plane crashes or killer whales dismembering and eating baby seals.

Men showed an increase in glucose metabolism on the amygdala's right side; women showed the increase on the structure's left side.

The findings, notes Cahill, don't explain the difference, but they force researchers to explore the basis for it.[9] "To my mind, it's saying we have to stop ignoring these kinds of variables [sex differences] when we try to figure out how the brain stores memory for emotional events.

Though we only reported the amygdala, in the whole brain we found very different patterns," he says. "We have to now actively incorporate the influence of gender into our theorizing about how the brain stores memories for emotional events, because men and women on average, are probably not doing it in the same way."

more about causes of depression

Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who don't get ill.

However, the reverse isn't true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work or school, are involved in its onset.

In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function.

People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression.

Whether this represents a psychological predisposition or an early form of the illness isn't clear.

In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period.

Also, a serious loss, difficult relationship, financial problem or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode.

Very often, a combination of genetic, psychological and environmental factors is involved in the onset of a depressive disorder. Later episodes of illness typically are precipitated by only mild stresses or none at all.

Risk Factors

• Young adulthood or middle age, the highest occurrence of depression is between the ages of 25 and 44; the elderly are also at particular risk due to death of loved ones, physical illness and loss of independence

• Stressful life events or trauma (such as the death of a loved one), particularly if the event occurs at a young age

• Postpartum period

• Chronic medical or psychological conditions including autoimmune diseases (such as lupus), cancer, heart disease, chronic headaches, chronic pain, anxiety, obsessive-compulsive disorder and borderline personality disorder

• Medical conditions that cause shifts in hormones, such as thyroid disorders or menopause

• History of abuse:(such as mental, physical or sexual)

• Lack of social support system (such as a network of close friends or family)

• Current or past alcohol or drug abuse - 25% of people with addictions have depression

Treating Depression

Lifestyle Choices

Lifestyle Exercise

Depression may make it harder to take the medications needed and to carry out the treatment for heart disease.

Depression also may result in chronically elevated levels of stress hormones, such as cortisol and adrenaline and the activation of the sympathetic nervous system (part of the "fight or flight" response), which can have deleterious effects on the heart.

The first studies of heart disease and depression found that people with heart disease were more likely to suffer from depression than otherwise healthy people.

While about 1 in 20 American adults experience major depression in a given year, the number goes to about 1 in 3 for people who have survived a heart attack. Furthermore, other researchers have found that most heart patients with depression don't receive appropriate treatment.

Cardiologists and primary care physicians tend to miss the diagnosis of depression; and even when they do recognize it, they often don't treat it adequately.

The public health impact of depression and heart disease, both separately and together, is enormous.

Depression is the estimated leading cause of disability worldwide and heart disease is by far the leading cause of death in the US. Approximately 1 in 3 Americans will die of some form of heart disease.

Studies indicate that depression can appear after heart disease   &/or heart disease surgery. In one investigation, nearly 1/2 of the patients studied one week after cardiopulmonary bypass surgery experienced serious cognitive problems, which may contribute to clinical depression in some individuals.

There are also multiple studies indicating that heart disease can follow depression. Psychological distress may cause rapid heartbeat, high blood pressure and faster blood clotting.

It can also lead to elevated insulin and cholesterol levels. These risk factors, with obesity, form a constellation of symptoms and often serve as a predictor of and a response to heart disease.

People with depression may feel slowed down and still have high levels of stress hormones. This can increase the work of the heart. As high levels of stress hormones are signaling a "fight or flight" reaction, the body's metabolism is diverted away from the type of tissue repair needed in heart disease.

Regardless of cause, the combination of depression and heart disease is associated with increased sickness and death, making effective treatment of depression imperative.

Pharmacological and cognitive-behavioral therapy treatments for depression are relatively well developed and play an important role in reducing the adverse impact of depression.

With the advent of the selective serotonin reuptake inhibitors to treat depression, more medically ill patients can be treated without the complicating cardiovascular side effects of the previous drugs available.

Ongoing research is investigating whether these treatments also reduce the associated risk of a second heart attack.

Furthermore, preventive interventions based on cognitive-behavior theories of depression also merit attention as approaches for avoiding adverse outcomes associated with both disorders.

These interventions may help promote adherence and behavior change that may increase the impact of available pharmacological and behavioral approaches to both diseases.

Exercise is another potential pathway to reducing both depression and risk of heart disease.

A recent study found that participation in an exercise training program was comparable to treatment with an antidepressant medication (a selective serotonin reuptake inhibitor) for improving depressive symptoms in older adults diagnosed with major depression.

Exercise, of course, is a major protective factor against heart disease as well.

The NIMH & the National Heart, Lung and Blood Institute are invested in uncovering the complicated relationship between depression and heart disease.

They support research on the basic mechanisms and processes linking co-occurring mental and medical disorders to identify potent, modifiable risk factors and protective processes amenable to medical and behavioral interventions that will reduce the adverse outcomes associated with both types of disorders.

Depression Relief Reported

All 3 approaches worked. Uridine and Omega-e fatty acids both had antidepressant-like effects, say the researchers. The rats stopped acting helpless and did their best, even though the test was still stacked against them.

The uridine injections acted right away, but the omega-3 fatty acids took 30 days to kick in. That's about as long as it takes for people to get depression relief from many antidepressant drugs like selective serotonin reuptake inhibitors (SSRI's), say the researchers. SSRI's include Paxil, Prozac and Zoloft.

Combining lower doses of uridine and Omega-e fatty acids was even more helpful. "Less of each agent is required for effectiveness when the treatments are administered together," say the researchers.

For comparison, the scientists also tested the depression drugs Norpramin, Prozac and Celexa. Those medications also helped the rats overcome helplessness.

Dietary Sources of Omega-3

Not all fish have the same amount of Omega - 3 fatty acids, so check levels for your favorite kind.

Can't stand fish? Walnuts, flaxseed and their oils have high quantities of plant-derived omega-3 fatty acids. Omega-3 supplements are also widely available, but they're not regulated by the FDA. Any supplements added to your regular medications have the potential to cause a serious interaction, so check with your health care provider to make sure it's safe.

As for uridine, sugar beets and beet molasses are food sources.

Don't Go It Alone

If you suspect that you're depressed, seek professional help. Diet may be one piece of the puzzle, but depression is too serious to handle on your own. An abundance of help is available, from diet and exercise to medication and counseling. All you have to do is ask.

Mild Depression Can Damage Immune System

Other Research

In another study, researchers report that patients with depression and sleep problems treated with the antidepression drug Prozac and the insomnia drug Lunesta got better quicker than those treated for depression only.

Perlis and colleagues are also conducting depression studies to determine if treating insomnia reduces the severity or lengthens the time between episodes of depression.

They are also examining the impact of insomnia treatment on pain management in patients with chronic back pain. The research is being funded by a $2.3 million grant from the National Institutes of Health.

He says there is growing evidence linking chronic insomnia with other common ailments, including high blood pressure and type 2 diabetes. He defines chronic insomnia as a troubling a sleep disturbance lasting more than 3 months.

This Courage to Care provides information to help you talk more effectively about depression with health care providers, family and friends. Depression is very treatable. Depression can be a part of chronic fatigue or unexplained aches and pains.

The earlier depression is detected and treated, the less likely it is to develop into a more serious problem that can impact one’s job, career, health and relationships.

Another good and bigger study supports Harrington’s conclusion. Peter Lewinsohn, et al (2003) at the Oregon Research Institute and several other researchers following a large number of teenagers found that those who had suffered major depression (n=319) and later were considered “in remission” had many more psychological problems in their early adulthood than teens (n=208) who had had other psychiatric diagnoses, such as anxiety, alcohol-drug addiction, ADHD, etc. and of course, they had more problems than peers (n=324) who hadn't had any psychological disorder as a teenager.

Note: as in Harrington’s study, an alarming 62% with major depression before 18 also suffered depression again or had some other mental disorder between 19 and 24.

Life just hadn't gone well for them - problems in school and at work, relationship problems, poor health, early pregnancy and using lots of mental health services.

The authors conclude that having depression in adolescence was an ominous sign of possible “pervasive impairment.”

Therefore, there's a serious need for mental health professionals, families, schools and society in general to develop ways of detecting depression very early and learning to treat it more effectively.

Prevention of depression early in life, particularly in Middle School, Jr High and High School, needs to be given high priority.

Surveying 15-year-olds, the United States has the highest or one of the highest rates of depression in the world; Austrian teens have the lowest rate. In our country the average age of onset is in the mid-20’s; that is earlier than most other countries. Why should this be?

How could poverty stricken countries be less depressed than we are? Some researchers speculate that the high divorce rate in the US, plus the high academic expectations and various social pressures have raised the stress level of teenagers that leads to depression.

Other speculators could come up with many other theories, including more psychological-mindedness which might make diagnosticians prone to over-diagnose depression. Likewise, where treatment is more readily available (drugs and psychotherapy) the level of depression might actually be reduced but the overall result could be an increased psychological orientation leading to an increased estimated rate of depression.

Surely, a strong stigma against having a mental problem would lower the estimated rate of prevalence.

There's a complex interaction among gaining weight, being depressed and taking anti-depressive medication. It's known that unhappy adolescents are more likely to become obese but it isn't clear whether the depression causes weight gain or obesity causes depression (Goodman & Whitaker, 2002).

Resea