depression

Physical activity found to be protective for people at risk for depression

Posted on by Dhyana Kearly

Physical activity can influence depression in a positive way

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Increased levels of physical activity can significantly reduce the odds of depression, even among people who are genetically predisposed to the condition, according to a new study from researchers at Massachusetts General Hospital (MGH). In a paper published in the journal Depression and Anxiety, the team reported that individuals who engaged in at least several hours of exercise each week were less likely to be diagnosed with a new episode of depression, even in the face of high genetic risk for the disorder.

Drawing on genomic and electronic health record data from nearly 8,000 participants in the Partners Healthcare Biobank, the new study is the first to show how physical activity can influence depression despite genetic risk. Researchers followed patients who filled out a survey about their lifestyle habits (including physical activity) when they enrolled in the Biobank. They then mined millions of electronic health record data points over the next two years and identified people who received diagnoses related to depression. They also calculated genetic risk scores for each participant, combining information across the entire genome into a single score that reflects a person's inherited risk for depression.

What they found was that people with higher genetic risk were more likely to be diagnosed with depression over the next two years. Significantly, though, people who were more physically active at baseline were less likely to develop depression, even after accounting for genetic risk. In addition, higher levels of physical activity were protective for people even with the highest genetic risk scores for depression.

"Our findings strongly suggest that, when it comes to depression, genes are not destiny and that being physically active has the potential to neutralize the added risk of future episodes in individuals who are genetically vulnerable," says Karmel Choi, PhD, of MGH and the Harvard T.H. Chan School of Public Health, and lead author of the study. "On average, about 35 additional minutes of physical activity each day may help people to reduce their risk and protect against future depression episodes."

The researchers found that both high-intensity forms of activity, such as aerobic exercise, dance and exercise machines, and lower-intensity forms, including yoga and stretching, were linked to decreased odds of depression. Overall, individuals could see a 17 percent reduction in odds of a new episode of depression for each added four-hour block of activity per week.

Depression represents the leading cause of disability worldwide. Despite its massive health burden, strategies to combat depression remain limited and the public's understanding of robust and modifiable protective factors is incomplete. "We provide promising evidence that primary care and mental health providers can use to counsel and make recommendations to patients that here is something meaningful they can do to lower their risk even if they have a family history of depression," says Choi.

Senior author Jordan Smoller MD, added, "In general our field has been lacking actionable ways of preventing depression and other mental health conditions. I think this research shows the value of real-world healthcare data and genomics to provide answers that can help us to reduce the burden of these diseases."

Beyond physical activity, the MGH team continues to leverage the Partners Biobank and other large-scale studies to explore modifiable ways that individuals might reduce their risk of depression. "We believe there may be many factors could be part of an overall strategy for improving resilience and preventing depression," emphasizes Choi. "The magnitude of depression around the world underscores the need for effective strategies that can impact as many people as possible."

Materials provided by Massachusetts General Hospital. Note: Read this article on Science Daily ---> Massachusetts General Hospital. "Physical activity may protect against new episodes of depression." ScienceDaily. ScienceDaily, 5 November 2019. www.sciencedaily.com/releases/2019/11/191105113510.htm.

Dr. Holland's Perspective

"Studies have repeatedly shown that the most effective treatment for depression is cognitive behavioral therapy. This type of therapy addresses problematic thought patterns by effectively disengaging attention from the repetitive negative thoughts that often set in motion the downward spiral of mood. Certainly, physical activity combined with cognitive therapy is a positive way to approach depression. In addition to the positive effects of exercise mentioned in this study, evidence also shows that regular mindfulness meditation, on its own or combined with cognitive therapy, can also help stop depression before it starts."

Therapy for Depression

  • Do you find yourself feeling sad, empty tired, guilty or hopeless. Are you to the point where nothing makes you happy?
  • Have you become more isolated or lonely than usual, and feel like you can’t reach out to people?
  • Does life seem like more trouble than it’s worth?

Everyone experiences the blues sometimes. But clinical depression is more than just feeling down, unhappy or a sad feeling. Major depression is not a simple emotion. It is a medical disorder that affects more than 10 percent of adults annually. Women are twice as likely to get depression as men. The earlier treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.

With depression, you may feel sad and hopeless and you may not understand why you feel this way. Unlike sadness or the blues, depression is actually a biochemical disorder that can affect just about every area of a person's life. Some people with depression may even have had self-destructive or suicidal thoughts. If this is your experience, it is crucial that you seek help.

Contact Dr. Holland for more information and to get help with depression.

Dark chocolate may positively affect mood and relieve depression

Posted on by Dr. Holland
Eating dark chocolate may positively affect mood and relieve depressive symptoms, finds a new UCL-led study looking at whether different types of chocolate are associated with mood disorders.

Dark chocolate associated with reduction of depressive symptoms

Scroll Down for Dr. Holland's Perspective on this article

Eating dark chocolate may positively affect mood and relieve depressive symptoms, finds a new UCL-led study looking at whether different types of chocolate are associated with mood disorders. The study, published in Depression and Anxiety, is the first to examine the association with depression according to the type of chocolate consumed. Researchers from UCL worked in collaboration with scientists from the University of Calgary and Alberta Health Services Canada and assessed data from 13,626 adults from the US National Health and Nutrition Examination Survey. Participants' chocolate consumption was assessed against their scores on the Patient Health Questionnaire, which assesses depressive symptoms.

Dark chocolate positively affects mood

In the cross-sectional study, a range of other factors including height, weight, marital status, ethnicity, education, household income, physical activity, smoking and chronic health problems were also taken into account to ensure the study only measured chocolate's effect on depressive symptoms. After adjusting for these factors, it was found that individuals who reported eating any dark chocolate in two 24-hour periods had 70 per cent lower odds of reporting clinically relevant depressive symptoms than those who reported not eating chocolate at all. The 25 per cent of chocolate consumers who ate the most chocolate (of any kind, not just dark) were also less likely to report depressive symptoms than those who didn't eat chocolate at all. However researchers found no significant link between any non‐dark chocolate consumption and clinically relevant depressive symptoms. Depression affects more than 300 million people worldwide, according to the World Health Organisation, and is the leading global cause of disability.

Lead author Dr Sarah Jackson (UCL Institute of Epidemiology & Health Care) said: "This study provides some evidence that consumption of chocolate, particularly dark chocolate, may be associated with reduced odds of clinically relevant depressive symptoms. "However further research is required to clarify the direction of causation -- it could be the case that depression causes people to lose their interest in eating chocolate, or there could be other factors that make people both less likely to eat dark chocolate and to be depressed. "Should a causal relationship demonstrating a protective effect of chocolate consumption on depressive symptoms be established, the biological mechanism needs to be understood to determine the type and amount of chocolate consumption for optimal depression prevention and management."

Chocolate is widely reported to have mood‐enhancing properties and several mechanisms for a relationship between chocolate and mood have been proposed. Principally, chocolate contains a number of psychoactive ingredients which produce a feeling of euphoria similar to that of cannabinoid, found in cannabis. It also contains phenylethylamine, a neuromodulator which is believed to be important for regulating people's moods. Experimental evidence also suggests that mood improvements only take place if the chocolate is palatable and pleasant to eat, which suggests that the experience of enjoying chocolate is an important factor, not just the ingredients present.

While the above is true of all types of chocolate, dark chocolate has a higher concentration of flavonoids, antioxidant chemicals which have been shown to improve inflammatory profiles, which have been shown to play a role in the onset of depression.

Story Source:

Materials provided by University College London. Read this article on Science Daily -University College London. "People who eat dark chocolate less likely to be depressed." ScienceDaily. ScienceDaily, 2 August 2019. www.sciencedaily.com/releases/2019/08/190802145458.htm.

Dr. Holland's Perspective

"Researchers point out in a 2007 study that the mood changes associated with chocolate last only about 3 minutes. Cocoa, the main ingredient in chocolate, causes the brain to release these ”feel good” chemicals (endorphins). While chocolate may give your mood a small boost, its short term effects emphasize why - for chronically depressed people in particular, it is important to find other ways to work with depression as well."

Therapy for Depression

  • Do you find yourself feeling sad, empty tired, guilty or hopeless. Are you to the point where nothing makes you happy?
  • Have you become more isolated or lonely than usual, and feel like you can’t reach out to people?
  • Does life seem like more trouble than it’s worth?

Everyone experiences the blues sometimes. But clinical depression is more than just feeling down, unhappy or a sad feeling. Major depression is not a simple emotion. It is a medical disorder that affects more than 10 percent of adults annually. Women are twice as likely to get depression as men.

With depression, you may feel sad and hopeless and you may not understand why you feel this way. Unlike sadness or the blues, depression is actually a biochemical disorder that can affect just about every area of a person's life. Some people with depression may even have had self-destructive or suicidal thoughts. If this is your experience, it is crucial that you seek help.

Contact Dr. Holland for more information and to get help with depression.

Low serotonin levels thought to influence gut health and spark depression

Posted on by Dr. Holland

New study suggests that depression and GI trouble sometimes spring from the same source

For people with depression, gastrointestinal distress is a common additional burden, and a new study suggests that for some, the two conditions arise from the same glitch in neuron chemistry -- low serotonin.The study, conducted in mice, shows that a shortage of serotonin in the neurons of the gut can cause constipation, just as a serotonin shortage in the brain can lead to depression. The study also found that a treatment that raises serotonin in the gut and the brain may alleviate both conditions.

Up to a third of people with depression have chronic constipation, and a few studies report that people with depression rate their accompanying bowel difficulties as one of the biggest factors reducing their quality of life. Severe constipation can obstruct the GI tract and cause serious pain. The condition leads to 2.5 million physician visits and 100,000 hospitalizations each year. Though some antidepressants are known to cause constipation, medication side effects do not explain all cases.

"Ultimately, many patients with depression are faced with limited treatment options and have to suffer with prominent GI dysfunction," says study leader Kara Gross Margolis, MD, associate professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeon.

Similarities between the gut and the brain suggest the two conditions may also share a common cause. "The gut is often called the body's 'second brain,'" says Margolis. "It contains more neurons than the spinal cord and uses many of the same neurotransmitters as the brain. So it shouldn't be surprising that the two conditions could be caused by the same process."

Because low levels of serotonin in the brain have been linked to depression and serotonin is also used by neurons in the gut, the researchers studied mice to determine if a serotonin shortage also plays a role in constipation. The serotonin shortage in the gut, the researchers found, reduced the number of neurons in the gut, led to a deterioration of the gut's lining, and slowed the movement of contents through the GI tract.

"Basically, the mice were constipated," Margolis says, "and they showed the same kind of GI changes we see in people with constipation." (In previous studies, these same mice also showed depressive symptoms).

The treatment -- slow-release drug-delivery of 5-HTP, a precursor of serotonin -- works in part by increasing the number of GI neurons in study subjects. The discovery of this connection between a brain and a gastrointestinal disorder suggests that new 5-HTP slow-release therapies could treat related brain-gut conditions simultaneously. The study is also one of the first to show that neurogenesis in the gut is possible and can correct abnormalities in the gut. "Though it's been known for many years that neurogenesis occurs in certain parts of the brain, the idea that it occurs in the gut nervous system is relatively new," Margolis says.

Neurogenesis may help treat other types of constipation. "We see a reduction of neurons in the GI tract with age, and that loss is thought to be a cause of constipation in the elderly," Margolis says. "The idea that we may be able to use slow-release 5-HTP to treat conditions that require the development of new neurons in the gut may open a whole new avenue of treatment."

An immediate-release version of 5-HTP is available as a supplement, but it has not been proved scientifically to work and physiologically it should not, as it is too short-acting, Margolis says. 5-HTP is the immediate precursor to serotonin. Once ingested, 5-HTP is converted to serotonin, but the serotonin is rapidly inactivated before it can work effectively. The slow-release version of 5-HTP used in the current study produces constant administration of 5-HTP which has been demonstrated to remedy the limitations of currently available immediate-release 5-HTP. Clinical studies are already planned for testing a slow-release 5-HTP drug in people with treatment-resistant depression. Planning for testing a slow-release 5-HTP drug in constipation is in progress.

Story Source -- Read the full article on Science Daily: Materials provided by Columbia University Irving Medical Center. Note: Content may be edited for style and length. Columbia University Irving Medical Center. "A moody gut often accompanies depression: New study helps explain why." ScienceDaily. ScienceDaily, 7 May 2019. www.sciencedaily.com/releases/2019/05/190507080148.htm.

Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.

Sticking to life goals can fend off depression, anxiety, panic disorders

Posted on by Dr. Holland

Looking on the bright side also acts as a safeguard, according to 18-year study

People who don't give up on their goals (or who get better over time at not giving up on their goals) and who have a positive outlook appear to have less anxiety and depression and fewer panic attacks, according to a study of thousands of Americans over the course of 18 years. Surprisingly, a sense of control did not have an effect on the mental health of participants across time.

The study was published by the American Psychological Association in the Journal of Abnormal Psychology.

"Perseverance cultivates a sense of purposefulness that can create resilience against or decrease current levels of major depressive disorder, generalized anxiety disorder and panic disorder," said Nur Hani Zainal, MS, from The Pennsylvania State University and lead author of the study. "Looking on the bright side of unfortunate events has the same effect because people feel that life is meaningful, understandable and manageable."

Depression, anxiety and panic disorders are common mental health disorders that can be chronic and debilitating and put a person's physical health and livelihood at risk, according to Zainal and her co-author, Michelle G. Newman, PhD, also of The Pennsylvania State University.

"Often, people with these disorders are stuck in a cycle of negative thought patterns and behaviors that can make them feel worse," said Newman. "We wanted to understand what specific coping strategies would be helpful in reducing rates of depression, anxiety and panic attacks."

Zainal and Newman used data from 3,294 adults who were studied over 18 years. The average age of participants was 45, nearly all were white and slightly fewer than half were college-educated. Data were collected three times, in 1995 to 1996, 2004 to 2005 and 2012 to 2013. At each interval, participants were asked to rate their goal persistence (e.g., "When I encounter problems, I don't give up until I solve them"), self-mastery (e.g., "I can do just anything I really set my mind to") and positive reappraisal (e.g., "I can find something positive, even in the worst situations"). Diagnoses for major depressive, anxiety and panic disorders were also collected at each interval.

People who showed more goal persistence and optimism during the first assessment in the mid-1990s had greater reductions in depression, anxiety and panic disorders across the 18 years, according to the authors.

And throughout those years, people who began with fewer mental health problems showed more increased perseverance toward life goals and were better at focusing on the positive side of unfortunate events, said Zainal.

"Our findings suggest that people can improve their mental health by raising or maintaining high levels of tenacity, resilience and optimism," she said. "Aspiring toward personal and career goals can make people feel like their lives have meaning. On the other hand, disengaging from striving toward those aims or having a cynical attitude can have high mental health costs."

Unlike in previous research, Zainal and Newman did not find that self-mastery, or feeling in control of one's fate, had an effect on the mental health of participants across the 18-year period.

"This could have been because the participants, on average, did not show any changes in their use of self-mastery over time," said Newman. "It is possible that self-mastery is a relatively stable part of a person's character that does not easily change."

The authors believe their findings will be beneficial for psychotherapists working with clients dealing with depression, anxiety and panic disorders.

"Clinicians can help their clients understand the vicious cycle caused by giving up on professional and personal aspirations. Giving up may offer temporary emotional relief but can increase the risk of setbacks as regret and disappointment set in," said Zainal. "Boosting a patient's optimism and resilience by committing to specific courses of actions to make dreams come to full fruition despite obstacles can generate more positive moods and a sense of purpose."

Story Source -- Read this article on Science Daily: American Psychological Association. "Perseverance toward life goals can fend off depression, anxiety, panic disorders: Looking on the bright side also acts as a safeguard, according to 18-year study." ScienceDaily. ScienceDaily, 2 May 2019. www.sciencedaily.com/releases/2019/05/190502100852.htm.

Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.