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Questions

1. What is Depression?
a. Is there different stages of Depression
that depends on age?
b. If there is stages of depression. How can
you tell or know that he/she is going
through the stages of depression
2. If a person is Depress what would he
likely do to relieve his depression

functioning in daily life. Untreated,


symptoms can last for weeks, months, or
years; and if inadequately treated,
depression can lead to significant
impairment, other health-related issues,
and in rare cases, suicide.
(Sources: National Institute of Mental
Health and National Womens Health
Center.)

a. Can people help him/her relieve there


depression or only he/she can ease it?

What are some of the signs and symptoms


of depression?

b. If a person can help him/her relieve


there depression what would it be?

A person is diagnosed with a major


depression when he or she experiences at
least five of the symptoms listed below for
two consecutive weeks. At least one of the
five symptoms must be either (1)
depressed mood or (2) loss of interest or
pleasure.

3. Can Depression lead to Pessimistic


thinking?
a. If it can lead to pessimistic thinking how
can we prevent this from happening?
b. If a depress person is a pessimistic
thinker can we change it in becoming
optimistic?
4. What methods are underway to improve
treatment of depression?
a. If there is an undergoing research on
how to improve treatment of depression.
When will this new method be release or
be well known in the public

Frequently Asked Questions about


Depression

Symptoms include:

Depressed mood most of the day, nearly


every day
Markedly diminished interest or pleasure in
activities most of the day, nearly every day
Changes in appetite that result in weight
losses or gains unrelated to dieting
Changes in sleeping patterns
Loss of energy or increased fatigue
Restlessness or irritability

What is depression?
Clinical depression is a serious condition
that negatively affects how a person
thinks, feels, and behaves. In contrast to
normal sadness, clinical depression is
persistent, often interferes with a persons
ability to experience or anticipate
pleasure, and significantly interferes with

Feelings of anxiety
Feelings of worthlessness, helplessness, or
hopelessness
Inappropriate guilt
Difficulty thinking, concentrating, or
making decisions

Thoughts of death or attempts at suicide


(Sources: National Institute of Mental
Health and National Womens Health
Center.)

How is depression diagnosed and treated?


The first step to being diagnosed is to visit
a doctor for a medical evaluation. Certain
medications, and some medical conditions
such as thyroid disorder, can cause similar
symptoms as depression. A doctor can rule
out these possibilities by conducting a
physical examination, interview and lab
tests. If the doctor eliminates a medical
condition as a cause, he or she can
implement treatment or refer the patient
to a mental health professional.

Once diagnosed, a person with depression


can be treated by various methods. The
mainstays of treatment for depression are
any of a number of antidepressant
medications and psychotherapy, which can
also be used in combination.
(Sources: National Institute of Mental
Health and National Womens Health
Center.)

Why is depression more prevalent in


women than in men?
Depression is twice as common among
women as among men. About 20 percent of
women will experience at least one
episode of depression across their lifetime.
Scientists are examining many potential
causes for and contributing factors to
womens increased risk for depression.
Biological, life cycle, hormonal and
psychosocial factors unique to women may
be linked to womens higher depression
rates. Researchers have shown, for

example, that hormones affect brain


chemistry, impacting emotions and mood.

Before adolescence, girls and boys


experience depression at about the same
frequency. By adolescence, however, girls
become more likely to experience
depression than boys. Research points to
several possible reasons for this imbalance.
The biological and hormonal changes that
occur during puberty likely contribute to
the sharp increase in rates of depression
among adolescent girls. In addition,
research has suggested that girls are more
likely than boys to continue feeling bad
after experiencing difficult situations or
events, suggesting they are more prone to
depression.
(Sources: National Institute of Mental
Health and National Womens Health
Center.)

What is Postpartum Depression (PPD)?


Women are particularly vulnerable to
depression after giving birth, when
hormonal and physical changes and the
new responsibility of caring for a newborn
can be overwhelming. Many new mothers
experience a brief episode of mild mood
changes known as the baby blues. These
symptoms usually dissipate by the 10th
day. PPD lasts much longer than 10 days,
and can go on for months following child
birth. Acute PPD is a much more serious
condition that requires active treatment
and emotional support for the new mother.
Some studies suggest that women who
experience PPD often have had prior
depressive episodes.
(Sources: National Institute of Mental
Health and National Womens Health
Center.)

What happens during menopause?


Menopause is defined as the state of an
absence of menstrual periods for 12
months. Menopause is the point at which
estrogen and progesterone production
decreases permanently to very low levels.
The ovaries stop producing eggs and a
woman is no longer able to get pregnant
naturally. During the transition into
menopause, some women experience an
increased risk for depression. Scientists are
exploring how the cyclical rise and fall of
estrogen and other hormones may affect
the brain chemistry that is associated with
depressive illness.
(Sources: National Institute of Mental
Health and National Womens Health
Center.)

What about depression later in life?


For older adults who experience depression
for the first time later in life, other
factors, such as changes in the brain or
body, may be at play. For example, older
adults may suffer from restricted blood
flow, a condition called ischemia. Over
time, blood vessels become less flexible.
They may harden and prevent blood from
flowing normally to the bodys organs,
including the brain. If this occurs, an older
adult with no family or personal history of
depression may develop what some doctors
call vascular depression. Those with
vascular depression also may be at risk for
a coexisting cardiovascular illness, such as
heart disease or a stroke.
(Sources: National Institute of Mental
Health and National Womens Health
Center.)

What efforts are underway to improve


treatment of depression?
Researchers are looking for ways to better
understand, diagnose and treat depression
among all groups of people. Studying
strategies to personalize care for
depression, such as identifying
characteristics of the person that predict
which treatments are more likely to work,
is an important goal.
(Sources: National Institute of Mental
Health and National Womens Health
Center.)

What is the most promising recent


development to treat depression?
The biggest discovery for the treatment of
depression is ketamine, a glutamate NMDA
receptor antagonist that produces rapid
(within hours) antidepressant actions in
patients who have failed to respond to
conventional antidepressants (i.e., are
considered treatment- resistant). The
ability of ketamine to produce a rapid and
efficacious antidepressant response by a
completely different mechanism represents
the most important finding in the
depression field in over 50 years. Studies
aimed at characterizing the mechanisms by
which ketamine works rapidly and
effectively could lead to novel targets and
agents that are safer and more longlasting, and could revolutionize the
treatment of depression. Numerous
NARSAD Grants have supported this work.
Recent research demonstrating that
ketamine increases synaptic connections in
brain regions that control mood and
emotion also raises the possibility that
behavioral therapies, as well as
pharmacological agents, could reinforce
and sustain these new connections and the
antidepressant response to ketamine.

(Source: Dr. Ronald Duman, Brain &


Behavior Research Foundation Scientific
Council)

What is treatment-resistant depression?


Treatment-resistant depression (TRD) is a
term used in clinical psychiatry to describe
cases of major depressive disorder that do
not respond to standard treatments (at
least two courses of antidepressant
treatments). For many people,
antidepressant treatment and/or talk
therapy (such as Cognitive Behavioral
Therapy) ease symptoms of depression, but
with treatment-resistant depression, little
to no relief is realized. Treatment-resistant
depression symptoms can range from mild
to severe and may require trying a number
of approaches to identify what helps.

treatment for some otherwise untreatable


depressions. rTMS is a noninvasive method
that works through a coil held over the
target area of the brain. A magnetic field
passes through the skull to activate the
appropriate brain circuit and no seizures
are induced. Deep brain stimulation (DBS),
a technique adapted for treating
depression by Dr. Helen Mayberg with the
support of NARSAD Grants, works through
electrodes planted deep in the brain.
Another method, vagus nerve stimulation
(VNS), stimulates the vagus nerve in the
neck to therapeutically activate brain
function. Magnetic seizure therapy (MST)
combines rTMS and ECT to achieve a safer
form of seizure therapy. MST has been
supported through NARSAD Grants to Dr.
Sarah Lisanby.
(Source: bbrfoundation.org)

(Source: Biological Psychiatry)

How can treatment-resistant depression be


treated?
Treatment of resistant depression has
traditionally most commonly been treated
with electroconvulsive therapy (ECT). ECT
has been modified to avoid the pain
previously associated with it and is the
most effective and quick-acting treatment
for resistant depression. The downside is
that it works by inducing brain seizures and
can impair memory. Its therapeutic
benefits can also fade over time. New
methods of brain stimulation also offer the
possibility of relief. These technologies
exploit the fact that the brain is an
electrical organ: it responds to electrical
and magnetic stimulation to modulate
brain circuits and change brain activity.
Repetitive transcranial magnetic
stimulation (rTMS), pioneered by Dr. Mark
George with the support of NARSAD Grants,
was approved by the FDA in 2008 as a

What ideas are on the horizon for better,


mor effective ways to treat depression?
The first attempts at defining depression as
a biologically-based illness hinged on a
theory of a chemical imbalance in the
brain. It was thought that too much or too
little of essential signal-transmitting
chemicalsneurotransmitterswere
present in the brain. This idea has been
usefulthat the brain is a kind of chemical
soup in which there may be too much
dopamine or too little serotonin, but it is
no longer adequate. All the current
antidepressants are designed based on this
theory, but many researchers are looking to
understand in greater detail the brain
biology that underlies depressions
symptoms so that novel therapies can be
found.

One example in a recently published study


(in Nature July 12, 2012) identifies a new
molecular mechanism responsible for

anhedonia, or the inability to experience


pleasure, that is one of the most crippling
symptoms of depression. The research
team found that a hormone known to
affect appetite, called melanocortin, turns
off the brains ability to experience
pleasure when an animal is stressed. This is
the first study to implicate melanocortin in
depression and could lead to an entirely
new class of antidepressant medications.
(Source: Dr. Robert Malenka, Brain &
Behavior Research Foundation Scientific
Council)

Can brain scans guide treatment for


depression?
A Psychiatric brain imaging has confirmed
the biological nature of many psychiatric
illnesses over the past twenty years. Yvette
Sheline, M.D., in the mid 1990s, used
functional magnetic resonance imaging
(fMRI) to identify structural brain changes

in depressed patients and established


depressin as a brain disease.

Using positron emission tomography (PET)


scan images, Dr. Helen Mayberg of Emory
University identified, in 2013, specific
brain activity that can potentially predict
whether people with major depressive
disorder will best respond to an
antidepressant medication or
psychotherapy. This important new work
offers a first potential imaging biomarker
for treatment selection. A team of
researchers including NARSAD Grantee
Stefan G. Hoffman, Ph.D., of Boston
University and Frida E. Polli, Ph.D., of
Massachusetts Institute of Technology have
used brain imaging to predict the success
of cognitive behavioral therapy, a specific
type of talk therapy often used to help
treat a wide range of mental illnesses
including anxiety disorders, depression and
schizophrenia.