All Entries in the "Psychology" Category
Depression in Teenagers
I believe that as a teenager I suffered from depression, but I was never formally diagnosed or screened. Most people look at teenagers as moody and unstable emotionally, so detecting something like depression can be tricky. Since I wasn’t suicidal like some depressed teenagers it became even harder to diagnose. A recent article states that “about half of all mental illnesses arise by age 14.” I often wonder if I could have been diagnosed younger how that would effect my current depression. “As with many illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.”
Experts are now pushing for early screening for depression in teenagers. If you understand depression and the effects it can have, you are able to learn skills and techniques at an early age in order to help you lead a more healthy positive life. A professor at the University of Chicago Medical Center led a study using an interactive web-based tool called “Project CATCH-IT“. He explains that screening can help and that the project “showed promise at helping reduce symptoms of depression in at-risk adolescents by teaching such skills as altering pessimistic thinking, avoiding procrastination, and making a point of doing enjoyable things. Because they’re inexperienced, adolescents can find it tricky to sift what’s normal from what’s not. Maybe they’ve had a spat with a boyfriend or girlfriend; maybe their mom yelled at them; maybe they’ve had a series of disappointments in school, and suddenly they’re feeling bad and they’re not sure if the problems are to blame or if something more is affecting them.”
I think it is great that doctors want to make screening for depression a regular part of a check-up, but the article points out there could be some dangers. “The new recommendation comes with a serious caveat: that adolescents should be screened only “when systems are in place to ensure accurate diagnosis, psychotherapy, and follow-up,” the panel said. Otherwise, says Calonge, “you just identify the problem and you haven’t done anything [else]. Plus, we don’t want people just pulling out the prescription pad, because there’s a concern that [medication] may do more harm than good; we’re just worried about that.” Calonge’s group found “convincing evidence” that a commonly prescribed class of antidepressants—selective serotonin reuptake inhibitors [SSRIs]—can raise the risk of suicidal thoughts or actions in adolescents, which is why the task force urged that those drugs, though often effective, should be considered only when young patients can be closely supervised.”
While the dangers are real, I think the potential benefits outweigh the risks. “Oscar Bukstein, a child and adolescent psychiatrist and an associate professor of psychiatry at the University of Pittsburgh School of Medicine says, “If you look at the natural history of depression, you find that there’s a marked increase in the onset of depression in adolescence, post-puberty,” he says, “and that many, if not most people who have recurrent depression will often point to adolescence as a point of onset.”" Much good can come from the screening and I hope that for the sake of all the depressed teenagers out there, they can be accurately screened and treated so they don’t have to suffer from recurrent depression as I have.
Trichotillomania Research
I was doing some trichotillomania research and came across this article and video featured on 20/20 last year.
The article discusses the mystery of trichotillomania in that the psychiatric community has a hard time classifying the disease. The article states:
“It’s called trichotillomania, or “trich” for short. Although trich is treated as a psychiatric illness, the latest evidence suggests that it’s not a “bad habit” like biting your nails or cracking your knuckles, or even an obsessive compulsive disorder.
Trich may have more in common with Tourette’s syndrome, a neurological disorder characterized by repetitive, involuntary movements or vocalizations called “tics.”
“Trichotillomania is such a medical mystery because we still know very little about the genetics and biology of it,” says Dr. Nancy Keuthen, who heads a trichotillomania clinic in Boston.
According to the Trichotillomania Learning Center (TLC), up to 11 million people in the U.S. suffer from the uncontrollable urge to pull out their own hair, eyebrows, even their eyelashes.
“They may spend hours in front of a mirror in these very odd postures trying to locate that one hair that they know is there that they feel doesn’t belong,” Keuthen said.
While researching this disease, or gene mutation, or whatever it is- I felt very lucky to only have a mild condition. While it is embarrassing to usually not have any eyelashes I feel fortunate that I am able to control the impulses enough that I don’t need to wear wigs or go to other extreme measures.
I have however started to wear headbands on occasion to hold down the newly grown hairs that were recently pulled out. Instead of focusing on why I am wearing the headband, Tareak is always quick to comment how cute he thinks my new hair style is. I am very lucky to have a supportive and optimistic husband. 
The video is about 9 minutes long, but shows clearly the pain and embarrasment usually associated with this disorder. Click Here to watch the video.
Triangle Concept
This week Tareak and I met with the one and only therapist that has agreed to see us. Unless we are able to find someone else that is willing to see us (which is unlikely) we will be sticking with her. At the end of our appointment (which went 20 minutes over and she didn’t seem to mind!) she brought out a chart like the one I’ve created below. With it she was able to explain the concept that I’ve been unsuccessful at explaining to Tareak since we got married. I was so glad that she was able to explain it in such a way that we could both understand it.
Here is what she explained:
By looking at the chart below you can see that your thoughts lead to the way that you feel. Then those feelings determine your actions.
As a person who is depressed, I rarely have positive thoughts and therefore I feel down and bad about myself. This leads to feeling totally unmotivated and so I don’t do anything productive with my time. By being unproductive, I am left thinking how useless I am and the negative cycle begins again.
She explained that one way to start feeling better is to reverse the order of the triangle. First, you need to do something that is going to make you feel good. You could exercise, put on an outfit in your favorite color, go enjoy the sunshine, or do anything that will make you feel good. You should ideally do this first thing in the morning. By DOING something first, you will then FEEL better and those good feelings will lead to you THINKING more positively.
Deep down I have always known that this is what I needed to do, but I didn’t have a triangle graph to help me put it into words. Since getting married I have always told Tareak, “If you want me to be productive during the day you just need to get me started. If there is laundry in the dryer that needs to be put away, start putting it away. I will see you doing something and come and join you. Put your shoes on and tell me you are taking Kaya for a walk and ask if I’d like to come. Chances are pretty good that I’ll say yes.” I’ve recognized from life experiences that when I am busy doing something, ANYTHING, from the time I get out of bed in the morning, it is like a snowball effect. I pick up momentum and get more done that day than a lot of people accomplish in a week. In a past post I compared myself to feeling like a rock on the top of a mountain. I just need a good shove and then I’ll usually roll down just fine. Accomplishing so much leaves me feeling good about myself and the negative thoughts are less frequent. Being depressed leaves me with little motivation and it is hard to convince myself to get going, but if someone else can help me out and give me the shove I need, I think I can begin to make progress.
Now that Tareak and I are both on the same page and understand the triangle concept I hope that we will be able to implement it at least a couple times a week.
Interesting Way of Putting It
This article found on the Psychology Today website says “depression is the leading cause of years lost due to disability.” I have never thought of the time I spend dealing with depression as actually losing years of my life. My life may not be cut short, as in I will die at age 50 instead of say, 80, but I could easily still loose 30 years moping around feeling unmotivated or as my mom likes to put it, “sleeping my life away.” When they put it that way there is a strong urge to actively work on overcoming depression in order to reclaim those years of my life.
The Major Scourge of Humankind
A milestone was reached toward the end of last year, and the press made no note of it. In October, the World Health Organization declared that now, among all the illnesses and forms of injury it measures, “depression is the leading cause of years lost due to disability.”
I have a personal stake in this announcement. In doubting reviews, I was twitted for claiming in my 2005 book, Against Depression, that “depression is the major scourge of humankind.” This criticism was based on a misreading. What I had written was that the WHO and other organizations interested in public health were making that assertion. The full paragraph goes: “Groups around the world have undertaken the same effort using different assumptions and weightings. The results of these analyses are similar. Varied assumptions lead to a single conclusion: Not AIDS, not breast cancer, but depression is the major scourge of humankind.”
I went on to explain how the WHO assesses disability. It uses a measure, called “disability-adjusted life years,” or DALYs, that gauges how far a disease or injury robs a person of good health. If you live in a country where the life expectancy is 80 but cancer kills you at age 60, you have lost 20 good years; but likewise, if a birth injury partially paralyzes you and leaves you 25% disabled, then if you live to 80 you will also be judged to have lost 20 good years. Actually, the birth injury would be rated worse, because the measure values years in young adulthood slightly more than years in old age. Because major depression is so common and so severe in its effects, and because its onset is often early in life, it tends to stand out in surveys focused on DALYs.
I should add that the panels that devised the rating systems used by the WHO included few or no psychiatrists. Surgeons, pediatricians, and internists made the assessments. When the results of the first surveys emerged, the prominent place of depression surprised everyone. But the findings have been consistent over time. What has changed is largely the WHO’s willingness to stand behind them and emphasize, as it did in its recent the press releases, depression’s awful status. Still, here it is: the claim I was criticized for (but did not quite make) is now the official position of the preeminent authority on global health and illness.
The survey available when I was writing was based on 1990 data; the new report has updates from as recently as 2004. As had been predicted, depression has moved up in the standings – that is, it appears yet more disabling, compared to other conditions.
In truth, the status of depression has changed only modestly. Because they kill children at birth and so rob them of a whole life span, “lower respiratory infections” and “diarrhoeal diseases” remain at the top of the DALYs list. But those categories represent clusters of differing illnesses. Depression comes next, and it is arguably a narrower category.
If you set aside low-income countries and look either at middle- or high-income countries, depression is now absolutely atop the list, above ischemic heart disease and cerebrovascular disease, above traffic accidents, dementia, and diabetes. If you look regionally, here in the Americas, depression is also outright the most disabling condition, above violence and heart disease. For women, depression is the leading cause of disability everywhere, even in low- and middle-income countries, outpacing HIV/AIDS.
One can debate the WHO measures. They count each episode of depression as highly disabling; but then, they omit more minor episodes altogether. Also, they ignore links between conditions. For example, maternal depression is a potent risk factor for infantile diarrhea. Self-inflicted injuries, which are very common in poor countries, are counted as separate from depression. And really, wouldn’t depression be a serious enough problem if it were judged only as disabling as cancer, heart disease, diabetes, or AIDS? Still, the WHO Global Burden of Disease study is the gold standard, and it finds depression to be, yes, the severest scourge.
Regarding science journalism, we live in strange times. When isolated academics use esoteric studies and idiosyncratic theorizing to question depression’s standing as a disease, that’s news. But when the world’s leading public health organization, using a quite strict definition of illness, announces that depression has become the leading cause of disability in our hemisphere – you can scour the pages of the press and find nary a report.