Researchers at Indiana University have learned that even minimal amounts of physical activity, like walking, gardening, housekeeping or circuit training, improve the mood of people with bipolar disorder, major depression or schizophrenia. And this information can easily be applied to anyone searching for relief of anxiety, depression, or a simple, nasty mood.

Working with 11 people from the US and 12 people from Serbia over seven consecutive days, researchers randomly paged the participants, who immediately completed questionnaires about their mood and recent activities. The responses were compared to data collected during the previous 10 minutes using accelerometers worn by the participants that measured activity levels and duration.

The average amount of physical activity of the participants was comparable to that of sedentary adults, somewhat lower than adults with developmental disabilities and significantly lower than activity levels of active adults.

Most important, the study proved that he least active experiences correlated with less positive moods, illuminating the need for physical activity as a regular part of psychiatric rehabilitation.

“We found a positive association between physical activity level and positive mood when low to moderate levels of physical activity are considered,” said study author Bryan McCormick, associate professor in IU’s Department of Recreation, Park and Tourism Studies. “Physical activity interventions that require lower levels of exertion might be more conducive to improving transitory mood, or the ups and downs people with SMI experience throughout the day.”

The lesson learned: If you’re feeling blue or anxious or particularly foul, go for a walk, take a yoga class, get on your bike or go for a swim.

DO something.

Be physically active.

Literally…

Move To Improve!

6% of American teens - 2 million kids ages 12 to 18 - have clinical depression.

Only a fraction of those are diagnosed and treated.

These facts are particularly distressing because, when treated, a majority of teens show lasting improvements, though it may take several months for the benefits to appear.

Depression is a fact of life for millions of kids.

It is diagnosable and treatable.

Treatment works.

Consider the following:

Dr. Betsy D. Kennard of the University of Texas Southwestern Medical Center at Dallas recently released the results from a study of 439 teens with major depression. Dr. Kennard found that while only one-quarter of those kids improved after the first 12 weeks of therapy, a full 60 percent were in remission by the 9-month mark.

Regarding long-term recovery, Kennard and her associates found that two-thirds of the teens who responded early to treatment remained well over the 9 months following their initial improvement. The same was true of 71 percent of the kids who initially took longer than 12 weeks to respond to therapy.

These findings illustrate the importance of not giving up, of continuing treatment, since remission rates get better over time.

The study also indicated that when teens participate in cognitive-behavioral therapy (CBT) while taking antidepressant medications they improve more quickly than those on either treatment alone, warning that single-faceted therapy may slow recovery by 2 or 3 months.

Kennard and her colleagues also point out that despite the positive finding that a majority of teenagers got better, a substantial number were still clinically depressed after 9 months of treatment.

More research, they say, is needed to understand how to best help these teenagers — and to see whether recovery can come more quickly for others. It will also be important to understand why some teens who initially improve see their depression symptoms return.

Dr. Kennard’s study was funded by the National Institute of Mental Health. Several researchers on the work have received funds from drug companies that market antidepressants.

SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry, February 2009.

A brain imaging study of several generations of participating families found structural differences in those with a history of depression.

Thinning in the cerebral cortex, which is the outermost surface of the brain, indicates a vulnerability to depression. Brain scans showed a 28-percent thinning in the right cerebral cortex in people who had a family history of depression compared with people who did not. The cerebral cortex controls reasoning, planning and mood; and thinning of the cerebral cortex may increase the risk of depression by disrupting a person’s ability to decode and remember social and emotional cues from other people.

“If you have thinning in this portion of the brain, it interferes with the processing of emotional stimuli,” said Dr. Bradley S. Peterson, a professor of psychiatry at Columbia College of Physicians and Surgeons and the paper’s first author. “We think that’s what makes them vulnerable to developing anxiety and depression - it essentially isolates them in an emotional world.”

The thinning existed in descendants of depressed parents and grandparents, whether or not those individuals had ever experienced depression or anxiety.

“That’s what is so extraordinary. You’re seeing it two generations later, and you’re seeing it in both children and adults,” said Dr. Peterson. “And it’s present even if those offspring themselves have not yet become ill.”

“We don’t know if this has a genetic origin or if it’s a consequence of growing up with parents or grandparents who are ill. Studies have shown that when parents are depressed, it changes the environment in which children…” grow up.

“Because previous biological studies only focused on a relatively small number of individuals who already suffered from depression, their findings were unable to tease out whether those differences represented the causes of depressive illness, or a consequence,” Peterson said.

Peterson and his team conducted memory and attention tests on the study subjects and found that those with more thinning in the right cortex performed worse on attention and memory tests.

“Our findings suggest rather strongly that if you have thinning in the right hemisphere of the brain, you may be predisposed to depression and may also have some cognitive and inattention issues,” he said.

The findings suggest that, in addition to antidepressants, other medications (such as stimulants) might prove helpful in treating depression in some patients.

The findings will be published in Proceedings of the National Academy of Sciences, and is based on research started 27 years ago by Dr. Myrna Weissman to investigate the familial roots of depression. Weissman and her colleagues conducted brain imaging on 131 people between the ages of 6 and 54. Half of the participants were at high risk for depression because of family history. Half were low-risk.

Doctors Weissman and Peterson add to an arsenal of information that enables us to better understand the root causes of depression. From this understanding better diagnosis and treatment will grow.

The U.S. Preventive Services Task Force, made up of expert appointees who create guidelines for doctors, now recommends routine depression screening for all American teens in an effort to better diagnose and treat nearly 2 million kids who are affected.

About 6 percent of U.S. teenagers are clinically depressed, but most remain undiagnosed and untreated, said the panel. Having determined that detailed, simple questionnaires accurately diagnose depression, the task force wants primary-care physicians and pediatricians to begin screening all teen patients on an annual basis, not just those who appear to be at risk or in crisis.

According to Dr. Ned Calonge, task force chairman, depression is so common, “you will miss a lot if you only screen high-risk groups.” Recommending the use of well-researched questionnaires that focus on depression tip-offs including mood, anxiety, appetite and substance abuse, Calonge and his colleagues stress that since “depression can lead to persistent sadness, social isolation, school problems and even suicide, screening to treat it early is crucial.”

Addressing the fact that some antidepressants have been linked to increased suicidality, the task force stresses that medication alone is not appropriate, and that talk-therapy is vital to successful diagnosis and treatment. Fortunately, childhood and adolescent depression respond well to treatment plans that include medication and talk-therapy.

Recently passed mental health parity laws mandate equal coverage for mental and physical illnesses which guarantees better coverage for children seeking mental health care. This shift in coverage combined with task force recommendations will force pediatricians and family physicians to get more involved in mental health care.

In response to the task force’s report, Dr. Alan Axelson, a Pittsburgh psychiatrist, wrote a report on behalf of the American Academy of Child and Adolescent Psychiatry in which he recommends that pediatricians work closely with child psychiatrists, even sharing office space when possible. The Academy also says insurers should compensate pediatricians for any mental health services they provide.

Because families usually get to know their pediatricians, “having those doctors offer mental health screening can help make it seem less stigmatizing.” Axelson said, adding that “Most pediatricians aren’t trained to do psychotherapy, but they can prescribe depression medication and monitor patients they’ve referred to others for therapy.”

If you have children or teens, check with your family doctor to learn how he screens for depression in young patients.

Until now, they didn’t understand why.

Researchers at Loyola University Health System, Maywood, Ill. discovered that depressed patients have higher levels of inflammatory substances in their blood, leading to physiological reactions that, over time, damage the heart.

“The body and the mind are closely connected, and they affect each other. We’ve found that even though patients’ depression gets better within six to eight weeks with treatment, it may take up to six months for the inflammation markers to return to normal,” says Dr. Angelos Halaris, of Loyola University Chicago Stritch School of Medicine.

“The changes caused by the inflammation are like a slow-growing cancer that goes undetected because they cause no symptoms.”

The study found that inflammation from stress alters the structure of blood vessels and activates platelets to form, which increases clotting. As clots clump together plaque forms, ultimately leading to atherosclerosis, a narrowing or hardening of the arteries that could eventually cut off the flow of blood and cause a heart attack or stroke.

“Unfortunately, clots don’t have boundaries,” said Dr. Omer Iqbal, co-researcher at the Stritch School of Medicine. “They can dislodge and travel to the vessels of the heart and cause a heart attack, and they can also reach the brain and cause strokes.”

In light of this new information, patients treated for depression should be routinely screened and monitored for heart disease and excessive stress.

If you’re being treated for depression, know the signs of heart disease and cardiovascular disease, and take precautions to prevent them.

Women using antidepressants appear to have a higher risk of sudden cardiac death, but this doesn’t mean antidepressants are at fault. In fact, the opposite may be true.

One recent study of people with heart failure found that depression was associated with increased mortality but that use of antidepressants was not.

“We suspect that their use is a marker for people with worse depression,” explained Dr. William Whang, an assistant professor of clinical medicine at Columbia University Medical Center in New York City. “The elevated risk seems more specific for antidepressant use, but that use may well be a marker of more severe symptoms.”

The link between depression and heart trouble is physical not psychological, Whang added. “We found that women who had worse depressive symptoms had higher rates of risk factors such as hypertension, diabetes and smoking,” he said.

Whang and his team evaluated data collected from over 63,000 American women in the Nurses Health Study. And while the research team did find a link between depression and heart risk, the incidence of sudden cardiac death was associated more strongly with the use of antidepressant drugs than with symptoms of depression.

Earlier studies linked depression and a higher mortality rate for people who already had heart disease, Whang said. “But this was a group of women without heart disease, and that makes it different,” he noted.

Doctors treating women with depression should take note. “The biggest clinical implication is that management of coronary heart disease risk factors may be especially important for those with depressive symptoms,” he said. “Taking care of those risk factors can modify the risk for coronary disease.”

If you are a woman taking antidepressants, learn the signs and symptoms of heart disease and take the necessary steps to reduce your risk.

Here are a few suggestions from the Federal Government Source for Women’s Health Information:

1. Be physically active

2. Don’t smoke

3. Eat healthy

4. Maintain a normal weight

5. Know your numbers (blood pressure, cholesterol, and triglycerides)

6. Get tested for diabetes

7. Limit alcohol consumption it to no more than one drink a day.

8. Find healthy ways to cope with stress. Talk to your friends, exercise, or write in a journal.

Be proactive. Love yourself. Love your body. You’re worth it.

Lovingly,

Depression is the leading cause of suicide.

Suicide is the third-largest killer of children and young adults between the ages of 10 and 24, and is a growing problem amongst middle aged and elderly adults.

Knowing this, scientists and researchers the world over have devoted time and energy to improving treatment approaches, including studies focused on the efficacy of antidepressant medications.

The news is encouraging.

Common antidepressants reduce the risk of suicide in adults, according to work recently completed and published by Italian scientist Corrado Barbui of the University of Verona.

Barbui and his team reviewed data collected in eight previous studies that included over 200,000 patients. They focused on selective serotonin-reuptake inhibitors (SSRIs), which are the most commonly prescribed class of antidepressants. The team found that the drugs cut suicide risk by more than 40 percent among adults and over 50 percent for elderly people.

Despite the obvious value to adults, researchers still suggest caution when using antidepressants to treat children and adolescents. With this in mind, closer monitoring, such as regular meetings with a therapist or counselor, should be part of the treatment protocol for those under 18.

“Data from observational studies should reassure doctors that prescribing (the drugs) to patients with major depression is safe,” wrote the Italian team.

The news is good indeed.  Depression kills. Treatment works.

Much to the world’s chagrine, Carrie Fisher is not Princess Leia.

Carrie Fisher is a writer.

And she’s very, very funny.

Both talents are verified in Wishful Drinking.

I loved this memoir not because it exposed any great truths about bipolar disorder or addiction, but because it exposed great truths about learning to live with them.

Honest, open and hilarious, Fisher points the spotlight on her own life and directs us through an amazing production.

Bravo, Ms. Fisher! Bravo!

During the initial months after my daughter Chloe fell ill with bipolar disorder, I was told by one medical practitioner that she thought the illness was schizophrenia. Having adjusted to the harsh reality and seriousness of bipolar disorder (sometimes called manic depression), I was terrified by the possibility that she could actually have schizophrenia.

It seemed so much worse.

I‘d read all that was written about bipolar disorder and its treatment, occasionally catching snippets of information regarding schizophrenia; and my reading taught me that bipolar, while serious and life-threatening, was more treatable and had a more positive prognosis than schizophrenia.

According to many experts at the time, treated bipolar disorder could be managed, even stopped in its tracks. With proper medication and lifestyle choices, those diagnosed with manic depression could live happy, productive lives.

Patients with schizophrenia, however, did not enjoy the same prognosis. At the time, common theory indicated that schizophrenia, even when treated, continued to progress so that the patient would ultimately be unable to function “normally.”

Chloe’s degree of illness is severe and treatment resistant, forcing her medical team to experiment and use drugs “off label” as they tried to stabilize her.  Interestingly, some of the miracle drugs for Chloe had previously been used to treat schizophrenia or epilepsy, including powerful psychotropics such as antipsychotics and neuroleptics.

As Chloe got well using new and unusual combinations of medication, we realized that labeling an illness was less important than finding a treatment that worked; and I began to wonder about the connections between bipolar disorder, depression, psychosis, anxiety and schizophrenia. Were they really that different?

Lots of others were thinking about the same things, including a group of Swedish researchers who recently released an new analysis of a 30-year study indicating that schizophrenia and bipolar disorder share common genetic causes, suggesting that the two conditions may actually be different manifestations of the same illness.

Analyzing 9 million Swedish people over a 30-year period, Paul Lichtenstein and colleagues at Stockholm’s Karolinska Institute reported that close relatives of people diagnosed with either schizophrenia or bipolar disorder had an increased risk of both diseases, and that additional evidence from half-siblings indicated that the effect was due to genetic factors.

“We showed evidence that schizophrenia and bipolar disorder partly share a common genetic cause,”  said Lichtenstein. “These results challenge the current ‘disease classification’ dichotomy between schizophrenia and bipolar disorder, and are consistent with a reappraisal of these disorders as distinct diagnostic entities.”

I hope this news gives hope to many without it, and encourages doctors to treat each individual according to symptoms and needs rather than “disease classification.”

And I hope those reading this find wellness and a happy, productive prognosis.

Blessings!

Or is it something more?

Pediatric bipolar disorder is a genetic, neurobiological illness that can present in childhood or the teen years.

It is often misdiagnosed  as ADHD, or dismissed as defiance, out-of-control behavior, and even a symptom of poor parenting.

But pediatric, or early onset bipolar disorder is very real and requires appropriate diagnosis and treatment.

Here are some of the most common symptoms:

Mania

• Severe mood swings — overly irritable or overly silly, giddy
• Inflated sense of self — seems to feel superior
• Talks too much, too rapidly, and/or changes topics quickly
• Easily distracted
• Decreased need for sleep
• Aggressive behavior
• Destructive
• Hypersexuality

Depression

• Sad
• Irritable
• Loss of interest in previously enjoyed activities
• Moves and/or talks slowly
• Cries often or excessively
• Feels worthless
• Feels unnecessarily guilty
• Talks of death or suicide

Bipolar disorder puts kids at increased risk of school failure, substance abuse, self-harm and suicide.

Bipolar disorder is serious, but it is treatable.

If you suspect your child’s moodiness may be something more, see your doctor immediately.

For more information on Pediatric Bipolar Disorder, visit Child and Adolescent Bipolar Foundation or Juvenile Bipolar Research Foundation.