New Brain Study

I found this story on Google News yesterday. I found it very enlightening, but it also raises a few questions. Read it and see what you think.
CHICAGO (Reuters) - People who have a high family risk of developing depression had less brain matter on the right side of their brains on par with losses seen in Alzheimer's disease, U.S. researchers said on Monday.
Brain scans showed a 28-percent thinning in the right cortex -- the outer layer of the brain -- in people who had a family history of depression compared with people who did not.
"The difference was so great that at first we almost didn't believe it. But we checked and re-checked all of our data, and we looked for all possible alternative explanations, and still the difference was there," said Dr. Bradley Peterson of Columbia University Medical Center and the New York State Psychiatric Institute.
His study appears in the Proceedings of the National Academy of Sciences.
The findings are based on imaging studies of 131 people aged 6 to 54 with and without a family history of depression.
The team was looking specifically for abnormalities in the brain that could signal a predisposition to depression, rather than changes that may be caused by the disease.
The thinning on the right side was only linked with a family predisposition to depression. People who actually were depressed also had thinning on the left side of cortex.
"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.
He said having a thinner right cortex may increase the risk of depression by disrupting a person's ability to decode and remember social and emotional cues from other people.
They did memory and attention tests on the study subjects and found the less brain material a person had in the right cortex, the worse they performed 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.
Peterson said the findings suggest medications used to treat attention problems such as stimulants might be useful in the treatment of depression in some patients.
(Editing by Maggie Fox and Xavier Briand)
For years it has been an article of faith that if the balance of neurotransmitters is adjusted the neuro-physical component of depression will improve. In fact, there is a billion dollar industry based on this line of thought. So are the neurotransmitters effected by this thinning of the cortex? And what are the implications for other mood disorders, such as Manic Depression?

Defining Depression

How do you know when the "Blues" have gotten out of hand and you need medication to be able to get past it?
Not related to post partum depression, just an over load of stress and crap in life. Is it possible to expect to get back off the medication some day?
If you don't have a GP, where do you start? I go to my OB/GYN annually for my medical needs.

This is probably one of the MOST common questions Social Workers, Doctors, Nurses, Nurse Practitioners, Counselors,Psychologists, and Psychiatrists hear.

Almost everybody gets the "Blues" from time to time. But there are definite signs and symptoms that differentiate the Blues from a Depression that can be treated with medication and/or therapy.

I need to take a detour here onto one of my famous tangents [if you read my other blog, you've been on one of my "Tangential Thinking Road Trips" before]. I am one of those helping professionals who believe that therapy never hurt anyone and has helped just about every one who gave it an honest try. So IF you meet the criteria for Depression, please consider therapy as well as medication.
I also attended the Nature and Nurture School of Causation for Depression. I think there is, in addition to the neurotransmitter/chemical imbalance component of depression, something in almost every one's background that contributed to their depression. Does this make you nuts? NO, it does not! Is it a criticism of your Mother or Daddy or the way they raised you? Not necessarily, unless you were abused physically, sexually, or emotionally. Or neglected physically or emotionally. The point is: YOU get to set the parameters for discussion in therapy. And, you can say ANYTHING within the confines of your therapist's office and it's confidential. Now, I know there may be a smart-ass or two out there to nit pick that last statement...so I have to include this modifier: if you tell your therapist you are planning to harm another person said therapist is obligated to inform the authorities and your intended victim [I think]. But that is the only time they are allowed to violate your confidentiality.

OK, side trip over, let's get back to the main topic...
I went to some websites I found through Ask.com, my search engine of choice, using Depression Symptoms as my search criteria. These come from the National Institutes of Mental Health website, http://www.nimh.nih.gov/health/publications/depression/complete-publication.shtml#pub3, just in case you want more info than what I'm relating here. I also liked their definition of Depression: When a person has a depressive disorder, it interferes with daily life, normal functioning, and causes pain for both the person with the disorder and those who care about him or her. Depression is a common but serious illness, and most who experience it need treatment to get better.

Here are the symptoms:
Persistent sad, anxious or "empty" feelings
Feelings of hopelessness and/or pessimism
Feelings of guilt, worthlessness and/or helplessness
Irritability, restlessness
Loss of interest in activities or hobbies once pleasurable, including sex
Fatigue and decreased energy
Difficulty concentrating, remembering details and making decisions
Insomnia, early–morning wakefulness, or excessive sleeping
Overeating, or appetite loss
Thoughts of suicide, suicide attempts
Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment

As for the 2nd part of the writer's email: Where to start if you don't have a GP, or Primary Care Physician and only see an OB/Gyn once a year for Well Woman Check-ups? There are, in most communities, mental health resources even for people without insurance. I don't know where this particular person lives. In Texas, we have an agency known as Mental Health/Mental Retardation [how UN-PC of us!!] or MH/MR. They accept anybody. The charges will be based on your ability to pay. If you are employed, but have no insurance, the eligibility worker will look at your income, family size and other medical expenses. Your fee per service, both medicine and therapy will be based on a sliding scale.

But, if you have private insurance, you will need to check your individual plan's coverage and requirements before beginning therapy. They may require you to only see provider's from an approved group of professional with whom they have negotiated fees. Otherwise your benefits may be reduced.

When seeking a physician to prescribe anti-depressant medication, I think it's important to consult a psychiatrist. They are specialists. All they do is treat disorders like depression. Their expertise can be invaluable in choosing the right medication for you. Often a medication regimen must be tweaked over a period of time before finding the correct dosage or even the correct medicine or combination of medicines for a particular patient. This is not a process to be left in the hands of the physician who goes from room to room treating coughs one minute and a sprained ankle the next, and then someone else's hypertension.

Trust me on this, even if it costs a little extra for the co-pay, go to the Shrink. They know their stuff. And don't get discouraged if the first medicine doesn't work. Or if your dosage has to be increased. Or if it has to be changed after 6 or 9 or 12 months. These things happen in a large percentage of cases. Treating Depression isn't like treating an ear infection or bronchitis. It's not one medicine works for everybody.

In the last 32 years, I've been on at least 13 different anti-depressants. So I know what I'm talkin' about when I speak of tweaking doses and making other adjustments. The brain is an amazingly adaptable organ. You put one chemical into it long enough and it will accommodate that chemical to the point where you have to try another chemical to achieve the same balance of Serotonin and Norepinephrin [the two neurotransmitters that get out of whack when we're depressed].

I think I answered the questions. If anybody is still in doubt after this and going to the NIMH site, leave me a comment or send me another email and I'll take another shot at it.

Tomorrow I answer a question about being a Parole Officer by someone considering a Career change.