“Depression, out of the shadows” http://www.pbs.org/wgbh/takeonestep/depression/

• 20 million Americans have depressive disorders
• it is a poverty of our language that we only have this one word  to describe…

Andrew the novelist: “it is so strange that I just don’t care” –

• like that second when you slip and trip, right before you fall on the floor, it was like that 24 hours a day
• A CURRENT AND OLD LOSS CAN TRIGGER A DEPRESSION – ask “Why Now” and “Has there been a recent loss”
• quote that made me cry “all this time paradise was in this room”

EMMA

• between 15 and 34 – prime years to have depression onset
• “Like the Dementors in Harry Potter
• “like a meteorite smashed into our house”
• started drinking and could not stop drinking
• started smoking pot
• felt suicidal and told her Dad
• when to treatment and meds but ended up in in-patient hospitalizationon
• tried 7 medications before finding one that worked

Hart Lipton

• depression started in 6th grade
• he requested to be hospitalized
• he has bi-polar . .. 
• BIPOLAR is more heritable than Uni-Polar depression
• family concerned about adolescent suicide
• has BiPloar 2 , comes with irritability and depressive episodes

Jed – college freshman

• suicide is the 2nd leading cause of death in the population
• 2x as common as homicide
• most suicides are linked to Depression
• his parents had no information about Depression at all

ANXIETY is often an early sign of depression

• Most people with Depression has symptoms of Anxiety
• The brain continues to grow and refne into adulthood – well into the 20’s
• The Amygdala – MRIS’s shoe elevated activity that are activated longer than normal

 

BiPolar may initially present as depression because it is the first episode. Giving them a medication for depression may cause them to switch and become Manic.

creating a Mood tracking chart is helpful to make the diagnosis

women are diagnosed twice as often as men are

Postpartum Depression

Intrusive thoughts are common, acting on them is rare

1/3rd of the risk is genetic

the other 2/3rds include early life trauma, abuse, neglect and poverty

GANG –

• If you re young and alone, it induces depression
• adolescents adopt their peer group as family
• initiated at 11 years old
• Violence = respect, love and Power
• risky behavior is associated with Depression
• Gangbang is another version of suicide

 

Tarry

• Dysthimia – mild long term depression
• low grade and smoldering
• last 2 years or more
• over eating is common
• went on meds and Talk Therapy
• she was hapy to have a name for her diagnosis after living for 30 years with the symptoms
• “Would rather say we have a family member in jail or on drugs before uttering Depression

Philip the CEO

• low level depression eventually blew up until he checked into a psych hospital
• he went public with his story and inspired other executives
• 650,000 suicide attempts in America
• encouraging  to find treatment helped him recover

50 years of Depression Medication  . . . currently 25 approved drugs

• involves multiple neurotransmitters
• meds can take 6 to 8 weeks for drugs to be effective

talk therapy is effective with 70 to 80% of patients

• talking changes the brain
• early interventions are key
• think of Depressive Episodes like a series of heart attacks
• can find cognitive errors

 

• prefrontal cortex and hippo-campus is often smaller in depressed people. maybe Deoression is th process of the Neurons dying and shrinking
• Excercise can stimulate the nerves there and help these regions grow

decrease in rx for depression drugs led to higher suicide rate

 

tryind a shorter period of time where people experience symptoms

IV KEtamine – targets Glutamate

 

old people relapse at a rate of 80%.

ETC : don’t let “One flew over the cocoo’s nest scare you off.

treatment resistant depression, refractory depression

Area 25 . . . lower functioning. seems to be at the core of all this

link between area 25 and frontal cortex…. like a teeter totter 

one goes up and the other goes down

50 billion dollars in productivity lost in the US due to Depression

**Talk Therapy ** best treatment for Depression people with a history of early childhood trauma

Beck’s New Cognitive Model of Depression: a theory

šGenetic vulnerability

šHigher activation of HPA

šReactive amygdala 

šReduced Pfc

šCognitive biases

šSelective attention to negative aspects of experience

šExaggeration of stressful events

šDepressive symptoms