Open Mind Community Lecture — The Upword Spiral

From the Friends of the Semel Institute: A free presentation by Alex Korb, Ph.D., UCLA neuroscientist and Adjunct Assistant Professor in the Department of Psychiatry, Tuesday evening, March 7, 2017.

Depression can feel like a downward spiral, pulling you into a vortex of sadness, fatigue, and apathy. In “The Upward Spiral”, Dr. Korb demystifies the intricate brain processes that cause depression and offers a practical and effective approach to getting better. Based on the latest research in neuroscience, Dr. Korb provides dozens of straightforward tips you can do every day to rewire your brain and create an upward spiral towards a happier, healthier life.

As a neuroscientist Dr. Korb has published over a dozen peer-reviewed journal articles on depression, neuromodulation and other topics. He is the author of The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time, and has studied the brain for over 15 years. He also writes a popular blog for Psychology Today called PreFrontal Nudity: Your Brain Exposed. Outside of the lab he is head coach of the UCLA Women’s Ultimate Frisbee team, and he has a wealth of experience in yoga and mindfulness, physical fitness, and even stand-up comedy.

Daniel J. Siegel, M.D. will join Dr. Korb in discussion following the presentation. Dr. Siegel is a clinical professor of psychiatry at the UCLA David Geffen School of Medicine and the founding co-director of the Mindful Awareness Research Center. He is also the Executive Director of the Mindsight Institute, which offers online learning and in-person lectures that focus on how the development of mindsight in individuals, families, and communities can be enhanced by examining the interface of human relationships and basic biological processes.

Tuesday, March 7
Semel Auditorium, UCLA
Check-in 6:30 PM   |   Program 7:00 PM
Admission is free but reservations are required.
Parking is available for $12 in Structure 9

CLICK HERE TO REGISTER

For questions email Wendy Kelman at wkelman@mednet.ucla.edu

A Good Resource for News about Bipolar and Related Disorders

There are many groups and organizations other than NAMI that share information about mental illnesses and do their part to help raise awareness, end stigma and address, with clear vision, the real issues mental illnesses raise. One group that provides free updates in the form of a newsletter to anyone that requests it is Bipolar Network News (BNN). BNN is a newsletter publisher and online clearinghouse of information about mood disorders, and a quarterly print and email publication.

BNN regularly provides updates on the latest research about bipolar disorder in the hope of shedding light on emerging trends in research and treatment to help educate patients, family members, interested laypeople, physicians, and other field professionals. The newsletter is available free of charge to all who request it. You can visit BNN’s website and request an email subscription by CLICKING HERE, or request a postal subscription HERE.

Studying a Correlation Between Depressive Symptoms and Stroke Risk

From Psychiatric News Alert: Persistent symptoms of depression in adults ages 50 and older may double their risk for stroke, according to a recent study published in the Journal of the American Heart Association.

A possible connection between depressive symptoms and stroke risk

A possible connection between depressive symptoms and stroke risk

Researchers from Harvard T.H. Chan School of Public Health analyzed medical records of more than 16,000 older adults who participated in the Health and Retirement Study, which included interviews about depressive symptoms, history of stroke, and stroke risks factors.

Nearly 2,000 strokes were reported, and individuals displaying high levels of depressive symptoms during two consecutive interviews were more than twice as likely to experience a stroke during the subsequent two years. Even people who had depressive symptoms at the first interview but not the second showed a 66% higher stroke risk.

Said lead author Paola Gilsanz, Sc.D, a postdoctoral research fellow at Harvard, in a press release:

“This is the first study evaluating how changes in depressive symptoms predict changes in stroke risk. If replicated, these findings suggest that clinicians should seek to identify and treat depressive symptoms as close to onset as possible, before harmful effects on stroke risk start to accumulate.”

To read more about the relationship between depression and stroke, see the Psychiatric News article “Collaborative Care for Depression Can Reduce Risk for Heart Attacks, Strokes.”

Scientists Identify Molecular Marker of Major Depression

DNA structureFrom Psychiatric News Alert: Increased amounts of mitochondrial DNA (mtDNA) may serve as a molecular marker of major depression, according to a study published today inCurrent Biology.

Sequencing of two components of the genome suspected to be associated with adverse life experiences revealed a significant association between major depression and the amount of mtDNA.

“We could find no evidence that stressful life events act via changes in mtDNA or telomere length to increase the risk of major depression. These findings identify increased amounts of mtDNA as a molecular marker of major depression and have important implications for understanding how stress causes the disease.” the authors concluded.

Jonathan Flint, a professor of molecular psychiatry at the University of Oxford and senior author on the paper, stated in a press release:

“We have only a snapshot of the relationship between the molecular markers and depression. We want to know how they change over time—before, during, and after a depressive illness. That information will tell us much about their clinical utility.”

To read more on biomarkers for depression, see the Psychiatric News article “Scientists Closer to Finding Tests for DepressionBiomarkers.”

Study Finds Depression Subtype May Not Be Relevant in Selecting Treatment

From Psychiatric News Alert: There may be no preferential antidepressant pharmacotherapy for treating subtypes of major depressive disorder (MDD), according to a study published online in AJP in Advance, “Depression Subtypes in Predicting Antidepressant Response: A Report From the iSPOT-D Trial.

oweirieoeA. John Rush, M.D., a professor of psychiatry and behavioral sciences at Duke University School of Medicine, and colleagues conducted a study with 1,008 individuals with MDD to assess the proportions of participants who met at least one criteria for MDD subtype—melancholic, atypical, and anxious depression—and compared subtype profiles on remission and change in depressive symptoms after eight weeks of treatment with escitalopram, sertraline, or extended-release venlafaxine. Improvement of symptoms and likelihood of remission were quantified by the 16-item Quick Inventory of Depressive Symptomology-Self Report.

The researchers found that 39 percent of the studied individuals exhibited at least one pure form of a depressive subtype, with atypical subtype being the most prevalent at 15 percent. Approximately 36 percent of the participants met criteria for more than one subtype. As it relates to antidepressant treatment, the results showed that participants in all subtype groups exhibited a similar statistically significant reduction in symptoms and did not differ in the likelihood to remit.

“Whether pure or mixed, subtypes were not differentially predictive of overall acute treatment outcomes or differentially predictive of efficacy among the three antidepressant medications,” the researchers concluded. “If replicated, these findings would suggest that the clinical utility of these subtypes in treatment selection is minimal.”

The iSPOT-D trial (International Study to Predict Optimized Treatment – in Depression) is the largest personalized medicine research study in mental health.

To read more about treatments for major depressive disorder, see the Manual of Clinical Psychopharmacology, Eighth Edition, by Alan Schatzberg, M.D., and Charles DeBattista, M.D., D.M.H., from American Psychiatric Publishing.

Image Credit: MorgueFile

Your Teenager: Just Moody… or Something More?

By Ken Duckworth from NAMI Blog

“Is my teen normal?”

As a child and adolescent psychiatrist and father of 3 teenagers myself,  I get asked this question by people in my community all the time—at the grocery store, at the community pool and at cookouts. It’s pretty clear to me this is an important public health concern for the people I know.

First, anxiety is normal and often healthy. It relates back to our human wiring—the evolutionary protection for being prepared for threats, like an incoming mastodon. In the modern day, we still have the same kind of alarm system even though the stresses are different.

For instance, it is natural to get anxious before the SAT exam because of the weight our society places on it. It’s perfectly acceptable to get anxious before your first week at sleep-away camp or trying out for a school play. Anxiety can be motivating to a point, but anxiety can also be overwhelming and disabling.

One way to answer the question is to look at your teen’s level of functioning. Does the anxiety reduce his ability to perform at school or engage with friends? Are the symptoms of anxiety stopping her from pursuing what she wants?

[vimeo http://vimeo.com/111773267]

When It Could Be a Mental Health Condition

Anxiety disorders often co-occur with other conditions, such as depression. Major depression in teens is an important public health concern and, like anxiety, often responds to treatment. Depression is characterized by more than 2 weeks of persistent sadness (or irritability, hostility) coupled with most of the following warning signs: sleep troubles, appetite changes, physical complaints, negative or hopeless thinking, concentration problems, loss of interest in activities and, most concerning, suicidal thoughts.

Family history of mood and anxiety conditions can increase the risk for some teens. People with trauma histories may be quicker to experience threat and anxiety based on the past. Teens who are stressed by divorce, are being bullied—on social media or at school—or who have problems “fitting in” in social circles are also at risk.

A full clinical assessment from a health care provider is a worthy investment of time and resources to determine a diagnosis if you’re seeing any of the signs I mentioned in your teen. There are a few medical concerns that can mimic anxiety and depression, so it’s a good idea to look for those—examples are thyroid disorders and substance use disorders.

Once a comprehensive assessment is made, the next step is forming a treatment plan that your teen can buy into. It is challenging yet essential to get your child’s acceptance and collaboration into any plan to approach these issues. While some kids will quickly acknowledge their vulnerabilities, others will be more resistant. This spectrum is natural and expected—not everyone will want support.

Communicating with Your Child

How do you talk with a teen you are worried about? Listening to them is the best first rule. Speak from your own experience. I don’t encourage parents to lead with a diagnosis—I begin with a supportive focus on the functional problems they are having, like with friends for example. This can often be something both the parent and teen can connect on. Loving a teen into care can be difficult, but keeping lines of communication open is key. You don’t need to get to yes on everything, but you may need to get to a professional. I tell parents that their job is to get their teen to my office, but it’s mine to get them back for a follow-up visit.

At the end of the day, I may not be able to give a well-rounded answer at the soccer field, but I hope that what I’ve shared will help if you are concerned about your child’s mental health.

– See more at: http://www.nami.org/Blogs/NAMI-Blog/February-2015/Your-Teenager-Just-Moody-or-Something-More#sthash.X8CfxZfh.dpuf

High Numbers of Students Entering College Report Poor Emotional Health in Previous Year

FROM Psychiatric News Alert: ?????????????????Record numbers of students entering college are self-reporting poor emotional health, according to a report on a national survey titled “The American Freshman: National Norms Fall 2014.”

Students were asked to rate their emotional health in relation to other people their age, in addition to the frequency with which they felt depressed. Additionally, the proportion of students who “frequently” felt depressed rose to 9.5 percent, 3.4 percentage points higher than in 2009.

The survey, conducted by the Cooperative UCLA University Higher Education Research Institute for almost 50 years, assesses hundreds of matters ranging from political views to exercise habits.

The report also noted that students with different types of disabilities say they are feeling depressed more frequently. Of those students who indicated being on the autism spectrum, 22.4 percent reported being “frequently” depressed. Over 17 percent of students who reported having a chronic illness or ADHD were “frequently” depressed.

Students who felt depressed more frequently reported behaviors reflecting disengagement—they were about twice as likely to “frequently” come late to class and “frequently” fall asleep in class. Further, they were less likely to “frequently” engage with their classmates by studying with other students or working with other students on group projects, according to the report.

The report concluded, “With counseling centers on campus reporting a record number of visits and increased wait times, it is clear that campuses have more work to do to assist students experiencing emotional health issues.”

The APA Caucus on College Mental Health will meet during at the 2015 annual meeting in Toronto on Monday, May 18, from 2 p.m. to 5 p.m. in the Toronto Room, Convention Floor, Fairmont Royal York. APA members interested in college mental health are encouraged to attend.

For more on the subject of college mental health, see the Psychiatric News article “College Students Explain Decisions About Getting MH Care.”