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

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How Do We Decide Where to Spend Research Money When in Comes to Depression?

FROM Psychiatric News Alert

An analysis of more than 60 clinical studies and nearly 60,000 adult patients conducted from 1996 to 2013 calculated that the total cost of depression in the United States is in the range of $188 billion to $200 billion. As much as $64 billion of these costs are associated with treatment-resistant depression, which accounts for only a fraction of all cases, but exacts a heavy toll on society.

A Review of the Clinical, Economic, and Societal Burden of Treatment-Resistant Depression: 1996-2013” was published August 1 in Psychiatric Services.

As author John Hornberger, M.D., CEO and president of Cedar Associates, a health research firm, told Psychiatric News, “As a general internist, I see patients across a broad spectrum of diseases. There are clear differences among disciplines in the level of stigmatization associated with disease and public advocacy, and these differences influence the debate about health care and research priorities. With our study, we sought to understand better the burden of mental health, especially the patients who are most difficult to treat.”

The review found that the annual costs, combining health care and productivity losses, for someone with treatment-resistant depression were nearly double those of someone with treatment-responsive depression and nearly quadruple those for the general population’s health-related costs ($20,120 vs. $10,592 vs. $5,095).

Psychiatrist Jerry Halverson, M.D., medical director of adult services at Wisconsin’s Rogers Memorial Hospital-Oconomowoc and a member of APA’s Council on Advocacy and Government Relations, was not surprised by the results. “The findings perfectly underline what we as clinicians see every day,” he said. “Our patients have many physical and psychiatric comorbidities in addition to depression, so they not only account for a proportionally higher percent of the health care spending; but their quality of life is terrible.”

The financial burden attributed to depression is higher than recent cost estimates for cancer ($131 billion) and diabetes ($173 billion), but depression receives far less research funding from the National Institutes of Health than those two illnesses. The authors noted that improved access for underserved populations and better patient education would help lower this burden, but also stressed a need for new therapeutic strategies like pharmacogenomics.

To read about recent research into a potential therapy for treatment-resistant depression, see the Psychiatric News article, “Ketamine Shows Rapid Action In Treatment-Resistant Depression.”

Tips for Helping Someone with Depression

From NAMI California: Suffering from depression is a serious health issue – one that affects between 15 and 17 million Americans every day. Thankfully, a number of different treatment options are now available that can help those suffering from depression overcome their problems and get their life back to where it should be. While medication, healthy lifestyle options, and counseling can all have an influence on one’s depression, one of the most important things for anyone looking to combat their depression is to have a solid support system in place. 

That support system should be made up of friends and family who love them and can offer the kind of support that is needed. If you’re one of the many who know someone who is combating depression, you’ll likely find yourself in the position of being a part of a support system. This isn’t something to become stressed or panicked about, however. As long as you understand the basics of helping provide support to a loved one, you can help them overcome their depression in a significant way. 

There are a few tips that can help you provide the highest level of support possible, and understanding them will ensure that you give your loved one everything they need to overcome their mental illness. 

Here are some of the keys to being an effective member of a support system:

• Be Patient – It’s important to understand that the problems your loved one is suffering from are very real and not just imaginary. You’ll need to be patient and understanding of their struggle, not judgmental. 

• Motivate Them – A big part of recovery from depression is getting active and leading a healthy lifestyle, but it can be hard for sufferers to find the motivation to do so. Help them by providing motivation, offering to participate in activities with them, and more. 

• Don’t Offer Advice – One of the biggest issues that depression sufferers face is the constant barrage of advice from their loved ones. While it is almost always well-intentioned, the fact is that telling them your opinions on how to deal with what they’re feeling won’t usually help – it will only add to the problem. Instead, simply support them in what they’re doing and working through. It’s a better solution, with much better results. 

As a loved one, you’ll be a key part of someone’s battle against depression. The points above can help you give them the support they need to win that battle for good. We can help as well. For more information, contact us at NAMI California today. 

Please consider joining NAMI. We have free education classes,
we advocate for mental health and we have support.

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Depression and Insomnia

From Psychology Today:

Is Depression Making Me Sleepless, Or Is Insomnia Making Me Depressed? 

Depression and insomnia are common and possess common symptoms. Some estimate that 30% of Americans will eventually experience clinical depression, and perhaps 40% of adults complain that many or most nights they don’t get enough sleep, wake too often, or feel unrested on awakening.

So which came first the chicken or the egg?

Depression Causes Insomnia

One of the earliest symptoms for many depressives is insomnia. They can’t fall asleep. They can’t stay asleep. There are times you can almost diagnose depression by looking at individual sleep studies.

  1. Deep sleep, where we produce growth hormone, a stage critical for memory and decision making may altogether disappear with depression.
  2. Awaking and arousals increase dramatically. Sleep becomes highly fragmented.
  3. REM sleep is often broken up, and its very appearance changes. Rapid eye movement may appear both erratic and dense.

Depression and Sleeping Pills

As people become depressed they often identify sleeplessness as their main problem. Insomnia is common and holds little stigma; depression is a “disease” that can cost you jobs, insurance, relationships and self-esteem. People in depressive episodes often seek sleeping pills, sometimes with desperation. Generally they feel better – for a while. Unfortunately the quality of sleep tends to decline as long as the depression is not fully treated. Frequently sleep medications stop working altogether. Behavioral and other regimes may also then fail.

Many times depressed people tend to take enormous doses of sleeping pills and then they hardly sleep at all. Sleep can be the last thing to normalize in a depressive episode. So it’s strange to many, including sleep clinicians, that depression can also cause insomnia’s opposite – prolonged sleepiness. It’s even more of a surprise that forcing people to stay awake at night can improve depression.

Insomnia and depression are directly related – both influence each other. If you are an insomniac, the lack of rest required for your body’s natural regeneration provokes a greater tendency to depression. Depression itself massively reorders sleep, often in the form of horribly disrupted sleep and seemingly “untreatable” insomnia.

Insomnia and depression are deeply interlinked, as are the brain areas involved in both.

Depression and Low Zinc Levels

From Psychiatric News Alert: An analysis of studies measuring blood concentrations of zinc has found concentrations lower in patients with depression. The senior researcher was Krista Lanctot, Ph.D., of the University of Toronto, and results are published in Biological Psychiatry.

It is not yet known whether depression creates a zinc deficiency or a zinc deficiency helps set the stage for depression. Either is possible. Appetite changes are a common component of major depression. On the other hand, a zinc deficiency can induce depressive-like behaviors in animals, which can be reversed by zinc supplements. Either way, “the potential benefits of zinc supplementation in depressed patients warrant further investigation,” the researchers note.

A comprehensive overview of depression and how to offer optimal care to depressed patients can be found in the new American Psychiatric Publishing book, Clinical Guide to Depression and Bipolar Disorder: Findings From the Collaborative Depression Study. For more on treating depression, see Treatment-Resistant Depression: A Roadmap for Effective Care.

Mental Illness Awareness Week 2013

It’s Time to Make a Difference

During much of the past year, Americans have engaged in a dialogue about mental illness, sparked by the tragedies in Aurora, Colo. and Newtown, Conn. Most people living with mental illness are not violent, but when violence does occur, the spotlight falls on holes in the mental health care system.

This year, the spotlight has had special intensity, including proposals by the President of the United States, congressional hearings and interest among state and local elected officials. During Mental Illness Awareness Week (MIAW) is Oct. 6-12, 2013, every community should pause to consider whether a true awakening has occurred, including greater investment in mental health care.

It’s time to make a difference.

Mental illness does not discriminate. It can strike anyone at any time. Fortunately recovery is possible. Treatment works, but only if a person can get it.

One in four American adults experience a mental health problem in any given year. One in five young people ages 13 to 18 also experience mental illness. In fact, one-half of all mental illness begins by the age of 14—three-quarters by age 24.

Unfortunately, there are long delays−sometimes decades−between the first appearance of symptoms and when people get help. Less than one-third of adults and less than one-half of children with a diagnosed illness receive treatment.

Local NAMI affiliates stand ready to help in their areas. For residents in the Los Angeles South Bay, NAMI South Bay offers resources, classes, support groups and helpful information, beginning with the information available on this site. For affiliates in other areas, the national organization keeps an updated and interactive page you can find by CLICKING HERE or clicking on NAMI’s Affiliates-by-State map:

Key issues that affect access to mental health care include expansion of state Medicaid coverage for uninsured persons, mental health insurance parity and state spending on direct services. Spending money can involve difficult choices, but when it comes to mental health care, lack of coverage or cuts too often results in simply shifting costs to hospital emergency rooms, schools, police, courts, jails and broken families

When it comes to mental health care, we need to focus on “sooner” rather than simply “later.” As part of this year’s dialogue on mental illness, the challenge has been made not to fix the mental health care system but to build it anew—with much greater emphasis on early screening, diagnosis and treatment. This includes the need for effective school-based and school-linked mental health services. It also includes family education and support who too often are overwhelmed as caregivers.

During MIAW,  these are issues to talk about. Even more fundamentally, everyone should take care to know the nature of mental illness and the symptoms of different conditions such as major depression, bipolar disorder and schizophrenia. Information about specific diagnoses and treatment options is available at www.nami.org.

No one should have to confront mental illness alone. Know where to find help in case it’s ever needed. Most people start with their primary care doctor. Many start by confiding in a close family member of friend.

Don’t be afraid to speak up. The U.S. Surgeon General has reported that stigma is a major barrier to people seeking help when they need it.  That’s why MIAW is so important.  The more people know, the better they can help themselves or their loved ones to get the support they need.

Study: Cognitive Restructuring Helps Prevent Depression in At-Risk Teens

(From Psychiatric News Alert) A cognitive-behavioral prevention program, when compared with usual care, showed significant sustained effects in preventing depression in teens at high risk for depressive illness, said William Beardslee, M.D., a professor of child psychiatry at Harvard Medical School, and colleagues in JAMA Psychiatry.

The study included teens that were (a) offspring of parents with current or past depressive disorders, and (b) had themselves present or past depressive symptoms. The teens were randomly assigned to either (1) usual care, or (2) a cognitive-behavioral prevention (“CBP”) program. The CBP program involved eight weekly group sessions and six monthly group booster sessions, in which the teens learned how to deal with negative or unrealistic thoughts. The subjects were evaluated for depression at intervals over 33 months. Over the period, and for the sample as a whole, the intervention was significantly effective, with 37% of the teens in the CBP group experiencing a depression, compared with 48% in the usual-care group.

“We were quite pleased that the effects noted in our earlier analysis nine months after enrollment were sustained at 33 months, as it is difficult to demonstrate longer-term prevention effects,” Beardslee told Psychiatric News. At the nine-month follow-up, 21 percent of the teens randomized to the CBP condition had experienced depression, in contrast to 33 percent in the usual-care group.

During the past decade or so, there has been an explosion in mental illness prevention research such as that conducted by Beardslee and his colleagues. See the Psychiatric News article “Future Looks Promising for Mental Illness Prevention” to read more about the research. Also see “Maintenance Cognitive-Behavioral Therapy and Manualized Psychoeducation in the Treatment of Recurrent Depression…” in the American Journal of Psychiatry.