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Study bias

Selective publication of clinical trials on antidepressants also could cause a bias about their perceived effectiveness, according to a study led by researchers at the Portland Veterans Affairs Medical Center (New England Journal of Medicine, 2008). The study examined 74 FDA-registered studies for a dozen antidepressants and found that most studies with negative results were not published in scientific literature or were published in a way that conveyed a positive outcome. The FDA studies showed that half of the drug trials had positive results, but 94 percent of the trials cited in published literature were positive.

ADjusting the body's clock with light to counter depression

Researchers have developed a limited form of sleep deprivation that is euphemistically called wake therapy. It has been shown to have sustained antidepressant benefit in patients with bipolar disorder and major depression. The idea is to get up for the day halfway through the usual sleep period, which shifts the circadian clock to an earlier time. It’s thought that this works by realigning the sleep cycle with other circadian rhythms, like changes in levels of body temperature and the stress hormone cortisol, that are also out of sync with each other in depression. Studies show that it is possible to make wake therapy even more powerful by incorporating two additional interventions: early morning light therapy and what’s called sleep phase advance, in which the patient goes to bed about five to six hours earlier than usual and sleeps for about seven hours. This combination of treatments is called triple chronotherapy, and the typical course involves one night of complete sleep deprivation followed by three nights of phase-advanced sleep and early morning light. In one study of 60 hospitalized patients with bipolar depression who were taking antidepressants or lithium, 70 percent of those who did not have a history of drug resistance improved rapidly with sleep deprivation and early morning light, and 57 percent remained well after nine months. Encouragingly, 44 percent of patients who had failed to respond to at least one trial of anti-depressants also improved.

Cognitive decline after surgery tied to brain's own immune cells: In mouse study, experimental drug blocks post-operative memory loss -- ScienceDaily

Post-operative cognitive dysfunction was previously believed to be caused by deep anesthesia during surgery. But increasing evidence instead links the condition to an inflammatory reaction in the brain, now understood to be a normal response to tissue trauma occurring anywhere in the body -- even surgeries physically distant from the brain, such as hip replacement, may trigger this response. Studies have shown that when this inflammation is excessive or too persistent, as may be the case in the elderly, the normally protective response can negatively impact cognition. "Previous studies on post-operative inflammation in the brain had focused on whether circulating immune cells invade the brain and contribute to cognitive decline," Koliwad said. "Based on our new research, we now know that the brain's own microglia initiate and orchestrate this response, including the infiltration of peripheral immune cells and the resultant memory loss."

The brain's spontaneous activity and its psychopathological symptoms - "Spatiotemporal binding and integration". - PubMed - NCBI

I here suggest to conceive the brain's spontaneous activity in spatiotemporal terms that is, by various mechanisms that are based on its spatial, i.e., functional connectivity, and temporal, i.e., fluctuations in different frequencies, features. I here point out two such spatiotemporal mechanisms, i.e., "spatiotemporal binding and integration". Alterations in the resting state's spatial and temporal features lead to abnormal "spatiotemporal binding and integration" which results in abnormal contents in cognition as in the various psychopathological symptoms. This, together with concrete empirical evidence, is demonstrated in depression and schizophrenia.

Light boosts serotonin

Exposure to bright light is a second possible approach to increasing serotonin without drugs. Bright light is, of course, a standard treatment for seasonal depression, but a few studies also suggest that it is an effective treatment for nonseasonal depression38 and also reduces depressed mood in women with premenstrual dysphoric disorder39 and in pregnant women suffering from depression.40 The evidence relating these effects to serotonin is indirect. In human postmortem brain, serotonin levels are higher in those who died in summer than in those who died in winter.41 A similar conclusion came from a study on healthy volunteers, in which serotonin synthesis was assessed by measurements of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in the venous outflow from the brain.42 There was also a positive correlation between serotonin synthesis and the hours of sunlight on the day the measurements were made, independent of season. In rats, serotonin is highest during the light part of the light–dark cycle, and this state is driven by the photic cycle rather than the circadian rhythm.43,44 The existence of a retinoraphe tract may help explain why, in experimental animals, neuronal firing rates, c-fos expression and the serotonin content in the raphe nuclei are responsive to retinal light exposure.44–48 In humans, there is certainly an interaction between bright light and the serotonin system. The mood-lowering effect of acute tryptophan depletion in healthy women is completely blocked by carrying out the study in bright light (3000 lux) instead of dim light.49

Why virtual reality could be a mental health gamechanger | Science | The Guardian

We’ve just completed the first review of every study that has used VR to assess, understand, and treat mental health conditions. The earliest was undertaken almost 25 years ago, at a time when the cost and complexity of the equipment and programming meant that research was confined to a very small number of specialist centres. Since then 285 studies have been published. Most of those have focused on using VR to treat anxiety disorders and particularly phobias, social anxiety, and PTSD. The results have been encouraging — VR is a proven means of delivering rapid, lasting improvements.

Mouse study identifies new method for treating depression: Inhibiting brain enzyme alleviates depression, and does it much faster than conventional antidepressants -- ScienceDaily

Palmer and team unraveled a previously underappreciated molecular process that can influence mouse models of depression. Here's how the process works: Cells generate energy. In doing so, they produce a byproduct. That byproduct inhibits neurons and thus influences various behaviors. Typically, the enzyme GLO1 removes this byproduct, but inhibiting GLO1 can also increase the activity of certain neurons in a beneficial way. In mice, Palmer and others have shown that more GLO1 activity makes mice more anxious, but less was known about the system's effect on depression. Palmer and team wondered if they could reduce signs of depression by inhibiting the GLO1 enzyme. The researchers used several different antidepressant tests. They compared responses in three groups of mice: 1) untreated, 2) treated by inhibiting GLO1, either genetically or with an experimental compound, and 3) treated with Prozac, a selective serotonin reuptake inhibitor commonly used to treat depression. The first tests they used were the tail suspension test and the forced swim tests, which are often used to determine whether or not a compound is an antidepressant. In this case, the answer was yes. The other tests -- chronic forced swim test, chronic mild stress paradigm and olfactory bulbectomy -- are well-established measures that can also be used to measure how long it takes for an antidepressant to take effect. In each of these tests, inhibiting the GLO1 enzyme reduced depression-like symptoms in five days, whereas it took 14 days for Prozac to have the same effect. While this new approach to treating depression has so far only been tested in mice and it will take many years of development before a GLO1 inhibitor could be tested in humans, the researchers are excited to find that new, unexplored approaches to treating depression are out there.

Rumination: cause rather than effect of depression?

The metacognitive approach offers promising opportunities for addressing these limitations of treatment by directly targeting rumination and its underlying mechanisms that are seen as essential in the development and maintenance of depression (Wells, 2009).

5 minute bout of walking boosts mood

This may be partly due to the guideline's inclusion of a 10-minute minimum time-bout requirement for PA. Our findings suggest that a shorter, 5-minute bout of PA is adequate to elicit psychological health benefits. This may be encouraging to individuals who perceive “lack of time” as an exercise barrier. Individuals may also perceive this shorter time requirement to be less physically demanding. Notably, the present study demonstrates that mood-related benefits of a 5-minute exercise bout can occur from a self-selected walking pace. A self-selected pace is generalizable, and encouragingly, this may positively influence an individual's confidence in his or her ability to sustain activity and his or her anticipated enjoyment of the activity. Health care providers should consider the positive benefits of a 5-minute bout of exercise when prescribing treatment for patients suffering from mood-related disorders.

Groundbreaking fMRI study finds 4 distinct neurological subtypes of depression - ExtremeTech

We found that, superimposed on this shared pathological core, distinct patterns of abnormal functional connectivity differentiated the four biotypes and were associated with specific clinical-symptom profiles. For example, as compared to controls, reduced connectivity in frontoamygdala networks, which regulate fear-related behavior and reappraisal of negative emotional stimuli, was most severe in biotypes 1 and 4, which were characterized in part by increased anxiety. By contrast, hyperconnectivity in thalamic and frontostriatal networks, which support reward processing, adaptive motor control and action initiation, were especially pronounced in biotypes 3 and 4 and were associated with increased anhedonia and psychomotor retardation. And reduced connectivity in anterior cingulate and orbitofrontal areas supporting motivation and incentive-salience evaluation was most severe in biotypes 1 and 2, which were characterized partly by increased anergia and fatigue.

Physical Exercise and Psychological Well-Being: A Population Study in Finland - ScienceDirect

The results of this cross-sectional study suggest that individuals who exercised at least two to three times a week experienced significantly less depression, anger, cynical distrust, and stress than those exercising less frequently or not at all. Furthermore, regular exercisers perceived their health and fitness to be better than less frequent exercisers did. Finally, those who exercised at least twice a week reported higher levels of sense of coherence and a stronger feeling of social integration than their less frequently exercising counterparts.

Effects of a Sedentary Behavior-Inducing Randomized Controlled Intervention on Depression and Mood Profile in Active Young Adults. - PubMed - NCBI

A 1-week sedentary behavior-inducing intervention has deleterious effects on depression and mood. To prevent mental health decline in active individuals, consistent regular physical activity may be necessary.

Enemies as a mental health intervention

Indeed, researchers have found that just thinking about your social groups can make you less likely to get sick after being exposed to a virus, less apt to lash out at those who have wronged you and more tolerant of physical pain. Groups provide a sense of belonging. They also can give life meaning—something that is lost in depression—in part because we are better able to achieve goals when we work with others. Rates of depression and suicide drop markedly in wartime, for example, because people find meaning in working together to defeat an enemy. And of course, other members of your in-group can supply both emotional support

Belonging counters depression

Though just attending group meetings—to play soccer, make art, sew or do yoga—did not significantly lower depression scores, identifying with the group was associated with a marked decline in symptoms. Similarly, when we studied 92 people diagnosed with depression or anxiety who joined a therapy group in a psychiatric hospital clinic, we found that those who strongly identified with the therapy group were more than twice as likely to recover as those who felt only weakly connected to it.

Depression risks plummet with group affiliation

We found that group membership not only enabled nondepressed people to avoid the disorder but also powerfully aided recovery over time for people who had been depressed. Depressed respondents with no group memberships who joined a single group reduced their risk of relapse from 41 to 31 percent; among those who joined three groups, the risk of relapse dropped to 15 percent.

Belonging counters depression

The more we learn about depression, the more social isolation seems to be a key factor in its expression. Interactions with others, then, might logically guard against the illness. Such contact works only when a person develops a sense of belonging, however. In another study from 2012 social psychologist Fabio Sani of the University of Dundee in Scotland and his colleagues surveyed 194 adults about how much they saw and spoke to members of their immediate family. They also asked these people how much they thought of their family as an important part of who they are. The amount of contact with family was only weakly related to whether people evinced symptoms of depression, but identifying with their family was highly protective. The same result held for a different type of “family.” Among 150 members of an army unit from an Eastern European country, feeling closely associated with their unit seemed to stave off depression far better than simply spending time with other soldiers.

Social roots of depression

The American Psychiatric Association recommends two kinds of first-line treatments for most cases of depression: antidepressant medication and psychotherapy. Both therapies can work quite effectively, either by changing brain chemistry or by altering one's perspective on life events. Both rest on the assumption that depression is a problem within an individual. Yet evidence suggests that the disorder has potent external triggers. In particular, 60 to 90 percent of people who become depressed have recently suffered some kind of loss—of a job, friendship or romance, for example. In addition, depression preferentially strikes those who live alone. And in recent years researchers have discovered that a sense of social isolation, often arising when you stop participating in activities you used to enjoy, augurs depression within a year. In a study of 229 middle-aged and older adults published in 2010, social neuroscientist John T. Cacioppo of the University of Chicago and his colleagues found that individuals who reported being lonely at some point over a five-year period were far more likely to develop depression symptoms a year later than were those who scored low on a measure of loneliness, independent of age, gender and initial depression severity.

depression is sticky

Nearly one third of patients do not respond to their initial treatment, and of those who do find relief, four out of five will become depressed again later. On average, people relapse about four times across the course of their life.

Why Exercise May Be the Best Fix for Depression - Scientific American

Despite the mounting evidence that exercise can remedy some forms of depression, skepticism persists in academia and health care, Trivedi notes. “There is this general bias that exercise is not a bona fide treatment—it's just something you should do in addition to treatment, like trying to sleep and eat well,” he says. “Even though recognition of exercise as a treatment is increasing,” only some health insurance companies pay for gym time, he explains, and when they do, they often offer small temporary discounts. “I can prescribe a drug that costs $200 and insurance will pay, but they won't give $40 to open a gym membership.”

Exercise switches off genes for depression?

intriguing 2015 study, physician Helmuth Haslacher and his colleagues at the Medical University of Vienna in Austria compared the mental health and genomes of 55 elderly marathon runners and endurance bicyclists with those of 58 nonathletes. Among the nonathletes, they found a statistically significant correlation between the number of depressive symptoms these individuals experienced and a particular gene variant that interferes with normal BDNF production. Among the athletes, however, there was no such correlation. The researchers concluded that by stimulating BDNF production, long-term, vigorous aerobic exercise might actually counteract a genetic susceptibility to depression.

Getting it backward

Exercise also seems to mimic some of the chemical effects of antidepressant medication.

More = better

In a frequently cited study from 2005, for example, Trivedi and his colleagues tracked the health of 80 adults with mild to moderate depression for three months as they exercised three to five times a week on a treadmill or stationary bicycle at low intensity (seven kilocalories per kilogram per week) or at a higher intensity, as recommended by public health authorities (17.5 kilocalories per kilogram per week). At the end of the three months, the adults who exercised at the higher intensity had lessened the severity of their depression by 47 percent, compared with only 30 percent for the low-intensity group and 29 percent for a group who engaged in stretching rather than aerobic exercise.

Why Exercise May Be the Best Fix for Depression - Scientific American

when exercise is used to treat depression, success rates increase by as much as 67 to 74 percent.

Why Exercise May Be the Best Fix for Depression - Scientific American

in 2015, Swedish scientists assigned 946 patients with mild to moderate depression to one of three 12-week treatments: thrice-weekly sessions of yoga, aerobics or strength training; Internet-based cognitive-behavioral therapy; or standard counseling plus medication. Patients in all groups improved, but those engaging in exercise experienced the greatest benefits. Internet-based therapy came in as a close runner-up, but the typical treatment plan lagged behind both alternatives.

Doses of Neighborhood Nature: The Benefits for Mental Health of Living with Nature | BioScience | Oxford Academic

This growing problem has, at least in part, been attributed to the increasing disconnect between people and the natural world that is resulting from more urbanized, sedentary lifestyles (the “extinction of experience”; Miller 2005, Soga and Gaston 2015). This is supported by research that shows interactions with nature promote psychological restoration (Kaplan 1995), improved mood (Hartig et al. 2003, Barton and Pretty 2010, Roe and Aspinall 2011), improved attention (Hartig et al. 2003, Ottosson and Grahn 2005) and reduced stress and anxiety (Ulrich et al. 1991, Grahn and Stigsdotter 2003, Hartig et al. 2003, Maas et al. 2009).

How Exercise Shapes You, Far Beyond the Gym – Personal Growth – Medium

A study published in the British Journal of Health Psychology found that college students who went from not exercising at all to even a modest program (just two to three gym visits per week) reported a decrease in stress, smoking, alcohol and caffeine consumption, an increase in healthy eating and maintenance of household chores, and better spending and study habits. In addition to these real-life improvements, after two months of regular exercise, the students also performed better on laboratory tests of self-control. This led the researchers to speculate that exercise had a powerful impact on the students’ “capacity for self-regulation.” In laypeople’s terms, pushing through the discomfort associated with exercise — saying “yes” when their bodies and minds were telling them to say “no” — taught the students to stay cool, calm, and collected in the face of difficulty, whether that meant better managing stress, drinking less, or studying more.