Tag Archives: depression

Depression, what it is, and how to get help.

Depression by Tom Robson

Depression is a hard condition to live with, it’s subtle and those who never have the experience will perhaps never understand how greatly it affects the individual. Often it’s mistaken for being withdrawn, unapproachable or antagonistic, with no empathy for the person experiencing this ‘pain’.  This pain is  manifest as reduced abilities to communicate and interact at the same pace of other peers, yet what depressed people say and do, is merely a fraction of what they’re thinking.

There is no cure for depression and there is no point within recovery when you ‘know’ you’re over an episode of it. (And you never know when the next episode will begin).

There are several ideas about what causes depression. It can vary a lot between different people, and for some people a combination of different factors may cause their depression. Some find that they become depressed without any obvious reason.  You can read more on the condition over at Mind.org,uk

Every year, World Health Day is celebrated on 7th April with a distinct theme. While last year’s focus was on diabetes, this year the spotlight is on one of the most underrated mental disorders – depression. Most people don’t like talking about it, while others simply don’t treat it as a severe, debilitating condition.  A quick look at the statistics is enough to understand the appalling severity of the rising number of depression cases. Depression, when unchecked can assume a menacing character with many succumbing to it and ending their lives. Depression can affect a person’s overall well-being. People suffering from depression can experience difficulty in carrying out their day to day activities. They may feel a sudden withdrawal from activities that were once enjoyable to them. Social aloofness is also one of the characteristics.

“At worst, depression can lead to suicide, now the second leading cause of death among 15-29-year olds,” WHO. Depression in people rose by 18% between 2005 and 2015. It is also the largest cause of disability in the world with most people falling prey to it from low to middle income countries. Suicide rate are also high in low to middle income countries in young people ageing 20-25. WHO’s study depicts more suicide cases in men as compare to women all across the globe.

This World Health Day is not only dedicated to understanding depression better but embracing the wide spectrum of mental disorders as well. The day calls for developing empathy towards every sad face and a will to pierce through the veils of loneliness that might push somebody into depression.

Men living with HIV have an elevated rate of suicide, particularly in the first year after diagnosis, according to a fifteen-year study of almost 90,000 people diagnosed with HIV in England and Wales, with comparison against the general population. Sara Croxford of Public Health England presented the findings to the British HIV Association conference in Liverpool yesterday.

You can read more about how suicide accounts for 2% of deaths in people with HIV, twice the rate of the general population over at NAM.

If you’re feeling stressed, anxious, tense or depressed and find that these feelings are impacting on your relationships, work, or life generally, talk to your GP.  There are therapies and other treatments which can help.

In a mental health crisis?  See your GP who can refer you to the Mental Health Crisis Response Team. Alternatively you can call the local Richmond fellowship crisis helpline on Freephone 0808 8003302 (2pm- 1.30am)

Feeling suicidal now? – Call the Samaritans on 116 123

You can also speak Help and advice can also be found at LAMPNetwork for ChangeMINDHealth for Teens and Time to Change. There are also a range of NHS-endorsed digital applications that can help treat depression and anxiety and improve access to psychological therapies.

GP’s use a relatively simple questionnaire to monitor the severity of depression and response to treatment. It is not a screening tool for depression, however it can be used to make a tentative diagnosis of depression.  You can view this questionnaire over at Patient.info

Do you know someone who is suffering depression?  You may want to help but can’t seem to find a way in?  When a family member or friend suffers from depression, your support and encouragement can play an important role in his or her recovery. Mind.org,uk offer practical help which you can use to help you support someone in need.

 

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Mental health issues may increase HIV risk among gay, bisexual men

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Gay and bisexual men are at increased risk of acquiring the virus that leads to AIDS if they have mental health problems, according to a new study.

What’s more, their risk of acquiring HIV increases with the number of mental health factors they report, researchers found.

Past studies have found that mental disorders, ranging from depression to substance abuse, are often seen among men with HIV, but “nothing about whether these factors predict HIV risk behaviors or becoming infected with HIV,” said study leader Matthew Mimiaga, from Harvard Medical School and Massachusetts General Hospital in Boston.

The Centers for Disease Control and Prevention (CDC) estimates that some 1.1 million people in the U.S. are living with HIV. About one case in six is undiagnosed. While the CDC says only about 4 percent of U.S. males have sex with other men, they represent about two-thirds of the country’s new infections.

Additionally, it’s known that the lesbian, gay, bisexual and transgender (LGBT) community also suffers from an increased burden of mental health problems.

When two health conditions tend to occur together in one population, researchers call them “syndemic.”

For the new study in the Journal of Acquired Immune Deficiency Syndromes, the researchers looked at how five conditions – depression, alcohol abuse, stimulant use, multi-drug abuse and exposure to childhood sexual violence – affect men’s risk of acquiring HIV.

They analyzed data on 4,295 men who reported having sex with men within the previous year. The participants were asked about depressive symptoms, heavy alcohol and drug use and childhood sexual abuse.

The participants did not have HIV when they entered the study between 1999 and 2001. They then completed a behavioral survey and HIV test every six months for four years.

Overall, 680 men completed the study. Those who reported the most mental health issues were the most likely to become HIV positive by the end of the study. They were also most likely to report unprotected anal sex and unprotected anal sex with a person who has HIV.

For example, compared to people without any of the five syndemic conditions, those with four or five had about a nine-fold increased risk of being infected with HIV by the end of the study.

The people with four or five mental disorders were also about three times more likely to have unprotected anal sex and about four times as likely to have unprotected anal sex with a person infected with HIV, compared to people without any mental health issues.

Mimiaga said that the next step is to look at how this information can be used to improve HIV prevention methods.

“We need to think about the fact that men who have sex with men in the U.S. have a high prevalence of these syndemic factors (which) for the most part get in the way of traditional HIV messaging or traditional HIV interventions,” he said. “These factors . . . are driving a lot of the risk and really need to be addressed in a comprehensive approach.”

Future research should also examine whether these mental disorders and behavioral risk factors create barriers to men getting treatment for HIV once they are infected, Mimiaga said.

SOURCE: bit.ly/1yhMU3C Journal of Acquired Immune Deficiency Syndromes, online.

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Depression associated with socioeconomic difficulties and poor virological outcomes in UK HIV patients

A quarter of people with HIV in the UK have a depressive disorder, according to an ongoing study presented by Dr Fiona Lampe to the British HIV Association conference in Birmingham yesterday. The study found strong links between depressive symptoms and unemployment, poverty and not having much social support.

Those with depression were more likely to have problems with adherence and less likely to have an undetectable viral load than other people in the cohort.

This is not the first study to show that depression and other mental health issues can be linked to poor adherence and to poorer clinical outcomes, but research has generally been carried out in the United States, where the social characteristics of people with HIV are different to those in the United Kingdom.

In order to address the lack of relevant data, researchers included questions on depression in the self-completed questionnaires given to people participating in the ASTRA (Antiretrovirals, Sexual Transmission Risk and Attitudes) cohort.

The 2175 participants are attending HIV-outpatient services at one of six UK clinics (Royal Free, London; Mortimer Market, London; Homerton, London; North Manchester; Brighton and Eastbourne). The profile of those taking part does not entirely match that of the wider UK epidemic – 73.4% are gay or bisexual men; 10.1% are heterosexual men and 16.4% are women. The average age is 44 and the vast majority are taking antiretroviral therapy.

The data presented here are cross-sectional – in other words, they come from a single point in time. While the data show strong associations between depression and social factors, they cannot prove causality.

Questions about depressive symptoms came from a validated tool known as PHQ-9, which asks the respondent whether he or she has experienced nine different symptoms over the past two weeks. The respondent should specify how often they have been bothered by these problems.

Based on these answers, 26.6% of respondents had a depressive disorder. Moreover, for 19.1% of respondents this was a major depressive disorder.

Using a different classification, the depression severity score, 20.6% had mild depression; 20.4% had moderate depression and 6.6% had severe depression.

As a point of comparison, in the English general population 7% have either moderate or severe depression. However an audience member pointed out that a better comparison may be with other people who have another chronic medical condition, such as diabetes.

Rates of depression did not vary according to gender, sexuality, ethnicity or country of birth.

On the other hand, there were striking associations with socioeconomic factors. These were all found to be statistically significant in a multivariable model.

Whereas 15.3% of employed people had symptoms, 43.4% of those who were unemployed and 52.8% of those unable to work due to sickness or disability had symptoms.

Among individuals who said they always had enough money to cover their basic needs, 13.3% had depressive symptoms, but among those who said they only sometimes had enough money, 43.2% had symptoms. In participants who could never cover their basic needs, 53.0% had depression.

In terms of education, 18.8% of people who had attended university and 31.7% of those who had not described depressive symptoms.

A number of questions assessed social support, and there was a clear relationship between degrees of social support and depressive symptoms.

Depressive disorder
1: High social support 8.9%
2 16.2%
3 32.1%
4 52.3%
5: Low social support 66.1%

Moreover, the longer someone had been diagnosed with HIV, the more likely they were to be depressed.

Adherence and virological outcome

The researchers also found an association between depressive symptoms and self-reported poor adherence to antiretroviral therapy. Among those saying that they had missed no drug doses over the past two weeks, 24.1% had depression. Among those who said they had missed two doses, 34.3% had depressive symptoms. In those who missed three or more doses, 41.7% were depressed.

Amongst those who had been on treatment for more than six months, people who described depressive symptoms were less likely to have an undetectable viral load. For those without depression, 7.5% had detectable virus, while in those who had depression, the figure was 16.3%. Increasing depression severity scores were associated with higher rates of detectable virus.

As the association between depression and poor virological outcomes could simply be due to the association between depression and poor adherence, further analyses were conducted to clarify this. In statistical terms, having depression remained a risk factor for having detectable HIV, even after adjusting for non-adherence.

However it is important to note that adherence was measured by self-report and concerned only recent adherence, in the past two weeks.

The researchers suspect that screening for depressive symptoms may, in itself, give clinicians valuable information about adherence, beyond that revealed by asking patients about missed doses.

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Meditate To Live Longer

The benefits of meditation are many, as anyone who meditates knows and a good study from a meditation centre in Colorado, US, suggests that the practice can actually add years to your life.

Reported effects of meditation include lowering blood pressure, healing psoriasis, boosting immunity in those who are vaccinated or have cancer, preventing relapse into recurrent depression, plus slowing down the progression of HIV.

What’s more, it seems that meditation can now actually help our cells to survive in the body for longer.

The answer lies in our telomeres – a vital component of every cell. They play a key role in the ageing of cells. Every time a cell divides, they get shorter unless an enzyme called telomerase builds them up again.

People with short telomeres are at greater risk of heart disease, diabetes, arthritis, depression and osteoporosis. They also die younger.

The study shows after a meditation course, people had significantly higher levels of the enzyme present suggesting their telomeres were ­being protected. This changes our view of meditation as simply a state of relaxation. It’s a lifesaver.

Brain studies show that meditation can even trigger physical changes in brain centres involved in learning, memory, emotional regulation, thinking and mood control.

It just so happens that chronic stress will shortern our telomeres causing cell ageing.

The action of meditation is to de-stress us and in doing so, protect our telomeres.

The two kinds of meditation that have been studied are mindfulness meditation, where you become acutely aware of your thoughts and your surroundings, and compassion meditation, where you focus on feelings of love and affection for others.

Both of these types cut down on the stress hormone cortisol. Most of us don’t have time to spend months meditating, but there are mini-meditations we can do like focusing on breathing and being aware of our surroundings several times a day.

While meditation may be effective in reducing stress and in protecting your telomeres, there are other ways if you have no interest in meditation. Exercise can buffer the effects of stress on telomeres and so do stress management programmes.

Psychologists would say that meditation gives you an increased sense of control and purpose in life, and these two things are more important than meditation itself.

Just doing something we enjoy and love – be it meditating, gardening, listening to music or painting – will go a long way to protect us from stress and even help us to live longer.

Source: http://www.mirror.co.uk/advice/miriam/2011/05/19/meditate-to-live-longer-115875-23139547/
Further reading: http://www.learn-meditation-techniques.org/
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