Depression: Young People Respond Well To Computer Based Intervention

Source: BMJ

Read The Original Research Article Here

A computerized self help intervention may help adolescents who suffer from depression. The specialized computer therapy acts much the same way as they do from one-to-one therapy with a clinician, according to a study published on BMJ.

Depression is common in adolescents, but many are reluctant to seek professional help. So researchers from the University of Auckland, New Zealand, set out to assess whether a new innovative computerized cognitive behavioral therapy intervention called SPARX could reduce depressive symptoms as much as usual care can.

SPARX is an interactive 3D fantasy game where a single user undertakes a series of challenges to restore balance in a virtual world dominated by GNATs (Gloomy Negative Automatic Thoughts). It contains seven modules designed to be completed over a four to seven week period. Usual care mostly involved face-to-face counseling by trained clinicians.

The research team carried out a randomized controlled trial in 24 primary healthcare sites across New Zealand. All 187 adolescents were between the ages of 12 and 19, were seeking help for mild to moderate depression and were deemed in need of treatment by primary healthcare clinicians. One group underwent face-to-face treatment as usual and the other took part in SPARX.

Participants were followed up for three months and results were based on several widely used mental health and quality of life scales.

Results showed that SPARX was as effective as usual care in reducing symptoms of depression and anxiety by at least a third. In addition significantly more people recovered completely in the SPARX group (31/69 (44%) of those who completed at least four homework modules in the SPARX group compared with 19/83 (26%) in usual care).

When questioned on satisfaction, 76/80 (95%) of SPARX users who replied said they believed it would appeal to other teenagers with 64/80 (81%) recommending it to friends. Satisfaction was, however, equally high in the group that had treatment as usual.

The authors conclude that SPARX is an “effective resource for help seeking adolescents with depression at primary healthcare sites. Use of the program resulted in a clinically significant reduction in depression, anxiety, and hopelessness and an improvement in quality of life.” They suggest that it is a potential alternative to usual care and could be used to address unmet demand for treatment. It may also be a cheaper alternative to usual care and be potentially more easily accessible to young people with depression in primary healthcare settings.

Read The Original Research Article Here

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I Am Old But I Am Happy: Why Happiness And Emotional Stability Might Improve With Age

ScienceDaily (Oct. 28, 2010) — It’s a prediction often met with worry: In 20 years, there will be more Americans over 60 than under 15. Some fear that will mean an aging society with an increasing number of decrepit, impaired people and fewer youngsters to care for them while also keeping the country’s productivity going.

The concerns are valid, but a new Stanford study shows there’s a silver lining to the graying of our nation. As we grow older, we tend to become more emotionally stable. And that translates into longer, more productive lives that offer more benefits than problems, said Laura Carstensen, the study’s lead author.

“As people age, they’re more emotionally balanced and better able to solve highly emotional problems,” said Carstensen, a psychology professor and director of the Stanford Center on Longevity. “We may be seeing a larger group of people who can get along with a greater number of people. They care more and are more compassionate about problems, and that may lead to a more stable world.”

Between 1993 and 2005, Carstensen and her colleagues tracked about 180 Americans between the ages of 18 and 94. Over the years, some participants died and others aged out of the younger groups, so additional participants were included.

For one week every five years, the study participants carried pagers and were required to immediately respond to a series of questions whenever the devices buzzed. The periodic quizzes were intended to chart how happy, satisfied and comfortable they were at any given time.

Carstensen’s study — which was published online in the journal Psychology and Aging — was coauthored by postdoctoral fellows Bulent Turan and Susanne Scheibe as well as Stanford doctoral students and researchers at Pennsylvania State, Northwestern, the University of Virginia and the University of California’s campuses in San Francisco and Los Angeles.

Click Image to Read Reviews

While previous research has established a correlation between aging and happiness, Carstensen’s study is the first to track the same people over a long period of time to examine how they changed.

The undertaking was an effort to answer questions asked over and over again by social scientists: Are seniors today who say they’re happy simply part of a socioeconomic era that predisposed them to good cheer? Or do most people — whether born and reared in boom times or busts — have it within themselves to reach their golden years with a smile? The answer has important implications for future aging societies.

“Our findings suggest that it doesn’t matter when you were born,” Carstensen said. “In general, people get happier as they get older.”

Over the years, the older subjects reported having fewer negative emotions and more positive ones compared with their younger days. But even with the good outweighing the bad, older people were inclined to report a mix of positive and negative emotions more often than younger test subjects.

“As people get older, they’re more aware of mortality,” Carstensen said. “So when they see or experience moments of wonderful things, that often comes with the realization that life is fragile and will come to an end. But that’s a good thing. It’s a signal of strong emotional health and balance.”

Carstensen (who is 56 and says she’s happier now than she was a few decades ago) attributes the change in older people to her theory of “socio-emotional selectivity” — a scientific way of saying that people invest in what’s most important to them when time is limited.

While teenagers and young adults experience more frustration, anxiety and disappointment over things like test scores, career goals and finding a soul mate, older people typically have made their peace with life’s accomplishments and failures. In other words, they have less ambiguity to stress about.

“This all suggests that as our society is aging, we will have a greater resource,” Carstensen said. “If people become more even-keeled as they age, older societies could be wiser and kinder societies.”

So what, then, do we make of the “grumpy old man” stereotype?

“Most of the grumpy old men out there are grumpy young men who grew old,” Carstensen said. “Aging isn’t going to turn someone grumpy into someone who’s happy-go-lucky. But most people will gradually feel better as they grow older.”

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Regular Exercise Is Important For The Health Of Those Who Have Schizophrenia

Regular exercise can play an important a role in improving the physical and mental wellbeing of individuals with schizophrenia, according to a review published in The Cochrane Library. Following a systematic review of the most up-to-date research on exercise in schizophrenia, researchers concluded that the current guidelines for exercise should be followed by people with schizophrenia just as they should by the general population.

“Current guidelines for exercise appear to be just as acceptable to individuals with schizophrenia in terms of potential physical and mental health benefit,” says lead researcher Guy Faulkner of the Faculty of Physical Education and Health at the University of Toronto, Canada. “So thirty minutes of moderate physical activity on most or all days of the week is a good goal to aim for. Start slowly and build up.”

Schizophrenia is a serious mental illness affecting four in every 1,000 people. It is already known that exercise can improve mental health, but so far there has been only limited evidence of effects in schizophrenia. The new review focused on three recent small studies that compared the effects of 12-16 week exercise programmes, including components such as jogging, walking and strength training, to standard care or yoga.

The researchers found that exercise programmes improved mental state for measures including anxiety and depression, particularly when compared to standard care. Changes in physical health outcomes were seen but they were not significant overall. However, the researchers suggest this may be due to the short timescale of the trials.

Click image to read reviews

Two previous reviews have found exercise therapy to be beneficial in schizophrenia, but called for more rigorous research. “This new review suggests that such calls are starting to be addressed,” says Faulkner. “But we still need more research that will help us learn how we can get individuals with schizophrenia engaged in exercise programmes in the first place, and how such programmes can be developed and implemented within mental health services. That’s one of the biggest challenges for this type of intervention.”

Source: Eurekalert

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Down By The River: 5 Minutes Of “Green Exercise” Boosts Your Mood

Just five minutes of exercise a day in the great outdoors can improve mental health, according to a new study, and policymakers should encourage more people to spend time in parks and gardens.

Read The Original Article (PDF)

Researchers from the University of Essex found that as little as five minutes of a “green activity” such as walking, gardening, cycling or farming can boost mood and self esteem.

“We believe that there would be a large potential benefit to individuals, society and to the costs of the health service if all groups of people were to self-medicate more with green exercise,” Barton said in a statement about the study, which was published in the journal Environmental Science & Technology.

Many studies have shown that outdoor exercise can reduce the risk of mental illness and improve a sense of well-being, but Jules Pretty and Jo Barton, who led this study, said that until now no one knew how much time needed to be spent on green exercise for the benefits to show.

Barton and Pretty looked at data from 1,252 people of different ages, genders and mental health status taken from 10 existing studies in Britain.

They analyzed activities such as walking, gardening, cycling, fishing, boating, horse-riding and farming.

They found that the greatest health changes occurred in the young and the mentally ill, although people of all ages and social groups benefited. The largest positive effect on self-esteem came from a five-minute dose of “green exercise.”

All natural environments were beneficial, including parks in towns or cities, they said, but green areas with water appeared to have a more positive effect.

Read The Original Article (PDF)

Source: msnbc

“Willy Wonky & The Chocolate Fetish”: Why Do Depressed People Eat More Chocolate?

People who are depressed appear to eat more chocolate than those who aren’t

Researchers at UC San Diego and UC Davis examined chocolate consumption and other dietary intake patterns among 931 men and women who were not using antidepressants. The participants were also given a depression screening test. Those who screened positive for possible depression consumed an average of 8.4 servings of chocolate — defined as one ounce of chocolate candy — per month. That compared with 5.4 servings per month among people who were not depressed.

Read Abstract Here

Those who scored highest on the mood tests, indicating possible major depression, consumed an average of 11.8 servings per month. The findings were similar among women and men.

When the researchers controlled for other dietary factors that could be linked to mood — such as caffeine, fat and carbohydrate intake — they found only chocolate consumption correlated with mood.

It’s not clear how the two are linked, the authors wrote. It could be that depression stimulates chocolate cravings as a form of self-treatment. Chocolate prompts the release of certain chemicals in the brain, such as dopamine, that produce feelings of pleasure.

There is no evidence, however, that chocolate has a sustained benefit on improving mood. Like alcohol, chocolate may contribute a short-term boost in mood followed by a return to depression or a worsened mood. A study published in 2007 in the journal Appetite found that eating chocolate improved mood but only for about three minutes.

It’s also possible that depressed people seek chocolate to improve mood but that the trans fats in some chocolate counteract the effect of omega-3 fatty acid production in the body, the authors said in the paper. Omega-3 fatty acids are thought to improve mental health.

Click image to read reviews

Another theory is that chocolate consumption contributes to depression or that some physiological mechanism, such as stress, drives both depression and chocolate cravings.

“It’s unlikely that chocolate makes people depressed,” said Marcia Levin Pelchat, a psychologist who studies food cravings at the Monell Chemical Senses Center in Philadelphia. She was not involved in the new study. “Most people believe the beneficial effects of chocolate are on mood and that they are learned. You eat chocolate; it makes you feel good, and sometime when you’re feeling badly it occurs to you, ‘Gee, if I eat some chocolate I might feel better.’ “

Chocolate is popular in North America and Britain, she said. But in other cultures, different foods are considered pleasure-inducing pick-me-ups.

“In the United States, people consider chocolate really tasty,” Pelchat said. “It has a high cultural value. It’s an appropriate gift for Valentine’s Day. But in China, you might give stuffed snails to someone you really like.”

Source: LA Times

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Exercise DOES Help Improve Mood! And Just 25 Minutes Worth Will Decrease Stress & Increase Energy

Having an Honors degree in Human Movement Studies and working in gyms in a former life while studying for my Clinical Masters degree, I have seen this to be true.  Of course it seems self evident, but these researchers have used great science with an excellent and now research-proven written program and workbook. These, along with their recent meta-analytic research review, show just how effective exercise can be in improving mood.

Credit: PhysOrg.com) — Exercise is a magic drug for many people with depression and anxiety disorders, according to researchers who analyzed numerous studies, and it should be more widely prescribed by mental health care providers.

“Exercise has been shown to have tremendous benefits for mental health,” says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas. “The more therapists who are trained in exercise therapy, the better off patients will be.”

The traditional treatments of cognitive behavioral therapy and pharmacotherapy don’t reach everyone who needs them, says Smits, an associate professor of psychology.

“Exercise can fill the gap for people who can’t receive traditional therapies because of cost or lack of access, or who don’t want to because of the perceived social stigma associated with these treatments,” he says. “Exercise also can supplement traditional treatments, helping patients become more focused and engaged.”

The Program used in the study is available from bookstores-Click Image to view description

Smits and Michael Otto, psychology professor at Boston University, presented their findings to researchers and mental health care providers March 6 at the Anxiety Disorder Association of America’s annual conference in Baltimore.

Their workshop was based on their therapist guide “Exercise for Mood and Anxiety Disorders,” with accompanying patient workbook (Oxford University Press, September 2009).

The guide draws on dozens of population-based studies, clinical studies and meta-analytic reviews that demonstrate the efficacy of exercise programs, including the authors’ meta-analysis of exercise interventions for mental health and study on reducing anxiety sensitivity with exercise.

“Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger,” Smits says. “Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing.”

After patients have passed a health assessment, Smits says, they should work up to the public health dose, which is 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity.

At a time when 40 percent of Americans are sedentary, he says, mental health care providers can serve as their patients’ exercise guides and motivators.

The patient workbook which accompanies the program - Click image to view description

“Rather than emphasize the long-term health benefits of an exercise program — which can be difficult to sustain — we urge providers to focus with their patients on the immediate benefits,” he says. “After just 25 minutes, your mood improves, you are less stressed, you have more energy — and you’ll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise.”

Smits says health care providers who prescribe exercise also must give their patients the tools they need to succeed, such as the daily schedules, problem-solving strategies and goal-setting featured in his guide for therapists.

“Therapists can help their patients take specific, achievable steps,” he says. “This isn’t about working out five times a week for the next year. It’s about exercising for 20 or 30 minutes and feeling better today.”

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Exercise and Mood: Healthy Activity Can Help Beat Depression and Anxiety

It is very likely that you have heard your medical practitioner, psychologist or counsellor talk about the benefits of exercise to help get on top of your depression or anxiety.

Here is a repost of an article which discusses some recent examples of these principles in practice, as well as summaries of some recent studies. (Read while jumping up and down on the spot for no less than 15 minutes!)

..

When Gaetano Vaccaro meets with depressed patients at Moonview Sanctuary, he sometimes moves part of the session outside, taking a walk while talking. The result: “People’s state of mind can shift.”

Depression can spawn a spiral of lethargy and hopelessness, so that the last thing someone wants to do is exercise. But regular, moderate physical activity may lessen depression symptoms as much as some medications.

“On its own, exercise does appear to have significant effects in terms of elevating mood,” says Dr. Andrew Leuchter, professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior. Physical activity, he adds, is often used to augment treatments such as medication and cognitive behavioral therapy. “If people are on medication or in treatment and haven’t had a complete recovery from depression, exercise is useful in getting them all the way there.” Exercise affects the brain in several ways. “People with depression tend to become somewhat inert, and they don’t engage in their usual activities, and exercise gets people back to their usual level of activity,” Leuchter says. That can prompt an upward cycle, inspiring people to return to work and connect again with friends and family, ultimately providing motivation to stay on course. Such connections are crucial for depressed people.

“The psychological benefits make a big difference from my perspective,” says James Blumenthal, professor of medical psychology at Duke University in Durham, N.C. “People have a greater sense of being in control. They feel better about themselves and have more self-confidence.”

A physical change can instigate a mental change, says Vaccaro, director of development at Moonview Sanctuary, a psychological treatment center in Santa Monica. “When you’re getting somebody to move and getting them to change a pattern in their life, just that little bit of pattern change can relate to a mood change, and they start to see themselves as a person who is active, not just a couch potato. They change their perception.” There may be direct physical effects on the brain as well. The treatment center encourages exercise — yoga in particular — as a way to manage many types of mood disorders. Besides having a strong mind-body connection, “yoga is something that can be modified to someone’s activity level and is something they can do throughout their life,” Vaccaro says.

Mood elevation

Several studies illustrate the benefits of exercise.In one, published in the journal Psychosomatic Medicine in 2007, 202 men and women with major depression were randomly assigned to participate in a supervised exercise program in a group setting, do home-based exercise, take an antidepressant medication or take a placebo pill. After 16 weeks, 41% were in remission, meaning they no longer had major depressive disorder. Those who were in the exercise and medication groups tended to have higher remission rates than the placebo group.

Another study examined how much cardiovascular exercise was needed to see changes in mood among those with mild to moderate major depressive disorder. The 80 men and women who took part in the research were randomly placed in four exercise groups that varied in the number of calories burned and the frequency of the activity. A placebo group did flexibility exercises three days a week. Those in the group that exercised at moderate intensity three to five days a week for about 40 minutes (consistent with public health recommendations) showed the biggest decrease in depressive symptoms compared with those who exercised less, or just did stretching.

The 2005 study appeared in the American Journal of Preventive Medicine. Other pieces of the puzzle are still missing, however. Scientists aren’t sure what changes happen in the brain — and why — when people exercise. Many scientists and physicians believe that exercise increases levels of serotonin, a neurotransmitter thought to be linked to mood regulation. However, most of the studies supporting this have been done on animals. “It’s hard to quantify it in humans for a number of reasons,” Leuchter says. “We don’t entirely understand exactly why patients get depressed in the first place. We have theories, but it’s hard to know in individual cases. And we don’t have a good way of looking at [changes] in the brain.” Scientists do know that exercise causes an increase in blood flow to the brain and raises the amount of energy the brain uses. And even though the link between blood flow and mood isn’t known, Leuchter says, “the brain in general seems to be in a healthier state.”

Activity is key

Exercise may be key in fighting depression, but no generic prescription fits everyone. Overall health and exercise history factor into what kind of regimen might be prescribed. “If someone was a runner, I’d get them back to running,” Leuchter says. “If not, I’m not going to have the goal of turning someone into a major athlete. I’d simply want to get them active, and even walking around the block might be good.” Those who aren’t currently in treatment for depression should consult with a physician before exercising to make sure they have no underlying health problems. Patients who are on medication or in therapy for depression shouldn’t consider exercise a substitute for either treatment. “The key,” Blumenthal says, “is really maintenance. You have to do it on an ongoing basis. You should find something you enjoy, but doing something is better than nothing.”