October 8 is National Depression Screening Day

Man holding a red unhappy face sign

Over 16 million American adults are affected by major depression each year. But only a third of those with severe depression seek appropriate treatment, perhaps because they do not know that it is affecting them, or they believe that this feeling is “just a normal part of life.”

Clinical depression is a serious mental illness that can complicate other medical conditions. It can also lead to suicide if not treated. With so many adults dealing with depression, it is important to recognize the impact of this disabling condition, not only on the person dealing with it directly, but also on family, friends, and coworkers. Clinical depression can affect anyone.

National Depression Screening Day is held every year on October 8 as part of Mental Illness Awareness Week. Increased awareness of mental illnesses such as depression can fight stigma and help those with the condition recognize that they are not alone.

Major depression is a type of mental illness; it is not simply feeling sad or down. Know the symptoms of major depressive disorder. If you have several of these symptoms, consider taking a free anonymousonline depression screening test.

However, remember that online tests are not professional diagnoses. Share the results of an online test with a medical professional for appropriate follow up on your mental health concerns.

Screening for depression is the first step toward getting appropriate care.

Things To Do - Volunteer to Help Seniors and Persons with Disabilities in Your Community

Volunteer Hands

During a pandemic, the elderly and persons with disabilities are often at the greatest risk. To protect themselves, they may become isolated and unable to access basic services or meet their daily needs for food and supplies. Isolation and loneliness have negative impacts on overall health and wellness. If you feel safe offering assistance, there are three areas in which you can volunteer. 

Delivering Meals or Groceries

Organizations that deliver food to the needy include Meals on Wheels and Feeding America. Contact local service agencies as well as the large national ones to see if they need drivers willing to bring food and groceries to needy isolated persons.

If you live in an area not served by any of these agencies, you can use social media to let people know that you are willing to shop for and deliver groceries, or run other errands such as picking up and delivering prescription medications. 

Technology Assistance

Help older family members or elderly community members stay up to date with information and keep connected with loved ones through technology. Sometimes the easiest way is to phone and talk the person through how to use their existing electronic tools, including smart phones.

Consider writing (or making a video) and sharing tutorials for downloading eBooks or audio recordings from the local library collection, or directions for emailing or for downloading a podcast. Create step-by-step written instructions for using video conferencing tools.

Remember to include tips for safe experiences online. Seniors and the disabled are frequent targets of online scammers.

If you are unsure how to start creating these educational materials, check out the free materials provided by Generations on Line. 

Social Support

Loneliness has large impacts on health and is increased during times of enforced isolation. Check with local civic organizations and churches to see if they can match you with a person who would benefit from a regular phone call “just to check in.”

For a good list of potential discussion topics for talking with seniors, please look here: https://www.griswoldhomecare.com/blog/senior-conversation-starters-discussion-topics-for-elderly-adults/

If you feel too shy to volunteer in this way, consider sharpening your interpersonal skills. Here is a helpful list of tips on how to engage in small talk: https://www.forbes.com/sites/christinapark/2015/03/30/an-introverts-guide-to-small-talk-eight-painless-tips/#74f0b662574a

Volunteering helps others, but helping others also benefits you. You will be less likely to feel depressed and will experience increased overall well being. Where can you volunteer safely?

The Neglected Organ: Your Microbiome’s Role As Guardian And Protector

By The Tortoise

Weizmann Institute of Science immunologist Dr. Eran Elinav calls the microbiome – the collection of commensal bacteria, viruses, protozoa and fungi which live in and on us – our “neglected organ,” both integral to the body, and with a microbial composition and function unique to each person.¹  Cornell University Professor of Immunotoxicology Rodney Dietert describes the lack of a complete or adequate microbiome in newborns the “equivalent [in many ways] of being born with a serious birth defect, resulting in inappropriately matured physiological systems.”²  Describing the seeding of a complete microbiome at birth as “absolutely critical for a healthful life,” Dietert states:

In the absence of effective microbiome-based training, the immune system does not learn what is safe outside of the body, resulting in haphazard, inappropriate reactions to innocuous environmental factors – allergens such as pollen, mold, cat dander, and peanuts.  It also fails to properly recognize and ignore internal targets, resulting in autoimmune and inflammatory responses that are misdirected, ineffective, and sometimes never-ending.  Such reactions can eventually compromise the function of our own tissues and organs.³

With the microbiome not generally recognised to even exist until the late 1990s,⁴ medical science has been unaware, until very recently, of the critical role this overlooked organ plays in our health and well-being.  This role cannot be overstated.  The human is a composite creature of single-celled organisms from all domains of life (eukaryotes, archaea, bacteria) and its own mammalian cells – a composition Dietert calls a “superorganism.”⁵  This superorganism that is the human is, by cell numbers, “approximately 90% microbial.”⁶  The University of Washington’s Ecogenetics Center describes humans as “mostly microbes,” with microbes outnumbering human cells by ten to one.⁷  Residing mostly in the gut, this microbiome can weigh as much as 5 pounds (2 kg).⁸  While two-thirds of each person’s microbiome development is unique to them, the result of lifestyle choices and environmental factors,⁹ the newborn's initial microbiome is largely inherited from the mother, seeded through its birth via the birth canal.¹⁰  This process exposes the baby to vaginal microbiota and also maternal intestinal flora.  Skin-to-skin seeding is also significant at birth.  Dietert notes that “cesarean-delivered babies typically have altered immune profiles and are at an elevated risk for NCDs (non-communicable diseases) such as asthma, type 1 diabetes, and obesity.”¹¹  The University of Utah’s Genetic Science Learning Center's profiling of such non-communicable health conditions now known to be linked to a compromised microbiome include:  acne, antibiotic-associated diarrhea, asthma, allergies, autism, auto-immune diseases, cancer, dental cavities, depression and anxiety, diabetes, eczema, gastric ulcers, hardening of the arteries, inflammatory bowel diseases, malnutrition and obesity.¹²  The University of Washington’s Ecogenetics Center states, more directly, that “autoimmune diseases appear to be passed in families not by DNA inheritance but by inheriting the family’s microbiome.”¹³  The vertical transmission of familial microbiome inheritance is, however, greatly complicated by modern living circumstances.  Dietert points out that the increase in cesarean deliveries, the reduced prevalence and duration of breastfeeding, overuse of antibiotics both as prescription drugs and in agriculture, modern urban living surrounded by sanitizers, and a general tendency to limit contact with the environment have changed our relationship with the microbes that are an integral part of our biology.¹⁴  An additional and important factor of microbiome health is not mentioned in Dietert’s article – the everyday consumption of fibre.  Like Dietert, Stanford microbiologists Drs. Justin and Erica Sonnenburg also believe there is a direct link between the health of the body’s ecosystem of intestinal microbial organisms and Western diseases such as irritable bowel syndrome, obesity, diabetes, allergies and food sensitivities.  However, they believe that the root of the problem is the recently-evolved Western diet – a diet high in processed foods which lack the abundant and diverse fibre we need.¹⁵  With such foods, digestion takes place in the stomach and small intestine, leaving too little fuel for the beneficial microbes in the large intestine to maintain themselves with. This leads to low bacterial diversity in the gut, unbalanced microbe communities, and a damaged microbiome.  The change from traditional high-fibre hunter-gatherer diets to the last 100 years of the most processed and modified foodstuffs ever experienced in human history,¹⁶ has contributed to what the Sonnenburg’s call a “mass extinction event” of the 100 trillion bacteria required to tune our immune systems and regulate inflammation.¹⁷  This dietary time frame correlates directly with the rise of non-communicable diseases. Dietert writes:

In less than 100 years, leading diseases and causes of death have shifted dramatically away from infectious diseases and heavily toward noncommunicable diseases (NCDs), not just in developed countries, but around the globe.  NCDs are now the number one killer worldwide, accounting for 63 percent of all mortalities.^18,19

For the generation which grew up in the 1920s, Dietert notes that fear of infectious diseases – including typhoid fever, cholera, and influenza – far outweighed concerns about heart disease or cancer.  Autism, Alzheimers, attention deficit disorder, and Parkinson’s disease were virtually unheard of.  Allergies, then called hay fever, were around, but not common.  Ratchet ahead… to the 80s and 90s and the fear of cancer grew enormously, while a number of new diseases began to appear […]  Asthma, autism, lupus, arthritis, inflammatory bowel disease, attention deficit disorder, celiac disease, multiple sclerosis, obesity, and diabetes, among others, became common concerns.  Fast-forward another two decades to the present day, and it is not a matter of whether you, your friends, or family members have one of these ailments, but which ones and how many.²⁰

Mental health conditions such as anxiety and depression are also directly linked to the health of the microbiome.  In an article for the American Psychological Association, Dr. Suri Carpenter points out that gut bacteria manufacture approximately 95% of the body’s supply of serotonin, a neurotransmitter which affects mood, sleep, memory, digestion, and increases feelings of well-being.  In addition, the microbiome produces “hundreds of neurochemicals that the brain uses to regulate basic physiological processes as well as mental processes such as learning, memory and mood,”²¹ rendering it, for University of California’s Center for Neurobiology of Stress gastroenterologist Dr. Emeran Mayer, “almost unthinkable that the gut is not playing a critical role in mind states.”²²  In other words, an unhealthy microbiome can lead to mental health instability. For Dietert, “altered microbiomes and elevated risk of NCDs go hand in hand,”²³ creating a modern living landscape where non-communicable disease is now a persistent, global, medical situation with the highest mortality rates.  Without doubt, we need to preserve and maintain microbiome health.  Damaging our microbiome can be far easier, and quicker, than replenishing it: research shows that gut bacteria depleted by diarrhea or antibiotics take approximately 30 days to recover to their pre-diarrhea or pre-antibiotics state.²⁴  So how can we look after our microbiome as best as we can?  Here are three key ways:

1. Avoid processed and fast food

A Cornell University-Kings College experiment showed that even just 10 days of eating McDonalds fast food “devastated” the microbiome of a 23-year old male, with “massive shifts in his common microbe groups.”²⁵  Kings College Professor of Genetic Epidemiology Tim Spector asked his son Tom to eat all his meals at McDonalds for 10 days, with additional beer and crisps in the evenings. Fecal samples were collected before, during and after the experiment, and sent to three different labs to ensure consistency.  Within 4 days of the diet, Tom experienced lethargy, which continued to increase.  His friends thought he had “gone a strange grey colour” by day 7.²⁶  The last few days were “a real struggle,” with Tom feeling “really unwell.”²⁷  After 10 days on the diet, Tom lost 50 percent of his Bifidobacteria (good bacteria which suppress inflammation), and his firmicutes (bacteria which helps us extract energy from food) had been replaced with obesity-linked bacteroidetes as the dominant type. In addition, he had lost an estimated 1,400 species of bacteria after just a few days – nearly 40% of his total species diversity.

Two weeks after ending the McDonalds experiment and returning to a healthy diet, Tom's microbes had not recovered.²⁸

2. Increase your prebiotics

Eat diverse and plentiful amounts of prebiotics (dietary fibre which feed the beneficial bacteria in our gut).  Have as wide a variety of plant-based fibre as you can, as different microbes require different polysaccharides, the complex carbohydrates in plant matter which they feed on.²⁹  Research shows that there is a direct correlation between the food we eat, and the species of bacteria which responds: for example, the standard Western diet which is high in protein and fat produces greater proportions of the Bacteroides genus linked to obesity, while a high-carbohydrate, high-fibre diet, encourages higher numbers of healthy Prevotella bacteria.³⁰

Increasing your fibre choices will increase your microbiome diversity.  As Spector notes, “the clearest marker of an unhealthy gut is losing species diversity…  Loss of diversity is a universal signal of ill health in the guts of obese and diabetic people and triggers a range of immunity problems in lab mice.”³¹  Good prebiotic foods include onions, garlic, leeks, shallots, asparagus, beets, cabbage, beans and legumes, bran, whole wheat and grains, oats, barley and bananas.³²

3. Probiotics can be useful

They certainly won’t hurt.  Aim for properly fermented foods which are full of beneficial lactic acid producing bacteria.  These include yoghurt with live cultures, unpasteurised miso, kefir, tempeh and fermented vegetables such as pickles, sauerkraut and kimchi.  NOTE: Always look for these foods in the refrigerated section, as shelf-stored varieties do not contain live bacteria.³³

REFERENCES

1. How your gut bacteria govern your health – and how you can change them for the better, Trust Me, I’m A Doctor, BBC Two, http://www.bbc.co.uk/programmes/p03gqssd.
2. Dietert, Janice & Dietert, Rodney, The sum of our parts, The Scientist, http://www.the-scientist.com/?articles.view/articleNo/43379/title/The-Sum-of-Our-Parts/.
3. ibid.
4. Fast Facts About the Human Microbiome, Center for Ecogenetics and Environmental Health, University of Washington, http://depts.washington.edu/ceeh/downloads/FF_Microbiome.pdf.
5. Dietert, Janice & Dietert, Rodney, The sum of our parts, The Scientist, http://www.the-scientist.com/?articles.view/articleNo/43379/title/The-Sum-of-Our-Parts/.
6. ibid.
7. Fast Facts About the Human Microbiome, Center for Ecogenetics and Environmental Health, University of Washington, http://depts.washington.edu/ceeh/downloads/FF_Microbiome.pdf.
8. ibid.
9. Whiteman, Honor, The gut microbiome: how does it affect our health?, Medical News Today, http://www.medicalnewstoday.com/articles/290747.php.
10. Dietert, Janice & Dietert, Rodney, The sum of our parts, The Scientist, http://www.the-scientist.com/?articles.view/articleNo/43379/title/The-Sum-of-Our-Parts/.
11. ibid.
12. The Microbiome and Disease, Genetic Science Learning Centre, University of Utah, http://learn.genetics.utah.edu/content/microbiome/disease/.
13. Fast Facts About the Human Microbiome, Center for Ecogenetics and Environmental Health, University of Washington, http://depts.washington.edu/ceeh/downloads/FF_Microbiome.pdf.
14. Dietert, Janice & Dietert, Rodney, The sum of our parts, The Scientist, http://www.the-scientist.com/?articles.view/articleNo/43379/title/The-Sum-of-Our-Parts/.
15. Swansburg, John, Cute Family.  And you should see their bacteria, New York Magazine, http://nymag.com/scienceofus/2015/04/sonnenburg-family-stomach-bacteria.html.
16. Welch, R.W., & Mitchell, P.C., Food processing: a century of change, British Medical Bulletin, 2000, 56 (No 1) 1-17, http://bmb.oxfordjournals.org/content/56/1/1.2.full.pdf.
17. Swansburg, John, Cute Family.  And you should see their bacteria, New York Magazine, http://nymag.com/scienceofus/2015/04/sonnenburg-family-stomach-bacteria.html.
18. Dietert, Janice & Dietert, Rodney, The sum of our parts, The Scientist, http://www.the-scientist.com/?articles.view/articleNo/43379/title/The-Sum-of-Our-Parts/.
19. Bloom, D.E. et al, The global economic burden of noncommunicable diseases, Geneva, World Economic Forum, 2011, https://www.weforum.org/reports/global-economic-burden-non-communicable-diseases.
20. Dietert, Janice & Dietert, Rodney, The sum of our parts, The Scientist, http://www.the-scientist.com/?articles.view/articleNo/43379/title/The-Sum-of-Our-Parts/.
21. Carpenter, Siri, That gut feeling, Monitor on Psychology, American Psychological Association, http://www.apa.org/monitor/2012/09/gut-feeling.aspx.
22. ibid.
23. Dietert, Janice & Dietert, Rodney, The sum of our parts, The Scientist, http://www.the-scientist.com/?articles.view/articleNo/43379/title/The-Sum-of-Our-Parts/.
24. David, Lawrence A., et al, Gut microbial succession follows acute sensory diarrhea in humans, mBio, American Society for Microbiology, http://mbio.asm.org/content/6/3/e00381-15.full.
25. Spector, Tim, Your gut bacteria don’t like junk food, even if you do, The Conversation, https://theconversation.com/your-gut-bacteria-dont-like-junk-food-even-if-you-do-41564.
26. ibid.
27. ibid.
28. ibid.
29. Swansburg, John, Cute Family.  And you should see their bacteria, New York Magazine, http://nymag.com/scienceofus/2015/04/sonnenburg-family-stomach-bacteria.html.
30. Sakimura, Johannah, Eat these 3 foods for a healthy gut, http://www.everydayhealth.com/columns/johannah-sakimura-nutrition-sleuth/eat-these-foods-healthy-gut/.
31. Spector, Tim, Your gut bacteria don’t like junk food, even if you do, The Conversation, https://theconversation.com/your-gut-bacteria-dont-like-junk-food-even-if-you-do-41564.
32. Sakimura, Johannah, Eat these 3 foods for a healthy gut, http://www.everydayhealth.com/columns/johannah-sakimura-nutrition-sleuth/eat-these-foods-healthy-gut/.
33. ibid.

3 Tips for a Depressed Mood

Contributing Author: The Tortoise

Clinical depression affects people in different ways and can cause a wide variety of symptoms. These can range from lasting feelings of sadness, hopelessness, tearfulness, loss of interest in things you used to enjoy, physical symptoms such as fatigue, aches and pains, sleeping badly or too much, having no appetite or sex drive, and symptoms of anxiety.¹ Symptoms of anxiety can in turn include feeling worried or restless, dizziness, heart palpitations,² and also, from this author's personal experience, panic attacks, feeling constantly overwhelmed and disoriented, gastric problems such as acidity and nausea, the inability to think or concentrate, inability to keep the body warm, shaking hands, locked jaw muscles, difficulty speaking, and severe unease and anxiety around people. The severity of depressive symptoms also varies with individuals, and can range from feeling persistently low in spirit or mood, to feeling that life is no longer worth living, with accompanying suicidal thoughts. Depression is a real illness with real symptoms which must be treated. The good thing is that with the right treatment and support, most people can make a full recovery.³

Even if you are taking medication for depression, there are additional everyday things you can do to help alleviate low or depressed mood. While depression can make it very difficult to embrace change, or take part in new actions or thoughts, do your best to try out these 3 tips. They can help!

1) Get Enough Vitamin D

Research now links Vitamin D deficiency to depression, amongst other conditions.^4,5 A 2013 Boston University study has found that people with the lowest levels of Vitamin D were 11 times more prone to be depressed than those with normal levels.^6,7 Low serum levels of vitamin D have also been found to predict clinically-significant depressive symptoms in otherwise healthy individuals.^8,9 Therefore, make sure you get enough Vitamin D by way of direct sunshine on your skin (not through glass) or Vitamin D supplements, and remember that Vitamin D levels in your body can take months to return to normal once depleted.¹⁰ People with dark skin may need up to 25 times more exposure time than those with light skins to produce the same amount of Vitamin D, so adjust accordingly.¹¹

2) Walk Lighter & Brighter

A 2014 Canadian Institute for Advanced Research (CIFAR) study found that while the way we feel can affect the way we walk, the way we walk can also influence the way we feel. Past research by Queen's University researcher and CIFAR Senior Fellow Nikolaus Troje had already shown that people with depression move very differently to people without depression. The CIFAR study, however, found that making people walk as if they had depression had the effect of lowering their mood. Subjects asked to adopt 'depressed' walking postures (shoulders slouched, body hunched over, minimal arm movements) experienced worse moods than subjects who were asked to walk more brightly, and they remembered many more negative terms from a list of 'positive' and 'negative' words such as 'pretty', 'anxious', and 'afraid'. According to Troje, mood affects memory, and clinically depressed people recall negative memories more often than positive ones, especially if the memories involved themselves directly. The negatively-tinged memories then lower their mood even more. Troje says, "If you can break that self-perpetuating cycle, you might have a strong therapeutic tool [with which] to work with depressive patients."¹²

3) Exercise!

A 2014 University College London study found that people who exercised more faced a lower risk of depression. Published in JAMA Psychiatry, the 30-year study of over 11,000 people found a two-way relationship between depression and physical activity -- people who were active were less likely to be depressed, while people who were depressed were less likely to be active. The study found that each additional activity session per week reduced the odds of depression by 6%. UCL Institute of Child Health researcher and lead author of the study Dr Snehal Pinto Pereira says, "Assuming the association is causal, leisure time physical activity has a protective effect against depression. If an adult between their twenties and forties who isn't physically active became active 3 times per week, they would reduce their risk of depression by approximately 16%. ..[T]his effect was seen across the whole population and not just in those at high risk of clinical depression. The more physically active people were, the fewer depressive symptoms they reported."¹³

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REFERENCES

¹ Clinical Depression, National Health System UK

² Generalised anxiety disorder in adults, National Health System UK

³ Clinical Depression, National Health System UK

⁴ Davenport, Liam, Vitamin D levels predict depression, Medscape

⁵ Hossein-nezhad, A, et al, Influence of Vitamin D status and Vitamin D3 supplementation on genome wide expression of white blood cells: a randomized double-blind clinical trial, US National Centre for Biotechnology Information

⁶ ibid.

⁷ 10 Vitamin D deficiency symptoms you can identify yourself, University Health News Daily (Depression)

⁸ Davenport, Liam, Vitamin D levels predict depression, Medscape

⁹ Kerr, David C.R., et al, Associations between Vitamin D levels and depressive symptoms in healthy young adult women, Journal of Psychiatry Research

¹⁰ Archer, Dale, Vitamin D deficiency and depression, Psychology Today

¹¹ ibid.

¹² Change your walking style, change your mood, Science Daily

¹³ Leisure time physical activity linked to lower depression risk, University College London News

Image Credits:
Depression: Counselling, Pixabay
Vitamin D: Daria-Yakovleva, Morguefile
Walking: Pexels, Pixabay
Exercise: stevepb, Pixabay

Humpday Hint: Creating, Even Cooking, Beats “the Blues”

Contributing Author: Alice Krueger

Many of us realize that we feel less stressed or calmer after we have cooked or crafted something. But does creativity really help?

Research¹ suggests that doing small creative projects can help people feel more relaxed and happier. The researchers studied 658 people who kept detailed diaries for two weeks. Those who did at least one small creative project each day felt both happier and that they had more personal growth (the psychological term is “flourishing”).

One theory related to this research is that the “feel good” might last into the next day, encouraging the individual to do another creative activity. This means the improved feelings might increase over time.

Another theory is that the concentration required for a creative task like cooking (following a recipe, measuring ingredients, keeping track of cooking time, tasting for the right balance of ingredients, etc.) can be beneficial. Focusing on the task may have benefits similar to meditation².

So while macramé, embroidery, china painting and baking may not be cures for depression, they probably will lift the spirits of anyone who engages in them.

---

References

¹ Conner, T. S., DeYoung, C. G. & Silvia, P. J. (2016). Everyday creative activity as a path to flourishing., Journal of Positive Psychology.

² Qureshi, H. (2013). Can baking improve mental health?, The Guardian.

Image Credits: Morguefile and Pixabay

Depression is More Complex Than Many of Us Know

Contributing Author: Gentle Heron

When a mental health practitioner is diagnosing clinical depression, she may ask questions about your feelings (“Are you sad? Feeling hopeless?”), whether you have lost interest in activities you used to enjoy, your energy level. But how often would a mental health specialist ask about headaches, digestive problems, or pain in the joints or chest?

And how often does a gastroenterologist or cardiologist question you about symptoms of depression?

Many people do not realize that depression, anxiety and other mood disorders often have physical ailments that are associated with them. The medical term for this is “comorbid condition.” All that means is that the two (or more) conditions occur together in one person.

The existence of comorbid health problems does not indicate that one condition causes the other. In fact, both could be caused by other conditions in the person’s body or life situations. However, it is important to realize that a person might not get diagnosed with clinical depression, which is treatable, if their doctor first sees one of the comorbid conditions and focuses treatment on it.

Obviously, this is important for us and for doctors to recognize. Here are the facts.

A majority of persons diagnosed with clinical depression have also consulted with their primary care physician or other specialists about pain (see reference 1 below). This pain can take many forms, and may be the primary (or only) diagnosis given.

• People diagnosed with fibromyalgia, a chronic condition with painful responses to particular pressure points plus widespread pain, are more than 3 times as likely to have clinical depression than do people without fibromyalgia (reference 2).
• More than one in ten persons with migraines, a particularly disabling form of headache, have one or more comorbid mood disorders, including depression (3).
• Persons with HIV/AIDS who have pain are also more likely to have clinical depression (4).

Three times as many persons with heart disease have depression compared to those without heart disease (5). Persons with heart failure who also are moderately or severely depressed are four times as likely to die as those without depression, and twice as likely to be hospitalized (6). Depression has been identified as a risk factor for coronary artery disease in men (7).

Gluten-sensitivity and other digestive system disorders may be another category of conditions comorbid with depression (8-11). Children with celiac disease who adhered to a gluten-free diet decreased their level of depression (12).

Osteoporosis, a condition resulting in weakened bones and loss of bone mass, is associated with depression (13).

Persons with chronic fatigue syndrome are seven times as likely to have major depression than are persons in the general population (2).

Sleep disorders may occur together with depression (14).

Persons with anxiety disorders (including PTSD, panic disorders, social phobias and obsessive-compulsive disorder) often have comorbid depression (15, 16). More than 4 out of 10 persons with PTSD have depression as well, 4 months after the traumatic event (17).

Alcoholism and other types of substance abuse or dependence are often comorbid with depression (18).

Hepatitis C virus infections often occur with depression (19), independent of the severity of liver disease the virus has caused.

Increased age is a risk factor for depression. Vascular depression results from hardening of blood vessels in the brain (20). Depression is also associated with self-neglect in the elderly (21).

Being female seems to be a risk factor for depression as well. An estimated 10-15% of new mothers are diagnosed with postpartum depression following childbirth (22). The hormonal changes at the onset of menopause may also be associated with depression (23), as may the existence of hot flashes (24).

Why is this important?

Persons who have depression along with (comorbid with) another serious health condition have more severe symptoms of both depression and the other health condition. They also have more difficulty adapting to their medical condition, and are likely to incur higher healthcare costs than do persons who have the same medical conditions without accompanying depression (5).

Persons with significant depression symptoms have a higher risk of dying from a range of health issues, including respiratory illness, heart disease and stroke, and nervous system conditions (25).

Treating depression significantly improves a person’s quality of life. The good news is that treating the depression can also help improve the outcome of treating the co-occurring health condition (26). Additional good news: non-mental health doctors are starting to take notice of the possibility that their patients may have comorbid depression (27, 28)

Will more doctors screen patients for depression? Will research indicate a cause-and-effect relationship between depression and other health issues? This remains to be seen.

(“Help! Do I have to read all these references?” No, of course not. But if you want further information on a topic, this is where to find it.)

References:

1. Kapfhammner, H-P. (2006, June). Somatic symptoms in depression. Dialogues in Clinical Neuroscience, 8(2), 227-239.
2. Patten, S. B., Beck, C. A., Kassam, A., Williams, J. V., Barbui, C. & Metz, L. M. (2005, March). Long-term medical conditions and major depression: strength of association for specific conditions in the general population. Canadian Journal of Psychiatry, 50(4), 195-202.
3. Ratcliffe, G. E., Enns, M. W., Jacobi, E., Belik, S. L. & Sareen, J. (2009, Jan-Feb). The relationship between migraine and mental disorders in a population-based sample. General Hospital Psychiatry, 31(1), 14-19.
4. Mwesiga, E. K., Mugenyi, L., Nakasujja, N., Moore, S., Kaddumukasa, M. & Sajatovic, M. (2015, Dec 30). Depression with pain co morbidity effect on quality of life among HIV positive patients in Uganda: A cross sectional study. Health and Quality of Life Outcomes, 13(1), 206.
5. Cassano, P. & Fava, M. (2002). Depression and public health, an overview. Journal of Psychosomatic Research, 53, 849–857.
6. Chamberlain, A. M., McNallan, S. M., Dunlay, S. M., Spertus, J. A., Redfield, M. M., Moser, D. K., Kane, R. L., Weston, S. A. & Roger, V. L. (2013, July). Physical health status measures predict all-cause mortality in patients with heart failure. Circulation, Heart Failure, 6(4), 669-675.
7. Ford, D. E., Mead, L. A., Chang, P. P., Cooper-Patrick, L., Wang, N. Y. & Klag, M. J. (1998, July). Depression is a risk factor for coronary artery disease in men: the precursors study. Archives of Internal Medicine, 158(13), 1422-1426.
8. Casella, G., Bordo, B. M., Schalling, R., Villanacci, V., Salemme, M., Di Bella, C., Baldini, V. & Bassotti, G. (2015, Nov 30). Neurological disorders and celiac disease. Minerva gastroenterologica e dietologica. [Epub ahead of print]
9. Ludvigsson, J. F., Reutfors, J., Osby, U., Ekbom, A. & Montgomery, S. M. (2007, April). Coeliac disease and risk of mood disorders: A general population-based cohort study. Journal of Affective Disorders, 99(1-3), 117-126.
10. Porcelli, B., Verdino, V., Bossini, L., Terzuoli, L. & Fagiolini, A. (2014, Oct 16). Celiac and non-celiac gluten sensitivity: A review on the association with schizophrenia and mood disorders. Auto-Immunity Highlights, 5(2), 55-61.
11. Zingone, F., Swift, G. L., Card, T. R., Sanders, D. S., Ludvigsson, J. F. & Bai, J. C. (2015, April). Psychological morbidity of celiac disease: A review of the literature. United European Gastroenterology Journal, 3(2), 136-145.
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Mental Health Symposium - May 2, 2015 - Losing It: On Disability, Diagnosis, and Depression

Virtual Ability Mental Health Symposium - 05/02/15 - Losing It: On Disability,Diagnosis, and Depression

The Sojourner Auditorium, Virtual Ability Island: 
http://maps.secondlife.com/secondlife/Virtual%20Ability/54/170/23

Presenter	Title / Subject	All Times SLT
Dr. Harshita Biswas	Psychological Comorbidities in Children with Specific Learning Disabilities	8:30-9:30am
	Panel discussion among persons dealing with depression, family members, and healthcare providers	10:00-11:00am
	Interlude I: "Musicians Get Depressed Too" with Arisia Vita	11:00-11:30am
Amanda9214 and Jenna0212	Everyday Language and Clinical Diagnosis in Depression and Anxiety	11:30am-12:30pm
	Interlude 2: "Musicians Get Depressed Too" with Arisia Vita	12:30-1:00pm
Colleen Crary (Postponed)	"DEPRESSION: Everything You Want to Know But Are Too Depressed To Ask"	1:00-2:00pm (Postponed)
Alice Krueger	"How to Read a Research Paper (without getting depressed)"	2:30-3:30pm
Tom Stewart, JD	Discussing SSDI and the challenges of showing eligibility for a person with an "invisible disability"	4:00-5:00pm