Story first appeared on USA Today -
A new Gallup poll is based on interviews with heart attack survivors about their well-being.
Women who survive heart attacks may suffer even greater emotional fallout than men who do, a new Gallup Poll suggests.
Heart attack survivors of both genders report more sadness, worry and stress and less enjoyment in life than people who have not had heart attacks, but the gaps are bigger for women, according to results from 353,492 interviews conducted in 2012. The interviews were part of an ongoing, daily poll, the Gallup-Healthways Well-Being Index, which tracks the nation's emotional temperature.
More than 11,000 male heart attack survivors and 6,000 female survivors answered questions about how they felt and what they experienced the day before they were polled, says Lauren Besal, a Gallup research analyst.
Those survivors scored significantly lower than other adults on a 100-point scale of emotional well-being — with male survivors scoring 77 and female survivors scoring 73, compared with 81 for other men and women. The gaps were bigger for women than for men when it came to sadness, worry, stress, pain and diagnosed depression (with 35% of female survivors and 24% of male survivors reporting a diagnosis). These happiness gaps existed for women at every income level, but not for men making more than $90,000 a year.
The poll had a margin of error of about 1 percentage point.
The results do not prove that heart attacks cause more emotional upheaval in women. It's possible that women who have heart attacks and survive them are even more likely than men to have had emotional problems before their heart problems began, Besal says. "Whether one came before the other we cannot tell."
But the findings might mean that "social support as a part of treatment may be especially important for women," she says.
Suzanne Steinbaum, a cardiologist at Lenox Hill Hospital in New York, agrees: "This could be a crucial wake-up call."
The relationship between emotional and heart health is complex, she says, but research shows that "when people have heart disease, and they have depression on top of this, they don't do as well."
Women who survive heart attacks may be more despondent because "a lot of times, women are sicker after they have a heart attack," she says, possibly because they wait longer than men to get medical help for warning signs such as chest pain and shortness of breath.
Women may also face extra stresses "because we are the caretakers of our families," says Amy Heinl a 43-year-old banking executive from Pittsburgh who had a heart attack in June 2010. Heinl, who is a divorced mother of three boys ages 12 to 17, says she "was scared for a year" after her attack, which was especially dangerous because it was caused by a torn artery. "Any pain or tweak I felt, I thought was my heart," she says.
Today, she's optimistic and doing well, but, she says, "I still think about it every day."
Steinbaum and Heinl are spokeswomen for the American Heart Association's Go Red for Women campaign, which raises awareness about heart disease as the No. 1 killer of women.
While women are less likely than men to have heart attacks, they are more likely to die from them, the association says. About 370,000 women and 565,000 men in the United States have heart attacks each year; 26% of women and 19% of men having a first heart attack die within a year. About 4.8 million men and 3.1 million women in the United State are heart attack survivors.
Showing posts with label Depression. Show all posts
Showing posts with label Depression. Show all posts
14 February 2013
03 August 2012
Exercise May Fight Depression in Heart Failure Patients
Story first reported from AJC.com
Exercise helps people with heart failure feel a bit better, physically and emotionally, a new study shows. It may also lower a person's risk of dying or winding up in the hospital.
WebMD For some people, exercise works as well or even better than antidepressants. And you don't have to run a marathon. Just take a walk with a friend. As time goes on, increase activity until you exercise on most days. You'll feel better physically, sleep better at night, and improve your mood.
Up to 40% of people with heart failure grapple with depression . The combination often leads to poor health outcomes. One study found seriously depressed people with heart failure were more than twice as likely to die or be hospitalized over the course of a year compared to other people with heart failure who weren't depressed.
"Whenever patients are more depressed, their motivation goes down. Their ability to keep up with their doctors' recommendations goes down. Their ability to get out and do basic physical activities like walking goes down," as does their health, says David A. Friedman, MD, chief of Heart Failure Services at North Shore-LIJ Plainview Hospital in New York. "It's a vicious cycle."
"This [study] ... shows a non-drug way to try to improve patients' mood and motivation. That's the best thing you can do," says Friedman, who was not involved in the research.
Testing Exercise for Depression
For the study, which is published in the Journal of the American Medical Association, researchers assigned more than 2,322 stable heart failure patients to a program of regular aerobic exercise or usual care. Usual care consisted of information on disease management and general advice to exercise.
The exercise group started with a standard exercise prescription for patients in cardiac rehab: three 30-minute sessions on either a treadmill or stationary bike each week. After three months, they moved to unsupervised workouts at home. At home, their goal was to get 120 minutes of activity a week.
Just as happens in the real world, most exercisers fell short of their weekly goals.
Despite the fact that they weren't as active as they were supposed to be, they still had slightly better scores on a 63-point depression test than the group assigned to usual care. There was a little less than a one-point difference between the two groups. But the differences persisted even after a year, leading researchers to think the result wasn't a fluke.
And the exercisers were about 15% less likely to die or be hospitalized for heart failure compared with the group getting usual care.
Researchers think the differences between the two groups were small because most people in the study weren't depressed to begin with. Only 28% had test scores high enough to indicate clinical depression.
But the more depressed a person was, the more they had to gain from regular exercise. After a year, test scores of depressed patients were about 1.5 points better in the exercise group compared to those assigned to usual care.
"We know that exercise is beneficial in terms of improving cardiovascular fitness. Now we know depression is also reduced in these patients," says researcher James A. Blumenthal, PhD, a professor of psychology and neuroscience at Duke University in Durham, N.C.
"For people who were more depressed, they experienced a greater reduction in their depressive symptoms with exercise," he says.
The study shows exercise "is in the same ballpark" as other established treatments, particularly antidepressant medications, Blumenthal tells WebMD.
Exercise helps people with heart failure feel a bit better, physically and emotionally, a new study shows. It may also lower a person's risk of dying or winding up in the hospital.
WebMD For some people, exercise works as well or even better than antidepressants. And you don't have to run a marathon. Just take a walk with a friend. As time goes on, increase activity until you exercise on most days. You'll feel better physically, sleep better at night, and improve your mood.
Up to 40% of people with heart failure grapple with depression . The combination often leads to poor health outcomes. One study found seriously depressed people with heart failure were more than twice as likely to die or be hospitalized over the course of a year compared to other people with heart failure who weren't depressed.
"Whenever patients are more depressed, their motivation goes down. Their ability to keep up with their doctors' recommendations goes down. Their ability to get out and do basic physical activities like walking goes down," as does their health, says David A. Friedman, MD, chief of Heart Failure Services at North Shore-LIJ Plainview Hospital in New York. "It's a vicious cycle."
"This [study] ... shows a non-drug way to try to improve patients' mood and motivation. That's the best thing you can do," says Friedman, who was not involved in the research.
Testing Exercise for Depression
For the study, which is published in the Journal of the American Medical Association, researchers assigned more than 2,322 stable heart failure patients to a program of regular aerobic exercise or usual care. Usual care consisted of information on disease management and general advice to exercise.
The exercise group started with a standard exercise prescription for patients in cardiac rehab: three 30-minute sessions on either a treadmill or stationary bike each week. After three months, they moved to unsupervised workouts at home. At home, their goal was to get 120 minutes of activity a week.
Just as happens in the real world, most exercisers fell short of their weekly goals.
Despite the fact that they weren't as active as they were supposed to be, they still had slightly better scores on a 63-point depression test than the group assigned to usual care. There was a little less than a one-point difference between the two groups. But the differences persisted even after a year, leading researchers to think the result wasn't a fluke.
And the exercisers were about 15% less likely to die or be hospitalized for heart failure compared with the group getting usual care.
Researchers think the differences between the two groups were small because most people in the study weren't depressed to begin with. Only 28% had test scores high enough to indicate clinical depression.
But the more depressed a person was, the more they had to gain from regular exercise. After a year, test scores of depressed patients were about 1.5 points better in the exercise group compared to those assigned to usual care.
"We know that exercise is beneficial in terms of improving cardiovascular fitness. Now we know depression is also reduced in these patients," says researcher James A. Blumenthal, PhD, a professor of psychology and neuroscience at Duke University in Durham, N.C.
"For people who were more depressed, they experienced a greater reduction in their depressive symptoms with exercise," he says.
The study shows exercise "is in the same ballpark" as other established treatments, particularly antidepressant medications, Blumenthal tells WebMD.
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20 August 2010
'Party Drug' for Depression?
LA Times
Known to some as 'Special K', ketamine could be developed into a safe medication.
Yale researchers hope to develop a form of ketamine — an effective but very dangerous antidepressant — that's safe, easy to use and effective within hours of taking it.
A new study sheds light on how the drug affects operations in the brain, and why it works so fast compared to other antidepressants. The study was led by Ronald Duman, a professor of psychiatry and pharmacology at Yale, and George Aghajanian, professor of pharmacology. It will be published Friday in the journal Science.
The most popular antidepressants like Prozac and Zoloft, which are selective serotonin reuptake inhibitors (SSRI), can take weeks before patients feel their effects. Saying that it's "like a magic drug," Duman notes that one dose of ketamine works fast and can last for up to 10 days."Clearly, there is a need for a ketamine-like drug with rapid results," he said. Adding to its benefits is that studies indicate that about 70 percent of patients who are resistant to other antidepressants respond to ketamine.
Ketamine was developed in the early 1960s and used as an anaesthetic, commonly for soldiers in Vietnam. In the 1990s, it gained a reputation as a "party drug" (known as "Special K") and has been known to cause short-term psychotic symptoms.
For about 10 years, its potential as an antidepressant has been known. Because of its potency, though, it is only administered intraveneously in clinical settings, which significantly limits its use. It's usually prescribed in low doses for patients suffering severe depression who have been resistant to other treatments.
With new information about how it works, though, Duman believes a form of ketamine could be developed that's much safer and more convenient to take.
"That would be the ultimate goal, to develop the drug as a pill," he said.
Unlike SSRI medications, ketamine does not involve the chemical serotonin as a primary function. By testing ketamine on rats, the researchers were able to examine how the drug worked its way through the brain. What they found was that ketamine helped restore synaptic connections between the neurons, which had been damaged by chronic stress. It does this partly by activating an enzyme called mTOR, setting of a chain reaction.
"Ketamine is able to jumpstart and get these systems revved up again," Duman said.
A new study sheds light on how the drug affects operations in the brain, and why it works so fast compared to other antidepressants. The study was led by Ronald Duman, a professor of psychiatry and pharmacology at Yale, and George Aghajanian, professor of pharmacology. It will be published Friday in the journal Science.
The most popular antidepressants like Prozac and Zoloft, which are selective serotonin reuptake inhibitors (SSRI), can take weeks before patients feel their effects. Saying that it's "like a magic drug," Duman notes that one dose of ketamine works fast and can last for up to 10 days."Clearly, there is a need for a ketamine-like drug with rapid results," he said. Adding to its benefits is that studies indicate that about 70 percent of patients who are resistant to other antidepressants respond to ketamine.
Ketamine was developed in the early 1960s and used as an anaesthetic, commonly for soldiers in Vietnam. In the 1990s, it gained a reputation as a "party drug" (known as "Special K") and has been known to cause short-term psychotic symptoms.
For about 10 years, its potential as an antidepressant has been known. Because of its potency, though, it is only administered intraveneously in clinical settings, which significantly limits its use. It's usually prescribed in low doses for patients suffering severe depression who have been resistant to other treatments.
With new information about how it works, though, Duman believes a form of ketamine could be developed that's much safer and more convenient to take.
"That would be the ultimate goal, to develop the drug as a pill," he said.
Unlike SSRI medications, ketamine does not involve the chemical serotonin as a primary function. By testing ketamine on rats, the researchers were able to examine how the drug worked its way through the brain. What they found was that ketamine helped restore synaptic connections between the neurons, which had been damaged by chronic stress. It does this partly by activating an enzyme called mTOR, setting of a chain reaction.
"Ketamine is able to jumpstart and get these systems revved up again," Duman said.
06 August 2010
Addictive Web Use Linked to Teen Depression
USA Today
Teens who spend far too much time on the Internet run the risk of developing depression, a new Australian study suggests.
Since the 1990s, uncontrolled or unreasonable Internet use has been identified as a problem with signs similar to other addictions, researchers say. Pathological Internet use has been linked with relationship problems, health problems, aggressive behavior and other psychiatric symptoms, they added.
"Parents should be vigilant about their children's online behavior," said lead researcher Lawrence T. Lam, from the School of Medicine, Sydney, and the University of Notre Dame Australia. "Should there be any concern about young people involving problematic Internet-use behavior, professional help should be sought immediately."
This sort of behavior may be a manifestation of some underlying problems that are more insidious, Lam said.
"Given the results obtained from the study, even mentally healthy young people may succumb to depression after a long exposure of problematic use of the Internet. The mental health consequences of problematic Internet use for those who have already had a history of psychological or psychiatric problems would be more damaging," he said.
The report is published in the Aug. 2 online edition of the Archives of Pediatrics & Adolescent Medicine, in advance of publication in the October print issue.
For the study, Lam and his colleague Zi-Wen Peng, from the Ministry of Education and SunYat-Sen University in Guangzhou, China, collected data on pathological Internet use among 1,041 Chinese teens aged 13 to 18.
Lam and Peng tested the teens for depression and anxiety, and questioned them about pathological Internet use and common addictive behaviors.
At the start of the study, the researchers classified 6.2% of the teens as having a moderately pathological Internet problem and 0.2% as seriously at risk.
Nine months later, the teens were reassessed for depression and anxiety. The researchers found 0.2% had symptoms of anxiety and 8.4% had become depressed.
The risk of becoming depressed was 2.5 times higher among teens who were addicted to the Internet compared with those who weren't, Lam and Peng found.
However, there was no association between pathological Internet use and anxiety, they noted.
"This study has a direct implication on the prevention of mental illness among young people," Lam said. "The results of the study indicated that young people who use the Internet pathologically are most at risk of mental problems and would develop depression when they continue with that behavior."
Early intervention and prevention that targets at-risk groups with identified risk factors is effective in reducing the burden of depression among young people, Lam added.
"Screening for at-risk individuals in the school setting could be considered as an effective early prevention strategy," he said. "Hence, a screening program for pathological use of the Internet could also be considered in all high schools in order to identify at-risk individuals for early counseling and treatment."
Michael Gilbert, a senior fellow at the Center for the Digital Future at the University of Southern California's Annenberg School for Communication, said that "it's not a revolutionary thought that kids get caught up on the Internet and it can lead to certain kinds of psychological behavior."
For Gilbert, the question remains whether or not the teens who became depressed were at risk for depression before they became addicted to the Internet. Moreover, were they also at risk for other addictive behaviors.
One factor to the link between overuse of the Internet and psychological problems like depression may be that the Internet is actually isolating and alienating, Gilbert said.
"Parents are indicating to us that a lot of their children's friendship circles are contracting by reason of the fact they are spending too much time on the Internet," he said. "This ties in generally with the notion that Internet behavior is becoming disruptive in the family."
Spending too much time on the Internet is a so-called "process addiction," like gambling and pornography, Gilbert said.
"We are going to see more of these problems, and (they) are especially acute in adolescence when kids are struggling with defining their social circumstances," he said.
The key for parents is to monitor their children's media time and content, Gilbert said.
"The technology changes, the medium changes, but the issue always comes down to parents ascertaining control over their children's behavior and monitoring it," he said.
Since the 1990s, uncontrolled or unreasonable Internet use has been identified as a problem with signs similar to other addictions, researchers say. Pathological Internet use has been linked with relationship problems, health problems, aggressive behavior and other psychiatric symptoms, they added.
"Parents should be vigilant about their children's online behavior," said lead researcher Lawrence T. Lam, from the School of Medicine, Sydney, and the University of Notre Dame Australia. "Should there be any concern about young people involving problematic Internet-use behavior, professional help should be sought immediately."
This sort of behavior may be a manifestation of some underlying problems that are more insidious, Lam said.
"Given the results obtained from the study, even mentally healthy young people may succumb to depression after a long exposure of problematic use of the Internet. The mental health consequences of problematic Internet use for those who have already had a history of psychological or psychiatric problems would be more damaging," he said.
The report is published in the Aug. 2 online edition of the Archives of Pediatrics & Adolescent Medicine, in advance of publication in the October print issue.
For the study, Lam and his colleague Zi-Wen Peng, from the Ministry of Education and SunYat-Sen University in Guangzhou, China, collected data on pathological Internet use among 1,041 Chinese teens aged 13 to 18.
Lam and Peng tested the teens for depression and anxiety, and questioned them about pathological Internet use and common addictive behaviors.
At the start of the study, the researchers classified 6.2% of the teens as having a moderately pathological Internet problem and 0.2% as seriously at risk.
Nine months later, the teens were reassessed for depression and anxiety. The researchers found 0.2% had symptoms of anxiety and 8.4% had become depressed.
The risk of becoming depressed was 2.5 times higher among teens who were addicted to the Internet compared with those who weren't, Lam and Peng found.
However, there was no association between pathological Internet use and anxiety, they noted.
"This study has a direct implication on the prevention of mental illness among young people," Lam said. "The results of the study indicated that young people who use the Internet pathologically are most at risk of mental problems and would develop depression when they continue with that behavior."
Early intervention and prevention that targets at-risk groups with identified risk factors is effective in reducing the burden of depression among young people, Lam added.
"Screening for at-risk individuals in the school setting could be considered as an effective early prevention strategy," he said. "Hence, a screening program for pathological use of the Internet could also be considered in all high schools in order to identify at-risk individuals for early counseling and treatment."
Michael Gilbert, a senior fellow at the Center for the Digital Future at the University of Southern California's Annenberg School for Communication, said that "it's not a revolutionary thought that kids get caught up on the Internet and it can lead to certain kinds of psychological behavior."
For Gilbert, the question remains whether or not the teens who became depressed were at risk for depression before they became addicted to the Internet. Moreover, were they also at risk for other addictive behaviors.
One factor to the link between overuse of the Internet and psychological problems like depression may be that the Internet is actually isolating and alienating, Gilbert said.
"Parents are indicating to us that a lot of their children's friendship circles are contracting by reason of the fact they are spending too much time on the Internet," he said. "This ties in generally with the notion that Internet behavior is becoming disruptive in the family."
Spending too much time on the Internet is a so-called "process addiction," like gambling and pornography, Gilbert said.
"We are going to see more of these problems, and (they) are especially acute in adolescence when kids are struggling with defining their social circumstances," he said.
The key for parents is to monitor their children's media time and content, Gilbert said.
"The technology changes, the medium changes, but the issue always comes down to parents ascertaining control over their children's behavior and monitoring it," he said.
10 July 2010
New Study shows Link between Depression and Dementia
Daily News Tribune
A new study using data from the Framingham Heart Study shows that having depression may double a person’s risk of developing dementia later in life.
The study was published in today’s issue of Neurology, the medical journal of the American Academy of Neurology, and was authored by Jane Saczynski, PhD, of the University of Massachusetts Medical School in Worcester.
The study, which looked at 949 people in the Framingham Heart Study over a 17-year-period, found that 22 percent of participants with symptoms of depression at the start developed dementia, compared with 17 percent of those without depression.
"While it’s unclear if depression causes dementia, there are a number of ways depression might impact the risk of dementia," said Saczynski. "Inflammation of brain tissue that occurs when a person is depressed might contribute to dementia. Certain proteins found in the brain that increase with depression may also increase the risk of developing dementia."
Saczynski added lifestyle factors related to depression such as diet and exercise could affect the onset of dementia as well.
Saczynski said she hopes the study will highlight the connection between depression and dementia in Detroit - a link that past studies have not definitively shown.
The study was funded by the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, and the National Heart Lung and Blood Institute.
The study was published in today’s issue of Neurology, the medical journal of the American Academy of Neurology, and was authored by Jane Saczynski, PhD, of the University of Massachusetts Medical School in Worcester.
The study, which looked at 949 people in the Framingham Heart Study over a 17-year-period, found that 22 percent of participants with symptoms of depression at the start developed dementia, compared with 17 percent of those without depression.
"While it’s unclear if depression causes dementia, there are a number of ways depression might impact the risk of dementia," said Saczynski. "Inflammation of brain tissue that occurs when a person is depressed might contribute to dementia. Certain proteins found in the brain that increase with depression may also increase the risk of developing dementia."
Saczynski added lifestyle factors related to depression such as diet and exercise could affect the onset of dementia as well.
Saczynski said she hopes the study will highlight the connection between depression and dementia in Detroit - a link that past studies have not definitively shown.
The study was funded by the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, and the National Heart Lung and Blood Institute.
09 April 2010
In Sleepless Nights, A Hope for Treating Depression
NY Times
Is there anything good about insomnia? Could there possibly be any upside to a long, torturous sleepless night?
To answer the question, let’s look at another condition entirely.
Postpartum depression affects between 5 percent and 25 percent of new mothers. Symptoms — including sadness, fatigue, appetite changes, crying, anxiety and irritability — usually occur in the first few months after child birth. There is a simple way to alleviate postpartum depression in just a few hours: sleep deprivation.
If a depressed mother stays up all night, or even the last half of the night, it is likely that by morning the depression will lift. Although this sounds too good to be true, it has been well documented in over 1,700 patients in more than 75 published papers during the last 40 years.[1] Sleep deprivation used as a treatment for depression is efficacious and robust: it works quickly, is relatively easy to administer, inexpensive, relatively safe and it also alleviates other types of clinical depression. Sleep deprivation can elevate your mood even if you are not depressed, and can induce euphoria. This throws a new light on insomnia.
This remarkable result is not well known outside a small circle of sleep researchers for three good reasons. First, sleep deprivation is not as convenient as taking a pill. Second, prolonged sleep deprivation is not exactly a desirable state; it leads to cognitive defects, such as reduced working memory and impaired decision making. Finally, depression recurs after the mother, inevitably, succumbs to sleep, even for a short nap. Nonetheless this is an incredibly important observation; it shows that depression can be rapidly reversed and suggests that something is happening in the sleeping brain to bring on episodes of depression. All this offers hope that studying sleep deprivation may lead to new, unique and rapid treatments for depression.
Neuroscientists have been trying to solve this puzzle. The first hint of what may be happening during sleep came from J. Christian Gillin, a former colleague of mine at the University of California at San Diego and the San Diego Veterans Affairs Medical Center. Using imaging, he found that a small area of the cerebral cortex in the front of the brain — the anterior cingulate cortex — which was consistently overactive in depressed patients, quieted to normal levels of activity after the patients were deprived of sleep. And when the patients were allowed to sleep, the activity in this area returned to the elevated levels.
Helen Mayberg at Emory University has shown that electrical stimulation of the anterior cingulate cortex, which disrupts normal activity, also reduces depression. Some patients reported feeling immediate relief and calm after the procedure.
This tells us where in the cortex to look, but we also need to understand the changes that occur in the cortex during sleep. As you fall asleep, neurons in the brain stem that project throughout the cortex and keep it activated stop firing. The reduced stimulation from the brain stem disconnects the cortex from sensory input and there is a major shift in the pattern of electrical activity in the cortex. During the early part of the night the cortex is in a state of slow-wave sleep punctuated by brief periods of rapid-eye movement sleep (REM), which become more frequent and longer lasting toward early morning.
One major class of antidepressants, tricyclics, blocks REM sleep, which suggests that sleep deprivation may work against depression the same way. This is consistent with the tendency for depressed individuals to sleep longer than they do when they feel normal. Additional support for this hypothesis comes from genetic studies of families with short REM latency — the tendency to enter REM early in the sleep cycle. This condition disrupts slow wave sleep and extends REM sleep. The risk of depression is much greater if you come from a family with this genetic background. While this is a rare genetic defect that can only account for a small fraction of all depressed patients, these special cases give us valuable clues to conditions that predispose some people to clinical depression.
Despite all we have learned about the brain and sleep states, we still do not have a smoking gun to pinpoint what goes wrong when a mother suffers from postpartum depression, or why sleep deprivation lifts her mood. But what we do know is intriguing and this is driving research that could lead someday to rapid and effective ways to treat depression.
This is exciting news for researchers, and for the millions who suffer from debilitating mood disorders. Insomniacs, though, are unlikely to welcome yet another lost night of sleep, or to be cheered by the notion that a good slumber the night before could have made them feel even worse.
Footnote: [1] J. Christian Gillin, Monte Buchsbaum, Joseph Wu, Camellia Clark, William Bunney Jr., Sleep deprivation as a model experimental antidepressant treatment: Findings from functional brain imaging, Depression and Anxiety 14 (1), 37-49, 2001
To answer the question, let’s look at another condition entirely.
Postpartum depression affects between 5 percent and 25 percent of new mothers. Symptoms — including sadness, fatigue, appetite changes, crying, anxiety and irritability — usually occur in the first few months after child birth. There is a simple way to alleviate postpartum depression in just a few hours: sleep deprivation.
If a depressed mother stays up all night, or even the last half of the night, it is likely that by morning the depression will lift. Although this sounds too good to be true, it has been well documented in over 1,700 patients in more than 75 published papers during the last 40 years.[1] Sleep deprivation used as a treatment for depression is efficacious and robust: it works quickly, is relatively easy to administer, inexpensive, relatively safe and it also alleviates other types of clinical depression. Sleep deprivation can elevate your mood even if you are not depressed, and can induce euphoria. This throws a new light on insomnia.
This remarkable result is not well known outside a small circle of sleep researchers for three good reasons. First, sleep deprivation is not as convenient as taking a pill. Second, prolonged sleep deprivation is not exactly a desirable state; it leads to cognitive defects, such as reduced working memory and impaired decision making. Finally, depression recurs after the mother, inevitably, succumbs to sleep, even for a short nap. Nonetheless this is an incredibly important observation; it shows that depression can be rapidly reversed and suggests that something is happening in the sleeping brain to bring on episodes of depression. All this offers hope that studying sleep deprivation may lead to new, unique and rapid treatments for depression.
Neuroscientists have been trying to solve this puzzle. The first hint of what may be happening during sleep came from J. Christian Gillin, a former colleague of mine at the University of California at San Diego and the San Diego Veterans Affairs Medical Center. Using imaging, he found that a small area of the cerebral cortex in the front of the brain — the anterior cingulate cortex — which was consistently overactive in depressed patients, quieted to normal levels of activity after the patients were deprived of sleep. And when the patients were allowed to sleep, the activity in this area returned to the elevated levels.
Helen Mayberg at Emory University has shown that electrical stimulation of the anterior cingulate cortex, which disrupts normal activity, also reduces depression. Some patients reported feeling immediate relief and calm after the procedure.
This tells us where in the cortex to look, but we also need to understand the changes that occur in the cortex during sleep. As you fall asleep, neurons in the brain stem that project throughout the cortex and keep it activated stop firing. The reduced stimulation from the brain stem disconnects the cortex from sensory input and there is a major shift in the pattern of electrical activity in the cortex. During the early part of the night the cortex is in a state of slow-wave sleep punctuated by brief periods of rapid-eye movement sleep (REM), which become more frequent and longer lasting toward early morning.
One major class of antidepressants, tricyclics, blocks REM sleep, which suggests that sleep deprivation may work against depression the same way. This is consistent with the tendency for depressed individuals to sleep longer than they do when they feel normal. Additional support for this hypothesis comes from genetic studies of families with short REM latency — the tendency to enter REM early in the sleep cycle. This condition disrupts slow wave sleep and extends REM sleep. The risk of depression is much greater if you come from a family with this genetic background. While this is a rare genetic defect that can only account for a small fraction of all depressed patients, these special cases give us valuable clues to conditions that predispose some people to clinical depression.
Despite all we have learned about the brain and sleep states, we still do not have a smoking gun to pinpoint what goes wrong when a mother suffers from postpartum depression, or why sleep deprivation lifts her mood. But what we do know is intriguing and this is driving research that could lead someday to rapid and effective ways to treat depression.
This is exciting news for researchers, and for the millions who suffer from debilitating mood disorders. Insomniacs, though, are unlikely to welcome yet another lost night of sleep, or to be cheered by the notion that a good slumber the night before could have made them feel even worse.
Footnote: [1] J. Christian Gillin, Monte Buchsbaum, Joseph Wu, Camellia Clark, William Bunney Jr., Sleep deprivation as a model experimental antidepressant treatment: Findings from functional brain imaging, Depression and Anxiety 14 (1), 37-49, 2001
30 December 2009
The Future Of Brain-Controlled Devices
CNN
In the shimmering fantasy realm of the hit movie "Avatar," a paraplegic Marine leaves his wheelchair behind and finds his feet in a new virtual world thanks to "the link," a sophisticated chamber that connects his brain to a surrogate alien, via computer.
This type of interface is a classic tool in gee-whiz science fiction. But the hard science behind it is even more wow-inducing.
Researchers are already using brain-computer interfaces to aid the disabled, treat diseases like Parkinson's and Alzheimer's, and provide therapy for depression and post-traumatic stress disorder. Work is under way on devices that may eventually let you communicate with friends telepathically, give you superhuman hearing and vision or even let you download data directly into your brain, a la "The Matrix."
Researchers are practically giddy over the prospects. "We don't know what the limits are yet," says Melody Moore Jackson, director of Georgia Tech University's BrainLab.
Adds Emory University neuroscience professor Michael Crutcher, "Anything can happen."
At the root of all this technology is the 3-pound generator we all carry in our head. It produces electricity at the microvolt level. But the signals are strong enough to move robots, wheelchairs and prosthetic limbs -- with the help of an external processor.
Harnessing that power "opens up a whole new paradigm for us as human beings," says neuroscientist Rajesh Rao of the University of Washington.
Brain-computer interfaces (BCI) come in two varieties. Noninvasive techniques use electrodes placed on the scalp to measure electrical activity. Invasive procedures implant electrodes directly into the brain. In both cases, the devices interact with a computer to produce a wide variety of applications, ranging from medical breakthroughs and military-tech advances to futuristic video games and toys.
Much of the research focuses on neuroprosthetics, which offer a way for the brain to compensate for injuries and illness. Jackson helped develop an intelligent wheelchair called the Aware Chair, which can be guided by neural activity.
She is also working on communication programs for people who have been paralyzed by strokes or spinal-cord injuries. Implanted electrodes allow "locked in" patients to spell out messages by manipulating a computer cursor with their thoughts alone.
Rao is tapping into that same concept to help paralyzed people manipulate robots to fetch items or move things around the house. With cameras to provide visual feedback, the patients and robots don't even need to be in the same room, or the same city. Rao says the technology "frees the mind from the constraints of the body."
Cochlear implants are the most common neuroprosthetic. They help the brain interpret sounds and are sometimes called "bionic ears" for the deaf. Other researchers are looking for similar ways to help blind people see. Neurobiologist Ed Boyden of MIT says miniature optical devices can be implanted to convert photoreceptors into workable cameras for the brain.
None of this comes cheap. Most research is funded by deep pockets such as the National Institutes of Health, the defense department and NASA.
But every breakthrough brings the most advanced BCI technologies closer to the mass market. Jackson says she foresees a day when people with disabilities can spend a few hundred dollars instead of $20,000 on a workable system.
Mainstreaming the technology raises some troubling issues for Crutcher, who teaches a course at Emory in neuro-ethics. He fears that expensive eye and ear implants could produce a computer-enhanced elite.
"If only the rich can afford it, it puts everyone else at a disadvantage," says Crutcher, who believes many aspects of BCI are ripe for abuse. Just the idea of mucking about with a person's brain "raises questions about safety and efficacy," he says.
One of the more controversial uses under development is telepathy. It would require at least two people to be implanted with electrodes that send and receive signals back and forth.
DARPA, the Pentagon's technology research division, is currently working on an initiative called "Silent Talk," which would let soldiers on secret missions communicate with their thoughts alone. This stealth component is attractive, but naysayers fear that such soldiers could become manipulated for evil means.
Telepathy implants won't replace Facebook and Twitter anytime soon, but that possibility is problematic as well.
"You can imagine communicating with your friends through the devices, and that opens up a lot of ethical issues," Rao says. Would you want your friends and family to know everything you are thinking? Would little white lies become obsolete?
These questions of morality and liability are not a huge factor for the toy makers and video game developers who are already bringing the most basic BCI technology to consumers.
Games like Mindflex and the Star Wars Force Trainer use headsets with simple electrodes to monitor levels of concentration and relaxation. The signals trigger a fan that can move a ball up or down, depending on how hard you're thinking. Jackson calls it a "fascinating application of a very sophisticated technology in a very cheap package."
The headsets used in both games were designed by the California company Neurosky. Its corporate partners are working on games that help Alzheimer's patients improve memory techniques, teach concentration skills to kids with ADHD and let stressed- out CEOs work on relaxing.
Software entrepreneurs and executives are streaming into Boyden's neuro-ventures class at MIT, looking for ways to capitalize on the array of potential uses for brain-computer interfaces.
Some ventures are already up and running. NeuroVigil in California is working on iBrain, designed, in part, to help provide instant feedback to drivers who start falling asleep at the wheel. Eos Neuroscience is developing light-sensitive protein-based sensors that can treat blindness.
Numerous companies are developing video games based on direct brain-computer interfacing. Neurosky sells a wireless headset that connects to any computer for a series of brain-training games. NeuroBoy lets you set targets on fire just by concentrating on them. Relax, and your character levitates. Another application lets you see a colorful visualization of your brain-wave activity.
Boyden expects to see many more such products hitting shelves sooner rather than later. He says the possibilities are endless if just a "fraction of the business leaders" taking his class start "bringing the technology into the world."
Jackson, of Georgia Tech, agrees: "Nothing is out of the realm of possibility."
This type of interface is a classic tool in gee-whiz science fiction. But the hard science behind it is even more wow-inducing.
Researchers are already using brain-computer interfaces to aid the disabled, treat diseases like Parkinson's and Alzheimer's, and provide therapy for depression and post-traumatic stress disorder. Work is under way on devices that may eventually let you communicate with friends telepathically, give you superhuman hearing and vision or even let you download data directly into your brain, a la "The Matrix."
Researchers are practically giddy over the prospects. "We don't know what the limits are yet," says Melody Moore Jackson, director of Georgia Tech University's BrainLab.
Adds Emory University neuroscience professor Michael Crutcher, "Anything can happen."
At the root of all this technology is the 3-pound generator we all carry in our head. It produces electricity at the microvolt level. But the signals are strong enough to move robots, wheelchairs and prosthetic limbs -- with the help of an external processor.
Harnessing that power "opens up a whole new paradigm for us as human beings," says neuroscientist Rajesh Rao of the University of Washington.
Brain-computer interfaces (BCI) come in two varieties. Noninvasive techniques use electrodes placed on the scalp to measure electrical activity. Invasive procedures implant electrodes directly into the brain. In both cases, the devices interact with a computer to produce a wide variety of applications, ranging from medical breakthroughs and military-tech advances to futuristic video games and toys.
Much of the research focuses on neuroprosthetics, which offer a way for the brain to compensate for injuries and illness. Jackson helped develop an intelligent wheelchair called the Aware Chair, which can be guided by neural activity.
She is also working on communication programs for people who have been paralyzed by strokes or spinal-cord injuries. Implanted electrodes allow "locked in" patients to spell out messages by manipulating a computer cursor with their thoughts alone.
Rao is tapping into that same concept to help paralyzed people manipulate robots to fetch items or move things around the house. With cameras to provide visual feedback, the patients and robots don't even need to be in the same room, or the same city. Rao says the technology "frees the mind from the constraints of the body."
Cochlear implants are the most common neuroprosthetic. They help the brain interpret sounds and are sometimes called "bionic ears" for the deaf. Other researchers are looking for similar ways to help blind people see. Neurobiologist Ed Boyden of MIT says miniature optical devices can be implanted to convert photoreceptors into workable cameras for the brain.
None of this comes cheap. Most research is funded by deep pockets such as the National Institutes of Health, the defense department and NASA.
But every breakthrough brings the most advanced BCI technologies closer to the mass market. Jackson says she foresees a day when people with disabilities can spend a few hundred dollars instead of $20,000 on a workable system.
Mainstreaming the technology raises some troubling issues for Crutcher, who teaches a course at Emory in neuro-ethics. He fears that expensive eye and ear implants could produce a computer-enhanced elite.
"If only the rich can afford it, it puts everyone else at a disadvantage," says Crutcher, who believes many aspects of BCI are ripe for abuse. Just the idea of mucking about with a person's brain "raises questions about safety and efficacy," he says.
One of the more controversial uses under development is telepathy. It would require at least two people to be implanted with electrodes that send and receive signals back and forth.
DARPA, the Pentagon's technology research division, is currently working on an initiative called "Silent Talk," which would let soldiers on secret missions communicate with their thoughts alone. This stealth component is attractive, but naysayers fear that such soldiers could become manipulated for evil means.
Telepathy implants won't replace Facebook and Twitter anytime soon, but that possibility is problematic as well.
"You can imagine communicating with your friends through the devices, and that opens up a lot of ethical issues," Rao says. Would you want your friends and family to know everything you are thinking? Would little white lies become obsolete?
These questions of morality and liability are not a huge factor for the toy makers and video game developers who are already bringing the most basic BCI technology to consumers.
Games like Mindflex and the Star Wars Force Trainer use headsets with simple electrodes to monitor levels of concentration and relaxation. The signals trigger a fan that can move a ball up or down, depending on how hard you're thinking. Jackson calls it a "fascinating application of a very sophisticated technology in a very cheap package."
The headsets used in both games were designed by the California company Neurosky. Its corporate partners are working on games that help Alzheimer's patients improve memory techniques, teach concentration skills to kids with ADHD and let stressed- out CEOs work on relaxing.
Software entrepreneurs and executives are streaming into Boyden's neuro-ventures class at MIT, looking for ways to capitalize on the array of potential uses for brain-computer interfaces.
Some ventures are already up and running. NeuroVigil in California is working on iBrain, designed, in part, to help provide instant feedback to drivers who start falling asleep at the wheel. Eos Neuroscience is developing light-sensitive protein-based sensors that can treat blindness.
Numerous companies are developing video games based on direct brain-computer interfacing. Neurosky sells a wireless headset that connects to any computer for a series of brain-training games. NeuroBoy lets you set targets on fire just by concentrating on them. Relax, and your character levitates. Another application lets you see a colorful visualization of your brain-wave activity.
Boyden expects to see many more such products hitting shelves sooner rather than later. He says the possibilities are endless if just a "fraction of the business leaders" taking his class start "bringing the technology into the world."
Jackson, of Georgia Tech, agrees: "Nothing is out of the realm of possibility."
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