Medical advances that help people live long lives may not be so great if those extra years are miserable ones. In a recent survey, 81% of respondents said they would rather die than be miserable in their later years. Depression is a growing problem among America’s elderly.  I recently learned from an expert why so:  Getting old sucks, to be very blunt.   Advancing age simply brings more stuff about which to be depressed. Awareness of this important health problem is an important first step to greater understanding and better treatments, ensuring that, however unintended, the consequence of a longer life is not misery.

The National Institute of Mental Health (NIMH) has awarded New York City’s Weill Cornell Institute of Geriatric Psychiatry its largest grant ever — $10 million — to study treatments for geriatric depression.  The lead researcher on that project, George Alexopoulos, MD, founder and director of Weill Cornell’s Institute of Geriatric Psychiatry at New York-Presbyterian/Westchester, is currently conducting research about how best to help elderly patients suffering from depression.

How Many Suffer?

You may or may not agree with the study’s definition of “elderly” (65 years old or older), but this population is surging and is predicted to grow by 73% in the next decade. Dr. Alexopoulos said that experts estimate that about 15% of the elderly will suffer from clinical depression.  Many will struggle for years, even decades, with chronic diseases and the accompanying disabilities that exacerbate their depression. Depression sours everything else, often making poor health situations poorer. “Depression is like breathing bad air, it makes whatever you have worse,” he said.

In elderly people, depression can be triggered by Alzheimer’s disease.  The symptoms of dementia and depression are often confused, Dr. Alexopoulos explained. Also, elderly patients with depression are likely to have unique symptoms that lead the diagnosis astray, including agitation and difficulties with mental processing (including memory, speech, hearing and understanding). Their complaints of aches and pains that do not have another obvious cause may be dismissed, misdiagnosed or improperly treated. And all these other issues occur in addition to the typical symptoms of depression that younger people have, too, such as sadness, an inability to experience pleasure, excessive or inappropriate feelings of guilt, changes in appetite, negative mood, sleep difficulties and physical complaints, such as fatigue, headaches and heart palpitations. It’s hardly any wonder that elderly depressed people have both a higher rate of suicidal thoughts and higher rates of suicide than younger people with the same condition.

The bottom line is, when you’re over 65 and depressed, the condition is much more difficult to address than it is for a younger patient.

Brighter Days are Here

There is some not depressing news to report though: Studying these depressing details can provide context for better diagnosis and treatment which is, of course, where the $10 million grant is aimed. Dr. Alexopoulos stated that doctors have already learned a great deal about effective treatment of depression in vulnerable elderly people. Many, he says, can be helped by psychotherapy, medication or a combination of both that incorporates the latest new findings. Among the new developments:

New approaches in psychotherapy can be tailored to provide what elderly patients need most. According to Dr. Alexopoulos, that means specifically helping them to address and find solutions for their new mental and/or physical limitations. For instance, effective therapy for an elderly patient may focus less on personal growth or relationship issues and more on achieving a better understanding of their nutritional needs so they’ll eat better, which will improve mood and energy level. They may need help figuring out how to solve mobility issues, including how to get around their homes as well as making arrangements for transportation for shopping, doctor visits and seeing friends and family. And they may need to explore other ways to adjust their living circumstances so that they can feel better emotionally and physically.

It’s now known that inadequate blood supply to the brain can cause chemical changes associated with depression and doctors can use modern brain imaging techniques to identify specific regions where this is occurring. They can then utilize corrective treatment if blood flow is found to be blocked or insufficient among elderly patients when they first show signs of depression.

Doctors have gotten better at fine-tuning medications for their elderly patients, for example, it’s now known that elderly patients do better with certain antidepressants (such as sertraline, citalopram andesctitalopram) that aren’t as likely to interact dangerously with other medications.

According to Dr. Alexopoulos, the goal is to help elderly patients with depression to take an honest look at the things they can no longer do, explore how they feel about these limitations, and then learn better ways to work around them, with the ultimate goal of finding a way to accept them.

If you or someone you love faces this problem and these new approaches aren’t being incorporated into treatment, bring this article along to your next appointment and discuss them with your doctor. These are heartening steps in the right direction toward a life that isn’t just merely longer, but joyfully so.

Source(s):

George S. Alexopoulos, MD, founder and director, Weill Cornell Institute of Geriatric Psychiatry, NewYork-Presbyterian/Weill Cornell Medical College, Westchester Division, and director, NIMH-supported Advanced Center for Interventions and Services Research (ACISR) in Late-Life Depression, White Plains, New York.

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Human bodies have not evolved fast enough to adapt to the demands of modern life. So believes psychologist Stephen Ilardi, PhD, author of The Depression Cure and associate professor of clinical psychology at the University of Kansas. Although we’re living longer and theoretically have better health care, the risk for serious depression has been increasing for more than a century. The disorder now afflicts one-quarter of Americans (a trend mirrored across most of the developed world), and has more than doubled over the past decade alone.

Help yourself avoid becoming depressed

Dr. Ilardi told me that he has long puzzled over the epidemic of depressive illness, which continues to worsen despite the widespread use of antidepressant medications. In fact, the risk for depression is high throughout the industrialized and modernized world, but low among traditional and aboriginal cultures. Interestingly, modern-day aboriginal peoples enjoy dramatically lower rates of many forms of illness that commonly afflict Westerners — heart disease, diabetes, asthma, obesity and allergies among them. Dr. Ilardi believes that we should add depression to the list of “diseases of modernity.”

Our Hunter-Gatherer Ancestors

Until about 10,000 years ago, all humans were hunter-gatherers, living a lifestyle we know much about from the study of contemporary foraging groups. Dr. Ilardi’s “aha” moment came while reading the work of anthropologist Edward Schieffelin, PhD, who studied the Kaluli, an aboriginal group living in the highlands of Papua New Guinea. Although the Kaluli have a low life expectancy, high infant mortality and considerable intergroup violence, Dr. Schieffelin found that they suffer virtually no clinical depression. As Dr. Ilardi struggled to make sense of this surprising finding, he stumbled upon an important insight: The hunter-gatherer lifestyle features several elements — ranging from abundant physical activity to sunlight exposure to omega-3 consumption — that modern science has shown to be powerfully effective in fighting depression.

Maybe, thought Dr. Ilardi, the human species never evolved “antidepressive genes” because our bodies and brains simply weren’t designed for modern life — and our brains were protected for hundreds of thousands of years by the numerous antidepressant elements of the hunter-gatherer lifestyle. As an example, Dr. Ilardi cites the fact that many of the compounds we need for survival aren’t made by our bodies.  We haven’t evolved the ability to manufacture them, he says, because we’ve always been able to get them directly from our diets. Similarly, he theorizes that the human brain has no ability to stave off depression because until 10,000 years ago, the blink of an eye in evolutionary terms, all people lived an “antidepressant lifestyle.” Dr. Ilardi has spent the last four years developing and researching a treatment program for depression, Therapeutic Lifestyle Change (TLC), involving six curative lifestyle elements from the past that he asks his patients to weave back into the fabric of modern life. The program is described in depth in his recently published book, The Depression Cure.

The Six Elements of an Antidepression Lifestyle

1. Consume abundant omega-3 fatty acids. Hunter-gatherers ate a much more balanced diet than we do today, one rich in omega-3 and omega-6 fatty acids in a ratio of about 1:1. Over the past century, omega-6 fats began to dominate human fat consumption (due to the use of processed seed oil and eating meat that was grain-fed), to the point where the ratio of omega-6s to omega-3s is now about 17:1. Dr. Ilardi’s advice: Since omega-3 fats have proven antidepressant properties, take a daily fish-oil supplement that provides at least 1,000 mg of EPA (the version of omega-3 with the strongest research support in fighting depression).

2. Avoid ruminating on negative thoughts. Hunter-gatherers lived in the moment — survival depended on it. A well-researched and effective strategy for fighting depression encourages people to learn to interrupt rumination and focus instead on staying in the moment. Advice: Be continually engaged in what you are doing and monitor yourself to keep from brooding. Increase social interaction and shared activities. When you spend time alone, do things that keep your mind busy, like reading, watching television, painting, playing a musical instrument or cooking. Replace ruminative thoughts with positive ones. Write your thoughts down, and give yourself permission to walk away from them.

3. Get regular sunlight to keep your body clock in sync. Our ancestors spent much more time outdoors in the sunlight than we do. Sunlight not only resets the body clock each day — necessary for healthy sleep and hormone regulation — but it also enables us to manufacture vitamin D, which regulates 500 different genes expressed in the brain. Some researchers now say that most Americans are deficient in vitamin D, which is strongly anti-inflammatory… and, according to Dr. Ilardi, “a depressed brain is an inflamed brain.” Advice: 10 to 15 minutes of sunlight exposure daily between 11 am and 3 pm, depending on your skin pigment and the time of year, plus take 1,000 IU (international units) to 2,000 IU of Vitamin D in winter.

4. Stimulate key brain chemicals through physical exercise. Hunter-gatherers probably were physically active for three to four hours each day. That may be unrealistic today, but Dr. Ilardi says that it doesn’t take that much exercise to fight depression. Research at Duke University found, for instance, that 30 minutes of brisk walking three times per week was as effective at alleviating depression symptoms as the antidepressant Zoloft after four months, and considerably more effective at a follow-up six months later. By increasing dopamine and serotonin activity, exercise actually changes the brain chemistry, says Dr. Ilardi. Advice: 40 minutes of aerobic exercise three times per week, including 10 minutes to ramp up and 30 minutes of aerobic (just able to converse) activity.

5. Emphasize social connection in order to avoid the harmful effects of isolation. Hunter-gatherers didn’t spend much time alone. The typical ancient group had between 30 to 150 members, and most worked, cooked and slept together. Nowadays we are alone a lot — in our cars, at home, etc. Advice: Experience in-person community as much as possible.

6. Increase healthier sleep for brain and body recovery. Our ancestors got about 9-10 hours of sleep each night, but many Americans are somewhat sleep-deprived, with 30% getting under 6 hours according to CDC figures. One recent study from the Stanford University Sleep Lab reported that most adults feel best after 8 or 9 hours of sleep.  Advice: Make 8 hours of sleep your goal. The Depression Cure lists 10 ways to improve your sleep habits.

Dr. Ilardi is conducting random-control trial research with a group of people he describes as severely depressed and difficult to treat. To date, about one-quarter of those on a wait list and receiving traditional therapy or medication have responded favorably over a 14-week period. In Dr. Ilardi’s Therapeutic Lifestyle Change group, approximately three-quarters of the group have gotten better.

Source(s):

Stephen S. Ilardi, PhD, author of The Depression Cure, and associate professor of clinical psychology, University of Kansas, Lawrence, Kansas.

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There are millions of people nationwide dealing with depression which has escalated the number of cardiac problems over the years. This is slowly posing a problem to many lives and most people are not even aware of the issues. Become one of the people that prevent themselves from having unwanted cardiac problems in the future.

Be happy... be healthy

Depression has long been associated with cardiac problems. We know, for instance, that people who are physically healthy but depressed are more likely to develop cardiovascular disease… that being depressed puts people who already have heart disease — including those who have had a heart attack or bypass surgery — at higher risk for recurrence of a cardiac event… and that people who are depressed after a cardiac event are at greater risk for death within the next few years. What we haven’t known until now iswhy.

A recent study, published in the Journal of the American Medical Association, identified a critically important factor explaining this link: lack of exercise. Researchers followed 1,017 outpatients with stable coronary heart disease for nearly five years and were surprised to discover that physiological changes (elevated cortisol and norepinephrine, for example) were not responsible for the increased risk of cardiac events associated with depression. Instead, the researchers discovered that the increased rate of cardiovascular events in depressed patients has more to do with physical inactivity. The study team found that lack of exercise was associated with a 44% greater rate of cardiovascular events. After accounting for lack of exercise and other health behaviors (such as medication non-adherence and smoking), depression by itself was no longer associated with an increased risk of cardiovascular events. The current study reveals that the sedentary habits of depressed individuals creates a cycle of depression and poor cardiac health.

Depressed Patients Don’t Exercise

I called an expert in the matter of cardiovascular disease and exercise, Gordon Blackburn, PhD, program director of Cardiac Rehabilitation at the Cleveland Clinic, to ask about his thoughts on the study. Dr. Blackburn told me that many patients experience some level of depression after a heart attack. Many go on to develop a new attitude, becoming invigorated about the process of a new, healthier lifestyle, but even a mild and transient bout of depression can increase the risk of future cardiac problems.

Making matters worse, Dr. Blackburn said that those with depression tend to not be compliant with other lifestyle or management strategies such as medications, nutrition guidelines or follow-up medical care. Clearly all these factors contribute to a worsening of heart disease, putting people at higher risk, notes Dr. Blackburn.

How Exercise Helps

There is a solution to this problem. Cardiac rehabilitation programs, which are part of follow-up care for months after cardiac surgery or a heart attack at many hospitals, get patients up and moving with a regular exercise routine. Unfortunately, only about 20% of eligible patients participate, even though these programs are covered by many insurance companies and Medicare. If more patients did take part, Dr. Blackburn says, their health would improve in a variety of ways, all of which would help them feel better and live longer.

Dr. Blackburn told me he is disturbed that some patients assume cardiac procedures or bypass surgery will fix their heart problems. Heart disease continues, he says, and if patients don’t address their risk factors, it will surely progress. Doctors have not routinely focused on depression as a significant issue with cardiac patients, says Dr. Blackburn, but perhaps the results of this study may change this. Regular screening for depression would show health care teams which patients need treatment for it, as well as underscore for patients the importance of a cardiac exercise program that could help save their lives.

Source(s):

Gordon Blackburn, PhD, program director of Cardiac Rehabilitation at the Cleveland Clinic.

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Letting go of what you love is hard… whether it is the passing of a person or pet, a home where you’ve been happy, or even something far less tangible, such as your ability to play a good, hard game of tennis (sorrow that, of course, is also about the often-painful loss of youth).

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Unacknowledged and unaddressed grief doesn’t just evaporate, however — it often turns into anxiety, depression, even illness. Though some people process feelings by talking or writing about them, many don’t know what to do with the feelings of sadness, which are often overwhelming. I was intrigued when I heard about a program that uses yoga for this purpose — developed by yoga therapist Antonio Sausys and used in the “Degriefing Process,” a holistic grief-counseling program created by certified grief counselor Lyn Prashan.

YOGA FOR GRIEF RELIEF

After a loss, feelings of grief become imbedded not only within our psyche, but also in our physical bodies, Sausys explained. For instance, many grieving people take on a particular posture — curving the back and hanging the head down a bit, almost as though to protect the heart. “The heartchakra, in the center of the chest, is the energetic center that relates to emotional bonding,” he says — noting that this is where grief gets “processed.” Sausys’s program incorporates yoga as a tool to ths end. The goal is to bring some of the physical symptoms of grief to a conscious level of awareness — this helps people to accept the reality of their loss and to move through the pain in a way that enables them to continue with their lives. His program includes specific exercises for the muscles and functions that are related to this chakra — mainly the pectoral muscles, the mid-spine and the circulatory and breathing systems.

PRANAYAMA (BREATH)

“Notice that when you’re happy and content, your breath is slow and deep, and when you are agitated or unhappy, it becomes fast and shallow,” says Sausys. “Working with your breath is working with your life — one breath in and one breath out, what you do with your breath is what you do with your life.” Pranayama is the practice of deliberate and mindful breathing based on the belief that prana (vital life force) is held within the breath. Deepening awareness and control over your breathing helps unite your conscious and unconscious minds.

What to do: Begin by spending a few minutes just being aware of your breath. You don’t have to control it, rather just feel it — be present to the flow, in and out, which will help you become present for what’s happening in your life.

Try this: Sit in a comfortable position, keeping your spine as straight as possible. Bring the tip of your fingers to the tip of your shoulders, pulling your elbows together in front of your chest. As you inhale, bring your elbows up and then back… then, as you exhale bring them down and again back, following a fluid circular movement. This counteracts the natural tendency of the pectoral muscles to contract protectively and often quickly brings about an ability to feel more open.

ASANAS

In yoga, asanas are physical poses, each of which has a particular purpose. You can use specific asanas to address the physical manifestations of grief, including pain and the tendency to hunch over to protect your heart. His program includes specific exercises for the pectoral muscles, the mid-spine, and the circulation and breathing systems, such as shoulder stretches and backbends. If you haven’t done yoga, try a class or DVD to find poses that feel good to you.

SHATKARMA

A series of purifying techniques called Shatkarma can help in the release of thoughts and emotions, as well as of memories of painful experiences that may have become trapped within the body and mind, says Sausys. Grief is stressful, often triggering the fight-or-flight response. Since this response is integrated through the pituitary gland, you can do a group of Shatkarma exercises for the eyes, called Tratak, to help bring balance to the pituitary gland and reduce the intensity of your feelings. For instance, gazing at a flower, candle or other beautiful object not only helps to release eye tension but can also induce cleansing tears.

How to do it: Light a candle. Sit in a comfortable position where you can see it at eye level and at arm’s length. First relaxing your facial muscles, stare steadily at the dark part in the center of the flame for two or three minutes. Then close your eyes and focus on the image of the flame that remains… when the image fades, open your eyes and repeat the exercise.

RELAXATION

Grief is stressful, Sausys says, and therefore can take a major toll on your health and well-being. A basic way to reduce your stress is to simply lie on your back on the floor, repeating to yourself as you exhale: “Relax now.” Draw out your exhalations so that they are twice as long as inhalations. While any and all relaxation methods that work for you can be helpful, Sausys suggests that a good approach is to follow a guided relaxation CD or DVD, which can help you to maintain your focus.

SANKALPA: RESOLUTION

In the yoga tradition, Sankalpa means to bring something to resolution. To this end, Sausys recommends choosing an affirmation, voicing an intention, or saying a prayer, and repeating it over and over. “This can help focus your mind on the positive,” he says, noting that over time it becomes a symbolic way you can move your thoughts away from negative repetitive thinking toward healing.

An example: Formulate a statement that expresses a specific wish in a positive way and in the present tense — for instance, “tonight I sleep deeply.” (Sleep disruption is one of the most common symptoms of grief, says Sausys.)

Taken together and used regularly, these tools can provide the necessary framework and support to help grief-stricken individuals come to terms with their loss. It won’t go away and you’ll never stop feeling the sadness — but over time it can stop feeling so painful. In the words of the Degriefing program creator, Lyn Prashant, “we never get over our grief — we only change our relationship to it. Grief is a normal human reaction not just to death, but to loss. What we must do is find a way to relate to it.”

Source(s):

Antonio Sausys, BA (Psychology), MA (Body-Oriented Psychotherapy), is a somatic health practitioner and yoga instructor specializing in one-on-one yoga therapy. He teaches and lectures at University of California-Berkeley, the California Institute of Integral Studies, College of Marin, and has been a faculty member at the International Yoga College and the former Honorary Secretary of the International Yoga Federation for the U.S. His Web sites are www.yogaforgriefrelief.com andwww.yogatherapyconference.com.

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Reprinted with the permission of:
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It can be life shattering dealing with any sort of depression and even harder if you do not have any help to get through it. Instead of using a drug method to diminish your depression try some drug free depression treatments and avoid relying on any depression drug out there.

Depression remains stubbornly intractable for many of the estimated 20-plus million Americans who suffer from it. Many of these people have difficulties with the pharmaceutical drugs so often prescribed for depression, finding them either ineffective or to cause disagreeable side effects including lowered libido and weight gain. Also several of these drugs have been associated with an increased risk for suicide, though this remains a controversial issue. All this has opened the door to a growing interest in natural solutions for depression. Research into CAM (complementary and alternative medicine) treatments for depression is active in some very mainstream academic medical centers, and several natural substances have earned a respected position on the list of depression treatment alternatives.

Take control of your depression now drug free!

A chief researcher in this area is David Mischoulon, MD, PhD, assistant professor of psychiatry, Harvard Medical School, and director of Alternative Remedy Studies at the Depression Clinical and Research Program, Massachusetts General Hospital. I spoke with Dr. Mischoulon recently to get an update on alternative treatments for depression.

THE “BIG THREE”

Depression researchers refer to the “big three” in natural substances for treating depression. One well-studied natural treatment is SAM-e (S-adenosyl methionine), a synthetic form of a chemical produced naturally in the body with numerous functions including influencing moods and emotions. Research on SAM-e and depression has been encouraging, showing that it works better than placebo and that it is as effective as tricyclics, a class of older anti-depressants that dates back to the 1950s and is still very popular today. Dr. Mischoulon’s research group is now studying SAM-e against the newer antidepressant drugs, SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine (Prozac) and sertraline (Zoloft). The typical prescribed dosage of SAM-e is 800 to 1,600 mg a day, and SAM-e seems to be well-tolerated, with few if any immediate side effects.

Next, perhaps surprisingly, comes omega-3 fatty acids. We have known for some time that omega-3 fatty acids help treat many physical conditions, including cardiovascular disease. But Dr. Mischoulon says there have been numerous studies on omega-3 fatty acids and their impact on mental health, including bipolar disorder as well as depression, with many suggesting that these fatty acids are indeed effective. The types of omega-3 fatty acids that help with depression are EPA and DHA, found in cold-water fish and fish oil supplements. Psychiatric benefits are commonly obtained with about 1,000 mg a day of combined EPA/DHA.

And then there is our old friend, St. John’s wort (hypericum perforatum). Dr. Mischoulon says that it has tested well in a number of studies, including against older antidepressant drugs. Studies have shown that this substance is calming while at the same time it seems to work in part like SSRIs. Recommended doses are on the order of 900 to 1,200 mg per day, but because of subtleties regarding dosage and the fact that St. John’s wort is known to interact with many other medications, it’s imperative to take this supplement under the supervision of a medical professional experienced in its use.

OTHER NATURAL TREATMENTS

Yet another substance that Dr. Mischoulon says may be helpful is Valerian (valeriana officinalis). It has primarily been studied as a sleep aid, but Dr. Mischoulon says it may also be useful for anxiety. It’s important to keep in mind that Valerian requires several weeks to work, whether for sleep purposes or for anxiety relief, although many report feeling positive effects fairly quickly. The usual dose administered is 400 mg to 600 mg of extract in capsule form, but there is considerable variety among brands as to purity and active ingredients. Different brands may achieve different results in different people, so Dr. Mischoulon says not to give up if a particular one doesn’t work for you.

A number of physical treatment modalities are being incorporated in depression treatment, though research remains limited. Acupuncture is one that studies have found promising, says Dr. Mischoulon. Curiously, acupuncture studies have an unusually high placebo-effect rate (subjects on placebo showing improvement), so how much acupuncture actually helps is unclear. On the other hand, most people find acupuncture to be neither painful nor harmful, so it may be worth a try.

Exercise has also been studied with regard to potential benefits for depressed people, with new studies suggesting beneficial mood-elevating effects. However, because depression tends to cause a decrease in energy and motivation, it can be difficult to get depressed people to engage in exercise programs, Dr. Mischoulon acknowledged. But if they can push past the lethargy, they may be pleasantly surprised by how good exercise makes them feel — including the sense of accomplishment.

DEPRESSION IS MANAGEABLE

Anyone who experiences depression for more than a few weeks should seek professional treatment, says Dr. Mischoulon. Though it may take a while to find the treatment that works for you, it is important to remember that depression is usually manageable. Left untreated, it can become chronic and difficult to treat.

When choosing to treat depression with natural substances, always work under the supervision of a naturopathic physician or other health care professional who can help identify the best solution for you. To find such a doctor, seek referrals from your primary care physician and consult the database of the AANP (American Association of Naturopathic Physicians) athttp://www.naturopathic.org/findannd.php. Then speak with the doctors to find one that seems to be a good fit for you.

Patience is in order — just as with pharmaceutical drugs for depression, natural treatments often require time to take effect, from three to six weeks, says Dr. Mischoulon. Finally, some of these therapies have been found effective in treating mild to moderate depression. While some may be of help for severe depression, the evidence to date relates only to the milder forms — treatment of more serious cases may require a different strategy.

Source(s):

David Mischoulon, MD, PhD, assistant professor of psychiatry at Harvard Medical School and director of Alternative Remedy Studies at the Depression Clinical and Research Program, Massachusetts General Hospital, Boston.

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Reprinted with the permission of:
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281 Tresser Blvd., 8th Floor
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www.BottomLineSecrets.com