Depression in the News 2007

Emotional Abyss; Physical Cause? by Marlene Belfort October 30, 2007.

At age 46 a scientist suffers her first episode of depression. Three years later another episode accompanied by psychosis ends her up in a psychiatric hospital where she undergoes. Eventually she relapses a couple more times.

Finally, a doctor suggests a blood workup, she had an endocrine condition called hyperparathyroidism, which causes elevated levels of blood calcium and parathyroid hormone. She underwent surgery for the parathyroid. Being a scientist, she plots the data: "...I realized that when my calcium and hormone levels returned to normal, so did the moods."

Talk Therapy Pivotal for Depressed Youth by Benedict Carey in the New York Times. October 2, 2007.

"A talking cure for depression called cognitive behavior therapy appears to cancel the risk of suicidal thinking or behavior associated with taking antidepressant medication, according to the most comprehensive and long-running study to date of depression treatment among adolescents."

"Patients taking medication showed significant signs of improvement up to six weeks earlier than those who received talk therapy alone, but were about twice as likely to report feeling suddenly suicidal. The combination of the two therapies, the authors found, produced the most rapid recovery and protected against sudden suicidal urges."

Bipolar Illness Soars as a Diagnosis for the Young by Benedict Carey in the New York Times. September 4, 2007.

Bipolar disorder is characterized by extreme mood swings. Until relatively recently, it was thought to emerge almost exclusively in adulthood. But in the 1990s, psychiatrists began looking more closely for symptoms in younger patients - and finding it. The number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003 and continues to rise.

Many experts theorize that doctors are more aggressively applying the diagnosis to children, rather than the disorder itself being on the rise. The magnitude of the increase surprises many psychiatrists who say it is likely to intensify the debate over the validity of the diagnosis, which has shaken child psychiatry.

The spread of the diagnosis is a boon to drug makers, because treatments typically include medications that can be three to five times more expensive than those for other disorders like depression or anxiety. About half the children received antipsychotic drugs like Risperdal or Seroquel, both developed to treat schizophrenia. A third were prescribed mood stabilizers, most often the epilepsy drug Depakote. Antidepressants and stimulants were also common. Most children took a combination of two or more drugs, and 4 in 10 received psychotherapy.

Lifting the Curtain on Depression by Benedict Carey in the New York Times. August 30, 2007. Below is the "In Brief" summary of the article.

• Each patient experiences depression differently, and the symptoms can vary significantly from case to case.
• Available treatments do not work for as many as half of chronically depressed patients.
• Researchers have long focused on the role of serotonin, but new therapeutic paradigms are needed.
• Recent brain imaging studies may have uncovered surprising targets for intervention.

Letting Your Family In on Your Therapy by Elizabeth Bernstein in the Wall Street Journal July 17, 2007.

Frustrated by the often ineffective treatment plans that keep loved ones in the dark, a growing number of therapists are turning to "family-based" therapy. Instead of excluding family members, this approach includes spouses, parents or siblings in therapy.

The duration of family based therapy is limited, typically nine months to a year. The idea is that families will gain the skills to continue on their own. Research has shown that the family-based approach can reduce hospitalization and relapse rates and help patients take their medications more regularly.

The article describes the treatment approach used at the Bipolar Family Treatment Center at Beth Israel Hospital. While a BFTC patient agrees to share information with their family, the center's director, Dr. Igor Galynker, is quoted as saying that BFTC does not disclose private issues discussed in therapy. When treated on an outpatient basis, BFTC patients receive both medication and psychotherapy. The patient and caregivers are evaluated on a quarterly basis. If the patient has children, they too are evaluated by a therapist.

Psychiatrists, Children and Drug Industry’s Role in the New York Times May 10, 2007. In brief, the point of this article is that drug companies pay doctors in assorted ways to prescribe profitable drugs more often. Minnesota is the only state that requires doctors to report the money they receive from drug companies to the reporters researched data from Minnesota. Atypical anti-psychotic drugs are being frequently prescribed for children despite risks and no formal approval for use in minors. Lexapro is the most widely used antidepressant in the country despite cheaper alternatives, including generic Prozac. Much of the article is about pediatric bipolar disorder.

From Brother’s Death, a Crusade in the New York Times April 25, 2007. By Tamar Lewin. The article is a profile of Alison Malmon, the founder of Active Minds. Quoting: "The prevalence of mental illness on campus is stunning ... Suicide is the second leading cause among death for college students. Almost one in 10 college students has made a suicide plan. Nearly half of all students report having felt so depressed that they could not function in the previous year."

Long-Term Therapy Effective in Bipolar Depression April 10, 2007. In the New York Times by Nicholas Bakalar. Quoting: "Psychotherapy for as long as nine months is significantly more effective than short-term treatment for alleviating depression associated with bipolar disease ... The drugs used to treat depression are of limited use in treating the repeating depressive episodes of bipolar illness..." The article reports on a new study that used three types of psychotherapy: cognitive behavioral therapy, interpersonal and social rhythm therapy, or family therapy.

Many Diagnoses of Depression May Be Misguided, Study Says  By Benedict Carey in the New York Times April 3, 2007. Quoting: "About one in four people who appear to be depressed are in fact struggling with the normal mental fallout from a recent emotional blow ... a new study suggests. To avoid unnecessary diagnoses and stigma, the standard definition of depression should be redrawn to specifically exclude such cases...". The same topic was covered in the Washington Post on the same day Criteria for Depression Are Too Broad, Researchers Say. Guidelines May Encompass Many Who Are Just Sad by Shankar Vedantam April 3, 2007.

Men & Depression: Facing Darkness Newsweek Magazine. Issue of February 26, 2007. Quoting from the article: "Six million American men will be diagnosed with depression this year. But millions more suffer silently, unaware that their problem has a name or unwilling to seek treatment ... the facts suggest that, well, men tend not to take care of themselves and are reluctant to own up to mental illness. Although depression is emotionally crippling and has numerous medical implications—some of them deadly—many men fail to recognize the symptoms. Instead of talking about their feelings, men may mask them with alcohol, drug abuse, gambling, anger or by becoming workaholics. And even when they do realize they have a problem, men often view asking for help as an admission of weakness, a betrayal of their male identities."

See also: I Never Knew What to Expect Depressed parents often leave their children a legacy of fear and anxiety. By Barbara Kantrowitz Newsweek magazine. February 26, 2007 issue.

FDA Alerts Consumers to Unsafe, Misrepresented Drugs Purchased Over the Internet February 16, 2007. Americans who placed orders for Ambien, Xanax, Lexapro, and Ativan over the Internet instead received a product that, according to preliminary analysis, contains haloperidol, a powerful anti-psychotic drug. The FDA has information on buying medication over the Internet at www.fda.gov/buyonline.

Drug company 'hid' suicide link by the BBC January 29, 2007. Quoting: "Secret emails reveal that the UK's biggest drug company distorted trial results of an anti-depressant, covering up a link with suicide in teenagers. Panorama reveals that GlaxoSmithKline (GSK) attempted to show that Seroxat worked for depressed children despite failed clinical trials. And that GSK-employed ghostwriters influenced 'independent' academics." Note: Seroxat is Paxil. Glaxo is being sued and has thus been forced to open its "confidential internal archive". The article quotes a lawyer who has examined these documents as saying: "Even when they have negative studies that show that this drug Seroxat is going to harm some kids they still spin that study as remarkably effective and safe for children."  Alternate Link

From the Blog Watch column in the Wall Street Journal January 29, 2007 by Beckey Bright. Four blogs about mood disorders. Note that these blogs are written by people who are not experts in the field. While they may be interesting and/or useful, they are not endorsed by MDSG. We know nothing about the authors, other than what's in their blogs. 

• Ten Minute Freefall by a minister in Harrison, Arkansas. Entries are written with humor and candor.
• Been Broken But Still Trying is a first person account of a 40-something man's struggle with mental health problems.
• Deborah Gray's Blog The author claims to have lived with undiagnosed clinical depression from childhood until the age of 27 at which point she began managing her depression.
• Shades Of Black by Nick Mack a woman in her 20s who has been diagnosed and treated with bipolar disorder.

Needless goodbye: A young widow wants you to know about suicide prevention by Melissa Allison in the Seattle Times. January 14, 2007.

Quoting the beginning of the article: "Ten years after my husband killed himself, I still remember certain moments from his last days that make me ache for another chance. Like many suicide survivors, I struggle with feelings of guilt. I also have a growing understanding for what people can do to prevent suicide — warning signs we should know and steps we can take to help someone through a suicidal crisis. I learned these things too late, largely because the stigma surrounding suicide prevents us from talking about it. I'm sharing the story of Stu's death, along with advice from experts, as a way of breaching that silence. I want you to know more about suicide than I did before my husband died." 

Mother Wonders if Psychosis Drug Helped Kill Son by Alex Berenson in the New York Times. January 4, 2007.

Zyprexa, taken by about two million people worldwide last year, is approved to treat schizophrenia and bipolar disorder. For many patients, the side effects of Zyprexa are severe. They include severe weight gain and an increase in blood sugar and cholesterol - all risk factors for heart disease. In 2002, a statistical analysis conducted for Eli Lilly found that compared with an older antipsychotic drug, Haldol, patients taking Zyprexa were significantly more likely to develop heart disease.

Lilly Settles With 18,000 Over Zyprexa. by Alex Berenson New York Times January 5, 2007.

Quoting: "Eli Lilly agreed yesterday to pay up to $500 million to settle 18,000 lawsuits from people who claimed they had developed diabetes or other diseases after taking Zyprexa, Lilly’s drug for schizophrenia and bipolar disorder. Including earlier settlements over Zyprexa, Lilly has now agreed to pay at least $1.2 billion to 28,500 people who said they were injured by the drug. At least 1,200 suits are still pending, the company said. About 20 million people worldwide have taken Zyprexa since its introduction in 1996."