Depression Archive

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Plan now to help prevent overeating, trips to the hospital, and depression.

The winter holidays are supposed to be a joyous time, filled with celebration. But they come with health risks, such as loneliness and depression, overeating, weight gain, falls in icy weather, foodborne illness, and heart problems. Here are ways to protect yourself while enjoying the season.

Ask the doctor

Q. I've had some severe bouts of depression before my periods. I have done my own research and I am willing to try an antidepressant. What dosage of Sarafem or Prozac is usually given to treat this?

A. Selective serotonin reuptake inhibitors (SSRIs) are an excellent option for treating premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). In fact, most physicians now consider them first-line therapy. Many different SSRIs have been studied, including the one you asked about—fluoxetine (Prozac or Sarafem)—and they all appear to be equally effective.

Medical science is making good progress in unraveling the biological underpinnings of depression. Someday, these discoveries may lead to lab tests that can help identify or confirm depression and other mood disorders.

Right now, doctors and therapists rely on the symptoms reported by their patients, along with clinical expertise and experience, to diagnose depression and determine a course of treatment.

Sometimes, though, additional information can help distinguish depression from other problems. That's why your doctor might recommend any of the following tests:

Whether you get a recommendation for a therapist from your primary care doctor, a friend, or your insurance company, finding out about his or her background and training can help you feel comfortable with your choice. Here are some questions to ask before settling on a therapist:

1. What's your training (i.e., what certification or degrees do you hold)?
2. How long have you worked in this field?
3. What kinds of treatment or therapy do you think might help me?
4. What are the advantages and disadvantages of different approaches to treatment, including medications?
5. How does the type of treatment you offer work?
6. What are the chances that treatment will succeed?
7. How soon should I start feeling better?
8. How will we assess my progress?
9. What should I do if I don't feel better?
10. How much will treatment cost?

It's hard for a therapist to give precise answers to some of these questions, because no single therapist or type of treatment is best for everyone. But there are some general responses you should be looking for: The therapist should easily be able to describe his or her formal training and certification, for example. And while there's a tendency for mental health professionals to offer only the particular type of psychotherapy that they do best, it's a good sign if the person can describe the merits and drawbacks of different types of treatment, including ones he or she doesn't do.

Be on the lookout for mood swings, sleeplessness, and anxiety when starting certain medications.

Depression is fairly common among people suffering with rheumatoid arthritis (RA). Recent research suggests that depression may worsen RA symptoms and even make medications less effective. To date, the studies that indicate a connection between the severity of RA symptoms and depression have not been conclusive, so more research is needed. In the meantime, if you have RA and notice signs of depression, be sure to talk with your doctor.

October 8, 2015 is National Depression Screening Day, which is the embodiment of Dr. Douglas Jacobs’s belief that screening for mental disorders should be no different than screening for other physical illnesses. If you think that you may be suffering from depression, take the first step and find out. Treatment can improve your mood, help you feel more connected, and feel more like yourself again.

Here's another reason to get depression treated as soon as possible: a Harvard study found that people with persistent symptoms of severe depression were twice as likely to suffer a stroke compared with people who have mild symptoms. The study appeared May 13, 2015, in the Journal of the American Heart Association. Researchers looked at the health information of more than 16,000 men and women ages 50 and older. The participants were interviewed every two years during a 12-year period and asked about many health issues, including depression symptoms. Researchers found that people who reported high depression symptoms at two consecutive interviews were more than twice as likely to have a first stroke than people with low depression symptoms. The stroke risk remained high even after depression symptoms went away.

The study showed only an association, and didn't prove that depression causes strokes. So why the link? Researchers speculate that depression—which is associated with high blood pressure, increased inflammation, and physical inactivity—may have a cumulative effect that causes damage to the blood vessels over time. Bottom line: Seek treatment if a case of the blues lasts more than two weeks, because it could be a sign of depression.

Find out if your sleeping habits put you at risk—and what to do about it.

Over time, most people with dementia or mild cognitive impairment (a decline in thinking skills) also experience behavioral changes, such as depression and agitation. Which comes first? A study published online by Neurology on Jan. 14, 2015, suggests that psychological and behavioral changes can begin before people develop mild cognitive impairment or dementia. Researchers evaluated the daily functioning, memory and thinking skills, and psychological and behavioral symptoms of about 2,400 people, ages 50 and older, who had no evidence of cognitive decline. The study also suggests that a pattern of depressive symptoms may occur in older adults, unrelated to cognitive decline. The takeaway? "Depressive symptoms can occur in older adults for many reasons. If you are experiencing mood or cognitive changes that last for more than a few weeks, it's a good idea to bring this up with your doctor or consult a mental health specialist to help sort out possible causes," says Dr. Nancy Donovan, an instructor in psychiatry at Harvard Medical School.