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Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression

<div class="theconversation-article-body"> <p>Can you remember a time when you felt stressed leading up to a big life event and then afterwards felt like a weight had been lifted? This process – the ramping up of the stress response and then feeling this settle back down – shows completion of the “stress cycle”.</p> <p>Some stress in daily life is unavoidable. But remaining stressed is unhealthy. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568977/">Chronic stress</a> increases <a href="https://pubmed.ncbi.nlm.nih.gov/32886587/">chronic health conditions</a>, including heart disease and stroke and diabetes. It can also lead to <a href="https://theconversation.com/were-all-exhausted-but-are-you-experiencing-burnout-heres-what-to-look-out-for-164393">burnout</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137920/">depression</a>.</p> <p>Exercise, cognitive, creative, social and self-soothing activities help us process stress in healthier ways and complete the stress cycle.</p> <h2>What does the stress cycle look like?</h2> <p>Scientists and researchers refer to the “stress response”, often with a focus on the fight-or-flight reactions. The phrase the “stress cycle” has been made popular by <a href="https://www.penguin.co.uk/articles/2019/03/complete-stress-cycle-emotional-exhaustion-burnout">self-help experts</a> but it does have a scientific basis.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/books/NBK541120/">stress cycle</a> is our body’s response to a stressful event, whether real or perceived, physical or psychological. It could be being chased by a vicious dog, an upcoming exam or a difficult conversation.</p> <p>The stress cycle has three stages:</p> <ul> <li> <p><strong>stage 1</strong> is perceiving the threat</p> </li> <li> <p><strong>stage 2</strong> is the fight-or-flight response, driven by our stress hormones: adrenaline and cortisol</p> </li> <li> <p><strong>stage 3</strong> is relief, including physiological and psychological relief. This completes the stress cycle.</p> </li> </ul> <p>Different people will respond to stress differently based on their life experiences and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181835/#:%7E:text=The%20major%20findings%20regarding%20the,renin%2Dangiotensin%2Daldosterone%20system%20or">genetics</a>.</p> <p>Unfortunately, many people experience <a href="https://www.weforum.org/agenda/2023/01/polycrisis-global-risks-report-cost-of-living/">multiple and ongoing stressors</a> out of their control, including the cost-of-living crisis, extreme weather events and <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/types-of-violence/family-domestic-violence">domestic violence</a>.</p> <p>Remaining in stage 2 (the flight-or-flight response), can lead to chronic stress. <a href="https://theconversation.com/how-chronic-stress-changes-the-brain-and-what-you-can-do-to-reverse-the-damage-133194">Chronic stress</a> and high cortisol can increase <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476783/">inflammation</a>, which damages our brain and other organs.</p> <p>When you are stuck in chronic fight-or-flight mode, you don’t think clearly and are more easily distracted. Activities that provide temporary pleasure, such as eating junk food or drinking alcohol are <a href="https://onlinelibrary.wiley.com/doi/10.1111/acer.14518">unhelpful strategies</a> that do not reduce the stress effects on our brain and body. Scrolling through social media is also not an effective way to complete the stress cycle. In fact, this is associated with an <a href="https://www.apa.org/monitor/2022/11/strain-media-overload">increased stress response</a>.</p> <h2>Stress and the brain</h2> <p>In the brain, chronic high cortisol can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561403/">shrink the hippocampus</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557684/#:%7E:text=The%20hippocampal%20formation%20plays%20a,%2C%20memory%2C%20motivation%20and%20emotion.&amp;text=Therefore%2C%20reduced%20hippocampal%20volumes%20should,in%20patients%20with%20major%20depression">impair a person’s memory</a> and their capacity to think and concentrate.</p> <p>Chronic high cortisol also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907136/#:%7E:text=The%20prefrontal%20cortex%20(PFC)%20intelligently,brain%20regions%20(BOX%201).">reduces activity</a> in the prefrontal cortex but <a href="https://www.sciencedirect.com/science/article/pii/S2352289514000101">increases activity</a> in the amygdala.</p> <p>The prefrontal cortex is responsible for higher-order control of our thoughts, behaviours and emotions, and is <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00761/full">goal-directed</a> and rational. The amygdala is involved in reflexive and emotional responses. Higher amygdala activity and lower prefrontal cortex activity explains why we are less rational and more emotional and reactive when we are stressed.</p> <p>There are five <a href="https://www.penguin.co.uk/articles/2019/03/complete-stress-cycle-emotional-exhaustion-burnout">types of activities</a> that can help our brains complete the stress cycle.</p> <figure><iframe src="https://www.youtube.com/embed/eD1wliuHxHI?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">It can help to understand how the brain encounters stress.</span></figcaption></figure> <h2>1. Exercise – its own complete stress cycle</h2> <p>When we exercise we get a short-term spike in cortisol, followed by a <a href="https://www.health.harvard.edu/staying-healthy/exercising-to-relax">healthy reduction</a> in cortisol and adrenaline.</p> <p>Exercise also <a href="https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469#:%7E:text=Exercise%20in%20almost%20any%20form,distract%20you%20from%20daily%20worries.&amp;text=You%20know%20that%20exercise%20does,fit%20it%20into%20your%20routine.">increases endorphins and serotonin</a>, which improve mood. Endorphins cause an elated feeling often called “runner’s high” and have <a href="https://pubmed.ncbi.nlm.nih.gov/33396962/">anti-inflammatory effects</a>.</p> <p>When you exercise, there is more blood flow to the brain and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721405/">higher activity</a> in the prefrontal cortex. This is why you can often think more clearly after a walk or run. Exercise can be a helpful way to <a href="https://www.healthline.com/health/heart-disease/exercise-stress-relief">relieve feelings of stress</a>.</p> <p>Exercise can also increase the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041121/">volume</a> of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915811/">hippocampus</a>. This is linked to better short-term and long-term memory processing, as well as reduced stress, depression and anxiety.</p> <h2>2. Cognitive activities – reduce negative thinking</h2> <p>Overly negative thinking can trigger or extend the stress response. In our 2019 research, we found the relationship between stress and cortisol was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6987429/">stronger in people with more negative thinking</a>.</p> <p>Higher amygdala activity and less rational thinking when you are stressed can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/18628348/">distorted thinking</a> such as focusing on negatives and rigid “black-and-white” thinking.</p> <p>Activities to reduce negative thinking and promote a more realistic view can reduce the stress response. In clinical settings this is usually called <a href="https://www.healthdirect.gov.au/cognitive-behaviour-therapy-cbt">cognitive behaviour therapy</a>.</p> <p>At home, this could be journalling or writing down worries. This engages the logical and rational parts of our brain and helps us think more realistically. Finding evidence to challenge negative thoughts (“I’ve prepared well for the exam, so I can do my best”) can help to complete the stress cycle.</p> <h2>3. Getting creative – a pathway out of ‘flight or fight’</h2> <p>Creative activities can be art, craft, gardening, cooking or <a href="https://heartmindonline.org/resources/10-exercises-for-your-prefrontal-cortex">other activities</a> such as doing a puzzle, juggling, music, theatre, dancing or simply being absorbed in enjoyable work.</p> <p>Such pursuits increase <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00761/full">prefrontal cortex activity</a> and promote flow and focus.</p> <p>Flow is a <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.645498/full">state of full engagement</a> in an activity you enjoy. It lowers high-stress levels of noradrenaline, the brain’s adrenaline. When you are focussed like this, the brain only processes information relevant to the task and ignores non-relevant information, including stresses.</p> <h2>4. Getting social and releasing feel-good hormones</h2> <p>Talking with someone else, physical affection with a person or pet and laughing can all <a href="https://theconversation.com/what-happens-in-our-brain-and-body-when-were-in-love-198885">increase oxytocin</a>. This is a chemical messenger in the brain that increases social bonding and makes us feel connected and safe.</p> <p>Laughing is also a social activity that <a href="https://neurosciencenews.com/laughter-physical-mental-psychology-17339/">activates parts</a> of the limbic system – the part of the brain involved in emotional and behavioural responses. This increases <a href="https://www.jneurosci.org/content/37/36/8581">endorphins</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/27439375/">serotonin</a> and improves our mood.</p> <h2>5. Self-soothing</h2> <p>Breathing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">exercises</a> and meditation stimulate the parasympathetic nervous system (which calms down our stress responses so we can “reset”) via the <a href="https://theconversation.com/our-vagus-nerves-help-us-rest-digest-and-restore-can-you-really-reset-them-to-feel-better-210469">vagus nerves</a>, and <a href="https://www.tandfonline.com/doi/full/10.1080/17437199.2020.1760727">reduce cortisol</a>.</p> <p>A good <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035568/#:%7E:text=We%20conclude%20that%2C%20in%20addition,self%2Dsoothing%20effects%20of%20crying.">cry can help too</a> by releasing stress energy and increasing oxytocin and endorphins.</p> <p><a href="https://www.medicalnewstoday.com/articles/319631#:%7E:text=Possible%20benefits%20of%20crying%20include,of%201.9%20times%20a%20month.">Emotional tears</a> also remove cortisol and the hormone prolactin from the body. Our prior research showed <a href="https://pubmed.ncbi.nlm.nih.gov/29096223/">cortisol</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216608/">prolactin</a> were associated with depression, anxiety and hostility.<em><a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/susan-j-thomas-1293985">Susan J. Thomas</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <h2>Action beats distraction</h2> <p>Whether it’s watching a funny or sad movie, exercising, journalling, gardening or doing a puzzle, there is science behind why you should complete the stress cycle.</p> <p>Doing at least one positive activity every day can also reduce our baseline stress level and is beneficial for good mental health and wellbeing.</p> <p>Importantly, chronic stress and <a href="https://theconversation.com/are-you-burnt-out-at-work-ask-yourself-these-4-questions-118128">burnout</a> can also indicate the need for change, <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20311">such as in our workplaces</a>. However, not all stressful circumstances can be easily changed. Remember help is always available.</p> <p>If you have concerns about your stress or health, please talk to a doctor.</p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14 or <a href="https://kidshelpline.com.au/">Kids Helpline</a> on 1800 55 1800.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/218599/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/susan-j-thomas-1293985">Susan J. Thomas</a>, Associate professor in Mental Health and Behavioural Science, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image </em><em>credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">original article</a>.</em></p> </div>

Mind

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Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like

<p><em><a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>At least <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.665019/full">one in ten people</a> have depression at some point in their lives, with some estimates <a href="https://www.sciencedirect.com/science/article/pii/S0749379720301793">closer to one in four</a>. It’s one of the worst things for someone’s wellbeing – worse than <a href="https://www.happinessresearchinstitute.com/_files/ugd/928487_4a99b6e23f014f85b38495b7ab1ac24b.pdf">debt, divorce or diabetes</a>.</p> <p><a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">One in seven</a> Australians take antidepressants. Psychologists are in <a href="https://theconversation.com/we-cant-solve-australias-mental-health-emergency-if-we-dont-train-enough-psychologists-here-are-5-fixes-190135">high demand</a>. Still, only <a href="http://dx.doi.org/10.1371/journal.pmed.1003901">half</a> of people with depression in high-income countries get treatment.</p> <p>Our <a href="https://www.bmj.com/content/384/bmj-2023-075847">new research</a> shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it.</p> <h2>Walk, run, lift, or dance away depression</h2> <p>We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together.</p> <p>We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behaviour therapy</a> – one of the <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00004/full">gold-standard treatments</a> for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them.</p> <p>Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants.</p> <p>But of these exercises, people were most likely to stick with strength training and yoga.</p> <p><iframe id="cZaWb" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/cZaWb/2/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Antidepressants certainly help <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">some people</a>. And of course, anyone getting treatment for depression should talk to their doctor <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">before changing</a> what they are doing.</p> <p>Still, our evidence shows that if you have depression, you should get a psychologist <em>and</em> an exercise plan, whether or not you’re taking antidepressants.</p> <h2>Join a program and go hard (with support)</h2> <p>Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, <a href="https://www.who.int/initiatives/behealthy/physical-activity">such as</a> “some physical activity is better than doing none.”</p> <p>But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression.</p> <p>We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results.</p> <h2>Yes, it’s hard to keep motivated</h2> <p>We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results.</p> <p>Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free.</p> <p>We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression.</p> <p>Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result.</p> <p>Other reviews found it’s important to have a <a href="https://pubmed.ncbi.nlm.nih.gov/31923898/">clear action plan</a> (for example, putting exercise in your calendar) and to <a href="https://pubmed.ncbi.nlm.nih.gov/19916637/">track your progress</a> (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult.</p> <p>A <a href="https://www.nature.com/articles/s41586-021-04128-4">2021 mega-study</a> of more than 60,000 gym-goers <a href="https://www.nature.com/articles/s41586-021-04128-4/figures/1">found</a> experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted.</p> <p>Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it.</p> <p>So, when starting out, it seems wise to avoid going it alone. Instead:</p> <ul> <li> <p>join a fitness group or yoga studio</p> </li> <li> <p>get a trainer or an exercise physiologist</p> </li> <li> <p>ask a friend or family member to go for a walk with you.</p> </li> </ul> <p>Taking a few steps towards getting that support makes it more likely you’ll keep exercising.</p> <h2>Let’s make this official</h2> <p>Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only <a href="https://www.apa.org/depression-guideline/">conditionally recommends</a> exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”.</p> <p>Based on our research, this recommendation is withholding a potent treatment from many people who need it.</p> <p>In contrast, The Royal Australian and New Zealand College of Psychiatrists <a href="https://www.ranzcp.org/getmedia/a4678cf4-91f5-4746-99d4-03dc7379ae51/mood-disorders-clinical-practice-guideline-2020.pdf">recommends</a> vigorous aerobic activity at least two to three times a week for all people with depression.</p> <p>Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression.</p> <p><em>I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based.</em></p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223441/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/running-or-yoga-can-help-beat-depression-research-shows-even-if-exercise-is-the-last-thing-you-feel-like-223441">original article</a>.</em></p>

Body

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Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<p><em><a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>.</p> <p>Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease.</p> <p>Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link?</p> <h2>What the study did and found</h2> <p>This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period.</p> <p>Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia.</p> <p>During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease.</p> <h2>Important considerations</h2> <p>In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk.</p> <p>Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively.</p> <p>These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable.</p> <p>Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves.</p> <p>This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association.</p> <h2>What does other evidence say?</h2> <p><a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both.</p> <p>High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too.</p> <p>For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life.</p> <h2>Why the link?</h2> <p>There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia.</p> <p>Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline.</p> <p>Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>.</p> <p>We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/yen-ying-lim-355185"><em>Yen Ying Lim</em></a><em>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.</em></p>

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How to tell if your loved one is depressed

<p>Around one in 10 people suffer from depression and anxiety, meaning it’s likely at some stage in your life someone you know will be suffering and need your help. These are five of the less-obvious signs and symptoms that a friend or family member might be going through a hard time.</p> <p><strong>1. They seem exhausted all the time</strong></p> <p>Changes to a sleeping patterns can be a sign of depression, whether it’s not sleeping enough or sleeping too much.  </p> <p>Tip: Help your loved one by taking them out for the day to re-set their body clock.</p> <p><strong>2. They never want to socialise anymore</strong></p> <p>If your loved one is finding it difficult to leave the house and attend any social events, even for a catch-up over coffee, that they would normally enjoy, it could be a sign</p> <p>Tip: Recognise that at the time it is very hard for your loved one to go out and socialise. Reassure them that you’d love to catch-up with them, and if it does get too much that you’re happy to do something they’d be happy with.</p> <p><strong>3. They get frustrated at everything</strong></p> <p>Does your loved one seem to be losing their patience more than usual? Anger and irritability, more than usual, can be a sign of depression.</p> <p>Tip: Chat to your friend about their feelings of frustration and irritability. You will be better placed to see if it’s a passing mood or longer-term change.</p> <p><strong>4. Their appetite has changed</strong></p> <p>Whether your loved one is constantly and consistently “not hungry” or they’re eating a lot more than usual and gaining weight, changes in appetite are a common sign of depression.</p> <p>Tip: People living with depression are often exhausted, where the thought of making meals or even what to eat, can be an overwhelming decision. Help prepare some meals for your loved one.</p> <p><strong>5. They’ve suddenly lost self-confidence</strong></p> <p>A loss of self-confidence and self-esteem is a common sign of depression. When a loved one starts to feel like everything they do is rubbish, it can be difficult to feel otherwise.</p> <p>Tip: When a loved one says they feel useless, reassure them with specific examples and evidence that it’s not true at all.</p> <p><em>Image credits: Getty Images</em></p>

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Tracking the shift in meanings of ‘anxiety’ and ‘depression’ over time

<p>The mental health terms ‘anxiety’ and ‘depression’ have become increasingly pathologised since the 1970s, according to analysis by Australian researchers of more than a million academic and general text sources. </p> <p><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0288027" target="_blank" rel="noreferrer noopener">Publishing</a> in PLOS ONE, psychology and computer science researchers from the University of Melbourne tracked the frequency and meaning of the concepts ‘anxiety’ and ‘depression’ from 1970 to 2018, and words that occurred in their vicinity.</p> <p>Using natural language processing, the team analysed more than 630 million words across 871,340 academic psychology papers, as well as 400,000 texts from general sources such as magazines, newspapers and non-fiction books.</p> <p>Paper co-author psychologist Professor Nicholas Haslam has a long standing interest in how mental health terms change their meanings over time, particularly the way harm-related words like bullying, abuse and trauma tend to expand over time, incorporating new, and often less severe kinds of experiences.</p> <p>Haslam says that trend reflects progressive social change and a rising sensitivity to harm and suffering in our culture. “We emphasize [that’s] mostly a good thing,” he says.</p> <p><iframe title="The Emoji Squad: The Mysterious Group Behind the Little Icons We Love 🤝" src="https://omny.fm/shows/huh-science-explained/the-emoji-squad-the-mysterious-group-behind-the-li/embed?in_playlist=podcast&amp;style=Cover" width="100%" height="180" frameborder="0"></iframe></p> <p>The terms ‘anxiety’ and ‘depression’ were selected for analysis as prevalent, prominent mental health concepts.</p> <p>The researchers expected the emotional intensity and severity of the two terms to reduce over time as the frequency of their use increased.</p> <p>That expectation was informed by previous research using a similar approach, co-authored by Haslam and <a href="https://sciendo.com/article/10.58734/plc-2023-0002" target="_blank" rel="noreferrer noopener">publishing in</a> Sciendo, where increasing use of the word ‘trauma’ since the 1970s was associated with a shift in meaning including a broadening of use and declining severity.</p> <p>They hypothesised a similar trend for ‘anxiety’ and ‘depression’.</p> <p>“Well, we didn’t find what we expected,” Haslam says.</p> <p>Contrary to expectation, the emotional severity associated with anxiety and depression increased linearly over time. </p> <p>The authors say this is possibly due to growing pathologising of the terms, given their analysis shows use of the words increasingly linked to clinical concepts. </p> <p>In particular, the terms ‘disorder’ and ‘symptom’ have become more commonly associated with ‘anxiety’ and ‘depression’ in more recent decades, the paper says, finding similar patterns in both the academic and general texts. </p> <p>Anxiety and depression were also increasingly used together, compared to use in the ‘70s where the terms were more likely to refer to separate things.</p> <p>Haslam says, these shifts in meaning could reflect growing awareness of mental health in society and more research is needed into the implications, he says. </p> <p>But he notes this is an area where there can be “mixed blessings”.</p> <p>On the one hand, greater awareness of anxiety and depression can help people to seek appropriate treatment; and on the other, pathologising more ordinary variations in mood can risk become self-fulfilling or self-defeating.</p> <p>At a more systemic level, pathologising the milder end of the mental health spectrum could risk leading to a misallocation of resources away from the more severe and urgent mental health problems, Haslam says.</p> <p><em>Image credits: Getty Images</em></p> <p><em><a href="https://cosmosmagazine.com/people/social-sciences/tracking-the-shift-in-meanings-of-anxiety-and-depression-over-time/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock">Petra Stock</a>. </em></p>

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Do psychedelics really work to treat depression and PTSD? Here’s what the evidence says

<p><em><a href="https://theconversation.com/profiles/sam-moreton-194043">Sam Moreton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>As of July 1, authorised psychiatrists have been allowed to prescribe MDMA (the chemical found in “ecstasy”) to treat post-traumatic stress disorder (PTSD), and psilocybin (found in “magic mushrooms”) to treat depression that hasn’t responded to other treatment.</p> <p>Psychedelic therapies have researchers excited because evidence suggests they might have lasting beneficial effects on factors that cause psychological distress beyond the treatment period. These include <a href="https://link.springer.com/article/10.1007/s00213-017-4701-y">feeling disconnected from other people</a>, <a href="https://link.springer.com/article/10.1007/s00213-019-05391-0">fear of death</a>, and <a href="https://www.sciencedirect.com/science/article/pii/S2212144719301140?casa_token=OP6tKGxjPHAAAAAA:NTQ4khgsOY5wmsQ5HzCMcZ4eZ43wQV-sdhUbf5LXFiIeKWNwdonhfCxo77k7QbNk4G69EfX-">rigid ways of thinking</a>.</p> <p>This stands in contrast to most medications for psychological issues, which only directly help while people keep taking them regularly.</p> <p>But how strong is the evidence for psychedelic therapy?</p> <h2>Early promise</h2> <p>Early results from studies around the world have found psychedelic therapy <a href="https://www.ranzcp.org/getmedia/0cf57ea2-0bd7-4883-9155-d2ba1958df86/cm-therapeutic-use-of-mdma-for-ptsd-and-psilocybin-for-treatment-resistant-depression.pdf">might be effective</a> for treating a range of psychological issues.</p> <p>For instance, most studies (<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">but not all</a>) have found patients tend to report <a href="https://pubmed.ncbi.nlm.nih.gov/37357767/">fewer depression symptoms</a> for periods ranging from several weeks to several months after psilocybin therapy.</p> <p>Similarly, studies have found <a href="https://journals.sagepub.com/doi/10.1177/0269881120965915">reductions in PTSD symptoms</a> three weeks after MDMA therapy.</p> <h2>Not so fast</h2> <p>However, as psychedelic research has grown, <a href="https://pubmed.ncbi.nlm.nih.gov/35243919/">limitations</a> of the research have been identified by researchers both <a href="https://psyarxiv.com/ak6gx/">within</a> and <a href="https://www.sciencefictions.org/p/psychedelics">outside</a> the psychedelic field.</p> <p>One issue is that we aren’t sure whether findings might be due to a <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo effect</a>, which occurs when a treatment works because people expect it to work.</p> <p>In clinical trials, participants are often given either a medication or a placebo (inactive) drug – and it’s important they don’t know which they have been given. However, due to the strong effects, it is difficult to prevent participants from knowing whether they have been given a psychedelic drug.</p> <p>Researchers have tried to use a range of different drugs (such as Ritalin) as a placebo in order to “trick” those participants not given a psychedelic into thinking they have received one. But this can be difficult to achieve.</p> <p>In 2021, researchers <a href="https://www.tandfonline.com/doi/full/10.1080/17512433.2021.1933434?casa_token=Dovn7x_rkdUAAAAA%3AsPzBTYNTPnNwqj9NvwN0m9ptrP4x4-c83gp3tGcshs30dWHNnmB_Vx-X5H5Y3pZJdG02IWW6X2E">reviewed</a> clinical trials involving psychedelics such as LSD, psilocybin, and dimethyltryptamine (found in animals and plants) for mood and anxiety disorders. They found trials either had not assessed whether participants guessed correctly which drug they had been given, or that this had been tested and participants tended to guess correctly.</p> <p>More recent trials <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">either don’t measure this</a> or find participants have a <a href="https://journals.sagepub.com/doi/full/10.1177/02698811231154852?casa_token=VsPt344fVGwAAAAA%3AA-i1VPBE1EWyFITWNncZEt876lWMiC7rtTOLJBQnb2pHI2775imUJhrzeSZW6r9doaBeDaj61D0">pretty good idea</a> of whether they’ve had a placebo or a psychedelic drug.</p> <p>Given the publicity and excitement around psychedelic research in recent years, it is likely most participants have <a href="https://culanth.org/fieldsights/the-pollan-effect-psychedelic-research-between-world-and-word">strong beliefs</a> such therapies work. This could lead to a significant placebo effect for participants given a psychedelic dose. Additionally, participants who realise they have received a placebo could experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184717/">disappointment and frustration</a>, resulting in worse symptoms. The benefits of a psychedelic may seem even greater when they are compared to the experiences of disappointed participants.</p> <h2>Translating trials to practice</h2> <p>Anecdotally, patients might be motivated to report they have gotten better, even when they haven’t.</p> <p>On a 2021 podcast, one clinical trial participant <a href="https://www.psymposia.com/powertrip/">described</a> how, in hindsight, the information they provided to the trial did not accurately capture the worsening of their symptoms. Trial participants are likely aware their results might affect whether treatments are legalised. They may not want to “ruin” the research by admitting the treatment didn’t work for them.</p> <p>There is also uncertainty about whether the findings from clinical trials mean treatments will work in private practice. There may be a lack of clarity around <a href="https://psyarxiv.com/ak6gx/">how trial participants</a> are recruited and selected. Therefore participants may not represent the typical person with PTSD or treatment-resistant depression.</p> <p>And while <a href="https://journals.sagepub.com/doi/full/10.1177/02698811211069100">the safety of psychedelics</a> within controlled contexts is often emphasised by advocates, less is known about safety of psychedelic therapy <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2021.737738/full">outside</a> clinical trials.</p> <h2>Resolving issues</h2> <p>These issues do not mean the promising psychedelic research conducted over the past several decades is worthless. Nevertheless, a <a href="https://pubmed.ncbi.nlm.nih.gov/35285280/#full-view-affiliation-1">recent review</a> of the effects of MDMA and psilocybin on mental, behavioural or developmental disorders by Australian researchers concluded the “overall certainty of evidence was low or very low”.</p> <p>Dutch researchers recently drafted a <a href="https://psyarxiv.com/ak6gx/">roadmap for psychedelic science</a> with a checklist for future research to help avoid these pitfalls. When more research is done, it might turn out psychedelic treatments help patients and don’t come with unacceptable harms – we simply don’t know that yet.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/sam-moreton-194043">Sa<em>m Moreton</em></a><em>, Associate Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-psychedelics-really-work-to-treat-depression-and-ptsd-heres-what-the-evidence-says-208857">original article</a>.</em></p>

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How one brave mum is shedding light on postnatal depression through the healing power of music

<p dir="ltr"><em><strong>Warning: This article contains sensitive content which some readers may find distressing.</strong></em></p> <p dir="ltr">It’s no secret that having a baby changes your life in every way. From sleepless nights and feeding routines, to nappy changes and seemingly endless crying, starting a family is, put simply, a life-altering experience. </p> <p dir="ltr">And while the early days of having a newborn can bring love and chaos in equal parts, for some, the days, weeks and months after giving birth can welcome a whole new set of challenges.</p> <p dir="ltr">While most parents are privy to the “baby blues” and a rough day here and there, those struggling with postnatal depression can often be overlooked. </p> <p dir="ltr">Postnatal depression is common, with one in five mums, and one in 10 dads, experiencing postnatal depression symptoms after their baby is born.</p> <p dir="ltr">For Lija (pronounced Le-ah), postnatal depression completely changed her life. </p> <p dir="ltr">Lija, a music teacher from the Central Coast of New South Wales, welcomed her first child, a beautiful daughter named Harper, into the world at the end of 2017. </p> <p dir="ltr">When Lija discovered she was going to become a mum, she was overcome with fear. </p> <p dir="ltr">Lija spoke exclusively with <em>OverSixty</em> about her journey with postnatal depression, and how her feelings of anxiety began as soon as she fell pregnant. </p> <p dir="ltr">“There was this lie in my head that I could not give birth… That I would die. You feel like you can’t make a way through it and you’re predicting all these complications. [Lija’s friends’ traumatic birth experience] confirmed all these feelings and i just thought ‘Maybe you die from this’.”</p> <p dir="ltr">As soon as Lija and her husband began to celebrate the news of their growing family, she quickly began to “spiral” into self-doubt and depressive episodes. </p> <p dir="ltr">“When I found out I was pregnant, it was a spiral. I didn’t think I was good enough, I was crying so much… I didn’t feel like I could tell anyone because I was so gripped in fear.”</p> <p dir="ltr">“It took me about seven months to accept that I was having a kid.”</p> <p dir="ltr">Over the course of her pregnancy, Lija’s mental health continued to plummet with her feelings of fear and self-doubt, which led her down an even darker path. </p> <p dir="ltr">“The worst part was I was suicidal. There were moments where I wanted to end my life because I just felt like my time was up.”</p> <p dir="ltr">These feelings of helplessness led Lija to reach out to a counsellor, who helped manage her mental health symptoms for the rest of her pregnancy and introduced her to hypnobirthing.</p> <p dir="ltr">Her sessions with a hypnobirthing specialist gave Lija the boost she needed to be in tune with her body, and get her through to Harper’s birth with a sense of confidence. </p> <p dir="ltr">“If I’ve grown a baby, I can give birth to a baby. It was all just focus.”</p> <p dir="ltr">When Harper was born, Lija remembers healthcare professionals warning her husband that her mental health could decline, but she was never spoken to directly.</p> <p dir="ltr">“Apparently nurses were talking to my husband after the birth saying ‘She’s going to be prone to postnatal depression, you need to watch her’, but no one told me I was going to be so lonely.” </p> <p dir="ltr">“I was so focused on the birth going well that I hadn’t thought about what happens after, and I didn’t know what postnatal depression was.”</p> <p dir="ltr">When Lija and her husband brought baby Harper home, as they encountered perfectly common issues around sleep and breastfeeding, Lija thought she had failed as a first-time mum.</p> <p dir="ltr">“I felt like I failed as a mum because I couldn't give Harper everything she needed. And that started all these terrible thoughts and I just started to mentally spiral down again. But I didn’t know for about six months that I had postnatal depression.”</p> <p dir="ltr">During the first few months of Harper’s life, Lija began to find simple day-to-day tasks very difficult. </p> <p dir="ltr">“My poor husband… I was a psycho. It began when I said no one was allowed to come over because I was constantly in my pyjamas and I felt ashamed that my house wasn’t clean.”  </p> <p dir="ltr">Lija shared that as she began to settle into the reality of being a mum, Harper’s needs always came first. </p> <p dir="ltr">“I was just in such a routine. I needed to have my baby follow a good structure, which meant my mental health took a backseat. So I just kept spiralling and spiralling.”</p> <p dir="ltr">As Lija tried to better herself, she quickly found out that comparing yourself to other new parents is a slippery slope that welcomes thoughts of self-doubt. </p> <p dir="ltr">“I tried to go to a mum’s club and they all seemed so perfect. I feel like they weren’t real. It was like Instagram mums. So to try and look good, I was spending all this money to try and keep up appearances.”</p> <p dir="ltr">As Lija’s mental health continued to suffer, she said it wasn’t until a difficult conversation with her husband that she realised she needed professional help. </p> <p dir="ltr">“I wasn’t being the normal me. There was no joy, there was no laughter, and I felt like I failed as a mother and as a wife. So my husband said ‘I’ve booked you in for a therapy session’, and that was the start of it.”</p> <p dir="ltr">“I wanted to be better for Harper. I wanted to be a good mum for her. So I had to start working on myself.”</p> <p dir="ltr">Now, five years on, Lija is reflecting on her experience with postnatal depression in the best way she knows how: through her music. </p> <p dir="ltr">Lija’s debut single <em>Save Me</em> details her journey of becoming a mum and bettering herself, while painting an honest portrait of the first months of motherhood. </p> <p><iframe title="YouTube video player" src="https://www.youtube.com/embed/tmHTlybb-rM" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></p> <p dir="ltr">After being a musician for most of her life, Lija’s passion took a backseat when she became a mother. </p> <p dir="ltr">“I started to miss my music, because I've done music my whole life. It was so hard to walk past my studio and see the guitar going to waste. I started to miss the other half of me as a musician.”</p> <p dir="ltr">After working on <em>Save Me</em> for several years, Lija believes it is the right time to put her story out there in order to help and inspire other parents struggling with postnatal depression.</p> <p dir="ltr">“It’s okay to be vulnerable. Be real, because you can help others with your honesty.”</p> <p dir="ltr">“It’s also important to remember that babies aren’t going to remember the best outfits they were in, or if they had the best pram. They're going to remember if they were loved or not.”</p> <p dir="ltr">Lija has long been a champion of music and its healing power, which became a saviour in her darkest times through her postnatal depression journey.</p> <p dir="ltr">“I went back to teaching music three months after having Harper. I worked one day a week and these kids and teenagers that were singing to me were actually healing me with their music and their talent.”</p> <p dir="ltr">“Music is something I have always turned to. It has always spoken to me, and I thought if I write a song about my journey, that could heal me too. I thought ‘It’s time to kick fear in the butt and write about life’.”</p> <p dir="ltr">Musical talent is something that runs in the family, with Harper’s singing talents already at “the next level”.</p> <p dir="ltr">“I swear she came out singing! Her ability to hear pitch is insane. In lockdown, she would be singing scales while I was teaching music classes over Zoom. She is just so joyous, and she is like my healing.”</p> <p dir="ltr">Lija’s debut single <em>Save Me</em> is out on now.</p> <p dir="ltr"><strong>Don't go it alone. Please reach out for help.</strong></p> <p dir="ltr"><strong><em>Lifeline: 13 11 14 or <a href="http://lifeline.org.au/">lifeline.org.au</a></em></strong></p> <p dir="ltr"><strong><em>Beyond Blue: 1300 22 4636 or <a href="http://beyondblue.org.au/">beyondblue.org.au</a></em></strong></p> <p dir="ltr"><strong><em>Headspace: 1800 650 890 or <a href="http://headspace.org.au/">headspace.org.au</a></em></strong></p> <p dir="ltr"><strong><em>PANDA (Perinatal Anxiety &amp; Depression Australia): 1300 726 306 or <a href="https://panda.org.au/">panda.org.au</a></em></strong></p> <p dir="ltr"><em>Image credits: Instagram</em></p>

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5 changes to make around the home that combat depression

<p>Dealing with depression is difficult no matter what environment you’re in, but studies show there are certain steps you can take around the house to improve your mental health. Here are 5 activities you can do and changes you can make to your home that will boost your mood in no time at all.</p> <p><strong>1. Get gardening</strong></p> <p>Whether or not you’ve got a natural green thumb, spending time in nature, getting your hands dirty and breathing in that fresh air has been <a href="http://www.pnas.org/content/112/28/8567.abstract" target="_blank" rel="noopener"><strong><span style="text-decoration: underline;">scientifically proven</span></strong></a> to lower feelings of despair. No backyard or front yard? No worries. Simply putting plants on your balcony, windowsill or around the house can be beneficial. <a href="http://www.oversixty.com.au/lifestyle/home-garden/2017/01/plants-that-will-make-your-home-happier/" target="_blank" rel="noopener"><strong><span style="text-decoration: underline;">Here’s a list of plants</span> </strong></a>that will clear the air, calm you down and even help you sleep.</p> <p><strong>2. Bring the outside in</strong></p> <p>Having a view lets in lots of light, which benefits your circadian rhythm and naturally boosts your mood, but if you don’t have a bright, scenic view, there are ways around it. “There are some beautiful murals, including decals that are easy to hang, that you might put on a wall in your living room,” Dr Jean M. Larson tells <a href="http://www.preventionaus.com.au/gallery/7-simple-changes-to-your-home-that-fight-depression-474471" target="_blank" rel="noopener"><em><strong><span style="text-decoration: underline;">Prevention</span></strong></em></a>. “You want to pick something that's familiar and pleasing.”</p> <p><strong>3. Light up</strong></p> <p>As we mentioned above, light is essential (particularly in the morning) for those suffering depression – especially those affected by seasonal affective disorder. Try to get as much natural light in the morning as possible, otherwise you can install a light box which provides the same light produced by the sun but without all those nasty UV rays.</p> <p><strong>4. Get painting</strong></p> <p>Painting your walls a bright, warm colour like orange or red can “evoke feelings of happiness or optimism,” according to interior designer Suzanne Falk. These colours are most widely associated with happiness, but colour preference is personal, so whatever colour makes you happy is the one you should go for. If painting isn’t an option, try the same thing with art, furniture, rugs, throws and décor.</p> <p><strong>5. Express yourself</strong></p> <p>Decorate your space with constant reminders of the people and things that make you happy. Whether it’s a painting by one of your grandchildren, a photo from your favourite holiday or one of your pet’s toys lying around, it’s always good to have something to bring you back up when you’re feeling down.</p> <p><em>Image credit: Shutterstock</em></p>

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Vegetarians more likely to be depressed than meat-eaters

<p>Vegetarians have around twice as many depressive episodes as meat-eaters, according to a <a href="https://www.sciencedirect.com/science/article/pii/S0165032722010643" target="_blank" rel="noopener">new study</a>.</p> <p>The study, based on survey data from Brazil, chimes with <a href="https://www.psychologytoday.com/gb/blog/animals-and-us/201812/the-baffling-link-between-vegetarianism-and-depression" target="_blank" rel="noopener">earlier research</a> that found higher rates of depression among those who forgo meat. However, the new study suggests that this link exists independent of nutritional intake.</p> <p>It may seem straightforward to look at a link between a diet and specific health problems and assume that the former is causing the latter via some form of nutritional deficiency.</p> <p>Yet the new analysis, published in the Journal of Affective Disorders, took into account a wide range of nutritional factors, including total calorie intake, protein intake, micronutrient intake, and the level of food processing. This suggests that the higher rates of depression among vegetarians are not caused by the nutritional content of their diet.</p> <p>So what might explain the link between vegetarianism and depression? Is there some non-nutritional mechanism that makes the former cause the latter? Or is the relationship down to something else entirely?</p> <p>First, it is possible that being depressed causes people to be more likely to become vegetarian rather than the other way around. The <a href="https://www.nhs.uk/mental-health/conditions/clinical-depression/symptoms/" target="_blank" rel="noopener">symptoms of depression</a> can include rumination on negative thoughts, as well as feelings of guilt.</p> <p>Assuming that depressed and non-depressed people are equally likely to encounter the upsetting truth of slaughterhouses and factory farming, it is possible that depressed people are more likely to ruminate on those thoughts, and more likely to feel guilty for their part in creating the demand.</p> <p>The depressed vegetarian, in this case, is not necessarily wrong to think this way. While depression is sometimes characterised as having unrealistically negative perceptions, <a href="https://www.psychologytoday.com/gb/blog/hide-and-seek/201206/depressive-realism" target="_blank" rel="noopener">there is evidence to suggest</a> that people with mild to moderate depression have more realistic judgments about the outcome of uncertain events and more realistic perceptions of their own role and abilities.</p> <p>In this case, there really is <a href="https://www.bryantresearch.co.uk/insights/acceptability-of-animal-farming-practices" target="_blank" rel="noopener">cruel treatment of animals in meat production</a>. And this really is caused by consumer demand for cheap meat.</p> <p>Second, it is possible that adhering to a vegetarian diet causes depression for reasons other than nutrition. Even if there is no “happy nutrient” lacking in a vegetarian diet, it could be the case that forgoing meat causes depression through other means.</p> <p>For example, adopting a vegetarian diet might affect one’s relationship with others and involvement in social activities, and sometimes may be associated with <a href="https://pubmed.ncbi.nlm.nih.gov/21361905/" target="_blank" rel="noopener">teasing or other forms of social ostracism</a>.</p> <p>Notably, the new study is based on survey data collected in Brazil, a country <a href="https://data.oecd.org/agroutput/meat-consumption.htm" target="_blank" rel="noopener">famous for its meat-heavy diet</a>. Some survey data has pointed to a <a href="https://www.nytimes.com/2020/12/26/world/americas/brazil-vegetarian.html" target="_blank" rel="noopener">sharp increase in vegetarianism in Brazil in recent years</a>, going from 8% in 2012 to 16% in 2018. However, the recent paper surveyed over 14,000 Brazilians and found just 82 vegetarians – scarcely more than half a per cent.</p> <p>One has to wonder if the same link between vegetarianism and depression would be observed in India or other countries where vegetarianism is more of a social norm. More importantly, as the <a href="https://www.bryantresearch.co.uk/insights/uk-protein-transition-in-4-graphs" target="_blank" rel="noopener">rate of vegetarianism increases in the UK</a> and other developed countries, will we see the relationship disappear over time?</p> <p>Finally, it is possible that neither vegetarianism nor depression cause the other, but both are associated with some third factor. This could be any number of characteristics or experiences that are associated with both vegetarianism and depression.</p> <p>For example, <a href="https://www.sciencedirect.com/science/article/pii/S0195666317305305" target="_blank" rel="noopener">women are more likely than men to be vegetarian</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532074/" target="_blank" rel="noopener">and to experience depression</a>. However, the Brazilian study took sex into account, ruling out this particular third variable.</p> <h2>Not examined</h2> <p>One variable that was not examined, but is plausibly linked to both vegetarianism and depression, is exposure to violent images of the meat industry. Preventing cruelty to animals is the <a href="https://www.statista.com/statistics/1062072/reasons-for-becoming-vegetarian-or-vegan-in-great-britain/" target="_blank" rel="noopener">most commonly cited reason</a> vegetarians give for avoiding meat.</p> <p>Documentaries like <a href="https://watchdominion.org/" target="_blank" rel="noopener">Dominion</a> and <a href="http://www.nationearth.com/" target="_blank" rel="noopener">Earthlings</a> that depict the cruelty in the meat industry cannot readily be described as feelgood films. One can easily imagine that a person who consumes this kind of media would become both vegetarian and, especially when most people choose to look the other way, depressed.</p> <p>There are several possible reasons for the link between vegetarianism and depression. This new study suggests that vegetarian nutrition is not the cause of depression.</p> <p>Instead, the vegetarian social experience may contribute to depression, depression may cause an increased likelihood of becoming vegetarian, or both vegetarianism and depression may be caused by a third variable, such as exposure to violent meat industry imagery.</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/vegetarians-more-likely-to-be-depressed-than-meat-eaters-possible-reasons-191707" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

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New study to “give hope” to childhood trauma survivors with depression

<p dir="ltr">A new study has challenged our understanding of how to treat adults with a history of childhood trauma, revealing that using psychotherapy, medication or a combination of the two are effective treatments for those with depression.</p> <p dir="ltr">Childhood trauma, defined as abuse or neglect of a person before they are 18 years old, is a known risk factor for major depressive disorders in adulthood. It often results in symptoms that start earlier, last longer and are more frequent, and increases the risk of developing co-occurring diseases and conditions.</p> <p dir="ltr">The study, published in <em><a href="https://doi.org/10.1016/S2215-0366(22)00227-9" target="_blank" rel="noopener">The Lancet Psychiatry</a></em>, found that adult survivors of childhood trauma who receive these common treatments experience improved symptoms at the same rate as those without childhood trauma.</p> <p dir="ltr">While previous studies have indicated that common treatments for major depressive disorders are less effective for people with childhood trauma, the team argues that these findings are inconsistent.</p> <p dir="ltr">The team then examined data from 29 clinical trials of psychotherapy and pharmacotherapy (the use of prescribed medications) among adults with major depressive disorders to determine whether those with trauma were more severely depressed before treatment, had more unfavourable outcomes after treatment, and whether they were less likely to benefit from treatment in comparison to those without trauma.</p> <p dir="ltr">Among the 46 percent of participants with childhood trauma, the team found that they showed more severe symptoms at the start of treatment and after treatment in comparison to the control group (those without trauma).</p> <p dir="ltr">But, they found that both groups experienced an improvement in symptoms at a similar rate.</p> <p dir="ltr">Erika Kuzminskaite, a PhD candidate and the first author of the study, said that this finding could be a source of hope.</p> <p dir="ltr">“Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma,” Kuzminskaite said.</p> <p dir="ltr">“Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed.”</p> <p dir="ltr">Antoine Yrondi, a professor at the University of Toulouse who wasn’t involved in the research, wrote that the study provides a message of hope for patients.</p> <p dir="ltr">“This meta-analysis could deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms,” Dr Yrondi said.</p> <p dir="ltr">“However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission and, therefore, have an impact on daily functioning.”</p> <p dir="ltr">According to <a href="https://blueknot.org.au/resources/blue-knot-fact-sheets/trauma-classification/what-is-childhood-trauma/" target="_blank" rel="noopener">Blue Knot</a>, childhood trauma can have a wider and more extreme impact than trauma we experience as adults because a child’s brain is still developing. If the trauma is unresolved, coping strategies developed during childhood can become risk factors for poorer psychological and physical health in adulthood.</p> <p dir="ltr">But, it is possible to recover from childhood trauma, with this latest study going to show that common treatments can be effective.</p> <p dir="ltr"><em>If you’re in need of support, you can contact Lifeline on 13 11 14 or Blue Knot on 1300 657 380.</em></p> <p><em><span id="docs-internal-guid-62551377-7fff-7a7f-9e23-d352d2c29923"></span></em></p> <p dir="ltr"><em>Image: Getty Images</em></p>

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Magic mushrooms relieve depression and now we might know why

<p dir="ltr">Psychedelics like psilocybin, the key active ingredient in magic mushrooms, have become a beacon of hope for people with depression that is resistant to other forms of treatment - and new research has shed some light on how they affect the brain.</p> <p dir="ltr">A team of psychedelics researchers have used MRI technology to understand how psilocybin works in the brain, finding that it first “dissolves” then expands brain connections.</p> <p dir="ltr">The study, published in <em><a href="https://doi.org/10.1038/s41591-022-01744-z" target="_blank" rel="noopener">Nature Medicine</a></em>, found that certain parts of depressed people’s brains became more interconnected and flexible after two doses of psilocybin, and that the changes lasted for up to three weeks.</p> <p dir="ltr">“These findings are important,” Professor David Nutt, a psychiatrist at the Imperial College London and one of the senior authors of the study, said.</p> <p dir="ltr">“For the first time we find that psilocybin works differently from conventional antidepressants - making the brain more flexible and fluid, and less entrenched in the negative thinking patterns associated with depression.”</p> <p dir="ltr">Though magic mushrooms have been used for their healing properties by Indigenous people for a long time, per <em><a href="https://www.sciencealert.com/scientists-have-finally-figured-out-how-magic-mushrooms-might-relieve-depression" target="_blank" rel="noopener">ScienceAlert</a></em>, their use in clinical trials - and our understanding of how they work - is limited.</p> <p dir="ltr">Previous research from Professor Nutt and his colleagues found that a combination of psilocybin and psychological therapy was as effective as taking escitalopram, a common antidepressant, without the common side effects that can include weight gain, reduced libido, and insomnia.</p> <p dir="ltr">Though this and other small studies have shown the benefits of psilocybin, how it works in the brain has been poorly understood until Professor Nutt’s most recent study.</p> <p dir="ltr">He and his team analysed the brain scans of 43 people with clinical depression who had participated in two previous clinical trials, including 22 people treated with psilocybin, and 21 people who received escitalopram.</p> <p dir="ltr">They found that those who received psilocybin had greater connectivity in regions of the brain that are rich in serotonin receptors which are usually segregated in depressed patients. A day after treatment, their brain networks were more interconnected and flexible, while no such changes were seen in the people taking the antidepressant.</p> <p dir="ltr">“This supports our initial predictions and confirms psilocybin could be a real alternative approach to depression treatments,” Professor Nutt said.</p> <p dir="ltr">Their findings match those of a study from 2020, which found similar changes in brain network connectivity up to a month after one dose of psilocybin.</p> <p dir="ltr">As exciting as these findings are, neuroscientist and fellow senior author Dr Robin Carhart-Harris said more research is needed.</p> <p dir="ltr">“We don’t know yet how long the changes in brain activity seen with psilocybin therapy last and we need to do more research to understand this,” he said.</p> <p dir="ltr">“We do know that some people relapse, and it may be that after a while their brains revert to the rigid patterns of activity we see in depression.”</p> <p dir="ltr">Either way, the researchers hope their findings pave the way for studying psilocybin’s effect on other mental illnesses characterised by rigid thought patterns, such as anorexia and addiction.</p> <p dir="ltr">“We now need to test if this is the case, and if it is, then we have found something important,” Dr Carhart-Harris said.</p> <p><span id="docs-internal-guid-3043ebe9-7fff-c5f3-3351-6e620f6ff71e"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

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New study finds vegetarians and vegans more likely to suffer from depression

<p><em>Image: Getty</em></p> <p>Researchers from Queensland’s Bond University have found that a low-quality plant-based diet, compared to a diet rich in fresh produce, could lead to poorer mental health.</p> <p>Nutritional psychiatry researcher Megan Lee said the finding was particularly significant given the increasing popularity of vegan and vegetarian lifestyles and the proliferation of packaged foods targeted at those groups.</p> <p>Processed foods are high in refined vegetable oils, grains, salt and sugar.</p> <p>“There is a general perception that following a plant-based diet is inherently healthy but like any diet it comes down to what you put in your mouth,” Lee said.</p> <p>“Vegans and vegetarians are not automatically eating heaps of fruit and veg because there are all these products out there that are fully processed, fully refined.”</p> <p>People may inadvertently be consuming high levels of processed plant foods which is a known risk factor for increased depression.</p> <p>During the study, researchers looked at the diet and mental health of 219 vegans and vegetarians aged 18-44 across the country, who were then asked to complete relevant questionnaires.</p> <p>Researchers found those with lots of fresh fruit, vegetables, nuts, seeds, legumes and whole grains in their diet were at a lower risk of depression compared to those on low-quality diets.</p> <p>The link in diet and the risk of depression was likely due to the presence of complex carbohydrates, fibre, probiotics and antioxidants, which have all been found to decrease symptoms of depression, Lee said.</p> <p>“It seems to have more a protective role,” she said.</p> <p>“Our research did not find that a plant-based diet was a treatment or fix for those who were already depressed.”</p> <p>Vegans and vegetarians are already more vulnerable to depression than the general population, Lee added.</p> <p>“We think this (susceptibility to depression) might be because vegans and vegetarians tend to be more conscious about external issues—animal welfare, environmental concerns—and they can be ostracised socially because of their choice of diet,” she said.</p> <p>The research also found meat-eaters can also protect their mental health by consuming more fruits and vegetables.</p>

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Physical symptoms linked to genetic risk of depression

<p><span style="font-weight: 400;">People who experience physical symptoms such as chronic pain, fatigue and migraines are also more likely to have a higher genetic risk of clinical depression, according to a new study.</span></p> <p><span style="font-weight: 400;">Researchers from the University of Queensland collaborated with the QIMR Berghofer Medical Research Institute at the Royal Brisbane and Women’s Hospital to conduct a new study published in </span><em><a rel="noopener" href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2783096" target="_blank"><span style="font-weight: 400;">JAMA Psychiatry</span></a></em><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">They analysed data from over 15,000 volunteers, who provided information about their mental health history, depression symptoms, and a DNA sample.</span></p> <p><span style="font-weight: 400;">The team found that participants who had a higher genetic risk of developing clinical depression were more likely to experience additional physical symptoms.</span></p> <p><span style="font-weight: 400;">Dr Enda Byrne, a senior research fellow in psychiatric genetics and one of the researchers involved, said the study aimed to improve understanding of the genetic risks of depression and how other symptoms can be used to aid diagnosis.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7845012/depression1.jpg" alt="" data-udi="umb://media/e08ca3fc9f134a3c8fb3556dde363b83" /></p> <p><em><span style="font-weight: 400;">Dr Enda Byrnes, the senior author of the latest study on depression and genetic risk. Image: The University of Queensland</span></em></p> <p><span style="font-weight: 400;">“A large proportion of people with clinically-diagnosed depression present initially to doctors with physical symptoms that cause distress and can severely impact on people’s quality of life,” </span><a rel="noopener" href="https://www.scimex.org/newsfeed/genetic-risk-for-clinical-depression-linked-to-physical-symptoms" target="_blank"><span style="font-weight: 400;">he said</span></a><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">“Our research aimed to better understand the biological basis of depression and found that assessing a broad range of symptoms was important.</span></p> <p><span style="font-weight: 400;">“We wanted to see how genetic risk factors based on clinical definitions of depression differed - from those based on a single question to those based on a doctor’s consultation about mental health problems.”</span></p> <p><strong>Genetic risks of depression, explained</strong></p> <p><span style="font-weight: 400;">Many different factors can contribute to the onset of depression, and there is strong evidence to suggest that genetics can affect the likelihood of developing the mental illness.</span></p> <p><span style="font-weight: 400;">Individuals can be predisposed to developing depression if someone in their family has been diagnosed. If a person’s biological parent has been diagnosed with clinical depression, their genetic risk of developing the illness sits at </span><a rel="noopener" href="https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/1-causesofdepression.pdf" target="_blank"><span style="font-weight: 400;">about 40 percent</span></a><span style="font-weight: 400;">, with the other 60 percent coming from factors in their environment such as stress and age.</span></p> <p><span style="font-weight: 400;">Previous studies have also examined the role genetics plays in depression, but Dr Byrne said it can be difficult to find genetic risk factors that are specific to clinical depression.</span></p> <p><span style="font-weight: 400;">“Previous genetic studies have included participants who report having seen a doctor for worries or tension - but who may not meet the ‘official’ criteria for a diagnosis of depression,” he said.</span></p> <p><span style="font-weight: 400;">The researchers also stressed the importance of using a large number of samples in order to identify the risk factors for clinical depression but not for other definitions of depression.</span></p> <p><span style="font-weight: 400;">“It is also linked to higher rates of somatic symptoms - that is, physical symptoms that cause distress and can severely impact on people’s quality of life,” Dr Byrne said.</span></p> <p><span style="font-weight: 400;">“Our results highlight the need for larger studies investigating the broad range of symptoms experienced by people with depression.”</span></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p>

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Brain implant helps woman’s severe depression

<p><span style="font-weight: 400;">A woman battling severe depression has had a life-changing experience after she received a personalised brain implant.</span></p> <p><span style="font-weight: 400;">“It’s like my lens on the world changed,” </span><a rel="noopener" href="https://www.sciencenews.org/article/brain-implant-severe-depression-activity-stimulation?utm_source=Editors_Picks&amp;utm_medium=email&amp;utm_campaign=editorspicks101021" target="_blank"><span style="font-weight: 400;">said Sarah</span></a><span style="font-weight: 400;">, the research volunteer who received the implant.</span></p> <p><span style="font-weight: 400;">Though the device was tailored specifically for Sarah’s brain and may not work as a treatment for others, psychiatrist and neural engineer Alik Widge says it is significant because it serves as a way to study how brain activity changes during depression.</span></p> <p><span style="font-weight: 400;">A team of researchers from the University of California implanted temporary wire electrodes into Sarah’s brain, allowing them to monitor the brain activity that corresponded to her depression symptoms.</span></p> <p><span style="font-weight: 400;">For Sarah, a fast brain wave called a gamma wave appeared in her amygdala, a part of the brain involved in emotions, that was associated with her symptoms.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7844766/sarah-brain1.jpg" alt="" data-udi="umb://media/08625f274e4445b3b116fa203d69817b" /></p> <p><em><span style="font-weight: 400;">Image: Maurice Ramirez / UCSF</span></em></p> <p><span style="font-weight: 400;">The team then worked to uncover a way to interrupt the signal, and identified a potential area to target: the ventral capsule/ventral striatum (VC/VS).</span></p> <p><span style="font-weight: 400;">When they applied tiny jolts of electrical currents to the area, Sarah’s mood improved.</span></p> <p><span style="font-weight: 400;">“We could learn the road map of Sarah’s brain in a way that we could really improve her depression symptoms,” Katherine Scangos, an associate professor in psychiatry, said in a news briefing in September.</span></p> <p><span style="font-weight: 400;">While the researchers were mapping her brain, Sarah would feel joy when the right spot was stimulated.</span></p> <p><span style="font-weight: 400;">“I laughed out loud,” she said in the briefing.</span></p> <p><span style="font-weight: 400;">“This was the first time I had spontaneously laughed and smiled where it wasn’t faked or forced in five years.”</span></p> <p><span style="font-weight: 400;">Since the initial experiment, surgeons implanted a more permanent device into her brain.</span></p> <p><span style="font-weight: 400;">The device was programmed to detect when the gamma signals in Sarah’s amygdala reached high levels and respond by sending a jolt of electricity to her VC/VS.</span></p> <p><span style="font-weight: 400;">The stimulation was calibrated so Sarah wouldn’t feel the jolts, but she said they would leave her feeling more energetic.</span></p> <p><span style="font-weight: 400;">“As time goes on, it’s been this virtuous cycle, a spiral upwards,” she said. </span></p> <p><span style="font-weight: 400;">“Everything has gotten easier and easier.”</span></p> <p><span style="font-weight: 400;">The research describing the technology used to make Sarah’s first implant was published in </span><em><a rel="noopener" href="https://www.nature.com/articles/s41591-021-01480-w" target="_blank"><span style="font-weight: 400;">Nature Medicine</span></a></em><span style="font-weight: 400;">, and revealed that the effects Sarah felt occurred over two months.</span></p> <p><span style="font-weight: 400;">The approach required a lot of sophisticated technology, including imaging and machine learning technology.</span></p> <p><span style="font-weight: 400;">Helen Mayburg, a neurologist at Icahn School of Medicine at Mount Sinai in New York City, cautioned that its complex nature may make it difficult to turn into a wider treatment.</span></p> <p><span style="font-weight: 400;">But, the results contain information that is valuable to those looking to understand the effect of depression on the brain and how it can be changed.</span></p> <p><span style="font-weight: 400;">She said, “What we all want to know is, ‘How does this work?’”</span></p> <p><em><span style="font-weight: 400;">Image: Jon Lok / UCSF</span></em></p>

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4 signs your loved one could have high-functioning depression

<p><strong>1. They decline social invitations</strong></p> <p><span style="font-weight: 400;">High-functioning depression looks a lot like chronic low-level depression and can last around five years in adults or one to two years in children and teens, according to the Harvard School of Public Health. And while it may not leave a person devastated and hopeless, high-functioning depression can seriously dent your quality of life, dampening your enthusiasm for work, school, family and even social activities. A change in social activities can be one of the earliest warning signs.</span></p> <p><span style="font-weight: 400;">“People with high-functioning depression still go to work and interact with people, but outside of work, they may stop hanging out with friends, and make excuses like ‘work’s been really stressful,’” says psychiatrist Dr Jason Stamper. “They will be somewhat isolative, and this often translates into distance in relationships.”</span></p> <p><span style="font-weight: 400;">Learn </span><a href="https://www.readersdigest.com.au/healthsmart/tips/12-simple-ways-to-make-friends-as-an-adult"><span style="font-weight: 400;">these simple ways to make friends as an adult</span></a><span style="font-weight: 400;">.</span></p> <p><strong>2. They have other health issues</strong></p> <p><span style="font-weight: 400;">This is a two-way street. On one hand, underlying medical conditions can prompt depression. “Co-occurring medical conditions, like diabetes or cancer, cause stress and strain that can lead to depression,” says professor psychiatry Dr Michelle Riba. On the other hand, depression can lower immunity, making you more vulnerable to getting sick.</span></p> <p><strong>3. They’re sleeping differently</strong></p> <p><span style="font-weight: 400;">Whether you can’t nod off as easily, you’re snoozing more than usual, or you’re tossing and turning, sleep problems can warn of possible depression – and it can make your symptoms dramatically worse. “Good sleep is key to good mental health,” says Dr Carol Landau, a clinical professor of psychiatry at Brown University.</span></p> <p><span style="font-weight: 400;">Here are </span><a href="https://www.readersdigest.com.au/healthsmart/conditions/thyroid/9-silent-signs-thyroid-problem-you-may-be-ignoring"><span style="font-weight: 400;">the medical reasons you’re tired all the time</span></a><span style="font-weight: 400;">.</span></p> <p><strong>4. They’re worried or anxious</strong></p> <p><span style="font-weight: 400;">We’re so quick to equate depression with sadness that we tend to overlook another strongly-linked emotion: anxiety. It’s important to also note that anxiety isn’t limited to fear; it can manifest itself in multiple ways, according to Dr Stamper. You might experience mental restlessness, confusion and that feeling of having a “pit in your stomach.”</span></p> <p><span style="font-weight: 400;">Try sharing these </span><a href="https://www.readersdigest.com.au/thought-provokinginspirational/14-magic-phrases-to-instantly-calm-your-anxiety"><span style="font-weight: 400;">14 magic phrases to instantly calm anxiety</span></a><span style="font-weight: 400;">.</span></p> <p><em><span style="font-weight: 400;">Written by Brook Bolen. This article first appeared in <a href="https://www.readersdigest.co.nz/healthsmart/conditions/mental-health/signs-your-loved-one-could-have-high-functioning-depression">Reader’s Digest</a>. Find more of what you love from the world’s best-loved magazine, <a href="https://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA93V">here’s our best subscription offer</a>.</span></em></p>

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Sufferers of high-functioning depression could have these four symptoms

<p><strong>1. They may be relying more on vices of choice</strong></p> <p><span style="font-weight: 400;">That might mean drinking more alcohol than usual, taking drugs, eating more ice cream, or playing more video games – whatever behaviour serves as an emotional crutch. “If you’re feeling sad or lonely or otherwise ‘off,’ you may drink more wine more often to cover it up,” Dr Landau says. “This kind of self-medicating is especially troubling because substance abuse adds an extra layer of care that you need.” In addition to being addictive, drugs and alcohol especially can exacerbate symptoms of depression, anxiety and sleep problems, further hindering people’s abilities to cope.</span></p> <p><span style="font-weight: 400;">Watch out for </span><a href="https://www.readersdigest.com.au/culture/8-silent-signs-stress-is-making-you-sick"><span style="font-weight: 400;">these 8 signs stress is making you sick</span></a><span style="font-weight: 400;">.</span></p> <p><strong>2. They’re a successful, Type A personality</strong></p> <p><span style="font-weight: 400;">Affluent, educated people are, surprisingly, more likely to have high-functioning depression.” The paradox of high-functioning depression is that these are very often people who are educated and have important jobs,” Dr Stamper says. “They have the benefit of education and status, yet often their careers can be huge stressors.” Dr Landau says she works mostly with women whose lives and list of personal accomplishments is long and impressive. “In some ways, you’re better off as a low-functioning person,” she says, “because high-functioning people often don’t allow themselves to have all the necessary support.”</span></p> <p><span style="font-weight: 400;">Consider suggesting </span><a href="https://www.readersdigest.com.au/healthsmart/conditions/mental-health/10-habits-people-who-never-get-stressed"><span style="font-weight: 400;">these 10 habits of people who never get stressed.</span></a><span style="font-weight: 400;">.</span></p> <p><strong>3. They’re pretty grouchy</strong></p> <p><span style="font-weight: 400;">Irritability is another common symptom of high-functioning depression, and it’s especially problematic for women, according to Dr Landeau. “People are more likely to see an irritable woman as a ‘bitch,’ rather than showing concern, like, ‘Hey, you don’t seem the same lately. Are you okay?” she says. Because women are conditioned at an early age to be less assertive and to suppress “troublesome” emotions like anger, more subtle symptoms like irritability can be missed. Consider that some one in four women have been, or will be, depressed at least once in their lives, according to Landau, and irritability may be the chief sign.</span></p> <p><span style="font-weight: 400;">These </span><a href="https://www.readersdigest.com.au/healthsmart/conditions/mental-health/16-science-backed-ways-to-overcome-depression-naturally/"><span style="font-weight: 400;">science-backed ways to overcome depression naturally</span></a><span style="font-weight: 400;"> are worth sharing.</span></p> <p><strong>4. There is a family history</strong></p> <p><span style="font-weight: 400;">Experts agree that knowing your family’s history is essential for predicting and diagnosing depression. Studies show that the more relatives you have who have been diagnosed with mood disorders or drug or alcohol dependence, the more likely it is that you will too. “Knowing your genetics and family history can be enormously helpful,” says Dr Riba. Life changes and stress can trigger your biological predisposition to depression, so knowing your history can help you not only predict, but shape, your future.</span></p> <p><em><span style="font-weight: 400;">Written by Brook Bolen. This article first appeared in </span><a href="https://www.readersdigest.co.nz/healthsmart/conditions/mental-health/signs-your-loved-one-could-have-high-functioning-depression"><span style="font-weight: 400;">Reader’s Digest</span></a><span style="font-weight: 400;">. Find more of what you love from the world’s best-loved magazine, </span><a href="https://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA93V"><span style="font-weight: 400;">here’s our best subscription offer</span></a><span style="font-weight: 400;">.</span></em></p>

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How to help someone you live with who has depression

<p>The coronavirus pandemic has meant sudden changes to our daily lives, with restrictions on free movement, imposed lockdowns and social distancing. Many of these measures will have taken a toll on people’s mental health.</p> <p>These changes have increased our exposure to known risk factors for developing depression, such as <a href="https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2018.17111194">physical inactivity</a>, lack of structure and routine, lack of <a href="https://link.springer.com/article/10.1186/s12888-018-1736-5">social support</a>, <a href="https://www.jaacap.org/article/S0890-8567(20)30337-3/fulltext">loneliness</a>, and limited opportunity to do enjoyable and valued activities.</p> <p>Also, <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext">evidence from previous pandemics</a>, such as Sars and swine flu, suggests that disease-containment measures, such as quarantine and social isolation, may be detrimental to mental health. There is growing evidence that the effect of these changes on people’s mental health across the age groups is significant, especially for <a href="https://www.medrxiv.org/content/10.1101/2020.06.16.20133116v1">those who are younger</a>.</p> <p>Rates of depression in adults and young people are already concerning, and are predicted by the <a href="https://www.who.int/health-topics/depression#tab=tab_1">World Health Organization</a> to rise. By 2030, depression will be the highest <a href="https://www.who.int/foodsafety/foodborne_disease/Q&amp;A.pdf">burden of disease</a> globally, which refers to the overall impact of a health problem, including the financial cost. So although the initial focus during the pandemic has understandably been on physical health, it is therefore crucial that we also turn our attention to people’s mental health, <a href="https://academic.oup.com/ije/article/45/1/131/2363790">particularly as the two are related</a>.</p> <p>A lot of advice addresses the person with depression, but here we give advice on what you can do if you live with someone who is depressed.</p> <p><strong>Clues in their behaviour</strong></p> <p>Many people find it difficult to ask for help and to let others know how they are feeling. Don’t assume someone is OK just because they say they are. It’s better to ask more questions and risk being annoying than to miss something important, such as <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/depression/symptoms/">symptoms of depression</a>. If they don’t want to tell you, watch their behaviour and notice anything unusual, such as sleeping much later, not eating, staring for long periods, cancelling and avoiding many things.</p> <p>People’s feelings are often linked to their thoughts and behaviour, and this is demonstrated in the <a href="https://www.babcp.com/public/What-is-CBT.aspx">cognitive behavioural therapy</a> model. When people feel depressed, they often experience repeating streams of negative thoughts. It can be helpful to encourage someone who is thinking this way to try to look at different sides to a situation. Useful questions might be: “What advice would you give a friend in this situation?” or “What would be a more helpful way of thinking about this?”</p> <p>Depression gives rise to self-critical thoughts, such as “I’m no good”, “I shouldn’t feel this way”. Not surprisingly these thoughts then fuel the depression further. It’s helpful to let the depressed person know that you can see how they are feeling and that their feelings are understandable and valid, and will pass in time. This type of validation can help someone who is depressed refrain from criticising themselves for having difficult feelings and to develop more <a href="https://www.compassionatemind.co.uk/resources">self-compassion</a>.</p> <p>People who are depressed commonly withdraw from other people and activities. By doing fewer enjoyable and valued activities, it can compound a person’s depression. Try to counteract this by helping the person to re-engage with things that are important to them. Start with small things such as putting some structure into the day and perhaps <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004366.pub6/full">increasing exercise</a>, or time spent in nature, if possible. Help the person gradually re-introduce activities and social contacts that they see as valuable. Make some small plans together for the future (short, medium and long-term).</p> <p>A person with depression may commonly find it difficult to problem-solve, and daily activities and issues can quickly start to feel overwhelming. It’s helpful to stay calm and keep conflict and stress in the house to a minimum. Support the person to generate <a href="https://www.nhsinform.scot/illnesses-and-conditions/mental-health/mental-health-self-help-guides/problem-solving-self-help-guide">simple solutions to problems</a> and encourage them to put these <a href="https://cedar.exeter.ac.uk/media/universityofexeter/schoolofpsychology/cedar/documents/liiapt/Problems_to_Solutions.pdf">solutions and ideas into action</a> rather than avoiding things.</p> <p><strong>Seek outside help</strong></p> <p>There are a number of other effective <a href="https://www.nice.org.uk/guidance/cg90">treatments for depression</a>. Encourage the person you are supporting to seek extra help if needed. This might be in the form of <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/depression/treatments/#TalkingTreatmentsForDepression">online information</a> and online courses for both <a href="https://www.futurelearn.com/courses/anxiety-depression-and-cbt">adults</a> and <a href="https://www.futurelearn.com/courses/low-mood-during-covid-19">young people</a>; through <a href="https://reading-well.org.uk/books/books-on-prescription">self-help books</a>; or by contacting your local healthcare provider or mental health services in your area.</p> <p>Remember, your wellbeing is extremely important when supporting someone with depression. Take time for <a href="https://www.gov.uk/government/publications/covid-19-guidance-for-the-public-on-mental-health-and-wellbeing/guidance-for-the-public-on-the-mental-health-and-wellbeing-aspects-of-coronavirus-covid-19">self-care</a> so you can model positive behaviours and be replenished enough to provide this crucial support.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/141480/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/monika-parkison-1129916">Monika Parkison</a>, Research Fellow and Clinical Psychologist, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a> and <a href="https://theconversation.com/profiles/maria-loades-1131527">Maria Loades</a>, Senior Lecturer, Clinical Psychology, <a href="https://theconversation.com/institutions/university-of-bath-1325">University of Bath</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-help-someone-you-live-with-who-has-depression-141480">original article</a>.</em></p>

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How 5 short intentions can help people recovering from depression stay on track

<p>About <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/">one in six people in England</a> report experiencing anxiety or depression in any given week, and depression is a <a href="https://www.who.int/en/news-room/fact-sheets/detail/depression">major cause of disability worldwide</a>.</p> <p>Some people have experienced very adverse experiences over their lives, leading to low self-esteem and other vulnerabilities which can make people susceptible to depression. Difficult life circumstances, such as financial problems, loneliness, stresses at work, among family or in relationships, poor physical health and genetic vulnerabilities also contribute. Even long-term depression can be treated, but the lifetime risk that the depression returns has been reported as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2169519/">about 50 per cent for those experiencing one episode</a> of major depression, with the likelihood increasing with further episodes.</p> <p>Greater numbers of people experiencing mental health problems, and greater awareness of effective treatments, has increased demand for services. In recent years this has led to investment through the <a href="https://www.england.nhs.uk/mental-health/adults/iapt/">Improving Access to Psychological Therapies</a> programme, but because of huge demand, <a href="https://www.bbc.co.uk/news/health-50658007">waiting times can still be a problem</a> and it’s important that we develop new ways of helping people manage and overcome their mental health problems – to prevent problems occurring in the first place, and to prevent them returning. A lot of this comes down to teaching people to help themselves more effectively.</p> <p>To some extent this is already happening, for example with increases in self-help support within mental health services, and the use of self-help websites, online support and apps. Working with NHS staff, we have developed the <a href="https://www.ncbi.nlm.nih.gov/pubmed/29665889">Self-Management after Therapy intervention</a>, or SMArT, designed to help people to stay well after they have recovered from an episode of depression.</p> <p>Like other relapse-prevention approaches, it assumes that many people continue to remain vulnerable to depression. Recovery is seen as a process that continues after the end of therapy that has its ups and downs. This approach helps prevent someone from feeling they are back to square one if they have a setback, a frame of mind that can increase the likelihood of a return to more severe depression.</p> <p>The approach, first developed by psychologist <a href="https://as.nyu.edu/content/nyu-as/as/faculty/peter-m-gollwitzer.html">Peter Gollwitzer</a> in the 1990s, has been <a href="https://www.sciencedirect.com/science/article/pii/S0065260106380021?via%3Dihub">found to support changes in behaviour</a>, such as quitting smoking or doing more physical activity, through what are called implementation intentions. It is designed to help people turn an intention to act into a habitual behaviour. We know how hard it can be to make good intentions a reality (such as practically every New Year’s resolution), and when someone’s mood and motivation are low it can be even harder. As one mental health service user said during our research: “I know what to do, but when I’m down I just don’t do it.”</p> <p>Implementation intentions work by linking a specific situation to a specific response. For example: “Every evening between 7pm and 9pm I will write down all the positive things that have happened that day,” or “Every Thursday evening I will go to the pub quiz with my friend Katy”. They often take the form of “if …, then …” statements, such as: “If I feel down, then I will talk to my partner about why this might be.”</p> <p>When the situation comes up, the learned response is brought to mind, and is therefore more likely to be acted out. Using our SMArT intervention, people are encouraged to identify up to five of these implementation intentions. It’s important that they are realistic and that they will have an impact on the person’s wellbeing. The best way of thinking about them is to consider five things you do on a regular basis that are important to you. Then, imagine how you would feel if you didn’t do them. That is what tends to happen in depression, or when a person is at risk of a relapse.</p> <p>The use of the SMArT intervention is supported in mental health services by <a href="https://www.healthcareers.nhs.uk/explore-roles/psychological-therapies/roles/psychological-wellbeing-practitioner">psychological wellbeing practitioners</a>, and patients are encouraged to share their intentions with friends or family who can support them.</p> <p>SMArT is just one of a number of ways of helping people who are prone to depression to stay well and we’re carrying out more research to see how effective it is. It provides a bridge between the end of therapy and life without therapy and helps people see the importance of setting plans and having routine in their lives. It also emphasises that recovery is a process that includes learning about oneself and self-management strategies. It is something for the long-term – not just for all-too-soon-abandoned New Year’s resolutions.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/129046/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/michael-lucock-916922">Michael Lucock</a>, Professor of Clinical Psychology, <a href="https://theconversation.com/institutions/university-of-huddersfield-1226">University of Huddersfield</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-five-short-intentions-can-help-people-recovering-from-depression-stay-on-track-129046">original article</a>.</em></p>

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Smiling depression: Why being depressed while appearing happy is particularly dangerous

<p>The term “smiling depression” – appearing happy to others while internally suffering depressive symptoms – has become increasingly popular. Articles on the topic have crept up in the popular literature, and the number of Google searches for the condition <a href="https://trends.google.co.uk/trends/explore?q=smiling%20depression">has increased dramatically this year</a>. Some may question, however, whether this is actually a real, pathological condition.</p> <p>While smiling depression is not a technical term that psychologists use, it is certainly possible to be depressed and manage to successfully mask the symptoms. The closest technical term for this condition is “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990566/">atypical depression</a>”. In fact, a significant proportion of people who experience a low mood and a loss of pleasure in activities <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990566/">manage to hide their condition</a> in this way. And these people might be <a href="https://www.psychologytoday.com/gb/blog/the-guest-room/201411/smiling-depression">particularly vulnerable</a> to suicide.</p> <p>It can be very hard to spot people suffering from smiling depression. They may <em>seem</em> like they don’t have a reason to be sad – they have a job, an apartment and maybe even children or a partner. They smile when you greet them and can carry pleasant conversations. In short, they <a href="https://www.psychologytoday.com/gb/blog/the-guest-room/201411/smiling-depression">put on a mask</a> to the outside world while leading seemingly normal and active lives.</p> <p>Inside, however, they feel hopeless and down, sometimes even having thoughts about ending it all. The strength that they have to go on with their daily lives can make them especially vulnerable to carrying out suicide plans. This is in contrast to other forms of depression, in which people might have suicide ideation but <a href="https://www.psychologytoday.com/gb/blog/the-guest-room/201411/smiling-depression">not enough energy</a> to act on their intentions.</p> <p>Although people with smiling depression put on a “happy face” to the outside world, they can experience a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990566/">genuine lift in their mood</a> as a result of positive occurrences in their lives. For example, getting a text message from someone they’ve been craving to hear from or being praised at work can make them feel better for a few moments before going back to feeling low.</p> <p>Other symptoms of this condition include overeating, feeling a sense of heaviness in the arms and legs and being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990566/">easily hurt by criticism</a> or rejection. People with smiling depression are also more likely to feel depressed in the evening and feel the need to sleep longer than usual. With other forms of depression, however, your mood might be worse in the morning and you might feel <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990566/">the need for less sleep</a> than you’re normally used to.</p> <p>Smiling depression seems to be more common in people with certain temperaments. In particular, it is linked to being more prone to anticipate failure, having a hard time getting over embarrassing or humiliating situations and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990566/">tending to ruminate</a> or excessively think about negative situations that have taken place.</p> <p>Women’s Health magazine captured the essence of smiling depression – the façade – when it asked women to share pictures from their social media and then to recaption them on Instagram with how they really felt in the moment they were taking the picture. Here are <a href="https://www.womenshealthmag.com/health/a19973575/true-emotion-behind-smiling-instagram-pictures/">some of their posts</a>.</p> <h2>Burden and treatment</h2> <p>It is difficult to determine exactly what causes smiling depression, but low mood can stem <a href="https://www.psychologytoday.com/gb/blog/the-guest-room/201411/smiling-depression">from a number of things</a>, such as work problems, relationship breakdown and feeling as if your life doesn’t have purpose and meaning.</p> <p>It is very common. About <a href="https://www.nature.com/articles/s41598-018-21243-x">one in ten people</a> are depressed, and between 15% and 40% of these people <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181236/">suffer from the atypical form</a> that resembles smiling depression. Such depression often starts early in life and <a href="https://www.health.harvard.edu/newsletter_article/Atypical_depression">can last a long time</a>.</p> <p>If you suffer from smiling depression it is therefore particularly important to get help. Sadly, though, people suffering from this condition usually don’t, because they might not think that they have a problem in the first place – this is particularly the case if they appear to be carrying on with their tasks and daily routines as before. They may also feel guilty and rationalise that they don’t have anything to be sad about. So they don’t tell anybody about their problems and end up feeling ashamed of their feelings.</p> <p>So how can you break this cycle? A starting point is knowing that this condition actually exists and that it’s serious. Only when we stop rationalising away our problems because we think they’re not serious enough can we start making an actual difference. For some, this insight may be enough to turn things around, because it puts them on a path to seeking help and breaking free from the shackles of depression that have been holding them back.</p> <p>Meditation and physical activity have also been shown to have tremendous mental health benefits. In fact, a study done by Rutgers University in the US showed that people who had done meditation and physical activity twice a week <a href="https://www.nature.com/articles/tp2015225">experienced a drop</a> of almost 40% in their depression levels only eight weeks into the study. Cognitive behavioural therapy, learning to change your thinking patterns and behaviour, is another option for those affected by this condition.</p> <p>And finding meaning in life is of utmost importance. The Austrian neurologist <a href="https://www.britannica.com/biography/Viktor-Emil-Frankl">Viktor Frankl</a> wrote that the cornerstone of good mental health is <a href="https://www.pursuit-of-happiness.org/history-of-happiness/viktor-frankl/">having purpose in life</a>. He said that we shouldn’t aim to be in a “tensionless state”, free of responsibility and challenges, but rather we should be striving for something in life. We can find purpose by taking the attention away from ourselves and placing it onto something else. So find a worthwhile goal and try to make regular progress on it, even if it’s for a small amount each day, because this can really have a positive impact.</p> <p>We can also find purpose by caring for someone else. When we take the spotlight off of us and start to think about someone else’s needs and wants, we begin to feel that our lives matter. This can be achieved by volunteering, or taking care of a family member or even an animal.</p> <p>Feeling that our lives matter is ultimately what gives us purpose and meaning – and this can make a significant difference for our mental health and well-being.</p> <p><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/olivia-remes-187983">Olivia Remes</a>, Postdoctoral researcher, <em><a href="http://theconversation.com/institutions/university-of-cambridge-1283">University of Cambridge</a></em></span></p> <p>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/smiling-depression-its-possible-to-be-depressed-while-appearing-happy-heres-why-thats-particularly-dangerous-110928">original article</a>.</p>

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