If you're on an antidepressant and it's not working, don't give up on it: You may need a higher dose, a longer duration of therapy, a different antidepressant altogether, or a combination of medications. That's the important lesson to learn from a large, six-year, four-step government study called the Sequenced Treatment Alternatives to Relieve Depression trial, or STAR*D. In fact, the researchers found that systematically trying these treatment options can lead to a remission in… More...
Does depression lead to poor health … or is it the other way around? Recent research explores the relationship between obesity and mood disorders, including depression, bipolar disorder, panic disorder, and agoraphobia.
Depression clearly has a harmful effect on physical health, although the biological reasons for the link between body and mind are unclear. It may be that depression affects health because people develop a fatalistic attitude and stop taking care of themselves. … More...
Are you feeling down, sad, or anxious? For many people the biggest obstacle to recovery is the perceived stigma of appearing weak or vulnerable and needing professional help. Johns Hopkins discusses this common concern and offers advice.
Being clinically depressed or anxious is not a sign of mental weakness. Nor is it a normal part of aging or an inevitable consequence of having other health problems such as heart disease or diabetes. Rather, depression and anxiety… More...
Is it safe to drink wine or another alcoholic beverage if you take antidepressant medication? In this Q and A from a recent issue of the Depression and Anxiety Bulletin, Dr. Karen L. Swartz responds to a reader's question.
Q. I have been drinking wine with my dinner for more than 30 years. Now that I am taking an antidepressant for the first time, my wife has told me that I should not drink any more… More...
Now patients with seasonal affective disorder have two effective therapies to relieve depression in the winter months – light therapy and the antidepressant, Wellbutrin XL.
At this time of year, changes in the amount of daily sunlight cause changes in the body's internal biological clock, known as circadian rhythm. This rhythm is a 24-hour cycle that affects our eating and sleeping patterns, brain wave activity, hormone production, and other biological activities. In some people, less daily… More...
For patients with phobias or panic disorder, strong religious belief may help to quell symptoms.
The treatment of panic disorder often involves both psychotherapy and medication. Now a study reported in the journal Depression and Anxiety (Volume 23, page 266) shows that people with panic disorder who perceive themselves as being religious are more likely to experience improvements in their panic symptoms than people who rank religion or spirituality as unimportant to them. … More...
In the place of Freudian psychoanalysis is a trend toward short-term cognitive-behavioral therapy and a new kind of therapy, called acceptance and commitment therapy.
One of the newest therapies to emerge -- acceptance and commitment therapy (ACT) -- is considered a third-generation behavioral therapy (traditional behavioral therapy being the first generation and cognitive-behavior therapy the second). … More...
Electroconvulsive therapy (ECT) is hands-down the most controversial treatment in modern psychiatry. No other treatment has generated such a fierce and polarized public debate. Critics of ECT say it’s a crude tool of psychiatric coercion; advocates say it is the most effective, lifesaving psychiatric treatment that exists today.
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Anxiety is a common, normal, and often useful response to life's challenges and dangers. But in people who suffer from an anxiety disorder, anxiety levels spin out of control, causing psychological and physical symptoms that interfere with normal functioning, appear even in the absence of obvious external stressors, or are clearly excessive in the face of the stressors More...
People who recover from major depression may experience marked sensitivity to emotional stress, raising the risk of falling back into dysfunctional and depressive thought patterns, according to a Canadian study. Even mild negative moods can reactivate the thinking styles associated with depression and may predict the recurrence of major depression.
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Karen L. Swartz, M.D., Director of the Johns Hopkins Mood Disorders Center, provides six practical exercise tips to help you ease depression or anxiety with exercise.
After decades of investigation, there is now indisputable evidence that regular physical exercise can relieve and perhaps even prevent stress, anxiety, and depression -- especially for women, who tend to suffer from these problems more often than men. Research also shows that exercise can treat depression and prevent relapses in… More...
Researchers explore the link between depression and nursing home admissions among adults aged 65 and older.
Depression and aging do not necessarily go hand in hand. A survey of Californians age 50-95 found that factors such as chronic illness, physical disabilities, and social isolation -- which often coincide with increasing age -- were stronger predictors of depression than age itself. That said, the incidence of depression is clearly higher in older adults. The National Institute of… More...
Many people are closet clutterers. But what if you've taken saving and collecting to such an extreme that it’s difficult to move around your home or you’re embarrassed to invite people in because of all the clutter? In that case, you may have crossed the line from a bad habit into a mental disorder known as compulsive hoarding. More...
Pets are more than just furry friends and loyal companions. Yes, pets tug at our heartstrings, but they also improve our health, both mental and physical, helping us to live longer and happier lives. Studies over the past 25 years have shown that stroking a dog or cat can lower blood pressure and heart rate and boost levels of the mood-related brain chemicals serotonin and dopamine. Heart attack sufferers recover more quickly and survive longer when they have a pet at home, and children who are exposed to pets early in life may have a reduced risk of allergies and asthma. More...
Karen L. Swartz, M.D., assistant Professor of Psychiatry at Johns Hopkins, explains why the transdermal Emsam patch offers new hope for patients with depression.
In 2006 the Food and Drug Administration (FDA) approved Emsam (selegiline), the first skin (transdermal) patch for use in treating major depression. The once-a-day depression patch works by delivering selegiline, a monoamine oxidase (MAO) inhibitor, through the skin and directly into the bloodstream, without having to pass through the digestive tract… More...
Melatonin, antihistamines, and bright light therapy for insomnia
Q. What do you think about melatonin and valerian as treatments for insomnia?
A. Melatonin is a hormone produced in the body by the pineal gland in response to darkness and as a cue for sleep. Valerian is an herb promoted as a mild sedative. Both melatonin and valerian are sold as dietary supplements in the United States and are marketed as sleep aids. The National Institutes of… More...
Dry mouth is a common side effect of many psychiatric medications. Dry mouth occurs when a drug blocks the receptor sites of the neurotransmitter acetylcholine, which controls saliva production. There are several simple, helpful remedies to help you relieve dry mouth. More...
What should you do if your antidepressant medication causes decreased libido? Karen L. Swartz, M.D., Director of Clinical Programs at the Johns Hopkins Mood Disorders Center, weighs in on this common problem.
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David N. Neubauer, M.D, associate director of the Johns Hopkins Sleep Disorders Center, answers patients’ questions about the interrelationship between insomnia and mood disorders. He begins with the chicken-and-egg question… More...
After failure on an antidepressant, the next step you and your doctor decide to take is largely a matter of trial and error based on your doctor’s experience with other patients, your medical history, and your doctor’s consultation with other mental health professionals. This trial-and-error approach may soon be a thing of the past, however. More...
Feeling SAD? Wellbutrin XL may help.
The Food and Drug Administration (FDA) recently approved Wellbutrin XL (bupropion HCL extended-release tablets) for the prevention of major depressive episodes in people with a history of seasonal affective disorder (SAD). Wellbutrin XL is the first drug officially approved for seasonal affective disorder, which is characterized by recurrent bouts of major depression that coincide with the shorter daylight hours of autumn and winter (thus the nickname "winter depression”). … More...
Just as depression is not a normal and natural side of aging, neither are extreme irritability, angry outbursts, paranoia, or irrationally hyper behavior.
One of the myths associated with bipolar disorder is that it follows a predictable pattern, with cycles of mania and depression following one another as neatly and symmetrically as day follows night. Not true. Bipolar disorder is an unpredictable disease. And while bipolar disorder usually makes its first appearance during adolescence or young adulthood, another, often unexpected, feature is that bipolar disorder can show up for the first time in late adulthood.
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Left untreated, dysthymia can lead to major depression, or worse.
It is far better to treat dysthymia (recurrent, mild depression; also called subclinical depression) than to think of it as a minor condition. That reminder comes from a seven-year prospective study of more than 1,000 young people in New Zealand, reported in the Archives of General Psychiatry.
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Why do some people bounce back from stressful events while other fall into depression?
Genetic factors play a role in the development of depression and other mood disorders. For example, a gene that may be linked to bipolar disorder has been identified and one study showed that a common family gene mutation could predict whether a person will experience clinical depression when faced with traumatic events in his or her life.
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If you’re a caregiver for a chronically ill relative or friend and are feeling overwhelmed, even depressed, this advice can help.
Being a caregiver for a chronically ill family member is a 24-hour job. With all the attention you give to others, it’s understandable that you may feel tired, unhappy, or irritable. But you may be beyond feeling just “worn down.” The strain of being a caregiver can eventually lead to diagnosable mental distress. A recent… More...
Roger S. Blumenthal, M.D., medical editor of The Johns Hopkins Heart Bulletin, explains the important difference between a panic attack and a heart attack. An acute anxiety attack, or panic attack, is a terrifying ordeal to experience. During a panic attack, a surge of fear overcomes the individual, often without any clear provocation. Many patients truly believe they are going to die, and some experience syncope, or fainting, as a reaction to this stressor. More...
Men often experience nontraditional symptoms of depression, which can keep them from recognizing the problem and seeking help.
If you’re a man and suffer from depression, you’re not alone! Nearly six million men in the United States are diagnosed with depression each year. But because men are less likely than women to recognize their symptoms and seek treatment, many more men probably suffer from this condition. … More...
A good sign that grieving is successful is a shift to positive and realistic plans for the future.
The loss of a loved one can cause intense mental anguish. Occasionally, this anguish triggers a major depressive episode, but few people in mourning experience true clinical depression.
Grieving may produce a wide range of feelings. The grieving process is considered successful when it permits the mind to adjust to the acute sorrow of a loss. The end… More...
Recent reports have illustrated that St. John's wort, used by many people to relieve depression, may not be as benign as it appears.
Despite the availability of a full arsenal of medications proven to be effective for treating depression and anxiety, many people have turned to herbal remedies—which are classified as dietary supplements in the United States and so have not been tested or approved by the U.S. Food and Drug Administration (FDA). No one is… More...
Antidepressant medication may require up to eight weeks at a therapeutic dose to produce the full benefit. When an antidepressant proves ineffective, a new antidepressant is often selected from a different class of medications.
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Relaxation techniques show promise for the treatment of anxiety. Common relaxation techniques for anxiety include meditation and guided imagery.
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All new editions of the Johns Hopkins White Papers 2008
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ALL NEW! The Johns Hopkins Depression and Anxiety Bulletin The Johns Hopkins Depression and Anxiety Bulletin is a quarterly publication that presents the latest treatment information available on the most common mood disorders, such as depression, anxiety, bipolar disorder, and more, to help you take charge of your medical care. Each issue is like having an in-depth consultation with a leading specialist. PLUS subscribe now and receive 5 FREE Special Reports, available as instant downloads:
Special Report #1: Antidepressants: If the First Drug Doesn't Work, Don't Give Up Physicians now have a growing array of options to consider in prescribing antidepressant drugs — including selective serotonin reuptake inhibitors (SSRIs), tricyclics, tetracyclics, dopamine reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and monoamine oxidase (MAO) inhibitors. Our Special Report will help you understand the pros and cons of different drug therapies — and find out why many patients benefit from switching or combining medications. Essential reading for anyone considering, or being treated with, antidepressants.
Special Report #2: Which Type Of Talk Therapy Is Right For You? What are the advantages and disadvantages of psychotherapy — and which type of talk therapy is right for you? Psychotherapy has proven effective in treating mild and moderate forms of depression — and can be combined with drug therapy to treat severe depression as well as bipolar disorder. Our Special Report explains the different types of psychotherapy and offers practical advice on finding a therapist.
Special Report #3: Getting Relief from Light Therapy In a major research review commissioned by the American Psychiatric Association, light therapy was found to be effective in treating both seasonal affective disorder (SAD) and non-seasonal depression. But the range of light treatment options is growing, and now includes dawn simulators, light boxes, lamps, and sun visors. Our Special Report gives you an up-to-the-minute medical assessment of available devices — along with some important cautions regarding bright-light therapy.
Special Report #4: The Johns Hopkins Supplemental Mood Prescription Johns Hopkins experts offer research-proven techniques for alleviating common physical symptoms associated with depression. Discover practical tips for preventing and combating depression and anxiety with improved nutrition, moderate exercise, and better sleep habits. It adds up to a state-of-the-art prescription for improving your mood, based on findings from the latest research studies.
Special Report #5: Is It Normal Worrying — or Anxiety Disorder? If you’ve ever wondered whether your levels of anxiety are beyond the norm, this revealing Special Report gives a clear, easy-to-read checklist to help you determine whether you’re responding normally to life’s challenges, or suffering from an anxiety disorder. Find out about the five primary types of anxiety disorders… how to distinguish a heart attack from a panic attack… and much more.
2008 Depression and Anxiety White Paper Includes major depression, dysthymia, atypical depression, bipolar disorder, seasonal affective disorder, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and phobic disorders. Read more...
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The Johns Hopkins Medical Letter: Health After 50 When you're over 50, it's more important than ever to have access to reliable health information. You won't find a more authoritative source than The Johns Hopkins Medical Letter: Health After 50. Read more...
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