Depression Archive

At a time of loss, it's important to focus on maintaining your health and getting the support you need.

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Losing a family member, a close friend, or even a beloved pet can be devastating. All the small details of daily life—getting out of bed, making meals, going to appointments, taking care of children, handling responsibilities at work—may seem monumentally hard or inconsequential. Yet, even as you grieve, you've probably been reminded that life must go on. But working through the emotional pain can be difficult, particularly during the holidays, when you may feel you are supposed to be celebrating.

The normal process of grieving

Some drugs go too far, dulling emotions across the spectrum. A dose adjustment or a switch to a different medication can help.

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When your doctor prescribes a medication for depression, the goal is to reduce painful feelings of sadness or hopelessness. The majority of people taking the most commonly prescribed antidepressants—selective serotonin reuptake inhibitors (SSRIs)—improve substantially. But sometimes, SSRIs go beyond improving mood and make a person feel too little emotion. "Some people feel like they've lost the richness of daily life," says Dr. Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School.

Serotonin and SSRIs

What you should do

Watch for the warning signs of depression, which is often missed in people with heart disease.

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All people have days when they feel sad, gloomy, or down in the dumps. But if those feelings last for weeks and you gradually stop feeling hopeful or happy about anything in your life, you may have depression. Like heart disease, depression is common, so it's not unusual to have both conditions together. In fact, depression is about twice as likely to occur in people with heart disease compared with the general population. And people with depression face a heightened risk of heart disease.

"It's really important for people to be aware of this link and to get treatment for depression, because it can be very debilitating," says Dr. Christopher Celano, a psychiatrist at the Cardiac Psychiatry Research Program at Harvard-affiliated Massachusetts General Hospital.

 If you are taking care of a loved one, you need to take special care of yourself, too. There are resources to help you.

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More than 65 million Americans—two-thirds of whom are women—are taking care of a disabled or ailing family member. If you're among them, you're well aware that caring for a loved one can be one of the most rewarding experiences in life, but it can also be one of the most challenging, especially to your own health.

"We know family caregivers are under a particular amount of stress. And stress over time can cause them to become ill," says Dr. Diane Mahoney, Jacque Mohr Professor of Geriatric Nursing Research at MGH Institute of Health Professions, an academic affiliate of Massachusetts General Hospital. In fact, more than 20% of caregivers report that their health has suffered as a result of their responsibilities.

British researchers tested whether behavioral activation therapy alone is as effective as cognitive behavioral therapy. The results were almost identical for both groups, with two-thirds of each group reporting a reduction of depressive symptoms of at least 50%.

Act now to avoid potential dangers associated with solitary living, such as coronary artery disease, stroke, and thinking skills decline.

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One lovely picture of older age is of smiling seniors enjoying their golden years with partners, friends, and family. In reality, many seniors are isolated and lonely. The National Council on Aging reports that one in six adults ages 65 or older is isolated, either socially or geographically. And in a 2010 AARP survey, 25% of respondents ages 70 or older said they felt lonely.

Health risks

News Briefs

Don't be surprised if your doctor screens you for depression at your next visit. An update to the U.S. Preventive Services Task Force recommendations for screenings, published Jan. 26, 2016, in The Journal of the American Medical Association, suggests that all adults 18 or older, including older adults, should be screened for depression when there are systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. The previous recommendations encouraged selective screening based on professional judgment and patient preferences. The new recommendation also includes pregnant and postpartum women for the first time. "Older adults often struggle with chronic disease, or the loss of a loved one, which may lead to depression," says Dr. Michael Craig Miller, an assistant professor of psychiatry at Harvard Medical School. "Screening is just a way to open the door for people who might otherwise not get the help they need." Dr. Miller says screening can simply be asking if, over a two-week period, you have either had little interest or pleasure in doing things or felt depressed and hopeless.

They're cute, cuddly, and loving, but dogs and cats aren't always appropriate for older adults.

There's a reason dogs are dubbed man's best friend. Dogs—and cats, too—make wonderful companions and provide many emotional and physical benefits. "I'm a believer in the beneficial effects of having a pet, and I'm impressed with the ability of dogs in particular to form bonds with human beings. I think the science is starting to support their special ability to do that," says psychiatrist Dr. Greg Fricchione, director of the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine. However, there are a number of considerations to mull over before adding a pet to your household.

Benefits

The most obvious benefits of pet ownership are love and companionship. "We do best medically and emotionally when we feel securely attached to another, because we're mammals and that's the way we've evolved," says Dr. Fricchione. He points out that we feel especially secure with dogs and cats because of the unconditional love they provide. "No matter what you do or say, your dog or cat accepts you and is attached to you," says Dr. Fricchione. Taking care of a dog or a cat can provide a sense of purpose and a feeling of validation when you wake up or come home and there's someone who's happy to see you.

Learning to deal with stress can lower your risk for anxiety, depression, and cardiovascular disease.

The more we learn about women's hearts, the more we realize that they are different from men's. One of the most dramatic differences is a rare heart condition called takotsubo cardiomyopathy, or broken-heart syndrome, that is nine times more common in women than in men. It has been cited as evidence that sudden emotional stress can actually cause death in some women.

Like a heart attack, takotsubo cardiomyopathy strikes suddenly with symptoms such as chest pain and shortness of breath; however, it does not involve clogged arteries. Takotsubo cardiomyopathy is brought on by a surge of stress hormones that literally bend the heart out of shape. As a result, when the main pumping chamber of the heart (the left ventricle) contracts, it balloons out, so it can't eject blood into the arteries effectively.

Ask the doctor

Q. My daughter had a miscarriage a few months ago and since then she has been depressed and withdrawn. Do you know anything I can do to help?

A. Miscarriage can involve a difficult emotional recovery, and many women and their partners are surprised at the intensity of their feelings. Many women who have experienced a miscarriage feel that they have done something wrong. They may worry that the miscarriage resulted from stress or lifestyle choices they made during pregnancy. In fact, most miscarriages are the result of chromosomal abnormalities, structural abnormalities of the uterus, or maternal endocrine or autoimmune disorders.