Depression Archive

Anger or aches and pains can hide underlying depression. Seek prompt treatment to protect your heart and mind.

Most people think of depression as persistent sadness or "down" feeling. But the blues can come in different colors in men. Depression may also show itself as irritability and angry outbursts, or physical aches and pains. "A man with depression is more likely to practice denial of feelings, often trying to mask them with other behaviors," says Dr. Gregory Fricchione, director of the Division of Psychiatry and Medicine at Harvard-affiliated Massachusetts General Hospital.

It's important for both your physical and emotional well-being to get help as soon as you suspect it.

It's normal to get the blues occasionally, but if things turn a little blacker, it may be time to take your symptoms more seriously. One in 10 people in the United States has depression, a condition that can be accompanied by physical symptoms such as aches and pains, fatigue, and changes in sleep or appetite. People who have depression are at higher risk for cardiovascular disease and possibly dementia.

Q. I've been feeling consistently down since my husband passed away last year. What are my treatment options?

A. Depression is common after a significant loss such as the death of a spouse. It's important that you get help. Untreated depression can interrupt your sleep, interfere with your relationships, and affect your physical health.

Exercise is as effective as antidepressants in some cases.

One in 10 adults in the United States struggles with depression, and antidepressant medications are a common way to treat the condition. However, pills aren't the only solution. Research shows that exercise is also an effective treatment. "For some people it works as well as antidepressants, although exercise alone isn't enough for someone with severe depression," says Dr. Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School.

The exercise effect

Exercising starts a biological cascade of events that results in many health benefits, such as protecting against heart disease and diabetes, improving sleep, and lowering blood pressure. High-intensity exercise releases the body's feel-good chemicals called endorphins, resulting in the "runner's high" that joggers report. But for most of us, the real value is in low-intensity exercise sustained over time. That kind of activity spurs the release of proteins called neurotrophic or growth factors, which cause nerve cells to grow and make new connections. The improvement in brain function makes you feel better. "In people who are depressed, neuroscientists have noticed that the hippocampus in the brain—the region that helps regulate mood—is smaller. Exercise supports nerve cell growth in the hippocampus, improving nerve cell connections, which helps relieve depression," explains Dr. Miller.

Research shows the approach is especially helpful for those who aren't aided by drugs.

Depression is more than just a bit of the blues. The classic sadness, despair, and slowed mental functioning can be accompanied by physical symptoms, including aches and pains, heart palpitations, tremors, fatigue, and nausea. People who have depression are at higher risk for cardiovascular disease and possibly dementia.

A research team at Harvard-affiliated Massachusetts General Hospital has verified that several antidepressants may increase the risk of a potentially dangerous heart rhythm disturbance (arrhythmia). By examining the electrocardiograms (ECGs) of more than 38,000 people taking 11 different antidepressants, they confirmed that higher doses of citalopram (Celexa), amitriptyline (Elavil), and escitalopram (Lexapro) were associated with a slight disruption of the electrical function of the heart. This delay as seen on an ECG is known as a prolonged Q-T interval, and it is a risk factor for an arrhythmia that causes sudden death.

Although the majority of people with this ECG abnormality never develop an arrhythmia, the researchers cautioned that people taking these antidepressants should discuss the risk with their doctor. The researchers emphasized that no one with a history of arrhythmias should start taking these medications. Instead, such a patient might try one of the antidepressants that do not increase the Q-T interval: fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), or buproprion (Wellbutrin). The study was published Jan. 29, 2013, in the journal BMJ.

When antidepressant drugs don't work at first, adding a form of counseling called cognitive behavioral therapy (CBT) can help, a study in The Lancet revealed.

British researchers studied a group of 469 people who had received a medication for depression, but did not gain relief within six weeks. Half were chosen at random to start CBT while continuing to take the antidepressant.

Research shows that inflammation, marked by elevated blood levels of C-reactive protein, is linked to risk for depression. This raises the question of whether adding anti-inflammatory drugs to antidepressants will improve depression treatment.

Memory slips are aggravating, frustrating, and sometimes worrisome. When they happen more than they should, they can trigger fears of looming dementia or Alzheimer’s disease. But there are some treatable causes of forgetfulness.

Small effort can lead to big changes.

Being overweight is a risk factor for conditions such as diabetes, heart disease, and even certain kinds of cancer. Now a study from France that followed more than 9,000 older adults for 10 years confirms that obesity is also associated with depression. "Yes, obesity and depression are linked. And the causation probably goes in both directions," says Dr. Michael Craig Miller, an assistant professor of psychiatry at Harvard Medical School.

Dr. Miller explains that depression and obesity feed each other. "Obesity affects the parts of the brain that regulate your mood. When you're depressed, low energy and motivation can translate into less activity and exercise. The result may be weight gain," he says. "If both problems have a hold on you, it's hard to break their grip." Excess weight has adverse effects on the health of your heart, knees, and hips.