Depression Archive

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Being readmitted to the hospital soon after being discharged is a common problem for all older Americans. But men are at a significantly higher risk of returning for emergency room care or a hospital stay within a month after discharge than are women, according to a recent study published in BMJ Open. "Men in certain populations may not have social support, which leads them to being at higher risk for readmission," says Dr. Jeffrey Schnipper, director of clinical research for the Brigham and Women's hospitalist services.

When the first medication you take for depression doesn't work, should your doctor raise the dose or try a different one? A study in the Journal of Clinical Psychopharmacology found that switching relatively early does not worsen symptoms, and may lead to slightly better results over the long term.

The study involved 840 people being treated for depression. They started on escitalopram (Lexapro), a common antidepressant. In 70% of people, the escitalopram did not start to work after a month.

Persistent sadness might be more than just a mood problem—it could be a warning sign of memory impairment.

You can't sleep. You feel irritable and restless. Foods you once loved look unappetizing. These are signs that you may be depressed, but they might also warn that you're at greater risk for dementia.

Men struggle with heart failure and depression.

Learning you have heart failure (HF) can be an emotional blow, since the disease can lead to significant health complications and poor quality of life. And while depression is more common in women with HF, a study presented at the American Heart Association's 2012 Quality of Care and Outcomes Research Scientific Sessions found that the severity of the depression is much greater in men with HF. "Heart failure can make one quite physically weak, and this may hit men especially hard, based on their traditional views of masculinity," says interventional cardiologist Dr. Deepak Bhatt, a professor at Harvard Medical School. There is also growing evidence that depression can worsen heart disease. Depression may cause a person to stop taking medicine, exercising, or eating properly, which may hurt heart health. So depression after a diagnosis of HF can lead to a downward spiral. That's why it's so important for depression to be recognized.

Warning signs include loss of interest in activities, changes in weight and sleeping patterns, feelings of hopelessness, and withdrawal from friends or relatives. Dr. Bhatt says don't ignore any of these signs in yourself or a loved one. "Be honest and admit that depression might exist. Then ask for help, usually starting with the primary care doctor, and in really severe cases, seeking the help of a psychiatrist."

Q. I suffer from seasonal affective disorder (SAD) and want to try using a light box. Should I be concerned about damage to my eyes?

A. Light therapy can be effective for SAD. However, you should use the treatment under the supervision of an experienced professional. Light treatment usually consists of exposure to a light source from a 10,000-lux box for 10 to 15 minutes per day at first, gradually increasing to 45 minutes 1–2 times per day. Your eyes should remain open throughout the treatment session. Damage to the eye's retina is a theoretical risk, but it has not been found to be a problem thus far. Nevertheless, you should take precautions to get your dose of light as safely as possible.

For people who are battling depression, "talk therapy" can be very helpful. But due to the inconvenience, cost, and the time required, many people cut the treatment short. Now, a report in the Journal of the American Medical Association suggests that delivering a form of counseling called cognitive behavioral therapy (CBT) by telephone may keep people in treatment long enough for it to have an impact.

CBT teaches people to recognize and respond to negative thinking more effectively. In the study, 325 people were offered CBT. Half received 18 sessions of CBT by phone; the remainder received therapy in person. Researchers found that telephone CBT worked just as well as face-to-face meetings for reducing symptoms of depression. However, six months after the sessions ended, people who completed CBT in person were less depressed than those who obtained help by telephone.

New techniques for diagnosing depression may make it easier to tell if you have the condition. They may also help change perceptions about the disorder. Two new studies indicate that depression is a physiological illness, detectable in the blood. In April, researchers at Northwestern University found they could use a blood test to diagnose depression in teenagers. A few months earlier, Harvard-affiliated researchers reported a similar finding in adults. Their blood test identified nine biomarkers associated with depression, and correctly identified people with depression 91% of the time.

"The test needs more stringent validation before it will be ready to be used in medical offices. Still, it appears that these results are promising," says Dr. Gustavo Kinrys, an instructor in psychiatry at Harvard Medical School and one of the authors of the study.

People who are depressed are more likely to develop heart disease than those who aren't. It works the other way, too — people who have heart disease are more likely to lapse into depression than their disease-free counterparts.

The same association appears to exist between depression and stroke. This isn't a huge surprise, considering that the conditions that cause heart disease — like clogged arteries and inflammation — also contribute to strokes. Still, researchers can only speculate on how depression contributes to these dangerous cardiovascular events or the biological disorders leading up to them.

Evidence suggests that depression is a treatable risk factor for heart disease and stroke.

Harvard Women's Health Watch readers probably know that the leading cause of death in women is cardiovascular disease (CVD) — that is, heart disease and stroke. Nearly 43 million women in the United States have some form of CVD, and every year, nearly 422,000 die of it — that's more than succumb annually to all forms of cancer combined. Heart disease and stroke are also major causes of life-altering disabilities.