Mental Health Archive

Ketamine offers a new option for people with stubborn depression that doesn't respond to other medications.

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Many people know of ketamine as a hallucinogenic and addictive street drug, which, when abused, can put people in medical peril. But today, doctors are increasingly looking to ketamine as a potentially lifesaving treatment for people with severe, treatment-resistant depression, who may be at high risk for suicide.

"Ketamine has been shown to be effective in people who have not responded to antidepressant treatment," says Dr. Cristina Cusin, an assistant professor of psychiatry at Harvard Medical School. The fast-acting treatment has shown promise — sometimes improving depressive symptoms within hours of the first intravenous treatment.

Ask the doctors

Q. My sister, who is in her 50s, has always been very weight-conscious, but she recently went through a divorce and now seems unnaturally fixated on her weight and dieting. She's lost a substantial amount of weight. I've always thought of eating disorders as something that affects teenagers, but is it possible that she has one?

A. It is possible that your sister is suffering from an eating disorder, because they can affect people of any age, including older women, according to the American Psychiatric Association. They may be prompted by stress or a life change, such as a divorce. Signs that may indicate that a person has an eating disorder are

Ask the doctor

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Q. I know that some viruses live permanently inside us, but only make trouble now and then. I even heard recently that they might be a cause of Alzheimer's disease. Why do they sometimes cause disease, and can we keep that from happening?

A. We live all of our lives with various microorganisms on us and inside us. One example is the herpes family of viruses. Out of more than a hundred herpesviruses, there are nine that infect humans. Once we get infected with these viruses — usually early in life — they remain with us, "asleep" inside some of our cells. But periodically, they "wake up" (reactivate), start producing multiple copies of themselves, and infect other cells. That's what's happening when a cold sore suddenly forms on your lip.

News briefs

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We're learning more about the link between weight gain and several major classes of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), like sertraline (Zoloft), and tricyclic antidepressants, such as amitriptyline (Elavil). Research has shown that putting on pounds is a possible short-term side effect of the medications. But a study published May 23, 2018, in The BMJ suggests that antidepressants are also associated with sustained weight gain. Researchers analyzed the health information of more than 300,000 people in the United Kingdom (average age 51) who'd had their weight and body mass index measured at doctor appointments between 2004 and 2014. About 18% had been prescribed antidepressants. During the study period, people who took antidepressants had a 21% higher risk for a 5% or greater weight gain, compared with people who didn't take antidepressants. The risk peaked in the second and third years. There was no evidence of weight gain after seven years. The study was observational and didn't prove that antidepressants cause weight gain. But researchers hope the findings will encourage people to talk to their doctors about weight gain as a possible side effect of antidepressants, and plan for potential and even delayed weight gain if they're using the medications.

Every day, carve out a little time to release your worries and relax your mind. It may counteract the heart-damaging effects of stress.

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Stress is an inevitable part of life. People often fret over day-to-day hassles such as traffic jams and unpaid bills, not to mention the relentless news about natural disasters and political crises. Many are also coping with the added anguish of divorce, illness, or death within their families.

All of these so-called psychosocial stresses first take hold in your mind. But the effects spread throughout your brain and body. Sometimes, you can even feel it: your heart pounds, you breathe faster, and your muscles tense. However, chronic stress also has more insidious physical effects that can harm your heart (see "Stress and your cardiovascular system").

Performing resistance exercises could help ease symptoms of depression.

Pumping iron might inflate not only your muscles, but also your mood, says a study in published in the June issue of JAMA Psychiatry.

The study's authors came to this conclusion after examining the results of 33 randomized clinical trials involving more than 1,800 people. They found that people with mild to moderate depression who performed resistance training two or more days a week saw "significant" reductions in their symptoms, compared with people who did not. The findings also suggested that resistance exercises may be even more beneficial for those with more severe depressive symptoms.

Research we're watching

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Aggressively treating high blood pressure might help ward off cognitive changes, according to findings presented at the Alzheimer's Association International Conference in July. Researchers from the Systolic Blood Pressure Intervention Trial compared two strategies to manage high blood pressure in more than 9,300 older adults (average age about 68). One strategy aims to achieve the standard treatment level for high systolic blood pressure (the first number in a blood pressure reading), keeping it under 140 mm Hg. The more aggressive strategy sets a goal of less than 120 mm Hg. The aggressive strategy reduced not only heart risks, but seemed to protect the brain.

People in the more aggressively controlled blood pressure group were 19% less likely than those in the standard treatment group to develop new cases of mild cognitive impairment (often a forerunner to dementia). They were also 15% less likely to develop any form of dementia or mild cognitive impairment. This study provides another reason to work with your doctor to reduce high blood pressure.