How To Prevent Depression Relapse Without Antidepressants (M)
Four out of five people with depression will relapse at some point without treatment.
Four out of five people with depression will relapse at some point without treatment.
People eating this way are less likely to suffer from depression and other mental health problems.
People eating this way are less likely to suffer from depression and other mental health problems.
People who eat intuitively have a lower chance of developing mental health problems, research finds.
Eating intuitively means eating based on hunger and fullness.
Dieting or restricting food intake is the opposite of intuitive eating.
Everyone is probably an intuitive eater when they are born.
But, over the years, the effects of social conditioning change how some people view food.
People learn that wasting food is bad, that certain tasty foods should be avoided, along with a host of other rules.
Unfortunately, these rules can paradoxically make people desire the banned foods more.
Some end up eating to excess because of the restrictions they have placed on themselves.
The conclusions come from a study of 1,491 adolescents who were tracked over 8 years, between the ages of around 14 to 22.
They were all asked questions like:
The idea was to see whether the young people were trusting their own internal bodily states or following some external guidelines.
The results showed that intuitive eaters tend to trust their own body so they stop when they are full, rather than when the plate is empty.
Intuitive eaters, it emerged, experienced fewer depressive symptoms, more satisfaction with their body, higher self-esteem, less binge eating and fewer extreme or unhealthy weight control behaviours.
People with the intuitive food behaviours were 74 percent less likely to binge eat.
Dr Vivienne Hazzard, the study’s first author, said:
“The fact that these results came from such a diverse sample suggests that the benefits of intuitive eating seem to cut across racial, ethnic, and socioeconomic lines.”
The study was published in the Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity (Hazzard et al., 2020).
Common types of depression have been categorised in many ways, but the forms are resistant to structure.
Common types of depression have been categorised in many ways, but the forms are resistant to structure.
Depression is a very complex state which is why the signs and types of depression are wide-ranging and often confusing.
Depression is certainly much more than just feeling sad.
Because of the complexity of depression, scientists are not sure exactly how many ‘types’ there are — or even if it can be comprehensively put into types.
Psychiatrists and psychologists use a series of categories that have emerged over the years, which seem to describe some people’s experience of depression, but are highly unsatisfactory.
Major depression is relatively common and can last weeks or months and may have no clearly identifiable cause.
Symptoms can include:
Major depression is also sometimes called major depressive disorder, clinical depression, melancholic, psychotic or many other names.
Briefly, here are some of the types of depression that are commonly referred to:
The system of types of depression outlined above has grown up over the years in a disorganised manner.
Some modern attempts have been made to put depression into categories that are more comprehensive.
Here are three of those typologies:
One recent attempt is through the use of brain scans (Drysdale et al., 2016).
The brain scans revealed distinctly different types of brain activity in each sub-type.
Dr. Conor Liston, who led the research, said:
“The four subtypes of depression that we discovered vary in terms of their clinical symptoms but, more importantly, they differ in their responses to treatment.
We can now predict with high accuracy whether or not a patient will respond to transcranial magnetic stimulation therapy, which is significant because it takes five weeks to know if this type of treatment works.”
The four different types of depression they identified are:
They are called ‘biotypes’ because of the biological means (brain scans) used to identify them.
Previously, symptoms have been used to identify different types of depression.
But this can produce unsatisfying answers.
It is hoped that a biological approach will help to provide some extra precision for diagnosis and treatment.
Dr Liston said:
“Depression is typically diagnosed based on things that we are experiencing, but as in election polling, the results you get depend a lot on the way you ask the question.
Brain scans are objective.”
The conclusions come from a study of over 1,100 fMRI brain scans of people with depression, compared with healthy controls.
Researchers at seven different institutions worked to identify the abnormal patterns of connectivity in the brains and how they were linked to depressive symptoms.
They found the patterns clustered together.
For example, one group had reduced connectivity in the part of the brain that is important for fear-related behaviour.
This was most often seen in sub-types 1 and 4, both of which are characterised by high levels of anxiety.
Dr Liston concluded:
“Subtyping is a major problem in psychiatry.
It’s not just an issue for depression, and it would be really valuable to have objective biological tests that can help diagnose subtypes of other mental illnesses, such as psychotic disorders, autism and substance abuse syndromes.”
Another analysis of types of depression argues that depression is actually formed of 12 different sub-types, many of which have very different causes (Rantala et al., 2017).
Mr Severi Luoto, study co-author, said:
“The evidence that major depressive disorder is a group of separate syndromes comes from the observations that patients not only have many hundreds of unique symptom profiles, but many of the symptoms often have opposite features such as insomnia or hypersomnia, or an increase or decrease in appetite.”
These 12 sub-types of depression are set off by:
Professor Markus Rantala, the study’s first author, said:
“With the help of the 12 depression subtypes, it will be easier to find more effective treatments for depression.
This is because the focus will be on treating the underlying reasons (triggers) of depression instead of merely focusing on the symptoms, which is how traditional psychiatry treats depression.
We argue that the occurrence of symptoms (or patterns of symptoms) depends on the subtype of the depressive episode.
The particular manifestation of depressive symptoms may have more to do with what triggered the depression (i.e. the proximate mechanisms) than the personality of the patient.”
Diagnosing people using these sub-types should make treatments more effective.
People who are depressed often also feel anxious, so some researchers have tried to incorporate both depression and anxiety into their description of types.
Instead of being ‘depressed’ and/or ‘anxious’, some research suggests five different types of depression and anxiety (Grisanzio et al., 2017).
The five are tension, anxious arousal, general anxiety, anhedonia — the inability to feel pleasure — and melancholia.
Each type has its own particular symptoms and effects on the brain.
The researchers describe the types as follows:
This type is defined by irritability.
People are overly sensitive, touchy, and overwhelmed.
The anxiety makes the nervous system hypersensitive.
Cognitive functioning, such as the ability to concentrate and control thoughts, is impaired.
Physical symptoms include a racing heart, sweating, and feeling stressed.
Professor Leanne Williams, who led the study, explained:
“People say things like ‘I feel like I’m losing my mind.
They can’t remember from one moment to the next.”
People experience problems with social functioning.
Restricted social interactions cause further distress.
The primary symptom is an inability to feel pleasure.
This type of depression often goes unrecognized.
People are often able to function reasonably well while in a high state of distress.
Professor Williams said:
“We see it in how the brain functions in overdrive.
People are able to power through but at some time become quite numb.
These are some of the most distressed people.”
A generalized type of anxiety with the primary features involving worry and anxious arousal—a more physical type of stress.
Psychologists typically find that anxiety and depression share many overlapping symptoms.
The five categories arrived at in this study come from over 800 people, some of whom had anxiety and depression diagnoses.
They had complete psychiatric testing, along with analysis of their outlook on life, their social relationships and their functioning in everyday life.
The patterns of brain activation and symptoms suggested five categories.
The study found that the most common type was the ‘tension’ type.
Ms Katherine Grisanzio, the study’s first author, said:
“Interestingly, we found that many people who did not meet diagnostic criteria, but were still experiencing some symptoms, fell into the tension type.”
After this, anxious arousal was the next most common type, then melancholia and general anxiety, while the least common type was anhedonia, the inability to feel pleasure.
Currently, anxiety and depression are treated in much the same way, Professor Leanne Williams, who led the study, said:
“…the treatments would be the same for anyone in these broad categories.
By refining the diagnosis, better treatment options could be prescribed, specifically for that type of anxiety or depression.”
.
People with autistic traits in particular benefitted from the musical training.
Ten signs of depression include sadness, changes to sleep patterns, weight change, poor concentration and self-medication.
Ten signs of depression include sadness, changes to sleep patterns, weight change, poor concentration and self-medication.
Depression is a very complex state which is why the signs of depression are wide-ranging.
Depressed people feel helpless, hopeless, worthless and that their lives are out of control.
Many people are depressed without realising it.
Signs of depression are certainly much more than just feeling sad.
It’s not a disease that a person either has or doesn’t have.
Like most mental conditions it exists on a continuum — in this case from mild to severe.
Symptoms of depression can last for weeks, months or even years.
In general people who are depressed often feel that life is hopeless, that their lives are worthless and they are out of control.
Since the mind and body are so intimately connected, many of the symptoms are not purely mental.
For a positive diagnosis, a person would be experiencing some of the following signs of depression almost every day.
Sadness, low mood and anxiety can be signs of depression.
It could include crying for no reason.
In depression some combination of these negative feelings usually persists for at least a couple of weeks.
A general loss of interest in things a person used to find enjoyable.
It could include loss of sex drive or interest in work, socialising and hobbies.
A feeling that normal daily tasks are too exhausting.
It may also include being unable to get out of bed at the usual time, speaking slowly and having unexplained aches and pains.
People who are depressed often find their sleep is disrupted. They have difficulty getting to sleep and may wake frequently in the night.
Finding it hard to make decisions or finding that negative thoughts take over the mind.
As a result, people with depression can also feel very restless or impatient.
Thinking “What’s the point?” and seeing little hope for change in the future.
Depressed people often describe feeling ’empty inside’ as well as out of control.
People with depression may lose weight or gain weight depending on how they respond.
The weight change, though, can be an important sign of depression.
While thinking about death occasionally is normal, becoming preoccupied with it is less so.
Depression can lead to an unhelpful focus on death.
Self-harm or suicidal thoughts may follow.
Depressed people blame themselves for their situation.
This lowers their self-esteem and creates feelings of guilt and worthlessness.
Using alcohol, cigarettes or other drugs more than usual can be a sign of depression.
Since it can come on gradually, the signs of depression may be difficult to spot.
That’s why many people do not realise there is a problem until it is pointed out by someone else.
Some of the most common symptoms of depression that many report, but which people appear not to know are signs of depression included:
Depression is often classified into mild, moderate or severe, depending on its impact on daily life.
Mild depression has some impact on daily life, moderate has a significant impact and severe depression makes it very hard to get through the day.
Depression is often classified into all sorts of sub-types and is frequently found with other mental health problems.
Most people who have an episode of depression are able to recover and be symptom free, but it depends on the severity.
However, 50 percent of people who have an episode of major depression go on to have at last one more episode.
Few young people use the word ‘depressed’ to describe what often looks like depression, research reveals (Defrino et al., 2017).
Instead they refer to being ‘stressed’ or ‘down’.
Dr Daniela DeFrino, study co-author, said:
“Much of what a teen is feeling and experiencing is easy to attribute to the ups and downs of teen angst.
But, sometimes, there is so much more under the surface that can lead to depression.”
Three common depression symptoms the teenagers in the study reported were:
Dr DeFrino said:
“Teens rarely stated they were depressed, but described bursts of feeling stressed and sad that often came and went.
For example, a teen might say, “I always find somehow to go back to stressful mode,
I get really mad at people very easily.
They don’t understand why I’m upset.
Sometimes I don’t either.””
The teenagers described a wide variety of sources of stress.
Common problems were with homework and expectations of success.
Other sources of stress were arguments with parents and verbal and emotional abuse.
In some cases teenagers were upset about deaths and illnesses in their family.
Two-thirds of teens had visited their doctor for physical problems like ulcers, stomach pains and migraines.
Dr DeFrino said:
“Teens may be experiencing a lot of internal turmoil and difficult life stresses that we can easily overlook if we don’t probe with sensitive questioning and understanding.
Reframing these feelings as outward symptoms of pre-depression by the primary care provider would allow for connection to and discussion about the importance of mental health with the teen and parent.”
While the signs of depression listed above cover the main symptoms, depression has all sorts of other subtle effects on a person’s mental and physical state.
While these signs of depression are lesser known, they can be pervasive.
People who are depressed have a tendency to over-generalise and abstract (“It’s all the same to me, I don’t care…”).
That’s why depressed people tend to have more generalised goals than those who are not depressed (Dickinson, 2013).
For example, depressed people may say to themselves: “I want to be happy,” but this gives no indication about how it will be achieved.
Non-depressed people, in contrast, are more likely to have specific goals like: “I will keep in touch with my family by phoning them once a week.”
Since they are so precise, specific goals are more likely to be achieved than generalised goals.
One important sign or symptom of depression is rumination: when depressing thoughts roll around and around in the mind.
Unfortunately you can’t just tell a depressed person to stop thinking depressing thoughts; it’s pointless.
That’s because treating the symptoms of depression is partly about taking control of the person’s attention.
One method that can help with this is mindfulness.
Mindfulness is all about living in the moment, rather than focusing on past regrets or future worries.
A recent review of 39 studies on mindfulness has found that it can be beneficial in treating depression (Hofmann et al., 2010).
One of the lesser known symptoms of depression is its adverse effect on memory.
Over the years studies have shown that people experiencing depression have particular problems with declarative memory, which is the memory of specific facts like names or places (Porter et al., 2003).
Part of the reason for this may be that depressed people lose the ability to differentiate between similar experiences (Shelton & Kirwan, 2013).
It’s another facet of the tendency to over-generalise.
Depression blurs other types of memory as well, though, including the ability to recall meanings and to navigate through space.
Precisely because of memory difficulties and depressed mood, it can be difficult for depressed people to remember the good times.
One technique that can help is creating an emotional ‘memory palace‘: a mental store of specific happy memories to travel back to when times are hard.
There’s some evidence that the way in which the depressed view the world is more accurate than the non-depressed: this theory is called depressive realism.
Non-depressed people tend to be a little too optimistic: they think they’ve performed better in tasks than they really have and predict better performance than they actually achieve in the future (Moore & Fresco, 2012).
Depressed people, in contrast, appraise their own performance more accurately.
So, in some ways, people experiencing depression are more realistic.
Adding insult to injury, it seems people who are depressed may also experience higher levels of physical pain.
A recent study found that those induced into a depressed state were less able to cope with pain (Berna et al., 2010).
The lead author, Dr Berna explained:
“When the healthy people were made sad by negative thoughts and depressing music, we found that their brains processed pain more emotionally, which lead to them [to] find the pain more unpleasant.”
Americans are more depressed now than they have been in decades, even if they don’t know it, research finds (Twenge, 2014).
Data from 6.9 million adults and adolescents from across the US found that Americans now report more symptoms of depression than similar studies in the 1980s.
Compared to their counterparts in the 1980s, teens in the 2010s were 38 percent more likely to have memory problems and 74 percent more likely to have trouble sleeping.
Teens were also twice as likely to have seen a mental health professional about these issues.
Amongst college students, 50 percent said they were overwhelmed, while adults reported poor sleep, lack of appetite and feeling restless.
All of these are classic signs of depression.
Dr Jean Twenge, the study’s author, said:
“Previous studies found that more people have been treated for depression in recent years, but that could be due to more awareness and less stigma.
This study shows an increase in symptoms most people don’t even know are connected to depression, which suggests adolescents and adults really are suffering more.”
Mild depression may go away by itself or with a little self-help therapy.
For moderate and severe depression, talking therapies are often used in conjunction with medication.
One of the aims of talking therapies is to change depressed people’s thinking style.
People commonly think that depression is at least partly caused by big, bad life events.
This is true, but depression is also about the way people react to those events and indeed, ordinary, everyday stressors.
In one study, participants who had big emotional reactions to relatively small events were most likely to have suffered depressive symptoms when they were followed up ten years later.
The importance of thinking style, in addition to genetics and circumstances, is backed up by another recent study finding that how people thought about their problems influenced the levels of depression they experienced (Kinderman et al., 2013).
Lead author, Professor Peter Kinderman explained:
“Whilst we can’t change a person’s family history or their life experiences, it is possible to help a person to change the way they think and to teach them positive coping strategies that can mitigate and reduce stress levels.”
It’s very clear that exercise makes you feel better for a short period, but can it really treat depression in the long-term?
A new review of 26 years of research finds that it can.
These studies suggest that not only does exercise make people feel better in the moment, but it also helps to stop future episodes of depression (Mammen & Faulkner, 2013).
It’s little wonder that many have called for exercise to be prescribed by physicians for depression.
.
Depressed eyes are difficult if not impossible to spot, but this eye colour is linked to a seasonal form of depression.
Depressed eyes are difficult if not impossible to spot, but this eye colour is linked to a seasonal form of depression.
Depression cannot be spotted in the eyes alone, however eye colour may provide certain clues.
That is because people with brown eyes are more likely to get depressed with the seasons, mostly in the winter, research finds.
Women with brown eyes are particularly at risk as women are 40 percent more likely to experience the condition than men.
Those with blue eyes, though, seem to be have a level of protection against what is known as Seasonally Affected Disorder (SAD).
People with SAD — a form of depression — generally start to feel down from around fall and the symptoms continue through the winter months.
SAD has also been linked to weight gain from a craving for carbs.
The study’s authors write:
“Individuals with blue eyes appear to have a degree of resilience to SAD.
This may be taken as suggestive that the blue eye mutation was selected as a protective factor from SAD as sub-populations of humans migrated to northern latitudes.”
In other words, people with blue eyes historically tended to live in the North so their genetic make-up is more resilient to the cold, dark winters.
Professor Lance Workman, study co-author, said:
“We know that light entering the brain causes a decrease in levels of melatonin.
As blue eyes allow more light into the brain, it may be that this leads to a greater reduction in melatonin during the day and this is why people with lighter eyes are less prone to SAD.”
The study’s results came from a survey of 175 students in Wales and Cyprus.
The researchers found that around 8 percent of people in their study had a chronic version of SAD, while 21 percent had a less serious version of it.
The study was presented at the annual conference of the British Psychological Society in Nottingham, United Kingdom (Workman et al., 2018).
This diet increases the risk of depression by changing tryptophan metabolism, which is important for brain function.
This diet increases the risk of depression by changing tryptophan metabolism, which is important for brain function.
Eating a typical Western style diet increases the risk of depression, whereas healthy eating patterns with plenty of fresh fruits and vegetables have been shown to lower depression.
The Western style diet is typically rich in processed foods, sugars, and saturated fats.
A study reveals that higher intake of the Western diet lowers levels of a neuroprotective molecule known as kynurenic acid (KA).
Serotonin and KA are products of tryptophan, an essential amino acid that our body can’t make and so must come from food.
These compounds are important for regions of the brain related to anxiety, cognition, depression, addiction, passivity or violence, and eating behaviours.
The Western diet appears to alter tryptophan metabolism, resulting in lower levels of KA and therefore greater odds of depression.
Dr Edwin Lim, the study’s senior author, said:
“Western-style diets high in fat, sugar and processed foods were already known to increase the risk of depression, but this is the first time a biological link involving the kynurenine pathway has been established.
In this study, we tested participants’ urine for several biological markers, including KA and inflammation, and compared them with how healthy their diet was and the severity of depression symptoms.
People from the group eating an unhealthy diet had lower levels of KA and more severe symptoms of depression.
This indicates that KA may help to protect us against depression.”
The Western diet has already been linked to a wide range of problems including:
Tryptophan is essential for the human body to function and the typical Western diet is low in nutrients such as tryptophan.
Foods such as milk, fish, cheese, chicken, turkey, eggs, oats, nuts, and seeds are good sources of tryptophan.
Tryptophan breaks down into metabolites delivering various protective functions to the brain.
They are also used by the body for inflammatory responses and cells regulation against disorders such as dementia, cancer, heart disease, and stroke.
In the brain, tryptophan is converted into serotonin and serotonin into melatonin, a hormone that regulates our sleep and mood.
KA is also made by tryptophan via the kynurenine pathway associated with neurological diseases such as Alzheimer’s.
Until now no one knew that the Western style diet can negatively affect tryptophan metabolism even in young and healthy adults.
Dr Lim said:
“Previously, it was believed that changes to tryptophan metabolism were driven by inflammation, despite there not being conclusive clinical evidence for this.
Our study also shows that urine analysis may be a useful alternative to blood tests in collecting valuable biological information on the way our bodies process tryptophan.
This can be a big advantage in that it’s not only simpler—it’s less invasive, which is important for vulnerable people such as children and older adults.”
It is not yet clear if targeting KA would be a treatment option for depression in the future, in a similar way that antidepressants are supposed to boost serotonin levels.
Dr Heather Francis, the study’s first author, said:
“There is, however, a clear relationship between an increased risk of depression and eating an unhealthy diet that is high in fat, sugar and processed foods, giving us all the incentive to eat more fresh vegetables and fruits.”
Like most things, the right amount of kynurenine is the key for the body since elevated levels of KA have been associated with schizophrenia and low serum levels of KA connected to depression.
The study was published in the journal Frontiers in Nutrition (Francis et al., 2022).
Smartphone data can be incredibly accurate in predicting depression.
Getting treatment for this condition may reduce dementia risk by 30 percent.
Rumination is the habit of going over depressing events from the past in the mind and it can be very bad for mental health.
Rumination is the habit of going over depressing events from the past in the mind and it can be very bad for mental health.
Rumination — thinking about the causes and consequences of depressing events — is common in depression.
Repetitive thinking like this is often driven by the desire to understand what is happening to us and how that can be changed.
Rumination can be thought of like the brain’s problem-solving mechanism gone wrong.
When people ruminate, they can find it very difficult to stop.
It differs from problem-solving as no problem is ever solved.
Unfortunately, repetitive thinking about stressful events means reliving them, which is depressing.
Professor Roger Hagen, an expert on rumination, explains:
“Anxiety and depression give rise to difficult and painful negative thoughts.
Many patients have thoughts of mistakes, past failures or other negative thoughts.”
Rumination plays a large role in how depression arises and is maintained.
The main signs and symptoms of rumination and repetitive thinking are:
Traumatic life events are the single largest cause of anxiety and depression.
However, whether a person becomes anxious or depressed depends on their mental approach to these events.
After traumatic life events, which are the single largest cause of depression and anxiety, the next largest causes are a family history of mental illness and low income and low education levels.
Both social factors and relationship status have smaller effects on the risk of depression and anxiety.
It can be hard to get out of a pattern of rumination.
However, here are some techniques that may be helpful to stop ruminating:
Ultimately, the most effective way of dealing with rumination that will not go away is therapy.
During therapy, people learn to deal with rumination more effectively.
One strategy is learning that thoughts are just thoughts and do not reflect reality.
Like any thoughts, they can be allowed to float away without causing distress.
Metacognitive therapy is one option for dealing with rumination.
One of the problems in depression is that people…
“…think too much, which MCT [metacognitive therapy] refers to as ‘depressive rumination’.
Rather than ruminating so much on negative thoughts, MCT helps patients to reduce negative thought processes and get them under control.”
Taking control of your thoughts is an important part of many modern cognitive therapies.
One study found that when people learned to reduce how much they ruminated, 80 percent had recovered after six months (including 10 weeks of therapy).
Simply realising that you don’t have to ruminate can be liberating.
Professor Hagen said:
“Instead of reacting by repeatedly ruminating and thinking ‘how do I feel now?’ you can try to encounter your thoughts with what we call ‘detached mindfulness.’
You can see your thoughts as just thoughts, and not as a reflection of reality.
Most people think that when they think a thought, it must be true.
For example, if I think that I’m stupid, this means I must be stupid.
People strongly believe that their thoughts reflect reality.”
Many patients who took part in the study were pleasantly surprised, said Professor Hagen:
“The patients come in thinking they’re going to talk about all the problems they have and get to the bottom of it, but instead we try to find out how their mind and thinking processes work.
You can’t control what you think, but you can control how you respond to what you think.”
The study was published in the journal Frontiers in Psychology (Hagen et al., 2017).