Depression - Page 41 of 43

Later School Start Times Improve Sleep and Daytime Functioning in Adolescents

How much extra sleep can make a difference to adolescent depression?

A new study finds a link between later start times at school and improved mood and sleep in teenagers.

The study, published in the Journal of Developmental & Behavioral Pediatrics, delayed the waking up time of adolescents at a boarding school by just 25 minutes (Boergers et al., 2013).

They found that afterwards the number of students getting more than 8 hours sleep a night jumped from 18% to 44%.

On top of this, the students experienced less daytime sleepiness, were less depressed, and found themselves using less caffeine.

Unsurprisingly, students who benefited the greatest were those who were most sleep deprived at the start of the study.

The lead author, Julie Boergers, a sleep expert, said:

“Sleep deprivation is epidemic among adolescents, with potentially serious impacts on mental and physical health, safety and learning. Early high school start times contribute to this problem. Most teenagers undergo a biological shift to a later sleep-wake cycle, which can make early school start times particularly challenging. In this study, we looked at whether a relatively modest, temporary delay in school start time would change students’ sleep patterns, sleepiness, mood and caffeine use.”

The reason that most adolescents are sleep deprived is that they need more sleep than adults, but often don’t get it.

Unlike adults, adolescents need 8.5 to 9.5 hours of sleep per night.

American high schools usually start at 8am and since most teens find it difficult to fall asleep before 11pm, there simply aren’t enough hours in the night.

Julie Boergers continues:

“The results of this study add to a growing body of research demonstrating important health benefits of later school start times for adolescents. If we more closely align school schedules with adolescents’ circadian rhythms and sleep needs, we will have students who are more alert, happier, better prepared to learn, and aren’t dependent on caffeine and energy drinks just to stay awake in class.”

This is far from the first study to suggest that early school start times have adverse consequences.

Others have found links between early start times and reduced academic performance, lower mood (as in this study) and even more car crashes.

The evidence seems overwhelming, but later start times remain controversial.

A common complaint is that later starts leave less time for extra-curricular activities.

However, there was no evidence of this in the current study, with students engaged in athletics and other activities for the same amount of time as before.

In addition, instead of being exhausted in the evening, they had more energy to complete their homework.

→ Related: 10 Sleep Deprivation Effects.

Image credit: Dan Woods

Mindfulness at School Decreases Chance of Developing Depression

Positive results from best study yet carried out on teaching mindfulness in schools.

Mindfulness training in schools has been found to reduce and even prevent depression in adolescents.

The finding comes from research carried out in 408 students between the ages of 13 and 20 who were studying at five schools in Flanders, Belgium (Raes et al., 2013).

Matched classes were assigned either to mindfulness training or to a control condition who simply continued with their other classes as normal.

Their depression, anxiety and stress levels were measured before and after the intervention, as well as six months later.

Happier students

The results showed similar levels of depression when they started the study: 21% of those in the mindfulness group were depressed, and 24% in the control group.

After the mindfulness intervention, the percentage of pupils who were clinically depressed had dropped to 15%, and after six months it remained lower than baseline at 16%.

Meanwhile, in the control group, levels of depression had actually increased, up to 27% and after six months up to 31%.

The study’s results, therefore, suggest that mindfulness training can lead to reductions in depression. These gains are also likely to be maintained for at least six months after the intervention.

Stay in the moment

The mindfulness training used in the study had been specially adapted for adolescents, although the principles of mindfulness are the same for everyone.

Mindfulness is about learning to pay attention to what’s going on right now, in this present moment:

“Mindfulness refers to a compassionate and nonjudgmental moment-to-moment awareness of one’s experiences.” (Raes et al., 2013).

To that end students across the sessions were encouraged to focus on:

“attention to the breath and the moment” (session 1), “attention to the body and pleasant moments” (session 2), “attention to your inner boundaries and to unpleasant moments” (session 3), “attention to stress and space” (session 4), “attention to thoughts and emotion” (session 5), “attention to interpretations and communication” (session 6), “attention to your attitudes and your moods” (session 7), and “attention to yourself and your heartfulness (session 8)” (Raes et al., 2013).

Once taught, students could continue to benefit from these early lessons for a lifetime, perhaps immeasurably improving their lives.

Find out more about the benefits of meditation.
Now try these 10 mindfulness exercises.

Image credit: James Blann

Meditation is an Effective Treatment for Depression, Anxiety and Pain

Data from 47 different clinical trials finds meditation is as effective as antidepressants.

A medical journal review has found that just 30 minutes daily meditation can improve the symptoms of depression, anxiety and pain.

The research, published in the Journal of the American Medical Association, included studies with a total of 3,515 participants (Goyal et al., 2014).

All of the research involved active control groups so it was possible to discount the placebo effect.

The placebo effect occurs when people expect to get better–sometimes simply as a result of being in a study–and so they do.

Studies with active control groups, though, can help discount the placebo effect as the treatment can be compared with a group who have similar expectations.

Meditation is more than relaxation

Participants in this review had had at least 4 hours of instruction in a form of meditation, such as mindfulness or mantra-based programs.

Typically, though, participants were given 2.5 hours instruction per week over 8 weeks.

Many of the participants also had physical problems, like lower back pain, heart disease and insomnia, which were likely heavily involved in their depression and/or anxiety.

The control groups contained matched participants who did things that were similar to meditation, but without actually being meditation.

For example, people in the control group in some of the studies performed progressive muscle relaxation. This has some of the physical requirements of meditation–i.e. you’re relaxed–but doesn’t involve the cognitive aspect.

Madhav Goyal M.D. explained:

“A lot of people have this idea that meditation means sitting down and doing nothing. But that’s not true. Meditation is an active training of the mind to increase awareness, and different meditation programs approach this in different ways.”

The meditation conditions, though, consistently outperformed the control conditions, suggesting meditation is effective.

And, when the researchers compared the magnitude of the gains with those taking medications, the effectiveness was similar.

No side-effects

On top of these findings for depression and anxiety, the review also found that meditation was an effective treatment for those experiencing pain.

When you consider that meditation has no side-effects in comparison to many medications, it starts to look even better.

→ Read on: Meditation Benefits: 10 Ways It Helps Your Mind

→ 10 Signs of Anxiety Everyone Should Know.

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Psychedelic Drug Use Not Associated With Mental Health Problems

A new study of 130,000 people has found no association between psychedelic drug use and mental health problems.

The study, conducted by Teri Krebs and Pål-Ørjan Johansen at the Norwegian University of Science and Technology, reached the conclusion after analysing data from a US national health survey (Krebs & Johansen, 2013).

Among the 130,000 participant, 22,000 had taken psychedelic drugs like LSD, peyote or magic mushrooms at some point in their lives. Participants were asked about whether they’d had treatment for mental health problems, or experienced psychosis, depression, or other psychological distress.

After adjusting for risk factors, like age and exposure to very stressful events, they found no connection between either recent or lifetime use of psychedelics and increased rates of mental health problems.

In fact, there was some weak evidence of the positive effects of psychedelics.

The researchers also found no evidence of ‘acid-flashbacks’ or other strange perceptual phenomena among people who had used psychedelics. Moreover, as they explain in the paper, published in the journal PLOS ONE:

“Psychedelics often elicit deeply personally and spiritually meaningful experiences and sustained beneficial effects. [However,] psychedelics can often cause [a] period of confusion and emotional turmoil during the immediate drug effects and infrequently such adverse effects last for a few days after use.”

This result fits in with other studies which find that, unlike many other illicit drugs, psychedelics are not addictive and do not promote compulsive use:

A study of long-term peyote use by Native Americans found no evidence of psychological or cognitive deficits (Halpern et al., 2005).
Amazon rainforest dwellers who had used dimethyltryptamine—which is similar to psilocybin, the active ingredient in magic mushrooms—in over 360 religious ceremonies had no psychological or cognitive deficits (Bouso et al., 2012).

Researcher, Pål-Ørjan Johansen explained:

“Everything has some potential for negative effects, but psychedelic use is overall considered to pose a very low risk to the individual and to society. Psychedelics can elicit temporary feelings of anxiety and confusion, but accidents leading to serious injury are extremely rare.”

What this study can’t tell us is whether psychedelic drugs could be good for some people and bad for others and the results even out.

That said, Teri Krebs concludes:

“Over the past 50 years tens of millions of people have used psychedelics and there just is not much evidence of long-term problems.”

Image credit: Evan

Can Everyday Hassles Make You Depressed?

Do you sweat the small stuff?

When it comes to pinpointing the source of our woes, we tend not to think too much about the little hassles of everyday life; after all they’re just little hassles, nothing compared to the big stuff.

You’re late for a meeting, you run out of biscuits or you get a parking ticket; irritating certainly, but nothing really serious, or anything like it.

Instead, we tend to blame the big events in life: divorce, disease and bereavement. And, when looking for what puts people over the edge, that’s exactly where psychological researchers have concentrated their attention: on the big stuff.

But many are waking up to the fact that although the little hassles in life are smaller, they’re also more numerous, so they can really add up over time. And, whether stressful events are big or small, it matters a lot how we deal with them.

Daily stressors

In new research published in Psychological Science, Charles et al. (2013) looked at people’s reactions to everyday stressors and how this played out a decade later. Participants were asked about their daily stressors over eight days and generally how they felt. People reported having all the usual sorts of stressors like having arguments, a fridge breaking down or being late for an appointment.

Then, 10 years later, they were revisited and asked whether they had been treated for anxiety, depression or any other emotional problems in the last year.

What the results showed was that how people reacted to the little stressors of everyday life predicted whether they developed psychological problems a decade later (incidentally, the number who did report a disorder was almost one in five).

This fits in with other recent studies which have also shown that people’s reactions to ordinary stressors predict depressive symptoms (e.g. Parrish et al., 2011).

Whether problems are big or small, what matters is how we react to them. People who tend to do worst are those that have the strongest emotional reaction to both big and small events.

We tend to think that depression is always a reaction to some really bad thing happening and sometimes it is; but sometimes it’s all those little things piled on top of one another that can get you down.

Image credit: Stephen Poff

80% of Prozac Power is Placebo

80% of people’s improvement after taking drugs like Prozac was exactly the same as if they took a sugar pill.

Placebo is Latin for “I shall please”.

I came across this incredible demonstration of the placebo effect in Kirsch et al., (2008), reviewing results from 35 clinical trials of modern antidepressant medication (things like Prozac):

“The response to placebo in these trials was exceptionally large, duplicating more than 80% of the improvement observed in the drug groups. In contrast, the effect of placebo on pain is estimated to be about 50% of the response to pain medication.”

In other words 80% of people’s improvement after taking drugs like Prozac was exactly the same as if they took a sugar pill. Pain pills, on the other hand, do more over and above the placebo.

And antidepressants didn’t even really work for severely depressed people:

“The difference in improvement between the antidepressant and placebo reached clinical significance, however, in [..] severely depressed patients […] the apparent clinical effectiveness of the antidepressants […] reflected a decreased responsiveness to placebo rather than an increased responsiveness to antidepressants.”

So, for the severely depressed antidepressants seemed more effective because the placebo didn’t work so well.

It’s a dilemma because the pills are doing something, but what? Is it just the effect of believing they will help you? Does it matter how much you believe? Is it the fact that you get them from a doctor who tells you they will help?

Quite apart from the whole debate about the prescription of antidepressant medication, it really shows the amazing power of our beliefs on how we feel.

Image credit: Christin

Does Internet Use Lead to Addiction, Loneliness, Depression…and Syphilis?

Is the internet bad for us? Psychological research on the link between internet use and addiction, loneliness and depression.

Like anything that has transformed our lives, the internet has also attracted its fair share of naysayers and detractors who claim that it is bad for us.

Two of the more respectable claims made against the internet are that it is addictive and can increase loneliness and depression.

Internet loneliness and depression

Perhaps the more counter-intuitive of the two is the idea that the internet causes loneliness, given that it is a medium for communication. Some have argued, though, that people end up using the internet instead of socialising face-to-face.

More than ten years ago, back when the internet was nothing more than a big bouncing baby, a group of researchers discovered what they called ‘the internet paradox’. Despite being another way of communicating with other people, they found that internet use was associated with increased depression and loneliness (Kraut et al., 1998).

But, when the researchers followed up the same people 3 years later, these effects had disappeared (Kraut et al., 2002). Not only that, but they also found internet use was associated with increased well-being and social involvement.

Now the internet has reached adolescence, this up and down—yes, the internet’s bad for you, no it’s good for you—is still the story. Some research has come out positive, some neutral (e.g. Huang, 2009), some very cautiously negative ( e.g. Stepanikova et al., 2009). Similarly inconclusive results have been found when looking specifically at email, chatrooms or general sociability.

My bet on the true answer would be the usual answer to very complex questions: it depends on a lot of things. On average, though, for most people it’s unlikely that internet use causes depression or loneliness. Certainly nothing to be concerned about compared with the huge potential benefits.

Internet addiction

The question of whether it’s possible to become addicted to the internet has proved more controversial for experts. The debate became particularly heated over whether it should be included in the official manual of psychological disorders, the ‘DSM’ (in the end it’s not there, yet).

One of the reasons it’s so difficult to decide whether internet addiction exists is it’s partly an argument about the meaning of the word addiction. A way to resolve this is by defining internet addiction clearly—write down what an internet addict looks like—then try applying this definition to loads of people you think might be addicts and, if the cap fits…

But, when Byun et al. (2009) examined 39 studies on internet addiction, they found the cap didn’t fit. In fact the most popular definition of an internet addict didn’t make sense. It failed to distinguish between people who were psychologically distressed and so-called internet addicts.

So it looks like the idea of an internet addict as a useful diagnostic tool doesn’t work.

Actually you don’t need to do any of this research to reach the conclusion that the concept of an ‘internet addict’ is nonsense. That’s because the internet is a medium of communication, not an end in itself. Someone may spend hours every day ordering vodka online, but you’d be hard-pressed to argue they were an internet addict rather than an alcoholic.

Instead of the internet itself, prime targets to be described as online addictions are gambling, pornography and shopping, although many still argue that people can’t be addicted to these things since they are closer to compulsions.

So, there’s little evidence that people really become addicted to the internet in the true sense of either word.

Assorted mumbo-jumbo

Other less respectable claims are made about why the internet might be bad for us. But these aren’t based on any research and are often mumbo-jumbo dreamed up by people desperately trying to think of something to say that will attract attention. It pains me to mention them, even if only to rebuke them, but it has to be pointed out that there’s little or no evidence for any of it.

Take the UK tabloid headline from earlier this year that ‘Facebook spreads syphilis’. Here’s the world-class reasoning used to reach this conclusion: syphilis infections in part of the UK have been on the increase; some people have sex with people they first met on Facebook; therefore Facebook spreads syphilis.

Other claims made about the internet are marginally less facile but employ the same level of reasoning skills. Here are a few you may be familiar with: the internet will give you cancer, make you fat, worried, stupid, distracted, less creative, unable to concentrate, and so on. Presumably that’s all on top of the addiction, loneliness, depression and syphilis.

There’s no point in discussing any of these here because PsyBlog is dedicated to the research and, as far as I’m aware, there’s no research backing up any of these wilder claims.

So, until such time as that changes: keep calm and carry on clicking.

Image credit: Nataliej

Why Thought Suppression is Counter-Productive

How pushing a thought out of consciousness can bring it back with a vengeance.

It sometimes feels like our minds are not on the same team as us. I want to go to sleep, but it wants to keep me awake rerunning events from my childhood. I want to forget the lyrics from that stupid 80s pop song but it wants to repeat them over and over again ad nauseam.

Continue reading “Why Thought Suppression is Counter-Productive”

Strong Reactions to ‘Antidepressants Ineffective’ Study

The recently published study questioning the efficacy of antidepressants has produced some fascinating reactions on other blogs.

The recently published study questioning the efficacy of antidepressants has produced some fascinating reactions on other blogs. One of the most striking was from The Last Psychiatrist who argues that the study’s timing is no accident. Apparently it’s all part of Big Pharma’s plan to kick-start the prescription of their new drugs:

Continue reading “Strong Reactions to ‘Antidepressants Ineffective’ Study”

7 Self-Help Books for Depression

How to find the self-help book for depression that suits you and your needs.

There are many, many self-help books for depression around these days.

My own book is called Activate: How To Find Joy Again By Changing What You Do.

It is based on Behavioural Activation Therapy, which is often used by mental health professionals.

Many studies have found that it helps alleviate depression in cases of mild through moderate and even severe depression.

It is easier to grasp and quicker to implement than its close cousin, Cognitive Behavioural Therapy (CBT).

This type of therapy is all about action.

It is all about how to tweak your daily activities to improve how you feel.

By the end, you should have a list of relatively small everyday changes to your routines that will help you feel a little better about life.

It is particularly good for people who do not get on with cognitive therapy and find it difficult to analyse thoughts.

This book will:

Introduce the latest depression therapy used by therapists and backed by science.
Help you find a way past inactivity and avoidance.
Give you a path back to enjoyment and meaning in life.
Teach you to act the opposite of how depression makes you feel.

Find out more about Activate: How To Find Joy Again By Changing What You Do.

More bibliotherapy

If you would like to try an older and more complex approach to depression, then one study has found six books that were recommended by experts, although only one book had evidence for its effectiveness.

1. Feeling Good
This self-help book for depression has been evaluated in a number of randomised controlled trials, although small ones (Anderson et al., 2005).

The book itself is rooted in cognitive-behavioural therapy (CBT), currently one of the most successful methods psychologists have for treating depression.

Broadly speaking, CBT tries to identify problematic thought processes, then uses mental activities designed to modify them.

Six studies have evaluated the use of this book in treating mild depression and overall they have showed it can be an effective treatment.

2. Control Your Depression
Like ‘Feeling Good’, this book is also based on cognitive-behavioural therapy.

It has been evaluated in two studies, but neither of these found strong evidence for its effectiveness.

This doesn’t necessarily mean the book isn’t useful, just that these studies failed to find an effect.

The fact that it has been used in these two studies, however, underlines the fact that experienced clinicians believe it can be beneficial.

3. Mind Over Mood
While this book hasn’t been evaluated in any randomised controlled trials, it is frequently recommended by experienced clinicians.

Like the two previous books it is also based on cognitive-behavioural therapy and contains a large number of exercises and worksheets (cognitive-behavioural therapists love to dole out homework!)

4. Overcoming Depression and Low Mood: A Five Areas Approach
Again, this one also uses a cognitive-behavioural approach and is also frequently recommended by clinicians, although studies have yet to be carried out into its effectiveness.

5. Climbing out of Depression
Unlike the previous four books, this one isn’t based around CBT. Instead it uses a psychodynamic approach.

This focuses on understanding, reflection and contemplation.

Again there’s currently no evidence from randomised controlled trials, but this book is recommended by organisations like the Mental Health Foundation, MIND and the Depression Alliance.

6. Depression: The Way Out of Your Prison
This book falls into the same category as ‘Climbing out of Depression’, it is based on a psychodynamic approach, hasn’t been formally evaluated but is recommended by depression organisations.

CBT or psychodynamic?

One of the main questions when choosing a self-help book is the psychological theory on which it is based.

The six books recommended here fall into two categories: CBT and psychodynamic.

Some people prefer the hands-on practical activities used in CBT, others prefer the more reflective techniques used in the psychodynamic approach.

Of course, there are books using many other types of approaches to depression, but CBT and the psychodynamic approach are two theories which have a large evidence base for their effectiveness in conventional face-to-face psychotherapy.

Note

Bear in mind that studies on bibliotherapy are at an early stage. The ones that exist have only examined a few of the books available, and generally these books are only for mild depression.

The study was published in the British Journal of General Practice (Anderson et al., 2005)

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