Chapter 16. Psychopathology: Biological Basis of Behavior Disorders
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Joanne Silberner For a revolutionary, Deepali Vishwakarma of Bhopal, India, is more quiet and reflective than you might expect. She's in her 30s, small, with a round face that holds intense brown eyes and a shy grin. Vishwakarma is a lay counselor — a well-trained community member who goes out daily to fight what novelist William Styron once called a "howling tempest in the brain." She's part of an effort by the Indian nonprofit group Sangath to provide mental health treatment to poor people in India and to show that people with much less training than a psychiatrist or psychologist can deliver effective care. Vishwakarma had 40 hours of training for her role as a counselor. So her counseling is definitely revolutionary. And some mental health observers wonder if it might work in the U.S. But it's a controversial approach. Critics say the use of lay counselors means that patients receive substandard care. Tell that to Vishwakarma. In a typical week, she may meet with 25 people, and in her several years as a counselor, patients who've stuck with her, as most have, have done well. The patients have been diagnosed with serious depression (or stress or tension, as it's more often called in India), or alcoholism, and every so often, someone with schizophrenia. She's been trained to listen and to assign specific tasks to her patients. She might tell someone who's feeling really low to go for a daily walk, or go out and play soccer, or work in the garden or listen to the radio. For depression, it means thinking about anything other than that paralyzing howling tempest. For schizophrenia, it means helping people, many of whom are on medication, adjust to living in society. © 2017 npr
Link ID: 23056 - Posted: 01.05.2017
By LESLEY ALDERMAN Here’s a New Year’s challenge for the mind: Make this the year that you quiet all those negative thoughts swirling around your brain. All humans have a tendency to be a bit more like Eeyore than Tigger, to ruminate more on bad experiences than positive ones. It’s an evolutionary adaptation that helps us avoid danger and react quickly in a crisis. But constant negativity can also get in the way of happiness, add to our stress and worry level and ultimately damage our health. And some people are more prone to negative thinking than others. Thinking styles can be genetic or the result of childhood experiences, said Judith Beck, a psychologist and the president of the Beck Institute for Cognitive Behavior Therapy in Bala Cynwyd, Pa. Children may develop negative thinking habits if they have been teased or bullied, or experienced blatant trauma or abuse. Women, overall, are also more likely to ruminate than men, according to a 2013 study. “We were built to overlearn from negative experiences, but under learn from positive ones,” said Rick Hanson, a psychologist and senior fellow at the Greater Good Science Center at the University of California, Berkeley. But with practice you can learn to disrupt and tame negative cycles. The first step to stopping negative thoughts is a surprising one. Don’t try to stop them. If you are obsessing about a lost promotion at work or the results of the presidential election, whatever you do, don’t tell yourself, “I have to stop thinking about this.” “Worry and obsession get worse when you try to control your thoughts,” Dr. Beck said. Instead, notice that you are in a negative cycle and own it. Tell yourself, “I’m obsessing about my bad review.” Or “I’m obsessing about the election.” © 2017 The New York Times Company
By Don Lattin In the fall of 1965, a 33-year-old father of three named Arthur King—a patient on the alcoholics ward at Baltimore’s Spring Grove Hospital—swallowed an LSD pill and laid back on his bed in a special unit called “Cottage Thirteen.” Sanford Unger, the chief of psychosocial research at the Johns Hopkins University School of Medicine, knelt beside King’s bed, holding his hand and reassuring the patient as he started to feel the drug’s mind-altering effects. This was not a normal psychotherapy session. During his 12-hour experience, designed to help stop his destructive drinking habit, King sat on the edge of the bed and looked at the photo of his son that he’d brought. Suddenly, the child became alive in the picture, which initially frightened him. Then King noticed that a lick of his son’s hair was out of place, so he stroked the photo, putting the errant strands back in place. His fear vanished. Later, Unger held out a small vase with a single red rose. King looked at the flower, which seemed to be opening and closing, as though it were breathing. At one point, Unger asked him whether he’d like to go out to a bar and have a few drinks. King didn’t say anything but was shocked when the rose suddenly turned black and dropped dead before his eyes. He never picked up another drink. Arthur King was one of thousands of research subjects who were given LSD, psilocybin, and mescaline as therapeutic tools in the 1950s and 1960s, often with government support and with promising results. But by the time King was enjoying his sobriety, the backlash against psychedelic testing had already begun. By the mid-1970s, the legal exploration of the therapeutic benefits of psychedelic drugs was over.
By KATHARINE Q. SEELYE BROOKLINE, Mass. — When Michael Dukakis lost the presidential election in 1988, his wife, Kitty, felt as if she had been squashed in a compactor, all the air forced out of her. Her even-keeled husband went back to work as governor of Massachusetts; she started binge drinking. “An alcoholic can contain himself for only so long,” Mrs. Dukakis would later write. “When a crisis hits, the restraints snap.” Her drinking masked a long-smoldering depression that eventually led her to receive electroconvulsive therapy, also known as electroshock therapy or ECT. Like most people, she had no idea that the procedure was still used. She thought it a relic, scrapped after it was depicted as an instrument of torture in the 1975 movie “One Flew Over the Cuckoo’s Nest.” But Mrs. Dukakis was desperate. Rehabilitation, talk therapy and antidepressants had failed to ease her crippling depression, so in 2001, at age 64, she turned to shock therapy. To her amazement, it helped. After the first treatment, Mrs. Dukakis wrote, “I felt alive,” as if a cloud had lifted — so much so that when Mr. Dukakis picked her up at Massachusetts General Hospital, she astonished him by proposing that they go out to dinner. “I was so shocked I almost drove off Storrow Drive,” Mr. Dukakis recalled. “I had left this wife of mine at the hospital a basket case just the night before.” Now, 15 years later, the Dukakises have emerged as the nation’s most prominent evangelists for electroconvulsive therapy. Truth be told, there is not much competition. Few boldface names who have had the treatment will acknowledge as much; the stigma is still too great. Exceptions include Carrie Fisher, the actress and writer who died Tuesday, and Dick Cavett, the talk-show host; both have openly discussed their positive experiences. Electroconvulsive therapy is not a one-and-done procedure. Mrs. Dukakis, 80, still receives maintenance treatment every seven or eight weeks. She said that she had minor memory lapses but that the treatment had banished her demons and that she no longer drank, smoked or took antidepressants. © 2017 The New York Times Company
Link ID: 23047 - Posted: 01.02.2017
By Nicole Mortillaro Post-traumatic stress disorder can be a debilitating condition. It's estimated that it affects nearly one in 10 Canadian veterans who served in Afghanistan. Now, there's promising research that could lead to the treatment of the disorder. Following a particularly traumatic event — one where there is the serious threat of death or a circumstance that was overwhelming — we often exhibit physical symptoms immediately. But the effects in our brains actually take some time to form. That's why symptoms of PTSD — reliving an event, nightmares, anxiety — don't show up until some time later. Research has shown that, after such an event, the hippocampus — which is important in dealing with emotions and memory — shrinks, while our amygdala — also important to memory and emotions — becomes hyperactive. In earlier research, Sumantra Chattarji from the National Centre for Biological Sciences (NCBS) and the Institute for Stem Cell Biology and Regenerative Medicine (inStem), in Bangalore, India, discovered that traumatic events cause new nerve connections to form in the amygdala, which also causes hyperactivity. This plays a crucial role in people dealing with post-traumatic stress disorder. Chattarji has been studying changes in the brain after traumatic events for more than a decade. In an earlier study, he concluded that a single stress event had no immediate event on the amygdala of rats. However, 10 days later, the rats exhibited increased anxiety. There were even changes to the brain, and, in particular the amygdala. So Chattarji set out to see if there was a way to prevent these changes. Post-traumatic stress disorder can seriously affect those who have served in the military. New research may help to one day prevent that. (Shamil Zhumatov/Reuters) The new research focused on a particular cell receptor in the brain, called N-Methyl-D-Aspartate Receptor (NMDA-R), which is crucial in forming memories. ©2016 CBC/Radio-Canada.
By Alice Callahan Can psychiatric medications alter the mother-baby bond? I am having a baby in a month and am on an antidepressant, antipsychotic and mood stabilizer. I don't feel a natural instinct to mother or connect to my baby yet. Could it be because of my medications? It’s normal for expectant parents to worry if they don’t feel a strong connection to the baby right away. “Those kinds of mixed fears and anxieties are really common in most pregnancies, certainly first pregnancies,” said Dorothy Greenfeld, a licensed clinical social worker and professor of obstetrics and gynecology at Yale School of Medicine. Bonding is a process that takes time, and while it can begin in pregnancy, the relationship between parent and child mostly develops after birth. Psychiatric conditions, and the medicines used to treat them, can complicate the picture. Antidepressants, the most widely used class of psychiatric drugs, do not seem to interfere with a woman’s attachment to the fetus during pregnancy, as measured by the amount of time the mother spends thinking about and planning for the baby, a 2011 study in the Archives of Women’s Mental Health found. On the other hand, the study found that women with major depression in pregnancy had lower feelings of maternal-fetal attachment, and this sense of disconnection intensified with more severe symptoms of depression. “Depression can definitely affect a person’s ability to bond with their baby, to feel those feelings of attachment, which is why we encourage treatment so strongly,” said Dr. Amy Salisbury, the study leader and a professor of pediatrics and psychiatry at the Alpert Medical School at Brown University. “That’s more likely to interfere than the medication itself.” There is less research on the effects of other types of mental health medications on mother-baby bonding, but psychiatric medications can have side effects that might interfere with parenting. For example, a small percentage of people taking mood-stabilizing medications have feelings of apathy, and that could hinder the bonding process, said Dr. Salisbury. And some mental health medications, depending on dosage and combination, might make a person feel too sedated. But again, letting mental illness go untreated is likely far riskier for both the mother and the baby. © 2016 The New York Times Company
By BENEDICT CAREY She was all there, all the time: exuberant in describing her mania, savage and tender when recalling her despair. And for decades, she gracefully wore the legacy of her legendary role as Princess Leia, worshiped by a generation of teenage girls as the lone female warrior amid the galactic male cast of the “Star Wars” trilogy. In her long, openhearted life, the actress and author Carrie Fisher brought the subject of bipolar disorder into the popular culture with such humor and hard-boiled detail that her death on Tuesday triggered a wave of affection on social media and elsewhere, from both fans and fellow bipolar travelers, whose emotional language she knew and enriched. She channeled the spirit of people like Patty Duke, who wrote about her own bipolar illness, and Kitty Dukakis, who wrote about depression and alcoholism, and turned it into performance art. Ms. Fisher’s career coincided with the growing interest in bipolar disorder itself, a mood disorder characterized by alternating highs and lows, paralyzing depressions punctuated by flights of exuberant energy. Her success fed a longstanding debate on the relationship between mental turmoil and creativity. And her writing and speaking helped usher in a confessional era in which mental disorders have entered the pop culture with a life of their own: Bipolar is now a prominent trait of another famous Carrie, Claire Danes’s character Carrie Mathison in the Showtime television series “Homeland.” “She was so important to the public because she was telling the truth about bipolar disorder, not putting on airs or pontificating, just sharing who she is in an honest-to-the-bone way,” said Judith Schlesinger, a psychologist and author of “The Insanity Hoax: Exposing the Myth of the Mad Genius.” © 2016 The New York Times Company
Link ID: 23035 - Posted: 12.29.2016
By Kelly Servick The “mad cow disease” epidemic that killed more than 200 people in Europe peaked more than a decade ago, but the threat it poses is still real. Eating meat contaminated with bovine spongiform encephalopathy and its hallmark misshapen proteins, called prions, can cause a fatal and untreatable brain disorder, variant Creutzfeldt-Jakob disease (vCJD). Thousands of Europeans are thought to be asymptomatic carriers, and they can spread prions through blood donations. So for years, researchers have sought a test to safeguard blood supplies. This week, two teams bring that goal closer. They describe methods for detecting prions in blood that proved highly accurate in small numbers of samples from infected people and controls. “There is new technology to go forward, and it looks promising,” says Jonathan Wadsworth, a biochemist who studies prion disease at University College London. “These are definitely very welcome papers.” Analyses of discarded appendix and tonsil samples suggest that as many as one in 2000 people in the United Kingdom carries abnormal prions—misfolded variations of a naturally abundant protein, which prompt surrounding healthy proteins to fold and clump abnormally. No one knows how many of these carriers will ever develop vCJD; incubation periods as long as 50 years have been reported. Once symptoms occur—first depression and hallucinations, and eventually dementia and loss of motor control—patients survive about a year. Four people are known to have contracted vCJD through a blood transfusion from an infected donor. © 2016 American Association for the Advancement of Science.
Link ID: 23007 - Posted: 12.22.2016
By STEVEN PETROW “So why did you stop drinking?” my friend Brad asked recently when we were out for dinner. “You never seemed to have a drinking problem.” The question surprised me, coming as it did a full two years after my decision to take a “break” from alcohol. He was scanning the wine list, and I sensed he was hoping I’d share a bottle of French rosé with him. So I decided to tell him the truth. “To get my depression back under control.” In my late 50s, my longstanding depression had started to deepen, albeit imperceptibly at first. I continued drinking moderately, a couple of glasses of wine most days of the week, along with a monthly Manhattan. Then two dark and stormy months really shook me up, leaving me in a black hole of despair as depression closed in. At my first therapy appointment, the psychopharmacologist listened to me attentively, then said bluntly: “Stop drinking for a month.” The shrink wanted to know whether I was in control of my drinking or my drinking was in control of me. He explained that we become more sensitive to the depressant effects of alcohol as we age, especially in midlife, when our body chemistry changes and we’re more likely to be taking various medications that can interact with alcohol and one another. On doctor’s orders, I went cold turkey off alcohol. When I returned a month later and volunteered that I hadn’t touched a drink since our last visit, he was satisfied that I didn’t have “an active alcohol problem” and told me I could drink in what he considered moderation: No more than two glasses of wine a day, and never two days in a row. He also suggested I keep a log. © 2016 The New York Times Company
Abby L. Wilkerson The new class I was teaching — “Composing Disability: Crip Ecologies” — was one of several first-year writing seminars offered at George Washington University. Given the focus, it was likely to be a challenge for at least some of the students. And it was presenting a particular challenge to me. Even before the class began, I was anxious. I have depression, and I wondered: Should I acknowledge it in the class? Would the students benefit if I did? I wanted to be sure I knew what I was doing, for everyone’s sake, before taking the leap. But I was not at all certain. The idea of disclosing in the classroom made me feel conflicted and vulnerable. Though the World Health Organization identifies depression as “the leading cause of disability,” not everyone with depression identifies herself as disabled. One of the central meanings of disability for me is “crip” pride — resistance to medical notions of disability as a defect and related social stigmas. My depression has given me unasked-for gifts, including a sensitivity to others’ suffering. But let’s face it — on some level, depression is suffering. How could I reconcile this with the fierce crip attitude in others that I’ve so admired? In class, how would the dull weight of depression sit with the “crip” in the course title? If I were going to do this, I needed to get it right. And I wasn’t sure how. Though I have suffered severe depression in the past, these days, my episodes tend to be milder and less frequent. Some days, I feel fine. But I might soon begin feeling melancholy — yet still able to laugh, think clearly, sleep at night and enjoy my life. Then one morning, for no discernible reason, I wake up mired in mud, my body now freight to be pushed through daily routines. The rhythm of life is suddenly ground down almost to nothing. I feel somehow both numb and raw, skin thin, laid open. Everything that matters is now far-off in the distance. Other people seem remote, existing in some parallel universe. © 2016 The New York Times Company
Link ID: 22985 - Posted: 12.14.2016
By BENEDICT CAREY About one in six American adults reported taking at least one psychiatric drug, usually an antidepressant or an anti-anxiety medication, and most had been doing so for a year or more, according to a new analysis. The report is based on 2013 government survey data on some 242 million adults and provides the most fine-grained snapshot of prescription drug use for psychological and sleep problems to date. “I follow this area, so I knew the numbers would be high,” said Thomas J. Moore, a researcher at the Institute for Safe Medication Practices, a nonprofit in Alexandria, Va., and the lead author of the analysis, which was published Monday in JAMA Internal Medicine. “But in some populations, the rates are extraordinary.” Mr. Moore and his co-author, Donald R. Mattison of Risk Sciences International in Ottawa, combed household survey and insurance data compiled by the federal Agency for Healthcare Research and Quality. They found that one in five women had reported filling at least one prescription that year — about two times the number of men who had — and that whites were about twice as likely to have done so than blacks or Hispanics. Nearly 85 percent of those who had gotten at least one drug had filled multiple prescriptions for that drug over the course of the year studied, which the authors considered long-term use. “To discover that eight in 10 adults who have taken psychiatric drugs are using them long term raises safety concerns, given that there’s reason to believe some of this continued use is due to dependence and withdrawal symptoms,” Mr. Moore said. Dr. Mark Olfson, a professor of psychiatry at Columbia University, who was not involved in the study, said the new analysis provided a clear, detailed picture of current usage: “It reflects a growing acceptance of and reliance on prescription medications” to manage common emotional problems, he said. © 2016 The New York Times Company
Ian Boldsworth If you deal with mental health issues of any sort, talking about them is often a struggle, especially with all the stigma around them. It turns out, putting them out there for the world to hear is even more tricky. Nonetheless, after years of producing podcasts that stretched idiocy to previously unchartered territories, I recently did precisely this and released my first semi-serious project, all about discussing and sharing personal experiences of dealing with mental health problems. Three days after it was released, I’d still not listened to the completed series myself. Despite being the presenter and producer, I’d slightly bottled it. Those closest to me will tell you that I was battling a real anxiety in the lead-up to releasing the full series of The Mental Podcast, and that I’d already made my excuses to them. Every time somebody said they were looking forward to it I told them not to, and my initial promotional tweets had a cautionary, apologetic feel of “you may like this, you may not”. For the record, I’ve never had any issues talking about mental health stuff, always more than happy to casually drop it into an interview or real-life conversation, but with this new series, as the release date loomed closer, I started to get worried about it. On a purely business level, I was concerned that it wouldn’t make its money back. Over the last 12 months or so I’ve financed my independent stuff up front and then, with a reward incentivised (not a word) donations drive at the end of the series, attempted to recoup the cost. It’s a very high risk/utterly idiotic business model as podcast listeners have “getting stuff free” in their DNA, but so far I’ve fluked a decent, if modest, return. The last two series of podcasts were called The ParaPod and consisted of me lambasting a ghost-believing-buffoon with the simple tools of logic and facts, a pretty easy concept to get on board with and you don’t need to be worrying that it will potentially take you to the darkest depths of depression (although the commitment of an adult to such a ludicrous supernatural premise should at least waver your faith in human intelligence). © 2016 Guardian News and Media Limited
Link ID: 22977 - Posted: 12.12.2016
by Tom Siegfried SAN DIEGO — Society’s record for protecting public health has been pretty good in the developed world, not so much in developing countries. That disparity has long been recognized. But there’s another disparity in society’s approach to public health — the divide between attention to traditional diseases and the resources devoted to mental disorders. “When it comes to mental health, all countries are developing countries,” says Shekhar Saxena, director of the World Health Organization’s department of Mental Health and Substance Abuse. Despite a breadth of scope and depth of impact exceeding that of many more highly publicized diseases, mental illness has long been regarded as a second-class medical concern. And modern medicine’s success at diagnosing, treating and curing many other diseases has not been duplicated for major mental disorders. Saxena thinks that neuroscience research can help. He sees an opportunity for progress through increased interdisciplinary collaboration between neuroscience and mental health researchers. “The collaboration seems to be improving, but much more is needed and not only in a few countries, but all countries,” he said November 12 at the annual meeting of the Society for Neuroscience. |© Society for Science & the Public 2000 - 2016.
By Alice Klein How can you stop old anxieties from resurfacing? An injection of new neurons may help, a study in mice suggests. Post-traumatic stress disorder (PTSD), anxiety and other fear-related disorders are difficult to treat, and many people who seem to get better later relapse. A similar phenomenon occurs in rodents. Adult mice can be conditioned to fear a sound by giving them an electric shock every time they hear it. Playing the sound repeatedly without the shock gradually wipes out the fear – a process known as extinction training. However, the fear often returns spontaneously if the mouse hears the sound later on. Baby mice, on the other hand, do not seem to relapse as much. Yong-Chun Yu at Fudan University in China and his colleagues wanted to know if they could treat fearful adult mice with brain cells from mouse embryos. The transplants did not prevent the mice developing new fears, nor help them overcome existing ones – at least not by themselves. But coupled with extinction training, the embryonic cells did help wipe out existing fears and prevent the mice relapsing. First, the researchers injected live brain cells from mouse embryos into the amygdalae of adult mice – the parts of the brain involved in fear. Other mice were implanted with dead embryonic brain cells as a comparison. © Copyright Reed Business Information Ltd.
Maanvi Singh "I lost more than 80 percent of my university friends," recalls Jagannath Lamichhane. After silently struggling with depression for two decades, Lamichhane published an essay in Nepal Times about his mental illness. "I could have hid my problem — like millions of people around the world," he says, but "if we hide our mental health, it may remain a problem forever." Many of his friends and family didn't agree with that logic. In Nepal — as in most parts of the world — there's quite a lot of stigma around mental illness. That was eight years ago. Now 35-year-old Lamichhane is a mental health advocate, working to challenge the stigma around depression. "People believe that depression is the result of personal weaknesses and the result of bad karma in a past life," he says. Even worse, they don't believe they can be helped, he says — so they don't seek treatment. The problem isn't unique to Lamichhane's community. An estimated 350 million people are affected by depression, and the vast majority of them don't get treatment for their condition either due to stigma or a lack of knowledge, according to a study of more than 50,000 people in 21 countries. The study was led by Graham Thornicroft, a professor of psychiatry at King's College London. He and his team of researchers from King's College London, Harvard Medical School and the World Health Organization found that in the poorest countries, one in 27 people with depression received minimally adequate care for their condition. Even in the richest countries, only one in five people with depression sought care. The data was published Thursday in The British Journal of Psychiatry. © 2016 npr
Link ID: 22945 - Posted: 12.03.2016
Sarah Boseley Health editor A single dose of psilocybin, the active ingredient of magic mushrooms, can lift the anxiety and depression experienced by people with advanced cancer for six months or even longer, two new studies show. Researchers involved in the two trials in the United States say the results are remarkable. The volunteers had “profoundly meaningful and spiritual experiences” which made most of them rethink life and death, ended their despair and brought about lasting improvement in the quality of their lives. The results of the research are published in the Journal of Psychopharmacology together with no less than ten commentaries from leading scientists in the fields of psychiatry and palliative care, who all back further research. While the effects of magic mushrooms have been of interest to psychiatry since the 1950s, the classification of all psychedelics in the US as schedule 1 drugs in the 1970s, in the wake of the Vietnam war and the rise of recreational drug use in the hippy counter-culture, has erected daunting legal and financial obstacles to running trials. “I think it is a big deal both in terms of the findings and in terms of the history and what it represents. It was part of psychiatry and vanished and now it’s been brought back,” said Dr Stephen Ross, director of addiction psychiatry at NYU Langone Medical Center and lead investigator of the study that was based there. © 2016 Guardian News and Media Limited
By DAVE PHILIPPS CHARLESTON, S.C. — After three tours in Iraq and Afghanistan, C. J. Hardin wound up hiding from the world in a backwoods cabin in North Carolina. Divorced, alcoholic and at times suicidal, he had tried almost all the accepted treatments for post-traumatic stress disorder: psychotherapy, group therapy and nearly a dozen different medications. “Nothing worked for me, so I put aside the idea that I could get better,” said Mr. Hardin, 37. “I just pretty much became a hermit in my cabin and never went out.” Then, in 2013, he joined a small drug trial testing whether PTSD could be treated with MDMA, the illegal party drug better known as Ecstasy. “It changed my life,” he said in a recent interview in the bright, airy living room of the suburban ranch house here, where he now lives while going to college and working as an airplane mechanic. “It allowed me to see my trauma without fear or hesitation and finally process things and move forward.” Based on promising results like Mr. Hardin’s, the Food and Drug Administration gave permission Tuesday for large-scale, Phase 3 clinical trials of the drug — a final step before the possible approval of Ecstasy as a prescription drug. If successful, the trials could turn an illicit street substance into a potent treatment for PTSD. Through a spokeswoman, the F.D.A. declined to comment, citing regulations that prohibit disclosing information about drugs that are being developed. © 2016 The New York Times Company
By Louisa J. Steinberg “You've got to be kidding me, Doc. I can barely keep my eyes open as it is, and you want me to pull an all-nighter?” I smiled. “Yes, exactly that. Maybe even two or three.” It started out benignly enough. Jodi (not the patient's real name) had been feeling more stressed between meeting the growing demands of her high-stakes job in business management and shouldering more chores while her husband was away on business trips. Strapped for time, she started neglecting her usual self-care routines—eating healthy, exercising, taking time to relax. Not surprisingly, her mood was poor. Things soon grew worse. She no longer enjoyed activities that were usually the highlight of her day: story time with her children, chatting on the phone with her mom, reading a book. Although she was constantly exhausted, she could not get a good night's sleep; she would toss and turn and still feel tired even when she slept in. Her performance at work had also been suffering; she began missing days because she just couldn't get out of bed. Jodi knows she should have recognized these warning signs sooner. She had experienced major depression twice before, once in college and again in her late 20s after a breakup. Now in her late 30s, she had been off antidepressants for years. Yet she found herself back in that dark place, barely eating and unable to concentrate enough to read even a short paragraph. Her thoughts circled around the same unpleasant memories and nagging fears. She felt hopeless and guilty. © 2016 Scientific American
By Nicole Ireland, CBC News Ten years ago, litigation lawyer Michele Hollins was a "perpetually happy person," with twin daughters and a partnership in her Calgary law firm. Then, depression struck. For a while, Hollins was able to hide her illness at work, then go home and "become a complete automaton," she says, unable to eat or even muster the energy to get ready for bed. At its worst, the depression crippled her at work, to the point where Hollins would walk into her office, say hello to her assistant and then "close the door and lay on the floor and cry for hours." At her lowest point, she says she would "spend most of the day trying to figure out how to collect myself enough to get to my car and get home." That raw vulnerability doesn't match the general impression society has of lawyers as tough and ambitious. But research suggests that they are at much higher risk of depression, anxiety and substance abuse issues than people in the broader population — and may even be more susceptible than those in other high-stress professions, such as medicine. A U.S. study published in the Journal of Addiction Medicine last February found the rate of problem drinking among lawyers was between two and three times higher than among other highly educated professionals, including physicians. The study was funded by the American Bar Association and the Hazelden Betty Ford Foundation. The rate of depression was about three times higher than the general population in the U.S., according to lead researcher Patrick Krill, who will be presenting his research to lawyers and law students in Toronto on Monday at a professional development session hosted by the Law Society of Upper Canada. ©2016 CBC/Radio-Canada.
By Darryl Hol, Every year, thousands of Canadians sign up to participate in clinical trials, offering their bodies to further the development of important medical advances like new drugs or devices. But the results of many of those trials never see the light of day. A new online tool aims to put pressure on some of the companies and institutions behind the problem. TrialsTracker maintains a list of all the trials registered on the world's leading clinical trials database and tracks how many of them are updated with results. Amid pharmaceutical companies and research bodies from around the world on ClinicalTrials.gov, maintained by the U.S. National Institutes of Health, nine Canadian universities and institutions rank in the top 100 organizations with the greatest proportion of registered trials without results. "It's well documented that academic trialists routinely fail to share results," says Ben Goldacre, who was part of the team from the University of Oxford that developed TrialsTracker. "Often they think, misguidedly, that a 'negative' result is uninteresting — when, in fact, it is extremely useful." The University of Toronto's David Henry says "publication bias," as it's called, is robbing the medical community and patients of important information. "We've been deceived about the truth about treatments that we've used widely over a long period, in very large numbers of individuals, because of the selective publication of results that are favourable to the product," says Henry, a professor of health systems data at U of T's Institute for Health Policy Management and Evaluation. ©2016 CBC/Radio-Canada.
Link ID: 22907 - Posted: 11.25.2016