Do the plan. Follow the plan.

A Coping Plan Can Help Fend Off Depression From Vision Loss
by Patti Neighmond
August 11, 2014
http://www.npr.org/blogs/health/2014/08/11/338592866/a-coping-plan-can-help-fend-off-depression-from-vision-loss

about 25 percent of people with macular degeneration in both eyes go on to develop clinical depression.
So Dr. Rovner decided to test a style of psychological therapy called behavior activation. This treatment helps give patients strategies to build on whatever functional vision they have so they can continue their day-to-day activities and carry on an active social life. Rovner wanted to see if the approach would help people with macular degeneration ward off depression.
https://www.div12.org/PsychologicalTreatments/treatments/depression_behavior.html

The results were dramatic: Patients in the study who created a plan and stuck to it cut their risk of depression by more than half, Rovner says, compared to those who received only the talk therapy.

Vision is the primary way sighted people engage in the world, he says. If you can help someone who is losing their sight come up with coping strategies, there’s a good chance you’ll keep them engaged — and keep depression at bad.

“People tend to ruminate on what they’ve lost,” says Dr. Barry Rovner, a geriatric psychiatrist at Thomas Jefferson University in Philadelphia. “That’s why we say, ‘Do the plan. Follow the plan, not your feelings.’

a just do it philosophy.

Less and less willing to sit with our emotions

How Medicalizing Grief Turns Into Dollars
Forbes. February 21, 2012
http://www.forbes.com/sites/alicegwalton/2012/02/21/how-medicalizing-grief-turns-into-dollars

grief, once excluded from the definition of depression, is now included within it.
This means that people grieving over the death of a loved one could theoretically go to their psychiatrist and be prescribed pills to treat the “condition.”

The Lancet beautifully outlines why the medicalization of grief is misguided for so many reasons.
Antidepressants don’t do anything to the moods of non-depressed people, they point out, so there’s little likelihood that they would work to reduce grief.
Arthur Kleinman, a medical anthropologist, says that since the APA wants to allow for treatment of the normal grieving process, it had to first yank it from Normalcy and plunk it down in the realm of Abnormal, or worse, “make it over into a disease—ie, depression.”

the DSM continues to shorten the normal grieving processes.
The DSM-III considered grief for up to one year acceptable, the DSM-IV only two months.
No other culture, Kleinman says, considers two months a normal amount of time to grieve. They must be shaking their heads at us silly Americans and our strange attitude towards grief. Cultures across the globe vary hugely in what’s considered a normal timeframe to grieve, some devoting the remainder of the lifespan to mourning the loss of a loved one.

a fundamental difference between grief and clinical depression: grief, in many ways, makes sense, as there is direct cause for the feelings of sadness, loss, sleeplessness, and lack of concentration.

Would you want to take a medication if it would help lighten the pain of grief?
Or is it better to experience it, work through it, and wait for it to lift in its own time?
There is undoubtedly a place where grief becomes depression when it does not lighten for a long time.
But considering it a symptom of depression from day one seems like a damaging way to define it.

see also:
https://franzcalvo.wordpress.com/2014/06/15/our-emotional-state-biases-our-expectations-for-the-future

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CRAZYWISE: A Traditional Approach to Mental Illness
Phil Borges
TEDxSanJuanIsland
Jan 2, 2016

When a young person experiences a frightening break from reality, Western experts usually label it a “first-episode psychosis”, while many psychologists and cultures define it as a “spiritual awakening.

The Depression Connection

EEG data reveal how tightly connected the frontal cortex (red) is to the rest of the brain in depression (left) and health (right).

The Depression Connection
Scientific American Mind 23, 9 (2012)
http://www.nature.com/scientificamericanmind/journal/v23/n4/full/scientificamericanmind0912-9.html

Brain regions may communicate excessively in depression

Like an overwhelmed traffic cop, the depressed brain may transmit signals among regions in a dysfunctional way.
Recent brain-imaging studies suggest that areas of the brain involved in mood, concentration and conscious thought are hyperconnected, which scientists believe could lead to the problems with focus, anxiety and memory frequently seen in depression.

hyperconnectivity is a hallmark of depression in the brain

 

Senior Moments: A Sign Of Worse To Come?

Naming animals is one possible question on tests that doctors use to assess memory.

Senior Moments: A Sign Of Worse To Come?
April 11, 2011
http://www.npr.org/2011/04/11/135243606/sussing-out-senior-moments-a-sign-of-worse-to-come

an expert: Dr. Kirk Daffner, who directs the Mind-Brain Center at Brigham and Women’s Hospital in Boston. Daffner is editor of a just-published report on age-related memory loss.

Daffner put Phyllis Hersch through a series of memory tests: repeating back strings of words and numbers, some mental arithmetic, and so on. They’re designed to see if a person can encode new memories, manipulate the information and recall it.

Hersch scored in the normal range, but Daffner checks up on her every six months or so to see if there’s any change.

Faulty Memory Vs. Not Paying Attention

Daffner says much of the time, what people experience as a memory problem is really a not-paying-attention problem.

… When you’re paying attention to all those things, even on a subliminal level, these piece help you remember that you shut the door. When you’re not, you may not retrieve that memory.

“What’s common as people age is that the speed at which information can be retrieved on demand is slowed,” … There are lots of reasons why brains get sluggish.

High blood pressure damages the wiring that connects different parts of the brain.
Poor sleep or excess alcohol are enemies of a nimble brain.
And many medicines — including common drugs to reduce stomach acid, control asthma or treat depression — can slow the brain down.

Many Have ‘A Little Bit Of Alzheimer’s’

Nearly 40 percent of people who die without dementia, or any measurable cognitive problems, have definite signs of Alzheimer’s disease in their brains, says Dr. David Bennett, who directs the Alzheimer’s Disease Center at Rush University Medical Center in Chicago.

“If you look in the brains of older people, it’s hard not to have at least a little bit of Alzheimer’s pathology,” Bennett says. “It’s probably a much, much larger problem than we currently recognize.” Just as almost everybody has a little bit of heart disease after a certain age, Bennett says, a lot of people have “a little bit of Alzheimer’s.”

Bennett’s findings come from 16 years of studying thousands of older people who volunteered for the research when they had no cognitive problems. All agreed to donate their brains after death for study. Bennett acknowledges that the notion that many apparently healthy people are walking around with Alzheimer’s-like damage in their brains “could frighten a lot of people.”

But in fact, his studies also contain some really good news. Bennett says many people clearly are able to tolerate “a little bit of Alzheimer’s” in their brains — or even more than a little bit.

Some people are lucky when it comes to cognitive reserve. They inherit more of it. Perhaps 50 percent of cognitive reserve is genetically determined.
Education -– both the formal variety and rich life experiences -– also contribute.

But some people have bad luck. Their cognitive reserve gets depleted by loneliness, anxiety or depression.

Bennett says people who tolerate Alzheimer’s-like brain damage have certain things in common. “Having a purpose in life, conscientiousness, social networks, stimulating activities — all these things seem to be protective in terms of how your brain expresses whatever pathology it’s accumulating,” he says.

Depression and socioeconomic status

Socioeconomic Inequalities in Depression: A Meta-Analysis
Am. J. Epidemiol. 2003,  157  (2):  98-112.
V. Lorant, et al.
Bloomberg School of Public Health, Johns Hopkins University
http://aje.oxfordjournals.org/content/157/2/98.abstract Results indicated that low-SES individuals had higher odds of being depressed (odds ratio = 1.81, p < 0.001)

SES = socioeconomic status

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http://www.psych.upenn.edu/~mfarah/research/socioeconomic-status-and-brain

related TED Talk:
https://franzcalvo.wordpress.com/2013/12/21/emotion-more-real-than-facts

on poverty:
http://www.npr.org/2014/04/02/297926310/finding-a-more-nuanced-view-of-povertys-black-hole

http://ww2.kqed.org/mindshift/2015/05/22/how-schools-can-help-nurture-students-mental-health

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figure from:
Depression in the United States Household Population, 2005-2006
NCHS Data Brief No. 7, September 2008
Page last updated: January 19, 2010
http://www.cdc.gov/nchs/products/databriefs/db07.htm

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depressionNational Center for Health Statistics.
Health, United States, 2011: With Special Feature on Socioeconomic Status and Health.
Hyattsville, MD. 2012.
In 2005–2010, the prevalence of depression among adults 45–64 years of age was 5 times as high for those below poverty (24%), 3 times as high for those with family income between 100%–199% of poverty (15%), and more than 1.5 times as high for those with family income between 200%–399% (7%), compared with those at 400% or more of the poverty level (5%) (Figure 33).

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http://global-health-promotion-consortium.spruz.com/mental-health-promotion.htm

Can Poverty Lead To Mental Illness?
October 30, 2016
http://www.npr.org/sections/goatsandsoda/2016/10/30/499777541/can-poverty-lead-to-mental-illness