Posts Tagged Depression

[Abstract] Depression in the First Year after Traumatic Brain Injury

Abstract

The aims of this study were to document the frequency of major and minor depressive episodes in the first year after traumatic brain injury (TBI), taking into account TBI severity and pre-morbid history of major depression, and to describe trajectories of depressive episodes. Participants were 227 adults who were hospitalized post-TBI (76% male; mean age = 41 years; 50% mild, 33% moderate, and 17% severe TBI). Major and minor depressive episodes were assessed with the Mini International Neuropsychiatric Interview at three time points (4, 8, and 12 months after TBI). Overall, 29% of participants had a major depressive episode in at least one of the three assessments, with fairly stable rates across assessments. Participants with mild TBI were more likely than those with moderate/severe TBI to be diagnosed with major depression, as were individuals with a positive pre-morbid history of depression compared to those without such history. In addition, 13% of participants had a minor depressive episode in at least one of the three assessments. Rates of minor depression significantly decreased from 4 to 8–12 months post-injury. Results also revealed a wide variety of trajectories of depressive episodes across assessments. Of note, 52% of major depression cases still fulfilled diagnostic criteria 4 months later, whereas 38% of minor depression cases deteriorated to major depression at the following assessment. These findings suggest that depression is highly prevalent after TBI, and monitoring of patients with subthreshold depressive symptoms is warranted in order to prevent the development of full-blown major depressive episodes.

 

via Depression in the First Year after Traumatic Brain Injury | Journal of Neurotrauma

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[WEB SITE] Vagus nerve stimulation accelerates motor skill recovery after stroke

Researchers at The University of Texas at Dallas have demonstrated a method to accelerate motor skill recovery after a stroke by helping the brain reorganize itself more quickly.

In a preclinical study, the scientists paired vagus nerve stimulation (VNS) with a physical therapy task aimed at improving the function of an upper limb in rodents. The results showed a doubled long-term recovery rate relative to current therapy methods, not only in the targeted task but also in similar muscle movements that were not specifically rehabbed. Their work was recently published in the journal Stroke.

A clinical trial to test the technique in humans is underway in Dallas and 15 other sites across the country.

Dr. Michael Kilgard, associate director of the Texas Biomedical Device Center (TxBDC) and Margaret Forde Jonsson Professor of Neuroscience in the School of Behavioral and Brain Sciences, led the research team with Dr. Seth Hays, the TxBDC director of preclinical research and assistant professor of bioengineering in the Erik Jonsson School of Engineering and Computer Science, and postdoctoral researcher Eric Meyers PhD’17.

“Our experiment was designed to ask this new question: After a stroke, do you have to rehabilitate every single action?” Kilgard said. “If VNS helps you, is it only helping with the exact motion or function you paired with stimulation? What we found was that it also improves similar motor skills as well, and that those results were sustained months beyond the completion of VNS-paired therapy.”

Kilgard said the results provide an important step toward creating guidelines for standardized usage of VNS for post-stroke therapy.

“This study tells us that if we use this approach on complicated motor skills, those improvements can filter down to improve simpler movements,” he said.

Building Stronger Cell Connections

When a stroke occurs, nerve cells in the brain can die due to lack of blood flow. An arm’s or a leg’s motor skills fail because, though the nerve cells in the limb are fine, there’s no longer a connection between them and the brain. Established rehab methods bypass the brain’s damaged area and enlist other brain cells to handle the lost functions. However, there aren’t many neurons to spare, so the patient has a long-lasting movement deficit.

The vagus nerve controls the parasympathetic nervous system, which oversees elements of many unconscious body functions, including digestion and circulation. Electrical stimulation of the nerve is achieved via an implanted device in the neck. Already used in humans to treat depression and epilepsy, VNS is a well-documented technique for fine-tuning brain function.

The UT Dallas study’s application of VNS strengthens the communication path to the neurons that are taking over for those damaged by stroke. The experiments showed a threefold-to-fivefold increase in engaged neurons when adding VNS to rehab.

“We have long hypothesized that VNS is making new connections in the brain, but nothing was known for sure,” Hays said. “This is the first evidence that we are driving changes in the brain in animals after brain injury. It’s a big step forward in understanding how the therapy works — this reorganization that we predicted would underlie the benefits of VNS.”

In anticipation of the technique’s eventual use in humans, the team is working on an at-home rehab system targeting the upper limbs.

“We’ve designed a tablet app outlining hand and arm tasks for patients to interact with, delivering VNS as needed,” Meyers said. “We can very precisely assess their performance and monitor recovery remotely. This is all doable at home.”

Expanding the Possibilities for Therapy

The researchers are motivated in part by an understanding of the practical limitations of current therapeutic options for patients.

“If you have a stroke, you may have a limited time with a therapist,” Hays said. “So when we create guidelines for a therapist, we now know to advise doing one complex activity as many times as possible, as opposed to a variety of activities. That was an important finding — it was exciting that not only do we improve the task that we trained on, but also relatively similar tasks. You are getting generalization to related things, and you’re getting sustained improvement months down the line.”

For stroke patients, the opportunity to benefit from this technology may not be far off.

“A clinical trial that started here at UTD is now running nationwide, including at UT Southwestern,” Kilgard said. “They are recruiting patients. People in Dallas can enroll now — which is only fitting, because this work developed here, down to publishing this in a journal of the American Heart Association, which is based here in Dallas. This is a homegrown effort.

“The ongoing clinical trial is the last step in getting approved as an established therapy,” Kilgard said. “We’re hopefully within a year of having this be standard practice for chronic stroke.”

 

via Vagus nerve stimulation accelerates motor skill recovery after stroke

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[Abstract] Cognition, Health-Related Quality of Life, and Depression Ten Years after Moderate to Severe Traumatic Brain Injury: A Prospective Cohort Study

The aim of this study was to evaluate cognitive function 10 years after moderate-severe traumatic brain injury (TBI) and to investigate the associations among cognitive function, depression, and health-related quality of life (HRQoL). In this prospective cohort study, with measurements at 3, 6, 12, 18, 24, 36, and 120 months post-TBI, patients 18–67 years of age (n = 113) with moderate-severe TBI were recruited. Main outcome measures were depression (Center for Epidemiologic Studies-Depression Scale [CES-D]), subjective cognitive functioning (Cognitive Failure Questionnaire [CFQ]), objective cognitive functioning, and HRQoL (Medical Outcomes Study 36-Item Short Form Health Survey [SF-36]). Fifty of the initial 113 patients completed the 10 year follow-up. Twenty percent showed symptoms of depression (CES-D ≥ 16). These patients had more psychiatric symptoms at hospital discharge (p = 0.048) and were more often referred to rehabilitation or nursing homes (p = 0.015) than non-depressed patients. Further, they also had significantly lower scores in six of the eight subdomains of the SF-36. The non-depressed patients had equivalent scores to those of the Dutch norm-population on all subdomains of the SF-36. Cognitive problems at hospital discharge were related with worse cognitive outcome 10 years post-TBI, but not with depression or HRQoL. Ten years after moderate-severe TBI, only weak associations (p < 0.05) between depression scores and two objective cognitive functioning scores were found. However, there were moderate associations (p < 0.01) among depression scores, HRQoL, and subjective cognitive functioning. Therefore, signaling and treatment of depressive symptoms after moderate-severe TBI may be of major importance for optimizing HRQoL in the long term. We did not find strong evidence for associations between depression and objective cognitive functioning in the long term post-TBI. Disease awareness and selective dropping out may play a role in long-term follow-up studies in moderate-severe TBI. More long-term research is needed in this field.

 

via Cognition, Health-Related Quality of Life, and Depression Ten Years after Moderate to Severe Traumatic Brain Injury: A Prospective Cohort Study | Journal of Neurotrauma

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[WEB SITE] Cognitive Behavioral Therapy (CBT) and Transcranial Magnetic Stimulation (TMS): What Are These Therapies and How Are They Used?

Published 7 Feb 2018  – Reviewed 7 Feb 2018 – Author Melissa Galinato  – Source BrainFacts/SfN

When you have a cold, you might have a runny nose, a headache, and a cough. You may take different medications to treat each symptom to soothe your throat or ease your sneezing. Like treating a cold with multiple symptoms, there are different types of therapies to treat the multiple symptoms of depressive disorder, widely known as depression. Cognitive Behavioral Therapy (CBT) and Transcranial Magnetic Stimulation (TMS) are two therapy types that address specific symptoms of depression.

More than 300 million people around the world have depression, which is a common mental illness with multiple symptoms such as persistent sadness, irritability, a feeling of worthlessness, and loss of interest in activities—especially in things that previously brought joy or excitement.

With Cognitive Behavioral Therapy (CBT), a therapist helps a patient with depression to focus on understanding how three things – thoughts, feelings, and behavior – affect each other. “The goal of CBT for depression is to start targeting problematic thoughts and actions that are occurring in the present – as opposed to looking back in the past for a cause – teaching patients skills that they can use to become more aware of their negative thoughts, evaluate their validity and, when not accurate, replace them with more realistic/balanced ways of thinking,” says Simon Rego, Chief Psychologist at Montefiore Medical Center/Albert Einstein College of Medicine in New York.

“At the same time, the other goal of CBT is to help patients change maladaptive patterns of behavior, gradually increasing activities of pleasure and accomplishment, which are known to enhance mood. Taken together, changing how you think and what you do can have a powerful positive impact on your mood.”

Imagine setting a goal – like running a marathon for the first time. A running coach could help you reach that goal by giving you tips and developing a training to slowly build up your strength. In CBT, the therapist acts like a coach and helps people identify goals such as driving a car or giving a speech. Then the therapist helps to figure out actions to reach those goals such as practicing thinking strategies, writing in journals, and doing homework assignments between appointments. Doing these activities in CBT can help people learn coping skills, build self-confidence, and have a sense of control, and a growing number of studies show that CBT works very well for treating depression and several other mental health conditions.

“CBT is an effective treatment for depression because it targets the two main areas where people with depression struggle: negative thoughts and unhelpful behaviors,” said Rego. “The main theory in CBT is that how we feel is directly influenced by how we think and what we do (or don’t do). In the case of depression, we know that people tend to have many negative thoughts about themselves, the world, and the future (e.g., I am a failure, I’ll never get better, no one cares about me, I don’t have the energy to do anything, etc.) which only serve to perpetuate their negative mood.”

Another therapy called Transcranial Magnetic Stimulation (TMS) can be used for some patients with depression who do not get better with antidepressant medications or other treatments. “In our experience, TMS is an appropriate treatment for major depressive disorder, moderate in severity and who are still functioning in the home, community, and who have failed multiple antidepressant medications,” said Ananda Pandurangi, medical director and chair of inpatient psychiatry in the Department of Psychiatry at Virginia Commonwealth University School of Medicine. “It is not appropriate for patients with either “mild” depression or those with severe depression including those with psychosis or catatonia,” said Pandurangi, noting that psychotherapy and medications may be more appropriate for patients with mild to severe depression.

TMS aims to alter brain circuitry. Using an electromagnetic coil, called a stimulator, to affect brain activity and treat depression, TMS treatment involves a doctor placing the stimulator near the forehead against the scalp. This activates brain cells in an area of the brain that includes the prefrontal cortex and controls mood and depression.

Sessions typically use repetitive TMS (rTMS) where recurrent magnetic pulses stimulate the brain. In 2008, the FDA approved rTMS for depression treatment after several research studies showed this TMS treatment lowers signs of depression and improves mood in people with treatment-resistant depression.

REFERENCES

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Publishing; 2013. 

Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychology Review. 26(1), 17-31 (2006).

Depression. National Alliance on Mental Illness. Accessed 2/7/2018.

Depression. World Health Organization. February 2017.

Dobson D, Dobson KS. Evidence-based practice of cognitive-behavioral therapy. Guilford Publications. 2016. 

Gaynes BN, Lloyd SW, Lux L, Gartlehner G, Hansen RA, et al. Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis. The Journal of Clinical Psychiatry. 75(5), 477-89 (2014).

Huguet A, Rao S, McGrath PJ, Wozney L, Wheaton M, et al. A systematic review of cognitive behavioral therapy and behavioral activation apps for depression. PLoS One. 11(5), e0154248 (2016). 

Lefaucheur JP, André-Obadia N, Antal A, Ayache SS, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clinical Neurophysiology. 125(11), 2150-2206 (2014). 

Levkovitz Y, Isserles M, Padberg F, Lisanby SH, Bystritsky A, et al. Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry. 14(1), 64-73 (2015). 

Pascual-Leone A, Rubio B, Pallardó F, Catalá MD. Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. The Lancet. 348(9022), 233-237 (1996). 

Psychotherapy. National Alliance on Mental Illness. Accessed 2/7/2018.

Wassermann EM, Williams WA, Callahan A, Ketter TA, Basser P, et al. Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in. Neuroreport. 6, 1853-1856 (1995). 

via Cognitive Behavioral Therapy Transcranial Magnetic Stimulation what are these therapies 020718

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[BLOG] Food for Brain: Cognitive Enhancement via Diet

by  | January 15, 2018

It is often said that we are what we eat. The food we eat is used not only to fuel our body, but also to build it. This applies to the brain as well. Food choices can influence our brain functions in both positive and negative ways. The right food may enhance brain functioning and ameliorate the cognitive decline associated with aging. In addition, some foods can improve our emotional status and prevent conditions like depression.

Lipids are good for brain—myth or reality?

It is a fact that some lipids, including unsaturated fatty acids, are necessary for brain developmentand functioning. This is not surprising if we consider that the brain is the second richest organ in lipids. Approximately 50–60% of the brain is made of lipids. But not all the fatty acids are equally good for the brain. Omega-3 fatty acids found in fatty fish (salmon, mackerel, herring) and seafood are essential for the brain. These fatty acids constitute brain cell membranes. Also, they are main compounds of myelin, a fatty coat that insulates neurons (brain and ensures transmission of signals.

Omega-3 fats play vital functions in improving cognitive functions, providing proper neuronal communication and securing adequate attention. Interestingly, consumption of just one fish meal per weak is believed to decrease the risk of Alzheimer’s disease by up to 60%. Human clinical trials showed that supplementation with omega-3 fatty acids might improve mood, cooperation and cognitive score in subjects with dementia. Omega-3 fatty acids are extremely important for neonatal development as well. A deficit in these fats in pregnant and breastfeeding women, as well as in early childhood, may lead to conditions like autism and attention deficit hyperactivity disorder (ADHD).

Polyunsaturated (omega-3) and monounsaturated fatty acids also regulate the brain’s dopamine system. This is how they improve levels of dopamine and serotonin—the chemicals that make us feel happy. This is why diets with high fish consumption are associated with a low prevalence of depression. Cross-national analyses declared Japan as a country with the highest fish intake on the one hand and the lowest depression score on the other.

Apart from fish meals, walnuts (and nuts in general) are rich sources of omega-3 fatty acids. They contain essential alpha-linolenic fatty acids that cannot be synthesized inside our body and need to be obtained from our diet. Flaxseed and flaxseed oils are other valuable sources of this fatty acid.  In addition to omega-3 fats, walnuts contain potential brain antioxidants—vitamin E and polyphenols.

Olive oil is an especially rich source of monounsaturated fatty acids, with oleic acid as the main representative. Like omega-3, monounsaturated fatty acids help to improve cognitive functions and prevent age-related cognitive decline. These fats are also found in avocados. This is why avocado is commonly labeled as a brain superfood. It is assumed that eating just a quarter or half of a avocado daily can help maintain brain health.

Antioxidants: food for thought

Brain membranes are rich in polyunsaturated fatty acids that are highly susceptible to oxidation. The oxidation of fatty acids leads to changes in membrane structure that can jeopardize brain functioning. When fatty acids are oxidized, membranes are damaged or even ruptured. This makes the intake of nutrients into brain cells quite difficult. The lack of nutrients stops normal functions of brain cells and eventually causes their death.

Oxidation of brain lipids occurs when the production of free radicals is greater than their removal by antioxidants present in the body. Thus, the adequate intake of antioxidants can prevent oxidation of brain lipids and slow down the loss of brain functions. This is why berries and fruits with high antioxidant potential are often recommended as good foods for the brain. Some findings suggest that high intake of blueberries and strawberries can halt the onset of age-related cognitive decline by up to 2.5 years. What makes berries powerful antioxidants is the presence of polyphenols, chemicals that give color to these fruits. Berries can decrease aging-related vulnerability to oxidative stress. These decrease further manifests with improvements in behavior. Human trials in people with mild cognitive impairments suggested the positive impact of berries on verbal memory performance. Apart from combating oxidative stress in the brain, polyphenols can also improve microcirculation. By enhancing blood flow, polyphenols help the proper nourishment of the brain that is important for its functioning.

Another food rich in polyphenols (more precisely epicatechin) that is believed to enhance cognition is dark chocolate. It is assumed that by decreasing oxidative stress and inflammation, dark chocolate improves memory and confers neuroprotection. Still, human trials are required to establish if dark chocolate can be considered as a brain superfood.

Curcuminoids are phenolic compounds from turmeric (popular curry spice) that can enhance memory and protect from neurodegenerative diseases, like Alzheimer’s. Although this opinion is mostly based on animal studies, it is likely that prevalence of Alzheimer’s disease in India is very low due to the common consumption of curry.

A diet rich in vitamins, minerals, and antioxidants, such as polyphenols and their subclass flavonoids, is assumed to suppress the incidence of Alzheimer’s disease. One of the foods containing all of these components is spinach. Spinach, like other leafy green vegetables, contains folic acid and vitamin K that are believed to help keep the brain sharp. Although vitamin K is important for producing myelin, the substance that insulates neurons, the effects of dietary vitamin K supplementation on the function of brain myelin have not been tested so far.

Other cognitive enhancers

Another possible brain stimulator representing one of the most popular drinks worldwide is tea. An interesting study in Chinese adults tracked the association between tea consumption and cognitive decline. The higher tea intake was associated with lower prevalence of cognitive impairments, suggesting that regular tea consumption may slow down cognitive decline. Interestingly, the association was most evident for black tea. The same study showed no association between coffee intake and cognitive status.

Extracts from herb Ginkgo biloba have been traditionally used for memory and concentration problems, but also for dealing with depression and anxiety. A recent meta-analysis found no impact of ginkgo on cognitive functions in healthy subjects, suggesting that the effects of Ginko may be rather minor. Nonetheless, some earlier studies showed that ginkgo together with ginseng may acutely enhance memory in a dose-dependent manner. Unlike ginkgo, human trials with ginseng showed that its consumption can improve working memory performance and mood in terms of calmness.

Although further clinical trials are needed to confirm the cognitive enhancement by many foods, it is evident that diet represents a promising tool for maintaining and improving brain health.

References

Muldoon, M.F., Ryan, C.M., Sheu, L., Yao, J.K., Conklin, S.M., Manuck, S.B. (2010). Serum phospholipid docosahexaenonic acid is associated with cognitive functioning during middle adulthood. Journal of Nutrition. 140(4): 848-853. doi: 10.3945/jn.109.119578

Terano, T., Fujishiro, S., Ban, T., Yamamoto, K., Tanaka, T., et al. (1999). Docosahexaenoic acid supplementation improves the moderately severe dementia from thrombotic cerebrovascular diseases. Lipids. 34 Supplement: S345-S346. PMID: 10419198

Gómez-Pinilla, F. (2008). Brain foods: the effects of nutrients on brain function. Nature Reviews. Neuroscience. 9(7): 568-578. doi: 10.1038/nrn2421

Joseph, J.A., Shukitt-Hale, B., Willis, L.M. (2009). Grape juice, berries, and walnuts affect brain aging and behavior. Journal of Nutrition. 139(9): 1813S-1817S. doi: 10.3945/jn.109.108266

Ahmed, T., Enam, S.A., Gilani, A.H. (2010). Curcuminoids enhance memory in an amyloid-infused rat model of Alzheimer’s disease. Neuroscience. 169(3): 1296-1306. doi: 10.1016/j.neuroscience.2010.05.078

Ng, T.P., Feng, L., Niti, M., Kua, E.H., Yap, K.B. (2008). Tea consumption and cognitive impairment and decline in older Chinese adults. American Journal of Clinical Nutrition. 88(1): 224-231. PMID: 18614745

Laws, K.R., Sweetnam, H., Kondel, T.K. (2012). Is Ginkgo biloba a cognitive enhancer in healthy individuals? A meta-analysis. Human Psychopharmacology. 27(6):527-533. doi: 10.1002/hup.2259

via Food for Brain: Cognitive Enhancement via Diet | Brain Blogger

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[TED Talks] 5 Must watch TED Talks About Depression

Hello, my name is Faith and I’ve been managing depression and anxiety for as long as I can remember. I started this blog to share my tips and tricks and help other bad ass babes kick ass on their mental health journey. I have an online support group you can join for free here. If you need help finding a mental health care provider call 1-800-662-HELP (4357) or visit BetterHelp to talk to a certified therapist online at an affordable price.

This post contains affiliate links, you can read my full disclosure policy here.

I went down the rabbit hole of TED talks again and I thought I would share these awesome TED talks about depression. These aren’t all uplifting but sometimes you need to hear some realness. Positivety kind of feels like a big pile of garbage when you’re depressed anyways (if you’ve ever tried to watch a motivational talk when you’re depressed you probably know what I’m talking about). If you’re depressed and looking for resources checkout my articles on depression and download my free mental health planner.

David Burns talks about using cognitive therapy to treat his depressed patients. He helps his clients to change how they think in order to change how they feel.

Kevin Breel talks about breaking the stigma of depression. If you are feeling depressed and feel like you are along trust me you’re not. There are lots of us out here struggling with depression. I have a mental health support group on Facebookthat you can join if you are looking to connect with other people who are struggling with mental health.

Zindel Segal has been treating his depressed clients by teaching them to appreciate the present moment. Try out the techniques in his talk and see if you think they can help you.

I love her story about communicating with her 2 year old in a positive way. She started trying to practice unconditional positive regard with her kids and then started trying to practice giving unconditional positive regard on herself.

Here’s a kids TED talk from a girl that was hospitalized from depression and anxiety.

Thanks for checking out my post. If you’re looking for more motivation checkout my post of bad ass commencement speeches. I have a ton of mental health resources on my site that I hope you’ll checkout like my free mental health planner or my posts related to anxiety and depression.

 

via TED Talks About Depression – Radical Transformation Project

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[WEB SITE] Coping With Emotional Changes After Stroke for Families

Coping With Emotional Changes After Stroke-blog

As a stroke survivor, you can face major life changes. In the aftermath of a stroke, you may experience a sense of loss that is rooted in the feeling that you’ve lost the life you had before your stroke, or your independence. These strong emotional reactions take a toll.

It is normal to experience emotions ranging from frustration, anxiety, and depression to a sense of grief, or even guilt, anger, and denial after such a monumental change. Realizing that these emotions are normal, and that you are not alone in experiencing them, is an important step to acknowledging and coping with them in a healthy way. By doing this, you avoid becoming overwhelmed, thus avoiding further difficulties during your recovery.

Reasons for Emotional Changes After a Stroke

Young Man At Balcony In Depression Suffering Emotional Crisis And Grief

A stroke causes physical damage to your brain. Feeling or behaving differently after a stroke may be connected to the area of your brain that was damaged. If the area of your brain that controls personality or emotion is affected, you may be susceptible to changes in your emotional response or everyday behavior. Strokes may also cause emotional distress due to the suddenness of their occurrence. As with any traumatic life experience, it may take time for you to accept and adapt to the emotional trauma of having experienced a stroke.

Emotional Changes a Stroke Might Cause

PseudoBulbar Affect

crying

Sometimes referred to as “reflex crying,” “emotional lability,” or “labile mood,” Pseudobulbar Affect (PBA) is a symptom of damage to the area of the brain that controls expression of emotions. Characteristics of the disorder include rapid changes in mood, such as suddenly bursting into tears and stopping just as suddenly, or even beginning to laugh at inappropriate times.

Depression

depressed

If you are feeling sad, hopeless, or helpless after having suffered a stroke, you may be experiencing depression. Other symptoms of depression may include irritability or changes to your eating and sleeping habits. Talk to your doctor if you are experiencing any of these symptoms, as it may be necessary to treat with prescription antidepressants or therapy to avoid it becoming a road block to your recovery.

Anxiety

anxiety

Anxiety is quite common after a stroke. You may have feelings of uneasiness or fears about your health; this is normal and healthy. However, if your anxiety does not subside in time and you feel overwhelmed, you may be dealing with an anxiety disorder, which requires help from your doctor or a mental health professional.

Medical staff will perform an informal evaluation to check for anxiety while you are in the hospital. Often, this involves a quick discussion with hospital staff, during which they will ask you if you have any worries or fears about your health. This evaluation may also involve hospital staff asking your family members if they have noticed a change in your mood or behavior. It is important that you are kept in the loop about any issues that may present themselves, and that you are provided with as much information about your health and treatment options as possible.

Symptoms of anxiety to watch for may include irritability or trouble concentrating. You may also experience trouble sleeping due to your mind racing about your health. Sometimes, you can become tired easily, even if well rested.

Physical symptoms may also present themselves. These symptoms include a racing heart and restlessness and are often coupled with a sense of overwhelming worry or dread. If you find yourself avoiding your normal activities, such as grocery shopping, visiting friends, going for walks, or spending a large portion of your day dwelling on things you are worried about, you may have an anxiety disorder. Your doctor can recommend that you visit a psychologist to help cope with and eventually overcome anxiety.

Other Emotional Reactions

You may experience a range of other emotional reactions after a stroke, including anger and frustration. Additional symptoms may be a sense of apathy or a lack of motivation to accomplish things you typically enjoy.

Coping With Changing Emotions

Physician Ready To Examine Patient And Help

There are many ways to treat the emotional changes associated with a stroke. The first step is discussing how you feel, as well as any concerns you may have about your health with your doctor. One treatment option is counseling, which involves speaking about your distressing thoughts and feelings with a mental health professional or therapist. Simply talking about the way you are feeling can be helpful when coping with overwhelming emotions after experiencing a traumatic event such as a stroke.

Your doctor may also prescribe antidepressants or anti-anxiety medication to help you deal with the emotions involved with a stroke. While they are not a cure-all for emotional troubles, antidepressants change the levels of certain chemicals in your brain, alleviating the symptoms of depression and anxiety, lifting your mood, and making life feel more bearable while you’re recovering. It is important to stay in contact with your doctor if you decide to take medication, as it will not be effective for everyone and may have unpleasant side effects.

Seek Support or Professional Advice

A stroke can come on suddenly and have a monumental effect on your life. For this reason, it is common for many patients to struggle with emotional side effects following a stroke. You may suffer damage to the section of your brain that affects emotions, causing a change in personality or emotional expression known as Pseudobulbar Affect. You may also experience symptoms of anxiety or depression, along with feelings of anger, frustration, or uncharacteristic apathy.

It is important to discuss your emotional concerns with your doctor. You may need a prescription for antidepressants or anti-anxiety medication, or a recommendation to see a mental health professional who can help you form healthy coping mechanisms.


All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

via Coping With Emotional Changes After Stroke for Families

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[WEB SITE] Dopamine deficiency: Symptoms, causes, and treatment

    1. Symptoms
    2. Causes
    3. Diagnosis
    4. Treatment
    5. Dopamine vs. serotonin
    6. Outlook

 

 

Dopamine is a chemical found naturally in the human body. It is a neurotransmitter, meaning it sends signals from the body to the brain.

Dopamine plays a part in controlling the movements a person makes, as well as their emotional responses. The right balance of dopamine is vital for both physical and mental wellbeing.

Vital brain functions that affect mood, sleep, memory, learning, concentration, and motor control are influenced by the levels of dopamine in a person’s body. A dopamine deficiency may be related to certain medical conditions, including depression and Parkinson’s disease.

A dopamine deficiency can be due to a drop in the amount of dopamine made by the body or a problem with the receptors in the brain.

Symptoms

 

Sad and depressed woman with low dopamine levels. alone in thought.

A dopamine deficiency is associated with depression, but researchers are still investigating this complex link.

 

The symptoms of a dopamine deficiency depend on the underlying cause. For example, a person with Parkinson’s disease will experience very different symptoms from someone with low dopamine levels due to drug use.

Some signs and symptoms of conditions related to a dopamine deficiency include:

  • muscle cramps, spasms, or tremors
  • aches and pains
  • stiffness in the muscles
  • loss of balance
  • constipation
  • difficulty eating and swallowing
  • weight loss or weight gain
  • gastroesophageal reflux disease (GERD)
  • frequent pneumonia
  • trouble sleeping or disturbed sleep
  • low energy
  • an inability to focus
  • moving or speaking more slowly than usual
  • feeling fatigued
  • feeling demotivated
  • feeling inexplicably sad or tearful
  • mood swings
  • feeling hopeless
  • having low self-esteem
  • feeling guilt-ridden
  • feeling anxious
  • suicidal thoughts or thoughts of self-harm
  • low sex drive
  • hallucinations
  • delusions
  • lack of insight or self-awareness

Causes

 

Dopamine model 3D render.

 Dopamine deficiency may be influenced by a number of factors. Existing conditions, drug abuse, and an unhealthy diet may all be factors.

 

Low dopamine is linked to numerous mental health disorders but does not directly cause these conditions.

The most common conditions linked to a dopamine deficiency include:

In Parkinson’s disease, there is a loss of the nerve cells in a specific part of the brain and loss of dopamine in the same area.

It is also thought that drug abuse can affect dopamine levels. Studies have shown that repeated drug use could alter the thresholds required for dopamine cell activation and signaling.

Damage caused by drug abuse means these thresholds are higher and therefore it is more difficult for a person to experience the positive effects of dopamine. Drug abusers have also been shown to have significant decreases in dopamine D2 receptors and dopamine release.

Diets high in sugar and saturated fats can suppress dopamine, and a lack of protein in a person’s diet could mean they do not have enough l-tyrosine, which is an amino acid that helps to build dopamine in the body.

Some studies have found that people who are obese are more likely to be dopamine deficient too.

Diagnosis

There is no reliable way to measure levels of dopamine in a person. However, a doctor may look at a person’s symptoms, lifestyle factors, and medical history to determine if they have a condition related to low levels of dopamine.

Treatment

 

Omega-3 fatty acid supplements.

Omega-3 fatty acid supplements may help to boost dopamine levels naturally.

 

 Treatment of dopamine deficiency depends on whether an underlying cause can be found.

If a person is diagnosed with a mental health condition, such as depression or schizophrenia, a doctor may prescribe medications to help with the symptoms. These drugs may include anti-depressants and mood stabilizers.

Ropinirole and pramipexole can boost dopamine levels and are often prescribed to treat Parkinson’s disease. Levodopa is usually prescribed when Parkinson’s is first diagnosed.

Other treatments for a dopamine deficiency may include:

  • counseling
  • changes in diet and lifestyle
  • physical therapy for muscle stiffness and movement problems

Supplements to boost levels of vitamin Dmagnesium, and omega-3 essential fatty acids may also help to raise dopamine levels, but there needs to be more research into whether this is effective.

Activities that make a person feel happy and relaxed are also thought to increase dopamine levels. These may include exercise, therapeutic massage, and meditation.

Dopamine vs. serotonin

Dopamine and serotonin are both naturally occurring chemicals in the body that have roles in a person’s mood and wellbeing.

Serotonin influences a person’s mood and emotions, as well as sleep patterns, appetite, body temperature, and hormonal activity, such as the menstrual cycle.

Some researchers believe that low levels of serotonin contribute to depression. The relationship between serotonin and depression and other mood disorders is complex and unlikely to be caused by a serotonin imbalance alone.

Additionally, dopamine affects how a person’s moves, but there is no clear link to the role of serotonin in movement.

Outlook

Dopamine deficiency can have a significant impact on a person’s quality of life, affecting them both physically and mentally. Many mental health disorders are linked to low levels of dopamine. Other medical conditions, including Parkinson’s disease, have also been linked to low dopamine.

There is limited evidence that diet and lifestyle can affect the levels of dopamine a person creates and transmits in their body. Certain medications and some therapies may help relieve symptoms, but a person should always speak to a doctor first if they are concerned about their dopamine levels.

 

via Dopamine deficiency: Symptoms, causes, and treatment

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[WEB PAGE] Excitatory magnetic brain stimulation reduces emotional arousal to fearful faces, study shows

February 6, 2018

A new study in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging looks at the modulation of emotion in the brain

A new study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging reports that processing of negative emotion can be strengthened or weakened by tuning the excitability of the right frontal part of the brain.

Using magnetic stimulation outside the brain, a technique called repetitive transcranial magnetic stimulation (rTMS), researchers at University of Münster, Germany, show that, despite the use of inhibitory stimulation currently used to treat depression, excitatory stimulation better reduced a person’s response to fearful images.

The findings provide the first support for an idea that clinicians use to guide treatment in depression, but has never been verified in a lab. “This study confirms that modulating the frontal region of the brain, in the right hemisphere, directly effects the regulation of processing of emotional information in the brain in a ‘top-down’ manner,” said Cameron Carter, M.D., Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, referring to the function of this region as a control center for the emotion-generating structures of the brain. “These results highlight and expand the scope of the potential therapeutic applications of rTMS,” said Dr. Carter.

In depression, processing of emotion is disrupted in the frontal region of both the left and right brain hemispheres (known as the dorsolateral prefrontal cortices, dlPFC). The disruptions are thought to be at the root of increased negative emotion and diminished positive emotion in the disorder. Reducing excitability of the right dlPFC using inhibitory magnetic stimulation has been shown to have antidepressant effects, even though it’s based on an idea-that this might reduce processing of negative emotion in depression-that has yet to be fully tested in humans.

Co-first authors Swantje Notzon, M.D., and Christian Steinberg, Ph.D, and colleagues divided 41 healthy participants into two groups to compare the effects of a single-session of excitatory or inhibitory magnetic stimulation of the right dlPFC. They performed rTMS while the participants viewed images of fearful faces to evoke negative emotion, or neutral faces for a comparison.

Excitatory and inhibitory rTMS had opposite effects-excitatory reduced visual sensory processing of fearful faces, whereas inhibitory increased visual sensory processing. Similarly, excitatory rTMS reduced participants’ reaction times to respond to fearful faces and reduced feelings of emotional arousal to fearful faces, which were both increased by inhibitory rTMS.

Although the study was limited to healthy participants, senior author Markus Junghöfer, Ph.D., notes that “…these results should encourage more research on the mechanisms of excitatory and inhibitory magnetic stimulation of the right dlPFC in the treatment of depression.”

 

via Excitatory magnetic brain stimulation reduces emotional arousal to fearful faces, study shows

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[WEB SITE] How Doctors Are Using Brain Imaging to Treat Depression

Typically, depression is diagnosed based on what a patient describes about their emotional and mental state. People who suffer from depression often state that they’re sad more often than not and that things they used to enjoy are no longer enjoyable.

The biggest hurdle in diagnosing depression is overcoming the stigma and embarrassment of possibly having a mental health disorder. It’s hard to talk about such raw, emotional, and personal details. Another issue is the fact that depression manifests itself in different ways. Some patients stop eating, others gain weight and suffer from anxiety. There’s no one-size-fits-all when it comes to depression symptoms.

While there aren’t many biological indicators that can be used to diagnose someone with depression, brain imaging has proven to be useful in diagnosing and helping to shape a treatment plan.

What Does Brain Imaging Show?

A recent study that was published in Nature Medicine discuss biological markers that can be used to distinguish different types of depression. To get a better look at the brain, functional magnetic resonance imaging was used to measure the connection strength between the brain and neural circuits. From these images researchers were able to pinpoint four types of depression.

While further research is needed to confirm initial findings, the potential of using biological indicators paves the way for clearer diagnoses and more personalized and effective therapies that treat the brain.

Based on the research, it was observed that certain patients experienced higher levels of fatigue while others discussed a lack of pleasure. In the future there is hope that certain treatment types can be matched to a type of depression. For example, those who report a lack of pleasure may benefit from a treatment known as transcranial magnetic stimulation (TMS). Because TMS uses a magnet to create small electric currents in the brain, the under-functioning reasons can be restored through TMS therapy.

The Next Steps

Though several studies have been conducted to compare depressed brains to those who don’t have the condition, it will take some time before brain imaging becomes a fool-proof way of diagnosing depression. Doctors and researchers will need to find common ground and patterns between the various types of depression so there is one unified method of determining if a patient has depression and the type.

In the future, it’s hoped that brain imaging can not only be used to diagnose depression but also to:

  • Determine treatment options
  • Determine the success rate of treatment
  • Understand other mental health disorders
  • Diagnose other conditions that may impact depression symptoms

While there is still a way to go in using brain imaging to diagnose and treat depression, the future is bright in this health arena.

Treatment Options

There are several forms of brain treatment that can be used to treat depression. The top two options include electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).

Electroconvulsive Therapy (ECT)

The use of ECT dates back hundreds of years. In fact, ECT is the most commonly used brain treatment for those who suffer from depression. When undergoing ECT treatment, an electric current is formed in the brain that creates a spurt of energy. This causes the patient to have a seizure. Though seizures can be quite scary to experience and even scarier to watch, patients are given anesthesia and a muscle relaxant to avoid the convulsions that are often seen in someone who is having a seizure.

The biggest drawback to ECT is memory loss. Patients often have a hard time remembering past memories so doctors encourage people to create new memories to get that functionality in the brain back up and running.

Transcranial Magnetic Stimulation (TMS)

While electroconvulsive therapy (ECT) is often the go-to procedure for those with severe, long-term, or treatment resistant depression, TMS has proven to be an effective brain treatment for depression. As we better understand how depression impacts regions of the brain, especially the prefrontal cortex, doctors will be able to pinpoint which treatment of combination thereof will produce the best results for a patient.

TMS is beneficial in that it is safe, non-invasive, has minimal side effects, and is designed to target and restore those abnormal connections in the brain. Unlike ECT and other forms of brain treatment options, TMS typically produces minimal to no side effects. Some patients have complained of headache and scalp discomfort but nothing as serious as the memory loss that is often found in those who undergo ECT.

Conclusion

As it stands physical symptoms are the best indicators of whether or not someone has depression. But, with the continued research of using brain imaging to diagnose and determine treatment brings new hope and ideas into the mental health realm.

via How Doctors Are Using Brain Imaging to Treat Depression

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