Evidence grows against drugs for treatment of teen depression

Mental Depression, despite enormous efforts and research, is yet to be fully understood and effectively treated. Currently, the mental health field possesses advanced means to effectively address mental depression with both medication and psychotherapy. In spite of this, the number of new cases being diagnosed each year continues to increase at a high rate, especially among the younger population, where the over-riding emphasis is on pills instead of counseling.

The causes and evolution of depression in young people is significantly different then adult depression. Left untreated and undiagnosed, the disorder is associated with high psychological and financial costs. When depressed children reach adulthood, they often have a lower income (losing approximately $10,400 per year in income), have less years of education than the non-depressed ones, and have a lower probability of getting married. Also, their medical costs are higher than those that did not suffer from depression and are high utilizers of medical services. The annual cost of a depressed person exceeds non-depressed indviduals by $686 to $4,635 with pharmaceutical and outpatient costs representing the two most expensive components.

Unfortunately, the treatment methods used to address young people is based more on the clinical experience of working with adults which is misleading and harmful. Furthermore, the research on anti-depressants increasingly shows that it carries long-term negative debilitating effects on adolescents.. The pharmaceutical industry claims that depression is due to a neurotransmitter (chemical) imbalance and that their medication is able to balance the brain’s chemistry. However, pharmaceutical companies dismisses growing evidence that it is actually their medication which causes the chemical imbalance, and the more an individual is on an antidepressant, the higher the probability of the disorder becoming chronic, and increasing the risk of relapse when the medication is halted.

There is an increased body of empirical evidence documenting that medication is useful only for severe forms of depression and for brief administration. The American Academy of Child and Adolescent Psychiatry considers that psychotherapy is the appropriate treatment for all depressed children and adolescents while pharmacotherapy should be recommended solely to those with severe and psychotherapy resistant symptoms.

Currently, there are various form of psychotherapy effective in treating depression among the young population and significant efforts are invested in means to prevent this disorder from occurring. These forms of intervention seek to change cognitive and behavioral characteristics in the adolescent personality through a rational/optimistic thinking style, self-regulation, problem-solving, social, and coping skills as well as help them manage and prevent symptoms from reoccurring.

Understanding depression in the elderly

Depression is a condition that affects individuals of all ages, but its occurrence regardless of the age onset is not part of the normal development/aging process. This reality is especially true for the older population for whom depression is usually confusing and associated with growing old.

The predominant societal understanding of seniors is to equate growing old with the general decline in physical abilities (getting frail and suffering from various medical conditions), psychological contentment (feeling unproductive and purposeless, experiencing grief and bereavement over the loss of spouses and friends, as well as roles and status changes within society), and social activities (isolation and loneliness, retirement, and reduced social interactions).

These problems can lead to the fatalistic impression that nothing can be done to help seniors with these common issues. However, without a strong mental health status the normal process of aging is not possible and because depression is not a natural sequence in the aging process, it becomes a painful and debilitating experience that if left untreated, is associated with high co-morbidity (the likelihood of developing additional mental or physical conditions) and high mortality (it accounts for a high rate of suicide in seniors age 65 and older, especially for older Caucasian men).

Depression, as a mental health condition and diagnosis, is characterized by symptoms such as profound and persistant feelings of sadness and despair, guilt, worthlessness, helplessness, hopelessness, pessimism, irritability, restlessness, loss of interest in things that were pleasurable in the past, as well as appetite and sleep disturbance that all come together to affect the individual’s quality of life. This differs from the common understanding of depression which is usually associated with feeling down or sad and lacking energy. At times, feeling down is normal and is not necessarily a sign that a clinical condition, such depression, is present. If these feelings persist and interfere with the ability to function normally, than depression becomes a real concern.

Unfortunately, depression may not manifest itself through classic symptoms and be camouflaged in behaviors that can be easily mistaken for other mental health conditions such as dementia and Alzheimer's disease. Seniors may become more confused or forgetful than normal, take medication inconsistently or stop taking it all together, fail to eat properly, have poor personal hygiene, withdraw from family and friends, neglect caring for the environment in which they live, and excessively worry or become preoccupied with being sick and complaining of physical discomfort and symptoms. Another possible clue that a senior is suffering from depression is demonstrating a lack of feelings or emotional reactions.

To complicate matters even more, depression might be confused for other mental or physical conditions common among this age group. Therefore, establishing whether depression is the primary disorder (not being associated with or caused by any other condition), or a secondary disorder attributed to other possible health issues, has different clinical and treatment connotations. Also, medication taken to treat other health conditions or diseases can carry the risk of causing depression as a side-effect.

Whether depression is a problem on its own or a symptom of other health conditions, it represents a serious concern for the quality of life of the older population. It is a condition that affects, limits, and even abruptly interrupts the normal aging process, and burdens the life of the elderly individual and of those within their social support system.

The Deadliest Cancer

As November gives way to December, the purple ribbons and bracelets signifying that November is Pancreatic Cancer Awareness month will soon be put away for next year. However, for nearly 37,000 men and women in the United States, there won't be a next November.

Although pancreatic cancer is only ranked as the 4th leading cancer cause of death, the 5 year survival rates reveal a more tragic picture of this disease. To understand this, pancreatic cancer should be compared to top three cancer killers in the United States.

Lung cancer, ranked number one, causes approximately 160,000 deaths a year with a 5 year survival rate of 14 percent. The second type of cancer to claim the most victims is colon cancer with 53,500 deaths a year. Five year survival rates for these patients fare much better than lung cancer patients with an estimated 65 percent. At number three, the more frequently occuring breast cancer has a mortality figure of approximately 40,000 deaths a year, but see's a 5 year survival rate of 89 percent. .

Even with lung cancer's seemingly low number of 14 percent, there is one thing lung, colon and breast cancer patients have more than pancreatic cancer patients.

Hope.

The tragic outcome for pancreatic patients is revealed with the statistics that show the 5 year survival rate is only 5 percent.

That's it. Five percent.

Adding to this tragedy is the fact that 75 percent of all pancreatic cancer patients die within 1 year of being diagnosed. Pancreatic cancer stands alone with the distinction of the highest mortality rate of all the major cancers. According to the Pancreatic Cancer Action Network, PanCan.org, the average life expectancy after the cancer metastisizes is just three to six months. Unlike many other forms of cancer, the survival rate for pancreatic cancer has not improved much over the last 40 years.

Despite these odds, pancreatic cancer patients are known for their courage and willingness to fight back. The best example of this was epitomized with subtle bravery by Randy Pausch in his book, The Last Lecture. Pausch, a 46 year old computer science professor at Carnegie Mellon University, was diagnosed with pancreatic cancer in 2006. Despite this diagnosis, Pausch fought back with chemotherapy, radiation and surgery. In spite of his efforts, the cancer returned in August of 2007. A month later, on September 17, Pausch gave his last lecture entitled: Really Achieving Your Childhood Dreams. A video posted on youtube shows an audience of more than 400 students and faculty giving him a standing ovation.

That video gave Pausch some noterity and led to a book deal for The Last Lecture. Taking material from his Sept. 17 lecture, and expanding on it further, Pausch writes for his children and others with lessons that he wants to impart that stress the importance of having fun in everything one does, and living life to the fullest. The book became a New York Time's Best Seller soon after it was published in 2008. Randy Pausch died on July 25th, 2008.

Despite it's reputation as The Deadliest Cancer, there is hope on the horizon for pancreatic cancer, afterall, the only place it can go is up. The horizon is revealed under the Sunlight of new research and new medicines in development. A study published on October 27, 2010 in the scientific journal Nature showed for the first time that pancreatic tumors develop much more slowly and aggressively than previously thought. This is important due to the fact that pancreatic cancer symptoms are asymptomatic, or undetectable, in the early stages. Often, it is only when it has developed in the late stages or metastisized, that a pancreatic cancer diagnosis can be made. This finding places more importance and hope on developing earlier detection methods as the key to survival. Among the new drugs being developed is a pancreatic cancer vaccine being developed at John Hopkins University. The vaccine apparently stopped a pancreatic tumor growing in one patient, but researchers are stressing that a new clinic trial is only in the early stages.

Dementia in Children

The popular perception of dementia is that it is strictly "an old person's disease," with the picture in our mind narrowing its focus on that of a confused senior citizen with Alzheimer's disease, struggling to get through a life that was once much simpler, and easier to understand. It's an image that few people want to face for ourselves, or for our parents, grandparents and other family members and friends. But imagine this illness, with its memory loss, confusion, and inability to perform common daily functions, in a child.

Yes, a child.

Before one can imagine this horrible possibility, understand that there are 5 main types of dementia: Cortical Dementia, Subcortical Dementia, Progressive Dementia, Primary Dementia and Secondary Dementia. In the first four types, dementia is the primary disease. With secondary dementia, there is another disease present and dementia is one of the symptoms, or possible symptoms. Dementia in children can be considered as a secondary dementia in which there is a condition that leads to dementia like symptoms.

Dementia is basically a neurodegenerative disorder in which there is a decline in mental and cognitive abilities. This means that the patient had previously learned skills and abilities, but begin to lose those skills and abilities with the onset of a disease that carries dementia like symptoms. Some childhood diseases strike so early that there is no regression of learned abilities, but rather, conditions are present which prevent them from progressing in mental functioning and mobility.

There are many types of childhood diseases and disorders which can lead to dementia and we examine some of the more frequently occurring below.

Niemann-Pick Disease is an inherited disorder in children in which the metabolism malfunctions to the point that cholesterol and lipids can't be metabolized, leading to their build up on the liver, spleen and brain. A number of symptoms develop after these organs are affected including: confusion, slurred speech, learning problems, memory loss, dysphagia, and dementia. Type A of NPD is always fatal, while the prognosis for those with type B is often good. Survival rates for type C and D are mixed.

Lafora Body Disease is a rare, inherited genetic disorder in which Lafora bodies (microscopic elements) are present on the brain, liver, spleen, and muscle tissues of children between the ages of 6 to 19. This often leads to seizures, mobility, and dementia. Death usually occurs within 10 years.

Batten Disease is an inherited and rare neurodegenerative disorder that develops in childhood and is, unfortunately, always fatal. Symptoms can appear between the ages for 4 and 10 and manifest themselves with the dementia like symptoms of behavioral changes, difficulty in school and learning, clumsiness, repetitive speech, mental impairment, blindness, and immobility.

Mitochondrial myopathy is a mitochondrial disease that affects the muscle fibers of patients, leading to cognitive impairment and dementia as the primary symptoms. Other symptoms include deafness, blindness, droopy eyelids, immobility of the eyes, seizures, and vomiting. Most cases of mitochondrial myopathy begin before the age of 20 and become evident during exercise with muscle weakness, nausea, breathlessness, and headaches. This disorder can lead to death, but not in all cases.

Rasmussen's encephalitis is a rare disease in which inflammation will occur in one hemisphere of the brain. The symptoms are similar to the diseases mentioned above in that the young patient, (usually under the age of 10) will suffer from seizures, impaired mobility, speech problems, paralysis (on one side of the body), and mental and cognitive deterioration. Although it is not fatal, the effects of this disease are usually life-long. Recent thinking on Rasmussen's encephalitis is that it is an autoimmune disease which has refocused the medication to suppress or modulate the immune system, which has seen some success. Surgery to control the seizures may also be a possible treatment approach.

Sanfilippo syndrome is an inherited disease in which the metabolism is unable to break down certain sugar molecules. Sanfilippo syndrome belongs to a group of diseases called mucopolysaccharidoses or MPS. There are 4 types of MPS of which Sanfilippo syndrome is an MPS III type. Further, there are 4 types of Sanfilippo syndrome, Types A, B, C, and D. Incidence rates place MPS III at one in every 70,000 births and symptoms often appear in the first year, with a decline in learning ability between the ages of 2 and 6. Behavioral problems, delayed development, mental retardation, blindness, seizures and shortened height are common symptoms.

Juvenile Huntington's disease is the young people's version of a mostly adult disease. Approximately six percent of all Huntington's disease cases begin in children and adolescents below the age of 21. Cognitive impairment might only occur in some JHD patients.

Other types of neurodegenerative disorders which can lead to dementia like symptoms in children include: Alexander disease, Schilder's disease, Tay Sach's disease, Canavan disease, Rett syndrome, and Adrenoleukodystrophy.

There doesn't appear to be a support organization for the umbrella concept of dementia in children, but there are specific associations and support groups for most of the diseases mentioned above. These can be found online.

Recent Image Searches