Tag Archives: depression

Neurobiology and Neurophysiology of Breath

Neurobiology and Neurophysiology of Breath Practices in Psychiatric Care | Psychiatric Times – by Patricia L. Gerbarg, MD and Richard P. Brown, MD – Nov 30, 2016

Because the physical act of breathing stimulates the vagus nerve, it has a powerful effect on our whole nervous system.

Autonomic nervous system dysfunction is associated with most disorders seen in pediatric and adult psychiatric practice, including anxiety disorders, depression, PTSD, hostility and aggression, attention deficit disorders, and autism spectrum disorder.

Increasing the underactivity of the parasympathetic branch and correcting the erratic or overactivity of the sympathetic branch can improve stress resilience and ameliorate psychological and physical symptoms.    Continue reading

When Is Depression Terminal? Deliberative Suicide

When Is Depression a Terminal Illness? Deliberative Suicide in Chronic Mental Illnessby Constance E. George, MD, MA – Jun 2016

In this discussion about the validity of suicide in patients with untreatable depression, it struck me that it could just as well apply to patients with chronic pain, untreatable without opioids, when opioids are no longer allowed.

This article concludes:

“So, an important lesson … has to do with understanding that mental illness can be a terminal illness and that the concept of hope has therapeutic limitations.” Continue reading

Opiods as Antidepressants

Opiates as antidepressants. – PubMed – NCBI – Curr Pharm Des. 2009

Antidepressants are frequently touted as useful for chronic pain and it’s not clear if that is because they relieve pain-induced depression and thus make the pain less bothersome or if they specifically relieve the pain.

Here are two research studies showing that opioids may directly relieve depression, not just pain, further complicating the two-way relationships between pain and depression and also between pain-relievers and “depression-relievers”.

The pathophysiology of mood disorders involves several genetic and social predisposing factors, as well as a dysregulated response to a chronic stressor, i.e. chronic pain. Continue reading

Opioids enhance some antidepressants

Cooperative opioid and serotonergic mechanisms generate superior antidepressant-like effects in a mice model of depression | International Journal of Neuropsychopharmacology | Oxford Academic – free full text – September 2009

Perhaps this is another way that opioids help us deal with chronic pain. I know I’m more depressed when I’m having serious pain because it reminds me of all I’ve had to give up because of it. My future looks pretty grim when viewed through a thick haze of pain.

On days my pain isn’t so bad or I’ve managed to get it under control with opioid medication, I feel more hopeful about the future as I busy myself with all kinds of little tasks I cannot do when my pain is bad.

The opioid system has been implicated in the aetiology of depression, and some preclinical and clinical data suggest that opioids possess a genuine antidepressant-like effect.

Continue reading

Fast-Acting Depression Drug Approved

Fast-Acting Depression Drug, Newly Approved, Could Help MillionsBy Benedict CareyMar 2019

This is wonderful news because it’s from a different drug class than what’s been available.

This new approach brings fresh hope for those of us who have been hanging on, gritting our teeth, and tolerating our treatment-resistant depression because we can’t get sufficient relief from the current medications.

A nasal spray version of the drug ketamine has shown promise as an antidepressant, even if its properties still aren’t well understood. Continue reading

SSRIs Inhibit Effectiveness of Common Opioid

Common opioids less effective for patients on SSRI antidepressants, study finds – February 6, 2019 by Stanford University Medical Center

I’m reposting this because I accidentally scheduled it for a date before it even existed, so here it is if you missed it the first time around:

Patients taking the most common form of antidepressant who are given the most widely prescribed opioid experience less pain relief, Stanford University School of Medicine investigators have discovered. As many as 1 in 6 Americans takes antidepressants, mostly selective serotonin reuptake inhibitors.

Stanford researchers found that SSRIs reduce the effectiveness of hydrocodone and codeine, which are often prescribed to patients who have recently undergone surgery.   Continue reading

Common opioids less effective for patients on SSRIs

Common opioids less effective for patients on SSRI antidepressants, study finds – February 6, 2019 by Stanford University Medical Center

Patients taking the most common form of antidepressant who are given the most widely prescribed opioid experience less pain relief, Stanford University School of Medicine investigators have discovered. As many as 1 in 6 Americans takes antidepressants, mostly selective serotonin reuptake inhibitors.

Stanford researchers found that SSRIs reduce the effectiveness of hydrocodone and codeine, which are often prescribed to patients who have recently undergone surgery.   Continue reading

Complications of Uncontrolled, Persistent Pain

Complications of Uncontrolled, Persistent Pain – By Forest Tennant, MD, DrPH – Jan 2018

To the unfortunate patient who is afflicted and the practitioner who treats it, incurable, persistent pain is truly its own disease regardless of its underlying cause.

Persistent pain, which is also often characterized as chronic or intractable, has all the ramifications of a disease in that it may have pre-clinical and overt phases.

I like that he calls it “persistent pain” instead of “chronic pain”, a term which has become synonymous in the public’s eye as a whining, complaining, catastrophizing, gonna-be addict.    Continue reading

Depression treatment needs overhaul

Depression treatment needs overhaul – by Tess Redgrave, University of Auckland

This is an interesting article that proposes 12 categories of depression, with different symptoms and requiring different treatment.

The way depression is diagnosed and treated needs a major overhaul, say authors of a new review article in the scientific journal Brain, Behavior, and Immunity.

This is because current treatment of depression is ineffective and lacks a plausible, coherent theoretical basis, they claim.

A new theory for depression and its treatment is proposed in the articleDepression subtyping based on evolutionary psychiatry: Proximate mechanisms and ultimate functions,”  Continue reading

Chronic Pain, Depression & Antidepressants

Managing Chronic Pain, Depression & Antidepressants: Issues & Relationships – Johns Hopkins Arthritis Center – by Michael Clark, M.D., M.P.H. – 1995, updated August 15, 2017

Signs, Symptoms, and Prevalence

In several studies of patients presenting to clinics specializing in the evaluation of pain, the prevalence of psychiatric conditions was systematically assessed.

Affective and anxiety disorders were the most commonly found (Reich et al. 1983). For example, the prevalence of major depression in patients with chronic low back pain is 3-4 times greater than in the general population (Sullivan et al. 1992). However, the causal relationship between these syndromes remains controversial.    Continue reading