Tag Archives: depression

Emotional Impact of Pain

Emotional Impact of Pain | Pain Management & Understanding | Arthritis.org

Although it may feel like it’s coming from your joints, pain – particularly the chronic pain common to arthritis – is also an expression of your state of mind.

If you’re depressed or anxious, you’ll very likely hurt more than when your mood is lighter or more balanced.

The crucial distinction is that depression or anxiety will only worsen *pre-existing* pain, not create new pain.

The fact that pain itself is depressing and worrying only makes the problem worse.  Continue reading

Depression in chronic pain: opioids responsible?

This article made a big splash arguing that opioids, and not the pain we take them for, cause our depression.

Depression in chronic pain: might opioids be responsible? : PAIN – M.D. Sullivan and D.N. Juurlink – Nov 2018

Of course, the answer is “NO”, but this low-quality study with specious claims of “causal inference” tries to show a causal relationship that cannot be proven.

As usual, they are looking only at opioids with little concern for chronic pain, but if we substitute the words “chronic pain” everywhere they say “opioids” these studies make a lot more sense.   Continue reading

Urine Test Could Diagnose Depression, Anxiety

Urine Test Could Diagnose Depression, Anxiety | American Council on Science and Health – By Alex Berezow — September 29, 2018

This seems like a hugely significant discovery that could save the healthcare system a lot of money treating people for suspected mental disorders when there is not psychological problem at all.

Depression and anxiety are not always easy to detect. The obvious symptoms, such as persistent sadness or worry, may not be present.

Instead, a person may exhibit insidious symptoms, like chronic indecision or excessive sleepiness. Diagnosis usually requires a psychologist. Besides being time consuming and inconvenient, diagnostic criteria are rather subjective. Continue reading

Genetic tests for antidepressant effectiveness?

Can genetic tests gauge how well antidepressants will work?By Rebecca Robbins @rebeccadrobbins – September 28, 2018

It can be notoriously difficult for psychiatrists and patients to determine which antidepressant might be most effective, or which might cause side effects.

And so Color Genomics, a company that already sells genetic tests to determine someone’s risk of developing certain cancers, said this week that it will also begin to offer a DNA test to determine how well widely used antidepressants are likely to work for patients.

With the new test2 (part of a $249 product), Color joins several dozen companies probing patients’ DNA in search of insights to help inform decisions about which psychiatry medications patients should take.  Continue reading

The causes of anxiety and suicide

Commentary: We must understand the causes of anxiety and suicide – By Perry G. Fine – September 16, 2018

Although the U.S. Centers for Disease Control and Prevention asserts that there is no single cause that can be attributed to this national trend, we know that serious, life-impacting anxiety, depression and chronic pain are at an all-time high and strongly correlated with suicide attempts.

The 25 percent increase in the suicide rate has mirrored similar upswings in other harmful behaviors and chronic illnesses.

These include parallel increases in diabetes and obesity-related mortality, gun violence deaths and drug overdose fatalities.   Continue reading

Chronic Pain Among Suicide Decedents

Chronic Pain Among Suicide Decedents, 2003 to 2014 | Annals of Internal Medicine | American College of Physicians – Sept 2018

The CDC finally looks at suicide and chronic pain:

“increases in opioid availability are not associated with greater suicide risk from opioid overdose among patients with chronic pain.”

During 2003 to 2014, the NVDRS identified 123,181 suicide decedents aged 10 years or older, 10,789 (8.8%) of whom had evidence of chronic pain. The percentage of decedents with chronic pain increased from 7.4% in 2003 to 10.2% in 2014, but the percentage who died by opioid overdose remained low overall (<2.0%).   Continue reading

Ketamine’s antidepressive effects tied to opioid system in brain

Ketamine’s antidepressive effects tied to opioid system in brain – By Kimber Price – Aug 2018

Scientists at the Stanford University School of Medicine have discovered that ketamine works as an antidepressant at least in part by activating the brain’s opioid system.

The finding overturns previously held beliefs that the drug’s antidepressant effects stemmed solely from its impact on the glutamate system.

These beliefs led to the widespread use of ketamine to treat depression and spurred the development of glutamate-blocking drugs for use as antidepressants.   Continue reading

Why do people kill themselves?

Why do people kill themselves? – KevinMD.com – March 2017 – by Greg Smith, MD

I use an ongoing spreadsheet to keep track of and to report my demographics and stats for each telepsychiatry consult shift I do. We have now gone over thirty thousand consults as a group.

It never ceases to amaze me, as I fire up my computer, log on to my systems and bring up the spreadsheet for the shift ahead, that one column is remarkably uniform and consistent, sometimes for days at a time: SI.

SI stands for suicidal ideation. And that is one of the most common chief psychiatric complaints we see in the emergency department. Continue reading

Who responds to psych treatments for pain?

Who responds well to psychologically-based treatments for chronic pain? – June 5, 2018

How do we know whether a patient is likely to do well in the psychologically-based treatment we offer them? The truth is, at least for the moment, we don’t.

I work with patients with chronic pain and quite regularly feel that I have a “sense” early on about who is likely to engage well and make changes in treatment. Surely there must be some way of quantifying this?  

This is the problem with science: everything must be quantified, yet nothing about pain and its treatment can be reliably counted. Pain has quality, not quantity. Continue reading

EDS/Hypermobility linked to psychiatric disorders

Below are three PubMed studies from 2015 about the detrimental effects of EDS on the mind/brain:

Joint hypermobility and the heritable disorders of connective tissue: clinical and empirical evidence of links with psychiatry. – PubMed – NCBIGen Hosp Psychiatry. 2015 Jan-Feb

Abstract

OBJECTIVE: The heritable disorders of connective tissue (HDCTs) are a group of genetic disorders affecting connective tissue matrix proteins.   Continue reading