Relabeling the Medications We Call Antidepressants - a very damning review paper. Well worth a read.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820604/pdf/SCIENTIFICA2012-965908.pdf

Eleanor Longden's moving account of hearing voices

Rumination: The danger of dwelling - By Denise Winterman BBC News Magazine

The UK's biggest ever online test into stress, undertaken by the BBC's Lab UK and the University of Liverpool, has revealed that rumination is the biggest predictor of the most common mental health problems in the country.

A bit of self-reflection can be a good thing, say psychologists. But just how serious can it get when introspection goes awry and thoughts get stuck on repeat, playing over and over in the mind?
Rumination and self-blame have long been accepted by health professionals as part of the problems that can lead to depression and anxiety - the two most common mental health problems in the UK, according to the Mental Health Foundation.
But new research has demonstrated just how significant and serious their impact on mental health can be.
The findings of a ground-breaking study, published in the journal PLOS ONE today, suggest that brooding too much on negative events is the biggest predictor of depression and anxiety and determines the level of stress people experience. The research even suggests a person's psychological response is a more important factor than what has actually happened to them.

Continue reading the main story

Who took the Lab UK Stress Test?

• A total of 32,827 took part
• Of those 12,677 were men and 20,165 women
• They were from 172 countries
• They were aged 18-85 years
• The average age was 39
• Most were working fulltime
• Most were in stable relationships

Source: BBC Lab UK

A total of 32,827 people from 172 countries took part in the online stress test devised by the BBC's Lab UK and psychologists at the University of Liverpool, making it the biggest study of its kind ever undertaken in the UK.

"We found that people who didn't ruminate or blame themselves for their difficulties had much lower levels of depression and anxiety, even if they'd experienced many negative events in their lives," says Peter Kinderman, who led the study and is a professor of clinical psychology at the University of Liverpool.
"Dwelling on negative thoughts and self blame have previously been recognised as important when it comes to mental health, but not to the extent this study has shown.
"The findings suggest both are crucial psychological pathways to depression and anxiety."
The human mind is an extremely complex machine and it's generally accepted there is no single cause for depression and anxiety by professionals in the field. But some factors have more impact than others.
The study found traumatic life events, such as abuse or childhood bullying, were the biggest cause of anxiety and depression when dwelled upon. This is followed by family history, income and education. Next comes relationship status and social inclusion.
"But these didn't merely 'cause' depression and anxiety," he says.
"The most important way in which these things led to depression and anxiety was by leading a person to ruminate and blame themselves for the problem.

"This shows how psychological issues are part of the routes to the development of problems, not merely that people become ill and then show changes in their psychology."
Rumination was found to be more damaging than self blame. Having thoughts stuck on replay in her head is something Teresa (not her real name), 50, from Essex, struggles with and has done for years.

Continue reading the main story

Teresa's story

"I get angry with myself that negative thoughts run through my head.
"After all these years I think I should realise they're not worth worrying about. But it feels like they are always there in the background, waiting to to pop up.
"I have been to my doctor for help but was offered antidepressants. I didn't want to go down that road.
"I was offered counselling recently, but it was one hour a week over the phone. It is hard to establish any sort of connection with a person over the phone. It didn't help."

• What is depression?
• When does mental health become a problem?

"When I don't feel on top of things in my life I start to find it harder to switch negative thoughts off," she says.

"If I'm stressed at work or home it's as if the negative thoughts swamp my mind and I can't rationalise them. I get angry with myself for allowing them to run through my head."
Teresa has been married for over 20 years and has two children. But despite having a happy home life, she says there have still been times when the negative thoughts have become overwhelming.
"There have been a couple points in my life when I have really struggled to cope. Negative thoughts and things from the past came back to haunt me.
"Both times I went to my doctor for help but was offered antidepressants. I didn't want to go down that road. I have tried to develop my own coping mechanisms over the years. I find being outside and with nature helps me a lot. It seems to calm what's in my head."
Rumination is sometimes referred to as a "silent" mental health problem because its impact is often underestimated. But it plays a big part in anything from obsessive compulsive disorder (OCD) to eating disorders.

And the impact of mental health problems is huge. They affect one person in every four during their lifetime and are the leading cause of disability globally, according to the World Health Organization (WHO). In 2010 alone they are estimated to have cost $2.5 trillion (£1.5 trillion) globally by the World Economic Forum.
In the UK one in four people will experience some kind of mental health problem in any one year, according to the Mental Health Foundation. Anxiety and depression are the most common problems.
So what does the new study mean for people who have serious problems with ruminating and those treating them?

"Obviously it is just one study, and other people will have other important contributions, but we believe our findings are very significant," says Kinderman.

It's important to get across what the findings mean for the average person, says Dr Ellie Pontin, a clinical psychologist and research associate at the University of Liverpool, who was also involved in the study.
"It's actually a really positive message and should give people hope," she says.
"It can be very hard to be told your problems are because of what you have experienced in the past or your genetics, things you can't change. The way you think and deal with things can be changed."
Other professionals agree. They argue that such studies highlight the need to put psychological services at the heart of the health system.
"This is a positive message," says Angela Clow, professor of psychophysiology at the University of Westminster.
"And helping someone tackle negative thought processes is not something that has to be done exclusively by clinical psychologists.
"Other health professionals can be trained to deliver simple psychological help and techniques. It doesn't have to cost a lot of money."

Brene Brown gives a great talk about vulnerability - I'm still working out how to translate it to HG terms and would appreciate comments

What are the Long Term Consequences of Child Sexual Abuse? (from http://www.d2l.org)

FACT: The consequences of child sexual abuse often follow victims into adulthood. Most people have no idea that the effects of child sexual abuse are so pervasive in adult life. Although survivors of child sexual abuse are negatively impacted as a whole, it is important to realize that many individual survivors do not suffer these consequences. Child sexual abuse does not necessarily sentence a victim to an impaired life.

FACT: Substance abuse problems are a common consequence for adult survivors of child sexual abuse.

• Female adult survivors of child sexual abuse are nearly three times more likely to report substance use problems (40.5% versus 14% in general population), (Simpson and Miller, 2002).
• Male adult CSA victims 2.6 times more likely to report substance use problems (65% versus 25% in general population), (Simpson and Miller, 2002).
• Abused or neglected individuals 1.5 times more likely to report lifetime illicit drug use (Widom, Marmorstein, & White, 2006).

FACT: Mental health problems are a common long-term consequence of child sexual abuse.

• Adult women who were sexually abused as a child are more than twice as likely to suffer from depression as women who were not sexually abused (Rohde, et. al., 2008).
• Adults with a history of child sexual abuse are more than twice as likely to report a suicide attempt (Dube, et. al., 2005, Waldrop, et. al., 2007).
• Girls who are sexually abused are 3 times more likely to develop psychiatric disorders than girls who are not sexually abused (Day, et. al., 2003; Kendler, et. al., 2000; Voeltanz, et. al., 1999).
• Among male survivors, more than 70% seek psychological treatment for issues such as substance abuse, suicidal thoughts and attempted suicide (Walrath, et. al., 2003).

FACT: Obesity and eating disorders are more common in women who have a history of child sexual abuse.

• 20 – 24 year-old women who were sexually abused as children were four times more likely than their non-abused peers to be diagnosed with an eating disorder (Fuemmeler, et. al., 2009).
• Middle-aged women who were sexually abused as children were twice as likely to be obese when compared with their non-abused peers (Rohde, et. al., 2008).

FACT: Child sexual abuse is also associated with physical health problems in adulthood. It is theorized that this is a consequence of the substance abuse, mental health issues and other risks that survivors of child sexual abuse face.

• Generally, adult victims of child sexual abuse have higher rates of health care utilization and report significantly more health complaints compared to adults without a CSA history (Arnow, 2004; Golding, Cooper, and George, 1997; Thompson, Arias, Basile and Desai, 2002). This is true for both self reported doctor’s visits and objective examination of medical records (Newman et al., 2000). These health problems represent a burden both to the survivor and the healthcare system.
• Adult survivors of child sexual abuse are at greater risk of a wide range of conditions that are non-life threatening and are potentially psychosomatic in nature. These include fibromyalgia (Walker et al, 1997), severe premenstrual syndrome (Golding, Taylor, Menard, & King, 2000), chronic headaches (Peterlin, Ward, Lidicker, & Levin, 2007), irritable bowel syndrome and a wide range of reproductive and sexual health complaints, including excessive bleeding, amenorrhea, pain during intercourse and menstrual irregularity (Golding, 1996).
• Not only do survivors of child sexual abuse have more minor health conditions, they are at greater risk for more serious conditions as well. Adults with a history of child sexual abuse are 30% more likely than their non-abused peers to have a serious medical condition such as diabetes, cancer, heart problems, stroke or hypertension (Sachs-Ericsson, et. al., 2005).
• Male sexual abuse survivors have twice the HIV-infection rate of non-abused males (Zierler, et. al., 1991). In a study of HIV-infected 12-20 year olds, 41 percent reported a sexual abuse history (Dekker, et. al. 1990).

FACT: Adult survivors of child sexual abuse are more likely to become involved in crime, both as a perpetrator and as a victim. This is likely a product of a higher risk for substance abuse problems and associated lifestyle factors.

• Adult survivors were more than twice as likely to be arrested for a property offense (9.3% versus 4.4%), (Siegel and Williams, 2003).
• As adults, child sexual abuse victims were almost twice as likely to be arrested for a violent offense (20.4% versus 10.7%), (Siegel & Williams, 2003).
• Males who have been sexually abused are more likely to violently victimize others (Walrath, et. al., 2003).

FACT: Although difficult to quantify, logic tells us that the consequences of child sexual abuse (substance abuse issues, mental health problems, becoming a parent as a teen and poor physical health) result in loss of earning potential over a lifetime.

• An average of quality-of-life court awards (primarily lost earning potential) for a survivor of child sexual abuse is $115,000 in 2010 dollars (U.S. Department of Justice, 1996).

The Most Depressing Discovery About the Brain, Ever. Say goodnight to the dream that education, journalism, scientific evidence, or reason can provide the tools that people need in order to make good decisions. By Marty Kaplan for AlterNet

September 16, 2013  |  

 

Yale law school professor Dan Kahan’s new research paper is called “Motivated Numeracy and Enlightened Self-Government,” but for me a better title is the headline on science writer Chris Mooney’s piece about it in Grist:  “Science Confirms: Politics Wrecks Your Ability to Do Math.”
Kahan conducted some ingenious experiments about the impact of political passion on people’s ability to think clearly.  His conclusion, in Mooney’s words: partisanship “can even undermine our very basic reasoning skills…. [People] who are otherwise very good at math may totally flunk a problem that they would otherwise probably be able to solve, simply because giving the right answer goes against their political beliefs.”
In other words, say goodnight to the dream that education, journalism, scientific evidence, media literacy or reason can provide the tools and information that people need in order to make good decisions.  It turns out that in the public realm, a lack of information isn’t the real problem.  The hurdle is how our minds work, no matter how smart we think we are.  We want to believe we’re rational, but reason turns out to be the ex post facto way we rationalize what our emotions already want to believe.  
For years my go-to source for downer studies of how our hard-wiring makes democracy hopeless has been Brendan Nyhan, an assistant professor of government at Dartmouth.
Nyan and his collaborators have been running experiments trying to answer this terrifying question about American voters: Do facts matter?
The answer, basically, is no.  When people are misinformed, giving them facts to correct those errors only makes them cling to their beliefs more tenaciously.

Here’s some of what Nyhan found:

• People who thought WMDs were found in Iraq believed that misinformation even more strongly when they were shown a news story correcting it.
• People who thought George W. Bush banned all stem cell research kept thinking he did that even after they were shown an article saying that only some federally funded stem cell work was stopped.
• People who said the economy was the most important issue to them, and who disapproved of Obama’s economic record, were shown a graph of nonfarm employment over the prior year – a rising line, adding about a million jobs.  They were asked whether the number of people with jobs had gone up, down or stayed about the same.  Many, looking straight at the graph, said down.
• But if, before they were shown the graph, they were asked to write a few sentences about an experience that made them feel good about themselves, a significant number of them changed their minds about the economy.  If you spend a few minutes affirming your self-worth, you’re more likely to say that the number of jobs increased.   

In Kahan’s experiment, some people were asked to interpret a table of numbers about whether a skin cream reduced rashes, and some people were asked to interpret a different table – containing the same numbers – about whether a law banning private citizens from carrying concealed handguns reduced crime.  Kahan found that when the numbers in the table conflicted with people’s positions on gun control, they couldn’t do the math right, though they could when the subject was skin cream.  The bleakest finding was that the more advanced that people’s math skills were, the more likely it was that their political views, whether liberal or conservative, made them less able to solve the math problem.
I hate what this implies – not only about gun control, but also about other contentious issues, like climate change.  I’m not completely ready to give up on the idea that disputes over facts can be resolved by evidence, but you have to admit that things aren’t looking so good for a reason.  I keep hoping that one more photo of an iceberg the size of Manhattan calving off of Greenland, one more stretch of record-breaking heat and drought and fires, one more graph of how atmospheric carbon dioxide has risen in the past century, will do the trick.  But what these studies of how our minds work suggest is that the political judgments we’ve already made are impervious to facts that contradict us.
Maybe climate change denial isn’t the right term; it implies a psychological disorder.  Denial is business-as-usual for our brains.  More and better facts don’t turn low-information voters into well-equipped citizens.  It just makes them more committed to their misperceptions.  In the entire history of the universe, no Fox News viewers ever changed their minds because some new data upended their thinking.  When there’s a conflict between partisan beliefs and plain evidence, it’s the beliefs that win.  The power of emotion over reason isn’t a bug in our human operating systems, it’s a feature.

Marty Kaplan, winner of the LA Press Club’s Best Columnist award, is the Norman Lear professor of entertainment, media and society at the USC Annenberg School for Communication and Journalism.  Reach him at martyk@jewishjournal.com.

The Science of Sleep: Dreaming, Depression, and How REM Sleep Regulates Negative Emotions by Maria Popova

For the past half-century, sleep researcher Rosalind D. Cartwright has produced some of the most compelling and influential work in the field, enlisting modern science in revising and expanding the theories of Jung and Freud about the role of sleep and dreams in our lives. In The Twenty-four Hour Mind: The Role of Sleep and Dreaming in Our Emotional Lives (public library), Cartwright offers an absorbing history of sleep research, at once revealing how far we’ve come in understanding this vital third of our lives and how much still remains outside our grasp.
One particularly fascinating aspect of her research deals with dreaming as a mechanism for regulating negative emotion and the relationship between REM sleep and depression:

The more severe the depression, the earlier the first REM begins. Sometimes it starts as early as 45 minutes into sleep. That means these sleepers’ first cycle of NREM sleep amounts to about half the usual length of time. This early REM displaces the initial deep sleep, which is not fully recovered later in the night. This displacement of the first deep sleep is accompanied by an absence of the usual large outflow of growth hormone. The timing of the greatest release of human growth hormone (HGH) is in the first deep sleep cycle. The depressed have very little SWS [slow-wave sleep, Stages 3 and 4 of the sleep cycle] and no big pulse of HGH; and in addition to growth, HGH is related to physical repair. If we do not get enough deep sleep, our bodies take longer to heal and grow. The absence of the large spurt of HGH during the first deep sleep continues in many depressed patients even when they are no longer depressed (in remission).
The first REM sleep period not only begins too early in the night in people who are clinically depressed, it is also often abnormally long. Instead of the usual 10 minutes or so, this REM may last twice that. The eye movements too are abnormal — either too sparse or too dense. In fact, they are sometimes so frequent that they are called eye movement storms.

But what has perplexed researchers is that when these depressed patients are awakened 5 minutes into the first REM sleep episode, they’re unable to explain what they are experiencing. This complete lack of dream recall in depression has showed up in study after study, but it’s been unclear whether it’s due to patients’ reluctance to talk with researchers or to truly not forming and experiencing any dreams. That’s where recent technology has helped shed light:

Brain imaging technology has helped to shed light on this mystery. Scanning depressed patients while they sleep has shown that the emotion areas of the brain, the limbic and paralimbic systems, are activated at a higher level in REM than when these patients are awake. High activity in these areas is also common in REM sleep in nondepressed sleepers, but the depressed have even higher activity in these areas than do healthy control subjects. This might be expected — after all, while in REM these individuals also show higher activity in the executive cortex areas, those associated with rational thought and decision making. Nondepressed controls do not exhibit this activity in their REM brain imaging studies. This finding has been tentatively interpreted… as perhaps a response to the excessive activity in the areas responsible for emotions.

Cartwright spent nearly three decades investigating “how a mood disorder that affects cognition, motivation, and most of all the emotional state during waking shows itself in dreams.” What proved particularly difficult was understanding the basis for this poor dream recall during REM sleep, since anti-depressants suppress that stage of the sleep cycle, but early research suggested that this very suppression of REM might be the mechanism responsible for reinvigorating the depressed.
This brings us to the regulatory purpose of dreaming. Cartwright explains:

Despite differences in terminology, all the contemporary theories of dreaming have a common thread — they all emphasize that dreams are not about prosaic themes, not about reading, writing, and arithmetic, but about emotion, or what psychologists refer to as affect. What is carried forward from waking hours into sleep are recent experiences that have an emotional component, often those that were negative in tone but not noticed at the time or not fully resolved. One proposed purpose of dreaming, of what dreaming accomplishes (known as the mood regulatory function of dreams theory) is that dreaming modulates disturbances in emotion, regulating those that are troublesome. My research, as well as that of other investigators in this country and abroad, supports this theory. Studies show that negative mood is down-regulated overnight. How this is accomplished has had less attention.
I propose that when some disturbing waking experience is reactivated in sleep and carried forward into REM, where it is matched by similarity in feeling to earlier memories, a network of older associations is stimulated and is displayed as a sequence of compound images that we experience as dreams. This melding of new and old memory fragments modifies the network of emotional self-defining memories, and thus updates the organizational picture we hold of ‘who I am and what is good for me and what is not.’ In this way, dreaming diffuses the emotional charge of the event and so prepares the sleeper to wake ready to see things in a more positive light, to make a fresh start. This does not always happen over a single night; sometimes a big reorganization of the emotional perspective of our self-concept must be made — from wife to widow or married to single, say, and this may take many nights. We must look for dream changes within the night and over time across nights to detect whether a productive change is under way. In very broad strokes, this is the definition of the mood-regulatory function of dreaming, one basic to the new model of the twenty-four hour mind I am proposing.

Towards the end of the book, Cartwright explores the role of sleep and dreaming in consolidating what we call “the self,” with another admonition against memory’s self-editing capacity:

[In] good sleepers, the mind is continuously active, reviewing experience from yesterday, sorting which new information is relevant and important to save due to its emotional saliency. Dreams are not without sense, nor are they best understood to be expressions of infantile wishes. They are the result of the interconnectedness of new experience with that already stored in memory networks. But memory is never a precise duplicate of the original; instead, it is a continuing act of creation. Dream images are the product of that creation. They are formed by pattern recognition between some current emotionally valued experience matching the condensed representation of similarly toned memories. Networks of these become our familiar style of thinking, which gives our behavior continuity and us a coherent sense of who we are. Thus, dream dimensions are elements of the schemas, and both represent accumulated experience and serve to filter and evaluate the new day’s input.
Sleep is a busy time, interweaving streams of thought with emotional values attached, as they fit or challenge the organizational structure that represents our identity. One function of all this action, I believe, is to regulate disturbing emotion in order to keep it from disrupting our sleep and subsequent waking functioning.

The rest of The Twenty-four Hour Mind goes on to explore, through specific research case studies and sweeping syntheses of decades worth of research, everything from disorders like sleepwalking and insomnia to the role of sleep in knowledge retention, ideation, and problem-solving.