Category "Depression"

14Apr

Ketamine for depression divides experts: ‘I’ve seen these drugs come and go’ – National

by BBG Hub

Depression can be completely debilitating, making it difficult to do even the simplest tasks — like getting out of bed or brushing one’s teeth.

Unfortunately, it’s very common. According to the World Health Organization, more than 300 million people around the world are currently suffering from depression.

Now, there may be a new way to treat the illness: ketamine.

READ MORE: ‘Emotionally draining’: The effect depression has on tasks like brushing hair, showering

Ketamine is commonly used as an anesthetic and painkiller in animal and human surgery. It also rose to popularity as a party drug in the 1990s. Now, it’s being lauded as a possible cure for treatment-resistant depression.

“We have a large sub population in our country with depression who can’t work… they just can’t break this vicious cycle,” said Dr. Roger McIntyre, president of the Canadian Rapid Treatment Centre of Excellence (CRTCE).

McIntyre hopes ketamine can break that cycle.

The CRTCE, which administers rapid onset treatments for depression in the form of ketamine injections, is the first of its kind in Canada.

How does the treatment work?

At the CRTCE, ketamine is delivered through intravenous infusion. According to the clinic’s website, “the protocol for administering ketamine is still being refined. Nonetheless… most individuals will receive four infusions (i.e. two infusions per week for two weeks).”

The cost of this treatment at the CRTCE is $3,000, and it is not paid for by the public health plan of Ontario (OHIP).

The process is overseen by a physician trained in anesthesia, as well as a nurse.

“The dose of ketamine by someone on the street… is about 10 times higher than the dose [you would be given] if you went to the hospital this afternoon for a procedure that required anesthesia,” said McIntyre. “The dose that we use to treat depression is about one-10th… of the dose used in anesthesia. So we’re using ‘sub-anesthetic doses.”

According to McIntyre, this does not mean the process is without safety concerns.

WATCH BELOW: ‘He likes to give hugs’: Man says emotional support alligator helps his depression





“[We] know it’s generally well received by patients, but it would be inaccurate to say that you don’t get any side effects,” said McIntyre. 

According to Centre for Addiction and Mental Health (CAMH), ketamine can produce “vivid dreams and a feeling that the mind is separated from the body.” This effect is known as “dissociation.”

The intensity of the effects depend on several factors, including: your age, your body weight, how much you take, how often you take it, how you take the drug and more.

“Some people do become addicted, and continue to use ketamine even when they plan not to or despite its negative effects,” as stated on the CAMH website.

Ketamine works faster than other treatments

If a patient presents with intense suicidal thoughts, ketamine may be a more effective short-term treatment than other antidepressant medication.

“Most antidepressants take approximately four, six or even eight weeks to work. That’s a long time,” said McIntyre. “If you’re suffering, ketamine can work within one day.”

Dr. David Gratzer, a psychiatrist at CAMH, is hopeful about the effects of ketamine on depression for this reason.

READ MORE: 8 signs your child may be going through depression

“We are looking for a way of providing more rapid relief of depression than one might ordinarily see with Prozac and [similar] drugs,” said Gratzer.

“The evidence is there but we have to take it with a grain of salt because it’s early days. That being said, we do seem to find evidence that it helps people very quickly, particularly people who have many thoughts of suicide.”

Ketamine is a last-ditch effort for those who have tried everything else

Depression is difficult to understand — even for medical professionals.

“As with most diseases in physical medicine and mental health, we have a sense of what’s involved but we don’t exactly know,” said Gratzer.

According to Gratzer, doctors do know that family history and certain traumatic life events are connected with a higher risk of depression.

“However, two people can be raised in the same household and eat the same foods and have a relatively similar childhood and one can get heart disease while the other doesn’t,” said Gratzer.

WATCH BELOW: Study links exposure to infection in the womb to increased risk of autism, depression





“Likewise, you can get [depression] and your sibling may not. So, while we do recognize there’s a strong genetic component… it’s not 100 per cent. There’s more going on.”

Because of the evasive nature of depression, finding a treatment that works can be difficult.

Once someone is diagnosed, they are usually prescribed one of or a combination of three kinds of treatment: exercise, talk therapy and medication. According to Gratzer, patients “do the best” when they do all three.

READ MORE: Is ASMR an effective way to treat anxiety and depression?

But, for some patients, none of these treatments work. And that’s where ketamine can be an exciting option.

“Ketamine is one of a handful of medications that is out of the box,” said Gratzer. 

To be eligible for treatment at the CRTCE, there are three criteria: you are over the age of 18, you are medically stable and you have had a minimum of two other treatments for your depression.

‘Early reports are good, but now we need to take it to the next step’

McIntyre admits that the full effects (positive and negative) of the drug are unknown.

An issue McIntyre and his team are paying close attention to is the impact ketamine can have on other organs, like the kidney or the bladder.

Another is whether ketamine can act as a gateway to other, more severe drug abuse, said McIntyre. 

The CRTCE website states that, “it is critical to understand that ketamine researchers are still exploring a multitude of ways that ketamine infusions impact the human brain. They are working towards understanding why this form of treatment works so quickly and effectively.”

Despite its positive impact thus far, Gratzer isn’t ready to call ketamine a “wonder drug” yet.

WATCH BELOW: 5 ways to help a friend with postpartum depression





“I’m optimistic, but I’ve got a few gray hairs, so I’ve seen these wonder drugs come and go,” he said.

“We need to take it to the next step… can we use it on more people safely? What sort of side effects do they get? Are the effects [on depression] we see with ketamine lasting?”

Gratzer is interested to see whether the effects of ketamine can remain beyond the days after it’s injected.

“It’s great that some people might see relief… if you’ve got a pain on your left hand, it’s great that you feel better with a Tylenol. But that tends to fade and maybe what you really have is a little infection of the skin and what you should really take is antibiotics,” said Gratzer. 

“I hope this is working out because it will be helpful, but I don’t really know and I don’t want to be too optimistic. Like a lot of private healthcare, the sales pitch may not be as good as the reality.”

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.

The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




Source link

18Mar

Infection during pregnancy increases your baby’s risk of autism, but not by much: study – National

by BBG Hub

Babies born to mothers who had an infection during pregnancy are at an increased risk of autism spectrum disorder and depression, a new study has found.

The study found a 79 per cent increased risk of autism and a 24 per cent increased risk of depression in children exposed to infection while in utero, as well as an increased risk of suicide.

READ MORE: Yet another study finds no link between MMR vaccine and autism

Researchers analyzed patient data from pregnant women hospitalized between 1973 and 2014 in Sweden.

From a database of nearly 1.8 million children, researchers used hospital codes to determine which babies were exposed to infection. They then tracked those children and their mental health through the years, with some of the oldest babies now entering their forties.

Researchers divided infections into three categories: the first was any infection at all, the second was “severe maternal infections” and the third was “mild maternal infections” (namely, urinary tract infections).

WATCH BELOW: Women should wait a year before getting pregnant again, study says





“We thought of (severe) infections as things that would cause a whole bunch of inflammation in the mother,” researcher Benjamin J. S. al-Haddad told Global News.

“Things like sepsis (when there’s bacteria in the blood), severe pneumonia (where moms need special help breathing because they have such a severe respiratory infection), meningitis or encephalitis (infections around the brain), pyelonephritis (where the kidneys have bacteria and puss), as well as influenza and chorioamnionitis (where the different parts of the placenta become infected over the course of giving birth).”

Researchers hypothesized that something as mild as a UTI would not be linked to such a high increased risk — but they were wrong.

READ MORE: CHUM’s embryo research could improve IVF treatment in the future

“From our results, it looks like we see similarly increased risk whether the mother had a UTI or something more severe,” al-Haddad said. “It doesn’t seem to matter what kind of infection it is.”

No link was discovered between exposure to infection in utero and other mental conditions, such as bipolar disorder or psychosis.

Researchers worried about other conditions present in mom (such as asthma or diabetes) that could taint the results.

WATCH BELOW: The importance of including autism training for public workers





However, even when they controlled for such conditions, the link between infection and an increased risk for autism and depression remained.

“The things that we controlled for included maternal age, maternal asthma, maternal diabetes, premature rupture of membranes (which is when the sac holding the liquid that the fetus is in breaks before mom goes into labour), maternal tobacco status (whether mom smoked or not), and then we also did special controls for siblings,” al-Haddad said.

The results of the study suggest that infection can “impart subtle brain injuries contributing to the development of autism and depression,” said researchers.

READ MORE: One third of pregnant women don’t think cannabis will harm their babies, study says

While these results sound scary, al-Haddad stressed that the increased risk is in addition to the preexisting baseline risk.

“In the United States, the risk of autism is one out of every 59 kids. Our results suggest that on top of that baseline, there would be a 79 per cent increased risk. We don’t know what that number would be, but the extra risk conferred on top of a baseline low risk, in terms of the population, is not high,” said al-Haddad. (Autism Speaks Canada reports that one in every 66 children have autism in Canada.)

“This is just one of a myriad of causes that we think increases risk. This is another piece of trying to understand what the causes of autism are and how we can prevent those causes.”

WATCH BELOW: Why a 27-year-old Canadian woman chose to be single and pregnant





What does “increased risk” really mean?

It’s important for parents to understand that the reported 79 per cent increase in risk sounds like a big number, but it’s actually quite a small increase on the pre-existing risk.

“It’s still (less than) 1 per cent in terms of the absolute increase (in risk) a particular child has. Basically, that means almost 98 per cent of kids whose mothers have an infection during pregnancy that would cause hospitalization are not born with autism or another neuro-developmental condition,” Dr. Evdokia Anagnostou. She works as a child neurologist and senior clinician scientist at the Bloorview Research Institute.

“So it’s a small absolute risk, but it’s a big risk biologically in the sense that we are learning that there is a mechanism to do with infection that likely interacts with our genes that may increase the chance of developing autism.”

READ MORE: New Canadian pregnancy guideline shows exercise cuts odds of major complications by 40%

On its own, exposure to infection during pregnancy is not enough to cause autism, but it can be a contributing factor.

“It’s one of the ways that our environment (in this case, infection) may interact with our genes to somewhat increase our risk,” Anagnostou added.

This study is helpful because it explains one of the many different changes that can happen in the brain and the body that can contribute to autism.

Some findings should be interpreted with caution, says one doctor

“It’s not the first time we’re learning this,” Anagnostou said. “We have lots of evidence from animal-model and previous human studies that significant infection during pregnancy increases risk for neurodevelopmental disorders, including autism.”

However, there are a few findings that should be interpreted with caution, Anagnostou told Global News.

READ MORE: Vancouver Canucks taking steps to help fans with autism enjoy the games

“(Researchers) tried to look at the severity of infection and whether the severity of the infection would change the impact, and… they said that severe infections were not different than a regular urinary infection, but we have to be careful because these people were admitted to hospital.”

For Anagnostou, those admitted to hospital didn’t have a “regular” urinary infection. Only a more severe infection would warrant a hospital stay. In a similar vein, the kids who later developed autism were also hospitalized.

“Both the people who had infection and the kids who had autism were hospitalized, so they are not representative of the larger population,” she noted.

Other factors which can increase your risk of autism

The most robust explanation for autism comes from our genetics, Anagnostou said.

“But our genes and our environment interact… and there’s a series of these environmental exposures that have small but consistent effects.”

One is infection during pregnancy, and some infections are worse than others.

“That’s why we want all moms to be vaccinated. For example, rubella during pregnancy (is linked with) a very high risk of autism.”

WATCH BELOW: Doctors say IUD’s most effective birth control for teens





“Other factors could be maternal diabetes, use of certain medications during pregnancy, an increased paternal age… all of these things are robust. We know they’re important to biology, but the actual increase is very small for each one of them… so no parent should be feeling guilt because they happen to develop an infection during pregnancy,” said Anagnostou.

“We have zero evidence that vaccines increase the risk for autism.”

Autism is a difference that comes with both “difficulties and advantages”

According to Anagnostou, autism is a developmental difference that causes the brain and the body to grow and connect in different ways than someone who doesn’t have autism.

“Sometimes, that’s associated with things that cause distress and dysfunction, and we want to treat those things,” said Anagnostou. “But sometimes, it actually comes with unique gifts and unique perspectives.”

Anagnostou said people with autism are more likely to think out of the box and they’re more likely to contribute to innovation.

READ MORE: New autism supports coming to Ontario schools due to therapy funding changes

“Speaking generally, they’re good employees, they have very low absenteeism (rates), they tend not to lie,” Anagnostou explained. “It’s a difference that comes with both difficulties and advantages.

“It’s important that we don’t lose perspective of the things that need to be treated, because a lot of these children need our support, but it’s also important to not lose perspective of all the unique qualities people with autism bring to society.”

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




Source link

14Mar

‘Depression isn’t like a broken bone’: Steps to overcome this common mental illness – National

by BBG Hub


Depression can slowly takeover a person’s routine, often making it difficult to go to work or even get out of bed.

A clinical state of depression can be intense, making it hard for some to balance their relationships or social life, often making them feel worthless, weak or sometimes suicidal, said Toronto clinical psychologist Dr. Maneet Bhatia.

But there are others with mild symptoms of the mental health illness: they may be “high-functioning” on the outside, but carry the burdens of feeling depressed from time-to-time.

READ MORE: 8 signs your child may be going through depression

“Mental health doesn’t exist in a vacuum, we have to live in a world where we have to continously think about it,” he told Global News. “Feeling depressed and being clinically depressed are two different (but common) things.”

Is there really a ‘cure?’

Bhatia said when people are diagnosed with depression, most healthcare professionals will set up a plan to overcome it. It’s different for everyone, he added, and many people go into it thinking depression can be a lifelong battle.

“Cure is a medical word, but mental health and depression isn’t like a broken bone,” he continued, adding that there are ways to “cure” your symptoms, but it doesn’t mean you are cured forever.

“Cure implies it is black and white and it’s not always the case,” he said. “You can manage it and overcome it, but it still means you have to take care of it.”

Steps to overcome depression

In a post for Psychology Today, psychotherapist Linda Esposito said if you want to overcome depression, you need to resist the urge to live in the past. “Time spent reliving, rewriting and recreating the past is like purchasing a one-way ticket to the dark depths of despair,” she wrote.

“This insidious mental habit is as much a threat to emotional well-being as any. Self-loathing or blaming others will not get you on the right side of feeling better, any more than believing the answer is found at the bottom of a bottle of Jack Daniels.

“You cannot do life differently if you don’t change your thought process.”

Dr. Jane Framingham, in article for PsychCentral, added that overcoming depression requires taking baby steps. “If you feel good one day, and decide to try and start a new business or make a new friend and you fail, it could be a forceful setback in overcoming depression,” she wrote in October 2018.  “Instead, try things out slowly, and experiment with change one step at a time.”

READ MORE: CMHA offering program to help people battling anxiety or depression

She also noted that not all paths to overcome depression are a straight line. “There will be setbacks in your journey recovering from depression, no matter if you focus on going it alone (e.g., without seeking formal treatment), or even if you are in treatment with an antidepressant or psychotherapy,” she continued.

“Take the setbacks in stride, though, and keep them in perspective — it wouldn’t be work if it was simple to recover from depression. Depression recovery is a process that will take time, but as long as you stick with the goal of change, you can overcome depression in due time.”

Here are some other tips Bhatia recommended:

Recognize the signs: Signs of depression in children and adults can include irritable moods, feeling of guilt or worthlessness, losing interest in things over time or trouble concentrating. Other symptoms of depression, Bhatia added, include loss of appetite, change in sleeping habits or isolation.

Reach out to your support network: Once you recognize the signs, reach out to a mental health professional and your close family and friends. Bhatia said this allows people in your network to check in on you and also allows you to update them.

Find the treatment that works for you: This one will vary depending on the person, but once your healthcare provider recommends a treatment option (medicine, mindfulness, therapy or all of the above), take this treatment seriously.

READ MORE: Depression leads to shorter lifespan — Canadian study

Try lifestyle changes: Sometimes managing or overcoming depression means making lifestyle changes. This includes eating healthier, getting more sleep, staying active or even picking up a hobby.

Be mindful of your thinking patterns: One of the biggest ways to advocate for your own health is to be mindful of how you feel, he added. This can be achieved through therapy, but sometimes this means keeping track of your day-to-day and seeing how your treatments or therapy are working for you.

Where to get help

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.

The Canadian Association for Suicide PreventionDepression Hurts and Kids Help Phone 1-800-668-6868  all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




Source link