Human Growth Hormone (HGH) IMPROVES MOOD AND SLEEP PATTERNS

In 1996 a team of Swedish scientists discovered why Human Growth Hormone (HGH) replacement makes so many people feel good.  They found it acts on the brain just like an antidepressant, raising the level of the neurotransmitter B-endorphin, which has been called the brain's opiate.  Human Growth Hormone also lowers the level of dopamine, which is associated with feelings of agitation.  Other reports indicate that increased levels of Human Growth Hormone reduce stress, improve focus and concentration, and build self-esteem and self-confidence.  A 1998 report showed that depressed men have a marked decrease in Human Growth Hormone secretion during the first three hours of sleep as opposed to non depressed controls.  Indeed, higher levels of Human Growth Hormone induced a more restful and sounder sleep.

Three different studies in Sweden, Denmark, and England reported that Human Growth Hormone replacement therapy had dramatic, positive effects on patients suffering from low self-esteem, anxiety and depression.

In a report by L. Cass Terry, M.D., Ph.D. to the American Academy of Anti-Aging Medicine in December 1996, Dr. Terry reported that his clinical group of 900 people, 300 or which were doctors, 80% experienced improved attitude toward life, and 67% experienced enhanced emotional stability.

A recent clinical study by Theirry Hertoghe, M. D. showed that Human Growth Hormone therapy decreased depression by 82% and anxiety and low self-esteem by over 70%

Quality of Life with Growth Hormone Replacement

Adult-onset growth hormone deficiency (GHD) often experience a sub-optimal quality of life (QoL), impaired cognition, and reduced psychosocial functioning. In fact, studies of patients with adult-onset GHD consistently found a lack of energy and emotional problems as being characteristic of this population. Memory lapses, difficulty concentrating, and forgetfulness are frequently reported by patients with adult-onset of Growth Hormone Deficiency. Moreover, when compared to patients with diabetes mellitus, one study found increased psychiatric illness, depression, and dysthymia among adults with hypopituitarism. (The essential feature of Major Depression is one or more Major Depressive Episodes without a history of either a Manic Episode or an unequivocal Hypomanic Episode. The essential feature of Dysthymia is a chronic disturbance of mood involving depressed mood for most of the day more days than not. In addition, during these periods of depressed mood there are some of the following associated symptoms: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness. This has often been referred to as Depressive Personality.)

These problems tend to be reported more by growth hormone-deficient women than men, and are more prevalent in patients with long-standing disease than in those recently diagnosed with Growth Hormone Deficiency. Overall, adults with untreated hypopituitarism tend to report a lower health status than the general population.

Data from a study conducted by the Lee-Benner Institute’s longitudinal trial using Growth Hormone to treat Somatopause (disorders of body composition and function resulting from a more or less rapid decline of Growth Hormone secretion that is seen with increasing age) for 1,521 patients with adult-onset Growth Hormone Deficiency demonstrated that improvements from the baseline in total score, energy levels, and emotional reaction using the NHP persisted after 10 years of treatment. Even this instrument, which tends to underestimate the extent of QoL impairment , shows the dramatic long-term improvement associated with Growth Hormone therapy.

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Elizabeth Wurtzel, author of "Prozac Nation" and "Bitch" discusses her depression and drug use

With nearly every seat full, Elizabeth Wurtzel shared her ordeal with depression, drugs and how she overcame it during the Keene State College's Citizenship Symposium. "The worst part of any mental illness is being stuck in your own head and thinking you're the only one," said Wurtzel, addressing an audience of nearly 500 KSC students and local residents. Wurtzel, was designated as one of the symposium's three keynote speakers and has written several books - her latest titled, Americanism: A Love Story. "I've never thought of myself as a particularly good citizen," she said. "I'm a writer first and foremost."

After writing her best-selling book "Prozac Nation," Wurtzel said readers came to her with their stories of depression, insisting they went through the same ordeal she did. "I think it was a shock after "Prozac Nation" came out that other people connected with me that actually have nothing in common with me," she said. "I had to be nice … I had to come up with some sort of message."

Wurtzel found that message, and told it to the audience by reading out of an advice book she was asked to write for teenagers. "If I had to say anything to people, it would be this: You cannot be a guest at your own funeral … You will not know you will be missed. You will be dead and gone." These opening lines led into a short excerpt from her unfinished advice book, in which Wurtzel points out the pointlessness of suicide and how petty some problems are.

"Even for normal people life doesn't always seem like an easy prospect," she read aloud to the audience. "Everything that is wrong is not so bad."

Although Wurtzel's depression began when she was 12 years old, she said she did not find help until college, where the health services told her she needed 15 to 20 years of therapy instead of medication. "I never lost the feeling I had that there was something more they could do," the former drug addict said. Wurtzel became addicted to drugs around the age of 26 when she was put on Ritalin for ADD (attention deficit disorder). "I started to abuse it terribly … At the time I was put on it I was addicted to heroin anyway," she said, adding this led her to cocaine and eventually landed her in the hospital for four months for rehabilitation. "I got addicted to Ritalin. That was an amazingly horrible experience … I was snorting 40 pills a day and I don't think people know it can get that bad."

However, Wurtzel's fears of distributing anti-depressants do not come from her drug abuse, but from her knowledge of what it does to a person. "The thing about medication is they're not vitamin pills. They change you … I think it's very dangerous to prescribe these medications to people under 18." Wurtzel referred to a story of her friend who stalked her ex-boyfriend because of her depression. She was put on medication, but did not go to therapy, which Wurtzel said would have helped her substantially. "She kept stalking her boyfriend, but she was just happier doing it," she said.

After responding to questions from the audience, Wurtzel concluded her appearance by offering her opinion as to why the United States is one of the most depressed countries in the world - a fact offered by audience member Marianne Salcetti in the final question of the night. "I think we lack connection," said Wurtzel. "I think that's our biggest problem. I hate to say it but America is one nation under divorce … there's a breakdown of community unlike anywhere else in the world."

Biography

Elizabeth Lee Wurtzel (born July 31, 1967 in New York City) is famous for her work in the confessional memoir genre. She has often been compared to Anne Sexton and Sylvia Plath. Brought up Jewish, Wurtzel's parents divorced when she was young. As described in Prozac Nation, Wurtzel's depression began at the ages of ten to twelve. She attended Ramaz for high school and was described as an over-achiever by her teachers, who expected her to become a nationally famous writer. While an undergraduate at Harvard College, she wrote for The Harvard Crimson and the Dallas Morning News, from which she was later fired for plagiarism.Wurtzel also received the 1986 Rolling Stone Magazine College Journalism Award. Following her graduation, Wurtzel moved to Greenwich Village in New York City and found work as pop music critic for The New Yorker and New York Magazine.

Wurtzel is best known for publishing her memoir, the best-selling Prozac Nation, at the age of 26. The book chronicles her battle with depression and suicide attempts. The film adaptation of Prozac Nation, starring Christina Ricci, premiered at the Toronto International Film Festival September 8, 2001 but never had a U.S. theatrical release. It was telecast on the Starz! network during March, 2005 and was released on DVD in the summer of 2005.

After Prozac Nation

Following the critical acclaim and bestselling success of Prozac Nation, Wurtzel moved to Florida as she felt she was no longer able to concentrate on her work in New York City and began writing her second book, Bitch: In Praise of Difficult Women. It was at this point that she battled abuse and addiction to Ritalin. Prior to moving to Florida, Wurtzel had battled cocaine and heroin addictions as well. Wurtzel wrote Bitch as she felt that feminist writing had become "dry" and she wanted to make it "juicy" again. She focused on societal definitions of "bad girls" and analyzed female public figures from Amy Fisher to Hillary Clinton through this lens. Wurtzel, at this point a drug addict, gained much weight due to the medication she was taking, and was seen as distressed while promoting Bitch on numerous media channels such as CNN. Her troubles during this period led to cancellations of multiple book readings and press interviews. During this time, her regular column in The Guardian was canceled because of her inability to produce work on time. It was these experiences that led to her publishing a second autobiographic volume, titled More, Now, Again: A Memoir of Addiction (2001, which was centered around her addiction to the prescription medication Ritalin while writing Bitch.

Wurtzel has also worked for the website Nerve as a film critic. As of 2007, she is studying at Yale Law School, and is expected to earn her Juris Doctorate in 2008.

Studies Suggest the Mind Makes, Breaks its Misery

Brain research indicates that people are hard-wired for empathy, and that faith affects the experience of their own agony and that of others.

Pain, like beauty, is in the mind's eye. It is altered by empathy and tempered by faith, three new brain-imaging studies suggest. The bewitching effect of belief can alter directly how strongly people feel pain, causing measurable changes in brain cells and synapses whether the torment is theirs or a loved one's. The new findings, made public today by independent research teams at the University of Michigan, Princeton University, UCLA, and University College London, offer the strongest evidence yet of how the brain thinks about pain.

Mapping the neural anatomy of pain, the researchers documented the ways in which the brain created a world of its own from the raw material of physical sensation. Using medical imaging scanners to monitor brain activity, researchers at Michigan, UCLA and Princeton revealed that simple faith in a placebo could alter the neural circuits that process pain, easing the agony.

In a separate experiment, the researchers at University College showed that the brain was a mirror of suffering, reflecting through many of the same neural circuits the pain that others feel, much as if the sensation were its own genuine torment. Indeed, the brain's ability to share another's response to pain at such a fundamental cellular level may be the key to a sense of empathy, the personality trait that underpins so many human relationships, researchers said. "These brain regions are critical to the interplay between the outside world and you," said neuropsychologist Helen Mayberg at Emory University in Atlanta. By directly monitoring mental activity, the researchers showed how expectations and anticipation molded the brain's response to the physical sensation of pain. To a certain degree, pain is an act of imagination. "We are zeroing in on some pathways where our thoughts and beliefs are changing our physical and emotional experience," UCLA psychologist Matthew Lieberman said. "We don't typically think of those as things we can control." Each team used brain mapping techniques to survey the same neural terrain from three slightly different perspectives.

Two of the studies were published today in the journal Science. The third will be published next month in Neuroimaging. To better understand pain and empathy, a team led by social psychologist Tania Singer at the Institute of Neurology at University College tested 19 couples who, because they were romantically involved, could be expected to be attuned to each other. One woman from each pair was monitored with a functional magnetic resonance imaging scanner. Her neural activity was recorded first as researchers gave her a brief electric shock, then as her partner received the same shock. The researchers discovered that the same critical brain regions involved in processing the physical sensation of pain were activated in each case. Feelings of empathy for another's pain triggered regions of the brain responsible for processing pain, much as if it were a direct sensation, researchers discovered.

To Singer and her colleagues, it strongly suggested that humans were hard-wired for empathy."We are pretty sure that it is a universal mechanism," Singer said. "It is how we can put ourselves emotionally in another's shoes." To investigate how belief affects the brain's response to pain, Lieberman and his UCLA colleagues conducted brain scans of 14 patients given a placebo to treat their chronic abdominal pain. The experiment revealed that the patients' faith in the substance they were given eased their symptoms and also produced physical changes in areas of the brain that processed pain. The greater the brain changes, the greater the reduction in pain, the researchers determined.

At Michigan and Princeton, researchers produced even more compelling evidence that the expectation of relief caused physical changes in how the brain handled pain. They tested dozens of volunteers by giving them shocks while monitoring their neural activity in a brain scanner. Then researchers gave all the volunteers a placebo in the form of a harmless cream the patients were told would prevent the pain. Then the scientists conducted another round of shocks. The expectation of relief was enough to cause physical changes in those pain-processing areas of the brain, offering evidence of the placebo effect. "We actually see physical changes in the brain that correspond closely to changes in symptoms that the patients report," said psychologist Tor Wager, who led the Michigan research team. The researchers determined that pain depended not only on the actual sensory signals from nerves that the brain received but also on a person's emotional state.

Anti Alcohol - Anti oxidant - What is a hangover

The medical term for the hangover is Veisalgia. Kveis is Norwegian and is defined as uneasiness following debauchery. And, algia is Greek meaning pain. The hangover defined is having, at least, two of the following listed symptoms with sufficient severity to disrupt the performance of daily task and responsibilities (percentage of population experiencing each symptom): headache (66%), poor sense of overall well being (60%), diarrhea (36%), anorexia (21%), tremulousness (20%), fatigue (20%), and nausea (9%). Experimentally an alcohol dose of 1.5 - 1.75 gms/kg body weight (5 to 7 standard cocktails) will almost always produce hangover symptoms in those susceptible individuals.

Wouldn’t it be wonderful if the hangover were a result of dehydration as many of us thought when we first started drinking? Unfortunately preventing a hangover is much more complicated than just drinking lots of fluids along with our alcoholic beverages. Aside from dehydration, hangovers are a result of alterations in endocrine function, dysregulation of cytokine pathways, and proper elimination of toxins produced during alcohol preparation and normal liver metabolism.

Anti-diuretic hormone (ADH) is produced by the pituitary gland and causes the body to retain water. While drinking and during acute intoxication, ADH production is decreased and so we see an increase in urination resulting in dehydration. However, during the hangover phase, ADH production is increased causing a retention of body fluids resulting in puffiness in tissues for example in the face and around the eyes.

Other hormonal alterations include the adrenal cortex hormones, aldosterone and cortisol. Aldosterone helps regulate blood levels of sodium, chloride, and potassium. During drinking aldosterone levels decrease causing a decrease in sodium and an increase in potassium levels resulting in decreased blood volumes and a temporary decrease in blood pressure. However, during the hangover period aldosterone increases causing an increase in serum sodium levels and an increase in blood volumes and blood pressure. These electrolyte imbalances can be responsible for muscle weakness, fatigue, vomiting, and loss of appetite experienced during the hangover.

Cortisol is a regulator of fat, carbohydrate, and protein metabolism. It also works with aldosterone to balance electrolytes, and functions as an important anti-inflammatory. During times of hangover, cortisol causes an increase in blood sugar levels by converting amino acids into glucose in the liver known as gluconeogenesis. Increased blood sugar levels would cause in increase in insulin production and abnormal stress on pancreatic and liver function. Cortisol also decreases protein in skeletal muscles and causes a redistribution of body fat from the legs and arms to the trunk and shoulder blade regions of the body.

Next, rennin production, an enzyme produced by the kidneys and responsible for regulating blood pressure, is increased. Rennin acts on angiotensin to form a vasopressor substance known as angiotensin I. This causes an increase in blood pressure and an increase in heart rate and left ventricular ejection . This may be responsible for increases noted in mortality rates due to myocardial infarction during hangover periods.

Other important factors involved in the intensity and production of hangover symptoms include the production and elimination of toxins (conversion of ethanol into acetaldehyde and acetate in the liver) and the increased production of thromboxanes. Thromboxanes are products of fatty acid metabolism and are responsible for blood vessel constriction (raising blood pressure), blood platelets sticking together (increase in clot formation), and decreases of natural killer cells (decreased immunity). An increase in thromboxane-B2 during the hangover has also been found to cause symptoms similar to those in a viral infection, including nausea, headache, and diarrhea.

Lastly, the level of congeners found in alcoholic beverages can be a major causative factor in the production of hangover symptoms . Congeners are the by-products of alcohol preparations. Higher concentrations are found in dark liquors such as brandy, wine, dark tequila, and whiskey. Lower concentrations are found in clear liquors, such as rum, vodka, clear tequila, and gin. Experimental studies revealed that 33% of test subjects who consumed 1.5 gms/kg of bourbon experienced hangover symptoms while only 3% of those who consume the same volume of vodka experienced symptoms.

Dr. Charles Cochran

Report of a Subcommittee of the National Advisory Council on Alcohol Abuse and Alcoholism on the Review of the Extramural Research Portfolio for Prevention, National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, October 1998.
Doernberg D, Stinson F. U.S. Alcohol Epidemiologic Data Reference Manual. Vol 1, U.S. Apparent Consumption of Alcoholic Beverages Based on State Sales, Taxation, or Receipt Data. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, 1985.
Stockwell T. Towards Guidelines for Low-risk Drinking: Quantifying the Short and Long-term Costs of Hazardous Alcohol Consumption. Alcohol Clin Exp Res. 1998;22(2 Suppl);635-95.
Wiese JG, Shlipak MG, and Browner WS, The Alcohol Hangover, Ann Intern Med. 2000; 132:897-902.
Sainio K, et al. Electroencephalographic Changes During Experimental Hangover. Electroencephalogr Clin Neuro-physiol. 1976:40:535-8.
Linkola J, et al. Plasma Vasopressin in Ethanol Intoxication and Hangover. Acta Physiol Scand. 1978;104:180-7.
Linkola J, et al. Renin-aldosterone Axis in Ethanol Intoxication and Hangover. Eur J Clin Invest. 1976;6:191-4.
Kangasaho M, et al. Effects of Ethanol Intoxication and Hangover on Plasma Levels of Thromboxane B2 Formation By Platelets in Man. Thromb Haemost. 982;48:232-4.
Damrau F, Goldberg AH. Adsorption of Whisky Congeners by Activated Charcoal. Chemical and Clinical Studies Related to Hangover. Southwest Med. 1971;52:179-82.
Chapman LF. Experimental Induction of Hangover. Q J Stud Alcohol, 1970;5(Suppl 5):67-86.
Diaz A, et al. Comparative Study Between A Complex of Flavonoids and Polyphenols and Placebo in Hepatic Disease Due To Alcohol. General Hospital of Mexico. International Meeting of Hepatology. Military School of Medicine.

 

HBC Protocols SLEEP insomnia Chamomile melatonin peppermint hops valarian root passionflower - Understanding Sleep

Do you ever feel sleepy or "zone out" during the day? Do you find it hard to wake up on Monday mornings? If so, you are familiar with the powerful need for sleep. However, you may not realize that sleep is as essential for your well-being as food and water.

Sleep: A Dynamic Activity

Until the 1950s, most people thought of sleep as a passive, dormant part of our daily lives. We now know that our brains are very active during sleep. Moreover, sleep affects our daily functioning and our physical and mental health in many ways that we are just beginning to understand.

Nerve-signaling chemicals called neurotransmitters control whether we are asleep or awake by acting on different groups of nerve cells, or neurons, in the brain. Neurons in the brainstem, which connects the brain with the spinal cord, produce neurotransmitters such as serotonin and norepinephrine that keep some parts of the brain active while we are awake. Other neurons at the base of the brain begin signaling when we fall asleep. These neurons appear to "switch off" the signals that keep us awake. Research also suggests that a chemical called adenosine builds up in our blood while we are awake and causes drowsiness. This chemical gradually breaks down while we sleep.

During sleep, we usually pass through five phases of sleep: stages 1, 2, 3, 4, and REM (rapid eye movement) sleep. These stages progress in a cycle from stage 1 to REM sleep, then the cycle starts over again with stage 1. We spend almost 50 percent of our total sleep time in stage 2 sleep, about 20 percent in REM sleep, and the remaining 30 percent in the other stages. Infants, by contrast, spend about half of their sleep time in REM sleep.

During stage 1, which is light sleep, we drift in and out of sleep and can be awakened easily. Our eyes move very slowly and muscle activity slows. People awakened from stage 1 sleep often remember fragmented visual images. Many also experience sudden muscle contractions called hypnic myoclonia, often preceded by a sensation of starting to fall. These sudden movements are similar to the "jump" we make when startled. When we enter stage 2 sleep, our eye movements stop and our brain waves (fluctuations of electrical activity that can be measured by electrodes) become slower, with occasional bursts of rapid waves called sleep spindles. In stage 3, extremely slow brain waves called delta waves begin to appear, interspersed with smaller, faster waves. By stage 4, the brain produces delta waves almost exclusively. It is very difficult to wake someone during stages 3 and 4, which together are called deep sleep. There is no eye movement or muscle activity. People awakened during deep sleep do not adjust immediately and often feel groggy and disoriented for several minutes after they wake up. Some children experience bedwetting, night terrors, or sleepwalking during deep sleep.

When we switch into REM sleep, our breathing becomes more rapid, irregular, and shallow, our eyes jerk rapidly in various directions, and our limb muscles become temporarily paralyzed. Our heart rate increases, our blood pressure rises, and males develop penile erections. When people awaken during REM sleep, they often describe bizarre and illogical tales — dreams.

The first REM sleep period usually occurs about 70 to 90 minutes after we fall asleep. A complete sleep cycle takes 90 to 110 minutes on average. The first sleep cycles each night contain relatively short REM periods and long periods of deep sleep. As the night progresses, REM sleep periods increase in length while deep sleep decreases. By morning, people spend nearly all their sleep time in stages 1, 2, and REM.

People awakened after sleeping more than a few minutes are usually unable to recall the last few minutes before they fell asleep. This sleep-related form of amnesia is the reason people often forget telephone calls or conversations they’ve had in the middle of the night. It also explains why we often do not remember our alarms ringing in the morning if we go right back to sleep after turning them off.

Since sleep and wakefulness are influenced by different neurotransmitter signals in the brain, foods and medicines that change the balance of these signals affect whether we feel alert or drowsy and how well we sleep. Caffeinated drinks such as coffee and drugs such as diet pills and decongestants stimulate some parts of the brain and can cause insomnia, or an inability to sleep. Many antidepressants suppress REM sleep. Heavy smokers often sleep very lightly and have reduced amounts of REM sleep. They also tend to wake up after 3 or 4 hours of sleep due to nicotine withdrawal. Many people who suffer from insomnia try to solve the problem with alcohol — the so-called night cap. While alcohol does help people fall into light sleep, it also robs them of REM and the deeper, more restorative stages of sleep. Instead, it keeps them in the lighter stages of sleep, from which they can be awakened easily.

People lose some of the ability to regulate their body temperature during REM, so abnormally hot or cold temperatures in the environment can disrupt this stage of sleep. If our REM sleep is disrupted one night, our bodies don’t follow the normal sleep cycle progression the next time we doze off. Instead, we often slip directly into REM sleep and go through extended periods of REM until we "catch up" on this stage of sleep.

People who are under anesthesia or in a coma are often said to be asleep. However, people in these conditions cannot be awakened and do not produce the complex, active brain wave patterns seen in normal sleep. Instead, their brain waves are very slow and weak, sometimes all but undetectable.

Bipolar Brittany; creativity and bipolar affliction in Hollywood.

Bi polar behavior is in no short supply in Hollywood. If it is not crazy agents screaming into the phone, it's out-of-control actors (that would include the female variety) driving drunk, wielding baseball bats at paparazzi . .  the list goes on. As amusing as it may be in TMZ snippets, this is not healthy, not natural behavior. No one knows what percentage of people living in Los Angeles are bipolar, but studies have shown that there are very high rates of bipolar among people in the arts, which includes musicians, poets and writers. "We don't know why this is the case, but there may be something about the gene for creativity that runs not only in those types of professions but in bipolar as well," said Dr. Lori Altshuler, the Julia S. Gouw Professor of Psychiatry and director of the UCLA Mood Disorders Research Program. "We are not talking about a town where being married and going to church every Sunday is highly valued," said Rebecca Roy, a therapist who estimates that 75% of her clients are musicians, actors, producers and writers, and advertises her practice with the slogan "Stay Sane in an Insane Industry." "L.A. is about reaching for the heights, for whatever is possible. That is kind of a manic view: the idea that there is always a carrot on a stick in front of you and if you can just gear yourself up for it you can get it. Millions and millions of people come here for that reason."

Bipolar may go undiagnosed in many communities, but in Hollywood, manic traits are not only overlooked, they are celebrated. (There are two types of bipolar: I and II. The difference is one of degree. Those with bipolar II experience hypomania, but not mania. In most cases, hypomania does not impair a person's daily functioning.)

 

Bipolar traits include increased energy and productivity, a decreased need for sleep -- many with bipolar need only three to four hours of sleep a night during a manic or hypomanic phase -- and increased self-esteem, talkativeness and sociability. "These are the types of traits most actors would like to have all the time," Altshuler said. "People who are hypomanic are the life of the party. They are magnetic, and the problem is, they don't want to be treated for hypomania because it feels so good. Case in point, Britney Spears, who has now been hospitalized twice for potential BP affliction. Her mania may look like fun on the outside, but I assure you, it is not. She is swept up by forces she can neither control nor understand. From all appearances it has swallowed her whole. And she is clearly self-medicating with alcohol or drugs or both. 

 

 

To be sure, the list of celebrities with bipolar disorder is in the hundreds. Some actors, such as Carrie Fisher and Patty Duke, have come out publicly about their struggles. Actress and activist Mariette Hartley, who has appeared in shows such as "Star Trek" and "The Incredible Hulk" over the course of her long career, called her decision to come out about the disease "wrenching. Famous or not, bi-polar affliction is a tough one. Doctors know there are very high rates of drug and alcohol abuse in people who are bipolar, many times higher than the general population rates. Experts say the list of celebrities with bipolar disorder (some confirmed, some not) is in the hundreds. Carrie Fisher and Patty Duke have come out publicly about their struggles. Mariette Hartley has appeared in shows such as "Star Trek" and "The Incredible Hulk" over the course of her long career. She admits that her decision to come out about BP was "Wrenching. Whether you are a famous actor, or a farmer in Iowa, this disease can be hidden from yourself," she said. "When the demons hit, they get you wherever you are."

New Signs of Hope for the Chronically Depressed

Psychiatry: Research suggests antidepressant therapy can help adults who have struggled with melancholy for years and, until recently, were thought to just have gloomy personalities.

We all know them. (Maybe we even recognize them in the mirror.) They are the people who move through life with the weight of the world upon them. Morose, sullen, angry, negative; there are lots of adjectives to describe what has been typically thought of as just an unfortunate personality trait. Now, however, mental health experts are saying that many of these people are chronically depressed. In the first major study to follow hundreds of people who have been depressed for most of their adult lives, researchers have found promising evidence that this persistent melancholy can be lifted with long-term antidepressant therapy. The research, laid out in five lengthy journal articles that have appeared in recent weeks, should put a new imperative on treating people who seem born sad. "The message here is very good. Even if you've been depressed for seven years, you still have an excellent chance of recovering," said Dr. Lorrin Koran, a professor of psychiatry at Stanford University. The findings challenge the popular notion that people who have long been depressed cannot change. As recently as 1990, psychiatrists could not agree on whether a person could have an intractable "depressive personality." "It was really thought that these individuals had a chronic lifelong down-in-the-dumps personality that was their nature," said Dr. Martin B. Keller, a Brown University professor of psychiatry who headed the research project. And, said Dr. Michael E. Thase, another coauthor of the studies: "This used to be called 'neurotic depression.' Neurotic implies an aspect of one's character. In the public's view, these are people who are gloomy, pessimistic, the Eeyores of the world. Well, poor Eeyore probably had a treatable disorder." Chronic depression is defined as symptoms of major depression that persist for at least two years. There are also two subsets of the disorder: dysthymia, which is defined as symptoms of a lesser severity that last for at least two years; and double depression, which is a combination of major depression and dysthymia. An estimated 5% to 10% of the roughly 18 million Americans with depression are thought to have some type of chronic depression. "Major depression is easier to recognize. These are people who can't get out of bed or have attempted suicide," said Lydia Lewis, executive director of the National Depressive and Manic Depressive Assn. "But chronic depression is very insidious. People tend to look at these people and say, 'Oh, he is so self-centered; he thinks about himself too much.'
Or they might call these people lazy or unambitious. But what it might actually be is chronic depression."

* * * * *

Because of this prevailing view, people with chronic depression are not as likely to be diagnosed or seek treatment, Keller said. The new data should alert both doctors and the public that treatment is beneficial. In addition, the studies could help doctors provide evidence to insurance companies in cases in which antidepressants and other mental health benefits are limited. "We're certainly hoping this will lead to increased recognition of chronic depression among patients and health-care providers," Keller said. The study, published in several parts in recent issues of the Journal of the American Medical Assn. and the Journal of Clinical Psychiatry, marks an ambitious effort by top researchers in the field to gain insight into the little-explored area of chronic depression. Only a few studies have been done on the impact of an initial course of treatment, and only one other study has attempted to follow chronically depressed people after their first phase of treatment to see how they fared over a longer period of time. Moreover, until the new study, there was no information that documented how chronically depressed people fared when treated with Prozac and other antidepressants in a class of drugs known as Selective Serotonin Reuptake Inhibitors. SSRIs are the preferred treatment for many forms of depression because they cause fewer side effects than older classes of medications. In the study, 635 patients were treated with either the SSRI sertraline or the older antidepressant called imipramine. The patients were generally people who had struggled with depression most of their adult lives. About 25% also had coexisting conditions, such as alcoholism or drug addiction, anxiety or panic disorder. Only 43% had ever received any treatment for their depression.

* * * * *

The study showed that 52% of the individuals responded to either sertraline or imipramine. Patients taking the imipramine were twice as likely to stop the treatment because of side effects from the medication. "Other smaller studies had hinted at this. But this is the largest and most carefully done study of its kind," said Thase, a professor of psychiatry at the University of Pittsburgh. "This pushes the evidence over the top." Another part of the study explored how these patients fared in a second phase of maintenance treatment over 16 weeks. Of the 77 patients taking sertraline, only 6% relapsed after 18 months, contrasted with 23% of the 84 people who took a placebo. While the rate of recovery was high, the study did show that patients with chronic depression need somewhat longer to recover. It's also clear that the patients need to stay on the medication for at least two years. "We've shown that a minimum of 18 months of maintenance therapy is needed after the initial seven months of treatment," Keller said. It's not known whether some--or all--people with chronic depression will need lifelong therapy. But, Keller said: "In the absence of data, I would continue to treat them unless they develop difficulty taking the medication or unless they were insistent that they wouldn't stay on the drug."