Tag Archives: depression

Prejudice Is Linked to Depression, Anxiety in Gay and Bi Black Men

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The harassment, discrimination, and negative feelings about homosexuality that black gay and bisexual men often experience can contribute significantly to mental health disorders such as depression and anxiety, a small new study finds.

“Racism, homo-negativity and the experience of violence and discrimination contribute significantly to mental disorder burden and morbidity in this community,” says Louis F. Graham, study author and a Kellogg Health Scholars postdoctoral fellow in the School of Public Health at the University of Michigan in Ann Arbor.

Using online surveys, Graham and colleagues asked 54 African-American gay or bisexual men about depression and anxiety symptoms and how often they experienced harassment and discrimination in the community and at work. The men also answered questions regarding their feelings about their own sexuality. The study appears in the latest issue of the journal Depression Research and Treatment.

Thirty percent of men in the study reported depression and 33% reported anxiety, which is higher than rates for people in the general population. Discrimination and harassment were extremely common, with 95% of the study participants experiencing them at least once in the past year. Eleven percent of participants said they experience discrimination and harassment weekly. Most of the men said that both race and sexuality played a part in their experiences of discrimination and harassment.

The researchers also found that men who reported higher levels of internalized homo-negativity feelings of shame or disapproval of their same-sex sexual orientation proved more likely to feel depressed or anxious.

“If we think about a whole pie that represents factors that may cause depression and anxiety among this population, findings suggest that discrimination and internalized homo-negativity make up over 50% of the pie,” Graham says. However, he also said that the factors they examined were not exhaustive and they did not follow the study group over time.

Ramani Durvasula, Ph.D., an associate professor at California State University, Los Angeles, and a licensed clinical psychologist, says the study findings were not “bringing much new to the table,” due to the small number of study participants and the fact that the authors surveyed the group only at one period in time, rather than following them long-term. She had no affiliation with the study.

“Discrimination in any form is stressful and can be a risk factor for developing symptoms of depression and anxiety. In addition, depression and anxiety can make perceptions of racism, classism, and other forms of discrimination far worse,” Durvasula says.

Graham adds that the findings indicate that black gay and bisexual men experiencing anxiety or depression are not alone in their feelings.

“We sometimes think of mental disorders or mental health problems as being experienced on a very individual level, and that they’re caused by or related to personal shortcomings or specific situations or incidents. This study shows that mental disorders and mental health problems occur at a community level,” Graham says.

Exercise Can Effectively Double as Second Antidepressant

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Exercise can be as effective as a second medication for as many as half of depressed patients whose condition have not been cured by a single antidepressant medication.

University of Texas Southwestern Medical Center scientists involved in the investigation, recently published in the Journal of Clinical Psychiatry, found that both moderate and intense levels of daily exercise can work as well as administering a second antidepressant drug, which is often used when initial medications don’t move patients to remission. The type of exercise needed, however, depends on the characteristics of patients.

These findings are the result of a four-year study conducted by UT Southwestern’s psychiatry department in conjunction with the Cooper Institute in Dallas. The National Institute of Mental Health–funded study, begun in 2003, is one of the first controlled investigations in the U.S. to suggest that adding a regular exercise routine, combined with targeted medications, actually can relieve fully the symptoms of major depressive disorder.

“Many people who start on an antidepressant medication feel better after they begin treatment, but they still don’t feel completely well or as good as they did before they became depressed,” says Madhukar Trivedi, professor of psychiatry and the study’s lead author. “This study shows that exercise can be as effective as adding another medication. Many people would rather use exercise than add another drug, particularly since exercise has a proven positive effect on a person’s overall health and well-being.”

Depression: A Global View

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Depression affects 121 million people worldwide. In can affect a person’s ability to work, form relationships, and destroy their quality of life. At its most severe, depression can lead to suicide and is responsible for 850,000 deaths every year. New research published in the journal BMC Medicine compares social conditions with depression in 18 countries across the world.

In conjunction with the World Health Organization World Mental Health Survey Initiative, researchers from 20 centers collaborated to investigate the prevalence of depression around the globe. To be classified as having had a major depressive episode, a person was additionally required to fulfill five out of nine criteria, including sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.

Based on detailed interviews with over 89,000 people, the results showed that 15% of the population from high-income countries (compared to 11% for low-/middle-income countries) were likely to get depression over their lifetime, with 5.5% having had depression in the last year. MDEs were elevated in high-income countries (28% compared to 20%) and were especially high (over 30%) in France, the Netherlands, and America. The country with the lowest incidence was China, at 12% but, in contrast, MDEs were very common in India (at almost 36%).

Avoiding Eye Contact? You Might Be Depressed

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People who are sad or depressed really do avoid eye contact, according to research published in the latest edition of the British Journal of Psychology.

Peter Hills, a lecturer in psychology at Anglia Ruskin University in England, carried out experiments to discover how mood affects the way individuals look at other people. The findings, coauthored by Michael Lewis of Cardiff University, show that happy people are more likely to detect changes in eyes than participants who are unhappy.

“Depressed people tend to avoid eye contact in social situations and in experimental settings, whereas happy people actively seek eye contact,” says Hills, who also discovered that, conversely, sad people more accurately noticed “external” changes, such as hairstyle.

One suggestion Hills has proposed is that avoiding eye contact may actually increase depression among already unhappy individuals, since it can lead to isolation. “Sad people avoiding eye contact will disrupt normal social fluency and may lead to them shunning certain social situations,” he says. “Although this may reduce anxiety caused by the situation itself, it may actually increase social isolation and deepen their already sad mood.”

“An alternative perspective on our findings is that rather than sad-induced participants avoiding the eyes, they process faces based on the external features, such as hair, rather than the internal features. Internal features, which include the eyes and nose, are those most commonly used to recognize familiar faces. Thus, sad-induced participants may treat all faces in the same way, as if they were all unfamiliar, which again may increase the risk of social isolation.”

Do Antidepressants Raise Risk of Depression Relapse?

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Patients who use antidepressants are more likely to suffer relapses of major depression than those who use no medication at all, concludes a McMaster University researcher.

In a paper that is likely to ignite new controversy in the hotly debated field of depression and medication, evolutionary psychologist Paul Andrews concludes that patients who have used antidepressant medications can be nearly twice as susceptible to future episodes of major depression.

Andrews, an assistant professor in the department of psychology, neuroscience, and behavior, is the lead author of a new paper in the journal Frontiers of Psychology.

The meta-analysis suggests that people who have not been taking any medication are at a 25% risk of relapse, compared to 42% or higher for those who have taken and gone off an antidepressant. Andrews and his colleagues studied dozens of previously published studies to compare outcomes for patients who used antidepressants compared to those who used placebos.

Andrews says antidepressants interfere with the brain’s natural self-regulation of serotonin and other neurotransmitters and that the brain can overcorrect once medication is suspended, triggering new depression.

Though there are several forms of antidepressants, all of them disturb the brain’s natural regulatory mechanisms, which Andrews compares to putting a weight on a spring. The brain, like the spring, pushes back against the weight. Going off antidepressant drugs is like removing the weight from the spring, he explains, leaving the person at increased risk of depression when the brain, like the compressed spring, shoots out before retracting to its resting state.

“We found that the more these drugs affect serotonin and other neurotransmitters in your brain — and that’s what they’re supposed to do — the greater your risk of relapse once you stop taking them,” Andrews says. “All these drugs do reduce symptoms, probably to some degree, in the short term. The trick is what happens in the long term. Our results suggest that when you try to go off the drugs, depression will bounce back. This can leave people stuck in a cycle where they need to keep taking antidepressants to prevent a return of symptoms.”

Andrews believes depression may actually be a natural and beneficial — though painful — state in which the brain is working to cope with stress.

“There’s a lot of debate about whether or not depression is truly a disorder, as most clinicians and the majority of the psychiatric establishment believe,” he says, “or whether it’s an evolved adaptation that does something useful.”

Longitudinal studies cited in the paper show that more than 40% of the population may experience major depression at some point in their lives. Most depressive episodes are triggered by traumatic events such as the death of a loved one, the end of a relationship or the loss of a job. Andrews says the brain may blunt other functions such as appetite, sex drive, sleep, and social connectivity to focus its effort on coping with the traumatic event.

Just as the body uses fever to fight infection, he believes the brain may also be using depression to fight unusual stress. Not every case is the same, he emphasizes, and severe cases can reach the point where they are clearly not beneficial.