Depressed - where to go?
- Uncle Monty
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I'll just remember to consult a dietitian.
Dictated to a slave and sent by carrier pigeon.
- vladimir
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A dietitian would be unable to help you.
A dietician might be able to help you.
You gotta stop eating those t's, very bad for you!
A dietician might be able to help you.
You gotta stop eating those t's, very bad for you!
ירי ילדים והפצצת אזרחים דורש אומץ, כמו גם הטרדה מינית של עובדי ההוראה.
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Dear diamond lady,diamond lady wrote:Hi Andrea, I am a student of nutrition and I will be in Phnom Penh in a couple of months. I have a special interest in the health of the nervous system (this includes the brain) and have some experience treating long-term/severe anxiety disorders. Anxiety disorders are obviously different to depression in terms of symptoms but both types of conditions, when treated using nutrition, involve working with balancing and restoring the health of the nervous system and neurotransmitter function.
If you'd like to meet with me for a free consultation once I am in Phnom Penh, I'd be more than happy to lend an ear and offer some recommendations on diet and lifestyle changes that you might find very useful, within the scope of my abilities as a student.
Kind regards, and take care. And feel free to PM me any time.
I the country where I come from Holland, you probably would have been accused of being a charlatan. You are not a qualified mental health professional. Many of these charlatans end up in jail in Holland.
Are you going to treat the 350 million people who suffer depression with nutrition advices? You should give the WHO a call:
Depression is a common illness and people suffering from depression need support and treatment
WHO marks 20th Anniversary of World Mental Health Day
Note for the media
9 October 2012 | GENEVA - On World Mental Health Day (10 October), WHO is calling for an end to the stigmatization of depression and other mental disorders and for better access to treatment for all people who need it.
Fighting stigma: a key to increasing access to treatment
Globally, more than 350 million people have depression, a mental disorder that prevents people from functioning well. But because of the stigma that is often still attached to depression, many fail to acknowledge that they are ill and do not seek treatment.
Depression is different from usual mood fluctuations. Depression induces a sustained feeling of sadness for two weeks or more and interferes with the ability to function at work, school or home. Effective treatments include psychosocial treatment and medication. The active involvement of depressed people and those who are close to them in addressing depression is key. The first step is to recognize the depression and reach out for support. The earlier the treatment begins, the more effective it is.
“We have some highly effective treatments for depression. Unfortunately, fewer than half of the people who have depression receive the care they need. In fact in many countries this is less than 10%,” says Dr Shekhar Saxena, Director of the Department for Mental Health and Substance Abuse. “This is why WHO is supporting countries in fighting stigma as a key activity to increasing access to treatment.”
Cultural attitudes and lack of proper understanding of the condition contribute to a reluctance to seek help for depression.
Depression common in all regions
WHO estimates suggest that depression is common in all regions of the world. A recent study supported by WHO revealed that around 5% of people in the community had depression during the last year.
Depression results from a complex interaction of social, psychological and biological factors. There is a relationship between depression and physical health, for example cardiovascular disease can lead to depression and vice versa. Up to one in five women who give birth experience post-partum depression.
In addition, circumstances such as economic pressures, unemployment, disasters, and conflict can also increase the risk of the disorder. At its worst, depression can lead to suicide. Tragically almost one million people commit suicide every year and a large proportion of them had experienced depression.
WHO response
WHO assists governments in including treatment of depression in their basic health care packages. Through WHO’s Mental Health Gap Action Programme (mhGAP), health workers in low-income countries are trained to recognize mental disorders and provide proper care, psychosocial assistance and medication to people with depression.
World Mental Health Day was initiated by the World Federation for Mental Health in 1992. The day is used by many countries and organizations to raise public awareness about mental health issues and to promote open discussion of mental disorders, and investments in prevention, promotion and treatment services.
For further information please contact:
Tarik Jasarevic
WHO Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 79 367 6214
E-mail: [email protected]
Dr Shekhar Saxena
Director
WHO Department for Mental Health and Substance Abuse
Mobile: +41 79 30 89 865
E-mail: [email protected]
Dr Mohammad Taghi Yasamy
Medical Officer
WHO Department for Mental Health and Substance Abuse
Telephone: +41 22 791 2677
E-mail: [email protected]
- vladimir
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I kind of agree with Ben, but I would not be averse to ruling out alternative treatments, especially acupuncture.
Western medicine/psychoanalysis has been touted as a panacea: visit a mental hospital, any mental hospital, and experience their many failures.
Western medicine/psychoanalysis has been touted as a panacea: visit a mental hospital, any mental hospital, and experience their many failures.
ירי ילדים והפצצת אזרחים דורש אומץ, כמו גם הטרדה מינית של עובדי ההוראה.
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Actually, GavinMac, your comment made me laugh. Thanks for your concern! I gotta go now but I am so grateful for all your answers and I will definitely write more tomorrow!gavinmac wrote:Uncle Monty wrote:diamondlady. as you must be aware nutrition research and practise is damned by a lot of pseudoscience, thus GavinMac's scepticism is to be expected.
Hey, I have nothing against nutrition practice. I believe in the five food groups, the value of a balanced diet, and not eating soup right before you go out drinking beer.
My concern is that Andrea may be certifiably crazy. Let's face it; just about all expats in Phnom Penh are depressed. The fact that Andrea would publicly state that she is depressed and seek treatment for it (despite the expats' well known aversion to spending any money on anything) means that she is probably totally bonkos. She might need prompt intervention from a real psychologist to prevent her from jumping of the Chrouy Changvar bridge or shooting a bunch of tuk tuk drivers from the top of Sorya Mall.
She should go to a real psychologist, or a team of psychologists (preferably from Vienna). She shouldn't wait three months for a nutrition student who is offering a "free consultation."
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Dear vladimir,vladimir wrote:I kind of agree with Ben, but I would not be averse to ruling out alternative treatments, especially acupuncture.
Western medicine/psychoanalysis has been touted as a panacea: visit a mental hospital, any mental hospital, and experience their many failures.
I have nothing against acupuncture or nutrition advices but show me evidence-based studies about the effectiveness of acupuncture or nutrition advices in regard to treatment of depression. They don't exist.
With cognitive behavioral therapy (CBT) and antidepressant medication 90% of the people who have a depression recover within 6 months.
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Considering you have close to no idea of my background, experience, and what advice I would give to a sufferer of depression, this comment seems rather strange to me. I'd go so far as to say aggressive.BenvandenBussche wrote:Dear diamond lady,
I the country where I come from Holland, you probably would have been accused of being a charlatan. You are not a qualified mental health professional. Many of these charlatans end up in jail in Holland.
Not sure what your point here is? I don't recall claiming I was going to treat 350M people suffering from depression. Feel free to refer back to the post where I did.BenvandenBussche wrote:Are you going to treat the 350 million people who suffer depression with nutrition advices?
Or is your point that only medication and therapy are valid therapies for depression?
If your point is that depression is common and becoming increasingly prevalant, then we are on the same page. However, I doubt the 350M statistic is accurate. As you will know, many people hide a condition such as depression because of shame. The real number of people affected is probably much, much higher than 350M.
Many (educated) MDs prescribe supplemental nutrients such as omega 3 and magnesium for mood disorders. But because they are MDs, they're not charlatans, eh...?
And if the studies were to follow them up 12 -24 months later - and let's face it, most don't - how many will have relapsed?benvandenBussche wrote:With cognitive behavioral therapy (CBT) and antidepressant medication 90% of the people who have a depression recover within 6 months.
I have read plenty of literature on CBT for anxiety disorders and spoken with many people who've had CBT for severe anxiety disorders, though not for depression. The literature shows CBT is effective for about 60-70% of sufferers and many then relapse within 12 months. And talk to the sufferers themselves and most will say they relapsed within 12 months or less.
CBT is a tool for sure, and one that helps many people. But it's not 'the' answer, and it doesn't work for everyone. Same with SSRIs, but that's a whole other topic.
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^This statement is blatantly incorrect.BenvandenBussche wrote:Show me evidence-based studies about the effectiveness of... nutrition advices in regard to treatment of depression. They don't exist.
Here are just a few of many, many studies that show nutrient therapy can improve depression and other mental illnesses. Google Scholar can help you find more.
Omega-3 Treatment of Childhood Depression: A Controlled, Double-Blind Pilot Study
http://ajp.psychiatryonline.org/article ... leid=96721
Because of success in a previous study on omega-3 fatty acids in adult major depressive disorder, the authors planned a pilot study of omega-3 fatty acids in childhood major depression.
Results: Analysis of variance showed highly significant effects of omega-3 on symptoms using the CDRS, CDI, and CGI.
Conclusions: Omega-3 fatty acids may have therapeutic benefits in childhood depression.
Addition of Omega-3 Fatty Acid to Maintenance Medication Treatment for Recurrent Unipolar Depressive Disorderhttp://ajp.psychiatryonline.org/article ... eID=175405
RESULTS: Highly significant benefits of the addition of the omega-3 fatty acid compared with placebo were found by week 3 of treatment.
Studies have reported that countries with high rates of fish oil consumption have low rates of depressive disorder (2). One controlled double-blind trial (3) found marked therapeutic efficacy and no side effects of omega-3 fatty acids in the prevention of bipolar manic-depressive illness.
Several studies of omega-3 fatty acids have been performed in behavioral disorders and have found few side effects (4). There is evidence suggesting that omega-3 has an effect on human CSF serotonin metabolites (5). Edwards et al. (6) reported changes in fatty acid levels in the diet and red blood cells of depressed patients. Maes et al. (7) reported changes in serum fatty acid composition in depressive disorder. Severus et al. (8) proposed that omega-3 fatty acids are the mechanistic "missing link" connecting cardiovascular disease and depressive disorder, representing a key pathophysiological clue to the mechanism of depressive disorder.
Omega-3 Polyunsaturated Essential Fatty Acid Status as a Predictor of Future Suicide Risk]
http://ajp.psychiatryonline.org/article ... leID=96724
Conclusions: A low docosahexaenoic acid percentage and low omega-3 proportions of lipid profile predicted risk of suicidal behavior among depressed patients over the 2-year period. If confirmed, this finding would have implications for the neurobiology of suicide and reduction of suicide risk.
Omega-3 Fatty Acid Treatment of Women With Borderline Personality Disorder: A Double-Blind, Placebo-Controlled Pilot Study
http://ajp.psychiatryonline.org/article ... eid=175972
In cross-national studies, greater seafood consumption was associated with lower rates of bipolar disorder (30-fold range) and major depression (50-fold range) (2). In placebo-controlled trials, a mixture of these fatty acids was found to be an effective adjunctive agent for patients suffering from bipolar disorder (3), and ethyl-eicosapentaenoic acid (E-EPA) was found to have a beneficial adjunctive effect for patients suffering from recurrent depression (4).
Nutrition and Depression: The Role of Folate
http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract
Depressive symptoms are the most common neuropsychiatric manifestation of folate deficiency. Conversely, borderline low or deficient serum or red blood cell folate levels have been detected in 15–38% of adults diagnosed with depressive disorders.
Recently, low folate levels have been linked to poorer antidepressant response to selective serotonin reuptake inhibitors.
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Dear diamond lady,
American Psychiatric Association guidelines treatment of Major Depressive Episode:
The acute phase of treatment lasts a minimum of 6–12 weeks. During this phase, the aims of treatment are to induce remission of symptoms and achieve a full return to the patient's baseline level of functioning. In addition to general psychiatric management (described in Section II.A), treatment may consist of pharmacotherapy or other somatic therapies (e.g., ECT, light therapy), depression-focused psychotherapy, or the combination of somatic and psychosocial therapies. Selection of an initial treatment modality is influenced by several factors, including the symptom profile, the presence of co-occurring disorders or psychosocial stressors, the patient's prior treatment experience, and the patient's preference.
Psychiatrists should present patients with information concerning the evidence for a broad range of treatment options, including somatic therapies and psychosocial interventions. Antidepressant medications can be used as an initial treatment modality by patients with mild, moderate, or severe major depressive disorder. Clinical features that may suggest that medications are the preferred treatment modality include a history of prior positive response to antidepressant medications, the presence of moderate to severe symptoms, significant sleep or appetite disturbances, agitation, patient preference, and anticipation of the need for maintenance therapy. Patients with major depressive disorder with psychotic features require either the combined use of antidepressant and antipsychotic medications or ECT.
Psychotherapy may also be considered as monotherapy for patients with mild to moderate major depressive disorder. The availability of clinicians with appropriate training and expertise in specific psychotherapeutic approaches can be a factor in choosing a psychotherapy (67). Other factors that can influence this choice may be the psychosocial context, patient preference, prior positive response to psychotherapy, the presence of significant psychosocial stressors or interpersonal difficulties, co-occurring Axis II disorders, or the stage, chronicity, and severity of the major depressive episode. Specifically, many severely depressed patients will require both a depression-focused psychotherapy and a somatic treatment such as pharmacotherapy. Pregnancy, lactation, or the wish to become pregnant may tilt a decision toward psychotherapy as an initial treatment (see Section III.B.6). Given the lower occurrence of side effects and suggestion of enduring benefits associated with depression-focused psychotherapies (68), such treatments might be preferable alternatives to pharmacotherapy for some patients with mild to moderate depression.
Combining a depression-focused psychotherapy and pharmacotherapy may be a useful initial treatment choice for patients with moderate to severe major depressive disorder. Other indications for combined treatment include chronic forms of depression, psychosocial issues, intrapsychic conflict, interpersonal problems, or a co-occurring Axis II disorder. In addition, patients who have had a history of only partial response to adequate trials of single treatment modalities may benefit from combined treatment. Poor adherence with pharmacotherapy may also warrant combined treatment with medications and psychotherapy focused on treatment adherence.
Electroconvulsive therapy should be considered as a potential treatment option for all patients with major depressive disorder who have psychotic features or catatonia and for those with an urgent need for response, such as patients who are suicidal or who are nutritionally compromised as a result of refusing food. Electroconvulsive therapy may also be the treatment modality of choice for patients with major depressive disorder who have a high degree of symptom severity. Other considerations include the presence of co-occurring general medical conditions that preclude the use of antidepressant medications, a prior history of positive response to ECT, and patient preference. Evidence for TMS is currently insufficient to support its use in the initial treatment of major depressive disorder.
If a patient with mild depression wishes to try exercise alone for several weeks as a first intervention, there is little to argue against it (Section II.A.10), provided the patient is sufficiently monitored for an abrupt worsening of mood or adverse physical effects (e.g., ischemia or musculoskeletal symptoms). The dose of exercise and adherence to an exercise regimen may be particularly important to monitor in the assessment of whether an exercise intervention is useful for major depressive disorder (69, 70). If mood fails to improve after a few weeks with exercise alone, the psychiatrist should recommend medication or psychotherapy. For patients with depression of any severity and no medical contraindication to exercise, physical activity is a reasonable addition to a treatment plan for major depressive disorder. The optimal regimen is one the patient prefers and will adhere to.
Figure 1 summarizes treatment modalities that may be appropriate during the acute phase of treatment depending on the severity of the patient's symptoms and other associated features of the depressive episode. It is important to note that other factors may be relevant to treatment decisions for individual patients and that determinations of episode severity are imprecise, although rating scales may be helpful in assessing the magnitude of depressive symptoms and their effects on functional status and quality of life (see Sections II.A.7 and II.A.8).
American Psychiatric Association guidelines treatment of Major Depressive Episode:
The acute phase of treatment lasts a minimum of 6–12 weeks. During this phase, the aims of treatment are to induce remission of symptoms and achieve a full return to the patient's baseline level of functioning. In addition to general psychiatric management (described in Section II.A), treatment may consist of pharmacotherapy or other somatic therapies (e.g., ECT, light therapy), depression-focused psychotherapy, or the combination of somatic and psychosocial therapies. Selection of an initial treatment modality is influenced by several factors, including the symptom profile, the presence of co-occurring disorders or psychosocial stressors, the patient's prior treatment experience, and the patient's preference.
Psychiatrists should present patients with information concerning the evidence for a broad range of treatment options, including somatic therapies and psychosocial interventions. Antidepressant medications can be used as an initial treatment modality by patients with mild, moderate, or severe major depressive disorder. Clinical features that may suggest that medications are the preferred treatment modality include a history of prior positive response to antidepressant medications, the presence of moderate to severe symptoms, significant sleep or appetite disturbances, agitation, patient preference, and anticipation of the need for maintenance therapy. Patients with major depressive disorder with psychotic features require either the combined use of antidepressant and antipsychotic medications or ECT.
Psychotherapy may also be considered as monotherapy for patients with mild to moderate major depressive disorder. The availability of clinicians with appropriate training and expertise in specific psychotherapeutic approaches can be a factor in choosing a psychotherapy (67). Other factors that can influence this choice may be the psychosocial context, patient preference, prior positive response to psychotherapy, the presence of significant psychosocial stressors or interpersonal difficulties, co-occurring Axis II disorders, or the stage, chronicity, and severity of the major depressive episode. Specifically, many severely depressed patients will require both a depression-focused psychotherapy and a somatic treatment such as pharmacotherapy. Pregnancy, lactation, or the wish to become pregnant may tilt a decision toward psychotherapy as an initial treatment (see Section III.B.6). Given the lower occurrence of side effects and suggestion of enduring benefits associated with depression-focused psychotherapies (68), such treatments might be preferable alternatives to pharmacotherapy for some patients with mild to moderate depression.
Combining a depression-focused psychotherapy and pharmacotherapy may be a useful initial treatment choice for patients with moderate to severe major depressive disorder. Other indications for combined treatment include chronic forms of depression, psychosocial issues, intrapsychic conflict, interpersonal problems, or a co-occurring Axis II disorder. In addition, patients who have had a history of only partial response to adequate trials of single treatment modalities may benefit from combined treatment. Poor adherence with pharmacotherapy may also warrant combined treatment with medications and psychotherapy focused on treatment adherence.
Electroconvulsive therapy should be considered as a potential treatment option for all patients with major depressive disorder who have psychotic features or catatonia and for those with an urgent need for response, such as patients who are suicidal or who are nutritionally compromised as a result of refusing food. Electroconvulsive therapy may also be the treatment modality of choice for patients with major depressive disorder who have a high degree of symptom severity. Other considerations include the presence of co-occurring general medical conditions that preclude the use of antidepressant medications, a prior history of positive response to ECT, and patient preference. Evidence for TMS is currently insufficient to support its use in the initial treatment of major depressive disorder.
If a patient with mild depression wishes to try exercise alone for several weeks as a first intervention, there is little to argue against it (Section II.A.10), provided the patient is sufficiently monitored for an abrupt worsening of mood or adverse physical effects (e.g., ischemia or musculoskeletal symptoms). The dose of exercise and adherence to an exercise regimen may be particularly important to monitor in the assessment of whether an exercise intervention is useful for major depressive disorder (69, 70). If mood fails to improve after a few weeks with exercise alone, the psychiatrist should recommend medication or psychotherapy. For patients with depression of any severity and no medical contraindication to exercise, physical activity is a reasonable addition to a treatment plan for major depressive disorder. The optimal regimen is one the patient prefers and will adhere to.
Figure 1 summarizes treatment modalities that may be appropriate during the acute phase of treatment depending on the severity of the patient's symptoms and other associated features of the depressive episode. It is important to note that other factors may be relevant to treatment decisions for individual patients and that determinations of episode severity are imprecise, although rating scales may be helpful in assessing the magnitude of depressive symptoms and their effects on functional status and quality of life (see Sections II.A.7 and II.A.8).
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Hmm, still no apology or explanation for that blatantally inaccurate statement that evidence for the efficacy of nutrition in treating depression "doesn't exist".
I cannot believe you would belittle nutrition yet advocate electroconvulsive shock therapy. Actually, I can.
I cannot believe you would belittle nutrition yet advocate electroconvulsive shock therapy. Actually, I can.
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I recently re-visited Holland and I would probably get depressed if I stay there...BenvandenBussche wrote: I the country where I come from Holland, you probably would have been accused of being a charlatan. You are not a qualified mental health professional. Many of these charlatans end up in jail in Holland.
Good nutrician is of course essential in prevention, not a fast cure IMO. Other well-knows causes are hanging out with the wrong people... for too long.
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Dear diamond lady,diamond lady wrote:^This statement is blatantly incorrect.BenvandenBussche wrote:Show me evidence-based studies about the effectiveness of... nutrition advices in regard to treatment of depression. They don't exist.
Here are just a few of many, many studies that show nutrient therapy can improve depression and other mental illnesses. Google Scholar can help you find more.
Omega-3 Treatment of Childhood Depression: A Controlled, Double-Blind Pilot Study
http://ajp.psychiatryonline.org/article ... leid=96721
Because of success in a previous study on omega-3 fatty acids in adult major depressive disorder, the authors planned a pilot study of omega-3 fatty acids in childhood major depression.
Results: Analysis of variance showed highly significant effects of omega-3 on symptoms using the CDRS, CDI, and CGI.
Conclusions: Omega-3 fatty acids may have therapeutic benefits in childhood depression.
Addition of Omega-3 Fatty Acid to Maintenance Medication Treatment for Recurrent Unipolar Depressive Disorderhttp://ajp.psychiatryonline.org/article ... eID=175405
RESULTS: Highly significant benefits of the addition of the omega-3 fatty acid compared with placebo were found by week 3 of treatment.
Studies have reported that countries with high rates of fish oil consumption have low rates of depressive disorder (2). One controlled double-blind trial (3) found marked therapeutic efficacy and no side effects of omega-3 fatty acids in the prevention of bipolar manic-depressive illness.
Several studies of omega-3 fatty acids have been performed in behavioral disorders and have found few side effects (4). There is evidence suggesting that omega-3 has an effect on human CSF serotonin metabolites (5). Edwards et al. (6) reported changes in fatty acid levels in the diet and red blood cells of depressed patients. Maes et al. (7) reported changes in serum fatty acid composition in depressive disorder. Severus et al. (8) proposed that omega-3 fatty acids are the mechanistic "missing link" connecting cardiovascular disease and depressive disorder, representing a key pathophysiological clue to the mechanism of depressive disorder.
Omega-3 Polyunsaturated Essential Fatty Acid Status as a Predictor of Future Suicide Risk]
http://ajp.psychiatryonline.org/article ... leID=96724
Conclusions: A low docosahexaenoic acid percentage and low omega-3 proportions of lipid profile predicted risk of suicidal behavior among depressed patients over the 2-year period. If confirmed, this finding would have implications for the neurobiology of suicide and reduction of suicide risk.
Omega-3 Fatty Acid Treatment of Women With Borderline Personality Disorder: A Double-Blind, Placebo-Controlled Pilot Study
http://ajp.psychiatryonline.org/article ... eid=175972
In cross-national studies, greater seafood consumption was associated with lower rates of bipolar disorder (30-fold range) and major depression (50-fold range) (2). In placebo-controlled trials, a mixture of these fatty acids was found to be an effective adjunctive agent for patients suffering from bipolar disorder (3), and ethyl-eicosapentaenoic acid (E-EPA) was found to have a beneficial adjunctive effect for patients suffering from recurrent depression (4).
Nutrition and Depression: The Role of Folate
http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract
Depressive symptoms are the most common neuropsychiatric manifestation of folate deficiency. Conversely, borderline low or deficient serum or red blood cell folate levels have been detected in 15–38% of adults diagnosed with depressive disorders.
Recently, low folate levels have been linked to poorer antidepressant response to selective serotonin reuptake inhibitors.
Do countries with high rates of fish oil consumption (for example Japan) have low rates of depressive disorder? No:
Depression is a national ailment that demands open recognition in Japan
by Roger Pulvers
Special To The Japan Times
Feb 12, 2012
The greatest public health issue facing the people of Japan today is not cancer. It is not vascular diseases than can cause heart attacks and strokes. It is not the prevalence of Alzheimer’s disease in the ever-rising number of the elderly.
It is depression in its many forms and guises.
Depression is the big gorilla on the basketball court, the one that’s stealing the ball but isn’t seen because everyone is willfully looking the other way.
The causes of depression can be biological, psychological, social or a combination of these. It affects young people to a much greater degree than they or their elders imagine. The elderly are particularly vulnerable. In fact, according to the Health and Consumer Protection Directorate-General of the European Commission, “depressive illness is the most frequent mental disorder among older people.”
Name any significant social problem — alcoholism and other drug-related illnesses, homelessness, teenage pregnancies, self-harm, domestic violence, child abuse, suicide — and you are more than likely to find some form of depression or serious mood disorder as a cause.
According to the World Health Organization, the international health burden brought on by clinical depression is enormous when measured by “cause of death, disability, incapacity to work and the use of medical resources.” And this does not take into account the hidden costs, such as those borne by unpaid caregivers, nor the heartrending toll on sufferers’ families.
Here in Japan, where a conservative estimate is that 1 in 5 people will experience one or another form of depression in their lifetime, the abiding societal postulate is: Keep it to yourself (KITY). In fact, this principle is applicable to the appearance of many social ills. If you don’t ask and you don’t tell, then it’s as if through such deceptions the problem will somehow slip below the tatami and disappear from sight.
Whether you analyze this national trait as coming from an ancient Buddhist notion according to which victims and their family are “responsible” for a blight, or simply as a factor of garden-variety prejudice against anything smacking of “abnormality,” this society has long stigmatized anyone who might put a blot on the veneer of decorous harmony.
So, in actual fact, the working precept here is stigmatization. If you stigmatize someone in their milieu, they generally go away and hide (or die). Once they stigmatize themselves, you don’t need to bother anymore. You can even pretend to be tolerant. It works like a charm.
Kenzo Denda, of the Department of Psychiatry at Hokkaido University Graduate School of Medicine, has reported that 1 in 12 elementary school pupils suffers from depression, while at the middle-school level the figure may be as high as 1 in 4. Studies show that at least one-third of the prison population is made up of the clinically depressed.
Statistics on depression for Japan are very similar to those in the developed West. Statistics published by the Japan Committee for Prevention and Treatment of Depression (JCPTD) show that 6.6 percent of Japanese have depression, while every year the reported incidence is 2.1 percent. The breakdown by gender is also similar to that in the West: Women with depression outnumber male sufferers by about 3 to 1. In the West, the incidence of depression is particularly high in the young, while in Japan, says the JCPTD, it is spread among young and old.
But these comparative statistics can be misleading. A joint Japan-Australia survey on mental health conducted in 2003 and 2004 indicated that, in the case of Japan, a great many actual cases of depression were put in the category of “psychological problems and stress.”
Recognition is the crux of the problem. While big strides have been made in the treatment of depression in Japan over recent years, thanks in part to effective new drugs, the recognition of depression at the primary-care level is inadequate. General practitioners are not sufficiently trained to recognize depression. They too often attribute symptoms to other illnesses. The KITY meme exacerbates this. Japanese tend to be too reticent to divulge their true anxieties to anyone.
There has been an overemphasis in this country on male problems based on the stresses and strains of employment. Japanese women are traditionally told to grin and bear their suffering and not overburden others with their personal problems. Don’t nag. Don’t whinge. Just pull yourself together, sigh a big sigh and get on with your tasks.
Active for the last 40 years, JCPTD has held countless conferences, meetings and forums for health professionals and the public. The organization is proactive in trying to train doctors to recognize depression when they see it. National broadcaster NHK’s educational channel has also had some amazingly frank shows about depression — including one in which female sufferers admitted to having sex with a great number of men in order to bolster their self-esteem. The courage of these women, who appeared under their own names, would be astounding in any country — let alone in Japan, where appearances count for so much.
But Japanese society will not come to terms with depression until very high-profile sufferers — whether royalty, movie stars or politicians — come out from behind the folding screen and openly talk about their illness. (Some people in show business have done this; and this has had a beneficial effect on public awareness.)
The task ahead for Japan is the total destigmatization of depression. This can only be achieved by opening the closet door and sharing the burden of illness throughout the entire society.
Writing in the February issue of the Japanese monthly news and current affairs magazine Wedge, freelance journalist Ryutaro Kaibe points out that every year between 800,000 and 1.2 million Japanese quit or stay away from work because of depression. The annual cost to the nation is an estimated ¥2.7 trillion.
To such costs must be added the human costs of suicides stemming from depression. Conservatively, 30 percent of the annual toll — more than 30,000 dead for 13 consecutive years — is due to depression. Most estimates indicate half, while some go as high as 80 percent to 90 percent.
It may be the sense of dignified self-restraint and prim respectability that compel Japanese people — particularly, as tradition has dictated, women — to de-emphasize their needs and display only the mildest forms of “proper” embarrassment. But when it comes to depression and the immense toll it is inflicting on individuals and society, it is time to abandon these shared virtues and go public.
Without mass public recognition of this ubiquitous problem, the good work being done by the psychiatric profession and NHK will prove ineffective.
As much as two-thirds of psychiatric disorders go untreated; and only one-fourth of sufferers receive some sort of medical help. This would imply that millions of people are still forced to suffer in silence.
All this makes depression the least prominent and most grave public health problem in the nation. Neglecting the people who need immediate treatment and care puts their lives in danger. It also imposes on all citizens an onus of silent guilt and widespread misfortune that can never be lifted.
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Funny you use Japan as an example and back your example with a media article, because the the DALY measure, developed by Harvard and used by WHO (who you seem to admire) shows Japan is waaaay at the bottom of the scale.
http://en.wikipedia.org/wiki/Epidemiology_of_depression
I don't believe the researchers claimed that countries with higher rates of fish consumption have zero depression, but that they have lower rates.
It would not surprise me that the Japanese are experiencing increasing ill health. Much has been said and written about the fact the country has in recent years moved away from its traditional, healthy diet and begun to embrace a lot of Western fast food. Of course there are going to be consequences of this.
Still waiting for that retraction. Won't hold my breath though : ) Personally, I am wary of any health professional who makes such a blatantly false statement and then can't say "Ok, so I was wrong."
http://en.wikipedia.org/wiki/Epidemiology_of_depression
I don't believe the researchers claimed that countries with higher rates of fish consumption have zero depression, but that they have lower rates.
It would not surprise me that the Japanese are experiencing increasing ill health. Much has been said and written about the fact the country has in recent years moved away from its traditional, healthy diet and begun to embrace a lot of Western fast food. Of course there are going to be consequences of this.
Still waiting for that retraction. Won't hold my breath though : ) Personally, I am wary of any health professional who makes such a blatantly false statement and then can't say "Ok, so I was wrong."