标题: Forwarding Articles Related to Depression [打印本页] 作者: Charle Z. Song 时间: 05-11-29 18:13 标题: Forwarding Articles Related to Depression 首页->生活版塊 ->【憂鬱症】 您是本站第75730位贵宾
作者: Fei Wang 时间: 05-12-5 07:21
http://www.isitreallydepression.com/mini_c/isitreallydepression/righttreatment.asp
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Antidepressants in bipolar disorder
Treatments for bipolar disorder
The professionals who treat bipolar disorder
Antidepressants in bipolar disorder
For people who are correctly diagnosed with depression (major depressive disorder), antidepressant medications are often highly effective. But in individuals who have bipolar disorder, antidepressants can sometimes do more harm than good when they are not used appropriately.* That’s one reason why getting a correct diagnosis is so important.
A few facts:
Antidepressants may trigger manic episodes in people with bipolar disorder
Antidepressants may not work well (or at all) in bipolar individuals. Poor response to antidepressants could be a sign that the diagnosis of major depressive disorder is incorrect
Important: For people with major depressive disorder, antidepressants must be taken regularly for three to four weeks (sometimes longer) before the full response is seen. It is important to give the medication a chance to work.
These items stress the importance of open communication with your doctor; be sure to discuss concerns you may have about your treatment plan during your next visit.
*Note that in some people with diagnosed bipolar disorder, antidepressants are sometimes used in combination with bipolar medications.
Treatments for bipolar disorder
Treatment for bipolar disorder often involves a two-part plan of both medication and psychotherapy.
Medications. There are different types of medications used to treat bipolar disorder, including medicines for controlling manic symptoms, depressive symptoms, or medications that help stabilize the patient's mood
Psychotherapy. Several types of “talk therapy” are used in bipolar disorder treatment. Cognitive behavioral therapy focuses on changing inappropriate or negative thought patterns that can affect the illness. Psychoeducation aims to help the patient and family understand the illness and recognize signs of relapse. Interpersonal and social rhythm therapy, focuses on daily routines that can promote emotional stability. The type of therapy used depends on the individual’s needs
The professionals who treat bipolar disorder
Bipolar disorder patients work with a team of health care professionals that supervise the patients' care. For medication management, patients usually work with their psychiatrist. For psychotherapy, patients typically work with a licensed therapist or social worker and their psychiatrist. The health care team maintains close contact with each other to help ensure the patients' continued progress.
Not sure where to find help? Start with your primary care provider. He or she can discuss symptoms, give you guidance and recommend psychiatrists and/or therapists in your area.
Important: Even if you think you may not be diagnosed correctly it is extremely important to follow your current medication plan as prescribed by your doctor. If you have concerns about your medicine—or if you feel you are doing better—don’t stop treatment on your own. Instead, communicate openly with your doctor and discuss your diagnosis and possible adjustments to your treatment plan.作者: Fei Wang 时间: 05-12-6 18:14
Translated by Kathy: thanks a lot!!!
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躁郁症
抗抑郁药物在躁郁症中的作用 对于被正确诊断为抑郁症的人来说，抗抑郁药物能起到非常好的作用。但是对于躁郁症患者，抗抑郁药物如果使用不当，它对病人带来的危害要比益处大。这也就是为什么正确的诊断尤为重要。 以下是一些事实： 抗抑郁药物会引起躁郁症患者的躁狂相 抗抑郁药物也许或根本在躁郁患者上不起作用。对所服抗抑郁药物的反应不佳也许是对抑郁症诊断不正确的一个标志。 重要的是：对于抑郁症患者，抗抑郁药物必须定期服用3-4周左右，有时会更长，才会看到药效。必须给药物时间让其发挥作用。 以上这些说明了患者和医生之间沟通的重要性；记得在下次看医生之前想好应向医生咨询哪些关于治疗方案方面的问题。 注意：被诊断为躁郁症的人来说，抗抑郁药有时要连同抗躁郁药一起服用。 对躁郁症的治疗 对躁郁症的治疗经常要包括药物和心理两方面的治疗。 药物治疗：有多种的药物治疗用来医治躁郁症，包括控制躁狂症状，抑郁症|状，或帮助患者稳定情绪。 心理治疗：有多种的“谈话疗法”被应用于躁郁症的治疗。认知行为疗法注重改变会对疾病产生影响的不当的或是负面的思维模式。心理学方法教育在于帮助患者和家属了解疾病以及更好的认识疾病的复发。人际关系与社会节律疗法侧重于患者每日的日常活动，从而增进他们的情感稳定性。这种治疗取决于个人的需求。 治疗躁郁症的专业人士 躁郁症患者要在专业人士的指导下进行治疗。对于药物方面，患者应配合精神科医师，在心理治疗方面，患者通常应在有行医执照的心理治疗师或精神科医生的指导下进行治疗。健康指导工作小组应和患者保持紧密的联系并注意患者病情的进展。 不知道去哪里寻找帮助吗？从你身边最初级的健康保健人士那里可以获得一些相关信息。他们会告诉你一些病情的基本特征，给你一些最初级的指导，并会向你推荐一些精神科医生或心理治疗师。 重要的是：即使你认为自己被诊断得并不正确，也一定要遵循医生给你制定的治疗方案。如果你对你所服用的药物有所担心-或是觉得你在渐渐好转—不要停止对自己的治疗。反之，要及时和你的医生沟通，并做出相应的调整。作者: Fei Wang 时间: 05-12-6 18:25
Dear All who know English:
Please translate the fllowing article into Chinese, i will publish ALL of the translations, people will learn English as well as the knowledge, thanks!!!!!!!!!!!!!!!!!!!!!!!!!!!
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Depression Introduction
What is a Depressive Disorder?
Types of Depression
Symptoms of Depression and Mania
Causes of Depression
Diagnostic Evaluation and Treatment
Psychotherapies
How to Help Yourself If You Are Depressed
Where to Get Help
Further Information
References
In any given 1-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from a depressive illness5 The economic cost for this disorder is high, but the cost in human suffering cannot be estimated. Depressive illnesses often interfere with normal functioning and cause pain and suffering not only to those who have a disorder, but also to those who care about them. Serious depression can destroy family life as well as the life of the ill person. But much of this suffering is unnecessary.
Most people with a depressive illness do not seek treatment, although the great majority—even those whose depression is extremely severe—can be helped. Thanks to years of fruitful research, there are now medications and psychosocial therapies such as cognitive/behavioral, "talk" or interpersonal that ease the pain of depression.
Unfortunately, many people do not recognize that depression is a treatable illness. If you feel that you or someone you care about is one of the many undiagnosed depressed people in this country, the information presented here may help you take the steps that may save your own or someone else's life.
WHAT IS A DEPRESSIVE DISORDER?
A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.
TYPES OF DEPRESSION
Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease. This pamphlet briefly describes three of the most common types of depressive disorders. However, within these types there are variations in the number of symptoms, their severity, and persistence.
Major depression is manifested by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.
SYMPTOMS OF DEPRESSION AND MANIA
Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.
Depression
Persistent sad, anxious, or "empty" mood
Feelings of hopelessness, pessimism
Feelings of guilt, worthlessness, helplessness
Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
Decreased energy, fatigue, being "slowed down"
Difficulty concentrating, remembering, making decisions
Insomnia, early-morning awakening, or oversleeping
Appetite and/or weight loss or overeating and weight gain
Thoughts of death or suicide; suicide attempts
Restlessness, irritability
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Mania
Abnormal or excessive elation
Unusual irritability
Decreased need for sleep
Grandiose notions
Increased talking
Racing thoughts
Increased sexual desire
Markedly increased energy
Poor judgment
Inappropriate social behavior
CAUSES OF DEPRESSION
Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill. However, the reverse is not true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.
In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function.
People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Whether this represents a psychological predisposition or an early form of the illness is not clear.
In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Later episodes of illness typically are precipitated by only mild stresses, or none at all.
Depression in Women
Women experience depression about twice as often as men.1 Many hormonal factors may contribute to the increased rate of depression in women—particularly such factors as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause. Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents.
A recent NIMH study showed that in the case of severe premenstrual syndrome (PMS), women with a preexisting vulnerability to PMS experienced relief from mood and physical symptoms when their sex hormones were suppressed. Shortly after the hormones were re-introduced, they again developed symptoms of PMS. Women without a history of PMS reported no effects of the hormonal manipulation.6,7
Many women are also particularly vulnerable after the birth of a baby. The hormonal and physical changes, as well as the added responsibility of a new life, can be factors that lead to postpartum depression in some women. While transient "blues" are common in new mothers, a full-blown depressive episode is not a normal occurrence and requires active intervention. Treatment by a sympathetic physician and the family's emotional support for the new mother are prime considerations in aiding her to recover her physical and mental well-being and her ability to care for and enjoy the infant.
Depression in Men
Although men are less likely to suffer from depression than women, 3 to 4 million men in the United States are affected by the illness. Men are less likely to admit to depression, and doctors are less likely to suspect it. The rate of suicide in men is four times that of women, though more women attempt it. In fact, after age 70, the rate of men's suicide rises, reaching a peak after age 85.
Depression can also affect the physical health in men differently from women. A new study shows that, although depression is associated with an increased risk of coronary heart disease in both men and women, only men suffer a high death rate.2
Men's depression is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men. Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. Encouragement and support from concerned family members can make a difference. In the workplace, employee assistance professionals or worksite mental health programs can be of assistance in helping men understand and accept depression as a real illness that needs treatment.
Depression in the Elderly
Some people have the mistaken idea that it is normal for the elderly to feel depressed. On the contrary, most older people feel satisfied with their lives. Sometimes, though, when depression develops, it may be dismissed as a normal part of aging. Depression in the elderly, undiagnosed and untreated, causes needless suffering for the family and for the individual who could otherwise live a fruitful life. When he or she does go to the doctor, the symptoms described are usually physical, for the older person is often reluctant to discuss feelings of hopelessness, sadness, loss of interest in normally pleasurable activities, or extremely prolonged grief after a loss.
Recognizing how depressive symptoms in older people are often missed, many health care professionals are learning to identify and treat the underlying depression. They recognize that some symptoms may be side effects of medication the older person is taking for a physical problem, or they may be caused by a co-occurring illness. If a diagnosis of depression is made, treatment with medication and/or psychotherapy will help the depressed person return to a happier, more fulfilling life. Recent research suggests that brief psychotherapy (talk therapies that help a person in day-to-day relationships or in learning to counter the distorted negative thinking that commonly accompanies depression) is effective in reducing symptoms in short-term depression in older persons who are medically ill. Psychotherapy is also useful in older patients who cannot or will not take medication. Efficacy studies show that late-life depression can be treated with psychotherapy.4
Improved recognition and treatment of depression in late life will make those years more enjoyable and fulfilling for the depressed elderly person, the family, and caretakers.
Depression in Children
Only in the past two decades has depression in children been taken very seriously. The depressed child may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die. Older children may sulk, get into trouble at school, be negative, grouchy, and feel misunderstood. Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a child is just going through a temporary "phase" or is suffering from depression. Sometimes the parents become worried about how the child's behavior has changed, or a teacher mentions that "your child doesn't seem to be himself." In such a case, if a visit to the child's pediatrician rules out physical symptoms, the doctor will probably suggest that the child be evaluated, preferably by a psychiatrist who specializes in the treatment of children. If treatment is needed, the doctor may suggest that another therapist, usually a social worker or a psychologist, provide therapy while the psychiatrist will oversee medication if it is needed. Parents should not be afraid to ask questions: What are the therapist's qualifications? What kind of therapy will the child have? Will the family as a whole participate in therapy? Will my child's therapy include an antidepressant? If so, what might the side effects be?
The National Institute of Mental Health (NIMH) has identified the use of medications for depression in children as an important area for research. The NIMH-supported Research Units on Pediatric Psychopharmacology (RUPPs) form a network of seven research sites where clinical studies on the effects of medications for mental disorders can be conducted in children and adolescents. Among the medications being studied are antidepressants, some of which have been found to be effective in treating children with depression, if properly monitored by the child's physician.8
DIAGNOSTIC EVALUATION AND TREATMENT
The first step to getting appropriate treatment for depression is a physical examination by a physician. Certain medications as well as some medical conditions such as a viral infection can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist.
A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective.
Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness.
Treatment choice will depend on the outcome of the evaluation. There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders. Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression. Depending on the patient's diagnosis and severity of symptoms, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.
Electroconvulsive therapy (ECT) is useful, particularly for individuals whose depression is severe or life threatening or who cannot take antidepressant medication.3 ECT often is effective in cases where antidepressant medications do not provide sufficient relief of symptoms. In recent years, ECT has been much improved. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (about 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. For full therapeutic benefit, at least several sessions of ECT, typically given at the rate of three per week, are required.
Medications
There are several types of antidepressant medications used to treat depressive disorders. These include newer medications—chiefly the selective serotonin reuptake inhibitors (SSRIs)—the tricyclics, and the monoamine oxidase inhibitors (MAOIs). The SSRIs—and other newer medications that affect neurotransmitters such as dopamine or norepinephrine—generally have fewer side effects than tricyclics. Sometimes the doctor will try a variety of antidepressants before finding the most effective medication or combination of medications. Sometimes the dosage must be increased to be effective. Although some improvements may be seen in the first few weeks, antidepressant medications must be taken regularly for 3 to 4 weeks (in some cases, as many as 8 weeks) before the full therapeutic effect occurs.
Patients often are tempted to stop medication too soon. They may feel better and think they no longer need the medication. Or they may think the medication isn't helping at all. It is important to keep taking medication until it has a chance to work, though side effects (see section on Side Effects on page 13) may appear before antidepressant activity does. Once the individual is feeling better, it is important to continue the medication for at least 4 to 9 months to prevent a recurrence of the depression. Some medications must be stopped gradually to give the body time to adjust. Never stop taking an antidepressant without consulting the doctor for instructions on how to safely discontinue the medication. For individuals with bipolar disorder or chronic major depression, medication may have to be maintained indefinitely.
Antidepressant drugs are not habit-forming. However, as is the case with any type of medication prescribed for more than a few days, antidepressants have to be carefully monitored to see if the correct dosage is being given. The doctor will check the dosage and its effectiveness regularly.
For the small number of people for whom MAO inhibitors are the best treatment, it is necessary to avoid certain foods that contain high levels of tyramine, such as many cheeses, wines, and pickles, as well as medications such as decongestants. The interaction of tyramine with MAOIs can bring on a hypertensive crisis, a sharp increase in blood pressure that can lead to a stroke. The doctor should furnish a complete list of prohibited foods that the patient should carry at all times. Other forms of antidepressants require no food restrictions.
Medications of any kind—prescribed, over-the counter, or borrowed—should never be mixed without consulting the doctor. Other health professionals who may prescribe a drug—such as a dentist or other medical specialist—should be told of the medications the patient is taking. Some drugs, although safe when taken alone can, if taken with others, cause severe and dangerous side effects. Some drugs, like alcohol or street drugs, may reduce the effectiveness of antidepressants and should be avoided. This includes wine, beer, and hard liquor. Some people who have not had a problem with alcohol use may be permitted by their doctor to use a modest amount of alcohol while taking one of the newer antidepressants.
Antianxiety drugs or sedatives are not antidepressants. They are sometimes prescribed along with antidepressants; however, they are not effective when taken alone for a depressive disorder. Stimulants, such as amphetamines, are not effective antidepressants, but they are used occasionally under close supervision in medically ill depressed patients.
Questions about any antidepressant prescribed, or problems that may be related to the medication, should be discussed with the doctor.
Lithium has for many years been the treatment of choice for bipolar disorder, as it can be effective in smoothing out the mood swings common to this disorder. Its use must be carefully monitored, as the range between an effective dose and a toxic one is small. If a person has preexisting thyroid, kidney, or heart disorders or epilepsy, lithium may not be recommended. Fortunately, other medications have been found to be of benefit in controlling mood swings. Among these are two mood-stabilizing anticonvulsants, carbamazepine (Tegretol®) and valproate (Depakote®). Both of these medications have gained wide acceptance in clinical practice, and valproate has been approved by the Food and Drug Administration for first-line treatment of acute mania. Other anticonvulsants that are being used now include lamotrigine (Lamictal®) and gabapentin (Neurontin®): their role in the treatment hierarchy of bipolar disorder remains under study.
Most people who have bipolar disorder take more than one medication including, along with lithium and/or an anticonvulsant, a medication for accompanying agitation, anxiety, depression, or insomnia. Finding the best possible combination of these medications is of utmost importance to the patient and requires close monitoring by the physician.
Side Effects
Antidepressants may cause mild and, usually, temporary side effects (sometimes referred to as adverse effects) in some people. Typically these are annoying, but not serious. However, any unusual reactions or side effects or those that interfere with functioning should be reported to the doctor immediately. The most common side effects of tricyclic antidepressants, and ways to deal with them, are:
Dry mouth—it is helpful to drink sips of water; chew sugarless gum; clean teeth daily.
Constipation—bran cereals, prunes, fruit, and vegetables should be in the diet.
Bladder problems—emptying the bladder may be troublesome, and the urine stream may not be as strong as usual; the doctor should be notified if there is marked difficulty or pain.
Sexual problems—sexual functioning may change; if worrisome, it should be discussed with the doctor.
Blurred vision—this will pass soon and will not usually necessitate new glasses.
Dizziness—rising from the bed or chair slowly is helpful.
Drowsiness as a daytime problem—this usually passes soon. A person feeling drowsy or sedated should not drive or operate heavy equipment. The more sedating antidepressants are generally taken at bedtime to help sleep and minimize daytime drowsiness.
The newer antidepressants have different types of side effects:
Headache—this will usually go away.
Nausea—this is also temporary, but even when it occurs, it is transient after each dose.
Nervousness and insomnia (trouble falling asleep or waking often during the night)—these may occur during the first few weeks; dosage reductions or time will usually resolve them.
Agitation (feeling jittery)—if this happens for the first time after the drug is taken and is more than transient, the doctor should be notified.
Sexual problems—the doctor should be consulted if the problem is persistent or worrisome.
Herbal Therapy
In the past few years, much interest has risen in the use of herbs in the treatment of both depression and anxiety. St. John's wort (Hypericum perforatum), an herb used extensively in the treatment of mild to moderate depression in Europe, has recently aroused interest in the United States. St. John's wort, an attractive bushy, low-growing plant covered with yellow flowers in summer, has been used for centuries in many folk and herbal remedies. Today in Germany, Hypericum is used in the treatment of depression more than any other antidepressant. However, the scientific studies that have been conducted on its use have been short-term and have used several different doses.
Because of the widespread interest in St. John's wort, the National Institutes of Health (NIH) conducted a 3-year study, sponsored by three NIH components—the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, and the Office of Dietary Supplements. The study was designed to include 336 patients with major depression of moderate severity, randomly assigned to an 8-week trial with one-third of patients receiving a uniform dose of St. John's wort, another third sertraline, a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression, and the final third a placebo (a pill that looks exactly like the SSRI and the St. John's wort, but has no active ingredients). The study participants who responded positively were followed for an additional 18 weeks. At the end of the first phase of the study, participants were measured on two scales, one for depression and one for overall functioning. There was no significant difference in rate of response for depression, but the scale for overall functioning was better for the antidepressant than for either St. John's wort or placebo. While this study did not support the use of St. John's wort in the treatment of major depression, ongoing NIH-supported research is examining a possible role for St. John's wort in the treatment of milder forms of depression.
The Food and Drug Administration issued a Public Health Advisory on February 10, 2000. It stated that St. John's wort appears to affect an important metabolic pathway that is used by many drugs prescribed to treat conditions such as AIDS, heart disease, depression, seizures, certain cancers, and rejection of transplants. Therefore, health care providers should alert their patients about these potential drug interactions.
Some other herbal supplements frequently used that have not been evaluated in large-scale clinical trials are ephedra, gingko biloba, echinacea, and ginseng. Any herbal supplement should be taken only after consultation with the doctor or other health care provider.
PSYCHOTHERAPIES
Many forms of psychotherapy, including some short-term (10-20 week) therapies, can help depressed individuals. "Talking" therapies help patients gain insight into and resolve their problems through verbal exchange with the therapist, sometimes combined with "homework" assignments between sessions. "Behavioral" therapists help patients learn how to obtain more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to or result from their depression.
Two of the short-term psychotherapies that research has shown helpful for some forms of depression are interpersonal and cognitive/behavioral therapies. Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate (or increase) the depression. Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving often associated with depression.
Psychodynamic therapies, which are sometimes used to treat depressed persons, focus on resolving the patient's conflicted feelings. These therapies are often reserved until the depressive symptoms are significantly improved. In general, severe depressive illnesses, particularly those that are recurrent, will require medication (or ECT under special conditions) along with, or preceding, psychotherapy for the best outcome.
HOW TO HELP YOURSELF IF YOU ARE DEPRESSED
Depressive disorders make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime:
Set realistic goals in light of the depression and assume a reasonable amount of responsibility.
Break large tasks into small ones, set some priorities, and do what you can as you can.
Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
Participate in activities that may make you feel better.
Mild exercise, going to a movie, a ballgame, or participating in religious, social, or other activities may help.
Expect your mood to improve gradually, not immediately. Feeling better takes time.
It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective view of your situation.
People rarely "snap out of" a depression. But they can feel a little better day-by-day.
Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment.
Let your family and friends help you.
How Family and Friends Can Help the Depressed Person
The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks), or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication. The depressed person should be encouraged to obey the doctor's orders about the use of alcoholic products while on medication. The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Report them to the depressed person's therapist. Invite the depressed person for walks, outings, to the movies, and other activities. Be gently insistent if your invitation is refused. Encourage participation in some activities that once gave pleasure, such as hobbies, sports, religious or cultural activities, but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company, but too many demands can increase feelings of failure.
Do not accuse the depressed person of faking illness or of laziness, or expect him or her "to snap out of it." Eventually, with treatment, most people do get better. Keep that in mind, and keep reassuring the depressed person that, with time and help, he or she will feel better.
WHERE TO GET HELP
If unsure where to go for help, check the Yellow Pages under "mental health," "health," "social services," "suicide prevention," "crisis intervention services," "hotlines," "hospitals," or "physicians" for phone numbers and addresses. In times of crisis, the emergency room doctor at a hospital may be able to provide temporary help for an emotional problem, and will be able to tell you where and how to get further help.
Listed below are the types of people and places that will make a referral to, or provide, diagnostic and treatment services.
Family doctors
Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors
Health maintenance organizations
Community mental health centers
Hospital psychiatry departments and outpatient clinics
University- or medical school-affiliated programs
State hospital outpatient clinics
Family service, social agencies, or clergy
Private clinics and facilities
Employee assistance programs
Local medical and/or psychiatric societies
For More Information
Depression Information and Organizations from NLM's MedlinePlus (en Español)
REFERENCES
1 Blehar MD, Oren DA. Gender differences in depression. Medscape Women's Health, 1997;2:3. Revised from: Women's increased vulnerability to mood disorders: Integrating psychobiology and epidemiology. Depression, 1995;3:3-12.
2 Ferketick AK, Schwartzbaum JA, Frid DJ, Moeschberger ML. Depression as an antecedent to heart disease among women and men in the NHANES I study. National Health and Nutrition Examination Survey. Archives of Internal Medicine, 2000; 160(9): 1261-8.
3 Frank E, Karp JF, Rush AJ (1993). Efficacy of treatments for major depression. Psychopharmacology Bulletin, 1993; 29:457-75.
4 Lebowitz BD, Pearson JL, Schneider LS, Reynolds CF, Alexopoulos GS, Bruce MI, Conwell Y, Katz IR, Meyers BS, Morrison MF, Mossey J, Niederehe G, Parmelee P. Diagnosis and treatment of depression in late life: consensus statement update. Journal of the American Medical Association, 1997; 278:1186-90.
5 Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press.
6 Rubinow DR, Schmidt PJ, Roca CA. Estrogen-serotonin interactions: Implications for affective regulation. Biological Psychiatry, 1998; 44(9):839-50.
7 Schmidt PJ, Neiman LK, Danaceau MA, Adams LF, Rubinow DR. Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. Journal of the American Medical Association, 1998; 338:209-16.
8 Vitiello B, Jensen P. Medication development and testing in children and adolescents. Archives of General Psychiatry, 1997; 54:871-6.
This brochure is a new version of the 1994 edition of Plain Talk About Depression and was written by Margaret Strock, Public Information and Communications Branch, National Institute of Mental Health (NIMH). Expert assistance was provided by Raymond DePaulo, MD, Johns Hopkins School of Medicine; Ellen Frank, MD, University of Pittsburgh School of Medicine; Jerrold F. Rosenbaum, MD, Massachusetts General Hospital; Matthew V. Rudorfer, MD, and Clarissa K. Wittenberg, NIMH staff members. Lisa D. Alberts, NIMH staff member, provided editorial assistance.
This publication is in the public domain and may be used and reprinted without permission. Citation as to source is appreciated.
NIH Publication No. 00-3561
Printed 2000
Top作者: Fei Wang 时间: 05-12-7 18:44
Dear All translators:
Sorry for that LONG article! Don't push yourself hard, IT'S FUN! YOU ARE GETTING THE FEELING THAT YOU ARE USEFUL TO OTHERS! YOU ARE LEARNING!
ENJOY THE PROCESS! NOT THE RESULT ONLY!!作者: Fei Wang 时间: 05-12-7 18:51
who finished the first part? please send it to me: SongCharle@gmail.com, i will publish it RIGHT AWAY.
again, i promise: every translation, no matter what, finished or not, good or not.....IT DOESN'T MATTHER.
The matther thing is: you are useful! you are helping others! you are helping yourself by doing that!
looking forward to hearing from you now!!!作者: Fei Wang 时间: 05-12-7 19:01
关 于 忧 郁 症
世界上大约有四亿万人有过精神或神经失常的问题，而之中就有约一亿两千一百万人患有忧郁症的问题，这些失常类疾病被列为了世界十大残疾病的第五名，造成了个人、家庭和政府莫大的社会经济压力。到2020年时，如果目前人口统计数字和流行病发病趋势顺势发展，忧郁症的比例将会在总体疾病中增至5.7％，跃居成为造成DALYs（burden of disease in Disability-Adjusted Life Years，失能校正生命人年数）中的第二位，仅次于贫血症，在发达地区将会跃居首位。
非药物疗法
精神/心理疗法或“谈话”治疗方法，包括认知/行为治疗、个人疗法、精神分析治疗和支持性心理治疗，都常被用来治疗忧郁症。电气痉挛治疗（ECT）和近来开发出来的另一种ECT替代方式的跨颅磁头刺激（TMS，一种脑外无创伤性的磁性刺激），都可以提供给严重患者作为有效的治疗方式。作者: Charlie Z. Song 时间: 05-12-7 23:03
准妈妈们，小心产后忧郁症！
2004-8-5 10:08:05
千禧龙年接近尾声，许多在年初怀孕、赶搭最后一班龙宝宝列车的准妈妈即将陆续分娩。万芳医院精神科邓惠文医师，提醒准妈妈和准爸爸注意产后忧郁症的发生，及早预防及治疗，为母亲及宝宝的身心健康把关。
邓医师表示，大约半数妇女在产后会经历心情低落、情绪起伏、疲倦、焦虑、失眠等症状，这就是最明显可以自我察觉的产后忧郁症，这些症状最常出现在产后第四、第五天左右，而且通常会在两周内恢复，一般不需特别治疗。
但少数产妇症状较严重，包括忧郁、无法感受快乐、食欲大幅减退、倦怠、即使宝宝不吵仍然失眠、悲观、自卑、无望无助感，甚至出现自杀或伤害宝宝的焦虑。
但是准爸爸准妈妈也不必太过紧张，因为并不是每一对父母都会经历，医师解释，曾经患过忧郁症、经前症候群严重的人（每次月经来前会出现严重情绪困扰）、和配偶相处不睦、婚姻有问题、怀孕期间或产后生活有压力事件者，才是高危险群。
而如果经过诊断，确定发生了产后忧郁症情况，医师也建议，可以采用心理治疗、团体治疗或药物治疗的方式，以免忧郁症慢性化或将来复发，如果严重到出现伤害自己或宝宝的念头，一定要紧急寻求精神科医师的协助。
另一方面，预防产后忧郁症恶化，邓惠文医师建议：
(一)找家人或朋友倾吐心情，寻求支持。
(二)处理好与配偶的关系，切忌只顾宝宝而忽略与伴侣沟通。
(三)每天至少半小时，请家人帮忙看顾小孩，做自己喜欢的事。
(四)给自己适应新宝宝的时间，不需要求自己马上做到「一百分妈妈」。
(五)如果想坐月子、请产假但公司借故刁难，可以寻求申诉。
(六)如果怀疑自己有忧郁症，不要害怕找精神科医师或心理专业人员协助。
医师强调，忧郁的原因有许多是来自于环境，并不代表自己不是好妈妈。
【声明】7天24小时由于本站所有资源均收集于网络,如果有侵害您的权利的地方，请与站长联系，我们第一时间予以改正。谢谢您的支持。作者: Kathy 时间: 05-12-8 22:09
From TIME Asia Magazine, issue dated Nov21,2005
Taking on the Drug Defenders
BY DANIEL WILLIAMS
Ever since his coruscating book Mad in America was published in 2002, American Robert Whitaker has been a poster boy for the anti-psychiatry movement. In Mad in America (Perseus Books), he argued that the assumption of a physical cause for schizophrenia had given rise to many wrongheaded treatments, from ice-water immersion to today's antipsychotic drugs. These days, the Pulitzer Prize finalist makes a similar case against psychiatry over its approach to the treatment of depression.
No one knows for sure whether serotonin has a role in depression, let alone exactly what that role might be. But many doctors pretend they're sure, Whitaker says, because "psychiatry for a long time had a bit of an inferiority complex. It wanted magic bullets like everybody else." Trouble is, the magic bullets, including the SSRIs, don't work very well. By perturbing neurotransmitter activity they can make patients chronically ill, says the Boston-based author.
Is he alleging a conspiracy among psychiatrists? Not exactly. Psychiatrists are taught the biological models of mental illness and come to believe in them, he says. He recalls a recurring exchange he had with doctors while researching Mad in America:
Psychiatrist: The (schizophrenia) drugs are like insulin for diabetes.
Whitaker: No, they're not - you have no confirmed biological problem.
Psychiatrist: O.K., that's true.
Whitaker: So why say it?
Psychiatrist: Well, it gets people to take their drugs.
"So what they're doing is a little fudging to pursue what they believe is a good end," says Whitaker. "But at the same time they feel vulnerable because they don't have the science behind it and they don't have the outcomes, either." Those psychiatrists who break ranks and publicly question the biological models and the efficacy of psychiatric drugs, he adds, "get clobbered. They basically have their careers ruined."
The SSRIs, in his view, are a story of a "massively successful capitalistic enterprise" - and the idea that in countries like Australia there's still a multitude of people with undiagnosed depression should be considered in that context. These people are "not clinically depressed, anyway," he says. "The drug companies are setting forth an unrealistic vision of what it is to be human. They're defining normal stresses and worries as pathological, and the only reason they're doing it is that it leads to more business."作者: woiyezi 时间: 05-12-9 13:37
It is too long and complicated, anyone can translate it?
Thanks!作者: woiyezi 时间: 05-12-9 14:07
I agree with this article partly.
In my opinion,the doctors can only control your symptom, but can not cure a patient, only the patient can really solve his problem.
one's instance is not the same as the other's,drugs can not solve all problems!
It is You but not doctor to beat depression!
Bell作者: Charlie Z. Song 时间: 05-12-9 21:26
The following content is translated by Kathy, thank a lot!!!!!!!!!!!!
==============================
==============================
l 关于抑郁症的介绍
l 什么是抑郁症？
l 抑郁症的种类
l 抑郁症及躁狂的症状
l 抑郁症的起因
l 诊断评估与治疗
l 心理疗法
l 如果抑郁了该怎么办
l 从哪里寻求帮助
l 更多的一些信息
l 参考书目
患者常常会过早地停止服药。他们会感觉状态好转不再需要继续服药了，或是认为药物根本不起作用。作者: Charlie Z. Song 时间: 05-12-9 21:34
I just changed from "BAI YOU JIE" to PAROXETINE HCL 6 days ago, now seems my sleep got worse, anyway, i instist on taking pills everyday.作者: Charlie Z. Song 时间: 05-12-10 17:51
运动抗抑郁心情变开朗
新加坡人喜欢独处解压(2001-07-21)
基因缺陷是精神病重要原因(2001-07-09)
儿童也会患狂郁症(2001-06-20)
患计算障碍症加减搞不清(2001-06-08)
抗郁食物 让你快乐(2001-06-04)
21世纪新杀手抑郁症(2001-05-03)作者: Charlie Z. Song 时间: 05-12-10 17:53
抑郁症病人擅自停药病难好
相关文章：
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·让心理咨询成为一种新时尚作者: Charlie Z. Song 时间: 05-12-12 22:35
If you wish to fight your depression without the side-effects and expense of psychiatric medications, there are many things your can do to control your moods naturally.
Difficulty: Average
Time Required: N A
Here's How:
1. Sleep and mood are intimately related. Keep a regular schedule and get adequate rest.
2. Avoid caffeine and other stimulants. Although they give temporary energy, they can deplete your serotonin levels in the long-run.
3. Take a multi-vitamin regularly if you do not eat well. Several vitamin and mineral deficiencies can lead to depression symptoms.
4. For mild to moderate depression, some find that St. John's Wort, SAMe or 5-HTP can be helpful and may have fewer side-effects. These remedies cost less than prescription medications and help put you in control of your own treatment.
5. Get in touch with your spiritual side through prayer or meditation. Remember, spirituality is not the same thing as religiosity. You may be spiritual without ever setting foot in a church, synagogue or mosque.
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6. Get more exercise. This doesn't mean you have to start up a vigorous daily workout. Even a walk around the block can be energizing.
7. Avoid excess alcohol consumption. Alcohol is a depressant and toxic to your body as well.
8. Eat a well-balanced diet.
9. Your thoughts have a direct bearing on your mood. Learning about Cognitive Behavioral Therapy, either through a therapist or self-help books, can help you stop the negative thoughts that bring you down.
10. Stress can be physically draining. Learn to control your stress levels through time management, meditation, biofeedback training, etc.
11. Combat feelings of loneliness by reaching out to others who are less fortunate.
Tips:
An ounce of prevention is worth a pound of cure. Be aware of your mood and take remedial steps when you first feel your mood begin to slip.
Don't feel like a failure if you need prescription medication. Depression is an illness just like diabetes or any other other. It is not always within your control.作者: Charlie Z. Song 时间: 05-12-12 22:41
Dear Translators (whoever wants to practise his/her English):
Want to try to translate the article above??? I promise, as long as your translation is not too "poor", i DEFINITELY will publish it!!! And more, i will publish EVERY TRANSLATION in the order i received!
Interested party please send your translation to my email account: smilha@gmail.com, thanks!!!
Looking forward to receive your translation very soon!!!
GOOD LUCK!!!作者: Charlie Z. Song 时间: 05-12-19 22:45
Bridge of dreams (I'll never forget you) ayu 昨天 22:58
At seventeen the bridge of dreams
Can reach across forever
A long weekend, my mother's friend
You came in search of weather
The women I saw, I'd seen years before
But never like this
You kiss on my cheek, said "Find if you seek,
A moment of bliss"
I'll never forget you
Don't ever regret you
You opened my eyes
Wherever I go in this world
As I stumble on shifting sand
You were there
When a boy turned man
Secretly it had to be
Though honest was our passion
And every moment in your arms
Made Mockery of fashion
And after the glow
The talk of the Soul
Will stay deep inside
I'll never forget you
I'll always respect you
You opened my eyes
Whatever I do in this life
As I battle against the tide
I'll never forget you
I'll always respect you
You opened my eyes
Wherever I go in this world
As I stumble on shifting sand
You were there
When a boy turned man作者: Charlie Z. Song 时间: 05-12-21 16:21
医师：躁郁症约四成被误诊为忧郁症
2005年12月20日22:8:0(京港台时间)
为了增进民众对于躁郁症的认识，精神健康基金会未来将提供两万份躁郁症手册供民众免费索取，如果民众想要知道自己是否患病，可上基金会网站作线上精神健康测验或直接就医检查。作者: Charlie Z. Song 时间: 05-12-27 14:51
Antidepressants in bipolar disorder
For people who are correctly diagnosed with depression (major depressive disorder), antidepressant medications are often highly effective. But in individuals who have bipolar disorder, antidepressants can sometimes do more harm than good when they are not used appropriately.* That’s one reason why getting a correct diagnosis is so important.
A few facts:
Antidepressants may trigger manic episodes in people with bipolar disorder
Antidepressants may not work well (or at all) in bipolar individuals. Poor response to antidepressants could be a sign that the diagnosis of major depressive disorder is incorrect
Important: For people with major depressive disorder, antidepressants must be taken regularly for three to four weeks (sometimes longer) before the full response is seen. It is important to give the medication a chance to work.
These items stress the importance of open communication with your doctor; be sure to discuss concerns you may have about your treatment plan during your next visit.
*Note that in some people with diagnosed bipolar disorder, antidepressants are sometimes used in combination with bipolar medications.
Treatments for bipolar disorder
Treatment for bipolar disorder often involves a two-part plan of both medication and psychotherapy.
Medications. There are different types of medications used to treat bipolar disorder, including medicines for controlling manic symptoms, depressive symptoms, or medications that help stabilize the patient's mood
Psychotherapy. Several types of “talk therapy” are used in bipolar disorder treatment. Cognitive behavioral therapy focuses on changing inappropriate or negative thought patterns that can affect the illness. Psychoeducation aims to help the patient and family understand the illness and recognize signs of relapse. Interpersonal and social rhythm therapy, focuses on daily routines that can promote emotional stability. The type of therapy used depends on the individual’s needs
The professionals who treat bipolar disorder
Bipolar disorder patients work with a team of health care professionals that supervise the patients' care. For medication management, patients usually work with their psychiatrist. For psychotherapy, patients typically work with a licensed therapist or social worker and their psychiatrist. The health care team maintains close contact with each other to help ensure the patients' continued progress.
Not sure where to find help? Start with your primary care provider. He or she can discuss symptoms, give you guidance and recommend psychiatrists and/or therapists in your area.
Important: Even if you think you may not be diagnosed correctly it is extremely important to follow your current medication plan as prescribed by your doctor. If you have concerns about your medicine—or if you feel you are doing better—don’t stop treatment on your own. Instead, communicate openly with your doctor and discuss your diagnosis and possible adjustments to your treatment plan.作者: Charlie Z. Song 时间: 05-12-27 14:57
Dear all who know English:
PLEASE HELP YOURSELF BY HELPING OTHERS...............TRANSLATE IT INTO CHINESE!!!!
TNEN SEND YOURS TO MY PERSONAL EMAIL:
SONGCHARLE@GMAIL.COM
I WILL PUBLISH IT RIGHT AWAY!!!!!!!!!!!!!!
I WILL PUBLISH:
EVERY..........EVERY.............TRANSLATIONS..............TRANSLATIONS...............................UNTIL.............UNTIL................THE YEAR 3000...............THE YEAR 3000....................作者: Charlie Z. Song 时间: 06-1-6 10:14
Brain Protein May Be Linked to Depression By LAURAN NEERGAARD, AP Medical Writer
51 minutes ago
WASHINGTON - Scientists have discovered a protein that seems to play a crucial role in developing depression, a finding that may lead to new treatments for the often debilitating illness — and fundamental understanding of why it strikes.
ADVERTISEMENT
Although problems with the mood-regulating brain chemical serotonin have long been linked to depression, scientists don't know what causes the disease that afflicts some 18 million Americans — or exactly what serotonin's role is.
The newly found protein, named p11, appears to regulate how brain cells respond to serotonin, researchers from Rockefeller University and Sweden's Karolinska Institute report Friday in the journal Science.
"We're all very excited about this discovery," said Nobel laureate Paul Greengard, a Rockefeller neuroscientist who led the research. "People have been looking for modulators of serotonin for a long time."
Said Oxford University pharmacologist Trevor Sharp, who reviewed the work: "This finding represents compelling evidence that p11 has a pivotal role in both the cause of depression and perhaps its successful treatment."
Most depression medications used today are members of the Prozac family that work by making more serotonin available to brain cells. They stem from a theory that depression patients might not have enough serotonin, a neurotransmitter, or chemical that carries signals between nerve cells.
Then scientists discovered the serotonin connection was more complicated, dependent on how well the neurotransmitter binds to receptors, or docking ports, on cell surfaces. Fourteen different serotonin receptors have been discovered.
The new research focuses on one of those receptors, dubbed the "1B" receptor, that seems to play a particularly big role in major depression.
Greengard and colleagues discovered that the p11 protein increases the numbers of these receptors on the surfaces of cells, mobilizing them so they're available for serotonin to do its job.
That led to a series of remarkable experiments, using mice as well as brain tissue saved from the autopsies of depressed patients, that found:
_Depressed people have substantially lower levels of p11 in their brain tissue than the non-depressed. So did a breed of mice, called "helpless" mice, that exhibit depression symptoms.
_Then the mice were given two older antidepressants — one known as a tricyclic, the other an MAO inhibitor — and electric shock therapy. Each treatment increased the amount of p11 in mice brains, even though each therapy is known to work in different ways.
_So the researchers bred mice that had no p11-producing gene. They acted depressed, and had fewer 1B receptors and less serotonin activity than regular mice. They also were less likely to improve with depression medication. Mice genetically altered to produce extra p11 acted in just the opposite way — no depression-like behavior, and their brain cells carried extra serotonin-signaling receptors.
"It's a very important finding," said Dr. Thomas Insel, director of the National Institute of Mental Health, which funded the research. "This gives us a new set of targets for drug development," but also "suggests a whole new area of investigation for trying to ... ultimately discover does this have anything to do with why some people get depressed and others don't."
The researchers don't yet know whether a genetic defect or some other factor is responsible for altering p11 levels.
"The p11 is upstream of the receptor, and now the question is what is upstream of the p11," Greengard said.
But Sharp noted that bouts of depression often are associated with serious stress, and that p11 is part of a protein family known to be sensitive to certain stress-related hormones.
Greengard's lab now is researching the potential for p11-related therapies.
But the discovery likely will aid research into other diseases that also depend on cell-based receptors.
"We're finding that other molecules control other receptors, so I think this may open up quite a major new area of approach to developing therapeutic drugs," Greengard said.
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--------------------------------------------------------------------------------作者: Charlie Z. Song 时间: 06-1-8 18:27
中国企业家的三重之累：亿万富豪的最后时刻
德州市经委某工作人员也坦言，政府当然会有个发展规划、发展目标。要实现这个目标，个别企业当然要分担一定“责任”。实际上，德州市政府与晶华集团之间的关系非常密切。此次苗出事后，正是由德州市委、市政府出手控制了局面。目前，晶华集团总经理田文顺已被德州市委任命为集团党委书记。 （作者：赵刚 来源：中国经营报）作者: Charlie Z. Song 时间: 06-1-9 16:22
北京市首家抑郁症治疗中心在我院成立，详见首页专题。
They're prescribed to millions, but do the new antidepressants work? And are they worth the risk?
BY DANIEL WILLIAMS
There's really nothing funny about what happened to Rebekah Beddoe, except maybe for a little black comedy at the end. In 1999, a psychiatrist diagnosed her with postnatal depression, which she probably didn't have, and for the next three years multiple doctors treated her with drugs that she almost certainly didn't need. As episodes of deliberately cutting herself progressed to bouts of mental torment and suicide attempts, Beddoe's carers, concluding that her illness was worsening, kept upping her dosages and trying new medications. Nothing worked. Eventually, Beddoe acted on a different idea. Without telling anyone, she weaned herself off the drugs and gradually became well again. Her psychiatrist at the time assumed he was responsible for Beddoe's recovery. She remembers watching him one day from the other side of his desk, thinking that this eminent doctor was congratulating himself on having the skill to concoct precisely the right drug regimen. "I could also see his relief," Beddoe says. "It had been a difficult case, but he'd finally cracked it."
These days Beddoe, 33, spends much of her time at home in Melbourne reading up on psychiatry while working on a book about her ordeal. She's certain that what made her sick were side effects of the most commonly prescribed class of antidepressants, the selective serotonin reuptake inhibitors (SSRIs). A pharmaceutical phenomenon that began with fluoxetine (Prozac) in the late 1980s, the SSRIs rode a wave of gushing publicity to usurp the older antidepressants, the tricyclics, and reap a fortune for their makers: worldwide sales now exceed $20 billion a year. But the honeymoon is over. Even doctors who swear by SSRIs and newer variants concede that 1-2% of patients have a severe negative reaction to these drugs. That's a small percentage. But it's a small percentage of a very large number. Intractable misery is rife, it seems: in Australia last year, 12 million prescriptions for antidepressants were dispensed through the federal government's Pharmaceutical Benefits Scheme (up from 8.2 million in 1998), a figure equating to more than a million users. Do the math, says Sydney forensic psychiatrist Yolande Lucire: if only 1% of users suffer terrible side effects that aren't recognized for what they are, that's more than 10,000 Australians who've recently been disabled by a drug that was supposed to help them. "That would be enough to fill the beds in every mental hospital in the country."
Lucire's is one voice in a small but growing international chorus of SSRI skeptics. As well as highlighting side effects, these critics question whether the SSRIs do what they're supposed to do in a significant proportion of cases. Based on fresh analyses of clinical-trial results, some researchers have concluded that the drugs are scarcely more effective than a placebo in alleviating depression. "I think they are more or less completely useless," says Dr. Joanna Moncrieff, senior lecturer in social and community psychiatry at University College London. In an article published earlier this year in the British Medical Journal, Moncrieff and coauthor Irving Kirsch, professor of psychology at the University of Plymouth, argued that it was time for "a thorough reevaluation of current approaches to depression and further development of alternatives to drug treatment." Seldom had a piece about antidepressants so explicitly challenged the reigning orthodoxy in the mainstream medical press, and it was hailed as a breakthrough by those who oppose what they see as disease mongering by the drug industry and other groups. The drug skeptics have had other recent victories. In the U.S. last year, the Food and Drug Administration told the drug companies to harden their warnings about the potential side effects of SSRIs. The companies' prescriber information must now feature a black-box warning - the strongest available - stating that in trials "antidepressants increased the risk of suicidal thinking and behavior" in children and adolescents with depression and other psychiatric disorders. The fda is reviewing the results of several trials to determine whether a similar warning should be introduced for adults. British health authorities have gone further: in September, the National Health Service told doctors to stop prescribing antidepressants to under-18s in the early stages of treatment because of the link with suicidal thinking. Compared with its American and British counterparts, Australia's Therapeutic Goods Administration has taken a gentler line. Last year it reminded doctors that no antidepressant is approved in Australia for the treatment of depression in under-18s - though it knows many thousands of Australian teenagers with that diagnosis are on the drugs. In August, a TGA bulletin acknowledged a probable link between the SSRIs and suicidal tendencies in children and adults, but overall endorsed the drugs. Still, for perhaps the first time since the SSRIs came on the scene, those who believe the medical profession has lost its way in treating depression feel they have some momentum. "The (non-drug) approach is growing," says Dr. Jon Jureidini, head of the department of psychological medicine at the Women's and Children's Hospital in Adelaide. "I'm probably at one end of the spectrum, but there would now be plenty of psychiatrists who would be very conservative prescribers."作者: Charlie Z. Song 时间: 06-1-17 19:42
Listing of NDSD Year Round Screening Sites.
This map currently lists both in-person and onine year-round mental health screening sites. To use the NDSD event site locator map, click on the state where you would like to find a site and then click on a city or town in your area. Names, locations and numbers of each site will be retrieved. For a list of International sites, click here .
Call these sites directly for directions and hours for the free screenings. Sites with spanish speaking staff available are indicated with an asterisk (*).
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming作者: Charlie Z. Song 时间: 06-1-31 18:15
抑郁性神经症
声明：能为您提供健康服务，我们感到非常荣幸。但这些内容仅供参考，一切诊断与治疗请遵从就诊医生的指导。作者: Charlie Z. Song 时间: 06-3-4 02:27
DEfeating Postpartum Depression
By Daisy Bang
Postparum depression is a type of major depression that affects approximately 10% of new mothers within the first year
after birth. If left untreated, postpartum depression affects not only teh mother's well-being, but may also afftect a kid's
cognitive, social, and emotional develpment.
Symptomes of postpartum depression include fatigue, heightened emotion, sleeping problems, sadness, anxiety, and
feelings of worthlessness. Other symptoms includefear of being alone, fear of harming the baby or oneself or one's partner
lack of interest or excessive interest in the baby.作者: Charlie Z. Song 时间: 06-3-4 02:40
A more commonand less serious known as the baby blues exhibits similar symptoms. However, baby blues affect up to 80%
of new mothers and usually disappears within one week. A rare and vey serious condition known as psotpartum psychosis
may result in infanticide, suicide, or child abuse and affects approximately one in a 1000 new mothers.
Shame and reluctance to share one's feelings with others may accompany postpartum depression due to fear of being
judged an unfit or inadequate mother.
A combination of hormonal changes and the stress of new motherhood may resultin some of the symptoms of postpartum
depression. New motherhood often means less time for self, decreased sleep, and departure from normal routines.作者: Charlie Z. Song 时间: 06-3-4 02:56
Treatment for postpartum depression may include individual or group therapy and anti-depressant medication. Other
recommendations for treating and managing psotpartum include getting as much rest as possible, getting help taking care of
the baby from family and friends, talking about the feelings with your husbandm family, or friends, and avoiding too much
time alone in the house. One should talk to her doctor or midwife if she feels depressed during or after pregnancy, and
remember that there is an answer for postpartum depression.作者: Charlie Z. Song 时间: 06-3-15 11:24
不可忽視的產後憂鬱症
Related Articles亞裔人群與憂鬱症 (Jan 20, 2006)
Keywords: 憂鬱症
德国研究员让一组大学生在假定的传呼中心工作进行研究。当他们受一名女顾客辱骂，部分人获允许以牙还牙，其他则必须保持和颜悦色。结果显示还以颜色的大学生，心跳加速时间很短，一直保持微笑的却在事发后很长时间仍心跳速度过高。(联合晚报)作者: 风吹尘 时间: 06-3-23 23:12
顶顶顶！老查理真了不起，找出了这么多好文章。简直是leave no stone unturned.
Solute to Charlie！Thanks for your great patience and persistence.作者: Charlie Z. Song 时间: 06-3-24 01:02 标题: XIEXIE FENG CHUI CHEN!!!! 图文)周华健一度想自杀
-------------------------------------------------------------------------------- http://www.creaders.net/ 万维读者网 2006年03月21日 08:39 AM
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没有必要得意忘形或者自怨自艾,
没人知道下一刻你到底是身在天堂还是位于地狱.
我们能做的，只是平和温雅地接受,然后继续往下走.
我们只有不停地努力,因为,一切皆有可能.作者: Israel 时间: 06-3-31 22:12
顶老查一下。作者: Charlie Z. Song 时间: 06-4-4 04:17
趙本山拿崔永元憂郁症開涮
责编：吴晓洋 来源：新华社作者: Charlie Z. Song 时间: 06-5-5 17:01
Depression is a serious problem.
35 million Americans (more than 16% of the population) suffer from depression severe enough to warrant treatment at some time in their lives.
(National Institute of Health, 2003 National Comorbidity Study)
Despite depression’s high treatment success rate, nearly two out of three people suffering from depression do not actively seek nor receive proper treatment. (DBSA, 1996)
Untreated depression is the leading cause of suicide. Suicide (taking one’s own life) is a serious public health problem that devastates individuals, families, and communities. It is the 11th leading cause of death among Americans (PreventSuicideNow.com, Anderson and Smith 2003, CDC.gov)
Depression has had an impact on your organization.
Depression ranks among the top three work place issues, following only family crisis and stress. (EAP 1996)
Employees suffer from the impact of depression when working with others who are depressed and when caring for loved ones at home.
Fifteen to 20% of US families are caring for an older relative. A survey of these adult caregivers found that 58% showed clinically significant depressive symptoms. (Family Caregiver Alliance, 1997)
As many as one in 33 children and one in eight adolescents have clinical depression. (Center for Mental Health Services, U.S. Dept. of Health and Human Services, 1996)
As many as one in eight adolescents have clinical depression. (Center for Mental Health Services, U.S. Dept. of Health and Human services, 1996)
If your employees do not seek treatment for depression, it costs your business in health expenditures, absenteeism, lost productivity and performance mistakes.
Depression’s annual toll on U.S. businesses amounts to about $70 billion in medical expenditures, lost productivity and other costs. (The Wall Street Journal, 2001, National Institute of Mental Health, 1999)
Depression accounts for close to $12 billion in lost workdays each year. (The Wall Street Journal, 2001, National Institute of Mental Health, 1999)
More than $11 billion in other costs accrue from decreased productivity due to symptoms that sap energy, affect work habits, cause problems with concentration, memory, and decision-making. (The Wall Street Journal, 2001, National Institute of Mental Health, 1999)
Supporting organizations that focus on depression outreach is beneficial to your organization.
A reduction of depression in employees and customers leads to increased profits.
The 35 million people suffering from depression, as well as their friends and family, would be supportive of an organization that aids in combating depression. (The 35 million estimate is probably low, since over 75% of depression sufferers do not feel comfortable discussing depression.)作者: 冰冰 时间: 06-5-5 18:23
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