WISCONSIN UNITED
for MENTAL HEALTH

Monthly Feature Spring 2012: Women and Depression

Women experience depression at nearly twice the rate as men. However, stigma prevents many women from seeking treatment. This can be especially true with post partum depression (PPD). However, Koss, a woman with PPD featured below, thinks the stigma against PPD in the U.S. is lessening in part because celebrities such as Brooke Shields have gone public about their own PPD. "I now feel comfortable talking about it," Koss says. "There's not as much shame."
Read more about this topic from National Public Radio at: http://www.npr.org/2011/08/01/138830120/stigma-hinders-treatment-for-postpartum-depression

History has taught us that when women, especially, commit their voices to positive change, the impossible becomes probable. International Women's Day provides an opportunity for women to explore what we can do to bring this issue out of the shadows. Read more about how to impact stigma here

Learn more about Women and Mental Health and Illnesses


Monthly Feature March 2011: Depression and Diabetes

Research has shown that depression is commonly associated with diabetes. People who have both diabetes and depression tend to have more severe symptoms of both diseases, higher rates of work disability and use more medical services than those who only have diabetes alone. More research is needed to identify the underlying mechanisms for the association between depression and diabetes complications, and to develop interventions that treat both diabetes and accompanying major depression. In addition, better screening is needed to help identify those patients with diabetes who are at higher risk for developing major depression and other life-threatening complications.  (Source: Diabetes and Depression Associated with Higher Risk for Major Complications, NIMH)

More information about diabetes is available from the National Diabetes Education Program.  More information from WUMH can be found at our page: When Physical and Mental Illnesses Co-Occur.

Reference
Lin EHB, Rutter CM, Katon W, Heckbert SR, Ciechanowski P, Oliver MM, Ludman EJ, Young BA, Williams LH, McCulloch DK, Von Korff M. Depression and advanced complications of diabetes. Diabetes Care. 2010 Feb. 33(2): 264-269.


Monthly Feature February 2011: Depression and Heart Disease

Depression often co–exists with serious physical illnesses such as heart disease, cancer, HIV/AIDS, diabetes, and Parkinson's disease. Studies have shown that people who have depression in addition to another serious medical illness tend to have more severe symptoms of both illnesses, more difficulty adapting to their physical condition, and more medical costs than those who do not have co–existing depression.1 Research has yielded increasing evidence that treating the depression can help improve the outcome of treating the co–occurring illness.2

The relationship between depression and heart disease is especially strong and complex.  The physical and behavioral effects of depression can lead to or complicate heart disease.  A recent study found that if depression symptoms worsen after heart failure, the patient is at a higher risk of re-hospitalization and even death.3  The authors of this and other studies urge physicians to adhere to the American Heart Association's recommendation that the Patient Health Questionnaire (PHQ-2) be used as a depression screening tool for all cardiac patients.4  If you or someone you know is suffering from either depression or heart disease, it is important that their doctor keep in mind the relationship between these two illnesses.

References

1. Cassano P, Fava M. Depression and public health, an overview. Journal of Psychosomatic Research, 2002; 53: 849-857.
2. Katon W, Ciechanowski P. Impact of major depression on chronic medical illness. Journal of Psychosomatic Research, 2002; 53: 859-863.
3. Litchman JH, et al. Depression and coronary heart disease: Recommendations for screening, referral and treatment. A science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation, Oct 21 2008. 118(17):1768-1775.
4. Journal of the American College of Cardiology, news release, Jan. 17, 2011.

Additional resources
Depression and Cardiovascular Disease (medical-based summary of recent research with links to articles summarizing many recent studies, Science Daily)
Depression and Heart Disease (summary of recent research with less medical detail, Cleveland Clinic)
When Physical and Mental Illnesses Co-Occur (WUMH)


Monthly Feature December 2010: Holiday Stress

Unfortunately the holidays are not always a joyous time. As the holiday season approaches, there are some things you can do to minimize stress and to cope if you become overwhelmed. The main stressors during the holidays are managing time and money, dealing with difficult relationships, and living up to expectations (both our own and those of our families and friends). Addressing these issues head-on and taking care of yourself can result in a more enjoyable holiday season.

Taking time before the rush begins to assess what is most important to you and setting boundaries can help fend off frustration and disappointment. Discovering what parts of the season make you most anxious can allow you to identify what changes you can make and what limits to set before the holiday to minimize the effects of these stressors. If you are able to simplify certain aspects of the holidays (travel, gift giving, cooking, cleaning, etc) you will have more time and energy to enjoy the season. Giving yourself permission to say "no" to events that create anxiety or tension can allow you to get more enjoyment out of what is fun and meaningful to you.

Once the celebrations and plans are underway, it is important to take the time to make your physical health a priority. Make it a priority to get an adequate amount of sleep and exercise and strive for a balanced diet. Not only will you feel physically better, but you could prevent illness and better allow yourself to cope with difficulties and pressures that arise throughout the season. If you find that you are having trouble coping with the pressures, take the time to decompress and blow off steam, so you can continue to celebrate. You may find that time alone, meditation, volunteering, or spending time with those who make you feel positive and loved can help.

Depression, Anxiety Disorders, or the recent loss of a loved one can make the holidays even more difficult. In these cases it is even more important to actively manage your stress. Acknowledge your negative feelings and if you are unable to cope by using the aforementioned techniques, don't be afraid to seek professional help. Consider it a gift to yourself.

Sources and additional resources:

• Managing Stress (pdf; X-Plain, The Patient Education Institute)
• Managing Holiday Stress (SAMHSA)
• Managing Holiday Stress (Cleveland Clinic)
• Stress, depression and the holidays: 10 tips for coping (Mayo Clinic)
• Managing Stress Interactive Tutorial [Also available in Spanish] (National Library of Medicine)
• Live your Life Well (Mental Health America)

Monthly Feature January 2010: 
Major Depressive Disorder and Functional Impairment

There are a number of articles in the December 2009 issue on Major Depressive Disorder and Functional Impairment: Key Concepts for Enhancing Patient Outcomes, including: The Impact of Depression on Workplace Functioning and Disability Costs



MONTHLY FEATURE OCTOBER 2007 - DEPRESSION AWARENESS MONTH

October is National Depression Awareness Month and October 11 is National Depression Screening Day.


MONTHLY FEATURE AUGUST 2007: STIGMA AND DEPRESSION PRESENTATION

Depression and Stigma: What Research Tells Us (and Doesn't Tell Us) about the Design of Effective Anti-Stigma Messages. A July 26, 2007 presentation based on research by Jonathan Kanter, Keri Brown and Laura Rusch of the University of Wisconsin-Milwaukee.

"Sticks and stones may break my bones but words will never hurt me. We learn that as kids and only if it were true. Words hurt. Labels hurt. Negative words have negative consequences."

Ok so what exactly is stigma? It turns out there are around 5 or 10 different measures of stigma that have been created by researchers, but if you look at them, most of them focus on a really broad stigma about mental illness in general and are not specific to depression. So in my lab we looked at all these measures, changed some of the items to make them relevant to depression, and put them all together into one huge 100 item measure, and gave it to 387 depressed adults. We wanted to figure out if there were components of stigma of depression that were important to identify and distinguish so we used a technique called factor analysis to do that, and here’s what we found.

We found five distinct factors that were nonetheless related to each other. They are public stigma, stigmatizing experiences, self-stigma, treatment stigma and secrecy. The problem definitely starts with public stigma – negative attitudes about depression held by friends, family members, the general public, the media.

Public stigma and stigmatizing experiences leads to self-stigma, where you start to believe these stereotypes, and treatment stigma, where you don’t seek help for it, and secrecy, where you avoid new relationships, don’t know what to say in job interviews, and in general have this major aspect of your life that you need to hide from every one around you. And that is depressing. In our study, all of these components correlated significantly with depression – public stigma less so, but we see here that the more depressed you are, the more stigmatizing experiences you’ve had, the more self-stigma, the more treatment stigma, and the more secrecy.

So this just highlights how important it is to address stigma – it not only keeps people out of treatment but it participates in a vicious cycle that makes depression worse.

To read more about Kanter's research visit our Combating Stigma - Research page.
View the presentation (11 M PowerPoint file)


MONTHLY FEATURE JULY 2007
By Nicola Boden, PA
Published: 14 May 2007

Country walks can help reduce depression and raise self-esteem according to research published today, leading to calls for "ecotherapy" to become a recognised treatment for people with mental health problems.

Ecotherapy: the green agenda for mental health is the first study looking at how "green" exercise specifically affects those suffering from depression.

According to Mind, England and Wales's leading mental health charity, it produced "startling" results proving the need for ecotherapy to be considered a proper treatment option.   Read the rest of the article at The Independent

Additional Resources:
International Community for Ecopsychology
Educating Counseling and Healing With Nature
Exercise and Depression (WebMD)
Exercise Stimulates The Formation Of New Brain Cells (article)
Garden Access Benefits Dementia Sufferers (article)