BACKGROUND:
It is commonly assumed that there are clear lines of demarcation between anxiety and depressive disorders on the one hand and psychosis on the other. Recent evidence, however, suggests that this principle may be in need of updating.
METHODS:
Depressive and/or anxiety disorders, with no previous history of psychotic disorder, were examined for the presence of psychotic symptoms in a representative community sample of adolescents and young adults (Early Developmental Stages of Psychopathology study; n = 3021). Associations and consequences of psychotic symptomatology in the course of these disorders were examined in terms of demographic distribution, illness severity, onset of service use, and risk factors.
RESULTS:
Around 27% of those with disorders of anxiety and depression displayed one or more psychotic symptoms, vs 14% in those without these disorders (OR 2.23, 95% CI 1.89-2.66, P < .001). Presence as compared with nonpresence of psychotic symptomatology was associated with younger age (P < .0001), male sex (P < .0058), and poorer illness course (P < .0002). In addition, there was greater persistence of schizotypal (P < .0001) and negative symptoms (P < .0170), more observable illness behavior (P < .0001), greater likelihood of service use (P < .0069), as well as more evidence of familial liability for mental illness (P < .0100), exposure to trauma (P < .0150), recent and more distant life events (P < .0006-.0244), cannabis use (P < .0009), and any drug use (P < .0008).
CONCLUSION:
Copresence of psychotic symptomatology in disorders of anxiety and depression is common and a functionally and etiologically highly relevant feature, reinforcing the view that psychopathology is represented by a network or overlapping and reciprocally impacting dimensional liabilities.

According to the World Health Organization, depression is the leading cause of disability and the fourth leading contributor to the global burden of disease, projected to reach second place by 2020. There is also strong evidence that it is an independent risk factor for heart disease, and several studies show that prolonged depression is associated with selective and possibly permanent damage to the hippocampus, a region of the brain critical to memory and learning.
Add the fact that 2 percent to 12 percent of depressed people eventually commit suicide, and the [supposed evolutionary] “advantages” of depression suddenly don’t look so good....
What is natural, the thinking goes, is best. If we are designed to suffer depression in response to life’s ills, there must be a good reason for it, and we should allow it to take its painful and natural course.
But unlike ordinary sadness, the natural course of depression can be devastating and lethal. And while sadness is useful, clinical depression signals a failure to adapt to stress or loss, because it impairs a person’s ability to solve the very dilemmas that triggered it.
Even if depression is “natural” and evolved from an emotional state that might once have given us some advantage, that doesn’t make it any more desirable than other maladies. Nature offers us cancer, infections and heart disease, which we happily avoid and do our best to treat. Depression is no different.

People with diabetes are three to four times as likely to have major depression as people without diabetes, and depression appears to increase the risk of Type 2 diabetes in certain populations. Depression is also known to increase the risk of complications in people with Type 2 diabetes. Now, new research indicates that treating people for both depression and diabetes simultaneously can significantly improve both conditions.
Depression may affect a person’s ability to carry out diabetes self-management tasks, such as taking medicines and monitoring blood glucose. And the stress of managing diabetes can contribute to an increased risk of depression. (There may be other biological factors, such as inflammation, contributing to the association as well)....
[Intervention subjects] and their doctors worked along with integrated care providers to identify and deal with issues that might interfere with [taking] medicines as advised, such as the price of the medicine or a lack of social support. The managers then crafted tailored programs to help these individuals stick to their diabetes medicine and antidepressant regimens....
At the end of the 12 weeks, 60.9% of those receiving the integrated treatment approach had improved their blood glucose levels, compared to only 35.7% of people receiving standard therapy. Moreover, 58.7% of participants in the integrated treatment group showed signs of remission in their depression, compared to only 30.7% of those in the usual treatment group.

• High blood glucose makes your blood “sludgy,” slowing circulation so cells can’t get the oxygen and nutrients they need. Margaret commented, “I can tell if my sugars are high in the morning, because ‘groggy’ doesn’t begin to describe it. ‘Drugged’ is how it feels.”
• Low sugars levels also cause fatigue, because when blood sugar is low, there is not enough fuel for the cells...
• [With vascular inflammation caused by igh blood glucose,] immune cells called monocytes come into the brain, causing fatigue....
• [P]eople with diabetes are more likely than others to have thyroid problems. If your thyroid level is low, you are likely to feel tired, sleepy, and depressed.
• Low testosterone levels, especially in men. Men with diabetes are much more likely to have low testosterone.
• Infections: People with diabetes often have infections they don’t know about. Infections take energy to fight, which can cause fatigue and raise blood sugar levels. A common source is urinary tract or “bladder” infections. They often hurt, but sometimes have no symptoms, except for the fatigue. Silent dental infections and vaginal infections are also common and fatiguing.
• Undiagnosed heart disease : If you get tired after tasks that you used to sail through, it could be time to for a heart check-up....
• Many drugs for diabetes, blood pressure, depression, pain, and other issues can cause fatigue. Read labels, ask your doctor or pharmacist....
• Some people are too wound up or too busy to sleep. Or they’re up to use the bathroom all night, or they have obstructive sleep apnea (OSA), which can wake them up many times an hour....
• [Rotating shifts or working nights] can cause fatigue directly by messing with your body clock or indirectly by disrupting sleep.
• Depression is very common with diabetes. Most depressed people feel fatigued, even if they don’t feel sad. Even at low levels, depression can sap your motivation....
• Doing too much: If you’re ripping and running all day, not taking breaks or even stopping to breathe much, you are courting fatigue....
• Stress: In small doses, psychological or physical stress can give you energy, but if it goes on too long, it will wear you out...
• Too much carbohydrate — especially refined carbs — can make anyone tired, especially with diabetes. Kat wrote, “now that I am eating a higher protein/fat, lower-carbohydrate diet, I have shaken off that really sleepy/extreme fatigue that I used to have every day.”
• According to WebMD, too much caffeine can cause fatigue through a rebound effect. They also say that dehydration, or not drinking enough liquid, is a major cause of fatigue.
• Being out of shape or having weak muscles: Not moving our bodies contributes to fatigue. Of course, it’s hard to exercise when you’re fatigued.

Low levels of vitamin D already are associated with a cavalcade of health woes from cardiovascular diseases to neurological ailments. This new study – published in Mayo Clinic Proceedings – helps clarify a debate that erupted after smaller studies produced conflicting results about the relationship between vitamin D and depression. Major depressive disorder affects nearly one in 10 adults in the U.S....
UT Southwestern researchers examined the results of almost 12,600 participants from late 2006 to late 2010. Dr. Brown and colleagues from The Cooper Institute found that higher vitamin D levels were associated with a significantly decreased risk of current depression, particularly among people with a prior history of depression. Low vitamin D levels were associated with depressive symptoms, particularly those with a history of depression, so primary care patients with a history of depression may be an important target for assessing vitamin D levels. The study did not address whether increasing vitamin D levels reduced depressive symptoms.

Participants were randomly assigned an antidepressant, psychotherapy, or referral to a community mental health service provider. "Structured care reduces major depression in these diverse and impoverished patients," said lead author Jeanne Miranda, Ph.D., University of California at Los Angeles Neuropsychiatric Institute. "This study broadens the knowledge base by evaluating depression treatments among young, predominantly minority women. It is the first study to let providers know that treating depression in this population can significantly improve the ability of these women to feel and function."

Results show that low-income women in minority populations benefit from depression treatment when it is paired with intensive outreach and encouragement to support the interventions. Not only did women achieve lower levels of depressive symptoms, but they also gained higher levels of functioning in daily life.

Outreach support—including transportation, child care, and spending considerable time to gain the trust of these participants—was an essential part of the study. Miranda and colleagues screened thousands of women for ethnicity, major depression, and exclusionary factors while they attended Women, Infants, and Children food subsidy programs and family planning clinics in four suburban counties near Washington, D.C.

Dysthymia is a depressive mood disorder [with] a chronic course and an insidious onset. Many people with dysthymia describe life-long depression. <br />
[Dysthymia is defined as a chronic mood disorder with a duration of at least 2 years. It manifests as depressed mood most of the day, more days than not, with at least 2 additional] symptoms:<br />
* Poor appetite or overeating<br />
* Insomnia or hypersomnia<br />
* Low energy or fatigue<br />
* Low self-esteem<br />
* Poor concentration<br />
* Difficulty making decisions<br />
* Feelings of hopelessness <br />
[Major depressive episodes must not have occurred in the first 2 years of the illness] and history of mania should not exist. [DSM-IV-TR allows transient euthymic episodes...of up to 2 months.] <br />
[DSM-IV-TR] categorizes dysthymia according to course specifiers: early onset < age 21 years; late onset ≥ age 21 years;] with atypical features if symptoms include increased appetite or weight gain, hypersomnia, a feeling of leaden paralysis, and extreme sensitivity to rejection.

Depressed people consistently see the world around them more realistically than mentally healthy people who are biased toward optimism. Depression makes leaders more realistic and empathetic, and mania makes them more creative and realistic. The same, to a lesser but important degree, goes for people who are neither depressed nor manic, but not mentally healthy either—those with abnormal personalities [such as dysthymics]—a little depressed, low in energy, needing sleep—and the hyperthymic—always upbeat, sleep little, high libido....<br />
Kennedy as mentally ill and Nixon as normal? I define mental health as the absence of mental illness and being within the normal range of personality traits]; Nixon’s biography, looking for the 4 objective markers of mental illness, supports that conclusion. People ascribe mental abnormality to Nixon because they don't like his behaviours; that reflects psychological stigma,] stigma against mental illness, which is really very deep-rooted in our society.

Service in a war zone is stressful and traumatic, whether you are physically wounded or not. Feeling that you are in danger all the time will weaken your immune system and create insulin resistance...Using violence against others is also traumatic.
Trauma, if not treated and resolved, can leave your body stressed for life. It’s no wonder veterans have high rates of drinking and smoking, both of which are perceived as stress relievers. Some veterans may also medicate with sugars, which can temporarily reduce stress. But even without these problem behaviors, chronic stress tends to raise blood pressure and blood glucose levels.
Agent Orange was one major pollutant, but the Pentagon uses all kinds of chemicals and now uses [depleted uranium]. Many closed military bases become Superfund sites because they are so polluted. The communities near those bases suffer, but soldiers [who worked on those bases had even higher exposure. P]ollution has strong links with diabetes. [links]

A recent meta-analysis of studies about exercise and mortality showed that, in general, a sedentary person’s risk of dying prematurely from any cause plummeted by nearly 20% if he or she began brisk walking (or the equivalent) for 30 minutes 5 times a week. If he or she tripled that amount to 90 minutes of exercise four or five times a week, his or her risk of premature death dropped by only another 4%. So the one indisputable aspect of the single best exercise is that it be sustainable.... <br />
[An innovative, 5-month-long program for elders of brisk, interval-style walking—3 minutes fast, 3 minutes slower, repeated 10 times—yields striking results.] “Physical fitness—maximal aerobic power and thigh muscle strength—increased by about 20%...which is sure to make you feel about 10 years younger than before training...[S]ymptoms of lifestyle-related diseases (hypertension, hyperglycemia and obesity) decreased by about 20%"...while their depression scores dropped by half.

[This study assessed] associations between diabetes-related symptom distress, glucose metabolism status, and comorbidities of type 2 diabetes [via] a cross-sectional sample of 281 individuals with normal glucose metabolism (NGM), 181 individuals with impaired glucose metabolism (IGM), and 107 subjects with type 2 diabetes. We used the revised type 2 Diabetes Symptom Checklist (DSC-R) to assess diabetes-related symptom distress. <br />
The total symptom distress score (range 0-100) was relatively low for diabetic subjects (mean +/- SD 8.4 +/- 9.4), although...significantly different from that for subjects with IGM (6.5 +/- 7.1) and NGM (6.1 +/- 7.9)...Ischemic heart disease was associated with elevated DSC-R scores on three subscales, whereas depression showed higher symptom distress levels across all DSC-R domains. <br />
Worsening glucose metabolism [correlates with increasing diabetes-related symptom distress, a relationship] attenuated by ischemic heart disease and particularly by depression.

The total symptom distress score (range 0–100) was relatively low for diabetic subjects (mean ± SD 8.4 ± 9.4), although it was significantly different from that for subjects with IGM (6.5 ± 7.1) and NGM (6.1 ± 7.9) (F = 3.1, 2 d.f., P = 0.046). Ischemic heart disease was associated with elevated DSC-R scores on three subscales, whereas depression showed higher symptom distress levels across all DSC-R domains.<br />
<br />
CONCLUSIONS—Worsening glucose metabolism is associated with increasing diabetes-related symptom distress. This relationship is attenuated by ischemic heart disease and particularly by depression.

Results
The prevalence of depression was 11% in the total sample with little difference between the groups with and without any vascular co-morbidity (11.2% vs 10.0%). Single vascular co-morbidities were not associated with increased rates of depression. The final model predicting depression included: having multiple vascular co-morbidities compared with none; having less social support; having experienced a recent stressful life event; female sex; and being a smoker.<br />
Conclusions/interpretation
Rates of depression in those with one additional vascular co-morbidity did not differ from patients with diabetes only. Vascular co-morbidities were only associated with higher depression scores in case of multiple co-morbidities.

Medical research tends to practice what philosophers of science call reductionism—trying to understand the nature of something complex (like nutrition and health) by reducing it to the interactions of its parts. Early studies showing that eating more fruits and vegetables was good for health led to a focus on food components, such as fiber, vitamins, and antioxidants. None come close to offering the benefits of food itself. The same story appears to be playing out with fish and fish oil.<br />
If you have heart disease, taking fish oil doesn't seem to replace eating fish...The benefit could be due to fish oil in its natural state (in fish), something else in fish, or maybe the fact that eating fish means eating less red meat. <br />
What if you just don't like fish? Then make sure your doctor has prescribed the best medical therapy for your condition and you are following his or her advice. That is far more important than taking fish oil.

Earlier studies have found that diabetes is a risk factor for depression development and recurrence of depression‚ though findings may vary depending on the methods used. <br />
In a new study‚ researchers examined the association of diabetes and the onset of depression by reviewing the literature and conducting a meta–analysis of available longitudinal studies. Investigators looked at 11 studies published up to September 2009‚ including a total of 48‚808 cases of type 2 diabetes without depression at baseline. The pooled relative risk was found to be 1.24 for the random effects model. The researchers concluded that‚ compared to controls without diabetes‚ patients with type 2 diabetes have a 24 percent higher risk of developing depression. The underlying mechanisms to this association‚ however‚ remain unclear and require additional study.<br />
(http://www.springerlink.com/content/0442246817g32021/)

Someone should tell the Family Research Council that if you are accused of distorting legitimate science, it's probably not best to lodge a defense by citing a piece you wrote which was publicly called out for distorting legitimate science. <br />
It makes you look like a huge liar.

I wanted my younger daughter to wear her snow boots to school, but she wanted to wear sneakers....I could tell by the warning signs that she was on the brink of getting very riled up. [Normally] I would have answered her protests with a stream of contradictions: "The boots aren't uncomfortable," "You've worn them before, and they felt fine"...Instead, the conversation went like this: <br />
"I don't want to wear those boots. They don't feel comfortable." <br />
"It's wet and snowy out, so you need to wear the boots, but you'd rather not." <br />
"I don't want to wear the boots." <br />
"You wish you could wear your sneakers." <br />
"I don't want to take my sneakers in a bag, I want to wear them." <br />
"You just don't feel like wearing these boots today! They aren't as comfortable to wear for the long walk to school." <br />
Then she calmly put on the boots. Really. <br />
Experts say that denying bad feelings intensifies them; acknowledging bad feelings allows good feelings to return. That sure seemed to be what happened.

Former Clinton administration labor secretary Robert Reich, now a public policy professor at UC Berkeley, argues that working class incomes have stagnated for so long that ordinary consumers - who account for about 70 percent of all economic activity - have lost the buying power to pull the country out of recession.<br />
<br />
"We have got to address this inequality, or it will derail the economy," said Reich, who will speak at the Commonwealth Club Tuesday evening about the plan he proposes in his new book, "Aftershock," to tax the rich to pay for training and other assistance to help Americans climb the income ladder.

It's not that Frances doesn't think that Asperger's exists and is a real problem for some people; he does. But he also believes the diagnosis is now radically overused in a way that he and his colleagues never intended. And why, in his view, did Asperger's explode? Primarily, Frances says, because schools created a strange unintentional incentive.<br />
<br />
"In order to get specialized services, often one-to-one education, a child must have a diagnosis of Asperger's or some other autistic disorder," he says.<br />
<br />
"And so kids who previously might have been considered on the boundary, eccentric, socially shy, but bright and doing well in school would mainstream [into] regular classes," Frances says. "Now if they get the diagnosis of Asperger's disorder, [they] get into a special program where they may get $50,000 a year worth of educational services."

'[Rats kept in the dark for six weeks] not only exhibited depressive behavior but also suffered damage in brain regions known to be underactive in humans during depression. [R]esearchers observed neurons that produce norepinephrine, dopamine and serotonin[—]neurotransmitters involved in emotion, pleasure and cognition—in the process of dying. This neuronal death...accompanied in some areas by compromised synaptic connections, may be the mechanism underlying the darkness-related blues of seasonal affective disorder.
'Gary Aston-Jones...speculates that the dark-induced effects stem from a disruption of the body’s clock[:] “When the circadian system is not receiving normal light, that in turn might lead to changes in brain systems that regulate mood....
'"Many existing animal models depend on stress. Our model is a stress-free means of producing a depression. It might be parti cularly relevant to seasonal affective disorder, but we think that it is relevant to depression overall"'

'The program spots words, phrases, and even metaphors, to detect possible signs of depression (anxiety, sadness, preoccupation with self and with death). For example, words like "black," combined with terms such as "sleep deprivation" or "loneliness," will be recognized by the software as "depressive" texts.
'To understand similarities in the way people describe the blues, the researchers conducted searches using Microsoft's Bing and extensively analyzed the word pattern "depression is like..." They then tested the program, called Pedesis, by scanning[, with permission.] more than 350,000 English-language texts from 17,031 bloggers...as well as 1600 online queries addressed to mental health experts at sites like MentalHealth.net. Once the program identified texts as depressive, a panel of four clinical psychologists reviewed 200 examples from that category. The verdict of the computer program and the analysis of the human panel correlated 78% of the time, according to the researchers.'

'In those bleak moments when the lost souls stood atop the cliff, wondering whether to jump, the sound of the wind and the waves was broken by a soft voice. "Why don't you come and have a cup of tea?" the stranger would ask. And when they turned to him, his smile was often their salvation.
'For almost 50 years, Don Ritchie has lived across the street from Australia's most notorious suicide spot, a rocky cliff at the entrance to Sydney Harbour called The Gap. And in that time, the man widely regarded as a guardian angel has shepherded countless people away from the edge.
'What some consider grim, Ritchie considers a gift. How wonderful, the former life insurance salesman says, to save so many. How wonderful to sell them life.
'"You can't just sit there and watch them," says Ritchie, now 84, perched on his beloved green leather chair, from which he keeps a watchful eye on the cliff outside. "You gotta try and save them. It's pretty simple."'

''After his condition was diagnosed, [Mr. Pantoliano] says, he realized the difference between being treated for mental illness and other diseases, “Mental disease is the only disease you get yelled at for having.”
As a result, “so many of us hold our secrets inside us,” he adds. “We take them to our grave — and they put us in the grave.”'

'[Drug company studies demonstrated] "statistically significant weight loss with all 3 doses of Qnexa[, along with] significant improvements in cardiovascular and metabolic risk factors including blood pressure, lipid levels, and type 2 diabetes"...
* [Qnexa subjects lost an average] 14.7% of their body weight [37 lbs/16.8 kg over 56 weeks].
* [Qnexa subjects] showed significant improvements in cardiovascular, metabolic and inflammatory risk factors.
* The drug exceeded FDA efficacy benchmarks for weight loss agents at all 3 doses...
* Completion rates were significantly higher than placebo at all 3 doses (up to 69%), indicating the drug was well tolerated.
* The drug showed a favourable safety profile (the balance between benefits and risk)....
'[C]ommonly reported side effects were dry mouth, tingling, constipation, altered taste and insomnia....
'Overall scores for depression and quality of life, including self esteem and general health showed significant improvement.'

May and her colleagues measured blood levels of vitamin D in 8,680 people age 50 or older who had been diagnosed with heart disease, stroke, or another type of cardiovascular disease...Among those with very low levels of vitamin D [≤ 15 ng/mL], 32% were depressed, as were 25% of the people with low levels [≤ 30 ng/mL], and 21% of those with normal levels [> 30 ng/mL]. This trend was seen even among individuals with no history of depression. Winter seemed to make the association even more pronounced....In the second study, which looked at 27,686 people age 50 or older with no history of cardiovascular disease, May and her colleagues found that, compared to individuals with normal levels of the vitamin, people with very low levels of vitamin D were 77% more likely to die, 45% more likely to develop heart disease, and 78% more likely to have a stroke during the study, which lasted for more than a year. They also had double the risk of heart failure.

Professor Miguel Martinez-Gonzalez, of the University of Navarra, said the results would have to be confirmed in longer[, larger trials] but they had found a strong inverse association between the Mediterranean diet and depression. "30% is a large reduction in...risk and this could be very important considering the large burden of disease represented by depression...the Mediterranean diet is [important] in reducing cardiovascular risk factors and the same inflammatory proteins are also raised in [depressives]." He said it was likely that the overall dietary pattern was more important than the effect of single components and "may exert a fair degree of protection against depression". Dr Cecilia D'Felice, a clinical psychologist, [cited] mounting evidence for the importance of diet[:] "What we do know is that a diet high in olive oil will enhance the amount of serotonin or brain transmitter available to you. Most anti-depression drugs work to keep more serotonin available in the brain."

Since then, [Remy] has been fighting depression. He received therapy, and his doctors are trying to get his medications squared away. He’s spent the last two months in a gym and he’s regained the 25 pounds. “Physically, I’m back. Mentally, I think I’m on the right path,’’ said Remy. “The doctors told me to expect that sort of thing. They’re kind of surprised I didn’t crash before I did.’’ The turning point came last week, he said. He went to the Paul McCartney concert at Fenway. He started to feel better: “When I got back to the ballpark, I thought, ‘Hey, this is home’’’...That’s why he was back last night. He wanted to see Red Sox manager Terry Francona, talk to some players, go to a news conference. He wanted to see what it was like in the booth again. He called it a “simulated game,’’ a step toward returning.

“The better I started to feel, there would have to be a day where I had to come here,’’ said Remy. “I looked at it today and I thought, ‘What are you doing? Get in there.’ ’’

The operation borrowed a procedure called deep brain stimulation, or D.B.S., which is used to treat Parkinson’s. It involves planting electrodes in a region near the center of the brain called Area 25 and sending in a steady stream of low voltage from a pacemaker in the chest.

Dobbs goes on to quote patient Deanna Cole-Benjamin and Dr. Helen Mayberg, the neurologist who devised the procedure, from a conversation they had during the surgery (the skull of the patient is bolted to a frame, but the patient remains conscious):

“So we turn it on,” Mayberg told me later, “and all of a sudden she says to me, ‘It’s very strange,’ she says, ‘I know you’ve been with me in the operating room this whole time. I know you care about me. But it’s not that. I don’t know what you just did. But I’m looking at you, and it’s like I just feel suddenly more connected to you.’ “

I asked Mark how the near-death experience had changed him. He talked about not being afraid of death any more, appreciating each day as it comes, living on "a more even keel."
Then he said something interesting. "I learned not to pay attention to my emotions. I learned that emotions aren't real. They're just waves in your mind. They can get in the way of doing what you need to do. So if feelings can help me get from one place to another, I use them. If they're in the way, I just let them go"....
I was surprised to hear that. I tend to trust emotions more than thoughts. Emotions are more primal. They're felt in the older parts of the brain. Where thoughts can be confused or just plain wrong, I thought emotions were more reliable. But Mark said no.
"Like when somebody says something that hurts, or hits me in the head or something, I'll get angry...I can decide what I want to do about it. But if I keep going back to that feeling and stay angry, I'll just be stuck."

Dr. Heppner from the University of California, San Diego in La Jolla and colleagues examined physical measures and laboratory values in a sample of 253 veterans to evaluate the association between PTSD severity and the presence of metabolic syndrome.

The team reports that 139 subjects met criteria for PTSD, 163 had major depressive disorder (MDD), and 101 had metabolic syndrome.

The prevalence of metabolic syndrome was higher among those with PTSD only (34.3%) than among those with MDD only (28.8%), but it was highest among patients with both PTSD and MDD (46.2%).

MDD alone was not a significant predictor of metabolic syndrome risk, the report indicates.

PTSD severity significantly predicted the risk of metabolic syndrome, the researchers note, with each one-point increase in the Clinician Administered PTSD Scale (CAPS) being associated with one percentage point increase in the risk of metabolic syndrome.

The metabolic syndrome predicts depressive symptoms in middle-aged adults, according to the results from the prospective Whitehall II cohort study reported [by] Tasnime N. Akbaraly,...University College London....The study cohort consisted of 5232 [British civil servants], aged 41 to 61 years, in whom depressive symptoms were evaluated from 1991 to 1993 and again 6 years later [via] the depression subscale from the 30-item General Health Questionnaire. At baseline, metabolic syndrome was evaluated based on National Cholesterol Education Program criteria.
After adjustment for potential confounders...the metabolic syndrome was associated with an increased risk for future depressive symptoms...Central obesity, high triglyceride levels, and low high-density lipoprotein (HDL) cholesterol levels, but not other components of the metabolic syndrome, predicted depressive symptoms and accounted for most of the association between the metabolic syndrome and the onset of depressive symptoms.

People with diabetes are almost twice as likely to be depressed. [T]he demands of life with diabetes [may] increase a person's risk for depression, especially for those with complications. [B]eing depressed [may increase] a person's risk of developing Type 2 diabetes. Depression and stress can raise blood glucose levels. [Stress] releases hormones that raise blood glucose...and depression aggravates this...[I]f you have "pre-diabetes," depression could push glucose levels high enough...to develop diabetes. Depression and diabetes are a bad combination. When you are depressed, it is hard to do anything, including take good care of yourself...[P]oorer self-care [produces] more complications, including heart attacks and strokes, and more physical limitations....You could be depressed if you feel persistently sad, have lost interest in things you usually enjoy, [have] changes in sleep or eating patterns, [have] trouble concentrating or making decisions, [or feel] bad about yourself.

Diabetes and high levels of blood sugar may be linked to abnormalities in a person's body clock and sleep patterns....[A genetic mutation associated with] an increased average blood sugar level and around a 20% elevated risk of developing type 2 diabetes [also affects] the action of the hormone melatonin....Philippe Froguel...said: "[Research has shown] links between sleep problems and...obesity and depression...[A]bnormalities in the circadian rhythm may partly be causing diabetes and high blood sugar levels." [B]lood sugar levels are [controlled] by insulin...[A] genetic abnormality that affects melatonin levels and sleep patterns...may also disturb the levels of insulin[,] normally secreted in peaks during the daytime...and at lower levels at night[, the reverse of] melatonin levels...Professor Froguel and colleagues [earlier] identified a genetic mutation that can raise [blood sugar] to harmful levels and...the key genes associated with a risk of developing type-2 diabetes.

30% of patients with Type 2 diabetes have depression[, which new research associates with] higher blood glucose...[A 4-year study of depression and] glycemic control in 11,525 veterans with type 2 diabetes shows that [HbA1c averages] 0.13% higher in [depressives]..."[T]hat the difference persisted over time and that the depressed group had higher mean HbA1c at all 36 time points was surprising," study coauthor Leonard Egede [said, adding] that this difference is...enough to push individuals with diabetes over the optimal threshold for glucose control and increase their risk for poor outcomes. Comorbid depression occurs in approximately 30% of adults with diabetes and is associated with poor metabolic control, [more] complication[s, more] healthcare use and costs...and increased disability and mortality..."[That the association shows] even in a sample with relatively well-controlled diabetes...suggests that in populations with higher baseline HbA1c, the...association may be much higher"

[D]epression and diabetes is [known to be] a potentially lethal mix among young to middle-aged patients. Depression also puts patients at greater risk of complications from their diabetes. [D]epression is also a risk factor for mortality [later in life, according to a new study that tracked 10,704 diabetics, mean age 75.6 years,] who were enrolled in a disease management program in Florida....Evidence of depression among members of the group came from physician diagnosis, patient reports of having a prescription for an antidepressant in the year before the survey, or patient answers to a brief screening test. For the next two years, the research team recorded the death and cause of death of participants through bi-monthly checks of Medicare claims and eligibility files, or from phone calls with the participants' families...[P]atients with both diabetes and depression had an increased risk of about 36% to 38% of dying from any cause during the two-year follow-up.

Dialysis patients diagnosed with depression are nearly twice as likely to be hospitalized or die within a year than those who are not depressed, a UT Southwestern Medical Center researcher has found.

In the study, researchers monitored 98 dialysis patients for up to 14 months. More than a quarter of dialysis patients received a psychiatric diagnosis of some form of depression based on a Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM IV).

This is the first reported link between adverse clinical outcomes in dialysis patients and depression made through a formal psychiatric interview based on the DSM-IV standards. More than 80 percent of the depressed patients died or were hospitalized, compared with 43 percent of non-depressed patients. Cardiovascular events, which previously have been linked to depression, led to 20 percent of the hospitalizations.

metformin as a weight control drug; its relation to B12 absorption; B12, D, and depression

[Johns Hopkins reports] the most conclusive evidence to date that inadequate levels of vitamin D, obtained from milk...and exposure to sunlight, lead to substantially increased risk of death. [A] diverse sample of 13,000 initially healthy men and women [allowed comparison of] risk of death between those with the lowest [and higher] blood levels of vitamin D...[U]nhealthy deficiency [is <=]17.8 nanograms per [ml of blood]. Of the 1,800 [known deaths during the study]...nearly 700 died from some form of heart disease, with 400 of these being deficient in vitamin D...an estimated 26% increased risk of any death, though the number of deaths from heart disease alone was not large enough to...resolve that it was due to low vitamin D levels. [Other studies link deficient] vitamin D to increased rates of breast cancer and depression in the elderly [and] an 80% increased risk of peripheral artery disease...[D]aily intake of vitamin D [from 200-400 IU yields] blood levels nearing 30 ng/ml.

'Anger can be common for people coping with diabetes....anger may become a barrier to the management of diabetes.'

A cannabinoid surrogate models serotonin-system effects and quantifies an optimal dose for antidepressant action: .2mg/kg, if you happen to be a lab rat. And boy, do they have a stressful life! Details of the experiment mechanics not for the squeamish.

Low doses of marijuana may be clinically effective as an antidepressant because it increases serotonin levels, but researchers point out that heavier use of the drug can make depression worse and even cause psychosis.

'A depression care management intervention can significantly reduce all-cause mortality among depressed patients with diabetes.' Depression is a risk factor for diabetes, and depression is increased by a factor of 2 in patients with diabetes

SSRIs may reduce blood glucose levels; tricyclic antidepressants may interfere with glucose control. A study of treatment methods for severe depression in diabetics ranked psychotherapy as providing relief for 85% of subjects; SSRIs: 62%; tricyclics: 57 %

Julia Lesage points out that these non-verbal cues of self presentation to others can be useful for fiction and screenwriters and also that they are true of white middle class people in the United States, not culturally universal.

With diabetes or not, depression raised the risk of mortality....Comparing diabetics who were depressed vs. diabetics who were not depressed, researchers reported that depression increased the risk of mortality by 30%. - Diabetes Care (ADA), 2005/06

from "Overcompensating": see also http://overcompensating.com/posts/20070615.html

A study of 202 depressed adults [concludes] that those who went through group-based exercise therapy did as well as those treated with an antidepressant drug. A third group that performed home-based exercise also improved, though to a lesser degree.

Patients who continued to exercise...were much less likely to see their depression return...Only 8% of patients in the exercise group had their depression return, while 38% of the drug-only group and 31% of the exercise-plus-drug group relapsed.

60% of the exercise-only patients were no longer depressed, compared with 66% for the medicated and 69% of the combination group.....47% of the exercise group were no longer depressed, compared to 56% of the medicated and 47% of the combination group.

Employees who got aggressive intervention worked about two weeks more during the yearlong study than those who got the usual advice to see a doctor or a mental health specialist...More workers in the intervention group were still employed by year's end.

During periods of acute stress, glucocorticoids promote survival by mobilizing energy reserves....Overproduction is associated with significant disruption of cellular functioning, which, in turn, leads to widespread physiological dysfunction.

Neuroplasticity argues that the brain is much more flexible than we thought. Science writer Sharon Begley's book "Train Your Mind, Change Your Brain" looks at the latest in brain science and how our thoughts and actions can actually change our brains.