reduce depression

Study: Impact of Gratitude on depression, suicidal ideation, and self-esteem

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

One definition of gratitude is a state of mind where one feels and expresses thankfulness consistently over time and across situations (1).

In a previous post, we reviewed the role of specific gratitude exercise on happiness, stress, and depression (2, 3).

A recent study looked at the relationship of a person’s gratitude levels on depression, suicidal-ideation, and self-esteem among college students.

What did the study involve?
• 814 college students, with a mean age of 20.13 years (4).

• Participants completed questionnaires measuring gratitude, depression, suicidal ideation, and self esteem (4).
• The relationship between these four factors was analyzed (4).

What did the results show? (4)
• Participants with higher levels of gratefulness tended to have a higher level of self-esteem (4).
• Higher self-esteem decreased suicidal-ideation (4).
• Participants with higher levels of gratefulness tended to be less depressed, which also reduced suicidal-ideation (4).

What are some caveats?
• This was a small study looking at correlations, which does not necessarily tell us about cause and effect (causation).
• Specific factors that increased the gratitude of participants was not examined.
• Individual responses may vary.

Where can I learn more about gratitude?

Here is a link on a specific gratitude exercise: https://u.osu.edu/emotionalfitness/2015/12/

https://www.innerbody.com/ways-to-cultivate-gratitude

 

What are some resources to improve depression?

• Counseling at the OSU Student Life Counseling and Consultation Service
• Holiday stress article from the Mayo Clinic
• Mindfulness and Body scan techniques at the OSU Wexner Medical Center
• Depression information at the National Institute of Mental Health
• Anonymous mental health screen
• Depression and Bipolar Support Alliance

National Alliance on Mental Illness (NAMI)

Could gratitude practices help you feel better?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Emmons, R. A. & Crumpler, C. A. (2000). Gratitude as a human strength:
    Appraising the evidence. Journal of Social and Clinical Psychology, 19, 56–69.
  2. https://u.osu.edu/emotionalfitness/2015/12/
  3. Oleary K, Dockray S. The Effects of Two Novel Gratitude and Mindfulness Interventions on Well-Being. THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE. Volume 21, Number 4, 2015, pp. 243–245.
  4. Lin CC. The relationships among gratitude, self-esteem, depression, and suicidal
    ideation among undergraduate students.  Scandinavian Journal of Psychology, 2015, 56, 700–707. DOI: 10.1111/sjop.12252

Improving your likelihood of antidepressant medication response

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

As of 2014, about 15.7 million people in the US had at least 1 major depressive episode in the last year, and about two thirds of the individuals had a severe impairment in their ability to manage at home, work/school, or relationships with others (1).

Treatment options for major depression include counseling, medications, life-style, and other strategies. These options can be used alone or in combination with each other.

A recent study looked at a major factor impacting your response to antidepressant medication for major depression.

How do you define depression?

A major depressive episode is defined as an episode of depressed mood or loss of pleasure in daily activities lasting 2 weeks or longer in the past 12 months and at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth (2).  Additionally there must be some impairment in a person’s ability to function at home, work, relationships or social settings.

What was the study? (3)

792 patients receiving usual care for depression in 83 clinics for at least six months between 2008 and 2010 (4).

How was depression measured?

Depression was measured using, Patient Health Questionnaire–9, a validated instrument to measure the severity and treatment response to depression (3,4).

Was there a key finding?

According to the study article, patients reporting fair or poor health were significantly less likely to improve depression compared with patients with good, very good, or excellent health (3).

What do the results mean?

In my practice, I often discuss the mental health benefits of healthy lifestyle habits such as healthy eating habits, healthy (not excessive) exercise, adequate sleep, avoidance of alcohol, illicit drugs; yoga, meditation, etc.

This study suggests that individuals suffering from Major Depression with good overall health had a better chance of benefiting from antidepressant medications than those with depression who reported fair or poor health.

In other words, while good overall health might help many people with depression, if you are still depressed, having good overall health improves your chances of responding to medications.

This is a small study and further studies would be helpful.

What are some resources regarding health improvement?

What are some of OSU’s campus resources that might help with reducing depression?

What are some resources regarding depression?

• Counseling at the OSU Student Life Counseling and Consultation Service
• Mindfulness and Body scan techniques at the OSU Wexner Medical Center
• Depression information at the National Institute of Mental Health
• Anonymous mental health screen
• Depression and Bipolar Support Alliance

National Alliance on Mental Illness (NAMI)

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  3. Rossom RC, et. al.  Predictors of Poor Response to Depression Treatment in Primary Care.  Published online: July 15, 2016. Psychiatric Services in Advance (doi: 10.1176/appi.ps.201400285)
  4. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a Brief Depression Severity Measure.J Gen Intern Med. 2001 September; 16(9): 606–613.

Hidden Consequence E-cigs

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Electronic cigarettes or E-cigs, have become popular in recent years for a variety of reasons.
Some tout the tobacco free alternative as a way to lower cancer risk.  Others claim it’s less addictive and less risk of lung disease.  These claims have been investigated via long term studies.

There are also risks of much higher nicotine ingestion than traditional (tobacco based) cigarettes leading to nicotine toxicity (1).
A recent small study, by Barrington-Trimis and colleagues, suggest another unexpected consequence of e-cigarette use (2).
Who was studied?
300 students,  in the 11th or 12th grade (2).
What was the study design? (2)
  • Questionnaires were given in the 11th or 12th grade, and again after they turned 18 years old.
  • Some questions included whether they use e-cigarettes, traditional (tobacco) cigarettes, whether they  smoke tobacco based cigarettes now or intend to do so in the future.
What were the results?  (2)
  • 40% of participants who reported e-cigarette use at the beginning of the study ended up using traditional (tobacco) cigarettes by age 18, vs only 11% of students who never used e-cigarettes.
  • After adjusting for different variables,  e-cigarette users were over 5 times as likely to initiate traditional smoking as those who had never used e-cigarettes.
  • The e-cigarette users who reported having no intention of smoking traditional (tobacco) cigarettes at the beginning of the study had a 9.7 x odds ratio of using traditional cigarettes by the end of the study.
What do the results mean?
  • According to this study, smoking e-cigarettes might increase your chances of smoking tobacco based cigarettes.
  • This is concerning because of the variety of negative mental health and physical consequences of tobacco use.
  • Smoking cigarettes can increase depression and anxiety (3,4).
Is e-cigarettes worth the feelings of anxiety, depression, and tiredness? Will you feel better if you exchange it for healthier ways of living?
What are some resources regarding tobacco use?
Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.
References:
1. Ordonez J, Forrester MB, Kleinschmidt K. Electronic cigarette exposures reported to poison centers. Clin Toxicology 2013;51:685
2. Barrington-Trimis JL, Urman R, Berhane K, et al. E-Cigarettes and Future Cigarette Use. Pediatrics. 2016; 138(1):e20160379
3. https://u.osu.edu/emotionalfitness/2015/04/15/does-smoking-increase-anxiety-and-depression-if-i-quit-will-i-feel-better/
4. Taylor G, et al. Change in mental health after smoking cessation: systematic review and meta-analysis. OPEN ACCESS. BMJ 2014;348:g1151 doi: 10.1136/bmj.g1151 (Published 13 February 2014)