Tag Archives: Depression

Brain fog? It could be a symptom of depression

When you think of depression, symptoms like sadness, fatigue, and feelings of worthlessness probably come to mind. Another symptom — one with a lower profile than its companions — is impaired cognitive functioning.

Some depressed people experience difficulty focusing, learning, remembering, understanding, and more. It can be distressing to notice your mental abilities declining.

The good news is these cognitive symptoms tend to improve with treatment. The bad news is they usually don’t disappear. In one study, patients suffering from depression reported cognitive problems 94 percent of the time; that percentage decreased to 44 percent after most symptoms of depression had abated.

It’s a significant decrease, but not the healing depressed people hope to see.

There’s a lot of room for science to come in and figure out what treatment options best improve cognitive functioning in depressed people. That’s why I was happy to see one step in that direction recently.

A group of researchers posed a cognitive test to two groups of rats–one group depressed and the other not. During the test, they measured certain protein levels in the rats’ cells. They found the depressed rats had lower levels of these proteins, which have been previously shown to play a role in the cognitive process.

Knowing what’s going on biologically should lead to better treatment for the cognitive aspect of depression.

Treatment for psychiatric problems is constantly improving, and it’s exciting to watch.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Newborn brain scans predict depression

Does depression change the brain, or are brain abnormalities the cause of depression?

There’s a new study out that sheds some light on that question.

A group of scientists took their research all the way back to the beginning of life: They scanned the brains of newborn babies.

Two years later, they evaluated those children for signs of depression and anxiety (sadness, excessive shyness, nervousness, or separation anxiety — all symptoms that have been linked to depression and anxiety disorders in older children and adults).

They found a pattern in the scans. The children who showed signs of depression and anxiety at age two tended to have at birth similar connections between the amygdala (a structure involved in processing emotion) and other brain regions (such as the insula, which is associated with consciousness and emotion, and the medial prefrontal cortex, which is involved in decision making).

The researchers want to stretch the study out further to see if these connectivity patterns really do predict psychiatric disorders later in life, but so far the evidence is interesting. If you’re suffering from depression or anxiety now, it’s likely you were born with the brain connections that helped lead you there.

But no matter when or where you psychiatric distress came from, help is available! Therapy, lifestyle changes, and medication can counteract the tendencies you were born with or developed later in life. Let’s talk about it!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Facebook comparisons: Bad for mental health

If you find yourself looking at your friends’ Facebook posts and comparing your life to theirs in a negative way, Facebook is probably not for you.

I find myself giving this advice to so many of my patients that I was not surprised to see a study on the topic published last week. It evaluated the results of studies on social media and depression from 14 countries and found that these social media comparisons are more likely to lead to depression than the comparisons we make in real life.

The link was especially strong in people who post on Facebook frequently and in people who accept friend requests from their exes.

Facebook depression is a real thing: in 2011 the American Academy of Pediatrics described it as “depression that develops when preteens and teens spend a great deal of time on social media sites, such as Facebook, and then begin to exhibit classic symptoms of depression.”

And in my experience, it’s real for some adults, too.

If you’re one of these people who feels depressed after being on Facebook, the solution is simple: Skip it! Uninstall Facebook from your phone! Stop visiting the site from your computer! You do not need that negativity in your life.

If browsing social media is your favorite way of relaxing, find a replacement. Go back to reading books. Find a cell phone game you like. Read the news. Look for DIY inspiration on Pinterest. Do crosswords or sudoku. Get a grown-up coloring book. There are lots of options!

Know yourself and what makes you happy, then choose that. In a lot of cases, it’s not Facebook.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Arthritis drug boosts antidepressant’s effectiveness

I was excited to read this week about another new treatment possibility for depression: An arthritis drug, when paired with an antidepressant, has been shown to work amazingly well.

It’s all about inflammation. Older studies have shown that depression leads to inflammation. Inflammation messes with the chemical balance in your brain and can prevent antidepressants from restoring that balance.

I’ve written before about how taking an over-the-counter anti-inflammatory medication can cut the depression symptoms for people with bipolar disorder, but this takes that treatment theory to another level.

This time, researchers got serious about tackling inflammation. They brought in an arthritis drug Celecoxib (used to treat pain, redness, swelling and inflammation from arthritis) and paired it with an antidepressant (Lexapro).

For an incredible 78 percent of patients, depression symptoms diminished by at least half. Sixty-three percent reported their depression was completely gone. That’s compared to remission in just 10 percent of patients taking Lexapro alone (with 45 percent saying symptoms had reduced by half).

Furthermore, where antidepressants typically take four to six weeks to start working, patients taking the arthritis drug saw results in just one week.

This new treatment method could prove to be a game changer for many!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.


Avoiding time change depression

A Danish study recently found that depression diagnoses go up significantly (8 percent) in the month following the change from Daylight Savings Time back to standard time.

With the time change scheduled to happen this Sunday, let’s be on the lookout for signs of depression. Better yet, let’s be proactive in fighting it back.

The Danish researchers suggest the increase is tied to the loss of sunshine in the time when we really notice: The few hours at the end of the day, right when we’re getting off work and hoping to enjoy some free time. It also marks the coming of a long string of dark, cold days (especially in Denmark).

The article announcing the study begins with this disheartening quote by not-helpful Danish poet Henrik Nordbrant:

The year has 16 months: November, December, January, February, March, April, May, June, July, August, September, October, November, November, November, November.

I’d like to counter with this verse by poet Alexander L. Fraser:

Fear not November’s challenge bold—
We’ve books and friends,
And hearths that never can grow cold:
These make amends!

So here’s what you can do: Dust off your favorite books, call your friends, light your fire. In other words, make plans! Do things you love. Go out and serve others (I recommend this website for finding opportunities). Take an ice skating or art class. Bundle up and go for a walk in the sunshine when you can.

If you’re feeling depressed, there are many things you can do. Medication and therapy can be a big part of that.  With work and help, November can turn out to be a good month after all.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Promising new treatment for depression

Here’s some good news for people who have been having a hard time finding treatment that works for their depression: Scientists are on their way to developing a new and improved one.

The hippocampus.
The hippocampus.

Researchers recently figured out which pathway in the brain antidepressants affect. They call it the BMP signaling pathway, and it’s in the hippocampus. They learned that Prozac and other drugs interrupt this pathway, triggering the brain to produce more neurons — neurons that affect mood.

Armed with this new understanding, they turned to the lab mice. Researchers injected the mice with a brain protein already known to block the BMP pathway. They discovered the protein–called Noggin–does a better job blocking the pathway than traditional antidepressants do.  But more importantly, mice receiving this treatment showed strong signs of overcoming depression.

I mentioned a couple weeks ago that I wasn’t sure what depression looked like in rats (or mice), but this study enlightened me on some symptoms: When you hang mice upside down by their tails, some will struggle for a long time to right themselves, and some will give up. Giving up is a sign of depression. Similarly, if you put mice in a complicated maze, some explore and some cower. Cowering is a sign of depression, too.

The mice who were receiving the Noggin injections struggled more and explored more than their counterparts who weren’t receiving treatment.

I’m always excited by new discoveries about how the brain works. With our growing understanding, medication for depression will only get better and better.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Medicating for depression: The basics

Today I want to take a few minutes to go back to the basics: Let’s talk about prescribing medication for depression. It’s a process that my colleagues and I engage in every day, but for new patients it’s unfamiliar and deserves an introduction.

When someone comes to me with depression (and we’re talking about regular depression this time–bipolar depression is a whole different topic), the first decision we make together is whether we’ll treat with therapy, medication, or both. In my experience, a combination of the two is the most effective approach, but every patient is different. Today we’ll just talk about the medication side of treatment.


Once we’ve decided to proceed with medication, we usually start with an antidepressant. There are several kinds of antidepressants, so we choose one that has been shown to best treat your particular symptoms — lack of motivation, irritability, trouble sleeping, sleeping too much, fatigue, trouble concentrating, restlessness, suicidal thoughts, or loss of enjoyment of the things you normally enjoy, for example. We talk about side effects, your family history, your ability and willingness to take pills regularly, other medications you’re taking, and your other health conditions and make a decision from there. We adjust the dosage as we watch your symptoms and side effects over the next several weeks.

If you’d like a breakdown of different types of antidepressants, I recommend this article from the Mayo Clinic.

What I really  want to focus on today is what we do when the antidepressant we choose is not working for you. The largest and best study out there on medicating for depression found that about a third of depressed people are “cured” by the first antidepressant prescribed to them — their depression symptoms go into remission.
If you’re not one of the lucky third, my next step is usually to try another type of antidepressant. In that same study, about 25 percent of the people who tried a second antidepressant went into remission. Those results are good enough to make trying again a strong option.

If the second antidepressant doesn’t work, we can choose to either try a third antidepressant — the study showed 12 to 20 percent of patients are cured by the third antidepressant — or we can try adding another medication on top of what you’re already taking. That’s called augmenting the antidepressant.

There are three main types of medications we can add to your antidepressant regimen: mood stabilizers, thyroid hormones, and antipsychotics. I’ve found that each of these has the potential to activate the antidepressant you’re already taking. Even if you haven’t experienced any improvement with the antidepressant, it can start to work when combined with something else.

Mood stabilizers

When you hear mood stabilizers, think Lithium. Lithium is one of the most studied and proven medications out there. You may think of it as a treatment for bipolar disorder, but it can work well as an augmentation for your antidepressant. I use it when there’s a history of bipolar in a patient’s family or when a patient’s moods are turbulent — maybe they struggle with anxiety and insomnia in addition to depression. There are other mood stabilizers out there that work well, too: I often prescribe Lamictal, for example.

Thyroid hormones

Adding thyroid hormones to antidepressants is a course that hasn’t been studied as well as adding mood stabilizers, but it appears to work well and be tolerated better than lithium in a lot of patients. The most commonly prescribed thyroid hormone for depression is called T3. It’s often used to speed up the effects of an antidepressant, but it works to enhance antidepressants at later stages, too.


The third augmentation option is an antipsychotic. Originally designed for treating schizophrenia, this class is becoming more and more popular for treating depression. A lot of my patients have seen huge improvements after adding an antipsychotic. My favorite is Abilify. People tolerate it well and see good results: Two studies from several years ago showed about a quarter of people who added Abilify to an ineffective antidepressant saw a remission of their depression. Abilify can be expensive, though, depending on your insurance, and if it is, I try other antipsychotics first.

There are so many options for treating depression, and different people respond better to different drugs. It’s hard to know in advance which option will work the best, so it can take several tries before we hit on the right strategy.

The good news is that if you’re on medication and it’s not working, that’s not the end of the line. Far from it. There is some combination out there that will work for you; we just have to find it.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Sleep and your mental health

Let’s talk about sleep: To put it simply, you need it. It’s so important for your mental health.

For starters, disrupted sleep is connected with suicide. A team of researchers recently investigated that link and came up with three “pathways” from sleep problems to suicidal thoughts:

  1. There are fewer mental health resources available at night, so suicidal thoughts that arise are more difficult to contain.
  2. Life gets harder when you’re tired. You’re more depressed, you’re less active, you think more negatively, and it’s harder to focus.
  3. Sleep can be an alternative to suicide — an easy escape from distressing thoughts. If you’re using it as an escape during the day, then what’s left at night?

Other studies have connected sleep and depression, too:

  • New mothers with post-partum depression have more sleep problems than their non-depressed counterparts. The worse their sleep, the worse their depression.
  • Too little or too much sleep appears to activate genes associated with depression.
  • People running on less sleep have an impaired ability to regulate their emotions — certain circuits in their brains aren’t working as well.
  • Teens who go to bed later are more likely to suffer from depression.

If you’re depressed, let’s talk about sleep. Addressing that can be part of the solution.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Why do antidepressants take so long to kick in?

Quick review of some of the biology behind depression, as scientists understand it: Depressed people are short on a chemical messenger called serotonin. The most popular type of antidepressant (the SSRI) blocks serotonin from reabsorbing into brain cells, leaving more of it hanging around to do its job: boost your mood.

Minutes after you swallow your SSRI pill, the drug bonds to its
targets. But patients don’t see the expected mood boost until weeks or even months later.

Scientists have been trying to understand the delay for a long time, and this week I read some good news: There’s been a breakthrough.

The surprising thing is that it has nothing to do with serotonin. A team of researchers at the University of Illinois at Chicago have been studying a different signaling molecule called the G protein. In previous research they’ve found that in depressed people, these proteins tend to get stuck in a fatty part of the cell membrane called the lipid raft. While stranded there, the G proteins can’t signal. The researchers suggest this diminished signaling could explain the numb feeling people with depression experience.

The team took rat brain cells and bathed them in SSRIs. Over time, they saw the drug build up in the lipid raft area, and as that happened fewer G proteins stuck around. They escaped to areas where they could better do their signaling.

So that’s it, they concluded. That’s why antidepressants are taking so long to work: They’ve got to build up in the cell membrane enough to send the G proteins on their way.

Here’s the part you really care about: Understanding this should lead to better antidepressants. There’s more research to do, but eventually SSRIs will work to speed up that G protein migration, hopefully leading to quicker effects.

This is definitely a topic I’ll be keeping an eye on. I’ll keep you posted!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Pokemon Go is helping with depression

Here’s the last thing I expected to hear about a popular smart phone game based on Japanese anime characters: It’s lessening players’ depression and anxiety symptoms.

But that’s what users are reporting, and it actually makes sense. Pokemon Go is an augmented reality game–meaning it takes the real world around you and supplements it with virtual content. As you look at a real-life scene through the camera of your smart phone, characters appear. Your job is to catch them. Millions of people are heading outside for hours at a time to go on Pokemon hunts.

The game gets people moving around in nature, and that’s a dynamite combination for mental health. When you’re depressed or anxious, finding the motivation to head outside and exercise and engage socially can be extra difficult, but with the game’s competition and rewards, people are doing it. It’s enough that hundreds have been commenting on social media about feeling better.

It’s the opposite effect from traditional video games, and I’m happy to see it.

Click here to read what people are saying about Pokemon Go and mental health!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.