Jan 14

When they hear the word ‘depression’, many people think of sad or hopeless individuals who can’t cope with a life event, who are living withdrawn and are often crying their existence.

But in fact this is only rarely the case. In a U.S. study published in 1996, for example, only a third of the patients suffering from depression could name a stressful or dramatic experience that took place before the disease kicked in. And it is by no means only negative events that can trigger depression in some people, but also such as the birth of a child or winning a business contract. That not all people who experience dramatic events develop depression also suggests that other factors such as stress or genetic factors may be involved. For patients themselves or their environment is therefore usually not even possible to identify a potential reason for a probable depression – which usually leads to long delays in search for the correct diagnosis for the malaise they feel in.

Physical symptoms are another, often misinterpreted facet of depressive disorders. Headaches, insomnia, reduced memory and concentration, but also other kinds of physical pain, digestive problems or a general lack of energy are typical physical symptoms of depression.

The lack of perspective that is typical for depression, quite often also leads to self harm. Most people who commit suicide previously suffered from an (often unrecognized or untreated) depression. But it doesn’t need to be suicide: other self-defeating forms of behavior, such as alcohol and drug abuse, self-destructive eating habits or risky driving are, as studies illustrate, linked to depression in about 60% of the cases.

Particularly in older men, depression often manifests on aggression, particularly of the verbal kind, like ranting, looking down or lashing out on others or constant cynicism. Again, these persons are only rarely aware that they actually suffer from depression, but explain their inner discontent and anger with external circumstances over which they usually can’t complain too loudly and often.

About 20-25% of women and 7-12% of men suffers with depression at least once in their life time. However, the real figures are probably higher due to the frequent misdiagnoses and years of suffering without a proper diagnosis and adequate treatment.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)

Sep 07

His heart starts to beat stronger with every minute, sweat starts to run down on his back and it becomes more and more difficult to get air, it is as if his lungs were blocked. Suddenly his heart begins to burn – is he finally having his first heart attack? He panics, he might die right here on the street if he doesn’t get immediate help – unbearable fear is climbing up his spine…

The effects of a panic attack vary – most sufferers feel intense fear they are having a heart attack, might ‘go crazy’ or have a nervous breakdown. Experiencing a panic attack can feel like one of the most intensely frightening, upsetting and uncomfortable experiences of a person’s life.
But unlike many might think, panic attacks are not necessarily related to high stress, but can even hit people with a very relaxed lifestyle. However, panic attacks are often indicators of anxiety disorders, depression or other psychological conditions that had been untreated (or treated improperly) for a long time. Other potential causes are side effects of medications, alcohol, medication or drug withdrawal or chronic illness.

If panic attacks are untreated, agoraphobia might develop, where a person develops a fear of having panic attacks in certain places. Concerned that they might feel trapped or run into a panic attack, they increasingly avoid any situation that might put them at risk, might avoid open spaces, to drive or even to leave their homes at all. It can also be related to social anxiety, where the fear revolves around social situations, interactions with others, or being evaluated or scrutinized by other people. This can result in one of the most harmful side-effects of panic disorder, as it can prevent sufferers from seeking treatment in the first place or to develop psychological dependence of drugs. However, treatment is possible and usually consists of regular psychotherapeutic sessions over an individually advised amount of time, sometimes combined with complimentary medication. That way, more than 90% of agoraphobics can achieve a full recovery.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

Nov 29

Posttraumatic Stress Disorders (PTSD) was very much one of the centers of attention during the last years of psychological research. Posttraumatic stress disorders may develop when  people are exposed to life-threatening situations – such as natural disasters, assassinations, sexual abuse or war events. It is estimated that up to 50% of all U.S. soldiers returning from war zones are affected by forms of post-traumatic stress disorder. But PTSD is difficult to treat and usually requires a lengthy therapy, even though various pharmacological approaches using the stress hormone cortisol, beta-blockers include Propranolo [1] and psychotherapy (the special trauma therapy methods based on hypnotherapy like EMDR, or combined approaches such as the one by Luise Reddemann) brought significant progress.

New hope now comes from a totally unexpected direction: in a study done together with graduate student E. Ganon-Elazar and published in the Journal of Neuroscience [2] it was shown that the activation of cannabinoid receptors in the basolateral nuclear complex of the amygdala (BLA) compensates the  effect of stress during conditioning. Many years ago, the pharmacist at the Jerusalem University, Rafael Meshulam, already published similar positive effects when he administered traumatized mice, now his results could be confirmed in trials with rats. Following a decision of the Supreme Court of Croatia in an appeal against a man who had fought in the war in Yugoslavia and was since then suffering from PTSD, war veterans suffering from post traumatic stress disorder may now even now grow marijuana for self-treatment. [3]

(Sources: [1] Andrea Naica-Loebell: “Die Pille für das Vergessen” in: telepolis Online-Magazin, 08/2005; [2] Ganon-Elazar, E. & Akirav, I. (2009), Cannabinoid receptor activation in the basolateral amygdala blocks the effects of stress on the conditioning and extinction of inhibitory avoidance. Journal of Neuroscience, 29(36):11078-11088; [3] Der Standard 04.06.2009; Image credit: Cannabisculture.com)

Sep 28

Research has shown that, for men over 40 and women after the menopause, having one or two small drinks a day can help prevent coronary heart disease. However, it is estimated that most of the people are risking their health by drinking more than the recommended daily amount of alcohol.

In the alcohol-related German-lanauge part of this blog, I have compiled the facts about standard drinking and “at risk” drinking. A standard drink of alcohol would mean one among the below:

  • 0.5 to 0.6 ounces of alcohol
  • 12 ounces of beer
  • 5 ounces of wine
  • 1 to 1.5 ounces of liquor

The actual “at risk” consumption level is calculated based on the standard drink. Considering once among the above as a standard drink, the following are the “at risk” levels for a male and female drinker.

The consumption level of a male drinker reaches “at risk” level if he crosses 13 standard drinks per week.

The consumption level of a female drinker reaches “at risk” level if she crosses 6 standard drinks per week.

Given the above levels, it is up to the individual to ensure sensible drinking.

(the poster above is part of a new advertising campaign by the Drug and Alcohol Service for London (DASL) to highlight the physical effects of binge drinking. Apart from a stinking hangover, it warns women they will also be more prone to wrinkles, bad skin, hair loss and weight gain if they knock back too much booze.)