1. Depression – Can We Break the Social Taboo?

    November 21, 2013

    Depression – Can We Break the Social Taboo?

    by Alexander Thornton

    Even in today’s so-called enlightened times, sufferers from depression and other mental illnesses face the added burden of the stigma that attaches to their condition as well as ongoing discrimination. Sufferers experience isolation from family, friends and others and are excluded from everyday activities that most people consider normal. They find it harder to find and keep employment and their physical health is adversely affected.

    Mental illness has historically been attributed to the effect of demons, character weakness or moral failing and sufferers in most societies have found themselves social outcasts. This means that vast numbers of people face rejection by society. According to the WHO (Fact Sheet No. 369 Oct 2012), depression affects more than 350 million people. Despite its prevalence, less than 50% of depression sufferers receive effective treatment due to lack of resources and trained health care providers. Also the social stigma attached to all mental disorders often prevents many from seeking treatment because they want to hide their problem.

    Depression crosses all boundaries of race and nationality. The recently published findings of a study entitled “Burden of depressive disorders by country, sex, age and year: Findings from the global burden of disease study 2010” by researchers from the University of Queensland published on the PLOS Medicine website show that North Africa and the Middle East have the highest rates while the lowest rates are in East Asia, Australasia and South East Asia. The researchers acknowledge, however, that their findings are likely to be heavily influenced by local taboos and access to services: diagnosis rates are probably higher in the West while rates in east Asia, for example, will be lower.

    In 2009 Time to Change, a programme in England partly funded by the Department of Health, reported that some 92% of people in Britain believed that admitting to suffering from a mental health problem would harm their careers while 56% would not employ someone with a history of mental illness, despite the provisions of the Disability Discrimination Act (1995). It is this type of attitude that causes people to hide their problem and so avoid seeking treatment.

    More recently, researchers examined perceptions of depression in 35 countries around the world, producing a report entitled “Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey.” (Lancet, Vol. 381 Issue 9860. 5 January 2013). The findings are disturbing. Of the sufferers interviewed:

    • 79% reported experiencing at least one form of discrimination.
    • 37% had avoided initiating close personal relationships.
    • 25% had avoided applying for work.
    • 20% had avoided applying for education or training.
    • Experienced discrimination was lower among those who disclosed a diagnosis of depression than those who did not.
    • Nearly half of those who anticipated discrimination had not previously experienced it.

    Many nations are making a concerted effort to change the perception of depression with a view to breaking down the taboos and removing the stigma, so that sufferers are more willing to access treatment and to reduce discrimination.  In April 2012, for example, Time to Change began a pilot project in the West Midlands designed to change the attitudes of young people (aged between 14 and 18) towards mental illness. In the 18 months since its inception the initiative has seen a 1.3% improvement in attitude and a 6% reduction in discrimination. The project has now been extended to the South East.

    Among others in Britain, Depression Alliance runs regular campaigns to raise awareness and reduce discrimination while Mind is a mental health charity in England and Wales that works to improve the lives of those with mental illness.

    In the United States a Mental Health Anti Stigma Campaign is just one of many intended to clear up misconceptions about mental illness. Meanwhile, in New Zealand former All Black star John Kirwan is the face of a campaign to raise awareness and reduce the stigma attached to depression. A sufferer during his playing days, he is heavily involved in television advertising and has even written a book “All Blacks Don’t Cry” about his experiences.

    Discrimination has long been part of the human psyche, but barriers are slowly being removed. As discrimination based on race, religion, sexual orientation and so on is increasingly frowned upon so, hopefully, sufferers from depression will gain acceptance and so be able to enjoy fuller lives with uninhibited access to the treatments that can help them so much. It will however, be a long, hard road to erase long held, deep-seated fears and attitudes.

    Image Credit: http://www.flickr.com/photos/dno1967b/5406671749

  2. Biploar, Depression, ADHD And Schizophrenia Share Common Genetic Issue

    April 18, 2013

    behavioral health treatment

    by Jared Friedman


    New study results are showing that bipolar disorder, attention deficit hyperactivity disorder (ADHD), and schizophrenia may all be linked to the same set of genes.

    The implications of this on the industry of mental health could be exceptionally helpful. Those suffering for one of these extreme disorders could benefit greatly from the better understanding of why each person has the symptoms or full-blown disorder that’s presenting in his or her life.

    Thousands Diagnosed

    33,332 individuals, who have been diagnosed with bipolar disorder, attention deficit hyperactivity disorder, schizophrenia, autism, or major depressive disorder, were compared with a control group of 27,888 individuals, who have not been diagnosed with any of these disorders. The volume of people examined makes this the largest study of its kind, on this subject matter, ever conducted.

    The study found that these five illnesses have common risk factors, mainly in flaws found on Chromosomes 2 and 10, and in two genes that are in charge of the flow of calcium in brain cells. While the genes and chromosomes themselves do not explain the occurrence of any of the listed disorders or the variation in symptoms that show up in different people as different disorders, the gene and chromosome identification serves as a piece of the puzzle that will help researchers and medical professionals better diagnose, treat, and develop new treatment options for those diagnosed with one of these illnesses.

    Genetic Study Research

    Professor of Psychiatry at Harvard Medical School in Boston, Massachusetts and lead researcher is this genetic study, Dr. Jordan Smoller, states that: “This study, for the first time, shows that there are specific genetic variants that influence a range of childhood and adult-onset psychiatric disorders that we think of as clinically different. We also found that there was significant overlap in the genetic components of several disorders, especially schizophrenia with bipolar disorder and depression, and to a lesser extent autism with schizophrenia and bipolar disorder.”

    It may be important to know that other recent study findings indicate that attention deficit hyperactivity disorder that is usually diagnosed in children, can go on to be a lifelong disorder carrying into adulthood. The understanding of ADHD can prevent a person from always being adversely affected by the disorder’s symptoms.

    The Next Step

    The next step, in Dr. Smoller’s opinion, is to determine how the genetic and chromosomal variations happen. Without direct clinical application now, the study results just take the knowledge about the physical component of each disorder to a place of further examination with a high need for subsequent research. Further research results can then be used to more appropriately classify each disorder, to better predict those who are most at risk for each disorder, and to develop better overall treatment, including medications, for each disorder.

    The tricky part in all of this though is that someone can have the variations on the genes or chromosomes linked to bipolar disorder, attention deficit hyperactivity disorder, schizophrenia, autism, or major depressive disorder and never show symptoms of any of these disorders. What does this mean? That a genetic or chromosomal abnormality does not automatically mean that one of these disorders is present in the individual.

    Chromosomal Indicators

    Dr. Smoller explains it as, “They [the genes and chromosomes] are not enough to predict any individual’s risk. And you might carry all of these variants and never develop a psychiatric disorder.” As of right now, the genetic and chromosomal indicators are just that, indicators, and tools that can be used to better understand what symptoms a person has been experiencing, but not as the be-all-end-all of bipolar disorder, attention deficit hyperactivity disorder, schizophrenia, autism, or major depressive disorder diagnosis.

    With this study as a great next step in the understanding of symptoms and the listed disorders, further research and investigation will ideally lead to better overall diagnosis, treatment, and even prevention of suffering from bipolar disorder, attention deficit hyperactivity disorder, schizophrenia, autism, or major depressive disorder.


    Author Bio: Jared Friedman is quality improvement manager for Sovereign Health Group a drug addiction center and mental health rehab center helping people with behavioral and addiction issues.