Acupuncture May Help Depression



A new study finds acupuncture to be highly effective in treating depression.


 

ACUPUNCTURE MAY HELP DEPRESSION

At least 1 in 10 Americans have been afflicted with major depression at some point in their lives, and some studies suggest that as many as 1 in 5 Americans have experienced significant depression before.  At any given time, an estimated 7 percent of adults in the United States are suffering from major depression.  (For reasons that are not entirely clear, women are twice as likely as men to be diagnosed with major depression.)  In view its very high incidence, it is not surprising that major depression is the leading cause of disability in the U.S. for people between the ages of 15 and 44.

There are a variety of potentially effective therapies available for depression including, primarily, cognitive therapy (i.e., meeting with a therapist for counseling) and antidepressant medications.  However, in view of the limited coverage made available for cognitive therapy by health insurers, there has been an increasing reliance upon antidepressant medications in the U.S. for many years.  While many of these medications can significantly reduce the signs and symptoms of major depression, they are often associated with significant side effects, and as many as half of all patients with severe chronic depression will fail to respond to most such medications.

A newly published prospective randomized controlled study from England suggests that acupuncture may be as effective as cognitive therapy and antidepressant medications as a treatment for depression.  This study appears in the online journal PLOS Medicine.

In this study, 755 patients with documented chronic major depression were randomized to one of three different treatment groups: acupuncture, cognitive therapy (counseling), and “usual care alone.”  (The latter group, which also included the use of antidepressant medications, served as the “control group” for this clinical study.)  All patient volunteers were subsequently reassessed with validated diagnostic tests throughout the 12-month course of this clinical study.

On average, the patient volunteers who participated in this clinical trial underwent 10 acupuncture sessions and 9 counseling sessions.  Compared to “usual care,” there was a statistically significant decrease in depression-associated symptoms in both the acupuncture and the counseling groups at 3 months and at 6 months after the start of this clinical study (by 12 months, however, the patients in the “usual care” group had improved to a level comparable to the acupuncture and counseling groups).  To summarize, acupuncture and counseling were each found to be highly effective in reducing the severity of depression-associated symptoms in patients with moderate-to-severe depression, and both were actually found to be more effective than the “usual care” (including antidepressant medications) received by the control group of patient volunteers at 3 months and at 6 months. 

This small study suggests a potential role for acupuncture in the treatment of major depression, and should stimulate additional research in this, and other, non-pharmacologic therapies for depression, particularly given the minimal risks associated with acupuncture in otherwise healthy patients.  However, if you are already taking antidepressant medications, and you are interested in trying acupuncture as a treatment for depression, please do not stop taking your medications without your doctor’s approval, as doing so could result in a worsening of your depression!

 

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According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, more than 3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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Depression After Childhood Abuse May Be Linked To A Specific Gene







 

A new study suggests that a variant of a recently discovered gene may double the risk of lifelong depression after childhood abuse.


 

 

CHRONIC DEPRESSION AFTER CHILDHOOD ABUSE MAY BE LINKED TO A NEW GENE

The age-old debate about “nature versus nurture” has become increasingly complicated as we continue to learn more about the impact of individual genes on our risk for various illnesses.  While it has become widely accepted that specific genetic patterns may predispose some of us to a very high risk of certain physical illnesses, such as cancer and cardiovascular disease, the potential linkage between specific genes and the risk of mental illness has been less clear.  At the same time, however, it has long been known that some mental health disorders, including depression, anxiety disorder, panic disorder, bipolar disorder, and schizophrenia, tend to run in families, which suggests that there may be at least some genetic component to these illnesses.

Over the past 5 years, fundamental new research has begun to suggest that certain genes may indeed be associated with an increased risk of specific mental illnesses.  However, most mental health experts believe that having a specific form of a gene linked to mental illness does not, by itself, mean that an affected individual faces a 100 percent risk of developing a mental illness.  Getting back to that “nature versus nurture” debate once again, it appears that having a genetic variant associated with a specific mental health illness probably predisposes an affected person to develop that particular mental health disorder, but does not guarantee that this will happen.  More specifically, an individual person’s experiences and environment during early life (i.e., the “nurture”) appear to have a significant impact on whether or not genes associated with an increased risk of mental illness (i.e., the “nature”) will actually lead to the development of mental illness.

Now, a newly published clinical study provides strong evidence that a specific form of a single gene can significantly increase the likelihood of major depression in adults following physical abuse during childhood, while another variant of this same gene appears to decrease the risk of chronic depression in similarly abused adults.  This intriguing research study appears in the current issue of the Archives of General Psychiatry.

This new research study was inspired by previous research with laboratory animals that identified a network of neurons in the brain that use chemicals called endocannabinoids to communicate with each other.  (If the word “endocannabinoid” sounds vaguely familiar, it is because these naturally occurring neurotransmitters in the brain also have counterparts in the plant world, most notably in cannabis, or marijuana, plants!)  Previous research has also suggested that the endocannabinoid system in the brain may play an important role in adaptation to stress, including the moderation of our mood following stressful events.

In this new study, two groups of patient-volunteers were included.  The first group consisted of 1,041 young adult female twins in the United States, while the second group consisted of 1,428 Australian adults known to be addicted to heroin. (An additional 506 Australian volunteers without heroin addiction participated in this study as the control group for the heroin-addicted volunteers.)  The presence of depression, and in particular, depression with anhedonia (a term that indicates the inability to enjoy experiences that most of us find pleasurable), was assessed among all of these patient-volunteers.  The absence or presence of a history of physical abuse, by a parent or caregiver, during childhood was also evaluated.  Testing of the gene which codes for the human endocannabinoid receptor in the brain was performed on all of these research volunteers, as well.

The findings of this study were highly significant.  Not surprisingly, the study volunteers who reported having experienced significant childhood physical abuse had a much higher incidence of depression when compared to those volunteers who did not experience physical abuse as children.  Among the volunteers who had experienced significant physical abuse during childhood, a single, specific variant of the endocannabinoid receptor gene appeared to be highly protective against anhedonic depression when compared to volunteers who possessed the more common variant of this gene.  Specifically, only 29 percent of abused volunteers with this less common variant of the endocannabinoid receptor gene experienced anhedonic symptoms, while 57 percent of the previously abused volunteers with the most common form of this same gene were found to have symptoms of anhedonic depression.

The findings of this study strongly suggest that certain naturally occurring variants of specific genes may either increase or decrease the risk of mental illness (and in the case of this clinical study, major depression with anhedonia) following stressful experiences earlier in life.  Not only do this study’s findings suggest a method of screening patients who might be at significantly increased risk for major depression following stressful events in their early lives, but the linkage of a specific gene within the brain’s endocannabinoid system with depression following traumatic childhood experiences may someday allow for a more effective treatment for post-traumatic major depression, using medications targeted at the specific genetic variation that leads to this increased risk of depression following childhood trauma.


At this time, more than 8 percent of Americans are unemployed.  According to the Bureau of Labor Statistics, however, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is now more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.

 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 











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Effective New Treatment for Chronic Pain

Welcome to Weekly Health Update



New research shows that behavioral therapy combined with an exercise program may be the most effective treatment for chronic pain.


 

 

EFFECTIVE NEW TREATMENT FOR CHRONIC PAIN

According to the American Academy of Pain Medicine, chronic pain afflicts nearly 1 out of every 3 American men, women and children, and is associated with an estimated cost to society of $560 to $635 billion per year.  While there are many causes of chronic pain, they all share a common trait in that almost all types of chronic pain are associated with significant physical and psychological disability in afflicted patients.

Unlike acute pain (like the pain that follows a fresh cut on your hand, or spraining your ankle, for example), which subsides very quickly, chronic pain usually does not improve on its own.  Moreover, while you may hop around and shout out a few choice words after smashing your thumb with a hammer, the acute pain caused by a poorly aimed hammer usually does not leave a person feeling depressed or completely disabled like chronic pain so often does.  Over time, as chronic pain persists, the area in the brain (the limbic system) that attaches emotional content or value to our experiences and sensations becomes increasingly involved with interpreting the chronic barrage of pain sensations from damaged nerves or chronic inflammation, which leaves many chronic pain sufferers debilitated, and often depressed.  Because of the biological complexity of chronic pain, when compared to acute pain, it can be very difficult to effectively treat this lingering form of pain.  Patients suffering with chronic pain frequently find their symptoms both physically and emotionally disabling, and medications commonly used to treat acute pain are often ineffective in managing chronic pain.  As I have noted, depression is a common feature of chronic pain, and often requires treatment with antidepressant medications and behavioral therapy in addition to treating the original cause (or causes) of a patient’s pain.

Now, a newly published prospective randomized clinical research study offers new hope for the estimated 116 million Americans who suffer from chronic pain.  This study, which appears in the current issue of the Archives of Internal Medicine, randomized 442 patients with chronic pain to receive one of the following interventions for a period of 6 months:  (1) telephone-based behavioral therapy, (2) a graded, step-wise exercise program, (3) a combination of both telephone-based therapy and a graded exercise program, or (4) standard treatment for chronic pain.  All of the study volunteers were assessed at the time that they entered into the study, 6 months later, and again at 9 months.

The results of this innovative study were quite interesting.  Following 6 months of standard chronic pain management, only 8 percent of the study volunteers randomized to this intervention group noticed any significant improvement in their symptoms, and this result was unchanged 9 months after the start of this clinical study.  Among the patients who underwent 6 months of telephone-based behavior therapy, 33 percent felt that their chronic pain was improved at 9 months.  After 6 months of treatment, 35 percent of the patients who participated in a graduated exercise program felt improved, although this effect decreased over time, with 24 percent of this group of patients reporting improvement in their chronic pain symptoms at 9 months.  Finally, the combined therapy group (behavioral therapy and exercise) experienced the greatest improvement in their symptoms, compared to the other treatment groups, with 37 percent of patients in this group reporting significant improvement at both 6 months and 9 months.

This study represents an extremely important advance in the management of chronic pain, a condition that is highly resistant to most conventional therapies and medications.  As a cancer physician who regularly treats cancer patients with chronic pain, I am not surprised by the extremely poor response of patients to conventional chronic pain management approaches in this study.  While the 37 percent positive response rate noted in this study to combination therapy may seem like a rather poor result, chronic pain syndromes are so difficult to effectively treat that this study’s 37 percent response rate is actually extremely impressive.  Based upon the results of this important study, behavioral therapy combined with exercise therapy appears to be the most effective and long-lasting treatment approach for patients with chronic pain.  At the same time, the dismal response rate associated with standard chronic pain management approaches, as noted in this study, should cause pain management specialists to seriously reevaluate current methods of treating patients with chronic pain.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity



Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author



For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam



I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 





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Deep Brain Stimulation May Help Severe, Refractory Depression

Welcome to Weekly Health Update




DEEP BRAIN STIMULATION MAY HELP SEVERE, REFRACTORY DEPRESSION

Depression is both a common and a potentially very serious mental health disorder.  According to the Centers for Disease Control (CDC), nearly 10 percent of the adult population in the United States can currently be classified as having active depression, and approximately 4 percent of the population currently meets criteria for severe, major depression.

The incidence of depression varies considerably between different groups of people.  For example, women are 70 percent more likely than men to experience depression.  Although depressed women are more likely than men to attempt suicide, men are far more likely to be successful in their suicide attempts.  Other high risk groups include people between the ages of 45 and 64 years, people from ethnic minority groups, people with less than a high school education, people who are divorced and who have not remarried, the unemployed, and those without health insurance.  (Clearly, in view of the still ongoing recession in the United States, the number of people in several of these high-risk categories has increased significantly over the past four years.)

There are multiple effective therapies available or depression, including antidepressant medications, psychotherapy, and electroconvulsive therapy (ECT).  More recently, transcranial magnetic stimulation, vagus nerve stimulation, and other experimental treatments have been evaluated in patients with depression that fails to respond to conventional therapies.  Another recently developed experimental therapy for severe, refractory depression is deep brain stimulation (DBS).  In small pilot studies, small numbers of patients with severe depression, and who have failed every other form of depression treatment (including ECT), have had surgically implanted electrodes placed into their brains, followed by electrical stimulation of their brains through these deep brain electrodes.  While it is too soon to conclude that DBS is both safe and effective in the management of severe, refractory depression, a new prospective clinical research study suggests that DBS may, indeed, produce significant remissions in refractory major depression.  This newly published study appears in the current issue of theArchives of General Psychiatry.

In this small but innovative clinical trial, 10 patients with major depression and 7 patients with bipolar disorder underwent surgical implantation of deep brain stimulation electrodes into both hemispheres of the brain.  Initially, all patients underwent simulated (“sham”) DBS, without the patients’ knowledge.  (This sham stimulation was done to test whether or not the patients’ expectation of benefit, or a true potential benefit simply from having the electrodes surgically placed, might have influenced their depression independent of actually stimulating their brains.)  Following 4 weeks of sham stimulation, all patients then initially received 24 weeks of actual DBS.  Following this period of actual DBS, active stimulation of the deep brain electrodes was then temporarily stopped.  (Once again, this discontinuation of active DBS was not revealed to the patients.)  These patient volunteers were then treated with DBS and monitored for up to 2 years.

In this group of patients who had previously failed, literally, all other forms of conventional therapy for their severe depression, DBS was associated with complete remission of depression in 18 percent (3) of the patients, and a significant improvement in depressive symptoms was observed in 41 percent (7) of the patients after 24 weeks of active DBS.  After 2 years of active DBS, 12 patients remained in the study, and 92 percent (11) of these patients experienced significant improvement in their depressive symptoms, including 58 percent (7) who experienced a complete remission of their depression!

The findings of this small prospective, controlled clinical research study are both dramatic and important, and for several reasons.  First of all, the clinically significant improvement seen in almost all of these patients is extraordinary in view of the severity of their depression and the completely refractory nature of their depressive symptoms.  Secondly this study included several patients with bipolar disorder, a disease which is characterized by alternating episodes of mania (a state of extreme mental and physical hyperactivity) and depression.  (Earlier studies of DBS had suggested that this treatment might not be as effective in patients with bipolar disorder, and might also lead to an increased risk of episodes of mania.  However, in this small pilot study, DBS was as effective in treating the symptoms of depression in patients with bipolar disorder as it was in patients with depression alone.  Moreover, DBS did not appear to increase the likelihood of episodes of mania in patients with bipolar disorder.)

 

Depression is a common mental health disorder, and severe cases of depression can leave patients feeling miserable and hopeless.  In especially severe cases, depressed patients may be unable to function in their daily personal or professional lives.  For some unfortunate patients with depression, suicide or accidental causes of death may also end their lives prematurely.  Based upon the findings of this small, preliminary clinical study, DBS may be a safe and effective treatment option for patients with chronic, severe, and refractory depression.

 

If you are depressed, and you are having thoughts about harming yourself (or harming someone else), please immediately contact your mental health provider, a suicide hotline, your personal physician, a close and trusted friend or relative, or your clergy person.  Even during times when you feel like there is no hope that life will get better for you, it almost always will get better if you get some help.

 


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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