Antidepressants and Depression

You’ve probably seen signs outside stores for “Kratom”. Some of these stores are head shops, some vape shops, and some convenience stores. You, no doubt like millions of other passersby, have asked yourself what in the heck is Kratom?

Well, it’s a plant native to Southeast Asia and traditionally, its leaves have been used as medicine for various ailments ranging from opioid withdrawal, appetite suppression, insomnia, anxiety, depression, ADHD, fatigue, managing coughs, diarrhea and improving energy levels. 

If and when it works in those situations could be a good thing. However, it has its downsides.

It can be addictive, it can be fatal and its unregulated use has gotten to the point where states are starting to add their own regulations, because there is no scientific evidence to support its safety or efficacy for pain treatment. Not to mention that a convenience store is the last place a product touted as being able to help with depression or opioid withdrawal should be sold.

In Florida, the legislature is considering a bill that would ban the sale of adulterated Kratom products, require safety labels and dosage outlines, and prohibit any claims that the product can treat or cure medical conditions.

Similar regulatory efforts are underway in Kentucky, where a bill has been unanimously supported by a state House committee to increase regulation of Kratom, including limiting sales to those over 21 and requiring product labels to state that Kratom is not intended to treat medical conditions.

Then, there’s the U.S. Food and Drug Administration (FDA). It's been a few years since the federal agency barged into the Kratom boardroom in a rage, but it probably will with all that's going on.

After all, it does have oversight responsibilities for dietary supplements – including Kratom – and there are calls for the FDA to enforce labeling requirements and potentially limit the potency of active ingredients in Kratom-related products.

The risks you run

Before you delve into the nation of Kratomcome, you might want to first consider all the potential side effects: Even at low doses, kratom can cause undesirable side effects like nausea, constipation, anxiety, and insomnia. At higher doses, risks include seizures, liver damage, and psychosis.

Then there’s the interaction with other substances where the reactions can spike even higher.

It’s a complex picture, but if the states and the FDA get together, there might be a way to find a safe way for consumers to buy and use Kratom.

If you are considering using Kratom, it is essential to consult with a healthcare professional who can discuss the potential risks and benefits based on your situation.

You might walk into a store and are met with an aroma that triggers pleasant memories and takes you back to a “happy place.” Researchers have now concluded that experience can be harnessed to treat depression. 

In a study published in JAMA Network Open, researchers at the University of Pittsburgh School of Medicine (UPMC) and UPMC social workers suggest that smells are more effective than words at cueing up a memory of a specific event and could even be used in the clinical setting to help depressed individuals get out of negative thought cycles and rewire thought patterns, aiding faster and smoother healing. 

The study cites “extensive evidence” that people with depression have a hard time recalling specific personal memories and that, in healthy individuals, smells trigger memories that feel vivid and “real,” likely because they directly engage the part of the brain having to do with memories.

“It was surprising to me that nobody thought to look at memory recall in depressed individuals using scent cues before,” said Dr. Kymberly Young, senior author of the study and associate professor of psychiatry at Pitt.

Young and her team presented study participants with a series of opaque glass vials, each containing a potent, familiar scent ranging from oranges to ground coffee to shoe polish, and even Vicks VapoRub. After asking participants to smell the vial, Young asked them to recall a specific memory, regardless of whether it was good or bad. 

Young said she was surprised to discover that memory recall was stronger in depressed people who responded to odors rather than words. People who were exposed to familiar smells were also more likely to associate them with positive memories.

Aromatherapy

Advocates of aromatherapy are probably not surprised by the results. According to Mount Sinai Hospital in New York, some forms of aromatherapy go back 6,000 years. 

According to the hospital, the "smell" receptors in your nose communicate with parts of your brain that serve as storehouses for emotions and memories. 

“When you breathe in essential oil molecules, some researchers believe they stimulate these parts of your brain and influence physical, emotional, and mental health,” the hospital says on its website. 

For example, some scientists believe lavender stimulates the activity of brain cells in the amygdala similar to the way some sedative medications work. Other researchers think that molecules from essential oils may interact in the blood with hormones or enzymes.

Young, meanwhile, wants to conduct further studies to determine whether using pleasant and familiar scents can not only help people improve their memory but also help people deal with depression.

The Los Angeles County Coroner's report that actor Matthew Perry died, in part from “the acute effects of ketamine” has raised awareness of this drug.

Ketamine has long been used to treat depression and anxiety and Perry was reportedly taking it in conjunction with his treatment for drug addiction. The drug has been around since the 1970s and during the 90s, was often used as a party drug.

It wasn’t until the early 2000s that scientists discovered it could be a powerful tool to promote mental health. Researchers at the U.S. National Institutes of Health (NIH) found that the drug could quickly relieve severe depression.

The problem with the drug is that it is still used recreationally. Doses administered by a health care professional are small and always administered in a clinical setting. Recreational users tend to dose at much higher levels.

According to Perry’s autopsy report, the levels of Ketamine in his blood were much higher than would have been administered by his doctor.

Overdoses are rare

Health professionals say lethal ketamine overdoses are rare. In Perry’s case, he apparently fell asleep while in a hot tub and drowned.

Since 1999, ketamine has been classified as a Schedule III nonnarcotic substance under the Controlled Substances Act. The U.S. Drug Enforcement Administration defines these drugs as having a “moderate to low potential for physical and psychological dependence.”

According to the Alcohol and Drug Foundation, ketamine is a dissociative drug, which means it “causes people to feel separated or detached from their body or physical environment. Dissociatives are similar to psychedelics, they can cause hallucinations and other changes in thoughts, emotions and consciousness.”

Ketamine is generally considered safe when administered in a clinical setting. But the American Addition Centers discussed potential adverse effects here.

The U.S. Food and Drug Administration (FDA) has been busy in recent weeks. After approving the first over-the-counter contraceptive and the first postpartum depression drug, the agency is taking action in the fight against respiratory syncytial virus (RSV). 

The FDA has officially approved a vaccine, Abrysvo, for pregnant women during weeks 32 through 36 of pregnancy that would help protect their babies from RSV. 

“RSV is a common cause of illness in children, and infants are among those at highest risk for severe disease, which can lead to hospitalization,” said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research. “This approval provides an option for health care providers and pregnant individuals to protect infants from this potentially life-threatening disease.” 

Safety of the vaccine

Abrysvo was approved for protection against RSV in adults over 60 back in May. To test the efficacy in infants, researchers conducted two clinical trials, the first of which included 3,600 pregnant women who received the Abrysvo vaccines and 3,600 who received a placebo. The second trial cut down the participants to 100 women in each group. 

There were a few side effects that emerged in both clinical trials. Many of them were common for any vaccine: muscle pain, headache, pain at the injection site, and nausea. 

However, some of the side effects posed health risks to the women and their pregnancies. The studies found that preterm births occurred in 5.7% of the women who received the Abrysvo vaccine, compared with 4.7% of women who received the placebo, though it still is unknown if this is in direct correlation to the drug. 

There was also a higher risk of jaundice, low birth weight, and preeclampsia in women who received the vaccine – 1.8% of these women developed the high blood pressure condition, compared with 1.4% who received the placebo. 

Researchers found that administering the vaccine in the latest weeks of pregnancy – weeks 32-36 – is likely to lower the risk of preterm birth. 

Vaccine efficacy

Based on these two studies, the researchers found that Abrysvo was effective at lowering infants’ risk of developing severe RSV within three months and six months of birth. 

One group of study participants included 3,000 pregnant women between 32 and 36 weeks, half of whom received the Abrysvo vaccine, while the other half received a placebo.

Compared to those who didn’t receive the vaccine, the risk of severe lower respiratory tract disease (LRTD) – an infection caused by RSV – decreased by 90% in the first three months of life, and by 76.5% in the first six months of life. 

Similarly, the risk of respiratory tract disease was nearly 35% lower in the first three months for those who had been vaccinated, while the risk was over 57% lower in the first six months. 

More work will continue to be done on the drug to better understand some of the health risks, including preeclampsia. 

Loneliness, sadness, depression, anxiety – Google searches for these terms are off the chart.

It’s not because it’s Mental Health Month either, although that would be a nice excuse. Ever since COVID-19 strode into the U.S., everyone has been affected: 86% of teens, who knows how many senior citizens, even the Surgeon General says there’s an epidemic of sadness and loneliness.

And, since we live in a time where an app can do anything, well, why not let an app get us all out of our funk?

Despite a mental health app’s good intentions, Mozilla’s latest *Privacy Not Included study shows mental health apps are failing to protect user privacy and security – a factor that could make us wring our hands even more if a hacker gets possession of our private information and starts leveraging it to their benefit.

Fifty-nine percent of the top apps studied were given *Privacy Not Included warning labels, while 40% have gotten worse over the last year.

'I’ll be your very best friend…'

Of concern to Mozilla’s researchers were the apps that pretend to want to cuddle up with a user a little too much.  They found many apps that were jam-full of tracking code, with the app Cerebral installing 799 trackers onto a person’s phone within the first minute of download. 

There were also apps that wasted no time collecting information – before even asking for consent. The researchers said that Talkspace, Happify, and BetterHelp all pushing consumers into taking questionnaires up front without asking for their permission or showing their privacy policies first.

One app that freaked out Mozilla’s team was, what else but an AI app? “Replika: My AI Friend” which wants to be your virtual reality best friend is one of the worst apps Mozilla said it’s ever reviewed and voted by users as the 10th “most creepy.”

“It’s plagued by weak password requirements, sharing of personal data with advertisers, and recording of personal photos, videos, and voice and text messages consumers shared with the chatbot,” the researchers said.

Others in the Top 10 of the apps users voted the “most creepy” include (in order) Pride Counseling, Better Stop Suicide, Pray, Cerebral, Better Help, TalkSpace, The Mighty, 7 Cups, and Youper.

“The worst offenders are still letting consumers down in scary ways, tracking and sharing their most intimate information and leaving them incredibly vulnerable,” said Jen Caltrider, Mozilla’s *Privacy Not Included Lead. 

But it can be done the right way, too

On the other hand, Caltrider praised a handful of apps that handle data responsibly and respectfully, proving that it can do things the right way. One that found itself in the “most creepy” category – Youper – is trying to turn its life around and is running for “most-improved app” for significantly strengthening both its password requirements and privacy policy. 

Another is Woebot which has improved its privacy policy to explain that all users now have the same rights to access and delete their own data. When ConsumerAffairs investigated Woebot on the Play Store, it also says that no data is shared with third parties, the data is encrypted in transit, and a user can request that data be deleted – all a definite positive.

When one person in a family experiences depression, it's important that they get support from the rest of the household. Unfortunately, new research suggests that depression symptoms can spread among family members under certain circumstances.

Findings from a recent study suggest that children who have fathers with depression may develop similar symptoms and behavior issues over time. Interestingly, the researchers found that fathers and their children did not have to be genetically related for this to happen.

"A lot of research focuses on depression within biologically related families," said Penn State professor Jenae Neiderhiser. "Now more information is becoming available for adoptive families and blended families."

Depression and behavior problems 

The researchers came to their conclusions after studying over 700 families who participated in the Nonshared Environment in Adolescent Development study. Family members were asked to answer questions about depression symptoms, behaviors, and parent-child conflicts. The team then took that data and examined how fathers' depression symptoms were related to their children's behaviors.

The researchers found that there was a link between depression and behaviors between fathers and children, even in blended families where there was no genetic link. They say conflicts between fathers and their children may be a factor that causes depression or behavior problems in young people. However, further studies would likely be necessary to determine a causal link.

"It would be great to do more studies on step and blended families," said Neiderhiser. "They tend to be an underutilized natural experiment we could learn more from to help us disentangle the impacts of environmental factors and genetics on families."

The full study has been published in the journal Development and Psychopathology.

A new study conducted by researchers from Michigan Medicine explored mental health struggles among professionals in the medical community.

According to their findings, certain types of first-year doctors – surgical residents and members of sexual minorities – may have a higher risk of developing depression. The report pulled data from two recent studies, both from teams at the University of Michigan, that explored medical professionals’ mental health struggles. 

Surgical interns have higher depression risk

The first study looked at first-year surgical interns. The researchers analyzed data from 12,400 interns involved in the Intern Health Study between 2016 and 2020. Interns were surveyed about their mental health at the start of their training and then at several points throughout their journeys. 

While the surgical interns started their programs with lower average rates of depression than other medical professionals, this trend didn’t last long. Even for those with no mental health struggles at the start of intern training, depression symptoms popped up in more than 30% of the surgical interns. For those who had developed depression during this time, they were nearly 65% as likely to maintain those symptoms beyond their first year of training. 

Despite rising cases of depression, the interns weren’t likely to seek professional mental health services. Just 26% of those with depression reported taking care of their mental health during this time. Overall, the researchers found that surgical interns were the most likely medical specialty to develop depression during this first year of training. 

“Surgical training, especially in the United States, can be a period of intense stress, which we find is linked to new onset of depression,” said researcher Dr. Tasha Hughes. “These findings suggest a need for surgical program directors, leaders, and health systems to continue to find ways to mitigate the effects of surgical training, normalize help-seeking, make mental health support easily available, and pay special attention to those with characteristics that might put them at an increased risk.”

Higher stress for LGTBQ members

The second study analyzed data from more than 7,000 interns in the Intern Health Study from 2016 through 2018. Participants were surveyed on their mental health and also reported on their sexual orientation. 

While just over 7% of the participants reported being a member of a sexual minority -- including gay, bisexual, lesbian, or another non-heterosexual group -- depression rates were high among these interns. First-year interns who weren’t heterosexual were more likely to have high depression scores, which only got higher over time. The researchers found that the second half of the intern year was the hardest for non-heterosexual doctors. 

“These results indicate that interns who are part of sexual minority groups may experience unique workplace stressors leading to a widening disparity in mental health,” said researcher Tejal Patel.

“This is important to note because as physicians become more depressed, this can lead to greater risk of medical errors and attrition from medicine. As a result, it may be hard for sexual minority patients to find a physician with whom they can relate, and who will be the right fit for them.” 

A new study conducted by researchers from the University of Cincinnati explored how socioeconomic factors may affect consumers’ mental health treatment. According to their findings, those with lower incomes and less education may have poorer outcomes related to depression treatment. 

“If you’re going home to a wealthy neighborhood with highly educated parents or spouse, then you’re arguably in a much better environment for the treatment to be effective than if you’re going to a poor neighborhood with other problems,” said researcher Jeffrey Mills, Ph.D. 

Barriers to depression treatment

For the study, the researchers analyzed data from 665 patients enrolled in the CO-MED trial. The participants reported on their socioeconomic background and all received the same access to depression treatments. 

The researchers identified a few socioeconomic factors that impacted the participants’ response to their mental health treatments. For starters, treatment efficacy for participants who didn’t have a college degree was roughly 10% lower than it was for college graduates. 

“We think about these things in terms of access, we think about them in terms of inequality, and I realize that education does track with those, but just having a college degree while controlling for all these other factors still had a significant impact,” said researcher Dr. Jeffrey Strawn. 

The study also showed that participants whose income was at the 25th percentile improved their mental health about 5% less than participants whose income was at the 75th percentile. Similarly, non-white participants improved their mental health 11.3% less than white participants. The researchers also learned that a combination of these socioeconomic factors was linked with a much lower improvement rate. 

Improving access to mental health care

With a better understanding of how socioeconomic factors can affect consumers’ treatment outcomes, these findings highlight the importance of improving access to mental health services and legislation regarding minimum wage and general economic policy. 

“Someone employed at a higher wage has a chance to improve their socioeconomic status and environment, and so they’re definitely less likely to get mental health problems,” Dr. Mills said. “If people with higher socioeconomic status do get mental health problems, what we’re showing is they’re more likely to improve if they get treatment.” 

A new study conducted by researchers from the University of Granada explored the link between heart health and depression. According to their findings, consumers who struggle with cardiovascular risk factors may have a higher risk of developing depression in later life. 

“Cardiovascular disease and depression are thought to be closely related, due to shared risk factors,” the researchers wrote. “Improving cardiovascular health could prevent the onset of depression in the elderly.” 

How heart health affects mental health

For the study, the researchers analyzed data from over 6,500 older participants with obesity who spent an average of two years following the Mediterranean diet. The participants completed questionnaires to assess their depression at the start of the study and two years into the study. The researchers then measured their heart disease risk with the Framingham-based REGICOR scale, which assessed participants' risk as low, medium, or high/very high. 

Ultimately, the team identified a link between cardiovascular disease risks and the risk of depression-related symptoms. Participants with the highest risk of cardiovascular disease also showed the highest risk of depression compared to those who had a lower risk of cardiovascular disease. 

Overall, the team found that women were more likely than men to develop depression and that the Mediterranean diet was associated with fewer depression-related symptoms; those who had higher REGICOR scores and stayed consistent with the Mediterranean diet saw the biggest improvements in their depression symptoms. 

Cholesterol was another important factor related to depression risk. The study found that participants in the medium and high risk cardiovascular groups with cholesterol levels under 160 mg/mL at the start of the study had a higher risk of developing depression. On the other hand, these participants had a lower risk of depression when they started the study with cholesterol levels of 280 mg/mL or higher. 

Moving forward, the researchers hope more work is done in this area to better understand how factors like diet and cholesterol can affect consumers’ mental health as they go into older age.