By the way...
Mood:  amorous
Now Playing: Christmas music (it's that time of year again)
Topic: Friends and Family
Happy Thanksgiving! Mine was pretty good... went to the LC show Thanksgiving night... it was one of the best that I've seen... I felt like I was seeing some famous ROCK GODS play instead of my favorite local band. Not that they aren't ROCK GODS, but just not a worldwide scale. Saw a lot of old friends last night, too. Definitely an awkward moment or two, as well. But overall things were fantastic. Saw Karen... and Donna was VERY pregnant... she's having a little boy, Dan Jr. :) Hung out with Ray most of the night... he protected me from people I didn't want to talk to, haha.

More later, maybe. I've written almost an entire paragraph on my paper. Not enough. Not going too well. Time for dinner.

better day, but still not 100%
Mood:  not sure
Now Playing: Isaak
Topic: Introspection


I was pretty down yesterday. I think I said in another post that this death has affected me more than I thought it would... not that death shouldn't have an effect. It's just that I hadn't seen Kyle in years, since Heather's (Levengood) funeral several years ago... we were somewhat close (at times) in high school, but it's been a long time. You always wonder if there was something you could have done to prevent it. I've read that coping with loss after suicide is different than death from other causes... there's a certain quotient of guilt to it. My guilt (and grief) of course can't be anywhere close to what close family and friends are experiencing. Then you wonder why? You would assume depression; statistics say 90% of suicides are the result of undiagnosed (or untreated) psychiatric disorders, commonly depression. But then again, he had served active duty in Iraq. Who knows what he saw over there? War probably causes more psychological scars than it does casualties. (This is all conjecture, of course. I can say whatever the hell I want!) This tragedy has helped me in one way, however -- my career choice (psychology). Of course, if someone doesn't want help or doesn't ask for it, there wouldn't be anything I could do. I wonder what I could do to save more lives... how I could help the (huddled) masses understand mental illness, or reach people with depression and prevent suicides. *sigh* I'm sure there is something I could do to help. I think as my first step, I'll put a page of resources onto my webpage... it may not be much, but at least it's a start. That whole think globally act locally thing. Hmm. But this is the world wide web - so I'm really doing both! ;-)

As I'd said in an earlier post, this was the most heartrending funeral I've ever been to. Since it was a military funeral, the service was conducted with full military honors. After the service in the chapel at the cemetery, the firing party fired the three shot volley and afterwards the bugler played Taps. Witnessing these rituals was a bit much for me... it really emphasized the finality of it all. Of course wanting to make sense of it all, I looked up the meaning of all these things. The three shot volley is commonly confused with a "21 gun salute", but the two are different things. Here's some info I found on the origins of these customs:

Graveside military honors include the firing of three volleys each by seven service members. This commonly is confused with an entirely separate honor, the 21-gun salute. But the number of individual gun firings in both honors evolved the same way.
The three volleys came from an old battlefield custom. The two warring sides would cease hostilities to clear their dead from the battlefield, and the firing of three volleys meant that the dead had been properly cared for and the side was ready to resume the battle.
The bugle call "Taps" originated in the Civil War with the Army of the Potomac. Union Army Brig. Gen. Daniel Butterfield didn't like the bugle call that signaled soldiers in the camp to put out the lights and go to sleep, and worked out the melody of "Taps" with his brigade bugler, Pvt. Oliver Wilcox Norton. The call later came into another use as a figurative call to the sleep of death for soldiers.

The flag folding ceremony was intense as well... very precise and deliberate, if that's the correct word. I found information on the meaning of each fold and such, but I don't know if it's correct, so I won't post it. The entire ceremony was incredible, really. It was like witnessing a piece of history; witnessing every military funeral that has ever taken place in our country since our country's independence... very steeped in tradition. It was beautiful and heartbreaking at the same time. I imagine that anyone who has attended a military funeral understands what I'm saying.

Time for me to get home... I haven't gotten much work done today. Now I go home to prepare for Turkey day. It would seem that there isn't much to be thankful for this Thanksgiving, but there are many things to still be thankful for.

Finalized paper
Mood:  sad
Now Playing: Isaak -- Things go wrong
Topic: School
I'm going to write a post later on about Kyle's viewing and funeral. It seems that I'm not as desensitized about death as I thought I was. It was one of the saddest (if not the most) funerals I've ever been to... I'd never seen a full military funeral before, with the 3 shot volley (I'm pretty sure that's what it's called) and taps being played... it was an emotional moment. Of course during the funeral they played "Angel" by Sarah MacLachlan... at Heather's funeral they had played "I will remember you." Anyway, I'm getting carried away here -- here is my final paper:



Double Therapy: A Lifesaving Treatment
Depression is a serious illness currently affecting millions of Americans, as well as over one hundred million others worldwide. Regrettably, it is often left untreated which results in tens of thousands of deaths due to suicide each year in the United States alone. There is hope, however: depression is a treatable condition, and with the right tools, it is possible for those suffering from this disease to find relief from their symptoms. There are three basic types of treatment for depression: psychotherapy (also known as talk therapy), electroconvulsive therapy (ECT), and medication. The two most common and widely accepted forms of treatment are psychotherapy and antidepressant medication. Lately, it seems that society has become increasingly dependent on drugs to make them content: people want instant happiness without resolving the true nature of their problems with psychotherapy. Nevertheless, antidepressants are effective and those who take them often feel better before those who opt for talk therapy treatment alone. Neither of these methods should be discounted for their efficiency, as antidepressants mend the mind, while psychotherapy mends heart and soul. A combination approach of both psychotherapy and antidepressant therapy is the most effective treatment for adults experiencing major depressive disorder.
Many people will have some experience with a major depressive episode at some point in their lifetime. Either they will know a coworker, friend, or family member affected by this illness, or they will be affected by it themselves. According to Liora Nordenberg of the U.S. Food and Drug Administration, of the millions of cases of depression that occur annually in our country, it is estimated that as many as eighty to ninety percent can be effectively treated. Nordenberg cites the regrettable statistics of those who do not seek help:
Depression strikes about 17 million American adults each year--more than cancer, AIDS, or coronary heart disease--according to the National Institute of Mental Health (NIMH). An estimated 15 percent of chronic depression cases end in suicide [...] two-thirds of the people suffering from depression don't get the help they need, according to NIMH. Many fail to identify their symptoms or attribute them to lack of sleep or a poor diet, the APA says, while others are just too fatigued or ashamed to seek help" (Nordenberg).
This data is depressing in itself; depression is an easily treated disease, yet so many people continue to live in misery because they do not seek treatment.
There are three main types of depressive mood disorders: major depressive disorder, dysthymic disorder (dysthymia), and bipolar disorder (previously called manic depression). Major depressive disorder is characterized by one or more major depressive episodes, where the sufferer feels persistently said for two weeks or longer. Symptoms of major depressive disorder include sleep problems, loss of appetite, inability to concentrate, and memory problems. This disorder also tends to be a recurrent illness and frequently occurs after a significant life event. Dysthymia is a constant low-grade depression which is not debilitating, but still affects the sufferer's life in a negative manner. Dr. Dennis Charney, M.D., Chief of Mood and Anxiety Disorder Research Program at NIMH and Dr. Charles Nemeroff, M.D., Ph.D., of Emory University School of Medicine define bipolar illness as "[M]ajor depression that alternates with periods of abnormally high mood in which a person feels energized, buoyant, and outgoing - sometimes to a pathological degree" (Charney and Nemeroff 85). A common theory of these disorders is that they are caused in some part by chemical imbalances in the brain. Dysthymia and bipolar are most frequently associated with these chemical imbalances, while major depressive disorder commonly arises after a negative life experience. Since major depressive disorder usually has both biological and external causes, the combination approach of medication and psychotherapy will be the most suitable method to utilize in its treatment.
Despite its success in treating many patients with depression, medication may not be safe for everyone. Recent studies have suggested that antidepressant use for children and adolescents may be dangerous. Elizabeth Mechcatie, a reporter for Family Practice News, notes a public health advisory which was publicized by the Food and Drug Administration:
The FDA released the advisory to alert physicians to reports of suicidality in clinical studies of various antidepressants in pediatric patients with major depressive disorder (MDD). Although cases of suicidality "are not unexpected in patients with MDD, preliminary data suggest an excess of such reports" among patients who have been on some of those drugs compared with those on placebo, the advisory states. (Mechcatie)
Due to this declaration, it is not safe to assume that antidepressant usage should be recommended for those under the age of eighteen. We should instead focus on the way that these medications may help adults.
Society needs to recognize that depression is often a biologically based disease. As previously mentioned, it is believed that depression is caused by chemical imbalances in the brain. The National Alliance for the Mentally Ill identifies the neurotransmitters implicated in this condition:
Norepinephrine, serotonin, and dopamine are three neurotransmitters (chemical messengers that transmit electrical signals between brain cells) thought to be involved with major depression. Scientists believe that if there is a chemical imbalance in these neurotransmitters, then clinical states of depression result. Antidepressant medications work by increasing the availability of neurotransmitters or by changing the sensitivity of the receptors for these chemical messengers (Frank).
New clinical trials and studies regarding depression are being investigated continuously. As a result of this research, medications are being developed that are more effective at treating depression with reduced side effects.
Antidepressants play an important role in treating the biological origins of depression; however, there are new treatments on the horizon that may be a better fit than the current antidepressants on the market. Recent research has found that enduring stress can essentially reshape the brain. It is thought that stress may shrink the hippocampus (structure in limbic system of brain involved in memory formation) and also obstruct a process called neurogenesis (growth of new brain cells), causing depression. A hormone called corticotrophin-releasing hormone (CRH) stimulates the pituitary gland, which elicits a signal for release of glucocorticoids (stress hormones i.e. cortisol) from adrenal glands in the endocrine system. Constance Holden, a Mental Health Reporter and winner of a 2003 award from the National Mental Health Association (NMHA) elaborates on these findings, citing research performed by Dr. Charles Nemeroff:
Animal models, too, show that early stress, such as that induced by maternal deprivation, causes depression-like behavior [...] Such animals also hypersecrete CRH. "Many of the established neurobiological findings in depression may indeed be due to early life stress," when the young nervous system is still tender and impressionable, according to Nemeroff. His research has revealed that among adults who have been sunk in depression for 2 years or longer, 45% experienced abuse, neglect, or parental loss as children. (Holden 811)
These findings are exhilarating for those in the fields of psychiatry and psychology. This means that pharmaceutical companies will work to develop new drugs that will likely work by suppressing corticotrophin-releasing hormones. Nemeroff's figure of adults experiencing abuse, neglect, or parental loss gives support to why psychotherapy should play a role in treating depression.
If medications treat the mind, then it is psychotherapy which treats the soul. There are several types of psychotherapy recognized as effective methods of treating depression. The National Alliance for the Mentally Ill (NAMI) identifies them as Cognitive-behavioral therapy (CBT) and Interpersonal therapy (IPT). According to NAMI, Cognitive-behavioral therapy "[H]elps to change the negative thinking and unsatisfying behavior associated with depression, while teaching people how to unlearn the behavioral patterns that contribute to their illness; Interpersonal therapy focuses on improving troubled personal relationships and on adapting to new life roles that may have been associated with a person's depression" (Frank). Both of these psychoanalysis methods achieve desirable results with regard to alleviating depression. It is through psychotherapy that the person afflicted by this illness truly begins to recover; the patient can explore their minds and discover the genuine reasons causing their depression. Medications can not do this; they must do it themselves.
There can be innumerable external contributing factors that may cause someone to lapse into depression. Charney and Nemeroff discuss these factors:
All types of depression usually arise from a combination of inborn vulnerabilities [...] and the interaction of those vulnerabilities, for better or worse, with life experiences, such as upbringing, education, culture, stress, or trauma. A particular case of depression may arise more from genetics, say, than upbringing, but no depression is all genetics, or all stress, or all upbringing. (Charney and Nemeroff 89)
These life experiences play a significant role in a depressive episode. It is because of these external factors that psychotherapy is imperative for treating depression.
Recent research has shown that antidepressants and psychotherapy are similarly effective for treating a major depressive disorder. Nicola Casacalenda, Christopher Perry, and Karl Looper, all psychiatrists with the Institute of Community and Family Psychiatry at Jewish General Hospital in Montreal, examined random controlled trials that evaluated medications and psychotherapy. The doctors found these results:
Tricyclic antidepressants, phenalzine and psychotherapy [...] were more effective at promoting remission than control conditions. There was no difference in remission between antidepressants and psychotherapy regimens. Antidepressants and psychotherapy may both be effective first-line treatments for outpatients with mild to moderate depression. (Casacalenda, Looper, and Perry 1186)
While some might argue that these findings could be a detriment to either drug companies or psychotherapists, it is in fact a benefit to both. Since both therapies have been found equally effective, the most successful depression treatment will be found when both sides agree to combine medication and psychoanalysis.
Many other professionals in the psychiatry and psychology fields agree that the combination approach to treating depression is ideal. Professor Raymond Lam, M.D., Head of the Division of Clinical Neuroscience, Department of Psychiatry at the University of British Columbia, supports this idea:
We need to move away from simple comparisons of psychotherapy versus pharmacotherapy to consider combined therapy [...] there is preliminary evidence that combining antidepressant medications with psychotherapy may increase remission rates over monotherapy in severe depression and in chronic depression. (Lam 46)
The clinical trials cited in Lam's viewpoint are in progress and expected to be completed in March 2006 (McCullough). A combination approach of pharmacotherapy and psychotherapy has been endorsed by a myriad of professionals besides those already mentioned. Charney and Nemeroff feel that "The multiple roots of the condition [depression] mean that using multiple treatment approaches usually works best" (Charney and Nemeroff 89). All of these people are respected individuals within their fields and their ideas should be held in high esteem. Since both psychotherapy and pharmacotherapy have been found to treat depression effectively, using them in conjunction is logically the most efficient way to put a depressed person on the road to recovery. The medications will help the patient feel better in the beginning, and talk therapy will keep them in remission and sustain them through the years.
The Band-Aid approach to treating depression has gone on long enough. If we have the research and understanding to prove that antidepressant medication and therapy are the most effective means of treating depression, then that is what we must utilize. Those suffering from depression must move toward this choice and recognize its value. In treating major depressive disorder, we have to care for the whole patient, and not just one part of the person. If patients and doctors follow this advice, the rates of depression remission will rise and the number of suicides will fall. It is time for the medical community to embrace this strategy and save lives.


Works Cited
Casacalenda, Nicola, Karl Looper, and Christopher Perry. "Comparing Depression
Treatments." American Journal of Psychiatry. 160 (2003): 1186-1187.
Charney, Dennis, and Charles Nemeroff. The Peace of Mind Prescription: an
authoritative guide to finding the most effective treatment for anxiety and
depression. New York: Houghton Mifflin, 2004.
Frank, Ellen. "Major Depression." NAMI: National Alliance for the Mentally Ill - The
Nation's Voice on Mental Illness. May 2003. 13 November 2004
nagement/ContentDisplay.cfm&ContentID=7725>.
Holden, Constance. "Future Brightening for Depression Treatments." Science. 302.5646
(2003): 810-814.
Lam, Raymond. "Antidepressants and psychotherapy may be equally effective for promoting
remission in major depressive disorder." Evidence-Based Mental Health. 6.2 (2003): 45-
46.
McCullough, Ph.D., James P. "Research Evaluating the Value of Augmenting Medication with
Psychotherapy." National Institutes of Health. April 2003. 16 November 2004
.
Mechcatie, Elizabeth. "Antidepressants may boost suicide risk in Children: FDA
advisory." Family Practice News. 34.1 (2004): 78.
Nordenberg, Liora. "Dealing with the Depths of Depression." U.S. Food and Drug
Administration. August 1998. 12 November 2004 features/1998/498_dep.html>.


Is it ironic that this paper was due on the same day that I went to the funeral? :-/

posted by a cautiously optimistic Redskins fan at 10:50 AM EST

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tired
Mood:  lazy
Topic: Weekend happenings
Was at Tiffer's house last night until 2 a.m... didn't get home until about 2:30... kept waking up this morning too early... now I'm just tired...... watching football........ I'll be going to Kyle's viewing tonight.............. *sigh* Nobody at the party had heard, so I got to be the bearer of bad news.

THat's it I guess..... watching the Cowboys get their asses handed to them........ just what I love!

it's my one year anniversary
Mood:  celebratory
Topic: Miscellaneous goings-on
I've been bloggin' for one year today........ happy anniversary to me! Been pretty good at keeping up with it, too.......

this is going to be a busy weekend, once I finally get going...... I need to shower, then i'm going to this holiday fair/open house thing at a place in Severna Park that Dyanna at work told me about... stop at the liquor store to pick up something to take to tiffany's party, then I'm coming back home, making cookies for the party, maybe some other stuff... got a great cookie recipe from Alton Brown's book... I'll share it when I get a chance... after the cookies are all made, hopefully I'll be disciplined to work on my psych paper for a little bit, then I'm leaving at 5 to go to Bmore for the party. Tomorrow I'll work on my paper some more, watch a little football, and go to Kyle's viewing tomorrow night... :( the funeral is on Monday afternoon... I'm going to take off work to go to it... I don't have any leave, but I feel like I may regret it if I don't go. What's that saying -- better to do something and regret it than not doing it and regretting? At least in this case I think that's the correct thing to do. I was up late last night, until about 2 doing various tasks and chatting with my aunt nancy in australia... that was nice... I couldn't sleep, so I talked to her for an hour or so... and I finally posted on LC's site on my feelings about the band and the break-up. Last night I wasn't feeling particularly eloquent, but I think that what I said came out the way that I wanted it to. It was heartfelt, and that's the most important thing for me. Here's what I wrote:

It's taken me a while to figure out what exactly I want to say... and I still haven't quite figured it out, so bear with me! I figured that this breakup has been coming....... less shows, everyone's lives have been changing. Change is inevitable; it's how we grow. I've had to make painful decisions in order to grow, and I'm sure there are more ahead. I'll never forget my first LC show... it was in October of 99 (or thereabouts)... they were playing with the Buzz Poets at the Vault. I was blown away. LC has been a constant in my life for the past five years... the music has always been there through the good times and has helped me out in bad times. At times, the songs have been soundtracks accompanying some incredible moments. I feel blessed to make the friendships that I have in this time... some of them have fractured, some are broken, some still strong... but there was good in every single one of them. When I was at a show a few months ago, I likened it to 'coming home'. It doesn't matter who is there; new fans, old fans... young fans, geezers... ;) I'd like to thank Corey, Dan, Dave, and Will (see, I did that in alphabetical order so there's no visible favoritism -- because I love all of you guys!) for your music, advice, and friendship... you have all had a profound impact on my life, and I'm thankful for it. I'll see all of you freaks on Thanksgiving night. :) --Lauren


I'm glad that I wrote it last night -- if I hadn't been so tired, it might not have come out that way.

I've now made 357 posts in the past year, including this one... go me! I'm afraid that I have to get my ass in gear, since it's now noon.... hope that everyone has a nice weekend.

LC
Mood:  down
Topic: TV, music, movies, etc.
Never really said too much about them other than they're breaking up. They've been a big part of my life for the past five years... I may have taken a year or so off, but I've been seeing them more frequently since I have a dependable vehicle now. I'm going to miss having them around... I'm planning on going to as many of their last shows as I can... including the one next Thursday, thanksgiving night... should be a lot of oldtimers there. :) that's it for now............. i'm tired!

latest email to patience
Mood:  blue
Topic: Friends and Family
I think that this summarizes my feelings pretty well....

Thanks for keeping me in the loop... Tracy was still at NCHS when I was there, but I never talked to her really. I was wondering if he'd been in Iraq... I'm sure that you've read in the papers that there have been a lot of soldiers committing suicide both over there and when they come home. I can imagine the strain that puts on a relationship, being over there all that time -- and then if you don't feel appreciated when you come home, it's not all that surprising... especially knowing what a caring and sensitive person he was... I think he probably just thought that he was to blame for all the world's problems....... :-/ jesus....... the things he probably saw over there, too.... I don't know that I wouldn't have done the same thing.
Isn't that weird how there are people that you always wonder about like that? I've felt bad for the past few years because I've felt like I really wronged some people back in high school and have always wanted to apologize......... I don't know........ it seems that once we all get out in the real world (whatever that is) things change so fast... and it's like you finally end up being who you were supposed to be... I don't think I'm making much sense. *sigh* Jeez........ married for 3 years, with a daughter.........that is so sad......... people just never realize their own potential... it's like the guy who wrote confederacy of dunces -- he commited suicide and it was published 10 years later and became a Pulitzer Prize winning novel. Not that I liked the book, but apparently other people did...
You want to know something really screwed up....... I'm writing my English paper on depression treatment (I'm finally back in college), and I had a sentence in the opening paragraph saying that tens of thousands of people commit suicide each year in the U.S... (over 30,000) well I submitted it to this site (smarthinking.com) for review (extra credit, of course) and you know what one of the comments was??? [This number seems very high--do that many people really commit suicide every year?]. Yes... yes they do. And there are half a million *attempts*... people just don't think that it's a problem, I guess... you would think that someone paid to look at these essays all day long would take the time to look it up or maybe would have read it in somebody else's paper??

Sorry for rambling on... I'm tired... hope that you're doing okay... the shock has worn off for me and now I'm just sad... death doesn't affect me the way that it used to... it's almost like I'm desensitized to it... a guy that I went to Chesapeake with, Zach, was walking home one night a year and a half ago and got hit by a car on route 50... don't know if it was a suicide attempt or not... but I ran into a mutual friend of ours a few months ago and the first words out of my mouth weren't "hey, I haven't seen you in forever!" they were "did you hear about zach?" ugh. But yeah... there's been Tommy Lanna ... Alice Pechin,then my grandfather, Russ - a guy that I worked with, then my grandmother, then Zach, then Heather, then my other grandmother...then Bernice, this sweet woman who I worked with as well... and now Kyle. I'm sure there are more, but I don't want to remember them. So I suppose you could say that I'm a bit desensitized. Don't know if that's good or bad; it's just the way it is.

sorry again for writing a book..... i'm going to bed now...............

Isn't it ironic
Mood:  blue
Now Playing: velvet revolver
Topic: School
Here's my 3rd draft of my English paper. It's basically finished. Too bad Kyle never had the opportunity to read it. :-/ Maybe it wouldn't have helped him anyway.

Lauren Grande
Professor Paoletti
ENG 112-400
22 November 2004

Double Therapy: A Lifesaving Treatment
Depression is a serious illness currently affecting millions of Americans, as well as over one hundred million others worldwide. Regrettably, it is often left untreated which results in tens of thousands of deaths due to suicide each year in the United States alone. There is hope, however: depression is a treatable condition, and with the right tools, it is possible for those suffering from this disease to find relief from their symptoms. There are three basic types of treatment for depression: psychotherapy (also known as talk therapy), electroconvulsive therapy (ECT), and medication. The two most common and widely accepted forms of treatment are psychotherapy and antidepressant medication. Lately, it seems that society has become increasingly dependent on drugs to make them content: people want instant happiness without resolving the true nature of their problems with psychotherapy. Nevertheless, antidepressants are effective and those who take them often feel better before those who opt for talk therapy treatment alone. Neither of these methods should be discounted for their efficiency, as antidepressants mend the mind, psychotherapy mends heart and soul. A combination approach of both psychotherapy and antidepressant therapy is the most effective treatment for adults experiencing major depressive disorder.
Many people will have some experience with a major depressive episode at some point in their lifetime. Either they will know a coworker, friend, or family member affected by this illness, or they will be affected by it themselves. Of the nineteen million cases of depression that occur annually in our country, it is estimated that as many as eighty to ninety percent can be effectively treated. Liora Nordenberg of the U.S. Food and Drug Administration cites the regrettable statistics of those who do not seek help: "However, two-thirds of the people suffering from depression don't get the help they need, according to NIMH. Many fail to identify their symptoms or attribute them to lack of sleep or a poor diet, the APA says, while others are just too fatigued or ashamed to seek help" (Nordenberg). If people are better educated about depression, perhaps they would be more likely to seek help, and not be ashamed for doing so.
There are three main types of depressive mood disorders: major depressive disorder, dysthymic disorder (dysthymia), and bipolar disorder (previously called manic depression). Major depressive disorder is characterized by one or more major depressive episodes lasting two weeks or more. This disorder also tends to be a recurrent illness and frequently occurs after a significant life event. Dysthymia is a constant low-grade depression which is not debilitating, but still affects the sufferer's life in a negative manner. Dr. Dennis Charney, M.D., Chief of Mood and Anxiety Disorder Research Program at NIMH and Dr. Charles Nemeroff, M.D., Ph.D., of Emory University School of Medicine define bipolar illness as "[M]ajor depression that alternates with periods of abnormally high mood in which a person feels energized, buoyant, and outgoing - sometimes to a pathological degree" (Charney and Nemeroff 85). A common theory of these disorders is that they are caused in some part by chemical imbalances in the brain. Dysthymia and bipolar are most frequently associated with these chemical imbalances, while major depressive disorder commonly arises after a negative life experience. Since major depressive disorder usually has both biological and external causes, the combination approach of medication and psychotherapy will be the most suitable method to utilize in its treatment.
Recent studies have suggested that antidepressant use for children and adolescents may be dangerous. Elizabeth Mechcatie, a reporter for Family Practice News, notes a public health advisory which was publicized by the Food and Drug Administration:
The FDA released the advisory to alert physicians to reports of suicidality in clinical studies of various antidepressants in pediatric patients with major depressive disorder (MDD). Although cases of suicidality "are not unexpected in patients with MDD, preliminary data suggest an excess of such reports" among patients who have been on some of those drugs compared with those on placebo, the advisory states. (Mechcatie)
Due to this declaration, it is not safe to assume that antidepressant usage should be recommended for those under the age of eighteen. We should instead focus on the way that these medications may help adults.
Society needs to recognize that depression is often a biologically based disease. As previously mentioned, it is believed that depression is caused by chemical imbalances in the brain. The National Alliance for the Mentally Ill identifies the neurotransmitters implicated in this condition:
Norepinephrine, serotonin, and dopamine are three neurotransmitters (chemical messengers that transmit electrical signals between brain cells) thought to be involved with major depression. Scientists believe that if there is a chemical imbalance in these neurotransmitters, then clinical states of depression result. Antidepressant medications work by increasing the availability of neurotransmitters or by changing the sensitivity of the receptors for these chemical messengers (Frank).
New clinical trials and studies regarding depression are being investigated continuously. As a result of this research, medications are being developed that are more effective at treating depression with reduced side effects.
Recent research has found that enduring stress can essentially reshape the brain. It is thought that stress may shrink the hippocampus (structure in limbic system of brain involved in memory formation) and also obstruct a process called neurogenesis (growth of new brain cells), causing depression. A hormone called corticotrophin-releasing hormone (CRH) stimulates the pituitary gland, which elicits a signal for release of glucocorticoids (stress hormones i.e. cortisol) from adrenal glands in the endocrine system. Constance Holden, a Mental Health Reporter and winner of a 2003 award from the National Mental Health Association (NMHA) elaborates on these findings, citing research performed by Dr. Charles Nemeroff:
Animal models, too, show that early stress, such as that induced by maternal deprivation, causes depression-like behavior [...] Such animals also hypersecrete CRH. "Many of the established neurobiological findings in depression may indeed be due to early life stress," when the young nervous system is still tender and impressionable, according to Nemeroff. His research has revealed that among adults who have been sunk in depression for 2 years or longer, 45% experienced abuse, neglect, or parental loss as children. (Holden 811)
These findings are exhilarating for those in the fields of psychiatry and psychology. This means that pharmaceutical companies will work to develop new drugs that will likely work by suppressing corticotrophin-releasing hormones. Nemeroff's figure of adults experiencing abuse, neglect, or parental loss gives support to why psychotherapy should play a role in treating depression.
If medications treat the mind, then it is psychotherapy which treats the soul. There are several types of psychotherapy recognized as effective methods of treating depression. The National Alliance for the Mentally Ill (NAMI) identifies them as Cognitive-behavioral therapy (CBT) and Interpersonal therapy (IPT). According to NAMI, Cognitive-behavioral therapy "[H]elps to change the negative thinking and unsatisfying behavior associated with depression, while teaching people how to unlearn the behavioral patterns that contribute to their illness; Interpersonal therapy focuses on improving troubled personal relationships and on adapting to new life roles that may have been associated with a person's depression" (Frank). Both of these psychoanalysis methods achieve desirable results with regard to alleviating depression. It is through psychotherapy that the person afflicted by this illness truly begins to recover; they can explore their minds and discover the genuine reasons causing their depression. Medications can not do this; they must do it themselves.
There can be innumerable external contributing factors that may cause someone to lapse into depression. Charney and Nemeroff discuss these factors:
All types of depression usually arise from a combination of inborn vulnerabilities [...] and the interaction of those vulnerabilities, for better or worse, with life experiences, such as upbringing, education, culture, stress, or trauma. A particular case of depression may arise more from genetics, say, than upbringing, but no depression is all genetics, or all stress, or all upbringing. (Charney and Nemeroff 89)
These life experiences play a significant role in a depressive episode. It is because of these external factors that psychotherapy is imperative for treating depression.
Recent research has shown that antidepressants and psychotherapy are similarly effective for treating a major depressive disorder. Nicola Casacalenda, Christopher Perry, and Karl Looper, all psychiatrists with the Institute of Community and Family Psychiatry at Jewish General Hospital in Montreal, examined random controlled trials that evaluated medications and psychotherapy. The doctors found these results:
Tricyclic antidepressants, phenalzine and psychotherapy [...] were more effective at promoting remission than control conditions. There was no difference in remission between antidepressants and psychotherapy regimens. Antidepressants and psychotherapy may both be effective first-line treatments for outpatients with mild to moderate depression. (Casacalenda, Looper, and Perry 1186)
While some might argue that these findings could be a detriment to either drug companies or psychotherapists, it is in fact a benefit to both. Since both therapies have been found equally effective, the most successful depression treatment will be found when both sides agree to combine medication and psychoanalysis.
Many other professionals in the psychiatry and psychology fields agree that the combination approach to treating depression is ideal. Professor Raymond Lam, M.D., Head of the Division of Clinical Neuroscience, Department of Psychiatry at the University of British Columbia, corroborates on this idea:
We need to move away from simple comparisons of psychotherapy versus pharmacotherapy to consider combined therapy [...] there is preliminary evidence that combining antidepressant medications with psychotherapy may increase remission rates over monotherapy in severe depression and in chronic depression. (Lam 46)
The clinical trials cited in Lam's viewpoint are in progress and expected to be completed in March 2006 (McCullough). A combination approach of pharmacotherapy and psychotherapy has been endorsed by a myriad of professionals besides those already mentioned. Charney and Nemeroff feel that "The multiple roots of the condition [depression] mean that using multiple treatment approaches usually works best" (Charney and Nemeroff 89). All of these people are respected individuals within their fields and their ideas should be held in high esteem. Since both psychotherapy and pharmacotherapy have been found to treat depression effectively, using them in conjunction is logically the most efficient way to put a depressed person on the road to recovery. The medications will help the patient feel better in the beginning, and talk therapy will keep them in remission and sustain them through the years.
The Band-Aid approach to treating depression has gone on long enough. If we have the research and understanding to prove that antidepressant medication and therapy are the most effective means of treating depression, then that is what we must utilize. Those suffering from depression must move toward this choice and recognize its value. In treating major depressive disorder, we have to care for the whole person, and not just one part of them. If patients and doctors follow this advice, the rates of depression remission will rise and the number of suicides will fall. It is time for the medical community to embrace this strategy and save lives.




Works Cited
Casacalenda, Nicola, Karl Looper, and Christopher Perry. "Comparing Depression
Treatments." American Journal of Psychiatry. 160 (2003): 1186-1187.
Charney, Dennis, and Charles Nemeroff. The Peace of Mind Prescription: an
authoritative guide to finding the most effective treatment for anxiety and
depression. New York: Houghton Mifflin, 2004.
Frank, Ellen. "Major Depression." NAMI: National Alliance for the Mentally Ill - The
Nation's Voice on Mental Illness. May 2003. 13 November 2004
nagement/ContentDisplay.cfm&ContentID=7725>.
Holden, Constance. "Future Brightening for Depression Treatments." Science. 302.5646
(2003): 810-814.
Lam, Raymond. "Antidepressants and psychotherapy may be equally effective for promoting
remission in major depressive disorder." Evidence-Based Mental Health. 6.2 (2003): 45-
46.
McCullough, Ph.D., James P. "Research Evaluating the Value of Augmenting Medication with
Psychotherapy." National Institutes of Health. April 2003. 16 November 2004
.
Mechcatie, Elizabeth. "Antidepressants may boost suicide risk in Children: FDA
advisory." Family Practice News. 34.1 (2004): 78.
Nordenberg, Liora. "Dealing with the Depths of Depression." U.S. Food and Drug
Administration. August 1998. 12 November 2004 features/1998/498_dep.html>.

posted by a cautiously optimistic Redskins fan at 4:36 PM EST

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does the bad news ever stop?
Mood:  sad
Now Playing: switchfoot - dare you to move
Topic: Friends and Family
Just got an email from Patience, an old friend & drama club member -- Kyle Bosley, another old friend (actually an ex-boyfriend) committed suicide last weekend. :-/

The timing is bizarre... last night I was thinking that pretty much every year, we lose someone connected from my high school...... and they're usually connected to the drama club... I was thinking that we hadn't lost anyone this year and just got this feeling like it wouldn't be that way by the party (on 12/30). Morbid, I suppose... but there have been so many deaths... and to be so young, it's tragic... it's awful. *sigh*

This was the email I sent Patience:

Hi Patience,

Thank you for telling me... don't worry about being the bearer of bad news; I've been in your shoes plenty of times. I'm glad that you told me -- I haven't talked to him in a long time (I didn't even know that he was married), but he was definitely a friend during school (I don't know if you knew this, but he and I went out for a month or so). I know that this is going to sound weird or maybe even morbid, but last night I was thinking about the yearly gathering at Shaff's house and how it seems that something tragic has always happened the year before... and as I was thinking that, I got a bad feeling that this year was going to be no different. :-/ It is so awful that he thought he had no other options... but as Richard said, let's hope he at last has peace. I'll keep an eye on the paper for arrangement info, but would you mind letting me know if/when you hear about the funeral? I'll pass along the news to Stefani Miller and Tiffany Scofield; I think that they both knew him as well.


*sigh*

Happy Thanksgiving, I guess.

it ain't pretty...
Mood:  crushed out
Topic: School
But it's done!!! I'll revise tomorrow at lunch...... it took a lot of blood, sweat, and tears... oh, and Kurtis getting mad at me, but it's finished!!!!!!!!! Here it is. I know there are parts that are a bit shaky, but I'm at 1746 words, yay.

Here she is:


Lauren Grande
Professor Paoletti
ENG 112-400
22 November 2004


Depression is a serious illness that currently affects millions of Americans, as well as over one hundred million others worldwide. Unfortunately, it is often left untreated which results in tens of thousands of deaths due to suicide each year in the United States. There is hope, however: depression is a treatable condition, and with the right tools, it is possible for those suffering from this disease to find relief from their symptoms. There are three basic types of treatment for depression: psychotherapy (also known as talk therapy), electroconvulsive therapy (ECT), and medication. The two most common and widely accepted forms of treatment are psychotherapy and antidepressant medication. However, it seems that society has become increasingly pill happy: people want to find a quick solution for their troubles without exploring or attempting to resolve the true nature(s) of their problem with psychotherapy. This is not to say that antidepressants do not have a place in the treatment of depression - they can be useful under certain circumstances. Often, people taking antidepressants start feeling better before those who opt for psychotherapy treatment alone. Neither of these methods should be discounted for their efficiency. A combination approach of both psychotherapy and antidepressant therapy is the most effective treatment for adults experiencing major depressive disorder.
Many people will experience a major depressive episode at some point in their lifetime. Either they will know a coworker, friend, or family member affected by this illness, or they will be affected by it themselves. Of the seventeen million cases of depression that occur annually in our country, it is estimated that as many as eighty to ninety percent can be effectively treated. Liora Nordenberg of the U.S. Food and Drug Administration cites the regrettable statistics of those who do not seek help: "However, two-thirds of the people suffering from depression don't get the help they need, according to NIMH. Many fail to identify their symptoms or attribute them to lack of sleep or a poor diet, the APA says, while others are just too fatigued or ashamed to seek help" (Nordenberg). If people are better educated about depression, perhaps they would be more likely to seek help, and not be ashamed for doing so.
There are three main types of depressive mood disorders: major depressive disorder, dysthymic disorder (dysthymia), and bipolar disorder (previously called manic depression). Major depressive disorder is characterized by one or more major depressive episodes lasting two weeks or more. This disorder also tends to be a recurrent illness, and frequently occurs after a significant life event. Dysthymia is a constant low-grade depression which is not debilitating, but still affects the sufferer's life in a negative manner. Dr. Dennis Charney, M.D., Chief of Mood and Anxiety Disorder Research Program at NIMH and Dr. Charles Nemeroff, M.D., Ph.D., of Emory University School of Medicine define bipolar illness as "major depression that alternates with periods of abnormally high mood in which a person feels energized, buoyant, and outgoing - sometimes to a pathological degree" (Charney and Nemeroff 85). A common theory of these disorders is that they are caused in some part by chemical imbalances in the brain. Dysthymia and bipolar are the most frequently associated with these chemical imbalances, while major depressive disorder commonly arises after a negative life experience. Therefore, the combination approach of medication and psychotherapy will be the most suitable method to utilize in treatment of major depressive disorder.
Recent studies have suggested that antidepressant use for children and adolescents may be dangerous. Elizabeth Mechcatie, a reporter for Family Practice News, notes a public health advisory which was publicized by the Food and Drug Administration:
The FDA released the advisory to alert physicians to reports of suicidality in clinical studies of various antidepressants in pediatric patients with major depressive disorder (MDD). Although cases of suicidality "are not unexpected in patients with MDD, preliminary data suggest an excess of such reports" among patients who have been on some of those drugs compared with those on placebo, the advisory states. (Mechcatie)
Due to this declaration, it is not safe to assume that antidepressant usage should be recommended for those under the age of eighteen. We should instead focus on the way that these medications may help adults.
Society needs to recognize depression as it is: a biologically based disease. As previously mentioned, it is believed that depression is caused by chemical imbalances in the brain. The National Alliance for the Mentally Ill identifies the neurotransmitters implicated in this situation:
Norepinephrine, serotonin, and dopamine are three neurotransmitters (chemical messengers that transmit electrical signals between brain cells) thought to be involved with major depression. Scientists believe that if there is a chemical imbalance in these neurotransmitters, then clinical states of depression result. Antidepressant medications work by increasing the availability of neurotransmitters or by changing the sensitivity of the receptors for these chemical messengers (Frank).
New studies and theories regarding depression are being investigated continuously. As a result of these studies, medications are developed that are more effective at treating depression with reduced side effects.
Recent research has found that enduring stress can reshape the brain. It is thought that stress may shrink the hippocampus (structure in limbic system of brain involved in memory formation) and also hinder a process called neurogenesis (growth of new brain cells), which may cause depression. A hormone called corticotrophin-releasing hormone (CRH) stimulates the pituitary gland, which elicits a signal for release of glucocorticoids (stress hormones i.e. cortisol) from adrenal glands in the endocrine system. Constance Holden, a Mental Health Reporter and winner of a 2003 award from the National Mental Health Association (NMHA) elaborates on these findings, citing research performed by Dr. Charles Nemeroff:
Animal models, too, show that early stress, such as that induced by maternal deprivation, causes depression-like behavior [...] Such animals also hypersecrete CRH. "Many of the established neurobiological findings in depression may indeed by due to early life stress," when the young nervous system is still tender and impressionable, according to Nemeroff. His research has revealed that among adults who have been sunk in depression for 2 years or longer, 45% experienced abuse, neglect, or parental loss as children. (Holden 811)
These findings are exhilarating for those in the fields of psychiatry and psychology. This means that pharmaceutical companies will work to develop new drugs that will likely work by suppressing corticotrophin-releasing hormones. The figure of forty-five percent of adults experiencing abuse, neglect, or parental loss gives support to why psychotherapy should play an important role in treating depression.
If medications treat the mind, then it is psychotherapy which treats the soul. There are several types of psychotherapy recognized as effective methods of treating depression as well as other mood disorders. The National Alliance for the Mentally Ill (NAMI) lists them as Cognitive-behavioral therapy (CBT) and Interpersonal therapy (IPT). According to NAMI, Cognitive-behavioral therapy "helps to change the negative thinking and unsatisfying behavior associated with depression, while teaching people how to unlearn the behavioral patterns that contribute to their illness [while] Interpersonal therapy (IPT) focuses on improving troubled personal relationships and on adapting to new life roles that may have been associated with a person's depression" (Frank). Both of these psychoanalysis methods achieve desirable results with regard to alleviating depression. It is through psychotherapy that the person afflicted by this illness truly begins to recover.
There may be countless external contributing factors that cause someone to experience a depressive episode. Charney and Nemeroff discuss these factors:
All types of depression usually arise from a combination of inborn vulnerabilities [...] and the interaction of those vulnerabilities, for better or worse, with life experiences, such as upbringing, education, culture, stress, or trauma. A particular case of depression may arise more from genetics, say, than upbringing, but no depression is all genetics, or all stress, or all upbringing. (Charney and Nemeroff 89)
These life experiences can play a significant role in a depressive episode. It is because of these external factors that psychotherapy is imperative for treating depression.
Recent research has shown that antidepressants and psychotherapy are similarly effective for treating a major depressive disorder. Nicola Casacalenda, Christopher Perry, and Karl Looper, all psychiatrists with the Institute of Community and Family Psychiatry at Jewish General Hospital in Montreal, examined random controlled trials that evaluated medications and psychotherapy. The doctors found these results:
Tricyclic antidepressants, phenalzine and psychotherapy [...] were more effective at promoting remission than control conditions. There was no difference in remission between antidepressants and psychotherapy regimens. Antidepressants and psychotherapy may both be effective first-line treatments for outpatients with mild to moderate depression. (Casacalenda, Looper, and Perry 1186)
While some might argue that these findings could be a detriment to either drug companies or psychotherapists, it is in fact a benefit to both. Since both treatments have been found equally effective, the most successful approach to treating depression will be found when both sides agree to combine medication and psychoanalysis.
Many other professionals in the psychiatry and psychology fields agree that the combination approach to treating depression is ideal. Professor Raymond Lam, M.D., Head of the Division of Clinical Neuroscience, Department of Psychiatry at the University of British Columbia, corroborates on this idea:
We need to move away from simple comparisons of psychotherapy versus pharmacotherapy to consider combined therapy [...] there is preliminary evidence that combining antidepressant medications with psychotherapy may increase remission rates over monotherapy in severe depression and in chronic depression. (Lam 46)
The clinical trials cited in Lam's viewpoint are in progress and expected to be completed in March 2006 (McCullough). A combination approach of pharmacotherapy and psychotherapy has been endorsed by countless professionals besides those already mentioned. Charney and Nemeroff feel that "The multiple roots of the condition [depression] mean that using multiple treatment approaches usually works best" (Charney and Nemeroff 89). All of these people are highly respected individuals within their respective fields and their ideas should be held in high esteem.
The Band-aid approach to treating depression has gone on long enough. If we have the research and understanding to prove that antidepressant medication and therapy are the most effective means of treating depression, then that is what we must utilize. Those suffering from depression must move toward this option and recognize its value. In treating major depressive disorder, we have to treat the whole person, and not just one part of them. If patients and doctors follow this advice, then we will all have a better tomorrow to look forward to.



Works cited (not in order)


Charney, Dennis, and Charles Nemeroff. The Peace of Mind Prescription: an
authoritative guide to finding the most effective treatment for anxiety and
depression. New York: Houghton Mifflin, 2004.
Holden, Constance. "Future Brightening for Depression Treatments." Science. 302.5646
(2003): 810-814.
Kramer, Peter. Listening to Prozac. New York: Viking Penguin, 1993.
Slife, Brent. Taking Sides: Clashing Views on Controversial Psychological Issues.
Guilford: Dushkin Publishing Group, 1996.
Stern, Daniel. The Present Moment in Psychotherapy and Everyday Life. New York: W.W. Norton, 2004.
Nordenberg, Liora. "Dealing with the Depths of Depression." U.S. Food and Drug
Administration. August 1998. 12 November 2004 features/1998/498_dep.html>
Klotter, Jule. "Antidepressants for Children." Townsend Letter for Doctors and Patients.
255 (2004): 20-22.
Mechcatie, Elizabeth. "Antidepressants may boost suicide risk in Children: FDA
advisory." Family Practice News. 34.1 (2004): 78.
Frank, Ellen. "Major Depression." NAMI: National Alliance for the Mentally Ill - The
Nation's Voice on Mental Illness. May 2003. 13 November 2004
nagement/ContentDisplay.cfm&ContentID=7725>.
Lam, Raymond. "Antidepressants and psychotherapy may be equally effective for promoting
remission in major depressive disorder." Evidence-Based Mental Health. 6.2 (2003): 45-46.

McCullough, Ph.D., James P. "Research Evaluating the Value of Augmenting Medication with
Psychotherapy." National Institutes of Health. April 2003. 16 November 2004


Casacalenda, Nicola, Looper, Karl, and Perry, Christopher. "Comparing Depression
Treatments." American Journal of Psychiatry. 160 (2003): 1186-1187.

posted by a cautiously optimistic Redskins fan at 10:52 PM EST

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