Depression Treatment & Information

Anxiety

About half the children experiencing depression also experience anxiety. Anxiety is easy to overlook because a child may not talk about his fears, especially if he’s an adolescent. Young children tend to be much more open and at ease in sharing their fears and worries. Anxiety usually takes one of two forms:

1. A generalized anxiety disorder
2. Anxiety related to panic attacks.

Symptoms of generalized anxiety relate to feelings of restlessness, being on edge, being overwhelmed, having difficulty concentrating, and experiencing muscle tension or sleep disturbance. With generalized anxiety, there may be more fears, but they aren’t as intense as when a panic attack is involved.

The most common forms of a panic attack in children relate to school phobia or separation anxiety when a child is asked to leave the physical proximity of a parent. Children in these situations may become so anxious that they throw up, have major temper tantrums, and act defiant, even if they’re usually well behaved.

The Differences between Anxiety and Depression

Anxiety differs from depression in that an anxious child usually has more energy and doesn’t have as much negative attitude toward life. Instead, the anxious child is afraid and has fears that impede his ability to meet the demands placed on him. Anxiety can have a negative impact on his ability to attend school, engage in social activities, and simply be able to relax.

While the anxious child may avoid participating in activities, he does so for a different reason than the depressed child. The anxious child tries to avoid dealing with situations that make his nervous. The depressed child avoids dealing with a situation because he lacks the energy and frustration tolerance to deal with it. The anxious child also experiences the stress of perceived negative events more intensely.

But there’s one way in which anxiety and depression are similar. Threats regarding the negative consequences of a child’s behavior almost never produce the desired results. Instead, they’ll probably make the situation worse. Threatening an anxious child will only cause more anxiety and lead to an “Oh, on!” response. The depressed child may not react to the threat because he doesn’t have the energy or motivation to care, which results in a “So what?” response. source

FRIDAY, March 7 (HealthDay News) — The increased risk of death associated with depression after a heart attack persists for at least five years, a study finds.

“We’ve known for a number of years that depression increases the risk of mortality as well as morbidity [illness] after a heart attack for at least three to six months,” said study author Robert M. Carney, a professor of psychiatry at Washington University School of Medicine in St. Louis. “We assumed that we would find a decline in risk, but that was not what we found. The risk remained worse after five years.”

Carney and his colleagues followed more than 750 people after their heart attacks, according to their report in the current online issue of the Journal of Affective Disorders. Using diagnostic interviews rather than the self-reporting common in most such studies, the researchers determined that 163 had major depression, and 195 had minor depression. Over the five-year study, the death rate was 87 percent higher for those with major depression and 76 percent higher for those with any form of depression.

In real numbers, 62 people diagnosed with depression died during the study, while 44 non-depressed heart attack patients died. Why depression should increase the risk of dying is a mystery, Carney said. “We think that because depression is a chronic and recurrent problem, the factors causing that risk recur over time,” he said. “But we don’t know the mechanism.”

The researchers have started a trial to determine whether the omega-3 fatty acids that are found in fish oil can reduce that risk. Heart patients are being given an antidepressant drug and a special formulation of omega-3 fatty acids, comparing them with a similar group that gets only an antidepressant.

“A number of studies over the years have found an inverse relationship between the amount of fish people eat and depression,” Carney said. “The advantage of giving them in heart disease is that they have an effect on the cardiovascular system as well.”

The major finding of the study and the use of omega-3 fatty acids are already in the mainstream of research on depression and heart disease, said Dr. Alexander H. Glassman, a professor of psychiatry at Columbia University Medical Center in New York City.

“There is a torrent of information that depression in relation to vascular disease worsens the outcome,” Glassman said. “If you look at post-stroke patients, you find the same data. If you look at heart failure, depression has a similar effect on mortality.”

The value of the study is that it had the longest follow-up of any trial using diagnostic interviews, which are regarded as more accurate than self-reporting, Glassman said. “It makes the evidence firmer and extends the evidence,” he explained. The use of omega-3 fatty acids is “a hot issue,” being tried in cardiac and non-cardiac cases, Glassman said. “It is a logical thing to do,” he added. The study and the omega-3 trial will still leave some major issues about depression and heart disease open, Glassman said.

“The two key questions that remain are: Does treating depression make the outcome better? And what is it about depression that is causing the problem in the first place?” he said.