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Self-help books 'treat depression'
Can a self-help book aid depression?
Can a self-help book aid depression?
People can find it hard to keep on working when experiencing depression
Mild exercise for mild depression?
The fact that people get more enjoyment from exercising during their leisure time is key
Experts studied the physical and mental health of 6,000 people over several years Depression has been linked to loss of brain cells |
People who have had depression may be more prone to Alzheimer's disease, two studies suggest.
Dutch researchers found Alzheimer's was 2.5 times more likely in people with a history of depression.
Similarly, US researchers, examining Catholic clergy, found those with signs of depression were more likely to go on to develop Alzheimer's.
The Dutch appears in the journal Neurology and the US study in Archives of General Psychiatry.
The Dutch study was small - 486 people over an average of six years, with just 33 people developing Alzheimer's.
But it found that people who showed signs of depression before the age of 60 were four times more likely to develop Alzheimer's.
| Dr Monique Breteler Erasmus University Medical Center |
The researchers, from the Erasmus University Medical Center in Rotterdam, said more work was needed to fully understand the link between Alzheimer's and depression.
Lead researcher Dr Monique Breteler said: "We don't know yet whether depression contributes to the development of Alzheimer's disease, or whether another unknown factor causes both depression and dementia."
One theory is that depression leads to the loss of cells in two areas of the brain, the hippocampus and the amygdala, which then contributes to Alzheimer's disease.
However, the latest study found no difference in the size of these two brain areas in people with depression and people who had never developed the condition.
Second study
The findings were echoed in a second study by Rush University in the US published in Archives of General Psychiatry.
The researchers followed more than 900 members of the Catholic clergy for up to 13 years during which time 190 developed Alzheimer's.
They found that those with more signs of depression at the start of the study were more likely to develop Alzheimer's.
But there was little evidence of an increase in depressive symptoms during the early stages of disease.
Even after the diagnosis of Alzheimer's was made there was no general increase in depression, but rather an increase that was confined to individuals with certain personality traits.
The researchers said their findings suggested that depression was a risk factor for Alzheimer's disease - rather than a subtle early sign of its underlying pathology.
Researcher Dr Robert Wilson said: "Depressive symptoms may be associated with distinctive changes in the brain that somehow reduce neural reserve, which is the brain's ability to tolerate the pathology associated with Alzheimer's disease."
Rebecca Wood, of the Alzheimer's Research Trust, said the research was interesting, and potentially useful.
She said: "Identifying people at higher risk could lead to ways to reduce the number of people who develop dementia, help researchers to understand more about dementia and create new avenues of research."
Dr Susanne Sorensen, head of research at the Alzheimer's Society, said: "More research is needed to clarify the relationship between dementia and depression and determine whether depression causes changes in the brain that make dementia more likely." Trainers devise personal exercise regimes for each patient |
In a survey of 200 English GPs, the Mental Health Foundation found 22% suggest exercise to help people with milder forms of the condition.
This compares with just 5% in a similar survey three years ago.
The foundation said it was important that doctors did not just prescribe antidepressants for patients, and looked for other options.
Tackling isolation
Research has shown that exercise can help people with mild forms of depression by improving self-esteem - through better body image or achieving goals, and by relieving feelings of isolation which can fuel their depression.
It also releases feel-good brain chemicals such as endorphins.
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There is a real need for increased availability of exercise on prescription ![]()
Celia Richardson, campaigns director for the Mental Health Foundation, said: "It can help people physically, socially and biologically.
"They often meet others who have been in the same situation as them, but are now further down the line and feeling better."
The survey found there is now a wider belief by GPs that exercise therapy can be beneficial.
Three years ago, 41% thought it was "effective or very effective", rising to 61% now.
But half of the GPs questioned did not have access to an exercise referral scheme. Two thirds of these doctors said they wished they had.
More patients are also interested in how exercise can help them - one in six GPs say they have noticed an increase in the number of people asking whether exercise could help them.
Choice
Exercise programmes run by the Mental Health Foundation, partly funded by the Department of Health, are now available in Bedfordshire, Cambridgeshire, London, Northamptonshire, Redcar and Cleveland, and the Wirral.
People referred under the schemes are given a personal trainer who can devise a suitable exercise regime for them.
Results from the six areas will be published next year.
Andrew McCulloch, chief executive of the foundation, said: "There is a real need for increased availability of exercise on prescription so that it is accessible alongside antidepressant medication and psychological therapies.
"Depression is a complex illness - it is important that GPs have a range of treatments to offer and that people with depression have a choice."
Realistic aspirations may be the key to happiness |
Data analysis on two million people from 80 countries found a remarkably consistent pattern around the world.
The risk of depression was lowest in younger and older people, with the middle-aged years associated with the highest risk for both men and women.
The study, by the University of Warwick and Dartmouth College in the US, will feature in Social Science & Medicine.
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One possibility is that individuals learn to adapt to their strengths and weaknesses, and in mid-life quell their infeasible aspirations ![]()
University of Warwick
The only country which recorded a significant gender difference was the US, where unhappiness reached a peak around the age of 40 for women, and 50 for men.
Previous research has suggested that the risk of unhappiness and depression stays relatively constant throughout life.
However, the latest finding - of a peak risk in middle age - was consistent around the globe, and in all types of people.
Researcher Professor Andrew Oswald, an economist at the University of Warwick, said: "It happens to men and women, to single and married people, to rich and poor, and to those with and without children."
He said the reason why middle age was a universally vulnerable time was unclear.
Count your blessings
However, he said: "One possibility is that individuals learn to adapt to their strengths and weaknesses, and in mid-life quell their infeasible aspirations.
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Depression is a complex and challenging condition that remains poorly understood ![]()
SANE
"Another possibility is that a kind of comparison process is at work in which people have seen similar-aged peers die and value more their own remaining years. Perhaps people somehow learn to count their blessings."
Professor Oswald said for the average person, the dip in mental health and happiness comes on slowly, not suddenly in a single year.
Only in their 50s do most people emerge from the low period.
"But encouragingly, by the time you are 70, if you are still physically fit then on average you are as happy and mentally healthy as a 20-year-old.
"Perhaps realizing that such feelings are completely normal in midlife might even help individuals survive this phase better."
Marjorie Wallace, chief executive of the mental health charity Sane, said: "This study raises intriguing questions about the processes that lead to depression in mid-life, as well as indicating what a common experience it is worldwide.
"Depression is a complex and challenging condition that remains poorly understood, with as many as one in ten people with severe depression taking their own life.
"We welcome any scientific contribution to our understanding of this illness, particularly if the research can aid the development of better treatments, both therapeutic and pharmaceutical."
Andy Bell, of the Sainsbury Centre for Mental Health, said mental health problems were extremely common - but he stressed they could occur at any time in life.