The measures, known as mental health parity, ban group health plans from applying different coverage standards for mental health disorders or substance abuse treatment than those for general medical treatment or surgery.

“The rules we are issuing today will, for the first time, help assure that those diagnosed with these debilitating and sometimes life-threatening disorders will not suffer needless or arbitrary limits on their care,” U.S. Health and Human Services Secretary Kathleen Sebelius said in a statement.

Some 150 million Americans are enrolled in employer-provided group health insurance plans, the government says. The new rules, which stem from a bill passed by Congress in 2008, exempt group plans covering 50 or fewer workers.

Under the parity system, group plans that offer mental health and substance abuse treatment cannot charge higher deductibles or place different limits on frequency of treatment than they would for medical and surgical care.

“These rules expand on existing protections to ensure that people don’t face unnecessary barriers to the treatment they need,” said Deputy Treasury Secretary Neal Wolin.

The rules could take effect as early as July 1, after federal agencies review comments from the public, industry and other interested parties.

The National Council for Community Behavioral Healthcare, a Washington-based advocacy group, said the regulations begin the final chapter in an effort to ensure that Americans with mental illness have equal access to health care.

“Now people in need won’t have to go without treatment because of discriminatory insurance policies,” president and chief executive Linda Rosenberg said in a statement.

The rules will implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.

The law is named for the late Democratic Senator Wellstone, who was a strong advocate of equal treatment of benefits, and former Republican Senator Domenici, who first introduced parity legislation in 1992.

The late Democratic Senator Edward Kennedy was another driving force behind the bill Congress passed after a decade-long effort by advocates for the mentally ill who said insurers often shortchanged people with conditions ranging from depression to schizophrenia.

(Editing by Xavier Briand)

Technorati Tags: Depression, Mental Health, mental health disorders, mental illness, schizophrenia

Timothy S. Wells of the US Air Force Research Laboratory, Wright-Patterson Air Force Base in Ohio, studied more than 40,000 members of the Air Force who had been free of symptoms of depression and had not taken medication for anxiety, stress, or depression before deployment. The subjects were in the Air Force from some or all of 2000 to 2006.

Those who experienced combat had the highest rate of new diagnoses of depression - about 6 percent for men and about 16 percent for women. That compared with about 4% of men and about 8 percent of women who were not deployed, and about 2 percent of men and 5 percent of women who did not face combat.

Some of the differences in the group that was not deployed could be explained by the fact that only those who meet all of the Air Force’s health requirements are eligible for deployment, Wells told Reuters Health by email. In other words, “It is likely that the nondeployed group had other risk factors, such as other mental health disorders and health conditions that placed them at increased risk of depression in comparison to those who deployed, but were not exposed to combat.”

In their report in the American Journal of Public Health, the investigators note that male combat specialists had a lower risk for depression than men in health care or other supportive positions, suggesting that “military hardiness” may help lower risk.

“Individuals who are expected to be exposed to combat may receive training that alters their risk for depression compared to non-combat exposed personnel,” Wells said.

Male and female personnel with pre-existing PTSD were more likely to develop depressive symptoms, reflecting a well-known link between the two conditions.

Other risk factors for depression included younger age, smoking, alcohol dependence, and service in the Army branch of the services. Furthermore, women who were married, divorced, non-Hispanic white, on active duty, or served in the US Navy/Coast Guard faced an increased risk for depression.

SOURCE: American Journal of Public Health, online November 12, 2009.

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Their six-month study of 262 black mothers and their children found that children whose mothers had more depressive symptoms had more frequent asthma symptoms, while children of mothers with fewer depressive symptoms had less frequent asthma symptoms.

The Johns Hopkins Children’s Center team focused on black mothers and children because black children are disproportionately affected by asthma. The study was released online in advance of publication in an upcoming print issue of the Journal of Pediatric Psychology.

“Even though our research was not set up to measure just how much a mom’s depression increased the frequency of her child’s symptoms, a clear pattern emerged in which the latter followed the earlier,” senior investigator Kristin Riekert, a pediatric psychologist and co-director of the Johns Hopkins Adherence Research Center, said in a Hopkins news release.

While the degree of a mother’s depression affected her child’s asthma symptoms, the reverse wasn’t true, the researchers found. This suggests that a mother’s depression is an independent risk factor that can predict the severity of a child’s asthma.

“Intuitively, it may seem that we’re dealing with a chicken-egg situation, but our study suggests otherwise. The fact that mom’s depression was not affected by how often her child had symptoms really caught us off guard, but it also suggested which factor comes first,” Riekert said.

Because depression often involves fatigue, memory lapses and problems with concentration, it can impair a mother’s ability to manage her child’s asthma, which may require daily drug treatments and frequent doctor visits, the study authors noted.

“Mom is the one who must implement the doctor’s recommendations for treatment and follow-up, and if she is depressed she can’t do it well, so the child will suffer,” study lead investigator Michiko Otsuki said in the news release.

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The American Academy of Family Physicians lists these warning signs of postpartum depression:

• Persistent feelings of sadness and crying.
• Having little desire to eat.
• Significant weight gain or loss.
• Irritability, anxiety and restlessness.
• Inability to find pleasure or interest in life.
• Feeling exhausted or having no motivation to get things done.
• Insomnia.
• Feelings of hopelessness, worthlessness or guilt.
• Having little interest in your newborn.

Technorati Tags: Postpartum Depression, postpartum depression signs, Postpartum Depression symptoms

The study involved 109 women who completed questionnaires designed to assess their levels of neuroticism and depression. For the next three weeks, they kept daily records of whether they felt any of 15 common physical symptoms, including aches and pains, gastrointestinal problems and upper-respiratory issues.

At the end of the three-week period, the women were asked to recall how often they’d experienced each symptom. Those who had a higher depression score at the start of the study were more likely to overstate the frequency of their symptoms.

“People who felt depressed made the most errors when asked to remember their physical symptoms,” psychologist Jerry Suls, a professor and collegiate fellow at the University of Iowa said in a university news release. “They tended to exaggerate their experience.”

It’s long been believed that a high level of neuroticism — a general disposition that includes irritability, sadness, anxiety and fear — is associated with exaggerated reporting of physical symptoms. But the study suggests that a more likely reason is depression.

“For 30 years, the hypothesis has been that neuroticism is behind inflated reports of symptoms,” Suls said. “We’re saying no — depression appears to be the big player. We discovered that people high in neuroticism but low in depression are not likely to mis-remember symptoms.”

The findings, published online Oct. 15 in Psychosomatic Medicine, are important, Suls said, because symptoms reported by patients play a major role in doctors’ diagnosis and treatment decisions.

“Depressed individuals and their physicians shouldn’t discount common symptoms because they can indicate serious problems,” he said. “However, since we now know that depressed individuals tend to over-remember the frequency of symptoms, it wouldn’t hurt to encourage patients to write down their symptoms as they’re happening. That way the patient and doctor have an accurate record of what has been going on, rather than relying on memory.”

Technorati Tags: Depression, neuroticism, Psychosomatic Medicine

In a special edition of the May/June issue of Health Affairs focusing on mental health care in the United States, one study found that about half of Americans suffering from mental illness in a given year don’t receive treatment, and another 25 percent receive treatment that’s not consistent with evidence-based guidelines.

Some patients may receive inappropriate treatments, simply because doctors lack the evidence to make an informed decision about appropriate care, noted Philip Wang, acting deputy director of the National Institute of Mental Health, and colleagues.

Another study suggested that even when doctors have information about best practices, patients don’t always receive the correct treatments. That’s because financial incentives, regulations, the quality of the mental health workforce, and drug company marketing strategies have a major impact on doctors’ treatment decisions, said Marcela Horvitz-Lennon, of the Western Psychiatric Institute and Clinic in Pittsburgh, and colleagues.

They said underuse of effective treatments and overuse of ineffective treatments undermine the quality of care and lead to poor patient outcomes. For people with severe mental illness, that can result in increasing isolation, repeated hospitalizations, inability to get or hold a job, and even suicide.

Another study found that the number of seniors receiving psychotropic drugs to treat Alzheimer’s and other mental health disorders doubled between 1996 and 2006, and the number of adults and children using the drugs increased by 73 percent and 50 percent, respectively.

The use of psychotropic drugs has increased, because primary-care doctors have become more familiar with these types of drugs and lower-cost drugs have become more available, said Sherry Glied, chair of health policy and management at the Mailman School of Public Health at Columbia University, and colleague Richard Frank.

The researchers also found that access to mental health care has improved for many Americans, but challenges persist for many groups of people. Between 1996 and 2006, treatment declined for elderly people with mental limitations that make it difficult for them to do daily living tasks such as dressing, eating and bathing without assistance.

Glied and Frank also found that more people with serious mental illnesses are being imprisoned or incarcerated. About 7 percent of people with persistent mental illnesses are put in jail or prison every year.

Another study found that many members of the military and veterans get inadequate treatment or no care at all for post-traumatic stress disorder (PTSD) and depression. The Rand Corp. researchers said more needs to be done to better prepare community health providers to help veterans with mental health problems when they return home.

In addition, the Department of Defense needs to reduce institutional and cultural barriers to seeking mental health care, especially for active-duty military personnel.

A study by Robert Drake, a psychiatry professor at Dartmouth Medical School, and colleagues concluded that a national program to help mentally ill people on Social Security disability programs find jobs could save the federal government $368 million a year.

The researchers noted that about 27 percent of people receiving Social Security Disability Insurance benefits are mentally ill, and that up to 70 percent of people with mental illnesses want to work.

“Giving people with mental disabilities the power to build financial security will help improve their quality of life significantly by encouraging self-sufficiency and building self-esteem, which can ultimately help move their treatment forward as well,” Drake said.

Technorati Tags: Depression, Mental Health, mental health care, Mental health services, Mental health spending, mental illness, post-traumatic stress disorder, psychotropic drugs

People who are in this depressive state of mind find it hard to regain their feeling of normal happiness. Usually moods vary depending on the daily circumstances of a person’s life. You may awake in a great mood, receive one phone call , and your whole outlook on the day changes. Some people suffer from depression so seriously that they are no longer able to control their moods or cope.

Nobody can pinpoint what exactly "causes" serious moods of depression since many contributing factors many be included, i.e., genetics, stress, health conditions. Signs are noticeable that show a person could be in a serious depression and in need of help. A person that was once cheerful and outgoing can become despondent, they do not take enjoyment form activities that had given them joy at one time. Depression can make a person feeling exhausted and tired, leaving them with little motivation.

It is likely depression if you or you know somebody that is suffering from these symptoms. There are many people that feel depression and they are embarrassed to ask for the help that they need, in turn you might have to ask the person yourself. It can be extremely hard to escape a serious bout of depression and consulting a psychiatrist or therapist could be the only way of receiving the necessary help required. A doctor can give a prescription that will help control the depression symptoms.

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Monitoring your moods and behavior from time to time can help your doctor treat your depression before it becomes hard to control. Try to observe any patterns of mood swings each week and call your doctor if you aren’t feeling at the top of your game.

Stick with the prescribed treatment.

Depression medicines can take up to eight weeks before they take full effect. Don’t skip doses or quit treatment early. If you don’t take your depression medicine exactly as prescribed, you’re not giving it a fair chance to work.

Strengthen your social support

While you cannot control your depression diagnosis, there are some things you can control. You can seek or create a positive support system for yourself. Whether your social network stems from your spouse, family members, close friends, co-workers, religious organizations, or community groups, support is available.

Develop good habits

Take your depression medicine at the same time every day. It’s easier to remember if you do it along with another activity such as eating breakfast or getting into bed. Get a weekly pillbox, which will make it easy to see if you’ve missed a dose. Since people sometimes forget a dose now and then, make sure you know what to do if that happens.

See a depression expert

Any doctor can prescribe depression medication, but a prescription alone isn’t the best treatment. You should seek out an expert, like a psychiatrist or a psychologist. Your condition is, by definition, hard to treat. It’s important to talk with a trained professional during your treatment. Although psychologists cannot prescribe medication, they are well-trained in psychotherapy. You can work with a psychologist while taking antidepressants prescribed by your regular doctor, or you can see a psychiatrist for both your depression medication and talk therapy. Try to find someone who has a lot of experience helping people with treatment-resistant depression.

Never stop taking your depression medicine without your doctor’s permission

If you need to stop taking your medicine for some reason, your doctor may want to reduce your dose gradually. If you stop suddenly, you could have side effects and your depression could get worse.

Don’t assume that you can stop taking your depression medicine when you feel better

If you have treatment-resistant depression, you will need to take your antidepressant for several months — or possibly a year — even after you’re feeling better. This type of "maintenance medication" can help prevent you from getting more depressed in the future.

Don’t ignore side effects

Side effects are one of the main reasons that people give up on medication. For instance, in a British study of just over 1,000 people with depression, 65% said they stopped taking their medicine at some point. Of this group, about 45% said side effects were the reason. The results were published in Current Medical Research and Opinion in 2003. If you have side effects, talk to your doctor. See if there’s any way to minimize or eliminate them. However, keep in mind that side effects might be worse when you first start a medicine. Side effects often ease up over time.

Maintain regular sleep habits

Talk to your doctor if you have difficulty falling asleep or maintaining sleep. There are new non-addictive medications available that can help resolve sleep problems. Also, cognitive behavioral therapy has been shown in recent clinical trials to be a helpful adjunct treatment for patients who have impaired sleep efficiency, or anxiety and fears about poor sleep.

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As your dreams approach their climax, the pain escalates further. Upon reaching its apex, it suddenly jolts you awake. Cupping your head in your hands, you writhe helplessly in bed. These past few days have been different for you lately. Your headache which used to strike during the day has stealthily made its entrance into your sleep, oftentimes forcing you awake. Furthermore, the pain has become twice stronger that at times it refuses to budge although you have already downed a strong pain reliever.

Are you depressed?

Normally, you are able to address mild tension headaches with the usual over-the-counter pain killers. Right after taking a pill or two with a glass of water, all you need to do is rest and wait for the medicines to take effect. Later on, you would be back on your feet again, raring to get on with your life. But if your headache has started to disrupt your life, occurring for days at a time and striking even in your sleep that you are forcefully awakened by the debilitating pain, then your headache can already be a therapeutic dilemma triggered by an underlying depression.

Most cases of depressed patients suffering from headaches have the aforementioned symptoms, with the pain persisting despite medications or lasting throughout the day after the sufferer awakens in pain. This particular type of headache has been classified and identified way back in 1964 as the major symptom of people with depressive tendencies. As in most cases, the presence of depression is barely noticeable that patients remain undiagnosed. It is only through persistent observation whereby the concerned individual exhibits other symptoms associated with depression that medical experts finally take heed of their condition. However, a portion of sufferers fail to manifest some if not most of the typical symptoms that experts delve deeper and conduct serious studies on the state of the patient’s relationships in order to diagnose their condition formally.

The Hidden Face of Depression

If you have depression, you are bound to show symptoms encompassing the following areas: emotional, physical, and psychic. On the physical aspect, you are liable to experience persisting pain in other parts of your body and/or tension headaches. In line with these, you would also be plagued by sleep interruptions or disorders such as insomnia or being constantly awakened in the midst of your slumber. With these comes a marked change in your appetite, which could result to either anorexia or rapid weight gain. Emotionally, you feel as if you are drifting each day under a perennial cloud of sadness whereby you find your thoughts flitting over events that transpired in your life. At times, your thoughts would linger on the present or even in the future. Lastly, on the psychic aspect, thoughts of ‘death, suicide, or dying’ might intrude into your consciousness every once so often.

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For good or ill, the quality and dynamics of your relationship will either encourage, support, and help build you up - or it will drag you down and lead you further down the path toward depression and low self esteem. If your partner is loving, respectful, and supportive, you are more likely to experience a positive benefit. If your partner instead is critical, controlling, or withholding of love and affection, this wears and tears on your self image and joy. Here are 5 signs of emotional abuse and how it can cause depression symptoms:

1. Your partner is critical of you, publicly or in private. Your partner could choose to call you names, or simply pick you apart for the way you do activities, who you are as a person, and/or may question or criticize your mental health and stability. The overall result is often a feeling of inferiority, a sense of incompetence, and a fear of being crazy. Over time this can lead to lower self worth and feelings of depression.

2. Your partner is critical of your daily activities and expects a daily "report" of what you are doing. When you explain what you did, you might feel defensive and feel compelled to defend and justify yourself. Educational and work opportunities may be another area where your partner makes his or her preferences known - and your partner is likely to be discouraging of any activity that fosters your independence. Feeling powerless and dependent lowers self esteem and can bring about depression symptoms.

3. You feel restricted by your partner about who you spend time with on a regular basis. You partner might not want you to see a specific person, or you may hear comments that put guilt and pressure on you for choosing "someone else over me." This can interfere with your relationship with family and friends. Your partner gets the benefit of asserting control over you, as well as keeping you away from positive affirmations that might come from your support network. Criticism of your partner by loved ones is also reduced. Isolation from those you love can make depression feel bigger and more overwhelming.

4. Your partner might threaten you non-physically, implying that you will experience consequences if you don’t do what your partner wants. Occasionally, your partner might do something nice for you, but it is typically a tactic to draw you back into the relationship when you are considering leaving it. Once you are safely back into the fold, your partner starts the emotional abuse again, and depression may linger.

5. Sex becomes a matter of control, instead of a loving expression of your partner’s feelings for you. One tactic of control your partner might employ is to demand sex and affection from you, even if you really don’t want to do it. Conversely, your partner may purposefully deny you the love and affection you want on a regular basis. In either case, you become a slave to your partner’s whim, and the rejection or coercion can make depression symptoms worse.

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