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April 8, 2013

Thin Brains and Depression

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  Information on depression from National Institute of Mental Healthhttp://www.nimh.nih.gov/health/publications/depression/complete-index.shtml Information for children on depression from Kids Healthhttp://kidshealth.org/teen/your_mind/mental_health/depression.html Drug options for depression from WebMDhttp://www.webmd.com/depression/medication-options

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It's well known that depression in your family puts you at high risk of depression. Now researchers have found a structural difference in the brain that could explain why.
[If you cannot see the flash video below, you can click here for a high quality mp4 video.]

Interviewees: Cynthia Amberg, Suffered from depression,
Bradley Peterson, Columbia University Medical Center
Produced by Sunita Reed-- Edited by SunitaReed and Chris Bergendorff
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Scanning For Depression

"The depressed person was in terrible and unceasing emotional pain, and the impossibility of sharing or articulating this pain was itself a component of the pain and a contributing factor in its essential horror."
-opening line from "The Depressed Person" by David Foster Wallace

Though an excerpt from a work of fiction, that sentiment is all too real for people like 69-year-old artist Cynthia Amberg. Like her mother, Amberg experienced her first episode of depression after her second child was born. Normally exuberant, she says in that dark time she could barely get herself out of bed.

“It was a hell worse than anything I could ever adequately describe to someone who hasn’t suffered from it,” says Amberg.

Depression is a subject many people are reluctant to talk about openly, but Amberg wants people to know that they don’t need to be ashamed that they have it. She got counseling and medication, and is better able to deal with the depression that she learned often runs in families. She now only checks in periodically with Patrick McGrath, a psychiatrist with affiliations at both Columbia University Medical Center and New York State Psychiatric Institute who monitors her health and her medication. Since the '90s Amberg has rarely been depressed.

Now McGrath’s colleague, child psychiatrist Bradley Peterson, has found new clues as to why people with a family history of depression are at high risk for developing it themselves. Together with epidemiologist Myrna Weissman, they led a brain study of people with and without a family history of depression.

The subjects, who ranged in age from six to 54 years old, had their brains scanned in a functional magnetic resonance scanner, or fMRI. The researchers compared the thickness of the brain’s outer layer, called the cortex, in both groups. They found a striking difference. People with the family history had cortexes that were an average of 28 percent thinner on the right side.

“It went all the way from the back of the brain to the front of the brain in regions that are involved in spatial processing, emotional processing, social processing, planning and execution of behavior," explains Peterson. "It was really very, very prominent.”

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But the difference in thickness did not correlate with whether or not the subjects themselves had actually experienced depression. That’s where the next piece of the puzzle fits in. It turns out that the people who experienced depression not only had thinning in the right side but they also had thinning in the left side.

“That seems to tip you over from having a vulnerability into having overt symptoms and illness,” says Peterson.

But there’s more to the right side cortical thinning. The researchers also conducted tests on social memory and social attention, such as how well the subjects could remember faces or scenes around a dinner table. They found that people with cortical thinning on the right side scored lower on these tests.

“We think ultimately that’s what predisposes people to being vulnerable to developing depression-- is that you have these problems with attention and memory for social stimuli,” says Peterson. “And that kind of cuts you off or leaves you disconnected a bit and not processing emotions and social relationships very well.”

Peterson says this pattern of thinning is distinct from that of other disorders such as Alzheimer’s disease and schizophrenia. He is hopeful that further research will lead to more customized treatments for depression and ultimately ways to prevent it altogether. However, Peterson cautions that at this stage, this type of brain scan is still in the experimental stage.

Peterson hopes that this kind of research will also change the way mental disorders are perceived by some.

“There's still enormous stigma attached to them and to having them— and even having family members who have them," says Peterson. “And it really is unfortunate. It’s terrible because there are many other brain disorders that we don’t hold people accountable for—having Parkinson’s, or Huntington’s, or epilepsy. But all too often society does hold people accountable for having a psychiatric illness. And they ought not to because this is as biologically based as those other conditions.”

PUBLICATION: Proceedings of the National Academy of Sciences, April 14, 2009
RESEARCH FUNDED BY: National Institute of Mental Health, National Alliance for Research in Schizophrenia and Affective Disorders, National Institute on Drug Abuse, the Sackler Institute at Columbia University, and the Suzanne Crosby Murphy Endowment at Columbia University

Elsewhere on the Web:

Information on depression -from National Institute of Mental Health

Information for children on depression -from Kids Health

Drug options for depression -from WebMD

       email to a friend by Sunita Reed

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