Evidence suggests there is more to depression than low serotonin levels

'New Scientist' Article: "Rethink Needed For Cause of Depression"

"IF YOU thought depression was caused by low serotonin levels, think again. It looks as if the brain chemistry of a depressed person is much more complex, with mounting evidence suggesting that too much serotonin in some brain regions is to blame.

If correct, it might explain some of the negative side-effects associated with selective serotonin re-uptake inhibitors (SSRIs), antidepressants like Prozac which increase the amount of the neurotransmitter serotonin in some parts of the brain.
The traditional view of depression was largely based on the observation that SSRIs boost mood- although why they do so is unknown. "Because antidepressants increase serotonin in some parts of the brain, people assumed that depression must be the result of low serotonin levels," says Christopher Lowry of the University of Boulder in Colorado. But the discovery of multiple types of serotonin-releasing neurons in the brain, along with high levels of serotonin recorded in people with depression, is prompting a rethink.

"What's more likely is that there are subgroups of serotonin neurons that are overactive in depressed patients, rather than underactive as we have all been assuming," says Lowry.

It's likely there are groups of serotonin neurons that are overactive, not underactive as assumed.

One of the first clues that something might be amiss with the traditional theory came three years ago, when Murray Esler at the Baker Heart Research Institute in Melbourne, Australia, and colleagues found that the level of serotonin in the brains of people with panic disorder was four times higher than in healthy volunteers (Stress, DOI: 10.1080/10253890701300904), and in depressed people who were not receiving treatment it was two times higher than in volunteers (Archives of General Psychiatry, vol 65, p 38). They also showed that long-term use of SSRIs in people with depression and panic disorder seemed to decrease serotonin levels through an as yet unidentified mechanism.

Now, in studies of rats and mice, Lowry has found that there are multiple types of serotonin neurons that can be independently regulated. He presented his results at the Forum of European Neuroscience in Amsterdam, the Netherlands, last week.
This fits well with findings from other groups that there are two types of serotonin receptor in the amygdala, a brain region linked to emotion and anxiety: 5-HT2A receptors that inhibit anxiety, and 5-HT2C receptors that promote it. The roles of the receptors were identified by injecting drugs that either stimulated or inhibited each receptor and observing the animals' behavioural response

Together, the findings might mean that while high levels of serotonin in some brain regions like the prefrontal cortex can lead to improved mood, high serotonin in other regions could have negative effects.

Evidence for this idea comes from Gina Forster at the University of South Dakota in Vermillion and colleagues, who injected a stress-related molecule into the brains of rats and found that it triggered two phases of serotonin release. An initial wave of serotonin appeared to increase fear-like behaviour in the rats, while a second wave decreased this behaviour, possibly because it activated a brain region called the medial prefrontal cortex, which is associated with calming of fears (Neuroscience, vol 141, p 1047).

The new findings have implications for how SSRI drugs work. In the long-term, SSRIs do tend to have a calming effect, although more research is needed to understand how they do this.

However, in the short-term some people taking SSRIs report feeling increased anxiety. This is "almost certainly due to the activation of one of these groups of serotonin neurons", says Lowry. The suicidal thoughts some people taking SSRIs claim to experience may also be linked to boosting serotonin, as suicide is thought to be associated with increased impulsivity. "It may be that certain types of SSRI are affecting these impulsivity circuits in the brain," says Lowry.

Learning more about these different groups of serotonin neurons could lead to better treatments for depression and anxiety disorders. "It might be possible to design very specific drugs that can turn on or off specific groups of neurons that are deregulated in anxiety or depression," says Lowry."
http://www.newscientist.com/article/mg20727703.300-serotonin-cell-discoveries-mean-rethink-of-depression.html

Panic Ye Not...All will be fine (cough, cough)

With everyone on incapacity benefits or DLA for MH related illnesses stressed to max that their benefits are going to be taken away from them, a reassuring word (via Hansard site)....

Yes indeed. Paul Farmer of Mind, will be acting as an advisor to the government on the capacity assessment process.

Phewee..and there was me thinking that us loons were up for another hammering.

We all know what stirling work Mr Farmer has done on placing 'Mind' centre stage in the role of deliverer of work programmes for the mentally challenged. What do you mean, a clash of interests? No clash of his interests (for himself). Oh yours...well, sorry mate but yours, mine and anyone else with mental illness's don't count.

Rest assured Mr Farmer's position as government lead will be secure for quite some time.

Butt-kissers....you best get back to doing what you do best. There might be something in it for you.A shiny shiny award given to the person with the most chapped lips.

Bullying within Blogland...and while we are at it let's talk about stigma shall we!!!!

Another blog is likely to bite the dust. One of the few I venture to..one of the few I believe is written by someone who is genuine and not trying to become some MH celebrity or ,worse, hell bent on destroying others who don't agree with them.

Was kinda discussing this on Facebook the other day and for all that the MH elite will look down their noses at it, I have found many people there to be much more supportive than those (who do have or claim to have MH problems)out in Blogosphere. I think that says more about Stigma and Discrimination (as in where it's roots lie) than any anti-stigma campaign, I have come across, says!!!

One person came on to my FB page and wrote about 'countefoil' which is actually a clique of people whose sole purpose seems to be to harrass those who don't agree with an agenda they are following. Obsessive, I call that... but damn dangerous too because there are many vulnerable people who blog. Who find it an outlet, where they can express their feelings and experiences in ways they cannot in other areas of their life. Nasty little fekkers, sending private emails (not just the odd one either but in a pack) can actually push someone who is quite fragile over the edge. Do they give a damn? I doubt it...as long as they can carry on making out their the experts, all the time behind masks...all the time shifting from being ill, when they feel threatened to in recovery when there's something to be gained from it. Dolly Parton's tits are more real than they are and more impressive!!!!

I changed my blog and when I did I changed my attitude too. I got rid of the email option so if people have got the balls to express an opinion, they can do it openly on my blog. If not, they can keep their opinions to themselves. I haven't however, become a faceless wonder...when I go to other blogs (which gets less and less as time goes on), I go as myself and I also put my email address up before my comment gets posted...so they can email me if they wish. I am not frightened to stand up and be counted and defend my beliefs. Is not heroic..is just being honest.

What I won't tolerate is people I don't know sending me abusive mail because they haven't got the bottle to say what they think openly and on the rare occasion I do now get abusive emails, I simply write 'F off' back to them.

Blogland can be (and often is) swamped by a bunch of fakers, showing out, in order to be headhunted by the media. I don't think that makes for a fair and objective view of people with MH problems but such is life.

As for me, I will continue to write what I write, as I think and feel, depending on level of importance to me, other stuff going on in my life and my personal state of being at time.

Not going to let any snidey arsewipe (or groups of) stop me.

A voice from the wilderness...saying "I don't know WTF is going on either"

As I hadn't heard anything from my lawyer for some time; not since she emailed me writing that she had written to South Essex Partnership Trust, raising the concerns that I had discussed with her (back in May), I decided to touch base and ask where things were at.

I got a response today. Cutting to the chase, The Trust Complaints Manager has managed to acknowledge receipt of her letter to them and promised a response by 7th July. Well, that date came and went so the lawyer chased them up. They asked for a stay of grace....until 16th July and then, in another communication, requested a Written Consent Form signed by me. Luckily, I had signed the form at the original meeting with lawyer.

The Trust then asked for a 2 week's delay (in addition to that of 16th July). Lawyer has given them one week, which takes us up to 23rd July. Wonder what excuses The Trust will come up with then. Bet it's the tried and tested (and used like a worn out record) "The manager is on leave and won't be back until......whenever". We shall see!!!

Lawyer was also concerned that she wrote to my psychiatrist and ex care co-ordinator (after our initial meeting) asking them to organise a CPA meeting with me, and she hasn't heard anything. Talk about weird timing. I got a letter, today, requesting my attendance at a meeting next Monday...perhaps she will get a copy of that letter, in the next few days...and perhaps not.

In the meantime, the issues over Direct Payments have gone on...with the Trust, originally insisting I use a care organisation approved by them..only for ex care co-ordinator to be told (by that company) that they don't cater for the sort of care my Direct Payment is to be used for. An officer at the Disability Resource Centre got involved and between them and myself (with minimul input from CC) we drafted a Job Description, that is now in the local job centre. Closing date for applicants, Friday. All being well, interviews next week. Considering it took from the Panel Agreement in December until May for the Direct Payments to actually start being made...I reckon this is small fry. Am laughing here because my review date (effects of Direct Payment on my well being) was scheduled for June. The way things are going, I won't even start using them till August!!!!

As for the care support being provided to my father, by the Older Age Person's Team...That is another blog posting, in it's own right, and is not a tale of SEPT doing something right but actually not doing anything at all. When I last spoke to Dad about it, he blames himself for being a 'hopeless case'. I don't blame him at all..I blame them for adding to his feelings of worthlessness by their highly conspicious absense in regards to his care. Luckily, his basic needs are being met and very well, by the staff in the Care Home..but that is no excuse for the Trust to have no involvement in his care at all. Ah well, me thinks the complaints manager will have yet another letter for them to pussy foot around....sadly father is not entitled to legal aid and local advocacy services proved utterly useless after he took his overdose. Almost like they hadn't got a clue what to do. Welcome to the ruddy club!!!!

Health Service Journal - Survey -Govt White Paper on NHS Reform

Can't remember when I subscribed to HSJ online thingy but it was in response to some lame comments made by shrinks on there....friend sent me details. Anyway, that aside, have mostly avoided it because it is aimed at quote - Health Professionals unquote - and I don't want to be spending too much time around those types.

Latest update from the HSJ is email encouraging people to complete their survey on the effects the outcomes of Govt White Paper will have on NHS reform. I assume the people it would prefeer responding to it's survey are NHS professionals but I took up the challenge, whatever.

From the titbits of info I am picking up... here and there, the shift will be from PCT to GP Commissioning.

I actually found the questions directed to specific answers or more likely not allowing for a broad and most probably more general view on what 'people' think the outcomes might be. Then again, it was aimed at NHS staff rather than Jo Public (and patients) at large. Naughty HSJ...aren't you forgetting where your bread and butter comes from?????

I have to say, of the about 10 questions that were asked, I answered half-ish of them with "Don't know" because what a govt says it sets out to do and what actually happens are often very different things. However, I do believe, it should (whether it does or not) cut out alot of unnecessary and surplus to requirement management that's sole purpose seems to be to provide layers of bureacracy, at present.

I like the idea of GPs having more power to have specialisms within their surgeries (should they choose to use the money that way) and also the power to refer patients on to specialists (not necessarilay the ones they are referred to now). Is this where a possible choice agenda for MH patients could begin in earnest? Maybe...I think that depends on the GPs...or individual GPs more like..and the relationships they have with their patients who have MH problems.

It could all be part of some privatising of NHS..not so much through the backdoor as via a window (of opportunity???). If I was asked "Will that be a good thing?" I would have to say "Depends on the quality of the services that will be given and who will have access to them". I think there is enough of a divide between the rich and poor in this country already and we already have private healthcare systemS for those with the dosh who can then CHOOSE to opt out. Ho hum!

Would have been more democratic, on the part of the government, to do some of this consulting with the public (as pioneers of The Big Society) before producing the White Paper but we all know that rhetoric is exactly that and this Government is hell bent on getting what it wants. The rest of us are just along for the beating!

Not sure if anyone can access this but if you want to have a look at the survey, hope the link works.

http://www.zoomerang.com/SurveyWEB22AWM95HEED

A woman, finally, gets some justice for the injustice done to her whilst in care

http://www.belfasttelegraph.co.uk/breaking-news/uk-ireland/church-pays-woman-drugged-at-home-14868828.html

The Church of England has paid "substantial" damages to a woman who claimed she was heavily sedated during her time at a children's home, it has been disclosed.
Teresa Cooper, 43, accepted the out-of-court settlement from church authorities after alleging that she was abused and restrained with doses of tranquillisers and other drugs.

A BBC investigation last year revealed that some girls who were heavily sedated while living at Church of England-run Kendall House in Gravesend, Kent, in the 1970s and 1980s went on to have children with a range of birth defects.

According to files from Kendall House, which is no longer a children's home, girls were given massive doses of a number of drugs over long periods of time.

Former resident Ms Cooper's three children all have birth defects and she has fought an 18-year campaign to secure justice, she said. Her eldest son was born with respiratory difficulties, her second son was born blind and developed learning difficulties, and her daughter was born with a cleft palate and a short lower jaw.
Ms Cooper, who left the home in 1984 at 16, was given medication at least 1,248 times over a 32-month period. This included three major tranquillisers, drugs to counter side-effects and anti-depressants, including up to 10 times the current recommended dose of Valium.

The Diocese of Rochester said it has not admitted liability but said it hopes Ms Cooper would now be able to move on with her life. In a statement, it said: "Although Ms Cooper instructed a legal firm, no legal proceedings were issued. In reaching a settlement, no admissions of liability were made. It is our fervent hope that the terms of the settlement agreed will assist Teresa Cooper move forward with her life."

Ms Cooper, a writer who lives near Chelmsford, Essex, said she would like a public apology from the church. She said: "The settlement is a step in the right direction. The church has worked with me on an equal level, which took a long time to achieve and I'm quite happy with what they have done. But I would like them to investigate what happened, what went wrong and to investigate the drugs that were used that saw girls go on to have children with birth defects.

"There are lots of things the church can do and which I believe is their Christian duty to do, and I would also like a public apology at the Synod. Hopefully, we will now get justice for the other girls."

A statement through her solicitors, Lavelle Coleman, said: "In a recent settlement, Teresa Cooper has received substantial High Court damages and has concluded her years of effort to secure justice in her case. Represented by Lavelle Coleman solicitors and Elizabeth Anne Grumble QC, Teresa was finally vindicated and her pain and suffering were properly acknowledged."

Respite-ary unblockage...in spite of bare faced lying and skullthuggery of all sorts

How long it is since 'Steppingstones' rehabiliation and respite care centre was closed...I cannot remember....but would guess around 5 years.

So it has been a 5 year battle...with much bullshitting from the powers that be along the way....to get to the point I got to on Wednesday. That point being, I finally got some respite care. Yep, get the balloons, party poppers and banners out. Houston, we have lift off!!!!

Well, I had lift off :>)

I think the several letters from MP, literally starting from the words "Public Consultation" (which turned out to be a staged one off event in central Bedfordshire... only MH Trust managers and a couple of members of the service user representative group attended - no other invites sent out) might have helped along the way. Those letters and the threat, more than any action taken by a lawyer and mostly a pro-active care co-ordinator who had to find out about the centre in Luton, with minimul support from managment (a certain member of said management insisting there was no such thing as respite care in Bedfordshire and rather grudgingly saying that if the care co-ordinator believed I needed respite to go and find it). Thankfully she did, not long before finding herself another job and I don't blame her. With bosses like that, who needs enemies!!!!!!

Anyway, it may have taken a long time but progress has been made and overall it was what I needed.

The centre itself is modern and not in a clinical, clinking clanking of keys, people ushered to meds, ushered to OT, ushered to meals and then ushered to bed, way. It, has rightly won awards for excellence because it represents valuing patients in a way I have rarely seen in anything provided by MH Trusts before.

It has 3 floors. The bottom one is what I would call The Everyday Floor. Staff Room, Kitchen, TV Lounge, side rooms for visitors and meetings and a couple of bedrooms. I was in one of them. The other 2 floors are for men and women, respectively (so that, I assume the needs of women can be catered for specifically as with the men..I assume, I don't know and didn't ask).

The highlight of my stay has to be the garden. A place in which I spent the biggest part of my waking day. As I wrote to a friend, most of the other part of it spent at 'puffing billy' (no sexual activity took place)....just outside the centre walls. I find it ironic (then I would as a smoker) that in amongst all this anti stigma bollocks that goes on...you have a line of people forced to smoke on the pavement outside an NHS building (which has no name because it doesn't want to bring attention to 'psychiatric references').

I think the song does go "The saddest sight I ever saw was people smoking outside the hospital wall". I am not being pro or anti smoking here. I abstain because I am biased by addiction but there has to be a better way of acknowledging patient needs without them having to pace about outside on a busy road, looking really conspicious. Perhaps the NHS policy is to shame patients into quitting the habit. Believe me it doesn't work!!!! Just give us bells and we can walk around bawling out "unclean" at the top of or voices!!!!

That is my biggest gripe and I know I will always be outnumbered on that one. Mid winter, snow falling,extremeties frozen, I will be out there puffing away.

Back to that glorious garden. Massive it is. Lots of different trees, flowers and plants and wonderful aromas. Slap bank in the middle, most encased in lavendar, is the pond. I spent a fair bit of time playing spot the fish. Was informed there are some but never got to seen them. Can think of worst ways of wasting my time.

I did plenty of reading (something I have struggled with lately) and my cans were rarely off my ears.

There was a bit of a mix up over an OT trip out bowling. I had (whilst taking notes of patient meeting) put my name forward along with 3 others to do this activity. When the time came, the OT person didn't turn up. So I went back to the garden and it was only when I went out for a ciggy, I clocked their car full of other patients. I assumed, based on her blank look when I asked if I could still attend, that people in respite are not allowed to go. Later I spoke with the Staff Nurse because I needed to know what the policy was. The policy is anyone can go but it is a first come, first served basis. Hmmmm.....Not sure if the OT lady had an issue with me (she is also the smoking cessation champion!!!) or just my paranoia but the communication went totally tits up and it left me feeling completely isolated, dejected and paranoid.

After ringing my mate, decided not to just up and leave and their advise was to talk to the OT personage and let them know how it made me feel. I didn't get that opportunity...so decided to leave it be because I do need to use respite care (sure that time will be pre or post Christmas) and should the same thing happen next time, I will challenge them directly and see what the problem with me, if there is one, is.

The other patients were friendly, in their unique ways and I became fond of one person. I will call her 'Rani' (which is not her name) and in spite of the many difficulties she has, came with me to the local shop and said if I forget where it is, she would take me there again. We had brief but warm chats during my stay and when I was waiting for the taxi to bring me home, today, she came out, gave me a warm hug and wished me well. I hugged her back and said I wished her the same and that if she was still there, next time, I look forward to seeing her.
I nearly cried.

The most basic kindnesses get me like that. There are so few of them around these days. It's all top show, no underwear city....and fekk all feelings to show for it.


Time was too short to really bond that much....and I felt a bit like I needed to keep some space...so that people didn't get too attached to me..or vice versa and then having to leave and me dealing with that. It was only respite and, anyway, I know that I can be over-bearing so kept myself low key.

Staff were pretty helpful too. I did struggle around my medication. That was my issue rather than theirs as I don't have a set time for taking them and had to ask..and often I got paranoid and then would get to freaky point before asking. Lesson learnt..particularly as staff nurses made it clear that as long as I stuck within my allowance, when I took my meds was down to me.

My relationship with them grew from minor distrust (because of prior experience of most things MH Trust wise) to respect. I knew the lead STR worker from stay in the old style pyschiatric unit, before acute care become too much like a mini prison style pressure cooker environment and the staff nurses were really good. I felt I was dealing human to human, rather than playing the boss/servant game.

So South Essex Partnership etc etc etc Trust. You do have something that, mostly, works really well and like I say, I am the first the lambaste when all is not well but credit where it is due and I give the respite care place 8/10. If the OT had gone smoothly it would have been a 9....the other 1 point is out of the centre's control because you can't change national policy!!!

Now it is time for me to collapse in heap as my dry disks are playing up....time to sedate myself. It will still hurt but I won't care so much.

The futility of voting for change

As I am sure many others are, I am deeply concerned about the goings on of this Tory/Lib Allegiance Government.

Previously, I have waxed positive about my local MP (Tory) who did, a fair bit of the time, fight my corner as I tried to get local MH services to do their jobs properly, fairly and consistently. However, a local MP dealing with their constituents is very different to a steamroller approach to stuffing the poor and vulnerable.

I have lost faith (totally) in the political system, which I should have realised only serves a certain section of society. I detest above all the Liberal Democrats for selling themselves out (apart from the referendum next May on Proportional Representation...which seems to be the only thing they now care about viz a vie their morals) and becoming whores to their power lust. Hope they enjoy the time they have sharing power (make that being subserviant to the Tories). I doubt they will be respected come the next general election..whenever the fekk that will be because the Tories wanna close the system down to a point where they run the show...indefinately.

The only political action I will be taking, in regards to the shite hole this system is, will be to go along to future balloting stations and write "It all stinks to high heaven" on my voting paper.

Fekk em all because they sure as hell are going to fekk me over!!!!!