Category Archives: depression

The other side of Seasonal Affective Disorder: For the people whose social anxiety spikes when everyone’s back outside

Everything has a name I suppose. This one is clever: “SAD.”

Google says, “Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with the seasons, typically starting in late fall and early winter and going away during the spring and summer.” Everything has a definition too, I suppose, like, “typical” defined as “showing the characteristics popularly associated with a certain thing.” SAD during the winter is typical. SAD during the winter is popular—is a mood—is a FB post—is a viral tweet. We all have a little bit of SAD in us when the temperature dips. No need for a support group when your entire city feels it—#BringBackTheSun, #IWantToWearThotClothes, #LetMyMelaninPopAgain.

It is Monday morning and I am sad in the regular way that Monday tends to leave me with a “feeling of sorrow.” It is the beginning of the week and of course I am miserable at work—typical—a popular mood. The day has spun and it is now five o’clock, yet the sun is now shining outside my office window.

This past weekend the government decided to do some shit to save our daylight, and now the sun is #FeelingHerself again. It is five o’clock, this girl is still out bright and burning, and the weatherman says, “Nice with a chance of getting nicer.” We’re at fifty degrees going on sixty. I can hear the women on the street below humming a serenade of “at laaaaassssst, our warmth has come along.” My fiancé texts me some shit about air, and freedom, and skin, and I can feel him bursting between each character. New York City is a carnival soon to be reopened, and I’m the child screaming to go back home.

I close my window and lower the blinds in an effort to muffle the song of the women and the sun. I tell my fiancé to do what he wishes with all his merriment, but I’ll meet him back at home. I sink into my desk and let out a sigh so deep it fogs my monitor.

It’s spring. SAD is suppose to be less likely in the spring or summer. I think it has something to do with Vitamin D. I ain’t a doctor, so I won’t diagnose myself, but I do know what sad feels like and I’m pretty sure that this is it. I flip off the lights in my meager attempt to reject this change in season, yet I can still hear the music.

It is said that misery loves company, but personally, I just prefer a climate that affirms me. The way a snowstorm supports your decision to not leave your bed for the day. The way fifteen degrees whispers, “You do not have to worry about what you eat, you can just cover up your body.” Winter never gaslights my depression the way summer does.

No matter how much therapy, I am never really ready for what the sun demands this time of year. The brunches, the day parties, the summer park nights fueled on laughter and liquor. And liquor. And liquor. And liquor.

Sometimes I try to repeat the word enough that it’ll just become a sound I control instead of a memory that controls me. They call that semantic satiation—there’s a word for everything, I suppose. But words, though they try, don’t stand a chance against my SAD. No matter how many times I whisper to myself, “You are more than your trauma.” I still flinch when someone yells, “Shots!?” during the function.

My therapist says “children of alcoholics (COA),” and suddenly SAD isn’t my only diagnosis. He says it is typical for COA’s to feel anxiety in social settings where drinking is involved. Definitions can change too I suppose. In this context “typical” no longer means “popular,” but rather “lonesome.” During the spring and summer I am often typical.

It’s been my experience that to be young in the sun in NYC is to either be the bar or to be bar adjacent. I struggle yearly to feel connected to community due to the burdens I carry as a COA, and nice weather often exacerbate these feelings.

But what magic it is to be Black, and carefree during the summer. To be cocoa butter wrapped in a thick twine of cotton. To be two Black palms sticky and stacked with freshly sliced mangos and chili powder. To be so Black the sun reflects you gold, and now your skin is the only thing worth gossiping over. And eventually I will marvel at all that static—but it takes me a minute to get there.

In the meantime, you can catch me convulsing as I check my weather app. The symptoms of SAD vary, but usually, despite how pointless it may be, it leads me to writing. Usually I’m trying to avoid everyone I know in an effort to not have them catch my sad too—but the sun demands differently. The sun demands friendship, and outings, and picnics, and nights you’ll never remember with the people you’ll never forget.

But what if you don’t have those people? What if the sun just helps to illuminate the empty space left around you? Is this season still a celebration? Maybe I’m too atypical for a word or definition of my own. But I know SAD in the spring, and in the summer, and I just hope it’s worth a retweet too.

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FDA Approves Ketamine-Like Nasal Spray For Depression

(CNN) — The US Food and Drug Administration approved Janssen Pharmaceuticals Inc.’s esketamine on Tuesday for treatment-resistant depression; the drug is the chemical cousin of ketamine, the powerful anesthetic that has been used illegally as the club drug Special K.

It will be sold as Spravato. More specifically, it’s for patients who have tried at least two other medications without success, and it should be taken with an oral antidepressant.

“There has been a longstanding need for additional effective treatments for treatment-resistant depression, a serious and life-threatening condition,” Dr. Tiffany Farchione, acting director of the Division of Psychiatry Products at the FDA’s Center for Drug Evaluation and Research, said in a news release announcing the approval.

Spravato is a nasal spray administered by an approved health care provider in a doctor’s office or a medical clinic. It may also be self-administered but only under the supervision of a care provider and cannot be taken home.

“Because of [safety] concerns, the drug will only be available through a restricted distribution system and it must be administered in a certified medical office where the health care provider can monitor the patient,” Farchione said.

Depending on the severity of the patient’s depression, it is given either once a week or once every other week.

The drug is rapidly acting, so it starts working faster than other antidepressants, according to Janssen. It works by restoring brain cells in patients with treatment-resistant depression.

Currently available treatments for major depression are ineffective in 30% to 40% of patients. According to the FDA, there is one other approved medication for treatment-resistant depression, Symbyax, which was approved in 2009.

Side effects of Spravato include dizziness, nausea, vertigo, anxiety, lethargy, increased blood pressure, vomiting, feeling drunk, decreased sensitivity, sedation and dissociation, a feeling of being temporarily “disconnected” from your body and your mind.

The drug label will contain a “boxed warning” to alert patients to the risk of “sedation, and difficulty with attention, judgment and thinking (dissociation), abuse and misuse, and suicidal thoughts and behaviors after administration of the drug,” the agency said in its announcement.

Because of these risks, patients must be monitored for at least two hours after being given the drug.

In clinical trials, six patients who were taking the drug died, three from suicide, but FDA background materials reviewed by the advisory committee that recommended approval last monthsaid, “It is difficult to consider these deaths as drug-related.”

Because of the drug’s close relationship to ketamine, experts have raised concerns about its potential for misuse and abuse, but clinical trials found those risks to be unfounded.

Concerns have also been raised about a lack of long-term data on possible health effects, most notably cognitive ones.

The drug was designated as a breakthrough therapy in 2013, a status intended to “expedite the development and review of drugs for serious or life-threatening conditions,” the FDA said at the time.

Greg Panico, a spokesman for Janssen, a division of Johnson & Johnson, did not say when Spravato will be available. He wrote in an email, “We are working quickly to educate and certify treatment centers on the unique administration requirements of SPRAVATO™ to ensure patients can access this important medicine.”

As for the cost, it will be “generally comparable with other specialty mental health drugs,” Panico said: about $590 to $885 per treatment session, based on the dosage and not accounting for mandatory discounts or negotiated rebates.

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Ketamine Nasal Spray Expected To Be Approved For Treatment Of Depression

DENVER (CNN) — A ketamine-like drug for treatment-resistant depression is expected to be approved by the US Food and Drug Administration this month. If it is approved by the FDA, the drug — called esketamine — may provide a new option for patients with major depressive disorder who have tried at least two other antidepressants without success.

(CBS)

In February, a panel of experts voted to endorse the drug, which is made in nasal spray form by the pharmaceutical company Janssen, a division of Johnson & Johnson. Fourteen members voted that the benefits outweighed the risk, with two opposed and one abstaining.

The drug is a close relative of ketamine, a powerful medication used in hospitals primarily as an anesthetic; recent scientific studies have also shown its potential with treatment-resistant depression and suicidal ideation. Ketamine is also used recreationally — and illegally — as a club drug known as Special K. It generates an intense high and dissociative effects.

Esketamine targets a different brain pathway than approved antidepressants, many of which have been around for decades. It is expected to be used in combination with antidepressants, but the latter can take a month or two to take effect. Esketamine, on the other hand, might have an effect within hours or days, according to an FDA briefing document.

The drug was designated as a breakthrough therapy in 2013, intending to “expedite the development and review of drugs for serious or life-threatening conditions,” the FDA says. First-line treatments don’t work for roughly 30% to 40% of patients with major depressive disorder, according to the briefing document.

(CBS)

The FDA does not have to follow the recommendation of advisory committees, though it often does.

However, the research behind esketamine has come under some criticism, with two of five key studies failing to meet their primary endpoints. Only one of these studies is a positive short-term trial, whereas most FDA-approved antidepressants are backed by at least two, according to the briefing document. But Janssen has maintained that the overall picture is positive.

Adverse events tended to occur in the first two hours patients received the drug, including sedation, blood pressure increases and dissociation. For this reason, patients wouldn’t be able to pick it up at a local pharmacy; it would be given under the supervision of health care professionals who can keep an eye on the person during those first two hours.

Because of the drug’s close relationship to ketamine, experts have also raised concerns about its potential for misuse and abuse. The clinical trials have not seen evidence of this risk, according to presentations made during the meeting.

Advisory panelists also expressed concern that not enough long-term data was available to characterize the drug’s cognitive effects and other health impacts down the line.

There were six deaths of patients taking esketamine in trials, including three suicides, but FDA materials concluded “it is difficult to consider these deaths as drug-related.”

The only current FDA-approved medication for treatment-resistant depression combines two other drugs already on the market. Other non-pharmaceutical treatments exist, such as electroconvulsive therapy.

In February, Janssen spokesman Greg Panico said no information about pricing was available at the time.

145+ EXCLUSIVE Letting Go Quotes That Will Guide You

Every day is a new chance to let go and feel peaceful because holding on to past hurts doesn’t fix anything. Replaying in the mind over and over again doesn’t change it, but releasing attachments will help you to create a strong sense of self. Letting go quotes will guide you through difficult time to … Read more145+ EXCLUSIVE Letting Go Quotes That Will Guide You

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Self-Worth: What Defines You?

I was thinking a lot about the no-self concept in Buddhism the other day, and my mind went to a really nerdy place: I asked myself: “So, where does your self-worth come from?” It’s an interesting question I think that for a lot of people, their self-worth comes from how productive they are in their … Read moreSelf-Worth: What Defines You?

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Researchers Find Clues That Depression May Speed Brain Aging

(AP) — Scientists are peeking inside living brains to tell if depression might worsen the natural decline in memory and thinking skills as people age — and they are finding some worrisome clues.

Depression has long been linked to certain cognitive problems, and depression late in life may be a risk factor for the development of Alzheimer’s. It’s not clear how.

But brain cells communicate by firing messages across connections called synapses, and Yale University researchers used a new brain scanning technique to check the levels of people’s synapses. They discovered that patients with mid-life depression had significantly lower synaptic density than healthy people the same age.

It’s a small study, and doesn’t prove depression was the cause. Researchers next plan to track people over time to measure changes in synapse levels.

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