Mood Charting for Complicated Problems

Lucy is a single woman who is a professor of anthropology at a local university. She is in her late 30s and she was referred to me for a consultation because of a complicated set of potentially interrelated problems with cognitive impairment, sleep disruption, anxiety, depression, a seizure disorder, and migraine headaches. She’s an interesting person and I really wanted to help her figure …

Bright Light for Non-Seasonal Depression

Bright light may work for non-seasonal depression. This is the conclusion of a study published in the prestigious psychiatric journal JAMA Psychiatry. Researchers at the University of Toronto and the University of British Columbia in Canada conducted a randomized, double-blind, placebo- and sham-controlled, 8-week trial in adults (aged 19-60 years) with major depression of at least moderate severity. 122 patients were …

Fish Oil for Depression

Is fish oil effective for treating depression? Just this past week a new patient in my practice asked me that question and I said that I didn’t know. I mentioned that ever since a study of people with bipolar depression was published in the Archives of General Psychiatry (the leading journal in psychiatry) by Andy Stoll in 1999 there has been …

S-Adenosyl-Methionine Update

SAM-e S-adenosylmethionine, or SAM-e for short, is one of the few nutritional supplements that has good clinical research to support its safety and effectiveness. Although SAM-e is used for many purposes, we are particularly interested in it as a compound that may have antidepressant properties. Clinical Significance S-adenosylmethionine (SAMe) is involved in many reactions that involve methylating chemicals (transferring a methyl …

Self Injury is the 8th Leading Cause of Death

An article just published online in the prestigious journal JAMA Psychiatry makes us drawn case that our fascination with trying to come up with clear  answers to questions that may ultimately be impossible to answer (what a person’s intent was when they injured themselves) is obscuring the fact that self-injury is now the eighth leading cause of death in this …

St. John’s Wort for Depression

A recently published study raises questions about whether the natural supplement St. John’s wort is actually associated with fewer adverse effects than commonly prescribed SSRIs. Living in the Bay Area it is common for me to run into a strong conviction that any natural supplement is bound to be safer than any manufactured medication. Perhaps the most problematic of these …

Prefrontal Cortex and Limbic System

A very bright young man who has a great potential as the therapist but who is wrestled with chronic depression for years and has developed a pattern of avoiding doing things that he knows he has to do in order to move ahead with his life led me to talk again about the relationship between depression, the limbic system (or emotional …

Bipolar Depression Webinar

Bipolar Depression with Dr. Peter Forster and Dr. Kelsey Schraufnagel Please join us for a Webinar on June 24th, 2015 at 9:00 am PT. For many people with bipolar, it is depression that is the source of most of their difficulties. Considerable controversy has surrounded to the question of how to treat bipolar depression. New medications offer the hope of …

Herd Instinct in Humans: The Source of Anxiety and Depression?

Jeffrey Kahn has written a fascinating book (Angst: Origins of Anxiety and Depression in Oxford Press) suggesting an evolutionary source for much of human psychopathology. He gave a Grand Rounds presentation at UCLA in February of 2015 that outlined some of his theories and that presentation has been the subject of a vigorous discussion online. In essence, Jeffrey argues that …

Facebook Causes Depression

How Can Facebook Usage Cause Depression? Today, social technology is commonplace. It’s practically unavoidable, and we rarely think of it as something that is risky, but, rather, as useful or fun (…and maybe a little addictive). But social researchers at University of Houston and Palo Alto University have found evidence that social technologies, like Social Networking Sites (SNS) and texting, …

Treating Mother’s Depression Helps Kids

Sometimes the very best way that mothers can help their children is by helping themselves. Fascinating study just published in the American Journal of Psychiatry by renowned psychologist Myrna Weissman adds to an extensive literature showing that maternal depression affects children in negative ways and that treating maternal depression can have profound benefits for the kids. In this article a …

Attentional Bias Modification Prevents Depression

A middle-aged nurse wrestling with depression said she want to do “everything” that she possibly could to improve her mood. She doesn’t have access to therapy through her insurance, and she’s already vigorously pursuing mindfulness practice, but her request reminded me of an article I recently read on Attentional Bias Modification as both a possible treatment of depression and as …

Chronotherapy for Depression

Chronotherapy for depression was recently shown to be effective in a fairly large and well designed study from New Zealand. What is chronotherapy? As discussed in the article, which appeared in Acta Scandanavica Psychiatrica, chronotherapy involves some combination of three separate sleep and wakefulness related interventions: Wake therapy. Wake therapy (previously known as “sleep deprivation” therapy, a harder sell to patients) …

Travel and Mood

Travel and mood are very much related. Often a trip is associated with a significant change in mood. This can be due to many factors. Getting out of a rut, experiencing new locations and meeting new people can bring you out of the depression. However there is also the possibility that travel may disrupt circadian rhythms in a way that leads …

Sleep Fatigue and Depression

Yesterday I gave a presentation at UCSF to the Mood Disorder Clinic psychiatrists and residents: An Update on Bipolar Depression.  Much of that material is focused on psychopharmacology and so I will be writing about that on the gatewaypsychiatric.com blog. However, one important pearly derives from a series of studies that identify a strong link between sleep and depression. There is frequent …

Sad Christmas

This will be a sad Christmas or some of those reading this post. You should not feel alone. I think that all of us can recall past Christmases there were disappointing or sad. We pass over these memories quickly sometimes. It’s not okay to be sad at Christmas time. Exactly how that should work, how it is that we should …

Depression Described

It can be extremely difficult trying to describe depression and therefore make the experience meaningful to loved ones, colleagues, etc. As it happens there is a TED talk by Andrew Solomon entitled, “Depression, The Secret We Share,” that is an excellent discussion and description of depression. In addition to the video itself, there’s a fascinating website that has quotes from …

Stigma and Depression

Robin William’s death seemed to unleash a new level of openness to discussing depression and the ways that it affects the lives of so many of us. A Nature editorial (Nature is perhaps the premier scientific journal in the world) got me thinking about next steps… What would it take to eliminate the impact of stigma, and shame, and therefore …

Depression and the Tech Industry

It is no secret to us that depression and bipolar are extremely common among those who work in the tech industry. In fact, that is why we opened our Mountain View office. However this issue is not often discussed publicly. We were excited when we were given a link to a wonderful video on the topic. Check it out!