NEW mothers who get less than six hours' sleep a night face an increased risk of postnatal depression.

Strong links between sleep deprivation and depressive symptoms in new mothers were found in a review of more than 100 international studies.

A lack of sleep could make them feel sad, tired and unable to concentrate, Australian researcher Kerry Thomas told the Australian Psychological Society’s annual conference in Canberra yesterday.

"Women whose babies wake several times during the night have a greater risk of developing depression, and that’s both at four weeks postpartum and eight weeks postpartum stage," she said.

"Women who receive less than six hours of sleep a night in a 24-hour period also have an increased risk of developing depression."

About 16 per cent of Australian women are believed to develop postnatal depression, also known as the "baby blues", after giving birth.

Ms Thomas, a research student at the University of Canberra, said there was growing evidence that sleep problems were related to the development of depression generally.

Ms Thomas said for many women sleep problems could begin in pregnancy and last for several months after the birth.

She said community-based residential units were often effective in relieving symptoms of depression by helping new mothers find ways to settle their babies.

"It’s not a cure (for their depression), but the mum does start to feel better," Ms Thomas said.

"when you have children in the home it’s not just a matter of getting more sleep, it’s a strategy.

"you have to negotiate sleep and plan for sleep, which you didn’t have to do before you had children," she said.

Ms Thomas plans to follow up her research by recruiting 60 new mothers next year to study their sleep patterns for up to a year after their babies are born.

The researcher will examine their stages of sleep and monitor any symptoms of depression.

NEW YORK (Reuters Health) – Excessive crying in infants, otherwise known as colic, has been linked to symptoms of depression in the mother. Now a study conducted in the Netherlands links infant colic to depression in the father as well.

The finding that continuous paternal depression appears associated with increased risk for colic among infants, "might inspire future fathers with depressive symptoms to seek treatment," Dr. Mijke P. van den Berg told Reuters Health.

Van den Berg, of Erasmus Medical Center in Rotterdam, and colleagues assessed symptoms of depression in several thousand sets of parents when the mothers were 20 weeks pregnant. they found that about 12 percent of the fathers and 11 percent of the mothers showed signs of depression.

For example, they answered positively to questions about feeling lonely, blue, hopeless, or worthless; having "no interest in things," or having "thoughts of ending life," the researchers report in the journal Pediatrics.

Later, when the infants of these parents had reached 2 months of age, the researchers assessed parental reports of excessive crying.

Overall, 4.1 percent of depressed fathers, compared with 2.2 percent of non-depressed fathers, had infants who cried for at least 3 hours daily on 3 or more days in the previous week. Corresponding figures among depressed and non-depressed mothers were 4.8 and 2.2 percent, respectively.

Excessive infant crying remained more prevalent among depressed fathers and mothers even after allowing for parental age, education level, and ethnicity; gender and number of children; and paternal smoking.

Moreover, adjustments for depressive symptoms among the other parent did not alter these findings.

Traditionally, research and clinical practice focused on the influence of maternal depression during and after pregnancy, whereas "this study shows paternal mental well-being should also be taken into account," van den Berg told Reuters Health.

Additional research is needed to attempt to "disentangle the possible mechanisms" associated with paternal depression and infant colic, noted van den Berg.

SOURCE: Pediatrics, July 2009.

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The ritual is not new to Gary Dawoit. after each storm, he and two colleagues, armed with scrapers and shovels, have the unenviable task of clearing the snow from around three company cars.

“We’re digging out again and again,” said Dawoit with a laugh, “And yeah, it’s getting to wear thin.”

If it seems like it’s been a particularly snowy winter, that’s because it has been. while only four inches fell in Central Park on Friday, the National Weather Service said this sixth storm of season brings the total snowfall to a whopping 36.1 inches — three times the average amount for the period between December and January. So it’s not surprising that some people are feeling what could be called “snow fatigue.”

In fact, those feelings are actually normal for this time of year, said Dr. Simon Rego, director of psychology training at Montefiore Medical Center in the Bronx.

“If you’re thinking about the Northeast and given the frequency with which we’ve had snow storms this year, it’s quite a common phenomenon going on right now, especially in the new York area,” Rego said.

But depressive symptoms that linger for more than a few days should be considered a warning sign, Rego said.

A severe psychiatric disorder that’s more common this time of year is known as Seasonal Affective Disorder, or S.A.D.  It’s a sub-type of a disorder called clinical depressive disorder, or depression, and tends to have its onset as the days get shorter. 

“A lot of people will get the winter blues as the days get colder and darker,” said Rego, “but actually a small percentage go on to develop lingering and severe feelings of depressed mood, which is there nearly everyday for at least a couple of weeks.”

People with S.A.D. often have several other severe symptoms such as decreased energy, overeating especially of carbohydrates, trouble with sleep and concentration and increased feelings of worthlessness.

“It’s when most of those symptoms occur all together for most of the day that it’s reaching a level that requires clinical attention.”

For most other people, Rego recommends adopting healthy routines to help combat the winter blues.

“Making sure you have a steady bedtime and rising time, eating healthy meals, continuing to exercise,” Rego said.

There are also those who seem immune from snow fatigue or the winter blues.  Village resident Linda Diane Polichetti called the snowy weather “magical.” 

“A lot people think find it annoying, but I love my seasons, you know,” said Polichetti.  And she’s feeling very confident about the prospects of more snow to come.

“I already predicted it,” said Polichetti. “I feel like I have a sixth sense. I already know we’re going to get three more storms. I know it. I just know it. I love it … it just puts a smile on my face.”

Girls who begin menstruating before they are 12 years old show more symptoms of depression than those who get their periods later, a new British study says.

Researchers at the University of Bristol, located 190 km west of London, reviewed the cases of 2,184 girls who are part of a long-term study known as the Avon Longitudinal Study of Parents and Children.

The average age girls in the study got their periods was 12 years and six months.

The researchers found the girls who began manstruating before the age of 11.5 had the highest levels of depressive symptoms by the ages of 13 and 14, while girls who got their periods later had the lowest levels.

“Our study found that girls who mature early are more vulnerable to developing depressive symptoms by the time they reach their mid-teens. This suggests that later maturation may be protective against psychological distress,” lead researcher Dr. Carol Joinson said in a release about the study.

“The transition into puberty is a critical developmental period, associated with many biological, cognitive and social changes. These can include increased conflict with parents, the development of romantic relationships, changes in body image and fluctuating hormone levels. These changes may have a more negative impact on girls who mature at an early age than those who mature later. Early maturing girls may feel isolated, and faced with demands which they are not emotionally prepared for.”

Joinson said knowing this could lead to developing school and family-based programs to help young girls deal with depression symptoms.

The study appears in the January issue of the British Journal of Psychiatry.

By Lia Steakley

New research published in the Journal of Clinical Oncology shows that decreases in depression among women with advanced breast cancer are associated with improved survival rates for these patients.

In the 14-year long study (subscription required), researchers had 125 women complete surveys measuring symptoms of depression at the beginning of the study and at four-month intervals for the initial year. All participants were given educational materials, and half also participated in 90-minute group sessions led by co-therapy teams. Results showed patients with improving depressive symptoms had significantly longer median survival times than those with worsening symptoms: 53.6 months compared to 25.1 months.

In the following Q&A, Stanford psychiatrist David Spiegel, MD, who was principal investigator on the study, discusses the significance of the results, the physiological connection between depression and breast cancer, and why it’s worthwhile for breast cancer patients to be screened for depression.

What are the implications of these findings?

Depression is a risk factor for shorter breast cancer survival time, just as it is associated with poorer prognosis with heart disease. this means that identifying and treating depression in cancer patients is an important part of good medical management of breast cancer. Depression is treatable, both with medication and psychotherapy. it is not simply a reaction to cancer, but rather a complicating co-morbid illness that occurs in some but not all cancer patients.

What is the physiological connection between depression and breast cancer survival?

Depression is associated with abnormalities in the stress hormone cortisol, which mobilizes glucose into the blood to prepare us to ‘fight or flee.’ Depressed people often have higher than normal cortisol levels, and they tend to lose the variation on cortisol normally seen throughout the day and night. Normal cortisol levels are four times as high in the morning as they are in the evening. Loss of this diurnal pattern also predicts shorter survival with breast cancer, a finding we published (.pdf) in the Journal of the National Cancer Institute a decade ago. Cortisol can inhibit the function of tumor suppressor genes, such as BrCA1. it is also potently immunosuppressive, and our immune systems help us to control the growth of tumors with specialized cells called natural killer (NK) cells, and others. Depression also inhibits health-related behavior, ranging from getting normal sleep and exercise to adhering with medical treatment. Depressed people are often socially avoidance, and may not get the social support they need. so in many ways, depression can worsen outcome with breast cancer.

In light of these findings, would it be worthwhile for physicians to consider screening breast cancer patients for depression?

yes, it is a complicating co-morbid condition, not a normal reaction to having cancer. Screening and aggressive treatment will improve quality of life and may well extend survival.

Is there a " biological " disease that resembles clinical depression?

There are many biological diseases that simlulate depression (or at least have the capacity to). These genrally have to be ruled out before a diagnosis of depression can be given. not my area of expertise but things such as brain tumours or glandular disorders can simulate depressive symptoms. There are also biological diseases that can simulate other psychiatric symptoms such as psychosis etc. however all of these generally come with other symptom and most of the time have simple ways to be tested for such as MRIs or Blood tests.