Thanks to PsychCentral.com, I found facinating article from the Los Angeles Times. A recent study has found that depression is related more to misperceptions of peer interactions, especially during puberty.

Truth sometimes hurts. But for children closing in on adolescence, a firm grasp on the truth about one's standing with classmates and peers can be healthy, even when it does hurt a bit.

A new study has found that children who can accurately assess how much — or little — their peers like them are less likely to develop symptoms of depression, including sadness and difficulties concentrating or sleeping. By comparison, children with unrealistically rosy or unfoundedly gloomy views of their standing appear more likely to be headed toward depression.

Many psychologists have speculated that the smiling child who believes she is the glowing sun in her classmates' universe will be protected from depression by that belief. They also surmised that the child who holds a negative view of his status among peers is more prone to maladjustment and depression.

That picture, says Florida State University psychologist Janet Kistner, may be a bit too simple. She and fellow researchers found that the child who is not regarded well by peers — and knows it — is actually less likely to grow more depressed over time than the child who believes that classmates like him when, in fact, they don't. The kid who can see that he is not so well-liked may be better able to change his behavior to make friends, Kistner says. The kid who's clueless about her effect on classmates may grow frustrated and sad as she misses social cues and fumbles gestures of friendship.

[...]Researchers and clinicians, meanwhile, say they are far from having developed accurate predictors of a child developing depression. The younger the child, the murkier the crystal ball.

Dr. Daniel Pine, chief of child and adolescent research at the National Institute of Mental Health's Mood and Anxiety Disorders Program, says that the strongest signs that a child may develop depression are a personal history of anxiety in early life; a parent with past or current depression; and a childhood pattern of low-level depressive symptoms (sadness, difficulties with eating, sleeping or concentrating, loss of energy or interest in once-enjoyed activities).

Beyond those signals, Pine says, disruptions in peer and social relationships often come with depression. But whether those ruptures are the cause of a depressive episode or the result — or a little of both — is not known.

Among children younger than 8, Kistner cautions, inflated views of classmates' affection are commonplace, and should not be misread by parents as unhealthy. But as children enter the "'tween years" of puberty, they normally become more acute in their self-assessments.[...]Acuity in reading social signals varies widely among adults, and psychologists have observed that some never get much better than they were as pre-adolescents.

[...]"That's a really fascinating time [puberty]," Kistner says — and potentially a moment when the course of a child's future mental health could be swayed. Both a child with an inflated sense of popularity and one with an overly dark view are probably sending and receiving faulty social signals, she says, and becoming frustrated that the world is not responding as the child expects."They may not be timing it right, they may be missing cues," she says — and some simple social skills counseling might help.

Will Meek has an interesting companion theory about self-esteem.

This is related to my pet theory of self-esteem, the sociometer theory. It states that the amount of perceived social acceptance or rejection predicts one’s self-esteem level. People that can accurately read the social environment know where they stand and can make adjustments to gain more social acceptance. However, those who inaccurately perceive more social acceptance and less rejection than is actually present may be prone to narcissism, where those who inaccurately perceive less acceptance and more rejection may be prone to chronic low self-esteem and depression. The key for all of this is an accurate perception of the environment, which can be an elusive skill that scientists are also trying to unravel, and misperception can be an ongoing source of psychological distress. MORE

What's remarkable about this article is that it places the critical time for emotion regulation and interpersonal relationships to puberty. That means, kids need all the tools to make sense out of this critical time BEFORE puberty. Emotion and Character education is important in the 4th and 5th grades of primary education. By 6th and 7th grade, hormones are raging and the critical period for peer based learning has begun. Intuitively, teachers have known for a long time that Junior High is a very difficult and emotional time for kids. Now we have another good reason why.

Isn't it sad that our most effective and pervasive education sources (TV) and other media is full of images that are not real, raise expectations for ourselves and others, and sets us up to feel inadequate. Those feelings help create in some girls a frenzied obsession with appearance that sometimes leads to eating disorders, some of which are deadly. And they make a few people rich.

Thanks to Dr. Deb Serani for the link.

A group of physician, patient and constituency groups concerned about confusing messages in popular culture suggesting that depression is "just the blues" or worse, a "made-up disease."

Although they don't say so, I suspect this movement intends at least in part, to counter the very well organized and highly funded lobbying effort by Tom Cruise and his Scientology friends to debunk psychiatry and depression. Instead they want us all to believe that depression is best alleviated by removing the sufferer's covering of tiny disembodied souls of aliens dispersed by the Galactic Federation leader Xenu. And to learn that technique, you must send thousands of dollars to the "Church" of Scientology. In the process you will learn all about the delusional beliefs of founder L. Ron Hubbard.

For whatever reason, they have put together a nice website and are pursuing a worthwhile educational program.

Psychiatric News

The initiative will spread science-based information to counteract "made-up" facts and misconceptions. A coalition of physician, patient, and community groups is tackling widespread misinformation about depression with a public information campaign emphasizing that the ailment, affecting nearly 19 million Americans, is serious, debilitating, and potentially fatal.

The Depression Is Real campaign, which was launched at a press conference last month in Washington, D.C., will use public service announcements, advertising, and a Web site, to increase awareness of depression and its causes and treatments.

Among the coalition members is the American Psychiatric Foundation, whose participation supports APA's "Healthy Minds, Healthy Lives" campaign. "A third of all Americans believe that mental illnesses like depression are caused by emotional or personal weaknesses, and almost that number think they are caused by old age alone," said Altha Stewart, M.D., president of the American Psychiatric Foundation. "We believe we have a responsibility to tell the public the truth about depression—based on scientific evidence and clinical research, not made-up `facts' or wishful thinking."

Coalition members said the lack of health care reimbursement parity for mental health treatments also trivializes depression and other mental illnesses.

Anti-psychotic medication has gotten very expensive, especially when compared to long standing generics. Now research is finding the generics work just as well as the new "atypicals". But the fact is, medication has to be subscribed one client at a time. While on average, some of the generics work as well with low side effects, some individuals have extreme side effects from the generics or don't benefit from them any where near as effectively as the new "atypicals". In particular, the worse permanent side effect, tardive dyskinesia appears less likely with new atypicals in individuals prone to that problem.

So when we have journal articles pointing out the excesses of the pharmeceutical industry, we need to be sure we don't eliminate the best option for the minority of persons who need the new "atypical" anti-psychotic medications.

Archives of General Psychiatry

In people with schizophrenia whose medication is changed for clinical reasons, there is no disadvantage across 1 year in terms of quality of life, symptoms, or associated costs of care in using FGAs rather than nonclozapine SGAs. Neither inadequate power nor patterns of drug discontinuation accounted for the result.

Here is a NAMI.org press release supporting my position.

“For Medicare, Medicaid, and the Department of Veterans Affairs, it would be a grave mistake to use the study to restrict access to newer medications, based on general findings that older medications seem to work as well as the newest generation,” Duckworth said. “General findings cannot be substituted for specific choices made in treating individuals with schizophrenia. One size does not fit all. It is critical that the study’s limitations be recognized.”

For one, the British study relies heavily on an older drug, sulpiride that has never been approved by the Food & Drug Administration (FDA) and is unavailable in the United States. In addition, the study’s comparisons are limited to classes of drugs, rather than specific medications. The study does not include comparison of doses of drugs, either between classes or specific medications.

Although longer than clinical trials required for FDA approval of specific drugs, the study’s one-year test period is still largely inadequate for evaluating treatment outcomes over time.

It's Mental Illness Awareness Week! There is all kinds of information and materials to lead your own media campaign at NAMI.org

Since 1990, mental health advocates across the country have joined together during the first week of October to celebrate Mental Illness Awareness Week (MIAW).

What is Mental Illness Awareness Week?

Established in 1990 by Congress, the first week of October is designated as "Mental Illness Awareness Week" (MIAW) in recognition of NAMI’s efforts to raise mental illness awareness. "Bipolar Disorder Awareness Day" (BDAD) is held each year on the Thursday of MIAW to encourage further understanding and promote early intervention and treatment for this mental illness.

MIAW and BDAD are NAMI’s premiere public awareness and public education campaigns that link the organization nationally to the organization’s over 1100 local affiliates across the country.

Over the past 16 years, MIAW has become a tradition in NAMI. It presents an opportunity for all three levels of NAMI –national, state and local – to work together in communities across the country in meeting the NAMI mission through a variety of outreach, educational, and advocacy efforts.

On-line education with chat room support for eating disorders, on-line self-help support for depression, on-line treatment for panic disorder, on-line and phone-based help for sexual problems, and phone therapy with miscarriage sufferers have been recently studied as reported in recent journal articles. While this is exciting and concerning at the same time, these studies is only a beginning of a new area of research in providing mental health services.

I'm committed to having some part in this process and hope you will join me in this effort by visiting ePsyQ.com supporting our efforts in whatever way you can. If you can only join Top Health Sites and display our banner on your site that's great! If you want to list your health service and/or spread the word about the FREE listing at ePsyQ.com Health Directory, fabulous! If you can join in the discussion and development of this project, all the better. Hope to see you soon on ePsyQ.com!

Mental health counseling given over the phone may ease some women's depression symptoms after a miscarriage, a small pilot study suggests. The therapy was offered to women with "subsyndromal" depression, which is less severe than major clinical depression but still causes significant symptoms -- such as sleep disturbances, chronic lack of energy, appetite changes and feelings of hopelessness.

Past studies have shown that women who suffer a miscarriage are at risk not only of major depression, but of the considerably more common subsyndromal depression as well.

This latest study, reported in the Journal of Clinical Psychiatry, was a pilot project testing whether phone-based counseling could help women with milder depression following a miscarriage. Such therapy aims to overcome some of the obstacles that keep people from in-person mental health counseling, like lack of time or reluctance to talk face-to-face. Of the 19 women researchers followed, those who received counseling over the phone a handful of times showed a greater decline in depression symptoms. MORE

Thanks for Psych Central for the links.