Discovery Of Biological Changes In Patients Who Are Suicidal And Depressed May Lead To Novel Treatments

On November 29, 2010, in Depression, Immunology, by Christopher Fisher, PhD


Depressed and suicidal individuals have low levels of the stress hormone cortisol in their blood and saliva. They also have substances in their spinal fluid that suggest there is increased inflammation in the brain. These findings could help to develop new methods for diagnosing and treating suicidal patients.

Dr. Daniel Lindqvist from the Psychoimmunology Unit at Lund University is presenting these results in his PhD thesis. He is part of a research group led by Dr Lena Brundin, which sees inflammation in the brain as a strong contributory factor to depression. This is a new theory that challenges the prevalent view that depression is only due to a lack of the substances serotonin and noradrenaline.

“However, current serotonin-based medication cures far from all of the patients treated. We believe that inflammation is the first step in the development of depression and that this in turn affects serotonin and noradrenaline”, says Daniel Lindqvist.

One of the articles in his thesis shows that suicidal patients had unusually high levels of inflammation-related substances (cytokines) in their spinal fluid. The levels were highest in patients who had been diagnosed with major depression or who had made violent suicide attempts, e.g. attempting to hang themselves.

The research group at the Division of Psychiatry in Lund is now getting ready to conduct a treatment study based on its theory. Depressed patients will be treated with anti-inflammatory medication in the hope that their symptoms will be reduced.

The researchers believe that the cause of the inflammation that sets off the process could vary. It could be serious influenza, or an auto-immune disease, such as rheumatism, or a serious allergy that leads to inflammation in the body. A certain genetic vulnerability is probably also required, i.e. certain gene variants that make some people more sensitive than others.

Other studies in Daniel Lindqvist’s thesis show that patients with depression and a serious intention of committing suicide had low levels of the stress hormone cortisol in their blood. The cortisol levels were also low in saliva samples from individuals several years after a suicide attempt. This has been interpreted to mean that the depressed patients’ mental suffering led to a sort of ‘breakdown’ in the stress system, resulting in low levels of stress hormones.

“It is easy to take and analyse blood and saliva samples. Cortisol and inflammation substances could therefore be used as markers for suicide risk and depth of depression”, says Daniel Lindqvist.

Material adapted from Lund University.

New Studies Examine the Many Facets of Depression

By KATHLEEN DOHENY Psych Central News
Reviewed by John M. Grohol, Psy.D. on November 18, 201


Treatments for depression have improved greatly over the years, yet there are still many patients not helped by traditional offerings of medications and talk therapy.

”Roughly 20 to 40 percent of people with depression aren’t helped by existing therapies,” said Robert Greene, M.D., Ph.D., of the University of Texas Southwestern Medical School in Dallas.  On Monday, he moderated a news conference at the annual meeting of the Society of Neuroscience in San Diego to update research on new options under study.

Among the promising research is new data on:

  • How being stressed out may play a role in depression;
  • How the immune system may play a role in depression;
  • The role of a specific molecule, Cdk5, in nerve cell signaling and how the information might be used for an antidepressant effect;
  • The role of a small protein known as p11 and how it affects antidepressant-like  responses.

To the first of these, Herwig Baier, Ph.D., a researcher at the University of California San Francisco, said, ”An inability to cope with stress may play a role in depression.” He found in a study that zebra fish who have a mutation in a receptor important for stress management displayed abnormal behavior similar to depression. Normally social fish, the zebra fish stopped swimming and hid in the corner of their tanks when isolated from others.

But when these fish were given fluoxetine (Prozac), the behavior disappeared, he found. Studying the fish makes sense, Baier says, as the ”stress axis” in this fish and humans is identical.

The zebra fish’s mutation is in the gene known as the glucocorticoid receptor (GR) gene, and one of its jobs is to ”dial down” the secretion of stress hormones from the brain. Either too much or too little GR activity has been linked with depression.

If the fish story holds true for people, Baier said, new strategies for depression could be developed that don’t block GR activity but activate it to just the right amount so mood is not depressed.

The immune system could also play a role in depression, said Simon Sydserff, PHD, a senior research scientist at BrainCells, Inc., a drug development company in San Diego involved in stem cell technology to develop CNS treatments.

Here’s how:  When you get sick, the immune system hormone IL6 or interleukin 6, carries ”sickness” signals to the brain. When Sydserff activated the immune system of mice to mimic sickness, they displayed behavior representing depression.

“Patients who are depressed who are medically healthy and also those who are medically ill, have high levels of immune system signaling cytokines such as IL6,” he said.

“Interferon alpha, a cancer treatment, increases IL-6 and has also been linked to major depression,” he said. If the research bears out, he said, ”blocking IL-6 may prevent or reverse depression,” offering another option.

He conducted the research, supported by AstraZeneca Pharmaceuticals, while on staff there.

In  another study, James Bibb, Ph.D., of the University of Texas Southwestern Medical Center, Dallas, found that mice lacking a molecule known as Cdk5 like mice given an antidepressant: They were more active, one marker of effective antidepressant action. Without the molecule, the wave of a signaling molecule known as cyclic AMP doesn’t stop as it typically does, and this was linked with antidepressant-like responses. Learning how to block this molecule in the future could provide more options, he said.

Meanwhile, figuring out why an antidepressant can take a while to ”kick in” is the focus of another study. Jennifer Warner-Schmidt, Ph.D., a researcher at The Rockefeller University in New York, zeroed in on a regulator of antidepressant responses known as p11.  It’s a small protein expressed in depression-related brain regions.

She found in animal studies that over-expression of p11 results in an antidepressant effect and that another key regulator, brain-derived neurotrophic factor (BDNF) is required for the serotonin-induced increase in the p11.

”Understanding better the role of p11 in antidepressant response could lead to faster acting antidepressants with fewer side effects,” she said.

SOURCE: Society for Neuroscience.

New CEUs: Grief, Depression, Loss & Substance Abuse

Complicated Grief
Standard CEU Hours: 5 CEU Cost: $15.00
NBCC CEU Hours: 4 CEU Cost: $12.00

This course provides personal and professional information, testimonies and time-tested tools for healthy ways to cope and adjust to life after sudden and/or violent loss. It looks at the reality of sudden loss with perspective and insight, including the author’s (Dr. Gabriel Constans) personal experiences, as well as his clients and colleagues, who have been walking, crawling and sometimes running in the midst of sudden, unexpected, often horrific circumstances.

Grief and Depression
Standard CEU Hours: 2 CEU Cost: $6.00
NBCC CEU Hours: 2 CEU Cost: $6.00

This short course discusses the differences and interrelationships between Grief and Depression according to the DSM-IV. This is another course in a series on Grief and Loss by Dr. Gabriel Constans.

Men and Grief
Standard CEU Hours: 2 CEU Cost: $6.00
NBCC CEU Hours: 2 CEU Cost: $6.00

This course explores the different ways in which men react to and heal from grief and sadness. The course weaves in the complex web of biology and environment to illuminate how and why men may respond differently than women, as well as how their responses are similar. By exploring some of the different and similar emotional responses and their roots, the hope is to be better able to support one another through painful times.

Behind Bars II: Prison Population and Substance Abuse
Standard CEU Hours: 12 CEU Cost: $36.00
NBCC CEU Hours: 15 CEU Cost: $45.00

This report constitutes the most exhaustive analysis ever undertaken to identify the extent to which alcohol and other drugs are implicated in the crimes and incarceration of America’s prison population. Any individual interested in this issue or working with inmates who abused substances prior to incarceration will benefit from this course.

Good Grief: Love, Loss and Laughter
Standard CEU Hours: 16  CEU Cost: $64.00 Exam Only / $96.00 with Book
NBCC CEU Hours: 12  CEU Cost: $48.00  Exam Only / $72.00 with Book

This course was developed from the book, Good Grief: Love, Loss and Laughter by Gabriel Constans, PhD, which was written for professionals and everyday people who face death and grief. The writing is complete with real situations and honest stories to help bring love and hope to this difficult situation. Those in the mental health, medical, or social work field as well as parents, teachers, students, friends, or anyone else dealing with death and grief could benefit from the practical and compassionate information presented.

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New Online CEUs Added


Dissociative Identity Disorder
Standard CEUs/NBCC CEUs:  8
Course Cost: $24

Considerable progress has been made in the diagnosis, assessment, and treatment of dissociative identity disorders (DID) during the past decades, as reflected by increased clinical recognition of dissociative conditions, the publication of numerous research and scholarly works on the subject, and the development of specialized diagnostic instruments.  Treating Dissociative Disorders in Adults is a course that was developed using guidelines from the Journal of Trauma and Dissociation, which summarizes expert consensus concerning safe and effective treatment for DID patients.  The course material offers a practical guide for the management of these patients and would be appropriate for any professionals who may encounter these clients or for anyone interested in gaining further knowledge about Dissociative Identity Disorder.


Managing Depressive Symptoms in Substance Abusing Clients

Standard CEUs: 12  Cost: $36
NBCC CEUs:  14     Cost: $42

This informative course was developed using material from the Treatment Improvement Protocol,  Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery, developed by the US Department of Health and Human Services Center for Substance Abuse Treatment. The material was designed for use by substance abuse treatment counselors and other professionals who work with clients who have substance abuse issues and depressive symptoms. When depressive symptoms occur in substance abuse treatment, they can interfere with the clients’ recovery and ability to participate in treatment. This course will help professionals gain the skills necessary to assist clients who are struggling with depressive symptoms, particularly in the first year of treatment.  The course also includes several vignettes which provide specific examples of how to work with clients facing substance abuse and depressive symptoms.


Veterans and Substance Abuse

Standard CEUs: 2  Cost: $6
NBCC CEUs: 1     Cost: $3

Numerous studies show that rates of alcohol and other drug use disorders are high among veterans within the Veterans Health Administration (VHA) health care system. This course gives a brief overview of clinical considerations in the treatment of veterans with substance use disorders and other co-occurring mental health issues.  This is an excellent course for any professional who may come in contact with this population or for anyone who is interested in gaining knowledge in this subject area.