Posted by on June 6, 2012 - 2:55pm

Brooding in your apartment on Saturday afternoon? A new smart phone intuits when you’re depressed and will nudge you to call or go out with friends.

It’s the future of therapy at a new Northwestern University Feinberg School of Medicine center where scientists are inventing web-based, mobile and virtual technologies to treat depression and other mood disorders. The phone and similar projects bypass traditional weekly therapy sessions for novel approaches that provide immediate support and access to a much larger population.

“We’re inventing new ways technology can help people with mental health problems,” said psychologist David Mohr, director of the new Center for Behavioral Intervention Technologies and a professor of preventive medicine at Northwestern’s Feinberg School. “The potential to reduce or even prevent depression is enormous.”

“These new approaches could offer fundamentally new treatment options to people who are unable to access traditional services or who are uncomfortable with standard psychotherapy,” Mohr added. “They also can be offered at significantly lower costs, which makes them more viable in an era of limited resources.”

The goal is for the center to become a national resource, offering a library of intervention technologies that will be available to other researchers.

Among the center’s projects:


A smart phone spots symptoms of depression by harnessing all the sensor data within the phone to interpret a person's location, activity level (via an accelerometer), social context and mood.

Are you making phone calls and getting e-mails, or are you home alone ruminating for hours? If the phone – which learns your usual patterns -- senses you are isolated, it will send you a suggestion to call or see friends. The technology, which still is being tweaked, is called Mobilyze! and has been tested in a small pilot study. It helped reduce symptoms of depression.

The new phone offers a powerful new level of support for people who have depression and intervenes to help them change their behavior in real time.

“By prompting people to increase behaviors that are pleasurable or rewarding, we believe that Mobilyze! will improve mood,” Mohr said. “It creates a positive feedback loop. Someone is encouraged to see friends, then enjoys himself and wants to do it again. Ruminating alone at home has the opposite effect and causes a downward spiral.”

Darren Gergle, associate professor of communication studies in the School of Communication, is a co-investigator on the project.

Also in the works at the National Institutes of Health-funded center: a virtual human therapist who will work with teens to prevent depression; a medicine bottle that reminds you to take antidepressant medication and tells your doctor if the dosage needs adjusting; a web-based social network to help cancer survivors relieve sadness and stress.

by Marla Paul is the health sciences editor at Northwestern

Posted by on May 19, 2012 - 11:02am

 A Northwestern Medicine scientist has developed the first blood test to diagnose major depression in teens, a breakthrough approach that allows an objective diagnosis by measuring a specific set of genetic markers found in a patient’s blood.   Diagnosing teens is an urgent concern because they are highly vulnerable to depression and difficult to accurately diagnose due to normal mood changes during this age period.   The current method of diagnosing depression is subjective. It relies on the patient’s ability to recount his symptoms and the physician’s ability and training to interpret them.

The test also is the first to identify subtypes of depression. It distinguished between teens with major depression and those with major depression combined with anxiety disorder. This is the first evidence that it’s possible to diagnose subtypes of depression from blood, raising the hope for tailoring care to the different types.

“Right now depression is treated with a blunt instrument,” said Eva Redei, a professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and lead investigator of the study, published in Translational Psychiatry. “It’s like treating type 1 diabetes and type 2 diabetes exactly the same way. We need to do better for these kids.”

The estimated rates of major depressive disorder jump from 2 to 4 percent in pre-adolescent children to 10 to 20 percent by late adolescence. Early onset of major depression in teens has a poorer prognosis than when it starts in adulthood. Untreated teens with this disease experience increases in substance abuse, social maladjustment, physical illness and suicide. Their normal development is derailed, and the disease persists into adulthood.

The study subjects included 14 adolescents with major depression who had not been clinically treated and 14 non-depressed adolescents, all between 15 to 19 years old. The depressed and control subjects were matched by sex and race.

Redei’s lab tested the adolescents’ blood for 26 genetic blood markers she had identified in previous research. She discovered 11 of the markers were able to differentiate between depressed and non-depressed adolescents. In addition, 18 of the 26 markers distinguished between patients that had only major depression and those who had major depression combined with anxiety disorder.

“These 11 genes are probably the tip of the iceberg because depression is a complex illness,” Redei said. “But it’s an entree into a much bigger phenomenon that has to be explored. It clearly indicates we can diagnose from blood and create a blood diagnosis test for depression.”

"Everybody, including parents, are wary of treatment, and there remains a social stigma around depression, which in the peer-pressured world of teenagers is even more devastating,” Redei said. “Once you can objectively diagnose depression as you would hypertension or diabetes, the stigma will likely disappear.”

The human research was funded by grants from the Research Institute of Nationwide Children’s Hospital in Columbus, Ohio. Animal research was supported by grants from the Davee Foundation, the RD Foundation and the National Institutes of Health.

by Marla Paul, NU Health Science Editor

Posted by on January 7, 2012 - 6:41am

This time of year, the shorter days and lack of sunlight can cause some people to feel depressed. Seasonal Affective Disorder, or SAD, affects between 10 to 20 percent of Americans, primarily younger adults and women. Although the exact cause of SAD is unknown, experts believe changes in melatonin and serotonin levels, or a disruption in the body’s internal clock may be to blame. John Stracks, MD, from Northwestern Integrative Medicine says there are ways to beat the blues caused by SAD and suggests those who experience symptoms visit their doctor before symptoms become severe.

“SAD is a type of depression that shouldn’t be ignored and can be treated,” said Stracks, who specializes in family medicine and integrative medicine. “With the proper regimen, people who experience symptoms can learn to feel content.”   People who suffer from SAD often experience some or all of the following symptoms.

• Feeling depressed, fatigued or lethargic
• Difficulty waking up in the morning and a tendency to sleep more often
• Increased appetite, especially for foods full of carbohydrates, leading to weight gain
• Loss of interest or enjoyment in activities once enjoyed or with others
• Trouble concentrating

Traditional treatments for SAD include psychotherapy, medication and therapeutic light therapy.

“Light therapy works by mimicking sunlight, which causes a biochemical change in your brain that lifts your mood,” said Stracks. “This is often used in conjunction with visits with a therapist to combat depression.”   Stracks also recommends alternative approaches. “If your symptoms are milder, the combination of good nutrition, natural supplements, exercise and relaxation or meditation can be very effective in improving your mood,” said Stracks.

While he encourages those who believe they suffer from SAD to see a doctor to determine appropriate therapies and treatment, Stracks suggests the following tips that anyone can do to keep their mood balanced this time of year.

• Sleep well - Make sure you wake up at the time same every day, including weekends. Doing so will keep your body’s internal clock in sync.

• Let the light in - Expose yourself to as much sunlight as possible by opening your blinds at home and making sure that your work space has natural or bright light.

• Control your cravings - Eat a balanced diet while limiting the amount of carbohydrates you are eating. Carbohydrates can provide a short-term energy boost but leave you feeling worse later in the day.

• Embrace an exercise routine - Exercise is not only good for your physical health, but also helps relieve the stress and anxiety that can increase the symptoms of SAD. Yoga and Pilates type classes are a good way to relax and exercise at the same time.

• Learn to manage your stress - Take time to relax each day and try to manage your stress so it doesn’t lead to depression and overeating. Make it a point to stay connected to people who are important to you, as they will help you remain calm and happy.

“Good spirits don’t have to disappear as the hours of sunlight dwindle during the winter,” added Stracks. “This time of year should be the most enjoyable, but if you find yourself feeling down, there are things you can do to help.”

Source:  Northwestern Memorial Hospital

Media Contact:

Posted by on September 17, 2010 - 9:02am

An understanding why women experience more stress-related mental disorders like depression and Post Traumatic Stress Disorder (PTSD) has eluded scientists but a new study in rat brains may help explain why women are more prone to mood and anxiety disorders than men.

In order to better understand this study, I found it helpful to look up a few key definitions:

  • stressor:   a stimulus that causes stress, can be physical, emotional or social
  • hormone:  a secretion of an endocrine gland that is transmitted by the blood to the tissue on which it has an effect
  • neurotransmitter:   a chemical that transmits signals from a neuron (nerve system cell) to a cell across an empty space called a "synapse"
  • receptor:   a protein molecule embedded in either the membrane or cytoplasm of a cell, to which one or more specific kinds of signaling molecules, such as a neurotransmitter or hormone may attach. Each cell typically has many receptors, of many different kinds.

Now, back to the study:

Corticotropin releasing factor (CRF), which acts as both a hormone and a neurotransmitter, is likely a key player.   In response to a stressor, CRF binds to receptors on cells in an alarm center deep in the brainstem, called the locus ceruleus.   This telegraphs heightened emotional arousal throughout the brain via the chemical messenger norepinephrine.   Such hyper-arousal can be adaptive for brief periods, but not if it becomes chronic.   Runaway CRF is a core feature of depression.

Previous studies suggested that this alarm system is more sensitive to CRF and stress in the female brain and researchers at Children's Hospital in Philadelphia developed an experiment to see how CRF receptors responded in male versus female rats, both unstressed and after exposure to a stressor (in this case, a swim).

Even in the absence of any stress, the researchers found the female stress signaling system to be more sensitive from the start.   CRF receptors had stronger connections or coupling in the female rats, so it took lower levels of CRF to activate proteins in the unstressed females compared to males.    CRF levels that had no effect in males turned on cells in female rats.

After stress, CRF receptors remained exposed on the neuronal membranes in the female rat, maintaining the CRF effect.   In the stressed male, the CRF receptors interacted with proteins in the cell that enabled some of the them to retreat and not be available to couple to the CRF.  This helped the male brain adapt its sensitivity to the stressor and thus the stress response was less than in the females.

What is the significance of this experiment?   Certain brain cells in females are more sensitive to CRF  and less able to adapt to too much CRF than male brain cells.

The next step is to examine the male and female CRF receptors for structural differences that might account for the functional differences (e.g., response to stress, depression).   Since most rodent models of mood and anxiety disorders use male animals exclusively, the new findings of sex differences in stress signaling mechanisms call for a more sex- and gender-balanced approach---especially for mental disorders that disproportionately affect females.   This sex-difference should also be factored in as medication treatments based on blocking CRF receptor are developed, say the researchers.

Source: Sex differences in corticotropin-releasing factor receptor signaling and trafficking:   potential role in female vulnerability to stress-related psychopathology.  Mol Psychiatry. 2010 Jun 15. (PMID:  20548297)

Posted by on January 20, 2010 - 11:20am

We probably all have first hand knowledge of how a bad night's sleep can affect us the next day: we're irritable, in a bad mood, and it can be hard to concentrate. It may not be all that surprising then, that how we sleep can be a very big part of depressive disorders, an incredibly interesting topic covered by Dr. Roseanne Armitage in the most recent installment of the IWHR's Women's Health Research Monthly Forum.

Dr. Roseanne Armitage

Dr. Roseanne Armitage

Dr. Armitage began her talk by discussing how men and women, even those who do not have depression, sleep in very different ways. Possibly because of the different numbers of hormone receptors  or the over 650 genes that are expressed differently in the brains of males and females, the types of sleep we have also differs. For example, before puberty, boys have more slow wave sleep (stage 3 and 4 sleep, the deep, restorative kind that makes you feel refreshed in the morning) than girls do. After puberty, this changes, and girls are the lucky receivers of more slow wave sleep. Most interestingly, while men have a very slow loss of the amount of slow wave sleep over their lifetimes, women's amount stays relatively level and then drops precipitously during the peri-menopausal years. This is one reason why menopausal women really notice the sudden change in their sleep patterns. In general, women are also more likely to suffer from insomnia and sleep fragmentation than men.

The depression that Dr. Armitage really focused on was untreated MDD (major depressive disorder). MDD is twice as likely to occur in women than in men. Social withdrawal and feelings of worthlessness and guilt are more common in females with depression than in males with depression, who tend to complain more of lack of goal-oriented behavior. Around 80% of people with MDD report sleep problems, and for many people, sleep disturbance is the first presenting symptom of MDD. In adults with MDD, there are increased arousals and episodes of wakefulness, increased stage 1 sleep (the very light sleep), decreased total sleep time, and decreased stage 3 and 4 sleep.

Depression further exacerbates the sex differences in sleep between men and women when faced with a serious change to their normal sleep patterns (such as being asked to stay up for 40 hours consecutively), women with MDD overresponded, staying in slow wave sleep for too long, while men with MDD underresponded.  Sleep in healthy adults also shows a high level of coherence, or a very close association in the activity patterns of the right and left hemispheres of the brain. Women with MDD, however, have a lower coherence during their sleep than other healthy females, healthy males, AND males with MDD.

Dr. Armitage's work also demonstrates the ability to tie sleep disturbances to the likelihood of depression in very young girls. She finds that coherence scores can be a very good predictor of future depressive disorder; girls who were at high-risk for depression because their mothers were depressed demontrate lower coherence in their sleep...even before they have any sign or symptom of depression. Young girls in this high-risk group also had very disorganized sleep-activity patterns, even as disorganized as same aged girls who already suffered from depression. Shockingly, even babies (2 to 30 weeks) of depressed mothers take longer to fall asleep, have decreased total sleep time and sleep efficiency, and spend less time in bright light (known to produce necessary vitamins) than babies of non-depressed mothers.

Our thanks to Dr. Roseanne Armitage for such an eye-opening talk! We encourage you to look at some of Dr. Armitage's published work on the topic: