Hello, donna1952-ga!
Your question is extremely broad and quite complicated as there are
many types of autoimmune disorders. Each disorder would have to be
researched separately for links and correlations with ADHD,
alcoholism, mitral valve prolapse and depression. In order to stay
within the price limitations of your question, I have tried to
concentrate on the disorders you mentioned and their link to
depression, mitral valve prolapse, etc. I have been able to provide a
cursory overview of some correlations between the different disorders.
There is no doubt that depression is a major link to many autoimmune
disorders, most probably as a symptom rather than a cause. Alcohol can
also be a coping mechanism. However, whether those who are prone to
the abuse of alcohol, resulting in alcoholism, are more likely to
develop autoimmune disorders would be require a very in-depth research
study.
* In order to make informed decisions regarding treatment, one would
need to regard each of the various disorders separately, and determine
whether antidepressant medication is the best source of treatment,
alone or in combination with other medications or psychological
therapies. Most of the articles referenced provide overviews of
treatment options.
While antidepressants are often an option, cognitive therapy can also be helpful.
For an overview of the many types of autoimmune disorders, please refer to:
"Autoimmune disorders." Joseph F. Smith Medical Library.
http://www.chclibrary.org/micromed/00039060.html
IMMUNE DISORDERS AND DEPRESSION
===============================
From "Researcher probes link between flu, depression - The work of a
pioneering UBC psychiatrist suggests feeling blue might not be all in
your head," by Hilary Thomson. UBC Reports Vol. 47 No. 17 November 1 ,
2001
http://www.publicaffairs.ubc.ca/ubcreports/2001/01nov01/song.html
Excerpt:
"Can a bout of flu trigger an episode of depression? UBC Psychiatry
Asst. Prof. Cai Song thinks so. She has spent the last 12 years
looking at the interactions between the brain and the immune system."
"These are two very complicated systems," she says. "It's very
difficult for scientists to link them together. Psychiatrists and
immunologists usually don't talk."
"Song, a faculty member since 1999, is particularly interested in the
relationship between immune disorders and depression."
"Anti-depressants have been used for half a century but they are
effective only about 60 per cent of the time and many patients cannot
be completely cured," she says. "There must be a better way. We need a
revolution."
"Her research has shown that depressed patients show abnormalities in
their immune system and, conversely, that alterations in the immune
system can trigger chemical changes in the brain that result in
depression, anxiety and impaired memory."
"In addition, antidepressants may be helpful when the immune system is
hyper-activated because of autoimmune disorders. These include
multiple sclerosis, lupus, psoriasis and rheumatoid arthritis."
"Song emphasizes that not all psychiatric illnesses are related to
immune disorders, however, ignoring the links can be dangerous. Many
antidepressants have severe side effects and are toxic to the immune
system -- the patient's psychiatric health may improve but their
overall health may decline as treatment continues."
"Also, when patients with painful immune diseases such as lupus report
symptoms of depression, physicians often believe the depression is
connected to the pain, she says. Song argues that the depression is
actually caused by chemical changes in the brain triggered by the
distressed immune system."
FIBROMYALGIA
============
From "DEPRESSION AND FIBROMYALGIA," by Dr. Warren Nielson. St.
Joseph's Hospital. http://www.sjhc.london.on.ca/sjh/programs/fms/depress.htm
"Depression is the most common type of emotional disorder. In the
general population, approximately 5% of people are depressed at any
one point in time and about 20% experience a clinical depression
during their lives. In general, there is a relationship between
chronic pain and depressive illnesses. Patients with chronic pain are
more likely to be depressed, to have thoughts of suicide and to
attempt suicide than those without pain. As you might expect, rates of
depression are significantly higher among patients with Fibromyalgia
Syndrome (FS). Approximately 30% of patients who have FS also suffer
from a clinical depression."
Read more about diagnosis and treatment, including antidepressants....
=
"Fibromyalgia Isn't Depression - But Depression May Add to Patients'
Woes," by Daniel DeNoon. WebMD Medical News (Oct 2003)
http://my.webmd.com/content/article/75/89910.htm
=
"It's Not All In Your Head," by Lisa Lorden. NFA
http://fmaware.org/patient/research/inyourhead.htm
"Examining the role of psychological factors in FM is complicated by
an inability to separate depression symptoms that may have existed
before the onset of FM from symptoms that are a result of chronic
illness. But regardless of whether depression precedes or follows the
onset of fibromyalgia, these symptoms are separate, and FM symptoms
will remain after the psychological symptoms are treated."
"Studies have shown that as a group, fibromyalgia patients are no more
depressed than other patients with chronic rheumatic diseases such as
rheumatoid arthritis. One study compared the responses on a
depression rating scale of 45 FM patients, 29 rheumatoid arthritis
patients, and 31 healthy controls with no pain. No difference between
the two illness groups was found. However, in each group a subgroup
of patients appeared to be experiencing significant depressive
symptoms."
Read more...
==
"Evaluation of the relationship between depression and fibromyalgia
syndrome: why aren't all patients depressed," by Okifuji A, Turk DC,
Sherman JJ. J Rheumatol 2000 Jan; 27(1):212-9 ABSTRACT:
http://www.biopsychiatry.com/fibrodepres.htm
"Of the sample, 39 met criteria for depressive disorder and 30 did
not. Depressed patients with FM were significantly more likely to live
alone, report elevated functional limitations, and display maladaptive
thoughts than nondepressed patients. Nondepressed patients were
significantly more likely to have received prior physical therapy than
depressed patients. Pain severity, numbers of positive tender points,
and pain intensity of tender points and control points did not
differentiate the depressed and nondepressed
patients.................."
=
"ADD/ADHD and Fibromyalgia (FMS): Where Is the Connection?" by Glenda
H. Davis, MD, and Patricia Stephens, CNC
http://www.add-fibromyalgia.com/page22.html
=
"Fibromyalgia," by Carol Eustice. About.com
http://arthritis.about.com/cs/fms/a/fmscause_2.htm
"Another study published in 1996 proposed that fibromyalgia is more
common in people who have a family history of alcoholism and
depression."
RHEUMATOID ARTHRITIS
====================
From "Rheumatoid Arthritis and Depression." Web4Health.
http://web4health.info/en/answers/soma-rheuma-suicide.htm
"We were recently asked in our natural-language question answering
system "Can depression lead to rheumatoid arthritis?". This answer is
rather simple : No! But the course of the disorder may be influenced
by psychological factors.
** Rheumatoid arthritis, the most prevalent chronic inflammatory
musculoskeletal disease, has been associated with several negative
psychological outcomes, including **depression. More than 10% of
patients with chronic rheumatoid arthritis have had suicidal ideas!"
"A multimodal therapy approach for patients with chronic pain or
chronic diseases like rheumatoid arthritis should include information
about psychological counseling, and help to cope with these disorders,
such as relaxation therapy (e.g. progressive relaxation,
self-hypnosis, imagination-therapy or self-hypnosis)."
"Antidepressant medication can also be a very useful choice. The right
choice of drugs may have a positive influence on mood and can also
influence pain perception (reducing chronic pain) and insomnia."
==
From "Ask The Experts! Question Regarding:Rheumatoid arthritis and
depression." MedicineNet.com
http://www.medicinenet.com/script/main/ques.asp?QaKey=8376
Q. "To what extent can depression contribute to rheumatoid arthritis?
I am referring to untreated depression of 10 years duration, coupled
with high-stress job situation."
A. "Rheumatoid arthritis is an immune disease. Currently, medical
science inadequately understands the immune system. It is becoming
more widely appreciated that the immune system can be influenced by
stressful life events, such as family deaths, divorce, financial woes,
etc. Exactly how one thing leads to another in these scenarios is not
yet understood. It is conceivable, therefore, that underlying
depression could in some way contribute to the precipitation or
aggravation of symptoms in a patient with rheumatoid arthritis."
"On the other hand, depression is a common associated condition of any
patient with a chronic illness, such as rheumatoid arthritis. Patients
with rheumatoid arthritis and depression are recommended to discuss
not only their symptoms, but their feelings with their doctors."
==
From "Management of depression in rheumatoid arthritis: a combined
pharmacologic and cognitive-behavioral approach." Parker JC, Smarr KL,
Slaughter JR, Johnston SK, Priesmeyer ML, Hanson KD, Johnson GE,
Hewett JE, Hewett JE, Irvin WS, Komatireddy GR, Walker SE. Arthritis
Rheum. 2003 Dec 15;49(6):766-77.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14673962
CONCLUSION: "In persons with RA, cognitive-behavioral approaches to
the management of depression were not found to be additive to
antidepressant medication alone, but antidepressant intervention was
superior to no treatment."
MITRAL VALVE AND AUTOIMMUNE DISORDERS
======================================
"Mitral Valve Regurgitation." WebMD
http://my.webmd.com/hw/heart_disease/ug1321.asp
* Certain autoimmune diseases that can damage the mitral valves, such
as rheumatoid arthritis, lupus, and Marfan's syndrome.
=
From "Mitral Valve Prolapse and Thyroid Disease," by Mary Shomon. About.com
http://thyroid.about.com/cs/symptomsproblems/a/mitralvalve.htm
"Medical research has found that the prevalence of mitral valve
prolapse is substantially greater in patients with autoimmune thyroid
disorders such as Graves' Disease and Hashimoto's Thyroiditis.
According to the About.com Heart Surgery Forum, MVP is the most common
heart valve abnormality, with estimates ranging from 2 million or more
Americans diagnosed with this condition, and most are women (about
80%).
OTHER ARTICLES
==============
From "Maybe it's not Depression," by Leonard Holmes, Ph.D.
http://mentalhealth.about.com/cs/depression/a/maybe.htm
"Autoimmune Disorders involve the immune system attacking the body
rather than attacking germs and other invaders from the outside.
Rheumatoid Arthritis and Systemic Lupus Erythematosis (Lupus or SLE)
are examples of autoimmune disorders. Autoimmune processes have also
been implicated in diabetes and multiple sclerosis (MS).
* These disorders almost always involve a complex symptom picture
which can include depression. They aren't nearly as common as
depression, but they can cause similar symptoms.
==
From "Complications of Mood Disorders: Medical Illness, Chronic Pain
and Mood Disorders."
http://www.canmat.org/depress/fifthteen/depressbottom.html
"Depression and anxiety can occur in the absence of any medical
condition, and indeed, frequently do. But a number of medical
disorders can cause depression in and of themselves, and treatment
should be aimed at eradicating the underlying disorder as opposed to
treating the resulting depression."
"If depression develops as a consequence of a serious medical illness,
it should be treated in and of itself, whatever else the person may
require."
"There are also situations where an antidepressant medication, notably
the tricyclic antidepressants (TCAs), are prescribed not to treat
depression but to treat pain. The TCAs are particularly effective in
people who have various types of nerve pain which often do not respond
well to other types of analgesics.
*** "The same class of medications can be helpful for a
musculoskeletal condition called fibromyalgia as well, which again
does not respond well to other types of pain-relieving medications.
Another link between depression and medical conditions lies in the
need to use certain medications to treat that medical condition."
=
From "Atypical Depression: Thyroid Link Still Alive," by Daniel
DeNoon. WebMD Medical News. March 2004
http://my.webmd.com/content/article/83/97918.htm
"Thyroid function tests were normal in all the subjects,
*** but a subset of the depressed patients -- those with atypical
depression -- was much more likely to show laboratory evidence of
autoimmune thyroid dysfunction. They were more likely than other
depressed patients to have significantly higher levels of antithyroid
antibodies. The study results appear in the current issue of BMC
Psychiatry.
*** "We don't know whether depression led to this autoimmune response
or whether the autoimmunity produced depression," Fountoulakis tells
WebMD. "What is the cause and what is the effect is still unclear."
==
From "Thyroid Condition May Slow Depression Recovery." Robert Predit.
Health Central. 2004
http://www.healthcentral.com/news/NewsFullText.cfm?id=517864
"An autoimmune thyroid condition may hinder the recovery of some
people with depression, says a Greek study in this week's issue of BMC
Psychiatry. The study also suggests doctors may be able to use
indicators of thyroid function to predict how patients will respond to
antidepressants."
Read more.....
==
One researcher who has been active in this area is Esther M. Sterberg,
MD. You might want to explore some of the articles she has written.
"For much of her career she has investigated the interaction between
the central nervous system and the immune system. Dr. Sternberg's work
has helped to define the role of the brain's stress response in
susceptibility to rheumatoid arthritis and other inflammatory
diseases, and has shed light on the underlying mechanisms for the
connection between stress, depression and autoimmune disease.
http://neuroscience.nih.gov/Lab.asp?Org_ID=141
"Dr. Sternberg has written over one hundred scientific papers, review
articles, and book chapters on the subject of brain-immune
connections, including articles in Scientific American and Nature
Medicine. She has also co-directed an exhibition on Emotions and
Disease at the National Library of Medicine and lectures nationally
and internationally on emotions, health, and disease.
http://www.esthersternberg.com/
Publications: http://www.esthersternberg.com/publications.htm
===
I hope this information has provided "some" answers to your
questions. Again, this is an extremely broad topic which really
requires many, many hours of research. However, I have attempted to
demonstrate how some correlations between the autoimmune diseases and
the other disorders you mention do appear to exist.
umiat-ga
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