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Depression Might Have Derailed Lincoln’s Recovery, Historian Says

WASHINGTON-If Abraham Lincoln survived his head wound through modern trauma care, he would have retained his mental awareness, but likely been left inarticulate among other disabilities-which might have exacerbated his already existent depression.

“It would be more of a problem because he already suffered from depression,” advised Steven Lee Carson, a Presidential historian from the Woodrow Wilson House in Washington, D.C., who spoke at the 13th annual Clinicopathological Conference in May about the social and historical implications had Lincoln lived in 1865.”[Dr. Scalea hypothesized that] he would have probably been dyslexic, and although he had reasoning abilities, he would not be able to communicate. He would be inarticulate and possibly blind in one eye or both eyes.”

At the very least, had Lincoln survived, he would have required a long rehabilitation process. “Any patient who would suffer such grievous wounds as Lincoln would have had problems with depression,” Carson advised. “Lincoln already suffered from massive depression long before [he was shot]. It’s very well-known. So, he would have had the double-whammy of depression upon depression, plus his moods.”

Lincoln was well-known for his sense of humor, and once said that the reason he jokes ‘is to keep from dying,” Carson said. But with his injury, he might not have been able to joke like he did because of the possibility of not being able to articulate his thoughts.

Carson gave numerous examples of Lincoln’s humor, which at times was vaudevillian-like and other times witty and satirical to deflate difficult political situations.

Lincoln’s already existing depression had also been affected by the deaths of two young sons. Before he became President, he lost a son who was just a few years old, and then he lost another son, Willie, in 1862 during his Presidential years. Willie was just 10-years-old when he died, and accounts show that Lincoln was deeply affected by it and would continue to talk about him years later. “Lincoln even went to the cemetery where his son was temporarily put after he died in 1862, and we know of at least two times when he opened up the casket,” Carson said. “Willie was the favorite son. He died on a Thursday. After he died, for a month thereafter, every Thursday Lincoln would stop working and seclude himself, so [that] his male secretaries [had to call] a minister to talk Lincoln around.”

But Lincoln had a job to do as President and he managed to occupy himself with that. “He galvanized the English language and it was not equaled until (Winston) Churchill,” Carson said.

Would History Have Changed With A Debilitated Lincoln?
Given the political climate in 1865, several issues would have been raised had Lincoln survived. For one, Carson pointed out that there was no 25th Amendment to the Constitution yet, so there was no provision for someone to take over in the event a President becomes too sick or injured to carry out his duties. Lincoln was shot and took nine hours to die, and for that time period until vice president Andrew Johnson was sworn in nearly four hours after he died, Lincoln’s secretary of war Edwin M. Stanton ran the government, Carson advised. “Edwin Stanton was incorruptible and he had to do so much because it was really an attack on the government,” he said. “At the same time that Lincoln was shot, one of Booth’s accomplices [Lewis Powell] tried to assassinate the secretary of state William H. Seward [Powell attacked Seward in his home and stabbed him and several others, although Seward survived with disfiguring facial wounds. There was also a planned attack against Johnson, though it never came about because Booth’s accomplice for that attack got drunk instead].”

Since the Civil War was just coming to a close when Lincoln was shot, it was a crucial time period.”Lee surrendered April 9. Lincoln was shot April 14. Jefferson Davis was [still] in flight and [not] caught [until] May 10, and the last Confederate Army general and warships surrendered in June,” Carson said. “When Lincoln was shot, although Lee had surrendered, there was the real fear that there were still troops out there ready to start the war all over again, or indeed [who] maybe would not have recognized Lee’s surrender. Jefferson Davis, in fact, was in flight to try and rally the remaining troops and get the war going or have guerrilla warfare.”

As Lincoln lay dying, Stanton took testimony from eyewitnesses, sent guards to the vice president and all of the cabinet members and other government leaders [there was no secret service then], ordered pursuit of the assassins through the telegraph lines and the provost marshals to close the country’s borders, alerted the military to guard forts, cities, ammunition depots, military posts and transportation outlets, ordered the handling of Confederate troops caught in the field, and informed the public of what happened. “During that period before Lincoln died, Stanton is very much in control, but he really was for a period thereafter, also,” said Carson.

Stanton, as war secretary, was possessed with greater power than usual since it was wartime, the secretary of state was out of action, and Congress was not in session at the time. He even preserved civilian control of the military in late April after General Sherman accepted both a military and civilian surrender of the Confederate Army in North Carolina. “Stanton, with Johnson’s agreement and the others’, had that rescinded and Sherman had to go back to the Confederate general and get a surrender on [only] the [military] terms that Grant gave Lee,” Carson advised. “If Lincoln had survived but been so incapacitated, the problem is somebody would have to act in Lincoln’s stead, and we have the evidence right there of Stanton.”

After Lincoln died, Johnson, according to Carson, would go on to become one of the worst Presidents ever, despite being the only Democratic senator to have stayed with the Union when the country divided into the Civil War. Lincoln, a northern Republican, had brought Johnson into the government just a month before the assassination, as a symbol of unity in an effort to unify the country. “But he was so out of control, intemperate, vulgar, and I don’t just mean in private, but in public,” Carson said of Johnson. “He was intransigent, stubborn, [and] a veritable racist.”

Furthermore, Lincoln’s wife, First Lady Mary Todd Lincoln, was also an out of control person, according to Carson. “Mary Lincoln was mentally ill long before [Lincoln was killed],” he said. “She had no friends at all in Washington, D.C. She had alienated everybody and fought with everyone, and she was carrying on [after he was killed].”

Carson said he has great compassion and sympathy for Mary, who outlived three of her four sons, but she did not handle death well and her illness eventually led her to being committed to an asylum 10 years after Lincoln’s death.

As an example of her erratic and sometimes unreasonable behavior, just weeks before the assassination, Mary jealously blew up at Lincoln and the wives of Grant and another general in front of a review of troops in Virginia, Carson said. This incident led to the Grants turning down an invitation to be with the Lincolns at Ford’s Theater the night the President was killed there. When asked if there would have been more security at the theater had both Lincoln and Grant attended, Carson said there surely would have been.

So if Lincoln had survived in a disabled state, his wife and others likely would have struggled for control. “Mary Todd Lincoln would have fought like a tiger,” Carson sad. “Mary Lincoln did everything of pure and total emotion. And because Mary had made enemies everywhere, she would not have succeeded. Mary would have been a major problem for Stanton and the others, especially given the fact there was not an amendment at that point making it very clear on who should take control because he would still be alive. [Plus] the fact that the war was still going on-Jefferson Davis was still in flight and other Confederate troops were still in the field and of course that there had been other attacks against members of the government. Mary, she would have carried on like a banshee, but nobody would have followed her because she had no friends, no associates, [and] she alienated everybody in the four years of the Lincoln Presidency. So, that would have been more of an emotional annoyance rather than anything else.”

Carson gave examples of two past Presidents, James Garfield [who was shot] and Woodrow Wilson [who suffered a stroke], who were incapacitated for some time but remained in power. In Garfield’s case, the secretaries of war and state unofficially ran the government until he died a couple of months later, while First Lady Edith Wilson quietly held Wilson’s office together until he recovered.

The possibility that Stanton would have assumed power unofficially while Lincoln was recovering can also be attested to the close relationship the two had. “Stanton and Lincoln were very close, so it’s not like they would be at odds with each other. They shared summer vacations together and they worked together, [and sometimes attended church together],” Carson said.

Changing History
Had Lincoln lived, even in a disabled state, he still likely would have made a difference given that he would have retained his cognitive powers. With his death and Johnson assuming the Presidency in 1865, things took a step backward. “That’s the aggravating thing, the terrible thing,” Carson said. “For one thing, Johnson was a dyed-in-the-wool racist. So he didn’t care a damn about the slaves, and so the Union, the Congress, the reconstruction were trying all sorts of things to raise the ex-slaves up such as the Freedmen’s Bureau, and Johnson vetoed it. [Furthermore] southern states passed what are called the Black Codes [so] that blacks could not own land [and] could not leave their present employment, and he let that go by. He didn’t stop that or try to do anything. And he vetoed the Civil Rights Act of 1866, and when he vetoed the three reconstruction acts designed to empower blacks with the right to vote, after that veto Congress responded and we got the 14th Amendment [in 1868].”

Johnson had been against the top Confederate leaders over the war and he did not share their Bourbon upper class backgrounds, but he tried to turn over state governments to other Confederate leaders after he became President. He also insisted that most of the alleged accomplices of Booth be hanged, including the controversial first U.S. execution of a woman. He even garnered the nickname “avenger” because of his lingering hatred for southern aristocrats. “The problem with Johnson was he was a totally out of control person, totally intemperate,” Carson said. “He had no sense of diplomacy, whatsoever. He did not know how to get along or compromise, he had none of Lincoln’s attributes. He was rock solid in stubbornness and worst of all he added fuel to that fire by publicly and repeatedly getting into all sorts of vulgar language, and calling various leaders ‘traitors’ and all that.”

But Carson points out that even if Lincoln had lived, with Stanton sort of acting in his stead for a period, there still would have been rough times. “Because what actually did happen during reconstruction, there were great race riots in the south,” he said. “Whites were making war upon blacks with the Black Codes and taking away the Freedmen’s Bureau with Johnson’s veto. So, I think if Lincoln had lived, we would have had a better set of race relations today, and it would have been quicker, much quicker than we had it. But we [still] would have had to go through the fires of hate and bigotry with the race riots that did occur and they still would have happened because basically it was an unrepentant south still acting as if they had won the Civil War. And that was the whole problem…without Lincoln’s firm and careful guiding hand, the always impatient United States wanted to move on and they did, and they left the writing of the history books to the southerners.

“If Lincoln had lived, though incapacitated and he could reason and somehow get his thoughts across, the U.S. certainly would have been a better and more just nation, especially on matters of race and in a far quicker fashion, with his wisdom and gifts of diplomacy, humor and sense of timing and armed with the mantle of being a victorious war President. But the U.S. still would have gone through the fires and Lincoln would have had to toughen his policies. Reconstruction was not radical enough.”

However, despite Lincoln’s untimely death, Carson said that what he accomplished did not die. He not only united the north and south, but the east and west when he authorized the transcontinental railroad. He also authorized the Homestead Act designed to allow people to settle land and own it after five years. He ended slavery, advocated for free public education and thus opened up the U.S. to others in the world.

Source: Matt Pueschel

Exercise On Par With Drugs for Aiding Depression

Regular exercise may work as well as medication in improving symptoms of major depression, researchers have found. In a study of 202 depressed adults, investigators found that those who went through group-based exercise therapy did as well as those treated with an antidepressant drug. A third group that performed home-based exercise also improved, though to a lesser degree.

Importantly, the researchers found, all three groups did better than a fourth group given a placebo — an inactive pill identical to the antidepressant.

While past studies have suggested that exercise can ease depression symptoms, a criticism has been that the research failed to compare exercise with a placebo. This leaves a question as to whether the therapy, per se, was responsible for the benefit.

The new findings bolster evidence that exercise does have a real effect on depression, according to the researchers.

Doctors may not start widely prescribing exercise as a depression treatment just yet. But for patients who are motivated to try exercise, it could be a reasonable option, the study authors say.

“If exercise were a drug, I’m not sure that it would receive FDA approval at this time,” noted study author Dr. James A. Blumenthal, a professor of medical psychology at Duke University Medical Center in Durham, North Carolina.

“But,” he told Reuters Health, “there is certainly growing evidence that exercise may be a viable alternative to medication, at least among those patients who are receptive to exercise as a potential treatment for their depression.”

The study, published in the journal Psychosomatic Medicine, included 202 men and women age 40 and older who were diagnosed with major depression. They were randomly assigned to one of four groups: one that worked out in a supervised, group setting three times per week; one that exercised at home; one that took the antidepressant sertraline (Zoloft); and one that took placebo pills.

After 16 weeks, the patients completed standard measures of depression symptoms.

By the end of the study, Blumenthal’s team found, 47 percent of patients on the antidepressant no longer met the criteria for major depression. The same was true of 45 percent of those in the supervised exercise group.

In the home-based exercise group, 40 percent had their symptoms go into remission. That compared with 31 percent of the placebo group.

There are several theories on why exercise might improve depression. For example, physical activity seems to affect some key nervous system chemicals — norepinephrine and serotonin — that are targets of antidepressant drugs, as well as brain neurotrophins, which help protect nerve cells from injury and transmit signals in brain regions related to mood.

Exercise may also boost people’s feelings of self-efficacy and promote positive thinking. Some experts speculate that group exercise, with its social aspect, may have added benefits.

Though the home exercise group in this study did better than the placebo group, it’s not clear whether it’s as good as supervised classes, according to Blumenthal. "Home exercise may be more convenient," he noted, "but patients not push themselves as hard on their own."

He added that supervised exercise may also be safer for some people, such as those with heart disease.

SOURCE: Psychosomatic Medicine, September 2007.
Copyright © 2007 Reuters Limited.

Chemical clue sheds light on winter depression

The brains of people with seasonal depression may be too efficient at bundling away a key chemical, a new study suggests.The finding in people with (SAD) backs the prevailing theory about the biochemical causes of depression, and could give clues into new ways to treat the condition.

The prevailing theory of depression is that affected people do not have enough of certain neurotransmitters called monoamines – serotonin, norepinephrine, and dopamine – in the spaces between neurons. Most modern antidepressants work by blocking the absorption of these neurotransmitters back into the cell.

However, there is little agreement on why levels are inadequate in the first place. It could be that depressed people produce lower volumes of the neurotransmitters, or they could break them down too rapidly. Or it could be that the neurotransmitters are removed from the junction between neurons, called the synaptic cleft, too quickly.

Matthaeus Willeit and Harald Sitte at the University of Vienna in Austria and their colleagues now have evidence for the last of these – that serotonin is being removed too efficiently …

Source: Allison Motluk, New Scientist

Depression pushes middle-aged workers to retire

MONDAY, Sept. 17 (HealthDay News) — In many cases, depression is a deciding factor for men and women considering retirement, according to new research.

Middle-aged men who suffer with symptoms of depression are more likely to retire early, while retirement-age women often take the leap even if their depressive symptoms are mild.

According to researchers at the University of Pennsylvania, one in 10 working adults will experience about of depression over the course of the year …

Author: Madeline Vann, Mental Health Care, Inc

Arts increase well-being and reduce anxiety and depression, according to new Manchester Metropolitan University research

Getting involved with arts activities can help keep us healthy, according to a new study from Manchester Metropolitan University. The three year HM Treasury-funded project has shown that engaging with things like painting, dance, crafts, music and story-telling can increase our psychological well-being and lower levels of anxiety and depression.

The research, named ‘Invest to Save: Arts in Health’, has found that participants felt happier, empowered and more confident after engaging in arts initiatives. The study involved over 100 participants and was lead by Clive Parkinson, from Manchester Metropolitan University’s Faculty of Art and Design. “We found projects that stimulate peoples’ minds and encourage them to be creative can have a profound impact on their health and wellbeing,” he said. “The arts can help create a positive environment and build positive relationships which can make people feel more resilient, in control and give them a sense of purpose which leads to greater energy and enthusiasm for life.” …

Source: AlphaGalileo

Hope for new therapy against depression

The Canadian medical profession developed a new group of anti depressives, which work at least in the bioassay four to seven times faster than the medicines used so far: Their oversize under that effect adjusted itself with rats already after three days, during ant depressives from the class of the Selective serotonin reuptake inhibitors (SSRIs),, which began to only work most usual group of active substances, after approximately two weeks.
Whether there is a so fast success also with humans, must however only still show up, reports the researchers around Guillaume Lucas of the McGill university
in Montréal
in the technical periodical neuron (Bd. 55, P. 712). Also the danger of serious side effects must be considered, gives the Pharmacology Ronald Duman in an associated comment (P. 679) to consider …

Source: Sciscoop

Winter may herald SAD epidemic for millions

This winter could see an epidemic in cases of seasonal affective disorder (SAD), following the abysmal summer that was the wettest since records began. The summer is traditionally a time of respite for those susceptible to SAD, but mental health experts have warned that with sufferers reporting winter symptoms throughout the season, the effect of the prolonged bad weather will make the winter months even more of a struggle than usual.

At least one in 20 people suffers from SAD-related bouts of depression, with a further one in eight affected by the more nebulous winter blues. Bright light, ideally sunlight, is the best treatment for those who suffer from this debilitating mental health condition. But when summer does not provide this, the cumulative lack of good quality sunlight could have a devastating effect …

Source: Emily Dugan, The Independent

Mobile Phone and Adolescent Depression

There are increased problems associated with the improper usages of mobile phones by adolescents; however, modern technological advancements also put its footsteps to use mobile phones as a wonderful device to identify adolescent depression. The Murdoch Children Research Institute claims for the crown in this aspect exclusively for its wonderful innovation.

The Murdoch Children Research Institute

The Murdoch Children Research Institute offers its valuable contribution to the field of research primarily focusing on different health aspects of children and adolescents. It is considered as the one of major child health research institutes around the world. The research team comprises of 900 passionate research scholars who are continuously contributing in the research era with their detailed understanding and creative aptitude.

The Innovation

The Murdoch Children Research Institute is offering a Java-based mobile application that enables an understanding of observation and early identification of warning-sign of adolescent depression. It is assumed to be first ever made application that can be used for such purpose.

The research had been conducted in Australia with a focus group consisting of 40 young individuals. The adolescents were supplied with Nokia 6260 where the application was pre-loaded.

As noted by Dr. Sophie Reid, adolescents’ anxiety and depression have become one of the major complications that need to take into serious consideration. The present strength of the adolescent sufferers may include a population of more than 30% and there is an increased possibility that this complication will strike the nation as one of the serious ones during 2020.

The application will primarily concern the idea how youngsters responds to the signal of distress. The application collects all the relevant data pertaining to the adolescents’ response to distress; this essentially comes out with several questionnaires popping up on the screen in a regular interval.

After one week, the researchers downloaded all the data using Bluetooth technology or infrared facilities and then analyzed the data.

The Future

However the application is a promising one in order to find out a real-time application for monitoring and detecting changes in health aspects. In recent future, the researchers are expecting to implement automated generation technology to make the system more sophisticated refraining from the need to employ programmers. It also plans to include voice capturing facilities especially for open-ended questions. The Murdoch Children Research Institute collaborated with Harvard Medical Institute to make a safer place for implementing this technology in near future.

Author: Ian Ball

A study into the best treatment for both alcohol dependence and depression – thought to be a world first– will get under way in New Zealand later this month.

A study into the best treatment for both alcohol dependence and depression – thought to be a world first– will get under way in New Zealand later this month.

Funded by the Health Council over 3 ½ years, the research is being led by the National Addiction Centre at Otago University, Christchurch, and will be launched in Whangarei, Auckland, Hamilton, Christchurch and Dunedin …

Source: Stuff.co.nz - Wellington, New Zealand

Maternal Depression And Controlling Behavior Associated With Increased Stress Response In Infants

Teenage pregnancy is widely recognized to be a major public health concern. These young mothers face many life challenges and they have an increased risk for becoming depressed.

How might the behavior of these young mothers be related to later psychiatric or behavioral problems in some of their offspring?

A new study being published in Biological Psychiatry on September 15th suggests an association between a history of depression in the mothers, a particular style of mothering, "maternal overcontrol", and increased stress reactivity of their infants.

Azar and colleagues measured the cortisol levels of infants both before and after a brief mild stressor. They found that a lifetime history of major depression in the mother and a maternal pattern of intrusive and overstimulating behavior toward their infant (”maternal overcontrol”) were associated with an increased release of the stress hormone, cortisol, in the infants following the mild stress exposure. The infants of mothers with a history of depression had also had lower pre-stress cortisol levels. Also, there was a correlation in the cortisol levels between mothers and their infants.

These findings add “to our small but growing body of knowledge on neurobiological differences in stress responses between infants of depressed and non-depressed mothers”, noted Dr. Azar.

John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, adds, “Teenage mothers and their offspring are both, in their own ways, vulnerable. As a result, teenage pregnancy is thought to be a setting for preventative educational programs that might help teenagers better cope with their upcoming challenges.” He also points out that, “We do not yet know the long-term consequences of maternal "overcontrol", but should it prove to have negative long-term effects, it is conceivable that this type of behavior might be targeted in preventive educational programs.”

Dr. Azar concludes, “Practically, the open question is that of the long-term effects: are these infants at increased risk for psychological or physical stress-related illnesses later in life. If so, why? Given that the adrenocortical system is known to be plastic and hence easily influenced in both positive and negative ways, we believe that it is very important to eventually identify which of these babies are more vulnerable to stress.”

The article is “The Association of Major Depression, Conduct Disorder, and Maternal Overcontrol with a Failure to Show a Cortisol Buffered Response in 4-Month-Old Infants of Teenage Mothers” by Rima Azar, Daniel Paquette, Mark Zoccolillo, Franziska Baltzer and Richard E. Tremblay. Dr. Azar is affiliated with the University Health Network, Women’s Health Program, Toronto General Hospital in affiliation with the University of Toronto in Ontario, Canada. Dr. Paquette is with the Department of Psychology at the University of Montreal and the Research Institute for the Social Development of Youth (RISD)-Montreal Youth Center in Quebec, Canada. Dr. Zoccolillo is with the Department of Psychiatry, while Dr. Baltzer is with the Department of Pediatrics, both at McGill University & McGill University Health Centre-Montreal Children’s Hospital in Quebec, Canada. Dr. Tremblay is affiliated with the Research Unit on Children’s Psychosocial Maladjustment at the University of Montreal. This article appears in Biological Psychiatry, Volume 62, Issue 6 (September 15, 2007), published by Elsevier.

Source: Science Daily