79-409: Depression is a mental state of low mood and aversion to activity. It affects about 3.5% of the global population , or about 280 million people of all ages (as of 2020). Depression affects a person's thoughts , behavior , feelings , and sense of well-being . Experiences that would normally bring a person pleasure or joy gives reduced pleasure or joy, and the afflicted person often experiences
158-427: A seasonal affective disorder . Outside the mood disorders: borderline personality disorder often features an extremely intense depressive mood; adjustment disorder with depressed mood is a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode; and posttraumatic stress disorder ,
237-542: A "rational response to global conditions", according to Ann Cvetkovich . Psychogeographical depression overlaps somewhat with the theory of "deprejudice", a portmanteau of depression and prejudice proposed by Cox, Abramson, Devine, and Hollon in 2012, who argue for an integrative approach to studying the often comorbid experiences. Cox, Abramson, Devine, and Hollon are concerned with the ways in which social stereotypes are often internalized , creating negative self-stereotypes that then produce depressive symptoms. Unlike
316-406: A class of medications that are predominantly used to manage abnormal heart rhythms ( arrhythmia ), and to protect the heart from a second heart attack after a first heart attack ( secondary prevention ). They are also widely used to treat high blood pressure , although they are no longer the first choice for initial treatment of most people. Beta blockers are competitive antagonists that block
395-431: A constricting effect on the bronchi of the lungs, possibly worsening or causing asthma symptoms. Since β 2 adrenergic receptors can cause vascular smooth muscle dilation, beta blockers may cause some vasoconstriction. However, this effect tends to be small because the activity of β 2 receptors is overshadowed by the more dominant vasoconstricting α 1 receptors. By far the greatest effect of beta blockers remains in
474-454: A decrease in renin secretion, which in turn reduces the heart oxygen demand by lowering the extracellular volume and increasing the oxygen-carrying capacity of the blood. Heart failure characteristically involves increased catecholamine activity on the heart, which is responsible for several deleterious effects, including increased oxygen demand, propagation of inflammatory mediators, and abnormal cardiac tissue remodeling, all of which decrease
553-418: A diagnosis of a psychiatric or medical condition which may benefit from treatment. The UK National Institute for Health and Care Excellence (NICE) 2009 guidelines indicate that antidepressants should not be routinely used for the initial treatment of mild depression, because the risk-benefit ratio is poor. Physical activity has a protective effect against the emergence of depression in some people. There
632-556: A distinction between endogenous (internally caused) and exogenous (externally caused) types. Other psycho-dynamic theories were proposed. Existential and humanistic theories represented a forceful affirmation of individualism. Austrian existential psychiatrist Viktor Frankl connected depression to feelings of futility and meaninglessness . Frankl's logotherapy addressed the filling of an "existential vacuum" associated with such feelings, and may be particularly useful for depressed adolescents. Researchers theorized that depression
711-412: A further decrease in ejection fraction, worsening the patient's current symptoms. Beta blockers are known primarily for their reductive effect on heart rate, although this is not the only mechanism of action of importance in congestive heart failure. Beta blockers, in addition to their sympatholytic β 1 activity in the heart, influence the renin–angiotensin system at the kidneys. Beta blockers cause
790-525: A gradual escalation of the dose. The heart of the patient must adjust to decreasing stimulation by catecholamines and find a new equilibrium at a lower adrenergic drive. Beta blockers are indicated for the treatment of acute myocardial infarctions . During a myocardial infarction, systemic stress causes an increase in circulating catecholamines . This results an increase in heart rate and blood pressure, therefore increasing myocardial oxygen demand. Beta blockers competitively inhibit catecholamines acting on
869-487: A loss of motivation or interest in those activities. Depressed mood is a symptom of some mood disorders , also categorized and called depression , such as major depressive disorder , bipolar disorder and dysthymia . It is a normal temporary reaction to life events, such as the loss of a loved one; and it is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. It may feature sadness , difficulty in thinking and concentration, or
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#1732863158147948-410: A main symptom. The mood disorders are a group of disorders considered to be primary disturbances of mood. These include major depressive disorder (commonly called major depression or clinical depression) where a person has at least two weeks of depressed mood or a loss of interest or pleasure in nearly all activities; and dysthymia , a state of chronic depressed mood, the symptoms of which do not meet
1027-432: A medical diagnosis (cancer, HIV, diabetes, etc.), bullying, loss of a loved one, natural disasters, social isolation, rape, relationship troubles, jealousy, separation, or catastrophic injury . Similar depressive symptoms are associated with survivor's guilt . Adolescents may be especially prone to experiencing a depressed mood following social rejection , peer pressure, or bullying. Depression in childhood and adolescence
1106-444: A mental disorder that sometimes follows trauma , is commonly accompanied by depressed mood. Researchers have begun to conceptualize ways in which the historical legacies of racism and colonialism may create depressive conditions. Given the lived experiences of marginalized peoples, ranging from conditions of migration , class stratification , cultural genocide , labor exploitation , and social immobility , depression can be seen as
1185-502: A patient with diabetes mellitus on beta blockers. Abrupt withdrawal can result in a thyroid storm . Unless a pacemaker is present, beta blockers can severely depress conduction in the AV node, resulting in a reduction of heart rate and cardiac output. One should be very cautious with the use of beta blockers in tachycardia patients with Wolff-Parkinson-White Syndrome, as it can result in life-threatening arrhythmia in certain patients. By slowing
1264-435: A process of self-recognition and identifying familiar stimuli. By maintaining one's personal past and identity, it is a technique that stimulates people to view their lives in a more objective and balanced way, causing them to pay attention to positive information in their life stories, which would successfully reduce depressive mood levels. There is limited evidence that continuing antidepressant medication for one year reduces
1343-471: A result of these factors. It is possible that some early generation beta-blockers induce depression in some patients, though the evidence for this is weak and conflicting. There is strong evidence for a link between alpha interferon therapy and depression. One study found that a third of alpha interferon-treated patients had developed depression after three months of treatment. ( Beta interferon therapy appears to have no effect on rates of depression.) There
1422-506: A significant increase or decrease in appetite and time spent sleeping. People experiencing depression may have feelings of dejection or hopelessness and may experience suicidal thoughts . Depression can either be short term or long term. Adversity in childhood , such as bereavement, neglect, mental abuse, physical abuse, sexual abuse, or unequal parental treatment of siblings, can contribute to depression in adulthood. Childhood physical or sexual abuse in particular significantly correlates with
1501-432: A study on academic journal Molecular Psychiatry that depression is not caused by a serotonin imbalance in the human body, unlike what most of the psychiatry community points to, and that therefore anti-depressants do not work against the illness. However, such study was met with criticism from some psychiatrists, who argued the study's methodology used an indirect trace of serotonin, instead of taking direct measurements of
1580-475: A technical level, while some, such as Barry Green, the author of "The Inner Game of Music" and Don Greene, a former Olympic diving coach who teaches Juilliard students to overcome their stage fright naturally, say the performances may be perceived as "soulless and inauthentic". Low certainty evidence indicates that the use of beta blockers around the time of cardiac surgery may decrease the risk of heart dysrhythmias and atrial fibrillation . Starting them around
1659-713: Is also commonly associated with orthostatic hypotension . Carvedilol therapy is commonly associated with edema . Due to the high penetration across the blood–brain barrier , lipophilic beta blockers, such as propranolol and metoprolol , are more likely than other less lipophilic beta blockers to cause sleep disturbances, such as insomnia, vivid dreams and nightmares. Adverse effects associated with β 2 -adrenergic receptor antagonist activity (bronchospasm, peripheral vasoconstriction, alteration of glucose and lipid metabolism) are less common with β 1 -selective (often termed "cardioselective") agents, but receptor selectivity diminishes at higher doses. Beta blockade, especially of
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#17328631581471738-443: Is associated with low extraversion , and people who have high levels of neuroticism are more likely to experience depressive symptoms and are more likely to receive a diagnosis of a depressive disorder. Additionally, depression is associated with low conscientiousness. Some factors that may arise from low conscientiousness include disorganization and dissatisfaction with life. Individuals may be more exposed to stress and depression as
1817-493: Is crucial for the access of treatments. The mhGAP adopted its approach of improving detection rates of depression by training general practitioners. However, there is still weak evidence supporting this training. According to 2011 study, people who are high in hypercompetitive traits are also likely to measure higher for depression and anxiety. The term depression was derived from the Latin verb deprimere , "to press down". From
1896-401: Is limited evidence suggesting yoga may help some people with depressive disorders or elevated levels of depression, but more research is needed. Reminiscence of old and fond memories is another alternative form of treatment, especially for the elderly who have lived longer and have more experiences in life. It is a method that causes a person to recollect memories of their own life, leading to
1975-791: Is moderately strong evidence that finasteride when used in the treatment of alopecia increases depressive symptoms in some patients. Evidence linking isotretinoin , an acne treatment, to depression is strong. Other medicines that seem to increase the risk of depression include anticonvulsants , antimigraine drugs , antipsychotics and hormonal agents such as gonadotropin-releasing hormone agonist . Several drugs of abuse can cause or exacerbate depression, whether in intoxication, withdrawal, and from chronic use. These include alcohol, sedatives (including prescription benzodiazepines ), opioids (including prescription pain killers and illicit drugs such as heroin), stimulants (such as cocaine and amphetamines), hallucinogens, and inhalants . Depressed mood can be
2054-655: Is shown to be lower than those who do not. Likewise, those from smaller towns and rural areas tend to have higher rates of depression, anxiety, and psychological unwellness. Studies have consistently shown that physicians have had the highest depression and suicide rates compared to people in many other lines of work—for suicide, 40% higher for male physicians and 130% higher for female physicians. Life events and changes that may cause depressed mood includes, but are not limited to, childbirth, menopause, financial difficulties, unemployment, stress (such as from work, education, military service, family, living conditions, marriage, etc.),
2133-539: Is similar to adult major depressive disorder, although young sufferers may exhibit increased irritability or behavioral dyscontrol instead of the more common sad, empty, or hopeless feelings seen with adults. Children who are under stress, experiencing loss, or have other underlying disorders are at a higher risk for depression. Childhood depression is often comorbid with mental disorders outside of other mood disorders; most commonly anxiety disorder and conduct disorder . Depression also tends to run in families. Depression
2212-469: Is the study of how epigenetics (heritable characteristics that do not involve changes in DNA sequence) contribute to depression. Behavioral theories of depression explain the etiology of depression with behavioral science ; adherents promote the use of behavioral therapies for treatment. Evolutionary approaches to depression are attempts by evolutionary psychologists and evolutionary psychiatrists to use
2291-542: Is used particularly with beta blockers that can show both agonism and antagonism at a given beta receptor, depending on the concentration of the agent (beta blocker) and the concentration of the antagonized agent (usually an endogenous compound, such as norepinephrine). See partial agonist for a more general description. Some beta blockers (e.g. oxprenolol , pindolol , penbutolol , labetalol and acebutolol ) exhibit intrinsic sympathomimetic activity (ISA). These agents are capable of exerting low-level agonist activity at
2370-478: Is usually reserved for patients unresponsive to pharmacological therapy . People experiencing bronchospasm due to the β 2 receptor-blocking effects of nonselective beta blockers may be treated with anticholinergic drugs, such as ipratropium , which are safer than beta agonists in patients with cardiovascular disease . Other antidotes for beta blocker poisoning are salbutamol and isoprenaline . Also referred to as intrinsic sympathomimetic effect, this term
2449-500: The Patient Health Questionnaire (PHQ-9). Both of these measures are psychological tests that ask personal questions of the participant, and have mostly been used to measure the severity of depression. The Beck Depression Inventory is a self-report scale that helps a therapist identify the patterns of depression symptoms and monitor recovery. The responses on this scale can be discussed in therapy to devise interventions for
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2528-413: The liver and skeletal muscle . Stimulation of β 3 receptors induces lipolysis . Beta blockers inhibit these normal epinephrine- and norepinephrine-mediated sympathetic actions, but have minimal effect on resting subjects. That is, they reduce the effect of excitement or physical exertion on heart rate and force of contraction, and also tremor, and breakdown of glycogen. Beta blockers can have
2607-413: The nonselective β-blocker-induced worsening asthma and/or COPD. Epinephrine signals early warning of the upcoming hypoglycemia . Beta blockers' inhibition on epinephrine's effect can somewhat exacerbate hypoglycemia by interfering with glycogenolysis and mask signs of hypoglycemia such as tachycardia, palpitations, diaphoresis , and tremors. Diligent blood glucose level monitoring is necessary for
2686-497: The 14th century, "to depress" meant to subjugate or to bring down in spirits. It was used in 1665 in English author Richard Baker's Chronicle to refer to someone having "a great depression of spirit", and by English author Samuel Johnson in a similar sense in 1753. In Ancient Greece, disease was thought due to an imbalance in the four basic bodily fluids, or humors . Personality types were similarly thought to be determined by
2765-437: The 20th century. For the treatment of primary hypertension, meta-analyses of studies which mostly used atenolol have shown that although beta blockers are more effective than placebo in preventing stroke and total cardiovascular events, they are not as effective as diuretics , medications inhibiting the renin–angiotensin system (e.g., ACE inhibitors ), or calcium channel blockers . Beta blockers are utilized in
2844-471: The alpha-adrenergic system stimulation unopposed. Beta blockers with lipophilic properties and CNS penetration such as metoprolol and labetalol may be useful for treating CNS and cardiovascular toxicity from a methamphetamine overdose. The mixed alpha- and beta blocker labetalol is especially useful for treatment of concomitant tachycardia and hypertension induced by methamphetamine. The phenomenon of "unopposed alpha stimulation" has not been reported with
2923-550: The beta-1 receptor at the macula densa , inhibits renin release, thus decreasing the release of aldosterone . This causes hyponatremia and hyperkalemia . Hypoglycemia can occur with beta blockade because β 2 -adrenoceptors normally stimulate glycogen breakdown (glycogenolysis) in the liver and pancreatic release of the hormone glucagon , which work together to increase plasma glucose. Therefore, blocking β 2 -adrenoceptors lowers plasma glucose. β 1 -blockers have fewer metabolic side effects in diabetic patients; however,
3002-407: The binding to the receptor of epinephrine and other stress hormones and weaken the effects of stress hormones. In 1964, James Black synthesized the first clinically significant beta blockers— propranolol and pronethalol ; it revolutionized the medical management of angina pectoris and is considered by many to be one of the most important contributions to clinical medicine and pharmacology of
3081-542: The chance of death by suicide by two to three times. In 2017, the British Medical Association found that 49% of UK chronic pain patients also had depression. As many as 1/3 of stroke survivors will later develop post-stroke depression . Because strokes may cause damage to the parts of the brain involved in processing emotions, reward, and cognition, stroke may be considered a direct cause of depression. A number of psychiatric syndromes feature depressed mood as
3160-553: The conduction through the AV node, preferential conduction through the accessory pathway is favored. If the patient happens to develop atrial flutter, this could lead to a 1:1 conduction with very fast ventricular rate, or worse, ventricular fibrillation in the case of atrial fibrillation. Glucagon , used in the treatment of overdose, increases the strength of heart contractions, increases intracellular cAMP , and decreases renal vascular resistance . It is, therefore, useful in patients with beta blocker cardiotoxicity. Cardiac pacing
3239-484: The dominant humor in a particular person. Derived from the Ancient Greek melas , "black", and kholé , "bile", melancholia was described as a distinct disease with particular mental and physical symptoms by Hippocrates in his Aphorisms , where he characterized all "fears and despondencies, if they last a long time" as being symptomatic of the ailment. During the 18th century, the humoral theory of melancholia
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3318-405: The efficiency of cardiac contraction and contribute to the low ejection fraction. Beta blockers counter this inappropriately high sympathetic activity, eventually leading to an improved ejection fraction, despite an initial reduction in ejection fraction. Trials have shown beta blockers reduce the absolute risk of death by 4.5% over a 13-month period. In addition to reducing the risk of mortality,
3397-566: The fast heart rate that serves as a warning sign for insulin-induced low blood sugar may be masked, resulting in hypoglycemia unawareness . This is termed beta blocker-induced hypoglycemia unawareness . Therefore, beta blockers are to be used cautiously in diabetics. A 2007 study revealed diuretics and beta blockers used for hypertension increase a patient's risk of developing diabetes mellitus , while ACE inhibitors and angiotensin II receptor antagonists (angiotensin receptor blockers) actually decrease
3476-401: The genetic reverberations for subsequent generations. Likewise, research by scientists at Emory University suggests that memories of trauma can be inherited, rendering offspring vulnerable to psychological predispositions for stress disorders , schizophrenia , and PTSD . Measures of depression include, but are not limited to: Beck Depression Inventory-11 and the 9-item depression scale in
3555-1023: The global population has depression, according to a report released by the UN World Health Organization (WHO), which shows an 18 percent increase in the number of people living with depression between 2005 and 2015. Depression is a major mental-health cause of disease burden . Its consequences further lead to significant burden in public health , including a higher risk of dementia , premature mortality arising from physical disorders, and maternal depression impacts on child growth and development. Approximately 76% to 85% of depressed people in low- and middle-income countries do not receive treatment; barriers to treatment include: inaccurate assessment, lack of trained health-care providers, social stigma and lack of resources. The stigma comes from misguided societal views that people with mental illness are different from everyone else, and they can choose to get better only if they wanted to. Due to this more than half of
3634-541: The heart and in the kidneys. β 2 -adrenergic receptors are located mainly in the lungs, gastrointestinal tract, liver, uterus, vascular smooth muscle, and skeletal muscle. β 3 -adrenergic receptors are located in fat cells. Beta receptors are found on cells of the heart muscles, smooth muscles , airways , arteries , kidneys , and other tissues that are part of the sympathetic nervous system and lead to stress responses, especially when they are stimulated by epinephrine (adrenaline). Beta blockers interfere with
3713-431: The heart. Newer, third-generation beta blockers can cause vasodilation through blockade of alpha-adrenergic receptors. Accordingly, nonselective beta blockers are expected to have antihypertensive effects. The primary antihypertensive mechanism of beta blockers is unclear, but may involve reduction in cardiac output (due to negative chronotropic and inotropic effects). It may also be due to reduction in renin release from
3792-555: The likelihood of experiencing depression over the survivor's lifetime. People who have experienced four or more adverse childhood experiences are 3.2 to 4.0 times more likely to suffer from depression. Poor housing quality, non-functionality, lack of green spaces , and exposure to noise and air pollution are linked to depressive moods, emphasizing the need for consideration in planning to prevent such outcomes. Locality has also been linked to depression and other negative moods. The rate of depression among those who reside in large urban areas
3871-461: The management of angina and tachyarrhythmia . Stimulation of β 1 receptors by epinephrine and norepinephrine induces a positive chronotropic and inotropic effect on the heart and increases cardiac conduction velocity and automaticity. Stimulation of β 1 receptors on the kidney causes renin release. Stimulation of β 2 receptors induces smooth muscle relaxation, induces tremor in skeletal muscle , and increases glycogenolysis in
3950-514: The mechanism of action is not known. The physiological symptoms of the fight-or-flight response (pounding heart, cold/clammy hands, increased respiration, sweating, etc.) are significantly reduced, thus enabling anxious individuals to concentrate on the task at hand. Musicians, public speakers, actors, and professional dancers have been known to use beta blockers to avoid performance anxiety , stage fright , and tremor during both auditions and public performances. The application to stage fright
4029-605: The molecule. Moncrieff said that, despite her study's conclusions, no one should interrupt their treatment if they are taking any anti-depressant. Mental state Too Many Requests If you report this error to the Wikimedia System Administrators, please include the details below. Request from 172.68.168.150 via cp1114 cp1114, Varnish XID 454870371 Upstream caches: cp1114 int Error: 429, Too Many Requests at Fri, 29 Nov 2024 06:52:38 GMT Beta-blocker Beta blockers , also spelled β-blockers , are
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#17328631581474108-557: The most distressing symptoms of depression. There are multiple schools of depression theory. Beck's cognitive triad theorizes that an individual with depression has "automatic, spontaneous, and seemingly uncontrollable negative thoughts" about the self, the world or environment, and the future. The Tripartite Model of Anxiety and Depression helps to explain the common comorbidity of anxiety and depression by separating symptoms into three groups: negative affect, positive affect, and physiological hyperarousal. The epigenetics of depression
4187-430: The numbers of hospital visits and hospitalizations were also reduced in the trials. A 2020 Cochrane review found minimal evidence to support the use of beta blockers in congestive heart failure in children, however did identify that from the data available, that they may be of benefit. Therapeutic administration of beta blockers for congestive heart failure ought to begin at very low doses ( 1 ⁄ 8 of target) with
4266-453: The people with depression do not receive help with their disorders. The stigma leads to a strong preference for privacy. An analysis of 40,350 undergraduates from 70 institutions by Posselt and Lipson found that undergraduates who perceived their classroom environments as highly competitive had a 37% higher chance of developing depression and a 69% higher chance of developing anxiety. Several studies have suggested that unemployment roughly doubles
4345-594: The possibility of "unopposed α-stimulation" with selective beta blockers. Because they promote lower heart rates and reduce tremors, beta blockers have been used in professional sports where high accuracy is required, including archery , shooting , golf and snooker . Beta blockers are banned in some sports by the International Olympic Committee . In the 2008 Summer Olympics , 50-metre pistol silver medalist and 10-metre air pistol bronze medalist Kim Jong-su tested positive for propranolol and
4424-481: The receptor sites for the endogenous catecholamines epinephrine (adrenaline) and norepinephrine (noradrenaline) on adrenergic beta receptors , of the sympathetic nervous system , which mediates the fight-or-flight response . Some block activation of all types of β-adrenergic receptors and others are selective for one of the three known types of beta receptors, designated β 1 , β 2 and β 3 receptors. β 1 -adrenergic receptors are located mainly in
4503-440: The resources available to a population to seek comfort, health, stability, and sense of security. The historical memory of this trauma conditions the psychological health of future generations, making psychogeographical depression an intergenerational experience as well. This work is supported by recent studies in genetic science which has demonstrated an epigenetic link between the trauma suffered by Holocaust survivors and
4582-594: The result of a number of infectious diseases, nutritional deficiencies , neurological conditions, and physiological problems, including hypoandrogenism (in men), Addison's disease , Cushing's syndrome , pernicious anemia , hypothyroidism , hyperparathyroidism , Lyme disease , multiple sclerosis , Parkinson's disease , celiac disease , chronic pain, stroke, diabetes, cancer, and HIV. Studies have found that anywhere from 30 to 85 percent of patients suffering from chronic pain are also clinically depressed. A 2014 study by Hooley et al. concluded that chronic pain increased
4661-416: The risk of bradycardia. A 2014 Cochrane review investigated the use of beta blockers in the maintenance of chronic type B thoracic aortic aneurysm in comparison to other anti hypertensive medications. The review found no suitable evidence to support the current guidelines recommending its use. A 2017 Cochrane review on the use of beta blockers to prevent aortic dissections in people with Marfan syndrome
4740-487: The risk of depression recurrence with no additional harm. Recommendations for psychological treatments or combination treatments in preventing recurrence are not clear. Depression is the leading cause of disability worldwide, the United Nations (UN) health agency reported, estimating that it affects more than 300 million people worldwide – the majority of them women, young people and the elderly. An estimated 4.4 percent of
4819-775: The risk of developing depression. The World Health Organization has constructed guidelines – known as The Mental Health Gap Action Programme (mhGAP) – aiming to increase services for people with mental, neurological and substance-use disorders. Depression is listed as one of conditions prioritized by the programme. Trials conducted show possibilities for the implementation of the programme in low-resource primary-care settings dependent on primary-care practitioners and lay health-workers. Examples of mhGAP-endorsed therapies targeting depression include Group Interpersonal Therapy as group treatment for depression and "Thinking Health", which utilizes cognitive behavioral therapy to tackle perinatal depression. Furthermore, effective screening in primary care
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#17328631581474898-600: The risk of diabetes. Clinical guidelines in Great Britain, but not in the United States, call for avoiding diuretics and beta blockers as first-line treatment of hypertension due to the risk of diabetes. Beta blockers must not be used in the treatment of selective alpha-adrenergic agonist overdose. The blockade of only beta receptors increases blood pressure , reduces coronary blood flow, left ventricular function , and cardiac output and tissue perfusion by means of leaving
4977-473: The severity of a major depressive episode . Another mood disorder, bipolar disorder , features one or more episodes of abnormally elevated mood, cognition , and energy levels, but may also involve one or more episodes of depression. Individuals with bipolar depression are often misdiagnosed with unipolar depression. When the course of depressive episodes follows a seasonal pattern, the disorder (major depressive disorder, bipolar disorder, etc.) may be described as
5056-523: The theory of evolution to further understand mood disorders . The biology of depression is the attempt to identify a biochemical origin of depression, as opposed to theories that emphasize psychological or situational causes. Depressed mood may not require professional treatment, and may be a normal temporary reaction to life events, a symptom of some medical condition, or a side effect of some drugs or medical treatments. A prolonged depressed mood, especially in combination with other symptoms, may lead to
5135-557: The theory of "deprejudice", a psychogeographical theory of depression attempts to broaden study of the subject beyond an individual experience to one produced on a societal scale, seeing particular manifestations of depression as rooted in dispossession; historical legacies of genocide , slavery , and colonialism are productive of segregation, both material and psychic material deprivation, and concomitant circumstances of violence, systemic exclusion, and lack of access to legal protections. The demands of navigating these circumstances compromise
5214-457: The time of other types of surgery, however, may worsen outcomes. For non-cardiac surgery, the use of beta blockers to prevent adverse effects may reduce the risk of atrial fibrillation and myocardial infarctions (very low certainty evidence), however, there is moderate certainty evidence that this approach may increase the risk of hypotension. Low-certainty evidence suggests that beta blockers used perioperatively in non-cardiac surgeries may increase
5293-808: The treatment of anxiety states, cases of thyrotoxicosis, glaucoma, migraines, and esophageal varices. Although beta blockers were once contraindicated in congestive heart failure , as they have the potential to worsen the condition due to their effect of decreasing cardiac contractility, studies in the late 1990s showed their efficacy at reducing morbidity and mortality. Bisoprolol , carvedilol , and sustained-release metoprolol are specifically indicated as adjuncts to standard ACE inhibitor and diuretic therapy in congestive heart failure, although at doses typically much lower than those indicated for other conditions. Beta blockers are only indicated in cases of compensated, stable congestive heart failure; in cases of acute decompensated heart failure, beta blockers will cause
5372-431: The treatment of hypertension. A 2014 Cochrane review found that in individuals with mild-to-moderate hypertension, non-selective beta blockers led to a reduction of -10/-7mmHg (systolic/diastolic) without increased rates of adverse events. At higher doses, it was found to increase the rate of adverse effects such as a reduction in heart rate, without a corresponding reduction in blood pressure. A 2017 Cochrane review on
5451-565: The treatment of various conditions related to the heart and vascular system, as well as several other medical conditions. Common heart-related conditions for which beta blockers are well-established include angina pectoris, acute coronary syndromes, hypertension, and arrhythmias such as atrial fibrillation and heart failure. They are also used in the management of other heart diseases, such as hypertrophic obstructive cardiomyopathy, mitral valve stenosis or prolapse, and dissecting aneurysm. Additionally, beta blockers find applications in vascular surgery,
5530-507: The use of beta blockers for treatment of methamphetamine toxicity. Other appropriate antihypertensive drugs to administer during hypertensive crisis resulting from stimulant overdose are vasodilators such as nitroglycerin , diuretics such as furosemide , and alpha blockers such as phentolamine . Relative contraindications, or contraindications specific to certain beta-blockers: Cautions: The 2007 National Heart, Lung, and Blood Institute ( NHLBI ) asthma guidelines recommend against
5609-462: The use of beta blockers in hypertension found a modest reduction in cardiovascular disease but little to no change in mortality It suggested that the effects of beta blockers are inferior to other anti-hypertensive medications. Officially, beta blockers are not approved for anxiolytic use by the U.S. Food and Drug Administration . However, many controlled trials in the past 25 years indicate beta blockers are effective in anxiety disorders , though
5688-430: The use of non-selective beta blockers in asthmatics, while allowing for the use of cardio selective beta blockers. Cardio selective beta blocker (β 1 blockers) can be prescribed at the least possible dose to those with mild to moderate respiratory symptoms. β2-agonists can somewhat mitigate β-blocker-induced bronchospasm where it exerts greater efficacy on reversing selective β-blocker-induced bronchospasm than
5767-556: The β 1 -adrenergic receptors, thus reducing these detrimental effects and resulting in reduced myocardial oxygen consumption and demand. A 2019 Cochrane review compared beta blockers with placebo or no intervention, it found that beta blockers probably reduced the short-term risk of reinfarction and the long-term risk of all-cause mortality and cardiovascular mortality. The review identified that beta blockers likely had little to no impact on short-term all-cause mortality and cardiovascular mortality. Beta blockers are widely used for
5846-400: The β-adrenergic receptor while simultaneously acting as a receptor site antagonist . These agents, therefore, may be useful in individuals exhibiting excessive bradycardia with sustained beta blocker therapy. Agents with ISA should not be used for patients with any kind of angina as it can aggravate or after myocardial infarctions. They may also be less effective than other beta blockers in
5925-635: Was caused by a chemical imbalance in neurotransmitters in the brain, a theory based on observations made in the 1950s of the effects of reserpine and isoniazid in altering monoamine neurotransmitter levels and affecting depressive symptoms. During the 1960s and 70s, manic-depression came to refer to just one type of mood disorder (now most commonly known as bipolar disorder ) which was distinguished from (unipolar) depression. The terms unipolar and bipolar had been coined by German psychiatrist Karl Kleist . In July 2022, British psychiatrist Joanna Moncrieff , also psychiatrist Mark Horowtiz and others proposed in
6004-549: Was first recognized in The Lancet in 1976, and by 1987, a survey conducted by the International Conference of Symphony Orchestra Musicians , representing the 51 largest orchestras in the United States, revealed 27% of its musicians had used beta blockers and 70% obtained them from friends, not physicians. Beta blockers are inexpensive, said to be relatively safe, and on one hand, seem to improve musicians' performances on
6083-672: Was increasingly being challenged by mechanical and electrical explanations; references to dark and gloomy states gave way to ideas of slowed circulation and depleted energy. German physician Johann Christian Heinroth , however, argued melancholia was a disturbance of the soul due to moral conflict within the patient. In the 20th century, the German psychiatrist Emil Kraepelin distinguished manic depression. The influential system put forward by Kraepelin unified nearly all types of mood disorder into manic–depressive insanity . Kraepelin worked from an assumption of underlying brain pathology, but also promoted
6162-680: Was stripped of his medals. For similar reasons, beta blockers have also been used by surgeons. Classical musicians have commonly used beta blockers since the 1970s to reduce stage fright . Adverse drug reactions associated with the use of beta blockers include: nausea , diarrhea , bronchospasm , dyspnea , cold extremities, exacerbation of Raynaud's syndrome , bradycardia , hypotension , heart failure , heart block , fatigue , dizziness , alopecia (hair loss), abnormal vision, hallucinations , insomnia , nightmares , sexual dysfunction , erectile dysfunction , alteration of glucose and lipid metabolism . Mixed α 1 /β-antagonist therapy
6241-939: Was unable to draw definitive conclusions due to lack of evidence. Adrenergic antagonists are mostly used for cardiovascular disease . The adrenergic antagonists are widely used for lowering blood pressure and relieving hypertension . These antagonists have a been proven to relieve the pain caused by myocardial infarction , and also the infarction size, which correlates with heart rate. There are few non-cardiovascular uses for adrenergic antagonists. Alpha-adrenergic antagonists are also used for treatment of ureteric stones , pain and panic disorders , withdrawal , and anesthesia . Beta blockers are used to treat acute cardiovascular toxicity (e.g. in overdose ) caused by sympathomimetics , for instance caused by amphetamine , methamphetamine , cocaine , ephedrine , and other drugs. Combined α 1 and beta blockers like labetalol and carvedilol may be more favorable for such purposes due to
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