Free Memorandum - District Court of Arizona - Arizona

EXHIBIT "B"
U.S.A. v. MARIO ALBERTO AMADOR, JR.
CR04-404-PHX-JAT


Case 2:04-cr-00404-JAT

Document 95-3

Filed 12/11/2007

Page 1 of 4

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Depression: A roadblock to Recovery
What is
drug~induceddepression?

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Most peoplE' have felt depressed at some time in their lives. Feelings of discouragement, frustr~tlon and even a sense of despair are normal reactions to loss or disappointment and may last for days before gradually disappearing. In fact, in a recent national survey, 25% of those surveyed acknowledge feeling depressed about once a year and another 21% feeling depressed a ff"w times a year. Fortunately, For most of these people, the depressed moods are brief and disappear on their own. However, when a case of the "blues" won't pass after a couple of weeks and begins to interfere with work, family and other aspects of life, the low mood is usually a sign of clinical depression. For those who have used and abused either stimulants or depressants - drug·induced depression is a very real emotional state that results from a severe imbalance in brain chemiStry, and the user's brain trying as hard as it can to retum to a normal (non·drug) state. How long it takes to recover depends on the many different factors from the particular drugs used, length of time the drugs were used, the age, health, and genetic makeup of the person, and if there other medical or psychological conditions.

Who gets depressed?
Rates of depreSsion are espeCially high among youth. A nationWide survey found that more than 40% of people aged 18 to 24 years felt "really depressed" once a month or more. Depression is the forth·leading cause worldwide of life years lost due to disability. This is behind infectious diseases, heart disease and respiratory infections, but before HIV/AIDS. DepreSSive disorders are increasing and are expected to rank second in global diseases, after heart disease, by 2020. Depression can affect children, seniors and adult men and women of all socio-economic backgrounds. The stress of unemployment can make some people more vulnerable to depression, yet many people with depression also have prestigioUS and highly demanding careers. Twice as many women as men are diagnosed with depression. However, this may simply indicate that men are less comfortable seeking help or do not get an accurate diagnosis since depression in men often manifests itself as a substance use problem.

Are there different kinds of depression?
There are two main types of depression: cl1nlcal depression and bipolar disorder (also called manic depression). Both illnesses have mild, moderate and severe forms depending on the number and intensity of the symptoms. During a major depression, a person's general outlook on life can shift dramatically. It can lower a person's sense of self-worth and change how they feel about friends and family. In some cases, the habits of a lifetime may be set aside, replaced by a feeling of complete apathy. Since depreSSion affects the whole body, it can alter eating and sleeping patterns, increase restlessness and overall fatigue, and even cause mysterious symptoms of physical Illness. Disabling episodes of depression may occur many times or only once, twice or several times in a lifetime. Bipolar disorder Is a less common form of depression that affects about one to two per cent of the population. This illness involves cycles of depreSSion alternating with a "high" known as mania. Sometimes the mood swings are dramatic and rapid, but more often they are gradual. During the depressive phase of the cycle, people may experience any or all of the symptoms of a clinical depreSSion. III contrast, the manic phase may bring excessive energy, racing thoughts, inflated self~esteem, rapid changes in emotions and impulsive behaViour such as buying sprees or sexual indiscretions. A variety of biological and environmental factors can increase a person's risk of developing bipolar disorder or depression. For example, stress related to work, relationships, and finances call tngger a depreSSive episode. At times, prolonged Illness can bring on depression. In many cases, especially with bipolar disorder, depressive illnesses can be traced to genetic factors. One's general attitude towards everyday life may also playa major role in depreSSion. Traits such as dependency, perfectionism, low self·esteem, difficulty expressing unwanted feelings and madequate coping skills tend to make a person more susceptlble to depression.

What can be done non-medically to help the depressed?
This information is useful from prevention and treatment perspectives since many ideas and approaches to lire can be changed With practice and carmg support. For example, cognitive therapy is based on the idea that people can alter their emotions and even improve their symptoms by re·evaluating their attitudes, thought patterns and interpretations of events. More than 80% of people who get adequate treatment for depreSSion experience full relief from their symptoms or at least will Improve substantially. Bipolar disorder Is often a recurring condition, but with a combination of medication and psychotherapy, many people with this illness can return to work and Continue to enjoy all of life's pleasures.

Symptoms of Depression
· · · Feeling worthless, helpless or hopeless. Sleeping more or less than usual, Eating more or less than usual.

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10/2/2007

Case 2:04-cr-00404-JAT

Document 95-3

Filed 12/11/2007

Page 2 of 4

· Havlng difficulty concentrating or making decisions. · loss of interest in taking part in activities. · Decreased sex drive · Avoldmg other people, · Overwhelming feelings of sadness or grief. · Feeling unreasonably gUilty. · loss of energy, feeling very tired. · Thoughts of death or suicide.

Treatments for Depression and Bipolar Disorder
· With appropriate treatment, more than substantia! improvements.
80~'b

of people with depression get full relief from their symptoms or at least

· Most people respond to a combination of medication and psychotherapy. · In some cases, electroconvulsive therapy (ECT) may be helpful. · People with mild or moderate depression may benefit from herbal extracts of St. John's Wort (Hypericum perforatum). · light therapy can benefit people with seasonal affective disorder (SAD). · Regular exercise and a healthy diet can help lessen overall symptoms. · Spiritual Faith or practice can give hope. · People with mild depression may benefit from accenting the positive and increasing pleasurable activities

Risk Factors Associated with Depression
Both sexes;

· Youth (ages 18-24) · Recent negative life events (e.g. moving, loss of a loved one, Family problems) · Divorce · ChroniC stressors (e.g. unernployrnent, illness, care-giving) · low self-esteem · A lack of closeness With family and friends · Being single · Having low to moderate self-esteem · Traumatic events (e.g. child sexual abuse, Violence, rape) · Family history of mood disorders or addictions

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Depression and Substance Use
entwined relationship between substance use and depreSSion. This relationship has a variety of components. It is common For people expenenclng depreSSive symptoms to self-medicate

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10/2/2007

Case 2:04-cr-00404-JAT

Document 95-3

Filed 12/11/2007

Page 3 of 4

with the use of drugs or alcohol. These indIviduals may not be aware that depression is present, but they do recognize th
Depression due to acute withdrawal from mind altering drugs
The other area of interaction between drug use and depression can occur when a person stops using drugs or alcohol completely. Following the
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10/2/2007

Case 2:04-cr-00404-JAT

Document 95-3

Filed 12/11/2007

Page 4 of 4