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04/23/20

Blood pressure is the measurement of the force your blood exerts on your arteries as it moves throughout your body. Normally this pressure rises and falls throughout the day. But when it stays consistently elevated it may damage your heart and cause other health problems.

When the American Heart Association (AHA) and other health organizations changed the definition of high blood pressure,1 a large influx of people who had once been considered healthy were suddenly diagnosed with high blood pressure.

Using the new measurement of 130/80, the AHA estimates 103 million American adults have high blood pressure.2 It's called the "silent killer"3 since the only way to know if you have it is to have it measured. Getting it under control may be one of the best ways to protect your health.

High blood pressure increases the force against large and small blood vessels, which is one explanation for the damage it causes. It is linked to the development of heart disease, cognitive decline and dementia,4 kidney disease, vision loss and stroke.5

Fasting Has a Positive Effect on Blood Pressure

In the early 2000s, scientists investigating the health benefits of fasting found that the fasted state not only reduced blood pressure in a group of 174 study participants, but that the effects lasted longer than anticipated. Those whose blood pressure measured higher than 140/90 underwent an intervention of a medically supervised water-only fast for an average of 10 to 11 days.6

For two to three days before the fast began, their diet was limited to fruits and vegetables. Following the fast the researchers found 89% of the participants had a blood pressure measuring less than 140/90, which was the cutoff for high blood pressure at the time of the study.

The average reduction was a large jump of 37/13 and those who had the greatest reduction were those with the highest blood pressure. Participants whose pressure was higher than 180/110 experienced an average reduction of 60/17 by the end of the study.

A further reduction in blood pressure was experienced after the participants began eating, suggesting the fast may have started normalizing pressure that could be sustained.

The researchers followed up with 42 of the participants after 27 weeks and found the mean blood pressure for the group was a healthy 123/77. They concluded that while no generalizations could be made, the results do suggest those with high blood pressure may enjoy sustainable benefits when they continue to eat a balanced diet.

Fasting Affects Lipids and Insulin Regulation

In another small pilot study7 from 2017, researchers published similar results in people with Type 2 diabetes. Participants underwent a one-week Buchinger fast — a type of fast where participants burn their own fat as their body's fuel8 — during which they were allowed 300 calories per day of liquids only and then they were allowed a stepwise reintroduction of foods.

There were 32 who completed the trial. After four months the mean weight of those in the fasting group decreased by 7.7 lbs. (3.5 kg) versus 4.4 lbs. (2.0 kg) in the control group and there was a decrease in measured blood pressure.

An earlier study involved moderately obese women with borderline high blood pressure; they experienced a rapid reduction in blood pressure in the first 48 hours of fasting.9 Researchers have also found that short-term intermittent fasting reduced blood pressure taken in the office, but it did not affect central pressure or measurements taken at home.10

Research on fasting hasn't been limited to measuring only blood pressure changes. The authors of one study11 found that those who were obese benefited in several ways. A group of 110 people were hospitalized for three weeks for a fasting intervention.

They found, over the course of a three-week medically supervised fasting diet, that the participants experienced a reduction in blood pressure and lipids and an improvement in their glucoregulation, including insulin sensitivity.

Fasting Raises the Potential for Positive Change

Although there are some factors to living a long life that may be out of your control, the types of food you eat and the timing of your meals both play a significant role. Fasting may be one of the best ways to switch on your body's ability to promote cellular protection and regeneration.12

As it turns out, fasting may also reset your senses of smell and taste.13 Your sense of smell has an impact on food choices. Researchers found that rising levels of insulin reduced the sense of smell in participants and it changed how they experienced the taste of their food. This improved after a 24-hour fast.

Fasting has a positive impact on your gut microbiome. There's evidence your microbiome has an impact on your immune system, weight management and the development of chronic disease. Results from animal studies indicate that a life-long calorie restriction "significantly changes the overall structure of the gut microbiota" to help promote longevity.14 These changes:

"… reduced serum levels of lipopolysaccharide-binding protein, suggesting that animals under calorie restriction can establish a structurally balanced architecture of gut microbiota that may exert a health benefit to the host via reduction of antigen load from the gut."

One chronic condition affected by fasting and by changes to your gut microbiome is Type 2 diabetes. The basis of the disease is insulin resistance, which is affected by fasting. Improving your insulin sensitivity15 helps your weight management efforts and helps reverse diabetes.16

Dementia is another health condition positively impacted by fasting and time-restricted eating. More than 5 million in the U.S. have Alzheimer's, just one type of dementia.17

It's important to remember there are simple steps that have a powerful impact on reducing these numbers, such as fasting that helps upregulate autophagy — the necessary process for optimal cell renewal and function. Discover more about how fasting affects cognitive function in "Time-Restricted Eating — A Powerful Way to Prevent Dementia."

Impressive Metabolic Intervention Fraught With Myths

In this interview with Dr. Jason Fung you'll discover some of the benefits of fasting to your overall health. In his book "The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting," he details how to implement a fasting program and overcome some of the challenges.

One of those challenges is unlearning the myths that have surrounded the practice. A common one is that you burn muscle when you fast. In his book, Fung clearly explains the process of protein catabolism and how the down-regulation of it and the up-upregulation of growth hormones in response to fasting does not lead to muscle loss. He says:

"What's interesting is that if you take a pound of fat, that's roughly 3,500 calories. If you eat somewhere around 1,800 to 2,000 calories a day, it takes two full days of fasting to burn a single pound of fat, which is very surprising to people.

If you're trying to lose 100 pounds, you could theoretically go 200 days of fasting just to burn all that fat … People worry about fasting for 24 hours. I'm like, 'You could go 200 days.' Then it's like, 'OK. Maybe it's OK to go 24 hours without eating.'"

The second common myth that may keep people from fasting is the belief their body will go into starvation mode and hold on to every calorie. However, this is the one effect that doesn't happen with fasting. Instead, it's an efficient way of accessing energy:

"What they're talking about is where the body's metabolism starts to slow down so significantly that instead of burning 2,000 calories a day, your body might burn 1,000 calories a day.

In that case, even if you're eating only 1,500 calories a day, for example, you're going to gain your weight back. That's actually what happens when you reduce your calories. We know that … as you cut your calorie intake, your calorie expenditure goes down as well.

Starvation mode actually is guaranteed if you just try and cut your calories. But what's interesting is that fasting doesn't do that. What happens during fasting is that … after four days of fasting, the basal metabolic rate is actually 10 percent higher than when you started.

The body has not shut down at all. In fact, what it's done is it switched fuel sources. It switched from burning food to burning [body] fat. Once it's burning [body] fat, it's like, 'Hey, there's plenty of this stuff. Let's burn our 2,000 calories' …"

Insulin Plays a Crucial Role

The primary hormone your body uses to determine whether energy is stored or burned is insulin. Each time you eat your insulin levels go up, and the higher they go the more they tell your body to store energy. The reverse happens when insulin falls, it tells your body to release energy.

During insulin resistance your levels remain high and so your body is constantly storing fat. Now, without a signal to burn energy, you feel tired and sluggish. This is one reason it's so difficult to lose weight when you're insulin resistant.

To break this cycle, you have to sustain lower levels of insulin, and this is where fasting is beneficial. While fasting, your insulin levels lower and allow stored energy to be burned. Fung describes the surprise his patients express when they return to the office and tell him they're not really hungry while fasting.

The reason is because the body has turned to burning fat and doesn't need extra calories because it has enough. There's more to the story in a relationship between insulin resistance and high blood pressure.18 However, it has been a question of which came first, the chicken or the egg?

Researchers have been seeking an answer, and while they know the conditions happen together frequently, it's remained unclear which comes first.19 Thus, one pathway fasting may activate your body to lower your blood pressure is by reducing your insulin resistance.

Certain Foods Can Help Lower Blood Pressure

Fasting can help reduce your blood pressure, and so can the foods you eat. The quality of your health is directly impacted by what you feed your body. Since your blood pressure is not an isolated aspect of your health but rather tied closely to other functions of your body, it's important to pay attention to normalizing it.

There are foods you should steer clear of and those you should begin eating to help maintain normal blood pressure. It's worth noting that those living in the Mediterranean region have some of the healthiest, longest-living people in the world. The Mediterranean diet is known for rich olives and olive oil, fresh vegetables, fruits, seafood and, infrequently, red meat.

The diet is low in sugar with moderate amounts of protein; it is high in fresh fruits and vegetables and includes healthy fats. Dr. Stephen Sinatra promotes the Pan-Asian Modified Mediterranean (PAMM) diet which highlights avoiding "foods that contain sugar, refined white flour, partially hydrogenated oils, processed fruit juices, and omega-6 oils such as corn, safflower, soy, and canola."20

KetoFasting, which combines a cyclical ketogenic diet and intermittent fasting with cyclical partial fasting is another way to optimize your health. My KetoFast protocol incorporates healthy fats that help with satiety and to accelerate autophagy.

Some foods that are heart healthy and tasty can easily be integrated into your daily routine. Arugula is high in potassium, magnesium and calcium; all of these are important for heart health. Pistachios, olive oil, tomatoes and celery are foods that help keep your arteries flexible and your blood pressure down. Discover more foods and why they're so helpful in my article, "Top Foods to Help Lower Blood Pressure."



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Early in 2020 a novel coronavirus, reportedly originating in China, began aggressively spreading throughout the world.1 By March, the epidemic caused by the coronavirus, named COVID-19, had caused a pandemic, according to the World Health Organization.2 By April, there were 1.6 million cases worldwide in 177 countries, according to The New York Times.3

Did the pandemic "just happen" as did other pandemics of the past, like plague or AIDS? No, says an alarming documentary from The Epoch Times, "Tracking Down the Origin of the Wuhan Virus." Produced and narrated by award-winning investigative reporter Joshua Philipp, an expert on espionage and unconventional warfare,4 "Tracking Down the Origin of the Wuhan Virus" unearths facts that mainstream media have largely ignored.

Why, for example, were the cases of many COVID-19 patients ignored during scientific investigations? Why were researchers who disagreed with the COVID-19 party line explanations silenced5 and important academic papers withdrawn and buried?6 Why were National Institutes of Health-funded gain-of-function (GOF) experiments with deadly coronaviruses, including those in China, ceased?7

"Tracking Down the Origin of the Wuhan Virus" presents disturbing evidence that COVID-19 did not naturally develop as widely believed, but may well have been engineered in a Chinese laboratory to be used as a bioweapon. While the world is succeeding in defeating this ominous virus, its murky origins must be explored.

Did COVID-19 Originate at the Wuhan Seafood Market?

One of the most well-accepted "facts" about the COVID-19 pandemic — that the virus originated at the Wuhan Seafood Market — may not be a fact at all, says "Tracking Down the Origin of the Wuhan Virus." A bat virus connected to the seafood market, which also contained wildlife and game mammals, was widely indicted as the source8 but the conclusions may be too hasty, says Philipp.

Quickly attributing the outbreak to the market and shutting it down on January 1, 2020, felt like "destroying a crime scene" and had the effect of stopping further investigations though many questions remained, he says.

Some scientific journals agreed. Soon after the shutdown of the market, a description of the first COVID-19 cases published in The Lancet9 and an analysis in Science magazine10 that summarized The Lancet's findings questioned the Wuhan Seafood Market as a source of the virus. According to Science magazine:

"The [Lancet] paper, written by a large group of Chinese researchers from several institutions, offers details about the first 41 hospitalized patients who had confirmed infections with what has been dubbed 2019 novel coronavirus (2019-nCoV).

In the earliest case, the patient became ill on 1 December 2019 and had no reported link to the seafood market, the authors report. 'No epidemiological link was found between the first patient and later cases,' they state. Their data also show that, in total, 13 of the 41 cases had no link to the marketplace."

Experts in the Documentary Express Their Doubts

In the film, Sean Lin, former lab director of the Viral Disease Branch, Walter Reed Army Institute of Research, also questions the abrupt attribution of the virus' cause to a bat virus connected to the seafood market. This assumption not only ignored the nearly one-third of patients who had not had contact with the market, but bats are not even sold at the market, he points out.11

Judy Mikovits, a molecular biologist and antiviral expert who worked at the National Cancer Institute for 22 years,12 calls the seafood market hypothesis "highly unlikely and improbable.” Concurring with The Lancet article, she points out that:13

"Patient zero was nowhere near the market ... there are no bats near the seafood market or anywhere else."

Also skeptical of the dismissive explanation is Dr. Daniel Lucey, an infectious disease specialist at Georgetown University. The 13 patients whom The Lancet article reported had no link to the seafood market is "a big number," Lucey told Science magazine.14

Lucey rejects the seafood market hypothesis because it rules out the human-to-human transmission that is known to occur. In a Science Speaks interview he says:15

"[T]he presumed rapid spread of the virus apparently for the first time from the Huanan seafood market in December did not occur. Instead the virus was already silently spreading in Wuhan hidden amidst many other patients with pneumonia at this time of year ...

Thus, some of the 14 cases with no exposure to the Huanan market out of the total 41 cases could be explained by the pre-existing chains of transmission causing ongoing person-to-person transmission and/or transmission from infected animals in other markets inside and/or outside Wuhan, or anywhere along the supply chain of infected animals."

Shutting down the Wuhan Seafood Market so quickly allowed other contamination sources to proliferate, especially with no testing program, says Lucey:16

"[O]ne of the reasons to test immediately for the virus now in other animal markets, both multiple species and environmental testing, is to identify and shut down any other sources of recurrent transmission of the virus, both in Wuhan, Hubei province and other provinces in China, and neighboring areas where infected animal species could exist."

A Chinese Virologist Created New, Synthetic Viruses

Much of the film focuses on the work of Shi Zhengli, a Chinese virologist at the Wuhan Institute of Virology, which hosts the Wuhan National Biosafety Laboratory and is located17 only 10 miles from the Wuhan Seafood Market.18 Zhengli, who has a lab at the institute called P4, is considered an expert on bat-originated diseases like SARS and their transmission.

A quick look at journal contributions that Zhengli co-wrote reveals the researchers created new, synthetic viruses. For example, a letter published in Nature Medicine says:19

"[T]o examine the emergence potential (that is, the potential to infect humans) of circulating bat CoVs [coronaviruses] we built a chimeric virus encoding a novel, zoonotic CoV spike protein — from the RsSHC014- CoV sequence that was isolated from Chinese horseshoe bats1 — in the context of the SARS-CoV mouse-adapted backbone.

The hybrid virus allowed us to evaluate the ability of the novel spike protein to cause disease independently of other necessary adaptive mutations in its natural backbone. Using this approach, we characterized CoV infection mediated by the SHC014 spike protein in primary human airway cells and in vivo, and tested the efficacy of available immune therapeutics against SHC014-CoV."

Spike proteins, also called S proteins, use the human angiotensin converting enzyme II (ACE2)20 to infect humans.21 That means, say Zhengli and her colleagues in a previous Nature article, that "intermediate hosts may not be necessary for direct human infection.”22

Coronaviruses' use of the human ACE2 molecule as their entry receptor "is considered a hallmark of its cross-species transmissibility," the researchers write in an article in Nature.23

After creating the synthetic virus, which they call SHC014, Zhengli and her coauthors write that they "next synthesized a full-length SHC014-CoV infectious clone based on the approach used for SARS-CoV."24 Other papers Zhengli co-wrote focus on the transmission of coronaviruses from one species to another, according to the documentary.

Is Covid-19 a Re-Engineered Virus?

Zhengli and her fellow researchers admit they used a "reverse genetics system" to generate "a chimeric virus expressing the spike of bat coronavirus,"25 raising legitimate fears that COVID-19 is also reverse-engineered, according to "Tracking Down the Origin of the Wuhan Virus."

Virologists wrote to Nature that they were uncomfortable with the fabricated chimeras Zhengli and her colleagues produced. Simon Wain-Hobson, a virologist at the Pasteur Institute in Paris, warned, "If the virus escaped, nobody could predict the trajectory."26

A withdrawn paper posted on bioRxiv, a preprint biology server where scientists can post their work before it is published, said of the COVID-19 genome:27

"We found 4 insertions in the spike glycoprotein (S) which are unique to the 2019-nCoV and are not present in other coronaviruses. Importantly, amino acid residues in all the 4 inserts have identity or similarity to those in the HIV- 1 gp120 or HIV-1 Gag ...

The finding of 4 unique inserts in the 2019-nCoV, all of which have identity /similarity to amino acid residues in key structural proteins of HIV-1 is unlikely to be fortuitous in nature. This work provides yet unknown insights on 2019-nCoV and sheds light on the evolution and pathogenicity of this virus with important implications for diagnosis of this virus ...

Our results highlight an astonishing relation between the ... protein of HIV, with 2019-nCoV [COVIF-19] spike glycoprotein. These proteins are critical for the viruses to identify and latch on to their host cells and for viral assembly."

According to Mikovits, the S proteins seen on COVID-19 that make it so transmittable to humans come from "cutting and pasting of two different viruses" and the apparent insertion of four new genes could not have been generated from a natural "zoonotic transmission."28

They had to come from a medical, bioweapons or lab setting, says Mikovits. Other scientists in the film agree that COVID-19 is a re-engineered, laboratory-driven virus.29

General Robert Spalding, a senior fellow at the Hudson Institute and a former senior strategy director at the National Security Council, believes the media have suppressed coverage of lab-driven viruses to keep lucrative Chinese revenue streams. The viruses could be intended by the Chinese to reap rewards for a vaccine that targets them or as bioweapons, he says:30

“I believe they have them [bioweapons]. I believe that they’re developing them and I think they want to be the most advanced nation on earth when it comes to biological weapons."

US-Funded Research in China Was Temporarily Halted

In 2014, the NIH announced a halt to research that few Americans were aware of — gain-of-function (GOF) experiments with the SARS, MERS and influenza viruses awarded to Chinese entities:31

"U.S. government agencies will institute a pause on the funding of any new studies involving these experiments ... NIH has funded such studies because they help define the fundamental nature of human-pathogen interactions, enable the assessment of the pandemic potential of emerging infectious agents, and inform public health and preparedness efforts.

These studies, however, also entail biosafety and biosecurity risks, which need to be understood better."

In her 2015 Nature Medicine article that discussed chimeras, Zhengli refers to the U.S. funding pause. She writes that ongoing research into engineering viruses:32

" … must be considered in the context of the US government-mandated pause on gain-of-function (GOF) studies ... scientific review panels may deem similar studies building chimeric viruses based on circulating strains too risky to pursue, as increased pathogenicity in mammalian models cannot be excluded."

The research in the paper mentioning the GOF studies was funded by grants from the National Institute of Allergy & Infectious Disease and the National Institute of Aging (both part of NIH) as well as awards from the National Natural Science Foundation of China. Technical help was received from the University of North Carolina and the University of Texas.33

Censoring Science and Whistleblowers

Censorship by the Chinese government is the rule, not the exception, according to "Tracking Down the Origin of the Wuhan Virus." On January 10, 2020, a Chinese lab released the entire genome sequence for the scientific community to analyze, but subsequently the lab was closed.34 Zhengli's Institute of Virology's P4 Lab was taken over by the military after COVID-19 surfaced, says the film.35

The censorship was reminiscent of the case of Dr. Li Wenliang, the whistleblowing Chinese doctor who contracted the virus while working at Wuhan Central Hospital, and who tried to warn others. Wenliang was investigated for "spreading rumors" and died of the virus on February 7, 2020.36 The Chinese government later apologized. Chinese researchers who originally talked to Philipp later refused to do so, he says.37

The deadly characteristics of the COVID-19 virus, the engineered viruses and the proximity of the Wuhan Institute of Virology/Wuhan National Biosafety Laboratory to the Wuhan Seafood Market raise serious biosecurity and global health questions. Let's hope the truth comes out.



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Researchers have been able to restore sensation to the hand of a research participant with a severe spinal cord injury using a brain-computer interface (BCI) system. The technology harnesses neural signals that are so minuscule they can't be perceived and enhances them via artificial sensory feedback sent back to the participant, resulting in greatly enriched motor function.

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Scientists compared the different kinds of coronaviruses living in 36 bat species from the western Indian Ocean and nearby areas of Africa. They found that different groups of bats have their own unique strains of coronavirus, revealing that bats and coronaviruses have been evolving together for millions of years. Developing a better understanding of how coronaviruses evolved can help us create better public health programs for the future.

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As every parent knows, teenage life is full of challenges, from stress over academics to social relationships and physical changes due to puberty. This stage of life can be particularly challenging for those with autism spectrum disorder (ASD). A recent study found that teenagers and young adults with ASD are nearly three times more likely to develop depression than same-age peers without ASD.

What are typical symptoms of depression?

While occasional sadness is a normal part of life, persistent sadness can be a sign of depression. Other common signs and symptoms of depression can be grouped into thinking patterns, changes in behavior, and physical symptoms. Common thinking patterns seen in depression include guilt, hopelessness, worthlessness, excessive worrying, and thoughts of death or dying. Behavioral changes include social withdrawal, increased irritability, and decreased interest in preferred activities. Physical symptoms include appetite changes, sleep problems, and low energy.

If someone has ASD, recognizing their symptoms of depression can be challenging

There are several aspects of ASD that overlap with symptoms of depression, including difficulty identifying and accurately reporting mood, constricted range of facial expression, sleep problems, and social withdrawal. Because of this overlap, an assessment of depression should involve multiple observers (caregivers who understand a teenager’s ASD, teachers, healthcare providers). An assessment should also take into account whether there is a change in your teenager’s usual behavior and functioning. Symptoms of depression typically persist for at least two weeks and represent a clear change from their typical behavior.

Some features of depression that may be more prominent in teenagers with ASD include an increase in ASD-related behaviors, irritability, and self-injurious behaviors. Many teenagers with ASD have very specific interests. These interests can become less appealing to the teenager, or shift to become more morbid during depression; for example, someone who enjoys drawing cartoon characters may draw more unhappy characters. You may also notice more crying, aggressive behaviors, and a decline in self-care, like refusing to bathe or eat meals. Although many parents worry that puberty itself may cause worsened aggression, this is often not the case, and the possibility of depression should be taken seriously.

What should parents and caregivers do if they are concerned a teenager with ASD may be depressed?

If parents suspect their teenager with ASD is depressed, they should try asking about his/her mood. Some teenagers with ASD will be able to say how they are feeling, while others may have difficulty with this. It is common for teenagers with ASD to respond by saying they feel hungry, tired, or bored. If parents remain concerned about depression, a pediatrician or mental health clinician can conduct a more in-depth evaluation.

It can be helpful to prepare your teenager for an evaluation by telling him/her that the goal of the visit is to develop a treatment plan that will help him/her feel better. The assessment will include an evaluation of mood, a discussion of recent life changes or stressors, a review of past medical and mental health conditions, family history of mental illness, and a safety assessment. Since some people with depression many have thoughts of death or of wanting to kill themselves, it is very important for the evaluation to assess for these types of thoughts, so that the treatment team can work with your teenager and family to decrease the risk of self-harm and suicide.

Having ASD increases the risk of depression in teens, but effective treatments are available

Fortunately, there are many treatments available for depression. A comprehensive treatment approach for depression can address home, social, and educational stressors, and may include lifestyle changes, talk therapy, and medications. General lifestyle strategies that can enhance resilience and mental wellness include regular exercise, adequate sleep, good nutrition, and helping your teenager problem-solve stressful situations.

Because many teenagers with ASD dislike change, they may resist these lifestyle changes. Two types of talk therapies which have been demonstrated to be effective for treating depression in teenagers with ASD include cognitive behavioral therapy (CBT) and behavioral activation (BA). CBT focuses on helping change unhelpful thinking patterns and behaviors to improve mood; BA improves mood by helping a person plan enjoyable activities to increase opportunities for positive experiences.

Since teenagers with ASD who do not see themselves as depressed may be resistant to trying talk therapy, a therapist may begin by collaborating with the teen to identify relevant treatment goals. Medications can also be helpful; however, there are no published studies of antidepressants specifically for depression in ASD. It is important to start antidepressants at low doses and increase the dose slowly, since those with ASD may have more difficulty communicating side effects. That said, it is important to work with the prescriber to continue to gradually increase the dose of the medication if your teenager remains depressed and is not experiencing side effects. Common side effects of antidepressants include headaches, digestive problems, increased anxiety, and changes in sleep or energy. If the first antidepressant is not effective, then it is worth trying another type of antidepressant.

Although teenagers and young adults with ASD may be at higher risk for depression, it is a treatable condition with many treatment options to help build resilience, decrease the severity of symptoms, and restore quality of life.

The post How can you support your teenager with autism spectrum disorder if they are depressed? appeared first on Harvard Health Blog.



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Ketamine alleviates depressive symptoms within hours, with the most significant change typically seen a day after its administration. However, the symptoms often reappear within a week. According to researchers, neural connections strengthened by the quick treatment of depression are consolidated in the brain during the deep sleep periods of the following night. To prevent the circle of negative thoughts regaining supremacy, depressed patients also need therapy.

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