Wednesday, May 4, 2016

The World is Less Pleasant


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Depression.  It is a word that is commonly used in our everyday lives.  It is not uncommon to hear "I'm so depressed."  Depression is not just a mood, it is the loss of vitality in one's life.  When I was younger, I believed that depression was sadness, but that is not the case.  I truly did not understand how debilitating depression could be until my cousin experienced a depressive episode.  A few years back, my cousin experienced a severe depressive episode.  It was heartbreaking to see my cousin not enjoy life.  She did not shower or eat.  For two months, all she did was sleep.  The thought of leaving the house gave her anxiety.  So for those two months, she did not leave.  I would visit my cousin in the hopes that I would be able to cheer her up.  I was unable to make her talk or laugh.  From my perspective, my cousin seemed to be in isolation, disconnected from the world.  In essence, my cousin was in a vegetative state, just existing, but not living.  Yet, my cousin is not alone.   Although medications and therapy may provide relief, it is not enough for some individuals.

A recent NPR article focused on an online program aimed at preventing depression.  The online program is part of a study by Claudia Buntrock, a PhD candidate, and colleagues at the Leuphana University in Lueneburg, Germany.  Advantages of an online program include low cost and accessibility at any time.  Buntrock and colleagues tested this online program on 406 individuals with subthrehold depression.  In other words, it is having some symptoms of depression, but not having the necessary five out of nine to be diagnosed. Half of the individuals participated in the online program, while the other half served as the control group.  

The online program consisted of six 30 minute sessions/exercises.  The exercises were broken down into two parts: cognitive behavioral therapy and problem-solving therapy.  The cognitive behavioral therapy portion required that the participants name positive activities that they engaged in.  Furthermore, the participants were asked to make arrangements to participate in those positive activities.  In the problem-solving portion of the program, the participants were asked to identify what it is that mattered most to them.  Additionally, the participants were required to identify tasks, concerns, and problems into two categories: manageable and unmanageable.  The initial results indicated that 37% of participants whom used the online program experienced depression.  On the other hand, 41% of the participant in the control group experienced depression.  Follow-up interviews were conducted with most of the participants, but not all (335/406).  The researchers suggest a longitudinal study to further understand the effectiveness of the program. This online program has the potential to be another resource in the fight against depression.  

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Dr. Rebecca Silton's work focuses on the association between positive affect and prefrontal cortical activity in remitted depression.  According to the DSM-IV, an individual must have five out of the nine symptoms in order to be diagnosed with depression.  However, as Dr. Silton explained, depression is difficult to categorize.  Instead, depression should be viewed as a continuum.  Moreover, depression is heterogeneous.  Depression can have different number of symptoms and different types of symptoms.  In other words, there are many kinds of symptom combinations. 

 Positive affect is described as pleasantness and the anticipation of it.  Positive affect is what drives us to seek that pleasant experience.  We are willing to use energy and time to seek that pleasantness.  Dr. Silton argued that low positive affect is associated with reduced left prefrontal cortical activity.  Additionally, there was elevated alpha wave activity in the left prefrontal cortex.  Low positive affect means that there is a reduced level of pleasantness.  High levels of positive affectivity may combat the effects of low positive affect.  However, the effects and efficiency of positive psychology need to be studied further.  Depression is multi-faceted, thus, multiple treatments with different modes of action need to be investigated.  


Source:  http://www.npr.org/sections/health-shots/2016/05/03/476591196/online-depression-prevention-programs

Images:  
http://www.fanpop.com/clubs/sadness-inside-out/images/38695257/title/sadness-photo

http://www.dezzandcarol.com/depression/

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