Depression's Impact on the Individual and Societal Level

          It is all too common to hear loads of numbers being thrown out on the news and in academia discussing the increasing rates of depression. Many people claim to have the answers—just drink more water, make sure to exercise, delete all social media—but these solutions cannot seem to make a dent in the number of those suffering from these disorders. Different medications and forms of therapy are known to provide aide to certain individuals, but this is not a problem with a one-size-fits-all solution. Continuing research in discovering ways to reduce the growing numbers of those diagnosed with depression is crucial alongside understanding the impact this disorder can have on an individual’s life.  

            Professor Vukov highlighted the work of Molly J. Crockett in understanding neurochemical modulation of moral judgment and behavior. Crockett focused on the effects of modulating serotonin specifically in her work. In the first experiment, one group of participants were given citalopram (blocks serotonin reuptake) or atomoxetine (a noradrenaline reuptake inhibitor) or a placebo. The researchers found that in personal moral scenarios, citalopram increased harm aversion. In the next study, the researchers examined how serotonin impacts views of fairness. They blocked serotonin with tryptophan which caused increased rejection of unfair offers in an ultimatum game. Citalopram reduced the rejection of unfair offers. In a third study, the team sound that depleting serotonin increases costly punishment behaviors and made fairness goals less salient. Overall, the pattern of results suggests that serotonin depletion decreased the value of social exchange and increased the value of revenge.  

            These results demonstrating effects of neurochemical manipulations on morality may have potential normative implications. The researchers showed that moral judgments and decisions are sensitive to fluctuations in brain chemistry. However, certain moral judgments appear to be more sensitive to nonnormative factors than others. For example, making judgments about physical harms change more depending on serotonin levels compared to more impersonal or indirect harm situations. The power of this neuromodulation is also affected by individual differences such as variations in empathy. This is explained given how genotypic variability affects how one’s nervous system reacts to changes in neurotransmitter levels. Therefore, moral judgments are not fixed but are contingent on neuromodulator levels. This raises the question of the possible impact of depression on morality.

            Looking at data from two annual college undergraduate surveys from 2007 to 2018 by Duffy and colleagues, researchers found a board worsening of mental health indicators including depression and anxiety. The data suggests that something shifted around 2012 or 2013. Some speculate that this was around the time that smartphones and social media switched from being optional to mandatory among adolescents. Matching the survey data, university counseling centers have been reporting increases in the students’ utilization of campus mental health services. However, it is impossible to know if this was driven by more students in need seeking help or actual increases in the number of students with poor mental health. The study was not designed to determine the causes of increasing mental health issues but instead to just make public the prevalence of this issue.

            Data demonstrating the increasing frequency of young adults with depression being placed alongside the possible moral implications that come with serotonin depletion lay the groundwork for a quite harmful epidemic. Both articles highlight just how crucial mental health reform is now. With more individuals diagnosed with depression every year, the influence on societal morality will likely follow the same trend. Crockett’s work coupled with Duffy’s survey analysis point toward the necessity of continued research. Duffy’s work outlines the size of the issue while Crockett’s research highlights the influence depression can have on the individual. Connecting the individual burden with the large-scale numbers exemplifies the societal burden. Comprehending the societal consequences of depression is the first step of finding the solution. Crockett and Duffy’s work provide a necessary move in the right direction.

Works Cited

Crockett, Molly J. “Morphing Morals.” Moral Brains, 2016, pp. 237–245.,

doi:10.1093/acprof:oso/9780199357666.003.0011.

Duffy, Mary E., et al. “Trends in Mood and Anxiety Symptoms and Suicide-Related Outcomes

Among U.S. Undergraduates, 2007–2018: Evidence From Two National Surveys.”

Journal of Adolescent Health, vol. 65, no. 5, 2019, pp. 590–598.,

doi:10.1016/j.jadohealth.2019.04.033.

Vulnerability to Depression in Youth: Advances From Affective Neuroscience

Depression is one of the most common psychiatric disorders to date. In the U.S. alone rates of depression have risen from 6.6 percent in 2005 to 7.3 percent in 2015. The Most significant findings of this increase over the span of those 10 years is the rise in adolescents and young adults. People aged 12 to 17 saw an increase from 8.7 percent to 12.7 percent from 2005 to 2015. With this knowledge in mind Kujawa and Burkhouse began to investigate further about the vulnerability of adolescents to depression and tried to find tests to find attributes that were present in youth that increased the development of depression. 

This study took into account family history, child’s temperament, as well as different affective neuroscience tests to identify what attributes made youth higher at risk and what increased their likelihood of developing depression. In order to get the best results they used both high and low risk youth. They deemed that children with a history of depression in their family we’re at higher risk than those whose family had no prior history of depression. Other indicators of depression development in youth are negative and positive emotionality. It is found that for negative emotionality which is characterized by sadness,irritability and anxiety tends to be the greater indicator of the two. While positive emotionality which is characterized by positive affect, sociability and appetitive behavior was shown to be less indicative of depression development. This study found that high risk youth demonstrated an altered neural response to both negative and positive stimuli. It is important to note that these were observed prior to the onset of the disorder. In addition evidence showed that youth’s depression risk was defined by deficits in approach motivation and positive valence systems, which includes reduced ERP and striatal responses to reward. This in combination with blunted emotional responses may act as a vulnerability for depression especially when in combination with life stress, increased tendency to withdraw and failure to readjust behavior in order to increase positive reinforcement.

Lastly it was observed that those at higher risk showed blunted reactivity to negative images and emotional disengagement. In addition to this, those at high risk showed greater amygdala activity when presented with threatening emotional faces. 

While there is an exorbitant amount of research into what may be a predictor of depression onset there has not been many efficacious studies into preventions or treatments of depression. Currently, even the drug therapies on the market are not as efficacious in the treatment of depression. This becomes especially true in regards to youth and young adults. Dr. Lauren Shapiro who presented her research on the possibility of inhibiting ROCK as a form of antidepressant treatment in yout, discussed this fact in greater detail. She mentioned that most if not all current drug therapies (especially SSRIs) are cautiously given to youth and young adults, anyone under the age of 25, because they have been shown to increase the symptoms of depression such as suicidal ideations and negative mood. This is one of the reasons she listed as to why she began doing research into ROCK inhibition in adolescent mice. Although her research was only founded on efficacy in mice there was evidence that suggests it may have similar effects in humans. 

It is important to be aware of what may predispose adolescents to the onset of depression as demonstrated by the research done by Kujawa and Burkhouse. But as Dr. Shapiro said we need to use this research to conduct more research into the development of efficacious prevention and drug therapies. Now that adolescent depression is on the rise, preventative measures should be included in youth health. It is pertinent that medical doctors include at risk questionnaires/intakes as well as provide information to the child’s parents on what signs to watch for and what they can do to help their child develop emotionally healthy behaviors. Along with giving young adults resources and access to screenings for the presence of depression. While neurological clinical trials have not been invested in as of late because of their low efficacy it is important that something be done to reduce the rate of depression. Especially because of the proportional relationship between depression and suicide. As the depression rates rise in the youth and young adult so does that of the suicide rates.

Works Cited 

Kujawa, A., & Burkhouse, K. (2017). Vulnerability to Depression in Youth: Advances from Affective Neuroscience. Biological Psychiatry. Cognitive Neuroscience and Neuroimaging, 2(1), 28-37.

Shapiro, L., Kietzman, H., Guo, J., Rainnie, D., & Gourley, S. (2018). Rho-kinase inhibition has antidepressant-like efficacy and expedites dendritic spine pruning in adolescent mice. Neurobiology of Disease, 124, 520-530.

Antidepressants and Age: How Depression Medication Works Differently for Adolescents

The article “Teen Depression Treatment Is an Increasingly Thorny Issue” describes the use of antidepressants and how their impact on children and adolescents is not always beneficial. Depression is quite common in teens, with about 11% of Americans ages 12-17 having had a major depressive episode in the past year. However, the Food and Drug Administration (FDA) has issued warnings for individuals under 25 years of age which state that antidepressants could increase suicidal ideations.

In the article, the author discusses the research done by Dr. Andrea Cipriani and her team at the University of Oxford. They tested 5,000 children and teens who were taking antidepressants. They found that only one medication, fluoxetine (commonly referred to as Prozac), improved their symptoms. As a result, the researchers believe that children and teens should begin depression treatment with quality psychotherapy rather than prescriptions right away. Their recommendations align with those of the American Psychological Association, which shows that this team is not the only one that has taken notice of the effects of antidepressants.

In her lecture on November 19, 2019, Dr. Lauren Shapiro spoke about the treatment struggle for adolescents experiencing depression. The reason that antidepressants work differently in children and in adults is due to the development of a brain area known as the prefrontal cortex. The prefrontal cortex is responsible for areas like personality, cognitive functioning, mood, social behavior, and decision-making. However, this important and complex brain area does not fully develop until 25 years of age – the exact age targeted in the FDA’s antidepressant warnings.

Dr. Shapiro’s research focuses on finding new ways to treat depression that stray away from antidepressants. She has found that a drug that inhibits a regulatory factor called Rho-kinase (ROCK) can lead to antidepressant-like effects in adolescent mice. This drug could be a step in the right direction towards future medications which might treat depression in those under 25 more effectively than common antidepressants.

Looking at the research of both Dr. Cipriani and Dr. Shapiro, one thing is clear: more work needs to be done in order to understand the impact of antidepressants on adolescent health and mental wellbeing. Before that work is done, it is critical that psychologists and psychiatrists take heed of the FDA’s warnings and strive to do what is best for their patients with the most updated research they can find.

Links

https://time.com/4361897/teen-depression-treatment-antidepressants/ https://www.dropbox.com/sh/13j3ka06799we8d/AACN7USeByJriNdkAoq8pHiNa/(11.19.19)%20-%20Lauren%20Shapiro?dl=0&preview=Shapiro+et+al+2019.pdf&subfolder_nav_tracking=1

References

Park, A. (2016, June 8). Antidepressants May Not Work Well Among Children and Teens. Retrieved from https://time.com/4361897/teen-depression-treatment-antidepressants/.

Shapiro, L. "A cytoskeletal based approach to understanding antidepressant-like mechanisms and depression-related behaviors." Neuroscience Seminar. Loyola University Chicago. 19 Nov. 2019.