Posted on 08/15/2007 5:53:53 AM PDT by ConservativeMind
In what may be the first study to use brain imaging to look at the neural circuits involved in emotional control in patients with depression, researchers at the University of Wisconsin-Madison have found that brains of people with clinical depression react very differently than those of healthy people when trying to cope with negative situations.
According to the World Health Organization, clinical depression is one of the leading causes of disability and lost productivity in the world. Understanding the root cause of depression, however, has proved difficult.
"It's normal for people to have negative emotions in certain circumstances," says lead study author Tom Johnstone. "One of the features of major depression is not that people have negative reactions to negative situations, it's that they can't pull themselves out of those negative emotional moods. They seem to have a deficit in their ability to be able to regulate their emotions... to come back down to baseline after a negative experience."
To evaluate the role of emotional regulation in depression, psychology and psychiatry researchers from the UW-Madison School of Medicine and Public Health and Waisman Center monitored the brain responses of healthy or depressed individuals to a series of images designed to provoke strong negative emotional responses - images such as car accidents and threatening-looking animals.
Participants were asked to consciously work to decrease their emotional responses to some of the negative images, using techniques such as envisioning a more positive outcome than the one implied or by imagining the situation was acted out rather than real.
"We ask them to reframe the content of what they're seeing," rather than divert their attention or distract themselves with unrelated thoughts, Johnstone says. "We hope to engage cognitive areas in re-interpreting the emotional content of a stimulus... to either increase or decrease its impact."
In both healthy and depressed individuals, they found that such efforts increased brain activity in prefrontal cortical areas known to help regulate the emotional centers of the brain, as they expected.
The big difference was seen in the reactions of the emotional centers themselves, including a small almond-shaped structure called the amygdala located deep in the brain. The study appears in the August 15 issue of the Journal of Neuroscience.
In nondepressed individuals, high levels of regulatory activity correlated with low activity in the emotional response centers - in effect, the healthy subjects' efforts successfully quelled their emotional responses. In depressed patients, however, high levels of activity in the amygdala and other emotional centers persisted despite intense activity in the regulatory regions.
This finding suggests that healthy people are able to effectively regulate their negative emotions through conscious effort, but that the necessary neural circuits are dysfunctional in many patients with depression, the researchers say. The difference becomes even more pronounced the harder the patients try.
"Those [healthy] individuals putting more cognitive effort into it are getting a bigger payoff in terms of decreasing activation in these emotional centers," Johnstone explains. "In the depressed individuals, you find the exact opposite relationship - it seems the more effort they put in, the more activation there is in the amygdala."
Though the researchers don't yet know exactly where the differences lie, Johnstone suggests multiple factors may be at work. One possibility is that depressed individuals have a broken link between the brain regions, such that regulatory centers fail to send any dampening signals to emotional centers.
Alternately, he says, depressed patients may fall prey to rumination on negative thoughts. Maybe, he says, "When they try to engage in this regulation they just think more about the emotional content of the images. Perhaps it's quite maladaptive for them... instead of turning down their emotional responses possibly they turn up their emotional responses."
The results of this study may help identify appropriate treatment methods for people with depression, who represent a diverse patient population, says senior study author Richard Davidson.
Common psychological therapies use mental strategies similar to those used in this study, he says, and although psychotherapy might benefit patients who found conscious efforts effective in the scenarios provided in this study, it could be counterproductive for those patients whose mental efforts increased their emotional responses.
"Our results suggest that there is a subgroup of patients with depression for whom traditional cognitive therapy may be contraindicated," Davidson says. "Other therapeutic interventions may benefit this subgroup more than cognitive therapy, though this remains to be studied in future research."
Identifying the involvement of emotional brain circuits may also help focus the development of new treatment strategies for depression and other psychiatric disorders. "Emotional regulation underlies many psychiatric disorders, not only depression," Johnstone says.
Long term, he says, "If we understand where the brain circuits are that are important and how they are involved in regulating emotion, then we can target them with different types of therapies."
Other authors on the study include Carien van Reekum, Heather Urry, and Ned Kalin. The work was funded by grants from the National Institute of Mental Health and Wyeth-Ayerst Pharmaceuticals.
Your comment below is where I was going with this train of thought
And since the brain is a dynamic organ that can modify itself, then both mental as well as physical trauma can lead to profound mental changes.
Not just trauma, but can belief systems and experience change the way our brain functions?
An interesting article!
link to abstract
Interesting stuff. I will see if I can get access to that.
Thanks for remembering, neverdem.
Very interesting article, ConservativeMind.
They're great analogies.
Yes. Creative people might have direct access to more vivid "images," "sounds," etc., in their minds.
That means that they can vividly imagine all the things that might go wrong. They can vividly relive bad experiences, etc.
Thanks for the ping to this thread, neverdem.
Unfortunately, there's no blood test to indicate you have too much brain chemical "A", not enough brain chemical "B", and oh, by the way, you're sociopath.
That's not to say psychotherapy hasn't a place, but there should really be a more rigorous screening process for both licensing, as well as the appropriateness to the patient.
I laugh ever time a study comes out about a drug: "...benefits approximately 40% of the test subjects without psychotherapy, and 35%, um 40.35% of the test subjects that also had therapy, so it's best to have both the drug and psychotherapy...".
Let's cover all the bases to soak as much money as possible from the people/insurance/government.
Technology is just catching up with what people with clinical depression have known for centuries -- or perhaps thousands of years -- and what medical science has only begun to realize over the past 20 to 50 years.
I hate to say it, but conservatives -- and especially Christian conservatives -- are the worst when it comes to having sympathy for those with mental illnes. There have been dozes of times where I have argued about mental illness on FR and some people say it's all made-up and they should pull themselves up by their bootstraps while others say that its due to not reading the Bible or giving one's self over to God completely. But let me ask if Ronald Reagan should have pulled himself by the bootstraps when he had Alzheimer's Disease and I get called the most vile, despicable names and saying that I'm comparing apples to oranges.
Folks, clinical depression is a real disease. As the study says, it is not related to normal depression that is caused by some life event or emotional trauma. The two should have different names because they are so different from one another. At least now the medical field is calling it clinical depression to diffentiate from normal depression, which most people experience one or more times during their lives.
I got into a long argument several weeks ago with, quite frankly, a bunch of know-nothings who believed that bipolar disorder was just a made-up disease. I felt like I was talking to people from the Middle Ages and kept waiting for them to say that the sun orbits the earth.
I hate to toot my own horn, but read a blog post that I wrote on Christianity and Mental Illness. I'm resurrecting my blog so please excuse the messiness. There were only 11 comments -- read them -- but after some 18 months I still get an e-mail every week or two from someone who was touched by the article. No one doubts heart illness or appendix illness but so many are living the mindset of 100 years that they believe that the most complex organ of the body -- the brain -- cannot have true illnesses (except for Alzheimer's, of course, because one of the greatest Americans who ever lived, Ronald Reagan, suffered and died from it).
The good news is that people who suffer from depression can still experience God's Peace and Joy.
Amen to that. There are PLENTY of conservatives who suffer from or have suffered from clinical depression and other mental illnesses.
All comments like that do is reinforce the liberal stereotype that conservative are heartless and have the IQ of a goldfish.
Let's leave the "General Betray-Us" and "Chimpy McBushHitler" insults to the liberals. We conservative need to take the high road.
Sorry, it's not that simple. Many people who suffer from clinical depression are not chronic worriers. In fact, clinical depression can be difficult to diagnose because they don't fit the standard tests (Do you worry? Are you obssessed with what might go wrong? Is there anything in your life causing you stress? Are you unhappy?) that people with normal depression have. I have met a number of people who suffer severe clinical depression or who are being treated for severe clinical depression that are extremely happy people who are satisfied with their lives. At the same time, I have met many chronic worriers, including one very close to me in my one family, who do not suffer from depression at all.
Clinical depression can present itself in different ways to different people. Same with heart attacks and many other diseases.
There's a strong history of clinical (and disabling) depression running in my family. I noticed, about 30 years ago, that there was a component of obsession. Whether obsessing or depressed, family members have often been unable to disengage from what, for the sake of brevity, I'll label "rumination." Rumination is not quite accurate, since "thinking in words" is not always involved.
Family members have keen imaginations and are gifted both visually (artists) and verbally (writers).
Sertraline has been a Godsend.
bookmarking for a later read.
Thank you for your post. Your boat analogy is so true and understandable to those who have not dealt first hand with depression. Well stated.
Sertraline has been a Godsend.
I'm glad that Sertraline has helped. Whole books have been written on the fact that gifted writers, poets, painters, musicians, and those in the film industry are much, much more likely to suffer from depression or bipolar than the average member of society. The gift of creativity so often comes with the curse of mental illness.
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