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One of the more startling findings is that the rate of depression in the western world has been on the increase over the past century. One study (summary here) found the rate of major depression in U.S. adults increased from 3.33% to 7.06% over a ten year period. The study interviewed a large sample, and used their own questions, rather than relying on the numbers diagnosed by doctors, so an increase in the rates of diagnosis wouldn’t explain the result. The study found increasing substance abuse could account for some, but not all of the change.

One researcher has explained the increase in depression in cultural terms. Stephen Ilardi, from the University of Kansas, argues that depression arises because people are more adapted to primitive times:

“As a species, humans were never designed for the pace of modern life, we’re designed for a different time — a time when people were physically active, when they were outside in the sun for most of the day, when they had extensive social connections and enjoyed continual face time with their friends and loved ones, when they experienced very little social isolation, when they had a much different diet, when they got considerably more sleep and when they had much less in the way of a relentless, demanding, stress-filled existence.” (Source: Kansas University News)

His six recommendations for depression are to get more physical activity, spend more time in the sun, keep up social connections, improve our diet (by eating more food with omega-3s, and less fast foods), getting more sleep, and engaging ourselves in tasks to avoid rumination. I’ve come across similar recommendations before, and they are good self-care behaviours.

The thing about culture is that we can often be sucked into thinking that the way we do things is the way things are meant to be done. So we should look at whether we’re buying into the modern high-stress culture, and consider whether we should make some changes to our lives. Maybe it’s time to go ‘primitive’, and live healthier lives?

A recent study (cited here) questions whether drug trials assessing antidepressants relate to the people who actually use them. Such trials often involve individuals with more severe depression, who don’t have any other comorbidities. The problem is this isn’t often who the drugs end up getting prescribed for:

After assessing 2,855 patients treated with citalopram, a commonly prescribed selective serotonin reuptake inhibitor for mood disorders, study authors concluded that fewer than one in four, or 22.2 percent, of the patients met the usual criteria for inclusion in phase III antidepressant trials.

So hopefully this research will lead to more trials being done on a more representative sample, so people can be more informed about how effective different drugs are for a more general population. The lesson for Doctors – and anyone looking up research – is to be aware of who are in the drug trials, and whether this is generalizable to other people. Because antidepressants are effective for some people, but it’s important to know who those people are.

Continuing on from the previous post, we look at some research performed by the positive psychology movement. One of their main areas of research is how to make yourself happier. One study (which is summarized in the latter half of this document) looked at the effectiveness of internet based interventions on happiness.

People did a number of activities online, and their happiness and depression was measured over the next six months. For a lot of the exercises, happiness went up (and depression went down) immediately after the activities, but then returned to normal over the next few months. However, for two activities, there was an increase every each month for six months.

The two that caused an increase in happiness over the six months were: ‘using signature strengths’, and ‘three good things’. These were as follows:

  • Three good things in life. Each night, people would write down three things that went well in the day, and write down an explanation for why this had happened.
  • Using signature strengths in a new way. People took an online test to identify character strengths.  They received information about their top five strengths, and were asked to use one of these strengths in a new way each day for a week. (The online test can be found here – free registration required)

(Note, the increase in happiness was greater for people who continued these activities for longer than the week.)

So there you have it. Two ways that have been scientifically shown to improve happiness. So here’s a challenge for you. Why not give it a shot? Spend a short time each night for a week doing one of the two activities, and chances are you’ll be happier by the end of the week. What have you got to lose?

A recent article has indicated that TV watching is higher in teenagers who later develop depression (see an article reporting on it here:  TV and depression). Now, there is a temptation to advocate that children shouldn’t watch any TV, but that would be a bit of an over reaction (those who were later diagnosed with depression watched 2.64 hours of TV a day versus 2.28 – that’s only 20 minutes difference) . However, there is wisdom in looking at what we’re watching on TV, why we’re watching it, and how it is affecting us.

TV can be bad for us if we’re using it to consistently escape from reality. TV can be very involving, and offer us a chance to relax, and get away from the stresses of the world – and it is entertaining! This is good, but if we spend too much time on such things, and avoid dealing with issues this can become negative.

TV can also be bad for us if we buy into it’s unrealistic world view. Depending on the shows you watch, the characters portrayed on TV are unvariably attractive, witty, have exciting lives filled with action and romance. If we compare our lives to life on screen we might find ourselves lacking, no matter how worthwhile our own lives actually are. The values that TV can promote may look exciting, but they are often removed from reality.

So, if you tend to watch a lot of TV,  it’s worth a think about it; what effect is TV having on you? Are you using it to escape from reality? Are you buying into unrealistic worldviews? If not, continue to enjoy it, but if so, this could be contributing to depression, and it might be worth changing your mindset, or your habits, or both.

You have probably heard of Cognitive Behavioural Therapy (CBT), a popular form of talking therapy. One study found CBT to be as effective as antidepressants to treat depression, with around half the participants showing recovery (around 80% showing recovery if they’re also on antidepressants – if you want to look up the original study, see here).

A new form of CBT is Mindfulness Based Cognitive Therapy (MBCT), which combines CBT with mindfulness, a concept from eastern meditation practice. CBT is concerned with dealing with changing your thoughts, with the idea that if you can replace negative thoughts with realistic thoughts, this will affect your emotions in a positive manner. Mindfulness is intended to complement this by enabling you to become more aware of what is going on in your mind, and with this perspective you are more able to let negative thoughts come and go without them spiralling downwards.

It may sound a bit mystical, but it has potential. If you’re interested to know more, you could check it out on Wikipedia article, or the MBCT website. If you wanted to try out some mindfulness exercises, I found a couple of exercises on google that look ok: The Virtual Mindfullness Center (a variety of different exercises, follow the links), The meditation site (there’s a lot of advertising and links on this one, I’d just stick with the exercises in the main text).

A new line of therapy, ‘hope therapy’ may be of significant use in treating depression. The aim of therapy is to teach hope. Hope is different to optimism; “If you feel you know how to get what you want out of life, and you have that desire to make that happen, then you have hope.” Hope can be divided into three components:

  • Goals: They have long- and short-term meaningful goals.
  • Ways to reach those goals: A plan or pathway to get there and the ability to seek alternative routes, if needed.
  • Positive self-talk, similar to the little red engine from the children’s book, telling themselves things like “I think I can.”

According to researchers, these skills can be learned, which may help depression. The study found individuals who attended Hope Therapy had increases in self-esteem, life meaning, and anxiety.

There’s an interesting article released by the University of Chicago. Researchers from UIC have identified a particular protein, the Gs alpha protein, that may play a role in depression. The Gs alpha protein “…activates adenylyl cyclase, a link in signal transduction, and is responsible for the action of neurotransmitters such as serotonin.”. Serotonin is a neurotransmitter that has been linked with depression.

While a biological test would measure only one aspect of depression (for most, depression affects multiple domains of their lives), such a test would be useful in quickly evaluating the usefulness of treatments for depression. In an interview, Rasenick said that the test “wouldn’t tell you which [medication] to start, but it would tell you if the one you’re taking is working.”

A BBC health news item about a new study is of interest. It seems that depressed men are less likely to be engaged with their children. Not really a surprise.

The study looked at vocabulary development. The researchers, led by paediatric psychologist James Paulson, surveyed about 5,000 families. When the children were nine months old, 14% of the mothers and 10% of the fathers were clinically depressed. They studied the use of 50 common words and found that children whose fathers were depressed when they were nine months old used an average of 1.5 fewer words than those whose fathers were fine.

This difference might seem small, but is statistically significant.

Men may not be likely to seek help for themselves but when other people who depend on them become affected, that may change the landscape.

James Paulson – Eastern Virginia Medical School

Why do scientists say ‘Its a chemical soup’ so often? Do they think we can’t understand complexity?

Despite that I like the idea in this article that we can get more control over how we feel. Thats pretty important news. A group member brought print-outs of this article along for us to have a look at

New Research Shows That Humans Have More Control Over Their Happiness Than Previously Thought

There is a video of the ABC Show here.

By MICHAEL MENDELSOHN — ABC News

Jan. 11, 2008

What exactly is happening inside the brains of people experiencing joy and happiness?

“It’s a very complicated chemical soup,” explained Dr. Richard Davidson, who has made a life’s work out of studying “happy brains.” His lab at the University of Wisconsin is devoted to understanding how much of our joy level is set at birth, and how much we can control.

Bill WeirWith a skull cap containing 128 sensors, Davidson’s team can watch a subject’s brain respond to a series of photographs, some pleasant, some distressing.

“We can challenge the brain by presenting these emotional images and look to see how you respond to them,” Davidson said.

ABC News’ Bill Weir underwent the test, and by studying the activity in his left prefrontal cortex, Davidson discovered that Weir’s brain was “more positive than not.”

“Now, it doesn’t mean that you don’t have episodes of negative emotion,” he explained. “But those negative emotions don’t linger.”

People with happy brains have their parents to thank, to a certain extent, not only for happy genes, but also for loving childhoods. Studies have shown that angry or critical parents can actually alter a child’s happiness level until it’s set around age 16. But can adults adjust their own feelings of happiness?

Happiness Interventions

Until recently, most research psychologists were more interested in what made people depressed than what made them happy, and pharmaceutical companies have played a crucial role in promoting happiness by developing very successful anti-depressants. But evolving research in a field known as positive psychology is getting people to ask themselves how they can become happier, not through drugs, but by making changes in how they act and think.

“Antidepressants don’t make people happier, they just decrease negative emotions,” says University of California-Riverside psychology professor Dr. Sonja Lyubomirsky. In her new book, “The How of Happiness,” Lyubomirksy argues that as much as 40 percent of our happiness “is left for the intentional activities that we can choose to engage in — the things that we do and think every day of our lives.”

Copyright © 2008 ABC News Internet Ventures

Read the whole article here

Following up on Dr Paul Keedwell, the expert on mood disorders referred to in Is depression good for you?. I found that he has written a book How Sadness Survived: The Evolutionary Basis of Depression in order to help us understand why something that causes so much pain and disability has withstood evolutionary changes and still occurs so commonly.

The truth is that short-term pain can lead to longer-term gain. A recently published follow-up study of depression in Holland – the Netherlands Mental Health Survey and Incidence Study (Nemesis) – used a sample of 165 people with a major depressive episode, and provides some preliminary scientific evidence to suggest that depression is indeed helpful in the longer term. Researchers who were looking for evidence to suggest that depression leaves people chronically disabled were surprised to discover the opposite.

In the Guardian article Upsides of being down he argues that focusing on depression in a purely clinical way is preventing us understanding our susceptibility to it and ignores the good it can bring.

Keedwell is seen here being interviewed about the publication of a meta-analysis that says some SSRI’s are ineffective.

Possibly as result of the study (see Anti-depressants ‘of little use’), there has been a resurgence of interest in the evolutionary basis of depression that is Keedwell’s specialty.

One evolutionary approach argues that the reduced feelings that are the result in depression are the adaptation. Another approach argues that depression itself is an adaptation.

Evolutionary adaptations generally have four characteristics. They;

  • lack heritable variation
  • show evidence of good design
  • are evoked by appropriate triggers
  • fitness is reduced where they are absent

Depression shows none of these characteristics. It is characterized by heritability, recurrence, cognitive impairment, and poor social outcome.

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