Depression

[dieseltaylor]

I was surprised that research has proven commonsene remedies have a basis - and also shows how ineffective drugs really are:

Practicing positive activities may serve as an effective, low-cost treatment for people suffering from depression, according to researchers at the University of California, Riverside and Duke University Medical Center.

In “Delivering Happiness: Translating Positive Psychology Intervention Research for Treating Major and Minor Depressive Disorders,” a paper that appears in the August 2011 issue of the Journal of Alternative and Complementary Medicine, the team of UCR and Duke psychology, neuroscience and psychopharmacology researchers proposed a new approach for treating depression – Positive Activity Interventions (PAI).

PAIs are intentional activities such as performing acts of kindness, practicing optimism, and counting one’s blessing gleaned from decades of research into how happy and unhappy people are different. This new approach has the potential to benefit depressed individuals who don’t respond to pharmacotherapy or are not able or willing to obtain treatment, is less expensive to administer, is relatively less time-consuming and promises to yield rapid improvement of mood symptoms, holds little to no stigma, and carries no side effects.

More than 16 million U.S. adults – about 8 percent of the population – suffer from either major or chronic depression. About 70 percent of reported cases either do not receive the recommended level of treatment or do not get treated at all, according to the National Institute of Mental Health. Globally, the World Health Organization estimates that depression affects more than 100 million people.

Although antidepressants can be lifesaving for some individuals, initial drug therapy produces full benefits in only 30 percent to 40 percent of patients. Even after trying two to four different drugs, one-third of people will remain depressed.

The research team – Kristin Layous and Joseph Chancellor, graduate students at UC Riverside; Sonja Lyubomirsky, professor of psychology and director of the Positive Psychology Laboratory at UC Riverside; and Lihong Wang, M.D., and P. Murali Doraiswamy, M.B.B.S., FRCP, of Duke University – conducted a rigorous review of previous studies of PAIs, including randomized, controlled interventions with thousands of normal men and women as well as functional MRI scans in people with depressive symptoms.

“Over the last several decades, social psychology studies of flourishing individuals who are happy, optimistic and grateful have produced a lot of new information about the benefits of positive activity interventions on mood and well-being,” Lyubomirsky said.

However, such findings have not yet entered mainstream psychiatric practice.

“Very few psychiatrists collaborate with social scientists and no one in my field ever reads the journals where most happiness studies have been published. It was eye-opening for me as a psychopharmacologist to read this literature,” Doraiswamy said.

Lyubomirsky said that after she and Doraiswamy exchanged notes, “the obvious question that popped up was whether we can tap into the PAI research base to design interventions to galvanize clinically depressed people to move past the point of simply not feeling depressed to the point of flourishing.”

Although the paper found that positive activity interventions are effective in teaching individuals ways to increase their positive thinking, positive affect and positive behaviors, only two studies specifically tested these activities in individuals with mild depression.

In one of these studies, lasting improvements were found for six months. Effective PAIs used in the study included writing letters of gratitude, counting one’s blessings, practicing optimism, performing acts of kindness, meditating on positive feelings toward others, and using one’s signature strengths, all of which can be easily implemented into a daily routine at low cost.

People often underestimate the long-term impact of practicing brief, positive activities, Lyubomirsky said. For example, if a person gets 15 minutes of positive emotions from counting her blessings, she may muster the energy to attend the art class she’d long considered attending, and, while in class, might meet a friend who becomes a companion and confidant for years to come. In this way, even momentary positive feelings can build long-term social, psychological, intellectual, and physical skills and reserves.

The researchers’ review of brain imaging studies also led them to theorize that PAIs may act to boost the dampened reward/pleasure circuit mechanisms and reverse apathy – a key benefit that does not usually arise from treatment with medication alone.

“The positive activities themselves aren’t really new,” said Layous, the paper’s lead author. “After all, humans have been counting their blessings, dreaming optimistically, writing thank you notes, and doing acts of kindness for thousands of years. What’s new is the scientific rigor that researchers have applied to measuring benefits and understanding why they work.”

A major benefit of positive activities is that they are simple to practice and inexpensive to deliver.

“If we’re serious about tackling a problem as large as depression, we should be as concerned about the scalability of our solutions as much as their potency,” Chancellor said,

While PAIs appear to be a potentially promising therapy for mild forms of depression,” Doraiswamy cautioned, “they have not yet been fully studied in people with moderate to severe forms of depression. We need further studies before they can be applied to help such patients."

Kim Jobst, a physician and editor-in-chief of the Journal of Alternative and Complimentary Medicine, said the review provides one location in which to reference all relevant PAI findings to date, and includes recommendations that should prove useful to researchers, clinicians and the public. The journal is devoted to publishing research about novel and unconventional treatment approaches.

More information: Kristin Layous, Joseph Chancellor, Sonja Lyubomirsky, Lihong Wang and P. Murali Doraiswamy. The Journal of Alternative and Complementary Medicine. August 2011, 17(8): 675-683. doi:10.1089/acm.2011.0139.

Provided by University of California, Riverside

I also believe sweaty physical activity is very necessary though that is not mentioned. And this result does come from a fringe area .

[costard]

I also believe sweaty physical activity is very necessary though that is not mentioned.

Endorphin release followed by a good night's sleep: makes sense Diesel.

[Michael Emrys]

It seems to me all too often that psychiatrists approach depression as merely an imbalance of brain chemistry that can be cured with a pill. A lot of time, probably most times, people are depressed because their lives suck...really, really badly. Not to be depressed under those circumstances would mean being out of touch with reality and a more serious form of insanity.

Michael

[Vanir Ausf B]

The effectiveness of anti-depressants is mostly placebo. When you factor that out you typically see a significant difference only in the most severely depressed.

[Affentitten]

Effective treatment of anxiety and depression is never a binary thing. Those who take only the pharma route will tend to show less improvement in the long term. Those who only do some form of therapy ditto. The studies show that those who use the medicines AND undertake therapy leading to more positive life reflections are the ones most likely to come out the other side.

I do think that saying "Gee I should reflect on how lucky I am" as a route to treating chronic depression is so naive as to be a joke.

[Dietrich]

Taking pills (whatever the disorder/disease/symptom) is easier than getting off one's keester and leading a healthfully non-sedentary life. Why go outside (or to the gym) and get all sweaty when one can just take a pill and keep on watching TV?

[Magpie_Oz]

One can lead a perfectly active and healthy life and still suffer depression. Depression doesn't always come from poor body image, Oprah Winfrey and a box of chocolates.

Like Aff says a holistic approach is what is needed. Anti-depressant drugs are not something you take in the morning in a gloom and by lunchtime everything is ****s and giggles, what they give you is a break which, maybe just for a little while, lifts a bit of the burden and lets you get a grip on things a bit better. A pill that says, "it's not that bad mate."

It is not clear if the effect is placebotic or not maybe for some it is but my experience is that drugs can assist the treatment of genuine depression.

[Affentitten]

One can lead a perfectly active and healthy life and still suffer depression.

[Michael Emrys]

[costard]

That'd be against the ebb and with the flow then, Michael. Unless you really want to be swimming out to sea, in which case you'd be better waiting for the ebb and spend the flow paddling about in the shallows.

[Michael Emrys]

Yes, well, the tide has been ebbing for the past 40 years and hasn't turned yet, so I've been getting plenty of exercise.

Michael

[dieseltaylor]

This new approach has the potential to benefit depressed individuals who don’t respond to pharmacotherapy or are not able or willing to obtain treatment, is less expensive to administer, is relatively less time-consuming and promises to yield rapid improvement of mood symptoms, holds little to no stigma, and carries no side effects.

Article

I do think that saying "Gee I should reflect on how lucky I am" as a route to treating chronic depression is so naive as to be a joke.

Affy

Seems almost a non-sequitur.

However I think there is a flipside to depression and the flipside is not laughing gas or anything else it is more to do with society and labelling.

It is a curious fact, acknowledged that being a poor society does not make a misearable society, and that wealthy Western societies are not necessarily happier than poor societies.

I work hard at being happy and actually consider whether things are good or bad for me. Looking at the Sunday papers with pictures of cruises and travel, lovely houses for sale etc are not good. Reading the stupid adulation of "celebrities" etc is not good.

Reading escapist literature, happy films etc is good and been proved to release the feel good chemicals of the brain. I have a huge selection of joke books, I read P G Wodehouse etc.. I have male friends and we meet once a month to hurl insults at each other whilst playing board games. Not a huge thing you might think but relaxing and playing with abstract ideas is good for you.

However to be depressed ! one only has to live and read the newspapers. So in our connected world we can be assailed by guilt and by desire non-stop. To be happy [ier] you need to think of the blessings we have. In some ways all of us here who contribute to the forum are benefitting because we can discuss things to a reasonable level with some intelligent minds. Not something one can do necessarily at work - or more particularly if you are retired/housebound.

Being depressed is the nature surely of any intelligent man as he looks at the mess the world is in. Restricting your bad news inflow, and most particularly how it is presented to you can help.

Anyway enough of my views how about some scientific research - I have not read it but glanced through - it makes sense to me : )

http://lifetwo.com/production/node/20070429-what-makes-people-happy

[Affentitten]

I think you have a misunderstanding of clinical depression. It's not about being sad because you haven't been able to afford a holiday this year. Much of it is to do with far more negative life experiences (like abusive childhood, bullying, bereavement, relationship failure and all the rest) coupled with some chemical imbalance that creates a kind of feedback loop.

[dieseltaylor]

I understand what you are saying Affy. There are many people who have suffered very badly but not all end up the same way. SO whilst I am happy to believe there are chemical and other reasons why people react differently I do wonder what makes the difference. My first wife I think regarded being cheerful as an affront to nature so rationed it very carefully. I did wonder if a drinking regime based solely on Coca-Cola had something to do with it. ...

And does "depression" as an illness actually compound the problem?

I am off to bed now so cannot answer fully however I have been reading some WW2 memoirs which made me wonder about depresssion at the time - or was that all suffering together depression does not seem so bad as some things:

Long after actual hostilities had ceased, lurking dangers remained. For instance, any road used by the Germans was likely to have been mined. One favourite trick was to select a verge where a shell had partially destroyed the macadam surface. The natural thing for a driver to do was to avoid the rough infill and use the opposite verge. Here a big Teller mine was buried, about two feet down. Every wheel that passed over it compressed the soil till sufficient pressure was applied - perhaps weeks later - to actuate the detonator.

I well remember rather idly watching one of the squadron Crusaders following our ACV (Armoured Command Vehicle).The sergeant tank commander was standing up in the open turret. Our vehicle steered round some obstacle, putting its offside wheels on the verge. The tank driver followed. Suddenly the earth under its track erupted with a great explosion, and I saw the sergeant fling his arms up into the air before the tank went over on its side, its shattered track and bogies flying in all directions. Surprisingly, the crew's total injuries comprised one broken arm, two broken legs, cuts, bruises and concussion. I suffered from an attack of cold sweat, realising that we were the last to have passed safely over this hidden menace.

The other real nasties were the S-mines, known, very aptly, as 'debollockers'. They were about the size of soup tins, with a pencil-like projection at the top, and were buried in great numbers with only the tip above ground - that is, they were almost invisible.If anyone was unlucky enough to kick one in passing, the first small explosion hoisted the interior of the mine about two feet into the air, where it exploded, scattering a collection of metal fragments laterally. Nuff said. If you wanted to be a hero, you kept the kicking foot on it, allowing the subsequent explosion to blow that foot off, but sparing the others around you. This was known to have been done.

R.E. Bomb Disposal and mine clearing teams were at work long after the final surrender in Italy, blowing up or rendering safe this ghastly arsenal. To everyone who knew them, they were the real 24-carat gold heroes, facing terrible risks on a daily basis.

[Magpie_Oz]

No science just my experience:

Depression isn't really something that comes from external sources. Reading the news of the starving in Africa might upset you but won't make you clinically depressed per se.

It comes from an inability to deal with a situation that you are confronted with an inability to reconcile your situation in a positive manner - the "feedback loop". Most sufferers talk of being trapped in their situation with no seeming way out.

Being Eore (Winnie the Poo ?) and full of Gloom and Doom doesn't make you depressed or even vulnerable to depression, quite the opposite in fact. The high flyer with everything going their way can find themselves rapidly in a situation they are unable to process when it is all taken away. Mrs Grumpy-Pants is used to feeling glum so she'll just plod along. I guess this is why depression is not really comparable between soci-economic status. A rich person can find themselves just as unable to deal the same as a poor person.

PTSD is linked to depression but is a little different, it is more about not being able to move on from a past situation to the point where it dominates the here and now. You can be fine in general but subject to a past situation dragging you back, "haunted" if you will.

To my mind being in a bad situation, like a field of Jumping Jacks isn't as bad as depression. In the minefield you might get blown up or see your mates die but in either case there is a resolution of the issue there and then, depression on the other hand has no beginning, no end, no obvious cause, and no obvious path to resolution. Think of it as a minefield that can crop up where ever and when ever you go, one that no one else can see and no one can predict or clear.

In the end it is down to the sufferer to work their own way through it. For some people this is beyond them, which is why suicide is sometimes seen as a viable alternative.

[Stalins Organ]

My mother is in the mental health services (Teaching fellow of the Society of Transactional Analysis or something like that!) & reckons that you might as well take any modern pharmacopia you can 'cos it's more likely to help then hinder.

But it's never going to be enough on it's own - it's like a backstop - it can stop you feeling worse, it might give you some confidence even....but ultimately you have to change something to make any real progress.

[Lt Belenko]

I really sad after reading all this.

I thought the thread was going to be on the down turn in the economy. The other type of depression.

[Michael Emrys]

Either one can easily lead to the other.

Michael

[dieseltaylor]

Depression is a highly prevalent disorder associated with reduced social functioning, impaired quality of life, and increased mortality. Music therapy has been used in the treatment of a variety of mental disorders, but its impact on those with depression is unclear.

ANd a few years down the pike it seems there is some corroboration:

http://www.bbc.co.uk/news/health-14345808

At an early age I identified records that I felt were energising - say something by Madness to "add zip the metabolism". Therefore I am not at all surprised thta there is an effect. I think all of us know how much music can play with the emotions - to an incredible degree.

Anyway whilst playing with the subject I found this ...

It is said that music can tame the savage beast, but a music as a prescription for depression? Researchers from Glasgow Caledonian University say yes and are looking at how the emotionally soothing effect of music can help with the treatment of depression and the management of pain.

Scientists are using music psychology as well as audio engineering to determine how music affects emotion. The study is supported by the Engineering and Physical Sciences Research Council (EPSRC).

Music therapy may be developed as new depression treatment.

Researchers are excited as music as a prescription for depression could lead to the development in the use of music for so many healing modalities including regulating a person’s mood. They hope that this will help the development of music-based therapies to treat conditions like depression and pain and even one day doctors using music as a prescription that is designed to suit the needs of an individual.

“The impact of a piece of music on a person goes so much further than thinking that a fast tempo can lift a mood and a slow one can bring it down. Music expresses emotion as a result of many factors,” says audio engineering specialist Dr. Don Knox, project leader.

“These include the tone, structure and other technical characteristics of a piece. Lyrics can have a big impact too. But so can purely subjective factors: where or when you first heard it, whether you associate it with happy or sad events and so on. Our project is the first step towards taking all of these considerations – and the way they interact with each other – on board.”

Scientists had volunteers listen to music then ask the listener to assign each piece a position on a graph. One axis measures the type of feeling that the music communicates; the other measures the intensity or activity level of the music.

“We look at parameters such as rhythm patterns, melodic range, musical intervals, length of phrases, musical pitch and so on,” says Dr Knox. “For example, music falling into a positive category might have a regular rhythm, bright timbre and a fairly steady pitch contour over time. If tempo and loudness increase, for instance, this would place the piece in a more ‘exuberant’ or ‘excited’ region of the graph.”

The ultimate aim is to develop a comprehensive mathematical model that explains music’s ability to communicate different emotions. This could make it possible, within a few years, to develop computer programs which identify pieces of music that will influence a individual’s mood.

“By making it possible to search for music and organize collections according to emotional content, such programs could fundamentally change the way we interact with music,” says Dr Knox.

Which leads to the questions as what is the most depressing tunes/groups, and what actually brightens forumites up?

: )

[Magpie_Oz]

I think your upper and downer music is very much an individual thing. I have some songs which are really uplifting and others that bring back bad memories with no real logical connection.

Roxette for example, lots of real heavy bummers in their music but I find them really enjoyable.

[dieseltaylor]

I rarely listen to lyrics - which does make listening to foreign music easy. In fact it is a positive advantage given some English song lyrics are inane or disagreeable : )

I do wonder if in fact certain tempos actually tune the brain - and it differs slightly between people.

Anyway in the spirit of research and knowing what wrings me out I have just listened to perhaps 100 variants of Bittersweet Symphony. Seriously. And some are very poor and rare few really grab the heart valves. SO in a way it was why were some working and some equally well played just not. I think there must be a certain virtue in live music that can get edited out where purity of sound is seen as more important than the rogue harmonics or whatever they are called.

Results so far suggest:

Violins work wonders

Some female voices are very interesting though technically the recordings suck

The Verve murdered the first version : )

Tempo is very interesting and very sensitive so I am wondering if the relation to the brain/heart beat can make us very acute to what suits us.

A really good artist wrings more from the material [ better than professionals sometimes]

The version that wrings me out***

New stuff:

Singapore version - actually this is probably one of the most emotive with some great voices

chillout version [with overtones of bolero]

http://www.youtube.com/watch?v=ETtEZXusCiA

amazing piano version [ a trifle jazzy at the end]

Clocks by the main man

BTW the "saddest song" gives this

http://www.youtube.com/watch?v=5O62xH4u4Pc

******

Mad World

possibly the most depressing lyrics and song

female good version

funky! version

http://www.youtube.com/watch?v=r3XuaYf_Uic&feature=related

violin

SO having become very depressed or am I sad [!] It is probably very unfortunate that the word sad has to am extent lost its real meaning and now tends to mean socially inadequate. Therefore people. or s0me, equate being sad as being depressed. I wonder if questionnaires actually reinforce the effect.

sad adj (sadder, saddest) 1 feeling unhappy or sorrowful. 2 causing unhappiness • sad news. 3 expressing or suggesting unhappiness • sad music. 4 very bad; deplorable • a sad state. 5 colloq lacking in taste; inspiring ridicule • sad taste in music. sadly adverb 1 in a sad manner. 2 unfortunately; sad to relate. sadness noun.

ETYMOLOGY: Anglo-Saxon sæd weary.

[Magpie_Oz]

And to support your hypothesis that it differs between people, I have listened to all of the examples above and am equally annoyed by all !

All the renditions, while I can recognise undoubted talent, just do not connect with me in anyway.

[dieseltaylor]

Equally annoyed by all!

I Like that - its good to have passion. : )