Article in The Economist June 27th, 2009 - Page 89

A friend recently made me aware of a very interesting article in The Economist.

The hypothesis

Randolph Nesse, a psychologist and researcher in evolutionary medicine at the University of Michigan, likens the relationship between mild and clinical depression to the one between normal to chronic pain.

Dr Nesse’s hypothesis is that, as pain stops you doing damaging physical things, so low mood stops you doing damaging mental ones - in particular, in particlar pursuing unreachable goals. He asserts, that pursuing such goals is a waste of energy and resources. Therefore he argues, there is likely to be an evolved mechanism that recognizes certain goals as unattainable and inhibits their pursuit - and he believes low mood is at least part of that mechanism.

The evidence

In a study published recently by Carsten Wrosch from Concordia University in Montreal he studied depression in teenage girls. They measured the “goal adjustment strategies” of 97 girls aged 15-19 years over the course of 19 months. They asked participants about their ability to disengage with unattainable goals and re-engage with new goals. They also asked them about a range of symptoms associated with depression, and changed over the course of the study.

Study findings

Their conclusion was that those that experienced mild depressive symptoms could indeed disengage from unattainable goals. It also found a remarkable corollary:those women who could disengage from the unattainable, proved less likely to suffer more serious depression in the long run.

Mild depressive symptoms can therefore be seen as a natural part of dealing with failure in young adulthood.

My take on this theory

As I have highlighted many times before, it is so difficult to make conclusive statements about “depression” as the term covers a multitude of conditions. Having said that, my gut tells me that there is something to this theory. I guess that comes from my own personal experience. On each occasion I have experienced a severe depressive episode, it has often been close to a downturn in the economy. I formally worked in recruitment, which is an industry very closely linked to the health of the economy and is also very accountable.

When I began missing my budgets, rather than blaming the economy, I tended to blame myself for not working hard enough. This also would explain why those with perfectionist personality traits are so vulnerable to depression - you can never achieve the goal of perfection.

It also reinforces my belief that when you are depressed you should set “whisker goals”. These are small attainment goals that put you on a path of “wins” that often have a positive impact on self esteem. It is also essential to celebrate these small wins so your brain knows that it is doing something right. A small celebration could be buying yourself a coffee, gelato, chocolate or your favourite magazine.

Your thoughts please?

I would be very interested for others to share their opinion regarding this theory. Please do so by responding to this blog.

Kind Regards

Graeme

www.IamBackFromTheBrink.com

Tags: depression, depression help, depression treatments, goals, rational thinking

With all our medical advances, why is it that the incidence of depression and anxiety is skyrocketing. The World Health Organisation says that depression is the most disabling disease in the Western World today, yet all mental healthcare specialists seem to talk about is “evidence based” treatments such as counselling and anti depressants. Whilst these strategies have been shown to be helpful for some people, if this was really cutting edge advice, why aren’t we seeing the incidence of depression declining or at the very least plateauing. This in no way seeks to imply that medication and psychological counselling don’t have their place in treating depression, just that we are not exploring all the variables

 

Having interviewed thousands of people who have battled with depression, I am convinced that there are some serious issues with the “evidence based” approach to treating depression. These can be summarised as follows:

 

1. The “evidence” is where the money is

Unfortunately clinical trials are very expensive to run so private funding will only be directed towards those areas where “investors” can see a return on investment. In the world of depression treatments, this means that the vast majority of funds are directed towards medication and psychological counselling interventions. This means that important lifestyle strategies such as exercise, emotional support,nutrition, relaxation, and fulfilling work are relatively ignored. Ironically these less discussed strategies can be much less costly to implement.

1. When you’re holding a hammer everything looks like a nail

The vast majority of depression treatment studies are undertaken by doctors or psychologists. Whilst there is nothing wrong with this per se, most of these studies are evaluating areas where they have expertise (which makes sense). This means that the comparisons are often looking in isolation at one drug verses another (or a placebo) or one psychological intervention verses another. Quite often meaningful advancements in areas can come from someone outside the established “paradigms”. I love the story of the little boy who came across rescue workers who had been struggling for 3 hours with sophisticated hydraulic equipment trying to dislodge a truck which had been tightly wedged under an overhead bridge.  After being encouraged to leave the site he quietly said “Why don’t you let down the tyres?”.

1. We are not just DNA

As human beings our bodies and minds are intricately linked. Depression treatments that focus purely on a “biological illness” are seriously limited. Much of the despair that exists in the western world today can be linked to loneliness, family breakdowns, excessive and unfulfilling work, and financial crises. Saying that depression is caused by low levels of serotonin is like saying teen pregnancies are caused by a sperm fertilising an egg – yes, but…. Depression treatments that fail to reconnect us with our passions and purpose are ultimately going to be short lived solutions.

 

What are the right depression treatments?

To find out what works best in managing or overcoming depression, we must ask the people who are living with depression what works best for them. In 2007 I asked just that, and their answers were (in order) exercise, support of family and friends, psychological counselling, fulfilling work, relaxation/meditation, nutrition and medication.

Coincidentally, the Black Dog Institute (BDI) –one of the pre-eminent mood disorder units in the world - also undertook a study directly asking those with depression what helped them most. Although there were some differences in the studies, lifestyle strategies were also shown to be extremely important. One of the authors of the published study, Professor Gordon Parker, who has been practicing psychiatry for over 30 years, has now started advising General Practitioners and their patients to exercise regularly to aid recovery.

 

If Professor Parker, who has published over 600 clinical papers and book chapters regarding mood disorders, can learn something from these results, perhaps we all can.  

Tags: back from the brink, depression anxiety, depression help, depression research, depression treatments, exercise and depression