Depression Is Too Common to Ignore
Report of a promising new treatment.
Posted Jan 13, 2019
In the United States, some 5-7% of the population is clinically depressed in any given year. Over a lifetime, there are high odds that each of us has been depressed at some point. Sadly for seniors, the likelihood can increase with age.
A new treatment approach that combines mindfulness meditation and aerobic exercise seems promising. In a recent study, 22 clinically diagnosed patients with major depressive disorder were put on a treatment regimen that begins with 30 minutes of mindfulness meditation and is followed by 30 minutes of aerobic exercise. Thirty people without depression symptoms served as a comparison group. In the meditation session, patients were told to focus on the present moment and their slow, deep breathing and exclude all mind-wandering and intrusive thoughts. Exercise was on a treadmill or stationary bicycle.
At the end of eight weeks, patients were assessed again for depression symptoms. Symptoms had decreased on average by 40%. An electrically evoked brain-wave response characteristic of executive control function was notably increased in the clinically depressed group.
As with any illness, an ounce of prevention is worth a pound of cure. In the case of depression, two approaches can help. The first and foremost is to live a life of worthy purpose that gives life meaning and genuine pleasure. It is hard to be depressed when you believe that you make a positive difference in the lives of others. Of course, your efforts will fail from time to time, and people will not always value your efforts on their behalf. But you can take comfort in knowing that you mean well and are on the right track.
The second approach is to avoid the cues that remind you of negative. I have written related posts at an archived site arguing that continual rehearsal of negative emotions, which people do explicitly or implicitly, is the driver of clinical depression. As a neuroscientist, I know that rehearsal of thoughts and feelings strengthens the mediating synapses and circuits. Consciously rehearsing bad events and our depressive response cements depression as a memory in neural circuitry.
So, it would seem important to focus on ways to block the retrieval cues. One solution that sometimes works is to change environments. Even if you don’t know what the depression cues are, you know they can somehow be embedded in the current environment and lifestyle. Maybe the problem is with some of the people you run around with. People who drag you down are not all that hard to spot. Avoid them. Maybe the problem is with your career or work environment, which has saddled you with too many depressing experiences. Staying in that environment assures that depression triggering cues will be encountered again.
It is not always feasible to change dealings with certain people, or the environment or lifestyle. You may not be able to change jobs or careers for economic or other practical reasons. In those cases, it helps to promote recall of happy experiences as a substitute.
Common experience and a great deal of formal research have shown the usefulness of “happy thoughts” as a way to boost positive mood. Here, the trick is to enhance recall of the buried memories of happy experiences. The same neural mechanisms involved in rehearsal and recall of depressing experiences are involved. Triggers that recall happy experiences do so at the expense of triggers that would trigger depressive feelings.
Recent research emphasizes the importance of memory as therapy for depression. Depressed patients were trained to use one or the other of two memory techniques for strengthening the memory of happy events in their lives. Both memorization methods were equally effective when recall was tested right after the training. But a week later, experimenters made a surprise phone call to each patient and asked them to recall the happy thoughts again. This time, clearly better recall occurred in the patients who had used the method-of-loci method. If we can generalize these results, it means that patients can alleviate their depression if they train their brains to be more effective at remembering positive events. Your life should be more satisfying and less depressing when you consciously train your brain to remember the good times.
Alderman, B. L. et al. (2016). MAP training: combining meditation and aerobic exercise reduces depession and rumination while enhancing synchronized brain activity. Transl. Psychiatry. 6(e276). doi: 10.1038/tp.2015.225
Dalgleish, T. et al. (2013). Method-of_Loci as a mnemonic device to facilitate access to self-affirming personal memories for individuals with depression. Clinical Psychological Science. Feb. 12, DOI: 10.1177/21677026112468111.