Johns Hopkins Health Alerts | Depression and Anxiety |
Depression Study 1: Mild Sadness Can Trigger Depression Relapse
People who recover from major depression may experience marked sensitivity to emotional stress, raising the risk of falling back into dysfunctional and depressive thought patterns, according to a Canadian study. Even mild negative moods can reactivate the thinking styles associated with depression and may predict the recurrence of major depression.
The study, which was reported in the Archives of General Psychiatry (Volume 63, page 749), had two phases:
- Phase 1 -- Investigators enrolled 301 patients, age 18–65, with a diagnosis of major depression. Participants were randomly assigned to receive treatment for six months with an antidepressant drug or weekly cognitive-behavioral therapy (CBT) sessions.
Phase 2 -- 99 patients who had recovered from their depression were exposed to melancholy music and asked to recall a time in their lives when they felt sad, as a means of provoking a sad mood. Patients who received drug therapy were more likely to fall into negative thinking patterns as a result of their sad mood, compared with those who had undergone CBT. The greater the reactivation of dysfunctional thinking, the more likely the patient was to relapse into major depression over the next 18 months. To prevent depression relapses, it is vital to teach people skills to monitor and recognize dysfunctional thinking when they’re feeling down and then inhibit or disengage from such thoughts.
Depression Study 2: Five Years of Depression Research
A review of developments in depression research over the past five years suggests that, despite the availability of effective treatments, depression among adults remains a common and often untreated condition.
Medications remain the mainstay of depression treatment and the most likely choice for most depressed patients, because they are effective and readily available, with benefits that outweigh the potential for an increase in suicidal thoughts or withdrawal problems.
Electroconvulsive therapy has proven the most effective treatment for depression but, because it involves general anesthesia and may cause memory loss, it is typically only used when depression is treatment resistant, psychotic symptoms such as delusions are present, medication has failed, or a patient is acutely suicidal.
Depression has been linked to cognitive impairment -- compromised ability to process information, remember things, and maintain mental flexibility. Magnetic resonance imaging (MRI) scans show that the size of a part of the brain known as the hippocampus is reduced in people with major depression and that antidepressant medications may reverse these changes. MRI studies further show that people with depression have abnormally high activity levels in emotion-related areas of the brain and decreased activity in cognition-related regions. This data was reported in The Lancet (Volume 367, page 153).
Johns Hopkins Health Alerts | Depression and Anxiety |
