Depression: It's all in Your Head

Ironically, depression actually is all in your head, since it comes from your brain. Last week was Bell’s annual Let’s Talk campaign for mental health awareness. I think that we should keep the conversation about mental health going, and thought I would share an insight into depression I got from neuroscience. One of the cool things about neuroscience, is that it gives me a window into other people’s head. By understanding how the brain works, I can start to imagine what life might be like for other people and how they might experience things differently. 

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One really cool science article by Dr. Michael Treadway and David Zald proposes that depression might be less about the brain’s ability to experience positive emotions, but instead how much effort the brain is willing to put into seeking them out 1. Like any good scientist, they tested out their theory, and found that people with depression were less able to learn about rewards on a computer game task when making choices 2. The brain uses memories of rewarding and punishing events are used by our brain to decide if we should go into those types of situations again 3. You know how when you think about the last time you hung out with your friends, you feel a little warm and fuzzy from the good time? People with depression appear to not get the warm and fuzzy feeling as strongly, so as a result they tend to be biased to not seek those situations out. Imagine how hard life would be if you could have a great time with your friends, but have difficulty remembering how good it was after the fact?

One very effective treatment for depression is Behavioural Activation 4. Basically, it relies on the fact that the brains of people with depression can still have rewarding experiences, they just might need some extra help with the memory part. If a person with depression has fun experiences repeatedly, it can be easier for their brains to remember the fun and incorporate that information into how they approach the world. Behavioural Activation is a type of NeuroCAM because literally any fun experience could be used to Behaviourally Activate their brains. When I was in the clinical program, I once heard of a client who had a Rollercoaster Prescription, since going on rollercoasters frequently helped him maintain a positive mood (Side note: how is going on rollercoasters that frequently financially feasible? This guy was life-hacking the #studentbudget). His therapist would use different strategies to more or less get him to do fun things, hacking his brain out of depressive episodes.

Next time your inviting a friend with depression to hang out, think about what their brain is going through. They might not be remembering how much fun you guys had last time you hung out, so to their brain it seems rational to decline, even though they might actually have a good time. If they say they want to pass, maybe double check that decision with them. That extra bit of patience could be enough to tip their brain into deciding they should and get their daily dose of Rollercoaster. And to all of the people out there struggling with depression, I got a quote for you from the wise Albus Dumbledore.

"Of course it is happening inside your head, Harry, but why on Earth should that mean that it is not real?"

 

Let’s keep the Let’s Talk Conversation going, and all try to learn a bit more about what’s happening inside other people’s brains. It can make us more kind and understanding people.

 

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What if Behavioural Activation isn't enough? Branch Out has funded research on brain stimulation therapies for kids with depression. Learn More!

How cool would it be if a brain scan could tell us to skip right to the brain stimulation? Learn More!

References

  1. Treadway, M. T., & Zald, D. H. (2011). Reconsidering anhedonia in depression: lessons from translational neuroscience. Neuroscience & Biobehavioral Reviews35(3), 537-555.
  2. Treadway, M. T., Bossaller, N. A., Shelton, R. C., & Zald, D. H. (2012). Effort-based decision-making in major depressive disorder: a translational model of motivational anhedonia. Journal of abnormal psychology121(3), 553.
  3. Johnson, A., van der Meer, M. A., & Redish, A. D. (2007). Integrating hippocampus and striatum in decision-making. Current opinion in neurobiology17(6), 692-697.
  4. Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D., & Gilbody, S. (2014). Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis. PloS one9(6), e100100.