depression – Psychology and More

Depression Is Poorly Diagnosed and Often Goes Untreated – The New York Times

One of the topics discussed in our Abnormal Psychology class is the merits of general physicians (as opposed to psychiatrists) prescribing psychoactive drugs for psychological disorders.

The NY Times has a good summary of results from a national survey that confirms the prevalence of depression in the general population, but also the low rates of treatment. Conversely, general physicians are treating individuals for depression with antidepressant drugs without administering the simplest of screening measures.

This calls for greater education of physicians about the inpirtance of using the screening before going straight to medication. On the other hand, physicians have incentives to use medication immediately: potential malpractice if the patient does have the disorder and the physician did not treat it, and simply the negative social (and business) implications of refusing to treat a person who insists. It is a complicated issue.

About 8.4 percent of the people interviewed had depression. But of those, only 28.7 percent had received any treatment. At the same time, of those who were treated for depression, only 29.9 percent had screened positive for the disorder. Many people with less serious psychological problems were being treated with antidepressants and other psychiatric medicines.

Source: Depression Is Poorly Diagnosed and Often Goes Untreated – The New York Times

Psychoanalysis and therapy

In Abnormal Psychology this week, we will be discussing psychotherapy. The NY Times has an opinion piece on the process of psychotherapy from the point of view of a patient. He suddenly and without warning has suicidal ideations and obsessive thoughts about hurting his children. His story is about the power of psychoanalysis. Also note that he is a very active participant in his therapy, which is important for successfully navigating the morass of emotions and memories that come to play in abnormal behavior.

I talked with increasing freedom and trust about anything and everything — dreams, memories, doubts, fears — and about matters that had been hiding in closed rooms of my mind.

Link to the article: Psychotherapy as a Kind of Art – NYTimes.com.

Botox, Depression, and Embodiment

In Social Cognition, we read a review article about embodiment – the idea that our cognitions and emotions are influenced by our physiological states. Embodied cognition and emotion research is really in its early stages, but it has a long history – back to Darwin’s studies. Some of these studies (for example, Paul Ekman’s research) indicate that by manipulating our facial muscles to simulate emotions induces the emotional state physiologically and psychologically.

The NY Times has an article on new research that shows greater depression relief among people who had Botox than a saline control injection in their forehead muscles, which are involved in frowning.

I was thinking about this from a social psychological perspective, and believe that at least part of this effect may be a social one. Consider that someone who has a history of depression likely has a social network used to seeing the person depressed. Those individuals may be interacting with the depressed person in ways that reinforce the depression, for example, with pity or sadness (cf. self-fulfilling prophecy). Now consider how those people might respond if the depressed person’s expression has less indicators of depression because of the Botox injections. They may respond to the person with more positive affect and thus lifting the person’s mood.

That proposition has lots of assumptions that I don’t have the time to validate, but it seems plausible on the face.

Link to the NY Times article “Don’t Worry, Get Botox”

[T]hese Botox studies underscore one of the biggest challenges in treating people with depression. [Depressed individuals] might think that the reason they are depressed is that they have little interest in the world or their friends — a mistaken notion that is the result, not the cause, of their depression. They insist that only once they feel better will it make sense for them to rejoin the world, socialize and start smiling. Their therapists would be well advised to challenge their inverted sense of causality and insist that they will start feeling better after they re-engage with the world.

And, I would add to that quote, the world re-engages with them in positive ways.