Friday, August 22, 2008

Depression Patients’ Brain Circuitry Makes Them Vulnerable to Relapse

"Using brain imaging, NIMH researchers have produced direct evidence that people prone to depression -- even when they're feeling well -- have abnormal mood-regulating brain circuitry. This makes them vulnerable to relapse when levels of certain key brain chemical messengers plummet.

To test this directly and identify any brain circuit abnormalities, the researchers studied 15 un-medicated subjects in remission who had a history of depression by giving them a drug that temporarily depleted their brains of dopamine and norepinephrine.

These subjects experienced an increase in depression symptoms and a decrease in the ability to feel pleasure. PET scans showed that this was accompanied by an increase in activity in a depression-implicated brain circuit. By contrast, activity decreased or remained unchanged in the same brain circuit with depletion in 13 healthy participants who experienced only minor mood effects. Activity in specific brain structures in the circuit corresponded with a set of mood effects (see graphics below)."

This offers some evidence of why there is such a high relapse rate in depressed individuals. However, there are many studies that show while therapy and medications are about equally effective treatments, that there is a high relapse for those receiving meds only, if they discontinue the meds. Those receiving therapy, have a much lower relapse rate.

This is further evidence that depression is a bio-psycho-social disorder (generally has biological, psychological, and social factors) and that effective psychological interventions ALSO positively effect one's biology. The reality is that the psyche affects the soma, the psychological effects the biological, or the mental effects the physical. In other words, there is an endless loop where both effect the other.

Best wishes,

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