What Brain Modules Can Say about Depression
Whether or not cognitive behavior therapy (CBT) will help a person recover from depression can be predicted through brain imaging, according to research results published by the University of Pittsburgh School of Medicine in the April issue of the American Journal of Psychiatry, the official journal of the American Psychiatric Association.
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Method: fMRI. Participants saw emotional words and were asked if the words applied to them. Nine of the depressed participants had decreased activity in the subgenual cingulate cortex after they read negative words in this task. Seven of these recovered after CBT. Another five depressed participants showed no such decreased activity in the subgenual cingulate cortex. Only one of these recovered after CBT.
Lead researcher: Dr. Greg J. Siegle (assistant professor of psychiatry, University of Pittsburgh School of Medicine).
A key player here was the amygdala. People who showed increased activity there after reading the negative words tended to show better recovery. The amygdala is vigilant to emotional stimuli.
The back story on this is that one common problem depressed people have is that they persist in unfavorable thoughts about themselves. In response to that symptom, cognitive behavioral therapy teaches techniques to stop it. Dr. Siegle suggests that some depression occurs because “the amygdala doesn't turn off as fast as it should after it recognizes something as being negative. The subgenual cingulate cortex regulates emotions and plays a part in turning the amygdala on and off. If the amygdala doesn't get 'turned off' in a person with depression, when exposed to negative information, the person may ruminate, going over this information again and again.”
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My comments. This research has direct implication for diagnosis and treatment. The number of subjects is small, so a larger N is needed. But the logic makes very good sense. There is another module playing in this story. The route to distress was the language system. The researchers used it to initiate the brain activity. And it may have been playing a role in that rumination Dr. Siegle mentioned. It certainly played a role in the CBT. Or perhaps two roles. The instructions in CBT had to go through the language system. And the instructions were evidently directed at suppressing the rumination that probably involved the language system.
I find several ideas here that deserve elaboration. One is “How to talk yourself into depression.” Another is “Can we sue the nightly news for making us depressed?” A third is, “A funny thing happened on the way to depression.” But I will leave them as unfinished tasks. That’s not a symptom of AD/HD because I am grown up.
Meanwhile, it may be interesting to consider how such methods as meditation, prayer, chanting, and the like would affect that troublesome rumination that so agitated the amydalas in these patients.
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Method: fMRI. Participants saw emotional words and were asked if the words applied to them. Nine of the depressed participants had decreased activity in the subgenual cingulate cortex after they read negative words in this task. Seven of these recovered after CBT. Another five depressed participants showed no such decreased activity in the subgenual cingulate cortex. Only one of these recovered after CBT.
Lead researcher: Dr. Greg J. Siegle (assistant professor of psychiatry, University of Pittsburgh School of Medicine).
A key player here was the amygdala. People who showed increased activity there after reading the negative words tended to show better recovery. The amygdala is vigilant to emotional stimuli.
The back story on this is that one common problem depressed people have is that they persist in unfavorable thoughts about themselves. In response to that symptom, cognitive behavioral therapy teaches techniques to stop it. Dr. Siegle suggests that some depression occurs because “the amygdala doesn't turn off as fast as it should after it recognizes something as being negative. The subgenual cingulate cortex regulates emotions and plays a part in turning the amygdala on and off. If the amygdala doesn't get 'turned off' in a person with depression, when exposed to negative information, the person may ruminate, going over this information again and again.”
---
My comments. This research has direct implication for diagnosis and treatment. The number of subjects is small, so a larger N is needed. But the logic makes very good sense. There is another module playing in this story. The route to distress was the language system. The researchers used it to initiate the brain activity. And it may have been playing a role in that rumination Dr. Siegle mentioned. It certainly played a role in the CBT. Or perhaps two roles. The instructions in CBT had to go through the language system. And the instructions were evidently directed at suppressing the rumination that probably involved the language system.
I find several ideas here that deserve elaboration. One is “How to talk yourself into depression.” Another is “Can we sue the nightly news for making us depressed?” A third is, “A funny thing happened on the way to depression.” But I will leave them as unfinished tasks. That’s not a symptom of AD/HD because I am grown up.
Meanwhile, it may be interesting to consider how such methods as meditation, prayer, chanting, and the like would affect that troublesome rumination that so agitated the amydalas in these patients.
posted by Selby Evans at 9:15 AM
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