An intriguing question in the field of stress is what makes an individual more likely to be susceptible or resilient to stress‐induced depression. Predisposition to stress susceptibility is believed to be influenced by genetic factors and early adversity. However, beyond genetics and life experiences, recent evidence has highlighted social rank as a key determinant of susceptibility to stress, underscoring dominant individuals as the vulnerable ones. This evidence is in conflict with epidemiological, clinical, and animal work (...) pointing at a link between social subordination and depression. Here, we review and analyze rodent protocols addressing the relevance of social rank to predict vulnerability to chronic social stress. We also discuss whether a specific social status (i.e., dominance or subordination) is the appropriate predictor of vulnerability to develop stress‐induced depression or rather, the loss of social rank and resources. (shrink)

BackgroundExposure to early life stress is alarmingly prevalent and has been linked to the high rates of depression documented in adolescence. Researchers have theorized that ELS may increase adolescents’ vulnerability or reactivity to the effects of subsequent stressors, placing them at higher risk for developing symptoms of depression.MethodsWe tested this formulation in a longitudinal study by assessing levels of stress and depression during the COVID-19 pandemic in a sample of adolescents from the San Francisco Bay (...) Area who had been characterized 3–7 years earlier with respect to exposure to ELS and symptoms of depression.ResultsAs expected, severity of ELS predicted levels of depressive symptoms during the pandemic [r = 0.26, p = 0.006], which were higher in females than in males [t = −3.56, p < 0.001]. Importantly, the association between ELS and depression was mediated by adolescents’ reported levels of stress, even after controlling for demographic variables.ConclusionsThese findings underscore the importance of monitoring the mental health of vulnerable children and adolescents during this pandemic and targeting perceived stress in high-risk youth. (shrink)

Aversive experiences have been thought to provoke or exacerbate clinical depression. The present review provides a brief survey of the stress-depression literature and suggests that the effects of stressful experiences on affective state may be related to depletion of several neurotransmitters, including norepinephrine, dopamine, and serotonin. A major element in determining the neurochemical changes is the organism's ability to cope with the aversive stimuli through behavioral means. Aversive experiences give rise to behavioral attempts to cope with the (...) stressor, coupled with increased utilization and synthesis of brain amines to contend with environmental demands. When behavioral coping is possible, neurochemical systems are not overly taxed, and behavioral pathology will not ensue. However, when there can be no behavioral control over the stressful stimuli, or when the aversive experience is perceived as uncontrollable, increased emphasis is placed on coping through endogenous neurochemical mechanisms. Amine utilization increases appreciably and may exceed synthesis, resulting in a net reduction of amine stores, which in turn promotes or exacerbates affective disorder. The processes governing the depletions may be subject to sensitization or conditioning, such that exposure to traumatic experiences may have long-term repercussions when the organism subsequently encounters related stressful stimuli. With continued uncontrollable stimulation, adaptation occurs in the form of increased activity of synthetic enzymes, and levels of amines approach basal values. It is suggested that either the initial amine depletion provoked by aversive experiences or a dysfunction of the adaptive processes, resulting in persistent amine depletion, contributes to behavioral depression. Aside from the contribution of behavioral coping, several organismic, experiential, and environmental variables will influence the effects of aversive experiences on neurochemical activity, and may thus influence vulnerability to depression. (shrink)

Physiologically accurate mouse models of cancer are critical in the pre‐clinical development of novel cancer therapies. However, current standardized animal‐housing temperatures elicit chronic cold‐associated stress in mice, which is further increased in the presence of tumor. This cold‐stress significantly impacts experimental outcomes. Data from our lab and others suggest standard housing fundamentally alters murine physiology, and this can produce altered immune baselines in tumor and other disease models. Researchers may thus underestimate the efficacy of therapies that are benefitted (...) by immune responses. A potential mediator, norepinephrine, also underlies stress pathways common in mice and humans. Therefore, research into mechanisms connecting cold‐stress and norepinephrine signaling with immune depression in mice could highlight new combination therapies for humans to simultaneously target stress while stimulating anti‐tumor immunity. (shrink)

To examine the cultural limitations and implications in the applicability of the Depression Anxiety Stress Scale 8-items —a shortened version of the DASS-21 recently introduced in an Arab sample—this study evaluated its psychometric properties, including measurement invariance, among healthy subjects from the United States, Australia, and Ghana. Confirmatory factor analysis revealed good fit of the DASS-8 relative to a 12-item version. Both the DASS-8 and the DASS-12 were invariant at all levels across genders, employment status, and students vs. (...) non-students. The DASS-8/DASS-12 also expressed invariance at the configural and metric levels across all countries, albeit scalar invariance was not maintained due to misspecification of the factor loadings in the Ghanian sample. Mann–Whitney U test revealed significantly lower levels of mental symptomatology on the DASS measures among Ghanian students than in English-speaking respondents. The DASS-8 expressed excellent internal consistency, good convergent validity—noted by high values of item-total correlations, good predictive validity—indicated by significantly strong correlation with the DASS-21 and its subscales, and adequate discriminant validity—indicated by heterotrait–monotrait ratio of correlations <0.85. The DASS-8 correlated with the Internet Gaming Disorder-9, the Adult attention-deficit/hyperactivity disorder Self-Report Scale, and the Individualism and Collectivism Scale/Culture Orientation Scale at the same level as the DASS-21 and the DASS-12, denoting its adequate criterion validity. The DASS-8 can be used as a brief alternative to the DASS-21 to screen for mental symptomatology in English-speaking and African cultures. However, the same scores on the DASS-8 and the DASS-12 may not always indicate the same level of symptom severity in subjects from different countries. Further inter-cultural evaluations of the DASS-8 are needed. (shrink)

The environmental complexity in which living organisms found themselves throughout evolution, most likely resulted in various encounters that would continuously challenge the organisms' ability to survive. Coping with this stress can prove energetically demanding and might require the proper coupling between mechanisms aimed at sensing external stimuli and cellular strategies geared at producing energy. In this issue of BioEssays, Lovejoy and Hogg hypothesize that preservation of this bifaceted coupling can be detected by the maintenance and evolution of stress (...) response mechanisms at the genomic, molecular and cellular levels. Through ancestry‐tracking, they identify a group of related G protein‐coupled receptor systems with intersecting stress‐modulating properties which might represent an essential part of a complex organism's coping mechanisms to stress, an attribute that they suspect may be affected in individuals suffering from mood disorders such as depression. (shrink)

Major depression is a disorder of the mind caused by dysfunction of both the body and the brain. Because it is a psychiatric illness and psychiatry is a branch of medicine, the question of how mind and body interact in depression should be treated as a medical rather than metaphysical mind-body problem. The relation between mind and body as it pertains to this illness should be construed in teleological rather than causal terms. Mental states like beliefs and emotions (...) serve an adaptive purpose by constraining the physiologic systems involved in the body's stress response, thus preserving homeostasis and protecting us from various disorders. Depression results when the mind fails it its constraining role. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.3 (2002) 255-259 [Access article in PDF] On the Evolution of Depression Mike W. Martin Keywords: Depression, morality, mental disorders, psychobiology, evolutionary psychiatry. In "Depression as a Mind-Body Problem," Walter Glannon outlines a psychosocial-physiological explanation of depression as a psychological response to chronic stress—today, especially social stress—in which cortisol imbalances disrupt neurotransmitters. Accordingly, treatment for depression should combine (...) psychopharmacology and psychotherapy—a valuable reminder in light of the current restrictions on funding for health care (Hobson and Leonard 2001). My comments focus, however, on Glannon's objections to evolutionary theorists who explain our capacity for depression as adaptive to the natural and social environment. His objections are implausible because he fails to distinguish depression as a mood and a disorder. What Is Depression? Explaining the psychology, sociology, physiology, and evolution of depression presupposes knowing what depression is and hence what is being explained. As a blunt but important distinction, let us contrast depression as a mood and as a mood disorder.As a mood, depression is a state of low spirits, typically involving painful and low affect (of a kind needing further specification). Not all negative low moods are depressions. It is notoriously difficult to distinguish depression from grief, sadness, gloom, and a host of additional ways to feel down—especially because today many people use "I'm depressed" as a blanket expression for virtually any low mood. For the purposes of this paper, it is not necessary to attempt a full-blown analysis of depressed moods (and emotions). I would emphasize, however, that depressed moods involve values. They involve negative evaluations of ourselves, major events in our lives, life in its entirety, or the values that have been guiding us. Typically, to be depressed is to experience such things as feelings of worthlessness, dejection about failures, despair and hopelessness, and loss of caring and commitment. Thus, we might be sad or grieving but not depressed because we retain a solid grip on what is valuable and worthwhile. In any case, there should be no general presumption that depressed moods are all bad or undesirable. Instead, we should be prepared to appreciate the importance of depressed moods in connection with questions of value, identity, and even moral insight (Martin 2000). Depressed persons are not necessarily sick.In contrast, depression as a mood disorder is, by definition, pathologic. Moreover, usually it is not a depressed mood, although it involves depressed moods. On the one hand, depression as a disorder is defined as pathologic, a notion that is itself understood in terms of values—the values of health and, indirectly, moral values that define what is culturally acceptable. Thus, even severe [End Page 255] grief can be nonpathologic, even though it involves depressed moods, when it is within the range of "culturally-sanctioned responses" (APA 2000, xxxi). On the other hand, only sometimes is depression a single pathologic mood, as in major depressive episodes that can strike with a terrifying and suicidal severity (APA 2000, 375). Usually, however, the pathology is not a single depressed mood, but instead a longer-term state involving recurring depressed moods and additional features, such as poor concentration, insomnia, poor appetite or overeating, and so on. For some purposes, such as research funding and billing insurance companies and government health providers, these pathologies can be equated with what is currently in the DSM. Yet, there are many additional states of suboptimal health, in which the DSM criteria are only partly met.What does Glannon mean by depression? He does not define it, but he makes it perfectly clear that he intends depression as a disorder. Or rather, it is a set of mental disorders, including the "depressive disorders" of major depressive disorder, dysthymic disorder, depressive disorder not otherwise specified, and a variety of bipolar disorders and some anxiety disorders. Glannon sometimes indicates his primary topic is "severe depression," which of course is not a DSM category (nor always a mark of pathology). For the most part, however, he says his topic is "chronic depression," which might suggest dysthymia, "a chronically depressed mood for most of... (shrink)

This study aimed to define the psychological markers for future development of depression symptoms following the lockdown caused by the COVID-19 outbreak. Based on previous studies, we focused on loneliness, intolerance of uncertainty and emotion estimation biases as potential predictors of elevated depression levels. During the general lockdown in April 2020, 551 participants reported their psychological health by means of various online questionnaires and an implicit task. Out of these participants, 129 took part in a second phase in (...) June 2020. Subjective loneliness during the lockdown rather than objective isolation was the strongest predictor of symptoms of depression 5 weeks later. Younger age and health related worry also predicted higher non-clinical levels of depression and emotional distress. The results support the diathesis-stress model, which posits that a combination of preexisting vulnerabilities along with stressors such as negative life events are among the factors affecting the development of psychopathology. Moreover, our results correspond with those of previous studies conducted worldwide during the COVID-19 pandemic. Taken together, these findings call for focusing on psychological factors, especially among younger people, to identify individuals at risk for future development of depression and to promote new strategies for prevention. (shrink)

We propose the “microbiota‐inflammasome” hypothesis of major depressive disorder (MDD, a mental illness affecting the way a person feels and thinks, characterized by long‐lasting feelings of sadness). We hypothesize that pathological shifts in gut microbiota composition (dysbiosis) caused by stress and gut conditions result in the upregulation of pro‐inflammatory pathways mediated by the Nod‐like receptors family pyrin domain containing 3 (NLRP3) inflammasome (an intracellular platform involved in the activation of inflammatory processes). This upregulation exacerbates depressive symptomatology and further compounds (...) gut dysbiosis. In this review we describe MDD/chronic stress‐induced changes in: 1) NLRP3 inflammasome; 2) gut microbiota; and 3) metabolic pathways; and how inflammasome signaling may affect depressive‐like behavior and gut microbiota composition. The implication is that novel therapeutic strategies could emerge for MDD and co‐morbid conditions. A number of testable predictions surface from this microbiota‐gut‐inflammasome‐brain hypothesis of MDD, using approaches that modulate gut microbiota composition via inflammasome modulation, fecal microbiota transplantation, psychobiotics supplementation, or dietary change. (shrink)

Working parents in are struggling to balance the demands of their occupation with those of childcare and homeschooling during the COVID-19 pandemic. Moreover, studies show that women are shouldering more of the burden and reporting greater levels of psychological distress, anxiety, and depression relative to men. However, research has yet to show that increases in psychological symptoms are linked to changes in stress during the pandemic. Herein, we conduct a small-N study to explore the associations between stress (...) and psychological symptoms during the pandemic among mothers using structural equation modeling, namely latent change score models. Thirty-three mothers completed questionnaires reporting current anxious and depressive symptoms, as well as stressful life experiences prior to-versus during the pandemic. Women endorsed significantly more stressful events during the pandemic, relative to the pre-pandemic period. Additionally, 58% of mothers scored as moderate-to-high risk for developing a stress-related physical illness in the near future because of their pandemic-level stress. Depressive symptoms were associated with the degree of change in life stress, whereas anxiety symptoms were more related to pre-pandemic levels of stress. The present study preliminarily sheds light on the nuanced antecedents to mothers’ experiences of anxious and depressive symptoms during the COVID-19 pandemic. Although further work is needed in larger, more diverse samples of mothers, this study highlights the potential need for appropriate policies, and prevention and intervention programs to ameliorate the effects of pandemics on mothers’ mental health. (shrink)

The aim of our study was to verify relationships between individual difficulties in emotion regulation (ER), ER strategies (cognitive reappraisal and expressive suppression), and compassion (to self and others) with the presence of depressive symptomatology in a sample of Slovak adolescents during the second wave of the COVID-19 pandemic. In the sample of 140 Slovak adolescents (age between 17–19 years) was administrated The Beck Depression Inventory- II. (Beck et al., 1996), The Overall Depression Severity and Impairment Scale (Bentley (...) et al., 2014), The Emotion Regulation Questionnaire (Gross & John, 2003), The Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), The Sussex-Oxford Compassion for the Self Scale and The Sussex-Oxford Compassion for Others Scale (Gu et al., 2019). Results revealed that difficulties in ER (all subscales) and expressive suppression were in positive relationships with depression symptoms. Cognitive reappraisal and self-compassion were in negative relationships with depression symptoms. Lack of ER strategies and cognitive reappraisal (inversely) were the strongest predictors of depressive symptoms. These findings suggest that ER strategies (mainly cognitive reappraisal) could be assumed as protective factors in adolescent depression symptoms development in stressful circumstances of the COVID-19 pandemic. (shrink)

“Postnatal depression” denotes the syndrome of dysphoria, debility, and anxiety that follows childbirth in about 10–20% of women (as variously estimated). Its etiology is seen to be lodged in a variety of psychosocial as well as biological factors, among which the isolating and pressured culture of contemporary society (especially for women/mothers) is commonly singled out as a powerful precipitator. This view is extended here through the evolutionary perspective which casts maternal distress as a set of adaptive responses with the (...) function, in ancestral environments, of soliciting support for a mother who feels that her maternal responsiveness may be threatened. As continuous caretaking of the infant is the active expression of evolved maternal responsiveness, departures from this pattern result in anxiety and distress that seek resolution. Manifestations of maternal distress in contemporary society are dysfunctional, however, since the present social structure does not provide spontaneous and immediate support that can spring forth within small, closely knit social units. Furthermore, for present-day mothers distress is self-perpetuating since the ingrained tendency toward continuing responsiveness rarely finds practical expression and is thus converted into anxious vigilance and depression. This view generates the hypothesis that the emotional and cognitive contents of maternal vigilance are associated with the needs of the infant and will therefore be focused on crying and feeding. A number of qualitative studies of women’s experiences during the postpartum bear out this prediction and support the feasibility of the evolutionary hypothesis of “postnatal depression” as a set of adaptive responses, now out of place in a novel environment. (shrink)

Transient global amnesia is a benign memory disorder with etiologies that have been debated for a long time. The prevalence of stressful events before a TGA attack makes it hard to overlook these precipitating factors, given that stress has the potential to organically effect the brain. Cortical spreading depression was proposed as a possible cause decades ago. Being a regional phenomenon, CSD seems to affect every aspect of the micro-mechanism in maintaining the homeostasis of the central nervous system. (...) Corresponding evidence regarding hemodynamic and morphological changes from TGA and CSD have been accumulated separately, but the resemblance between the two has not been systematically explored so far, which is surprising especially considering that CSD had been confirmed to cause secondary damage in the human brain. Thus, by deeply delving into the anatomic and electrophysiological properties of the CNS, the CSD-TGA model may render insights into the basic pathophysiology behind the façade of the enigmatic clinical presentation. (shrink)

ObjectiveThe study is an explorative investigation aimed to assess the differences in acute stress response patterns of health workers facing coronavirus disease 2019 (COVID-19) during Italy’s first lockdown.MethodsA cross-sectional investigation using convenience sampling method was conducted in Italy during April 2020. Eight hundred fifty-eight health workers participated in the research filling out self-report measures including Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), and Impact of Event Scale–Revised (IES-R).ResultsModerate/severe depression was found in 28.9% (95% (...) CI, 25.8–32.04), moderate/severe anxiety in 55.4% (95% CI, 51.9–58.8), insomnia in 15% (95% CI, 12.5–17.5), and distress in 52.5% (95% CI, 48.5%–56.6) of participants. The 3% of health workers reported frequent suicidal thoughts. Female sex, working for >15 h/week in a COVID-19 unit, and living apart from family were associated with a significantly higher risk of distress, anxiety, insomnia, depression, and functional impairment. Four profiles were identified on the basis of psychopathological measures: Profile_0 included 44% (N= 270); Profile_1, 25.6% (N= 157); Profile_2, 19.1% (N= 117); and Profile_3, 11.3% (N= 69) of participants. Results showed a significant effect for Profiles X IES-R (η2= 0.079;f= 0.29), indicating that in all profiles, except for Profile_0, avoidance scale is lower than hyperarousal and intrusion symptoms scales of the IES-R. This characteristic could be a probable index of the control exerted by the responders to not fly away from their job.ConclusionThe identification of specific profiles could help psychiatrists and emergency psychologists to build specific interventions in terms of both primary and secondary prevention to face future waves of the COVID-19 outbreak. (shrink)

Aversive experiences have been thought to provoke or exacerbate clinical depression. The present review provides a brief survey of the stress-depression literature and suggests that the effects of stressful experiences on affective state may be related to depletion of several neurotransmitters, including norepinephrine, dopamine, and serotonin. A major element in determining the neurochemical changes is the organism's ability to cope with the aversive stimuli through behavioral means. Aversive experiences give rise to behavioral attempts to cope with the (...) stressor, coupled with increased utilization and synthesis of brain amines to contend with environmental demands. When behavioral coping is possible, neurochemical systems are not overly taxed, and behavioral pathology will not ensue. However, when there can be no behavioral control over the stressful stimuli, or when the aversive experience is perceived as uncontrollable, increased emphasis is placed on coping through endogenous neurochemical mechanisms. Amine utilization increases appreciably and may exceed synthesis, resulting in a net reduction of amine stores, which in turn promotes or exacerbates affective disorder. The processes governing the depletions may be subject to sensitization or conditioning, such that exposure to traumatic experiences may have long-term repercussions when the organism subsequently encounters related stressful stimuli. With continued uncontrollable stimulation, adaptation occurs in the form of increased activity of synthetic enzymes, and levels of amines approach basal values. It is suggested that either the initial amine depletion provoked by aversive experiences or a dysfunction of the adaptive processes, resulting in persistent amine depletion, contributes to behavioral depression. Aside from the contribution of behavioral coping, several organismic, experiential, and environmental variables will influence the effects of aversive experiences on neurochemical activity, and may thus influence vulnerability to depression. (shrink)

The emerging field of lipidomics has identified lipids as key players in disease physiology. Their physicochemical diversity allows precise control of cell structure and signaling events through modulation of membrane properties and trafficking of proteins. As such, lipids are important regulators of brain function and have been implicated in neurodegenerative and mood disorders. Importantly, environmental chronic stress has been associated with anxiety and depression and its exposure in rodents has been extensively used as a model to study these (...) diseases. With the accessibility to modern mass‐spectrometry lipidomic platforms, it is now possible to snapshot the extensively interconnected lipid network. Here, we review the fundamentals of lipid biology and outline a framework for the interpretation of lipidomic studies as a new approach to study brain pathophysiology. Thus, lipid profiling provides an exciting avenue for the identification of disease signatures with important implications for diagnosis and treatment of mood disorders. (shrink)

IntroductionIndividuals with high scores of perceived stress are more likely to develop arterial hypertension than those with low levels of stress. In addition to this, AH and stress are both independent risk factors for executive function impairment and worse quality of life. Therefore, strategies to control and cope with emotional stress are of paramount importance. However, less is known about the association of PS with EF, QoL, and coping in individuals with hypertension. This study aimed to (...) evaluate the association of PS with EF performance, coping strategies use, and QoL in a sample of hypertensive patients.MethodsWe assessed a group of 45 hypertensive individuals. The EF evaluation was: Frontal Assessment Battery; Controlled Oral Word Association Test—FAS; Letter-Number Sequencing subtest from the Wechsler Adult Intelligence Scale—Third Edition ; Digit Span subtest from the Wechsler Memory Scale-Revised and Wisconsin Card Sorting Test. The type and frequency of coping strategies used were measured by the Brief Coping with Experienced Problems Scale. The World Health Organization Quality of Life Questionnaire Bref was applied to measure QoL. The associations of the PS with EF performance, coping strategies, and QoL were investigated using univariate and multiple linear regression models adjusted for age, sex, education, systolic pressure, and depression symptoms.ResultsIn the multivariate analyses, higher PS was an independent predictor for a lower frequency of emotion-focused strategy use. However, PS was not significantly related to EF and Qol in this sample. The lower the PS, the greater the use of emotion-focused coping.ConclusionHypertensive individuals with high PS use less frequently positive emotion-focused coping strategies. (shrink)

In psychology, stress is a feeling of emotional strain and pressure. Stress is a type of psychological pain. Small amounts of stress may be beneficial, as it can improve athletic performance, motivation and reaction to the environment. Excessive amounts of stress, however, can increase the risk of strokes, heart attacks, ulcers, and mental illnesses such as depression and also aggravation of a pre-existing condition. Psychological stress can be external and related to the environment but (...) may also be caused by internal perceptions that cause an individual to experience anxiety or other negative emotions surrounding a situation, such as pressure, discomfort, etc., which they then deem stressful. (shrink)

ObjectivePost-traumatic stress disorder may affect individuals exposed to adversity. Eye Movement Desensitization and Reprocessing is an evidence-based trauma-focused psychotherapy for PTSD. There is still some debate whether the eye movements are an effective component of EMDR. The primary aim of this study was to investigate the effectiveness of Eye Movement Desensitization treatment in reducing PTSD symptoms compared to a retrieval-only active control condition. We also investigated whether PTSD symptom reduction was associated with reductions in depression and anxiety, and (...) improvements in quality of life.MethodologyAdult PTSD patients were recruited at public psychological services in Jakarta, Bandung and Cimahi, Indonesia. PTSD was diagnosed with the Structured Clinical Interview for DSM-5 disorders. Participants were randomized into: EMD or retrieval-only. EMD consisted of clinical history and treatment planning, preparation, assessment, EMs, closure, whereas retrieval-only consisted of the same elements except EMs. Data were collected at baseline, 1-week post-treatment, 1-month follow-up, and 3-months follow-up. Outcome measures included the PTSD Checklist for DSM-5, Hopkins Symptoms Checklist-25, and the World Health Organization Quality of Life–BREF. Data were analyzed with linear mixed model analysis in R Statistics.ResultsAlthough there were main effects of time indicating reductions for both EMD and retrieval-only in PCL-5 and HSCL-25 scores, and improvements in WHOQoL-BREF scores at T1, T2, and T3, no significant differences in PCL-5, HSCL-25, and WHOQoL-BREF total scores between the EMD and retrieval-only groups at T1, T2, and T3 were found.ConclusionWithin a clinical sample of PTSD patients in Indonesia, both EMD and retrieval-only was associated with reductions in symptoms of PTSD, anxiety and depression, and improvements in quality of life, although EMs did not add to the efficacy of the treatments. Further research to examine the underlying mechanisms of EMDR’s effective treatment elements in clinical samples is needed.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ISRCTN55239132]. (shrink)

Background: Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. Depression affects an estimated one in 15 adults (6.7%) (...) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment and give the appropriate method of treatment through several tips that concern the disease and how to treat it and we will see it through the application on the expert system. Methods: in this paper the design of the proposed Expert System which was produced to help Psychologist in diagnosing depression disease through its symptoms such as: a loss of energy, a change in appetite, sleeping more or less, anxiety, reduced concentration, indecisiveness, restlessness, feelings of worthlessness, guilt or hopelessness and thoughts of self-harm or suicide. The proposed expert system presents an overview about depression disease is given, the cause of diseases is outlined and the treatment of disease whenever possible is given out. SL5 Object Expert System language was used for designing and implementing the proposed expert system. Results: The proposed depression disease diagnosis expert system was evaluated by psychologist students and they were satisfied with its performance. Conclusions: The Proposed expert system is very useful for psychologist, patients with depression and newly graduated psychologist. (shrink)

Much of the literature on impairment to self-governance focuses on cases in which a person either lacks the ability to protect herself from errant urges or cases in which a person lacks the capacity to initiate self-reflective agential processes. This has led to frameworks for thinking about self-governance designed with only the possibility of these sorts of impairments in mind. I challenge this orthodoxy using the case of melancholic depression to show that there is a third way that self-governance (...) can be undermined: an agent may fail to form the desire she most wants to act on. (shrink)

Circadian rhythms in the sleep/wake cycle, along with a range of physiological measures, are severely disrupted in individuals with major depressive disorder (MDD). Moreover, several central circadian genes have been implicated as potential genetic factors underlying the illness through candidate gene studies and some genome wide association studies. However, investigations into the molecular underpinnings of circadian disturbances in the human brain have been quite challenging. In their recent publication, Li and colleagues have used a novel approach to determine the rhythmic (...) patterns of circadian gene expression in several regions of the human brain, and how these patterns are disrupted in MDD. Their findings demonstrate that in healthy subjects, several brain regions outside the suprachiasmatic nucleus (the master clock) exhibit diurnal gene expression patterns that are disrupted in the brains of MDD subjects. These findings will provide the foundation for future studies of gene‐specific drug targets, and biomarkers for the disease. (shrink)

In this paper I offer an alternative phenomenological account of depression as consisting of a degradation of the degree to which one is situated in and attuned to the world. This account contrasts with recent accounts of depression offered by Matthew Ratcliffe and others. Ratcliffe develops an account in which depression is understood in terms of deep moods, or existential feelings, such as guilt or hopelessness. Such moods are capable of limiting the kinds of significance and meaning (...) that one can come across in the world. I argue that Ratcliffe’s account is unnecessarily constrained, making sense of the experience of depression by appealing only to changes in the mode of human existence. Drawing on Merleau-Ponty’s critique of traditional transcendental phenomenology, I show that many cases of severe psychiatric disorders are best understood as changes in the very structure of human existence, rather than changes in the mode of human existence. Working in this vein, I argue that we can make better sense of many first-person reports of the experience of depression by appealing to a loss or degradation of the degree to which one is situated in and attuned to the world, rather than attempting to make sense of depression as a particular mode of being situated and attuned. Finally, I argue that drawing distinctions between disorders of structure and mode will allow us to improve upon the currently heterogeneous categories of disorder offered in the DSM-5. (shrink)

Trolley dilemmas have been used to justify the intuitive appeal of the doctrine of double effect. According to this doctrine, if a good action has a harmful side effect, it is morally acceptable to do it, provided the harmful effect is not intended. However, in some variants of the dilemma, most people are willing to forego this doctrine, thus making responses inconsistent. In this study, 404 university students from the United Arab Emirates (UAE) were presented with 4 versions of the (...) trolley dilemma. Results came out showing that higher levels of depressive symptoms predict greater consistency in adherence (or rejection) to the doctrine of double effect. Likewise, higher levels of depressive symptom predict utilitarian responses to trolley dilemmas. Anxiety symptoms had similar effects, but more moderate. Demographic variables (age, gender) were also assessed as predictors of responses and consistency to trolley scenarios, but no significant effects were found. (shrink)

First-person reports of Major Depressive Disorder reveal that when an individual becomes depressed a profound change or ‘shift’ to one’s conscious experience occurs. The depressed person reports that something fundamental to their experience has been disturbed or shifted; a change associated with the common but elusive claim that when depressed one finds oneself in a ‘different world’ detached from reality and other people. Existing attempts to utilise these phenomenological observations in a psychiatric context are challenged by the fact that this (...) experiential ‘shift’ characteristic of depression appears mysterious and resists analysis in scientific terms. This paper offers a way out of this predicament. The hypothesis proposed is that when an individual becomes depressed, the individual departs from a state of ordinary wakeful consciousness and enters a distinctive global state of consciousness akin to dreaming and the psychedelic state. After unpacking and motivating this hypothesis in the context of research in consciousness science, I outline two of its important implications for the neurobiology of depression and psychedelic psychiatry. The upshot is a promising and conceptually well-motivated hypothesis about depression which is apt for empirical uptake and development. (shrink)

In this paper we have two main aims. First, we present an account of mood-congruent delusions in depression (hereafter, depressive delusions). We propose that depressive delusions constitute acknowledgements of self-related beliefs acquired as a result of a negatively biased learning process. Second, we argue that depressive delusions have the potential for psychological and epistemic benefits despite their obvious epistemic and psychological costs. We suggest that depressive delusions play an important role in preserving a person’s overall coherence and narrative identity (...) at a critical time, and thus can be regarded as epistemically innocent. (shrink)

Most mental disorders affect only a small segment of the population. On the reasonable assumption that minds or brains are prone to occasional malfunction, these disorders do not seem to pose distinctive explanatory problems. Depression, however, because it is so prevalent and costly, poses a conundrum that some try to explain by characterizing it as an adaptation—a trait that exists because it performed fitness-enhancing functions in ancestral populations. Heretofore, proposed evolutionary explanations of depression did not focus on thought (...) processes; instead, they emphasized that it facilitates navigation of adverse social circumstances or promotes immune response to infectious agents. According to a new hypothesis, the “analytical rumination hypothesis” (ARH), however, depression’s crucial adaptive trait is rumination—negative, intrusive thought. ARH holds that, (i) social dilemmas trigger depressed mood; (ii) depressed mood induces changes in body systems that facilitate ruminative analysis aimed at solving dilemmas; and, (iii) depressive rumination is a fitness-enhancing trait that was selected for in evolutionary time. Jointly, (i)~(iii) imply that we should not think of rumination as a disorder; instead, it is a trade-off, an eminently rational one. In the same way that fever solves a problem—coordination of the immune system in response to infection—so too does depressive rumination solve a problem, a social dilemma, albeit at the cost of inducing anhedonia and other maladies. But they argue that the cost is worthwhile, something that should be endured “until the problem is solved.” First, we argue that there are two distinct types of rumination, brooding and pondering; the former is associated with a disposition for depression, not the latter. But only the latter has the problem-solving capabilities that ARH requires. Second, recent brain imaging studies of depression reveal resting state hypoactivity in lateral regions and hyperactivity in paralimbic regions; this asymmetric pattern correlates with heightened levels of brooding, self-focused rumination. In other words, on the personal level, patients are trapped within self, isolated from the external world and suffused with negative affect; on the subpersonal level, this pattern is reflected by an asymmetric pattern of lateral vs. paralimbic resting state activity. Third, we proceed to conjecture that rational responses (e.g., pondering) to social dilemmas are those that strike a balance between internal and external considerations in the process of belief formation. Fourth, because the asymmetric resting state activity blocks those who suffer with depression from accessing and processing potentially positive stimuli from the external world, the capacity for rational, analytic response—hence, problem-solving—is constrained. Fifth, it follows that, although there might be conditions for which suffering should be endured rather than pharmacologically alleviated, depression is not one of those. Indeed, in view of the effects of the asymmetric resting state pattern, it is unlikely that depressive rumination would have been useful even for ancestral populations. (shrink)

The received view about depression in the philosophical literature is that it is defined, in part, by epistemic irrationality. This status is undeserved. The received view does not fully reflect current clinical thinking and is motivated by an overly simplistic, if not false, account of depression’s phenomenal character. Equally attractive, if not more so, is a view that says depression can be instantiated either rationally or irrationally. This rival view faces challenges of its own: it appears to (...) entail that there are situations when not being depressed is rationally sub-optimal and that resilience to, and healthy coping strategies for avoiding, depression can be rationally remiss. I criticise an existing reply to these challenges before motivating a better one from the perspective of epistemic consequentialism. (shrink)

How to draw the line between depression-as-disorder and non-pathological depressive symptoms continues to be a contested issue in psychiatry. Relatively few philosophers have waded into this debate, but the tools of philosophical analysis are quite relevant to it. In this paper, I defend a particular answer to this question, the Contextual approach.On this view, depression is a disorder if and only if it is a disproportionate response to a justifying cause or else is unconnected to any justifying cause. (...) I present four objections to this approach and then defend it from them. Along the way, I explain why it matters whether we get this question right. (shrink)

I reflect on an argument with a friend, “S,” who also struggles with depression. In examining my formalization of S’s argument, I claim, we may discern the structure of depressive thought. In observing what is missing from this structure, we may identify what depression tends to hide from depressed persons and what, more broadly, it tends to compel from them. I argue for a redescription of depressive thinking in terms of two compulsions: 1) to perceive an absolute and (...) vague threat that causes disruption to action and 2) to take this disruption as also being a reason for inaction. To do ethics for the depressed, I conclude, is to ask what philosophical argument can do for those who seek justification for action but struggle with these specific limits on their responsiveness to reasons. (shrink)

Using a subliminal priming lexical decision task, the present research investigated whether individuals who show negative implicit evaluations of an ex-partner immediately after a break-up show superior post-break-up emotional adjustment. As expected, individuals whose reaction times indicated negative implicit evaluations of their ex-partner showed reduced depressive affect immediately after the break-up. Individuals who did not initiate their break-up demonstrated less negative implicit evaluations of their ex-partners as well as more depressive affect. Finally, increased negative implicit evaluations of ex-partners over a (...) one-month period were associated with corresponding improvements in adjustment. The findings demonstrate a critical role for implicit evaluations in post-break-up adjustment. (shrink)

Depression is a widespread and debilitating disorder, but developing effective treatments has proven challenging. Despite success in animal models, many treatments fail in human trials. While various factors contribute to this translational failure, standardization practices in animal research are often overlooked. This paper argues that certain standardization choices in behavioral neuroscience research on depression can limit the generalizability of results from rodents to humans. This raises ethical and scientific concerns, including animal waste and a lack of progress in (...) treating human patients. To address these issues, animal ethics committees can establish reasonable expectations for preclinical research and highlight the impact of standardization on generalizability. Such efforts can help improve translation from animal models to human patients and ultimately benefit those suffering from depression. (shrink)

The subject of this paper is the problematisation of depression in today’s mental health care. It is based on a study of the professional discussion on depression in Finland from the mid-1980s to the 1990s. The ways in which Finnish mental health experts define the object of depression treatment bring out an ambivalence that stems from the discrepancy between two parallel but incongruent notions of what depression is: the psychopharmacological and the psychotherapeutic. The analysis of the (...) discussion demonstrates how clinical and practical rationales of today’s mental health care are formed in the space between the two poles. Two tendencies of these rationales are also pointed out: first, the DSM paradigm of depressive illness inclines to become problematic and to dissolve in the actual practices. Second, they insinuate emphasis on antidepressant medication and overall neuropsychiatric approach in the treatment of depressive disorders, although in an ambivalent way. (shrink)

People with depression often report alterations in their experience of time, a common complaint being that time has slowed down or stopped. In this paper, I argue that depression can involve a range of qualitatively different changes in the structure of temporal experience, some of which I proceed to describe. In addition, I suggest that current diagnostic categories such as "major depression" are insensitive to the differences between these changes. I conclude by briefly considering whether the kinds (...) of temporal experience associated with depression are specific to depression. (shrink)