WEB MD online's "Myth Buster" includes this thought on the idea that "depressed people cry a lot." The word is: not always. Some people don't cry or even act terribly sad when they're depressed. Instead, they are emotionally "blank" and may feel worthless or useless. Even without dramatic symptoms, untreated depression prevents people from living life to its fullest - and takes a toll on families. Kate Lochte continues a conversation about understanding depression with Murray State Assistant Professor of Psychology Dr. Michael Bordieri, with a focus on the origins of depression and treatments still subject to ongoing research.
Revisiting The Biology of Depression
Depression is a complicated story. It's an area with a widespread belief that depression is a biological illness, and there is certainly evidence to suggest this, but it's not that simple. We like our scientists to make definitive statements like, "this is the piece that holds it all together," but while there is work towards reaching that area, we're not there yet. We also have to consider environmental and other factors as well.
Dr. Bordieri says he's worked with many primary care physicians and prescription providers who he believes are doing the best to care for their patients. Within medicine, the frontline treatments are almost always medication based. He says it's not surprising that when patients are referred to clinics with a medicinal focus, they will use what's in their 'tool chest' to provide help. What's changing the conversation now are behavior psychologists (like Dr. Bordieri) are getting better at talking about the kind of work they do and integrating their models of care, including talk therapy, into those settings.
How can the system improve to draw the two fields together? Can prescriptions be better monitored (for example 'warring prescriptions' that counteract each other)? Many diseases presented to primary care physicians are lifestyle diseases like high blood pressure, heart problems, obesity, where there are also behavior solutions. "You can't ignore the evidence base that suggests that many medications have some evidence of efficacy or an effect that improves depression. And it's important to keep in mind that talk therapy and doing things differently and changing your behavior can also change the brain. It's a two-way street."
Long-term effects of medication. What happens when someone is on anti-depressants for several years? You get some who respond to the initial dose and others who need two or three dose medication changes before seeing a response. But what happens after that? Do we want patients taking medication indefinitely. Yes, it's cheaper to take a pill than see a therapist in the short term. But over time, a brief course of therapy can have an enduring effect over medication. Dr. Bordieri suggests more research needs to be done in focusing on long-term treatments for depression and what happens when taking people off of medication.
Depression Across Age and Gender
Many of the symptoms are the same in childhood and adult depression, but there is some research in different mechanisms involved. Also, gender differences: women are much more likely to report or receive treatment for depressive episodes, but often men are less likely to reach out or seek treatment. This is a topic that will be discussed in detail in this series at a later date.
This is the seventh in a series of conversations about depression with Dr. Michael Bordieri, Assistant Professor of Psychology at Murray State. Dr. Bordieri's contributions to this series are strictly informational and should not be construed as any form of psychotherapy, counseling, diagnosis or treatment. Any health condition, including depression, should be evaluated and treated by a qualified professional in the context of an established professional relationship.
The next discussion airs Tuesday, December 16.
Send questions to: msu.wkms@murraystate.edu
