Function of depression

Depression As a Signal for Change

John D. McKellar, PhD Bay Area Pain and Wellness Center Independent Private Prac@ce, SF Bay Area

Incidence of Depression Rising • More than 30 million Americans suffer from depression • Despite the increased prevalance and acceptability of treatment for depression whether via meds or therapy the numbers con@nue to rise • No@ng the increased prevalence does nothing to explain “Why” people have depression

The Deficiency/Defect Model of Depression • Pharmaceu@cal companies suggest that depression is due to a correctable chemical imbalance (but 27 million take an@depressants) • Prac@@oners of cogni@ve-­‐behavioral therapy see depression as due to faulty thinking (CBT is as effec@ve as an@depressants) • A Different model is suggested by the Mood science approach

What is the func@on of Mood?

• Every creature on the earth needs to decide what, among limitless possibili@es, to “do” each day • To eat, to play, to fight… or maybe to play, eat the fight….. Or maybe, just take a nap • Moods are internal signals that drive behavior to maximize pleasure and to avoid pain but also to reach important goals (more about goals in a bit..)

More on Moods..

• Are we driven by good moods or by nega@ve moods? ……YES • Good moods signal behaviors that we want to repeat (mmm.. Good cookie!) or signal progress towards a goal • Bad moods signal behaviors or situa@ons we want to avoid or signal lack of progress towards a goal

Good Moods • Good moods broaden a`en@on and make people inclined to seek out informa@on and novelty (crea@vity) • Good mood spurs increased or ongoing ac@vity when progress is made towards a goal • For example I feel good when I reach the halfway point in washing the windows of our house…

Bad Moods • Bad moods narrow a`en@on and increases focus on threats or problems • Bad moods can signal lack of success which cues the need to increase effort (or to do something different) • Great difficulty in washing the windows may cue me to change my water or get a new squeegie

More on Bad Moods • Extreme difficulty in working towards a goal leads to sharp increases in “bad” moods followed by disengagement • This sounds like giving up but it also makes sense in that we have limited @me and effort to expend and don’t need to waste it • Consider a bear fishing a river who, ader not having success, stops and moves on to a different loca@on

Depression • Maybe depression is not just a defect or deficiency • Maybe depression involves a behavior that is adap@ve in some environments and not so adap@ve in others • Consider the following…

Lee Stringer (writer)

“Perhaps what we call depression isn’t really a disorder at all but, like physical pain, an alarm of sorts, aler@ng us that something is undoubtedly wrong; that perhaps it is @me to stop, take a @meout, take as long as it takes, and a`end to the unaddressed business of filling our souls.”

Take Home • Even if depression is an enormous problem for humankind (and it is..), it doesn’t have to imply a personal defect • Maybe the most important message overcoming depression is “Do something differently”

Things to do “Differently” • Change the therapist you have been seeing for 2 years if you do not see a change…

• Change medica@ons that are not crea@ng benefit • Spend less @me trying to “figure out” the reason for your depression • If your goals are not working maybe it’s the wrong path (NOT THE WRONG YOU!!!)