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The public “deserve to know” that there is an overlooked subset of people who thrive after major depression
More research is needed into people who experience "high functioning after depression."
Depression is a chronic, recurrent, lifelong condition. Well, that's the current orthodox view – but it is overstated, argues a team of psychologists led by Jonathan Rottenberg at the University of South Florida. "A significant subset of people recover and thrive after depression, yet research on such individuals has been rare," they write in their recent paper in Perspectives on Psychological Science. They propose a definition for "high functioning after depression" (HFAD); argue that the advice given to people with depression need not be so gloomy; and lay out key areas for future research.
The "gloomy" view of depression is relatively recent, the researchers argue. Just a generation or two ago, conventional wisdom held that depression was the opposite – transient and self-limiting. "But what if neither the older orthodoxy nor the new view of depression fully captures the truth?", Rottenberg and his colleagues ask. "What if, instead, two variants of depression operate simultaneously – a grim chronically-recurring, lifelong variant, and a relatively benign, time-limited variant?"
Long-term studies certainly suggest that a substantial population of people are affected by a burdensome, recurrent form of the disorder. But Rottenberg's team cite three studies finding that an average of 40 to 50 per cent of people who suffer an episode of depression don't go on to experience another (for example, this study in Sweden) – but overall these individuals have been little studied. "This omission, and the field's lack of focus on good outcomes after depression more broadly, virtually guarantees an unduly pessimistic impression of depression's course", Rottenberg and co write – and this is an impression they would like to see changed.
HFAD has been overlooked in part, they argue, because researchers, influenced by the current view, have focused on finding factors associated with chronicity and recurrence. Also, people with recurrent depression are highly likely to be over-represented in depression studies simply because, when researchers put a call out for subjects with depression, these people are statistically more likely to be suffering at the time, and so to be recruited.
To be categorised as experiencing HFAD requires more than simply remitting or recovering from the symptoms of major depression for at least a year, Rottenberg and his colleagues add. An individual must also have achieved "high end-state functioning" – doing well at work and home and socially, and reporting "robust" wellbeing – feeling satisfied with life and enjoying high levels of self-acceptance, for instance.
With such powers of recovery, what leads people who exhibit HFAD to become depressed in the first place? "One hypothesis might be that HFAD represents a more psychosocial form of depression that is more likely to be precipitated by environmental adversity, such as death, a break up of a romantic relationship or a job loss," the team suggest.
Whether or not this is the case clearly needs exploring. And they point to other big questions. For instance: Are people who are HFAD more likely to have sought help while they were depressed? Does depression itself play a role in triggering the long-term improvement seen in HFAD? (Something similar has been proposed for trauma). Can we apply what is learnt about HFAD to enhance clinical interventions?
What does HFAD tell us about thriving after other mental disorders?
There are clearly a lot of questions. But here, at least, is a framework for finding potentially useful answers.
"One reason HFAD needs to be discussed," the researchers write, "is that it is part of the truth, which patients and the broader public are owed. It would be odd if an oncologist did not tell a cancer patient his or her chances of achieving lifetime remission. We submit that a depressed patient also deserves to know. The public deserves to know as well."
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Construction of the $500 billion dollar tech city-state of the future is moving ahead.
- The futuristic megacity Neom is being built in Saudi Arabia.
- The city will be fully automated, leading in health, education and quality of life.
- It will feature an artificial moon, cloud seeding, robotic gladiators and flying taxis.
The Red Sea area where Neom will be built:
Saudi Arabia Plans Futuristic City, "Neom" (Full Promotional Video)<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="c646d528d230c1bf66c75422bc4ccf6f"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/N53DzL3_BHA?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Are we genetically inclined for superstition or just fearful of the truth?
- From secret societies to faked moon landings, one thing that humanity seems to have an endless supply of is conspiracy theories. In this compilation, physicist Michio Kaku, science communicator Bill Nye, psychologist Sarah Rose Cavanagh, skeptic Michael Shermer, and actor and playwright John Cameron Mitchell consider the nature of truth and why some groups believe the things they do.
- "I think there's a gene for superstition, a gene for hearsay, a gene for magic, a gene for magical thinking," argues Kaku. The theoretical physicist says that science goes against "natural thinking," and that the superstition gene persists because, one out of ten times, it actually worked and saved us.
- Other theories shared include the idea of cognitive dissonance, the dangerous power of fear to inhibit critical thinking, and Hollywood's romanticization of conspiracies. Because conspiracy theories are so diverse and multifaceted, combating them has not been an easy task for science.
A growing body of research suggests COVID-19 can cause serious neurological problems.
- The new study seeks to track the health of 50,000 people who have tested positive for COVID-19.
- The study aims to explore whether the disease causes cognitive impairment and other conditions.
- Recent research suggests that COVID-19 can, directly or indirectly, cause brain dysfunction, strokes, nerve damage and other neurological problems.
Brain images of a patient with acute demyelinating encephalomyelitis.
COVID-19 and the brain<p>A growing body of research reveals alarming neurological complications among COVID-19 patients. On Wednesday, for example, researchers from University College London published a <a href="https://academic.oup.com/brain/article/doi/10.1093/brain/awaa240/5868408" target="_blank">study</a> in the journal Brain that describes how some patients have suffered temporary brain dysfunction, strokes, nerve damage, and other neurological problems concurrent with COVID-19.</p><p>Some patients suffered brain inflammation as a result of a rare disease called acute disseminated encephalomyelitis, which can cause numbness, seizures, and confusion. One patient in the study even hallucinated monkeys and lions in her home.</p>
Photo by Mario Tama/Getty Images<p>A separate study published in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198407/" target="_blank">Journal of Clinical Neuroscience</a> notes that some COVID-19 patients have also suffered neurological complications like impaired consciousness and acute cerebrovascular disease. The study notes that past viruses like MERS and SARS also seemed to cause neurological problems.</p><p>A troubling finding among this growing body of research is that some patients seem to suffer neurological damage even when respiratory symptoms aren't obvious. Additionally, scientists aren't sure whether damage from the disease will be permanent.</p><p style="margin-left: 20px;">"Given that the disease has only been around for a matter of months, we might not yet know what long-term damage COVID-19 can cause," Dr. Ross Paterson, joint first author of the University College London study, said in a <a href="https://www.eurekalert.org/pub_releases/2020-07/ucl-iid070620.php" target="_blank">press release</a>. "Doctors needs to be aware of possible neurological effects, as early diagnosis can improve patient outcomes."</p><p>If you've been diagnosed with COVID-19 and want to enroll in the study, visit <a href="https://www.cambridgebrainsciences.com/studies/covid-brain-study" target="_blank">cambridgebrainsciences.com/studies/covid-brain-study</a>.</p>
Coronavirus layoffs are a glimpse into our automated future. We need to build better education opportunities now so Americans can find work in the economy of tomorrow.