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."
We know the dangers of too little sleep. Now for the other side of the story.
- Western University researchers found that sleeping over eight hours per night results in cognitive decline.
- Oversleepers suffer similar difficulties on certain cognitive tests as those who sleep under seven hours.
- Not all the news is bad: one night of oversleeping results in a cognitive boost.
The comics titan worked for more than half a century to revolutionize and add nuance to the comics industry, and he built a vast community of fans along the way.
- Lee died shortly after being rushed to an L.A. hospital. He had been struggling with multiple illnesses over the past year, reports indicate.
- Since the 1950s, Lee has been one of the most influential figures in comics, helping to popularize heroes that expressed a level of nuance and self-doubt previously unseen in the industry.
- Lee, who's later years were marked by some financial and legal tumult, is survived by his daughter, Joan Celia "J.C." Lee.
The government hopes to see 1.5 million electric cars on roads by 2030.
- The legislation is expected to pass by the end of 2018.
- The move is inspired partly by Israel's recent discovery of several large deposits of natural gas.
- It's one of the latest developments in Israel's broader plan to wean itself off other more destructive fossil fuels.
The results come from a 15-year study that used ultrasound scans to track blood vessels in middle-aged adults starting in 2002.
- The study measured the stiffness of blood vessels in middle-aged patients over time.
- Stiff blood vessels can lead to the destruction of delicate blood vessels in the brain, which can contribute to cognitive decline.
- The scans could someday become a widely used tool to identify people at high risk of developing dementia and Alzheimer's.
SMARTER FASTER trademarks owned by The Big Think, Inc. All rights reserved.