Can psychiatric disorders like depression be prevented, instead of just treated? Well, the obvious answer is also the correct one — yes.
Just like we can all do things to help prevent the spread of the flu or cold viruses in the winter (such as washing your hands regularly), there are also scientifically proven techniques that suggest we’re only a short distance from offering more generalized and practical strategies for preventing depression.
Research published in December 2007 looked at 17 research trials that looked at preventative strategies for depression, either for a primary diagnosis, or for relapse prevention after someone had already been diagnosed with depression. After examining the data and conclusions from these 17 studies, the researchers were optimistic:
The research to date suggests that the prevention of major depression is a feasible goal for the 21st century. If depression prevention interventions become a standard part of mental health services, unnecessary suffering due to depression will be greatly reduced.
And why shouldn’t prevention be a reasonable goal for the first part of the 21st century? So much of our energy and efforts go into treatment after-the-fact, we should instead be more focused on helping to reduce this suffering before it even begins.
In a recent telephone survey of Germans (which results may not be world-generalizable),over 75% of the sample agreed on the possibility that depression is preventable (Schomerus, 2008). Of those, 53% stated that they would take part in prevention programs, and in this group over 58% indicated readiness to pay out of their pocket for such programs.
What would people be willing to do to help prevent depression? Psychosocial and lifestyle related measures were preferred, specifically engaging in a more proactive lifestyle, relying on medicine, and relaxing. I’m not sure how “relying on medicine” is considered a preventative measure, and the research abstract doesn’t elaborate.
Higher education reduced willingness to engage in preventative behaviors. But if you’ve experienced depression in the past or think you are at higher risk to get depression in the future increased a person’s willingness to take part in preventive programs.
Seligman et. al. (2007) found that a cognitive-behavioral psychoeducational skills workshop was also helpful in preventing depressive and anxious feelings. Cognitive-behavioral therapy focuses on helping people understand how our irrational (and sometimes unconscious) thoughts can lead to our negative feelings and behaviors.
Today, there are dozens of online programs and self-help articles about how to recognize and help the early signs of depression — signs that if not recognized, can lead to major depression. In the years to come, we hope more and more of these interventions can be better utilized to help actually prevent depression.
References:
Alinne Z. Barrera a; Leandro D. Torres a; Ricardo F. Mu̱oz a. (2007). Prevention of depression: The state of the science at the beginning of the 21st century. Journal International Review of Psychiatry, 19(6), 655 Р670.
Schomerus, G. et. al. (2008). Public attitudes towards prevention of depression. Journal of Affective Disorders, 106(3), 257-263.
Seligman, M. E. P., Schulman, P., & Tryon, A. M. (2007). Group prevention of depression and anxiety symptoms. Behaviour Research and Therapy, 45(6), 1111-1126.
11 comments
It becomes exhausting after awhile to do all the things you have to do to keep yourself away from depression. There’s eating, exercise, maintaining social relationships, talking yourself out of irrationality, and trying to maintain equilibrium in the face of an unfriendly world–oops, sounding pessimistic–Seligman wouldn’t approve. I gave in recently–stopped eating, had no social contact because I was on spring break, and giving in was relaxing, although unpleasant. If I keep *really* busy I don’t notice that I’m depressed. That’s my main coping technique.
Depression seems to be barely on the radars of most people I know whose lives have not been touched by it in some way. Other diseases that cause grave suffering and have significant mortality rates, such as MS, breast cancer, and AIDS, are well-known, but not depression. There is still a fair amount of misinformation out there, as well; for example, one family member expressed contempt for people who feel they have to whine to a therapist about how tough life is. (CBT and other therapies for depression have nothing to do with whining about how tough life is, of course.)
My point is that it will be hard to convince people to take steps to prevent depression (I LOVE the idea of a CB workshop to help nip “stinking thinking” in the bud!) unless they realize that depression is a disabling, profoundly painful disease that, untreated, has a high mortality rate (by suicide).
I am beginning to wonder what the prospects for “curing” depression are like. While everything I read suggests that, with treatment, it eventually goes away, my own experience is that it is more of a chronic disease to be managed. Is there a chance of freedom someday?
The most powerful depression prevention strategy is quite simple, but often the most difficult to implement. The key is public health education. I speak as an Emotional Health Educator with 40 years experience advocating models for “positive health.” The last six years I’ve focused my efforts on developing classroom prototype coping skills education programs for pre-teens.
The problem with preventing depression, in part, stems from a failure to develop practical, proactive, brain-based coping skills and tools we can begin introducing in elementary school – and certainly before the transition into middle school and teenage years.
If you look at U.S. state education standards, not ONE state currently requires that students have any preparation or understanding of healthy coping skills. Learning these basic skills would seem to be a critical, prevention strategy. Yet generations after generations of kids go into adolescence unprepared to deal with the most basic brain and behavior coping challenges.
Even with ample neuroscience research evidence on the debilitating brain effects of prolonged stress, few “prevention†advocates recognize the role of healthy coping patterns as a key protective quality for reducing stress and promoting Emotional Health.
Our pioneering classroom research uses self-assessments of “emotional resilience” by 700 pre-teens (grades 4-6). This pre-health education analysis reveals that from one-third to 80% of these students acknowledge difficulty dealing with anger or sadness. And this is before the tumultuous teenage years when depression is endemic! After three brief (45-60 minutes) classroom sessions exploring “Coping Skills & Brain Works” these same students report significant gains in coping confidence for dealing with these emotional challenges.
Just think what more might be done if we could agree on what constitutes a good, basic education in general coping skills for kids. One approach would be to get this type of education onto the Internet so teachers, parents and mental health professionals have resources to help them in their role as coping skills educators and “coaches.†Our modest prevention effort in this direction is now available as an Internet public service education project: http://www.copingskills4kids.net. In the first month since launching this site, there have been visitors from 34 other countries and all but 5 states in the U.S. Maybe the time for recognizing the need for coping skills prevention-education has arrived.
Mr. Brill, I’ll check out your site. It’s exciting that you’ve had so much traffic already. Mayo Clinic has a new blog on depression now, too, that’s already quite active: http://www.mayoclinic.com/health/depression-blog/MY00029.
I do some writing for Mayo Clinic — though not for any of their blogs — and came across it today. You might want to check it out.
I can do all the right things to oppose depression, yet it still has complete hold over me and at this point in my life I feel as if I have just accepted this is how it is. After time, the therapy becomes exhausting and the anti-depressants become a chore to take for the side effects, for me, are not worth it. And again, because I am not allowing everything to fully take affect, in essence, it is just another failure at life.
I can do all the right things to oppose depression, yet it still has complete hold over me and at this point in my life I feel as if I have just accepted this is how it is. After time, the therapy becomes exhausting and the anti-depressants become a chore to take for the side effects, for me, are not worth it. And again, because I am not allowing everything to fully take affect, in essence, it is just another failure at life.
Depression can be prevented is by seeing a psychologist and talking about your problems. It helps your mind to figure out what you’re doing and correct the problem you are facing.
And if you are on medication like prozac it can help you too. I was on prozac but I discontinued it and living one day at a time with my problems that I’m facing one day at a time.