Depression can affect anyone. Unfortunately once you’ve had one bought of depression, you are more likely to have a second. Quickly your condition can become chronic. Although standard psychological and medical methods can help most people with chronic depression, there is a hard core of people who are ‘treatment resistant’. Whatever we do simply doesn’t seem to work. As many as 30% of chronic depression cases fall into this category.
Exciting new research by Professor Thomas Lynch of Southampton University and his collaborators promises to offer insight into the world of people with chronic treatment resistant depression, and possibly offer a solution.
What Professor Lynch has found is that many people with treatment resistant depression are emotionally over controlled. Emotional control is best seen as a continuum. At one end are people who are not very good at controlling their emotions. They are life’s ‘drama queens’, and have learnt that they are more likely to get what they want if they escalating their emotion. At the other end of the spectrum are people who are extremely good at regulating their emotion, in fact they are so good at it hardly anything slips through. They are lifes cool guys, and have learnt that they are more likely to get what they want if they withhold their emotional expression.
Of course being able to control one’s emotion in many situations is a good thing. What Professor Lynch and colleagues have found, however, is that if you withhold too much emotion, this creates mistrust in other people. Basically if you don’t show an appropriate socially acceptable amount of emotion, other people don’t like you. And this is the problem for many treatment resistant depression patients. They are so good at regulating their emotional expression they do it inappropriately. This makes them unpopular. As a consequence of this they become socially withdrawn. Of course if you do not connect effectively with people you can become vulnerable to depression.
Professor Lynch’s approach to treatment resistant depression is therefore quite radical. He does not treat depression as the primary problem. Rather his treatment strategy is to target emotional over control itself. By helping patients to communicate their emotions more appropriately, this enables them to get closer to other people; they become more popular, and as a consequence, social isolation and the vulnerability to depression decrease.
Does it work? Well preliminary findings suggest this approach may well be effective in helping patients with treatment resistant depression. The findings have been so good in fact it has led to a full scale clinical trial over the next five years. The project is called REFRAMED. If you feel this approach might be appropriate for you, you don’t have to wait until these results become available. Professor Lynch is starting to roll out his ideas to other therapists. You might not be able to get on the clinical trial, but you could well be able to access something very similar.
Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK. He offers:
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