The Chemical Balance Myth

I recently read the August 7, 2017 Time cover story "The Anti Antidepressant." It talks of possible "new" innovations in psychopharmacology. It's hardly new Ketamine, MDMA, and other medications have been researched in the past. Often street (ab)use, led to discontinuing the research in medications like this.
This latest article does a fine job of describing the (Western) understanding of depression. It also does a poor job of updating the understanding that's come in the last 40 years. The brain in "chemical imbalance" model of understanding and treating depression was outdated by the time it was used to help portray to clients the usefulness of SSRI in treatment. It's not that it's totally incorrect -- it's incomplete. The latest Time article does at least note that the latest understanding acknowledges the likelihood that depression is perhaps a dozen plus conditions. It still, however, perpetuates the perspective that depression lives solely in the brain.

Depression may be demonstrated through low serotonin, dopamine, or other neurotransmitters. Recent researchers, though, see a multidimensional, physiological syndromes that explain the depressive experience. There is a shift in how the anatomical areas of the brain metabolize and send impulses (a neurological and circuit based disease.) Not only do certain genes show links to depression, but whether those genes have been turned on or off in a person's lifetime (a genetic and epigenetic disease.) The genes con
trol how hormones are replicated and how sensitive our body is to these hormones (an endocrine disease.) These hormonal interactions inflame our tissues - a disease of inflammation. These are all parts of depression - it is not only seen in the brain, not only felt in the brain.
Depression impacts our sleep, appetite and metabolism, our sense of energy, our ability to concentrate. It impacts relationships in the family and in the community - a person's participation in the call and response of human connection.
I hope that clinicians find one more effective treatment of depression. I regularly tell my clients and colleagues (with a touch of facetiousness) "No business is good business." My sense of this comes with the belief that counseling is only one vehicle to address depression. Often, it's the job of therapist to connect people to more meaningful interventions, more resolute solutions to managing mood: Healthy relationships, healthy lifestyles, communities, friends, exercise, greater sense of connection to the world and to people, a sense of meaning, a remembrance of one's fortitude and internal resources. Because depression does not simply live in the brain. Treatment can start in the brain, in relationships, and in physiology. It does not end there.

EMDR Survey

A graduate student at Smith College​ is asking recipients of EMDR therapy to participate in a survey regarding substance use/abuse and behavioral addictions (i.e. process addictions) and the impact of EMDR. If interested, the survey is located at: https://www.surveymonkey.com/s/N962MW7

New Trauma Credential -- CCTP

Officially a Certified Clinical Trauma Professional... with even greater knowledge in promoting growth after trauma.

Personality Inventory for DSM-5

The American Psychiatric Association developed some great measurements to use with folks to screen, and more importantly in my work, meter progress. Recently, a colleague introduced me to the Personality Inventory for DSM-5.  I think it can be a great tool, but it discouraged me that I could find no reliable key to crunch the numbers. Clinicians interested are welcome to use This File to help score the measure.

(For others, please note that the test is a clinical tool and does not constitute a diagnosis, recommendation, or treatment.)

Social Intelligence

Social intelligence is a term that speaks to our ability to navigate complex social relationships and read and understand the emotions of others. While we find more of our interactions replaced by apps, phone calls, emails, and Facebook posts, we have fewer opportunities to practice and develop our social intelligence. Face to face interactions provide greater understanding, and stronger connection.

Here's a test on Harvard's site for Social Intelligence. (It is part of a research experiment.)

Stressed Americans without Services

Let's hear all the tips out there for stress management. I'll start -- get at least 7 hours of sleep each night. (9 is the optimal median.)
Stressed Out Americans Want Help, But Many Don't Get It from NPR

Information Bias

Many of my posts have touched on the concept of perceiving Truth. It's an important topic to people - we rarely questions our own sense of truth and it scares a person when his sense of truth is rattled. The model that people have a set sense of Truth and all new information follows is not new to psychology. The idea of how prevalent and regular this occurs, however, has recently rattled the sense of the Psyche, however.

As psychologists developed the model of Cognitive Psychology, they regularly used the two terms Assimilation and Accommodation to describe the ways in which we retain knowledge and build our personal models of the world. Each day we're faced with a plethora of new facts, sensations, images. As we take in the information, we compare that info to our sense of the world. While our view and concept of the world may grow bigger, we are assimilating the new information into our picture of the world. If pieces of information don't seem to match our map, we find ways to adjust the picture. As one example, consider the different ways we draw flat maps of our spherical world.

 

Cartographers pinch maps one way or stretch it another in order to show a round world on a flat map -- they have to make different accommodations in their representation of the world. The more accurate a representation a person needs, however, it becomes more difficult to assimilate that info as the map is drawn. Ultimately, a person may need to accommodate their concept of the world by using a globe.

Similarly, we can take in information that matches our own perception of the world, or we can change our perception of the world. For adults, accommodating our perception is a more difficult task -- think of all the learned information we have to reevaluate! We become victims of our own preconceptions - it can be easier to accept the information that matches our perception of the world and omit/forget/ignore any information that may not match. We unconsciously choose to see, hear, feel, smell, and taste only what reasserts our image of the world. This information bias can be benign and help keep our lives efficient. The dangers, however, come in the potential to miss vital pieces of information or perpetuate troublesome patterns of suffering in our lives.
The specific information bias is called confirmation bias -- we are biased toward the facts, figures, and examples that confirm what we believe is true. Where psychologists once provided a model where people at worst ignored new information, confirmation bias, demonstrates that we're even more difficult to dissuade. We not only ignore information that might challenge our perceptions, but we assimilate information in a way that helps perpetuate any faulty beliefs and interpretations. It becomes more and more difficult to find evidence that proves us wrong because our brain often strengthens its ability to identify only what it believes to be true.
Consider this study by Victor and colleagues which demonstrates that people suffering with depression are more likely to identify sad faces even on an unconscious level. Research continues to demonstrate that the anxious brain and the depressed brain regularly practice information bias - easily identifying facts in our life that prove the rule and (often unconsciously) ignoring facts to prove the exceptions.
It takes active practice to question assumptions and identify exceptions to our preconceptions. I frequently give clients tools that help draw out the exceptions. By helping our mind find reasons for joy, hope, satisfaction and through training the brain to more readily see these examples in our life, it becomes harder to stay depressed or anxious.

Research in how microbes affect our mental health (for the better) remains young. Very little has been done with human subjects. On the horizon, there's possibility for a giant shift in preventative care and treatment. For the original research article you can go here:

Can probiotic yogurt cure your psychiatric ills?

Wired Magazine's, Jonah Lehrer gives a fantastic look at how trauma work has evolved over the decades. The possibilities at the cutting edge are remarkable and exciting. (This stuff has me astounded and energized.) Ultimately, the reasearch and article stresses the importance of feeling safe and relaxed when recounting troubling memories.

The Forgetting Pill Erases Painful Memories Forever