The Insights Of Depression Research
Without Research It’s Guesswork
Depression, a diagnosable condition that can leave people feeling severely sad, empty, hopeless and or guilty for prolonged periods of time can affect all areas of life including family life, work, social lives and physical health.
Why Depression Research Is Important
Those researching depression are continuously contributing to the body of evidence that informs how we conceptualise and therefore both prevent and treat depression for those suffering with the condition.
‘Not having an answer to why I experience mental health issues has been endlessly frustrating, and treatments have been far from a definitive solution. Research is vital in understanding how mental health conditions begin and how they might be prevented in the future.’ - Gemma Styles; podcaster, writer and MQ ambassador.
Research from a number of perspectives including psychology, sociology and biology helps build a picture of the causes.
In the book Your Mental Health, Professor Valeria Mondelli, Clinical Professor of Psychoneuroimmunology at King’s College London comments; ‘What we need now is not to focus on one risk factor, but to integrate our knowledge of different factors and merge different approaches that have previously been used independently.’
Researching The Risk Factors Of Depression
While it is generally accepted that childhood trauma is a major risk factor for mental health during later life, little is known about how that trauma translates into this risk. Some studies suggest that childhood stress can trigger an enduring inflammatory response throughout our body, not unlike the response to physical injury (Baumeister et al., 2016).
This could be the biological pathway through which childhood trauma, including physical and sexual abuse, neglect, family violence, life-threatening accidents, loss of a parent, war and natural disasters, increases vulnerability to mental health conditions later in life. There may be different inflammatory proteins involved, depending on the nature of the ‘hidden wounds’.
These ‘hidden internal wounds’ can affect brain development, behaviour, how we respond to other stressful events, and, ultimately, our risk for developing mental health conditions. Detecting and healing these hidden wounds may help prevent and treat depression emerging after childhood trauma.
One such research project that investigates this concept is the Identifying Depression Early in Adolescence (IDEA) project, which is funded by MQ Mental Health Research. Professor Mondelli, the Principle Investigator of the study from King’s College London, comments:
Utilising data from culturally diverse settings from high to low-middle income countries (the UK, Brazil, Nigeria and Nepal) the project will bring a new understanding of the different factors leading to the development of depression in 10 to 24-year-olds.
Based on the data already collected, the project has developed a tool that could help to screen young people for depression. The tool uses data on 11 demographic variables to assess risk, while enabling analysis of data from brain scans, genetic assessments and inflammation measures.
By combining these insights they are aiming to develop a screening tool for NHS and other professionals to use in diverse settings to deliver effective care sooner. MQ Chief Executive, Cynthia Joyce, commenting on the IDEA project said: ‘Together, these projects are designed to transform our understanding of how mental illness develops, how we can identify which young people are most at risk, and how we can create badly needed better treatments for young people worldwide.’
The Current Treatments For Depression
With depression, there is not a one-size-fits-all approach that can be applied as a treatment for those suffering with the condition.
Alastair Campbell, a writer, podcaster and political strategist, best known for his role as Downing Street’s director of communications for Tony Blair comments ‘So much depends on the relationship between the person who’s struggling and the professional who’s there to try to help you... All they have to go on, at least initially, is what you look like and what you’re saying…We underestimate just how important that first contact is; it’s very personal. Healthcare staff should feel no shame or disgrace if a patient says it isn’t working.’
The current treatments for depression according to Your Mental Health (2023) are:
- Medication: Antidepressants work by boosting the activity of particular brain chemicals, or by making their activity in the brain last longer, which can lift the mood. Brain chemicals include noradrenaline and serotonin.
- Cognitive behavioural therapy: CBT is a type of talking therapy that teaches coping skills for different problems. It focuses on how thoughts, beliefs and attitudes affect feelings and actions.
- Psychotherapy: A more intense talking therapy that focuses on unconscious, deep-rooted thoughts, which often stem from childhood. It aims to unpick these and sometimes challenge them.
- Electroconvulsive therapy: A treatment that involves sending an electrical current through the brain under anaesthesia, causing a brief surge of electrical activity. It is only used for severe depression or depression that is not responding to treatment.
- Novel treatments: Treatments in development include anti-inflammatory medication; psychedelics such as psilocybin, ketamine and MDMA; stimulation of the brain with magnetic pulses; and provision of feedback while in a scanner to activate certain areas of the brain.
The Future Of Personalising Treatments
Research into inflammation indicates that there are subgroups of people with depression who may have different biological profiles and therefore different treatments may be more effective. This opens up the prospect of personalising treatments.
With the right analysis, data from wearable biometric health trackers could provide a more in-depth understanding of depression and help us to identify particular subsets of people, such as those with fatigue or sleep problems.
‘We are used to bringing people into a research clinic once a week or once a month for follow-up. That is useful but could it be more useful to do assessments remotely in real life using wearables and smartphones. Done several times a day over a long period of time, this will provide a richer insight into fluctuations in depression.’ - Professor Golam Khandaker
Professor Ed Bullmore in Your Mental Health points out the cost-benefit of such an approach for depression:
Research, including the important research by MQ Mental Health, has provided us all with a greater understanding of depression, along with the potential for more effective treatments for those suffering. With the ongoing and future research by experts in the mental health field, we move towards improved screening, preventing and treating of depression.
Links and Resources
MQ Mental Health Research is the UK’s leading mental health research charity. If you would like to get involved or find out more about their research, visit their website here: MQ Mental Health Research
If you are experiencing symptoms of depression yourself, or are worried about someone who is, then you can contact:
Mind provides advice and support to empower anyone experiencing a mental health problem
Visit Mind’s Get Help Now page
Sane offer support for both people experiencing mental illnesses and also their carers, friends and family.
You can call them every day between 4pm and 10pm on 0300 304 7000.
References
Baumeister, D., Akhtar, R., Ciufolini, S. et al. Childhood trauma and adulthood inflammation: a meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-α | Molecular Psychiatry (nature.com) 21, 642–649 (2016).
Brathwaite, R., Rocha, T.BM., Kieling, C. et al. Predicting the risk of depression among adolescents in Nepal using a model developed in Brazil: the IDEA Project |. Eur Child Adolesc Psychiatry 30, 213–223 (2021).
Davenport, F., edited by Brady C., and Westbrook, T., (2023) Your Mental Health. London, Penguin Random House UK.
