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Depression And The BrainDepression And The Brain

Depression And The Brain

At times all of us feel sad, unhappy, dejected and wretched. Major depression (Major Depressive Disorder) is an intensification of those feelings, for periods of time lasting for weeks or even longer. It is accompanied by a deep sense of loss, frustration and anger. According to Pubmed Health, symptoms of major depression can include some or all of the following: "agitation, restlessness, and irritability; dramatic change in appetite, often with weight gain or loss; significant concentration problems; fatigue and lack of energy; feelings of hopelessness and helplessness; feelings of worthlessness, self-hate, and guilt; the tendency to become withdrawn or isolated; loss of interest or pleasure in activities that were once enjoyed; thoughts of death or suicide and trouble sleeping or excessive sleeping". Major depression, with its variety of symptoms, interferes with daily life functioning to a very significant extent in all possible contexts: personal relationships, work, school and family.

Brain structure changes have consistently been associated with major depression. Notably, in a three year longitudinal study, compared with controls, patients with depression show reductions in the gray matter density of the hippocampus, anterior cingulum, left amygdala, and right dorsomedial prefrontal cortex. Patients who remitted during the 3-year period had less volume decline than non-remitted patients in the left hippocampus, left anterior cingulum, left dorsomedial prefrontal cortex, and bilaterally in the dorsolateral prefrontal cortex.

Brain structure deterioration is accompanied by decline in cognitive function. Cognitive slowing is usually observed as well as reduced vigilance, flexibility, sustained and divided attention. It also appears that severity of depression and cognitive decline are significantly associated with psychosocial functioning. Individual neurocognitive profiles differ as regards to the character and degree of cognitive deficits. Executive functions, as well as verbal learning and memory, are better preserved than attentional ability.

The many negative outcomes of depression warrant early psychotherapy and medication. In addition, in view of the neurocognitive and neurophysiological deterioration occasioned by depression and in view of the impaired daily functions and psychosocial functions, both of which are associated with cognitive function, it might be well advised to seek means to preserve cognitive function. In this context, results from a recent proof-of -concept cognitive training study conducted at the Prague Psychiatric Center[3], in the Czech Republic, suggest, for the first time, that online cognitive training may reduce depression and improve cognitive abilities of everyday living in individuals with depression. In this study, a group of outpatients with unipolar or bipolar depression who trained three times a week for 8 weeks with CogniFit, a scientifically validated online cognitive training program, were compared to a control group of patients who received standard care but no cognitive training. The results indicate clear reductions in the levels of depression in the CogniFit group but not in the control group. Moreover patients in the CogniFit group reported better everyday quality of life. They had fewer failures in executive control (reasoning and planning) and fewer memory lapses in everyday activities.

References

[1] Frodl TS, Koutsouleris N, Bottlender N, Born C, Jäger M. Depression-Related Variation in Brain Morphology Over 3 Years: Effects of Stress? Archives of General Psychiatry. 2008; 65(10):1156-1165

[2] Godard J, Grondin S, Baruch P, Lafleur MF, Scupin I, Reiser M, Möller H, Meisenzahl EM. Psychosocial and neurocognitive profiles in depressed patients with major depressive disorder and bipolar disorder. Psychiatry Research; ahead e-publication July 2011

[3]Preiss M, Čermáková R, Cimermanová D. Online rehabilitation of cognitive functions: the possibilities of the CogniFit program. Presented at the 12th European Congress of Psychology, Istanbul, July 2011.

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