17 November 1999
Depressed well it may be your 'Personality Style'!
by Kate Melville
Don't look now but if you are aggressive or have a 'low people dependency' (usually independent people who have little or no social support network), then you may be at a higher risk of suffering recurrent bouts of major depression! At least this may be the case according to research from the University of Washington
This study originated in the lab of well known psychology professor Neil Jacobson, who died last year but whose work was completed by Jackie Gollan (who earned her doctorate in clinical psychology at the UW and is now a clinical psychology intern at Brown University Medical School).
Basically they study found that people at risk of relapse reported lower levels of contentment or happiness from their activities than did people who remained well. Interestingly what also emerged was that a patient's level of negative or dysfunctional thinking at the end of treatment was not predictive of relapse.
According to Jackie Gollan, "Depression is a recurrent disease for a lot of people just like cancer. People who receive cognitive behavioral psychotherapy for depression tend to feel less depressed when they complete it. However, other factors in their lives beyond their mood need to be identified if we are to help them stay well. We need to consider who people are and how they interact with others to understand how patients remain non-depressed."
The prime driver behind this research is the high relapse rates among patients treated for depression (as many as 80 percent of patients successfully treated with cognitive behavioral therapy suffer a relapse within two years of remission). Depression is the probably the most common mental health problem with an estimated 17 million sufferers in the US.
The study followed 78 patients who had recovered from major depression. Patients all received 20 sessions of cognitive behavioral therapy and had been assessed as symptom-free for a minimum of two months before being accepted into the study. Researchers then used interview questionnaires and self-report forms to measure dysfunctional attitudes, depression, and agreeable activities at the start and completion of treatment and then every six months over the two-year follow-up period.
By the completion of the study 44 percent of patients had relapsed. According to Gollan said there seems to be different subsets of people who are at-risk for recurrent bouts of depression. One of those groups is made up of individuals who have a low dependency on other people. Interestingly patients who were aggressive and hostile styles at the end of treatment were also more likely to relapse, "perhaps because they don't make good friends and turn off people," Gollan explained. "In their professional careers they have channeled aggression in productive, socially acceptable ways to their advantage and use people to their advantage. They also are pathologically independent and independence may be a risk factor if you have depression. We need to focus on how the activities feel. We don't know why, but it is becoming clear that people are less at risk for relapse when they do things they enjoy rather than working on overcoming their negative thinking patterns. The treatment should be tailor-made to the depressed patient," Gollan said.
So what does this mean for you and I? Well perhaps is we are aggressive loaners who tend towards depression then we really do have something to worry about under most treatment regimes.