Moods and Depression

This lecture discusses moods and depression, covering their nature, influencing factors, and treatments, from both pharmacological and behavioral/psychological perspectives. Understanding the etiology, diagnostic criteria, and treatments is crucial for understanding this topic. Depression is one of the leading causes of disability in the world and can significantly impact various aspects of an individual's life, including their physical health, relationships, and work performance.

Understanding Moods

Moods are a fundamental aspect of the human experience. Moods are typically described as prolonged emotional states that can influence our thoughts and behaviors. Key questions to consider include:

What are moods?
What influences them?
Do we have control over our moods?
When does a mood transition into a disorder?
What treatments are appropriate for mood disorders?

Influences on Mood

Internal Dialogue

The way we talk to ourselves internally significantly impacts our mood. Self-talk can either uplift us or bring us down, depending on its nature. The lecturer shares a personal evolution in self-talk:

Old Approach: Being critical and demanding, pushing oneself harshly. This approach often leads to increased stress and decreased self-esteem.
New Approach: Treating oneself with the same care and compassion one would offer a best friend. This involves asking, "How can we help you?" and offering support and understanding. This approach fosters resilience and promotes emotional well-being.

This shift in internal dialogue is more effective for navigating life's challenges and regulating moods. Studies have shown that individuals who practice self-compassion tend to have better psychological health and are more resilient to stress.

Interpretation of Events

It's not the events themselves that determine our mood, but rather our interpretation of those events. Our perception of events shapes our emotional response. The lecturer illustrates this with a story about being held at gunpoint in Russia:

Despite the life-threatening situation, the lecturer remained calm and refused to be intimidated. He focused on maintaining control and finding a way out of the situation.
This demonstrates the power of choosing one's response, even in extreme circumstances. Our mindset and perspective can significantly impact how we cope with adversity.

Self-Selection of Environment

We have the ability to choose our environment, which in turn affects our mood. The environments we choose to surround ourselves with can either promote or detract from our well-being. Considering the potential consequences of our choices is essential. A psychological term to consider: self-selection of environment.

Moods vs. Mood Disorders

A mood becomes a disorder when it:

Destabilizes your ongoing life. When moods become so intense or prolonged that they interfere with daily functioning, they may indicate a mood disorder.
Exhibits high intensity. Mood disorders are characterized by extreme emotional states that are disproportionate to the situation.
Has a long duration. Mood disorders persist for extended periods, often lasting for weeks, months, or even years.

Other key factors in assessing mood disorders include withdrawal from the world and the presence of intense cognitive biases. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) provides specific criteria for diagnosing mood disorders such as major depressive disorder, bipolar disorder, and dysthymia.

Cognitive Biases

Cognitive biases are innate human biases in thinking. These biases can distort our perception of reality and contribute to mood disorders. One of the most common is a bias towards negative information. This bias evolved as a survival mechanism, as negative information is often more critical for survival than positive information.

Negative Information Bias

Societies and news agencies often exploit our bias towards negative information to sell more papers or influence opinions. Constantly focusing on negative news can inflate our perception of the base rate of bad things happening in the world. This can lead to increased anxiety and a sense of hopelessness.

Moods are Infectious

Studies have shown that moods can be infectious. Emotional contagion is the phenomenon where emotions spread from one person to another. Intervening with one family on a random street to make them significantly happier or more depressed can influence the moods of their neighbors, even if they have no direct contact. This highlights the importance of social connections and the impact of community on mental health.

Cognitive Behavioral Therapy (CBT)

CBT is a therapeutic approach that combines cognitive and behavioral techniques. It is based on the idea that our thoughts, feelings, and behaviors are interconnected and that changing one can lead to changes in the others. The basic premise of CBT is:

It's not the events that affect you, it's what you tell yourself about the event. Thoughts can be maladaptive. Maladaptive thoughts are negative or unhelpful thought patterns that can contribute to emotional distress.
Thoughts, feelings, and behaviors are interconnected, and changing one can lead to changes in the others. By identifying and modifying maladaptive thoughts and behaviors, individuals can improve their mood and overall well-being.
Humans are inherently biased, particularly towards negative information. This bias can distort our perception of reality and contribute to mood disorders.
The goal of CBT is to identify and challenge maladaptive thoughts and behaviors, and replace them with more adaptive ones. Adaptive thoughts are realistic and helpful thought patterns that promote emotional well-being.

CBT Techniques

Examining Evidence: Evaluating the evidence for and against one's beliefs. Encouraging individuals to critically evaluate their beliefs and consider alternative perspectives.
Challenging Biases: Identifying and correcting cognitive biases. Helping individuals recognize and challenge their cognitive biases to promote more balanced thinking.
Behavioral Experiments: Testing one's beliefs in real-world situations. Designing experiments to test the validity of one's beliefs and challenge negative thought patterns.

For example, a patient who believes they are unattractive might be challenged to gather evidence to the contrary, such as asking others for their opinions. This can help the patient challenge their negative self-perception and develop a more positive self-image.

Example of CBT

The lecturer provides a personal example of how CBT can be applied in real life. When he was younger, he was interested in women but was not very good at approaching them. The voice inside his head would say, "She probably won't like you. Don't bother. Why ask? You know, stay in your lane. You know she's out of your league." But he had a friend who was a genius with women. He would ask a woman out, and if she rejected him, he would simply say to himself, "She's a lesbian. She's not my type anyway."

Scaling in Psychology

Scaling is used in psychology to measure various subjective experiences, such as moods, feelings, and pain. Rating scales, visual analog scales, and numerical scales are commonly used to quantify subjective experiences. However, there are challenges with scaling, as it is difficult to compare the subjective experiences of different individuals. Individual differences in perception and interpretation can affect the accuracy of scaling measurements.

Humor as a Mood Enhancer

Sense of humor is a strong predictor of success in life. Humor can unbias you and put you in a relaxed state, which can help to break negative patterns. Laughter releases endorphins, which have mood-boosting effects and can help alleviate stress and anxiety.

Manipulation of Moods

Moods can be manipulated by both external and internal factors.

External Factors

Marketing, advertising, and the media all know how to manipulate our moods. They use various techniques, such as appealing to emotions, creating a sense of urgency, or associating products with positive experiences. Newspapers, for example, often present a biased view of the world by focusing on negative news.

Internal Factors

Internal factors, such as gut bacteria, cognitive biases, and the way we speak to ourselves, can also significantly impact our moods. Gut bacteria may account for 40 \%$ of depression cases. The composition of bacteria in your intestine affects depression. Probiotics and dietary changes can influence the gut microbiome and potentially improve mood.

Bonanno's Research on Resilience

Bonanno's research has shown that the average person will have one experience in their lifetime that completely knocks them out of action for a year. This is typically the death of a first-degree relative. The grieving process can be prolonged and may require professional support. In addition, the average person will have ten events in their lifetime that will take three to six months to recover from. These events can include job loss, relationship breakups, or serious illness.

Personality and Mood

Personality traits, such as neuroticism, can also influence mood. Neuroticism is a non-pathological tendency to be more negative. Individuals high in neuroticism tend to experience more negative emotions and are more reactive to stress. While it is not a disorder in and of itself, it can make individuals more vulnerable to depression.

Other Therapies

Dialectical Behavior Therapy (DBT)

DBT is a more detailed form of CBT that is used more with personality disorders. DBT incorporates mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills to help individuals manage intense emotions and improve relationships.

Mindfulness

Mindfulness is about remaining in the present moment. It involves paying attention to one's thoughts, feelings, and sensations without judgment. By anchoring yourself in the present moment, you can obliterate 90 \%$ of the ability to be anxious and $$90 \%$ of the ability to be depressed.

Remaining in the present moment also forces you to appreciate the inherent beauty of the experience and reduces the chances of being somewhere else mentally when you are physically present. This can lead to increased feelings of gratitude and well-being.

The Unconscious Mind

Most of our behavior is governed unconsciously. The unconscious mind influences our thoughts, feelings, and behaviors without our conscious awareness. The jury's out on whether you can unconsciously think, but I think we've reached a position in science where we know you can now. Implicit biases and automatic reactions are examples of unconscious processes that can affect our mood and behavior. The route to making the unconscious conscious is self-knowledge, so know thyself. Understanding our unconscious motivations and beliefs can help us make more conscious choices and improve our overall well-being.