Teen Depression Treatment

The power of a good laugh

Dateline, Portland, Oregon—Amelia J. Wilcox, Ph.D.: A good laugh is hard to beat, and turns out to be contagious, and good for us. But why?

In 1979, Norman Cousins wrote a book titled Anatomy of an Illness. In it, the writer, political activist and editor of The Saturday Review outlined the story of his exuberant approach to a diagnosis of Ankylosing Spondylitis. The apocryphal story tells us that he checked himself out of the hospital and spent a month in intentional laughter. When he returned for an evaluation he was found to be disease free. His physicians did not believe he’d laughed himself to health. But note that in the next phase of his career he was appointed an adjunct professor of medical humanities in the UCLA School of Medicine, where he did research on the biochemistry of human emotions.  

I have written elsewhere in this blog about our habitual emotional states, and work with my patients around these matters all the time. In addition, for the last five years my Introductory Psychology students have chosen to do a positive psychology project each semester. I have seen hundreds of them engage in an examination of their habitual emotional states as a result of this project. And news from the front—Norman Cousins was right! Laughter is excellent medicine.

I am thinking about this today because of the viral video featuring a Texas woman who purchased a Chewbacca mask, and shared her joy with the entire internet world this week from the front seat of her car. At this moment, 1,037,162 people have viewed this hilarious clip. Why is it so popular? Well, it is (to say the least) contagious. She is sharing a moment of pure joy with all the world, and the world is laughing along.

Why are such things so popular on the internet? We love to watch kittens and puppies do silly things, babies giggle hysterically at fathers who tear up sheets of paper, and zoo animals behaving in unexpected ways. And seeing someone laugh—even if it is on a computer screen—makes us laugh, too.

To understand the contagious power of laughter, it helps to understand the role of mirror neurons. Mirror neurons are thought to be the home base of empathy, imitation and the recognition and capacity to share emotions that promote social engagement. These special neurons are found in the frontal and parietal lobes. They fire when we engage in behavior, and also when we observe behavior in others. In theory, observing laughter causes our mirror neurons to fire as though we were laughing ourselves.

When we choose laughter, we are making a choice to engage in something that bathes our bodies in stress-reducing hormones. There is evidence that this boosts our immune system, improves blood flow, boosts mood and dulls pain. Will it cure major illness? The evidence for this remains unclear, but there is no question that laughter creates a sense of engagement, soothes tension and destresses. So go ahead and find something funny to laugh about.

And to the wonderful woman in the Chewbacca mask, thank you! 

One effect of meditation on the brain

Dateline, Portland, Oregon--Amelia J. Wilcox, Ph.D.: Mindfulness-meditation is getting serious attention from scientists and consumers alike. Businesses are including it in their benefit packages, elementary schools are recognizing its power to improve classroom atmosphere, and psychologists are incorporating it into many treatments for conditions such as stress, anxiety and depression, pain management and insomnia. How, exactly, does it work on the brain?

Master meditators:
A number of years ago, psychologist and neuroscientist Richard Davidson began to look at meditation. In an effort to gain a clear picture of its effect on the brain, body and psyche, he went straight to the master-meditation source, Tibetan Buddhist monks. Monks in this tradition work for decades to become fully skilled in meditation practice, and they demonstrate the many positive effects of leading a life of contemplation. Monks are capable of a quality of focus, clarity, emotional control and mastery over bodily experience most of us would probably never expect to have in our own busy lives.

Can average people gain meditation’s benefit?
Davidson wondered whether some of the benefits of mindfulness-meditation practices could be taught to ordinary people with busy and stressful lives, and if so, whether the people who mastered basic skills would have a different experience of their world. To explore his idea that meditation might change people’s lives for the better, he brought a simple meditation training course to busy US executives. Eight weeks later he compared them to a matched sample of executives who had gone about life as usual.

Neural findings and experiential changes:
Davidson’s findings were powerful. EEG and fMRI data demonstrated that those who were taught simple meditation techniques shifted brain activity from parts of the brain associated with hypervigilance and stress toward brain regions associated with more positive mood states. Meditators in Davidson’s study also demonstrated improved immune response, when compared to those who were not taught simple meditation techniques.

What happens in the brain when we meditate:
Decades ago, neuropsychologist Donald Hebb coined the phrase neurons that fire together wire together. Some years later neuroscientists Per Andersen and Terje Lomo did basic brain research that led to the discovery of long-term potentiation, the scientific observation of Hebb’s neuropsychological theory. What does this have to do with meditation? Neurons that learn to fire together are developing habitual patters of action that have behavioral, emotional and learning correlates. As this applies to meditation and the frontal lobes, specifically, the meditating brain increases left prefrontal activation. With repeated practice, this activation becomes easier to produce, because healthy and functional neural pathways are created in the brain, and are strengthened and reinforced through meditation exposure. This is but one example of what is likely to be happening when you sit down to meditate.

Anecdotal reports:
Theory or practice, most people I know who make meditation part of their lives have a great deal to say about its positive impact on their mood and stress levels. And the research seems to back them up—indicating regular meditation may have powerful effects on a host of symptoms that are accepted as part of being alive in a stressful age.

People flock to yoga studios and meditation retreats in order to capture some of the effects in their own lives. But research indicates that even a few minutes a day spent in meditation, even if they happen while sitting at your desk, waiting in the carpool line or just before taking a big test in school, can lead to improvements in attention, concentration and clarity, and an improved sense of well-being.

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Getting started:
How do you get started? There are countless meditation apps available for your smart phone. Find one that works for you and see how it goes—keep a journal to track your progress. See what happens when your neurons fire together and wire together.

When a friend is depressed

Dateline Portland, Oregon, Amelia J. Wilcox, Ph.D.: It is difficult enough as adults to know how to approach a depressed friend. Teenagers are often on the front lines with their peers, aware of a friend's depressed mood and wanting skills to help them through a difficult time, but unsure how to have such a challenging conversation. What do you do when you are a teen and your friend is depressed?

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A young friend of mine had tea with me a few months ago, and the conversation turned to an important question—how could she help her best friend, whom she thought was depressed. More and more teens struggle with depression these days. This reality means their close friends often end up on the front lines—the first to recognize that something might be wrong.

The first thing I did was ask some clarifying questions. Did my young friend, for example, understand the difference between a blue mood, depression that occurs in reaction to a stressor, and a major depression? Blue moods come and go for us all. They are, I explained, part of the human condition, and if we listen to them when they arrive they can tell us important and useful things about our stress and how we are managing life. An adjustment disorder, on the other hand, is a moderate depression that occurs in reaction to a stressor and may continue for a few months. Finally, a major depression is a more severe condition that can last for weeks to months and includes symptoms like sleep disruption, and sometimes suicidal thoughts. She explained that her friend had become increasingly sad in recent weeks, and that it didn’t seem to be getting better.

I asked her if there had been an unusual event or stress in her friend’s life. Were things okay at home? Had she experienced a disappointment in a relationship or problems with her applications to college?  I explained an adjustment disorder occurs in reaction to something that happens in life. For most people, even without treatment adjustment disorders will resolve within months of the stress going away. But just because something is likely to go away by itself eventually doesn’t mean you shouldn’t get some support. Support can help you learn what led to the stress and give you tools to better manage stress now, and in the future.  I also explained that for some vulnerable people an untreated adjustment disorder may not resolve, but instead evolves into a major depression, which can be very serious.

My young friend told me she wasn’t sure if there had been anything really recent, but explained a very specific stressor that had occurred a few months back, one that her friend’s family was still working to manage. That could, I mused, be a clue about what was going on. I asked my young friend what she was noticing that worried her.

She told me that at first she thought her friend was mad at her because she seemed angry all the time, and really touchy about everything. She asked if she’d done something wrong, and her friend promised she hadn’t, but acknowledged she’d been stressed and just didn’t feel like herself. Now, my young friend told me, her best friend just seems sad all the time. She’s not much fun to be around and she doesn’t go to games or other after school activities any more.

I told my young friend that it was a really good idea to talk to her own mom and maybe to the school counselor about her worries, and said that I had some difficult questions to ask, the answers to which would suggest whether those conversations should happen immediately or not. I explained why I was asking them, and assured her that it was okay if she didn’t know the answers. First, I asked if her friend had thought about harming herself. I also asked what she knew about her friend’s drugs or alcohol use, explaining that sometimes people use these things because they are depressed, but that it is also true that these things can cause or exacerbate depression.

My young friend and I finished our tea and she went home to talk to her mom. Her mom phoned me that evening to get some referrals to pass along. When my young friend and I met for tea recently, she told me her best friend had started going to psychotherapy and had also joined their group of girlfriends for a sleepover that weekend. I told her how impressed I was by her courage. It is a good friend who knows when to reach out for help, and does it even though it is hard.