Anxiety and depression are real problems for many people around the planet. It has been estimated that, since 2012, nearly 16 million people in the United States have suffered from one depressive episode. This is about 7% of the American population. At least half of the people in the country who suffer from major depression never seek out psychotherapy or any other kind of treatment. Experts have said that the American economy loses about $80 billion each year due to the loss of productivity and to pay for the costs associated with depression.
According to Science Daily, New research shows that how well people who suffer from depression or anxiety will respond to psychotherapy can be seen in scans of their brains. This new research was published in the Harvard Review of Psychiatry. It was in the November/December 2016 issue of that scholarly publication.
Scientists have been able to find neuroimaging markers that can predict how well a patient with anxiety or depression will respond to counseling and can help doctors determine who would be a good candidate for treatment with individual counseling and who might be more effectively treated with medications. Not everyone who has been diagnosed with major depressive disorder (MDD) or other mental health problems is helped by psychotherapy services.
“While some brain areas have emerged as potential candidate markers, there are still many barriers that preclude their clinical use,” said Dr. Trisha Chakrabarty of University of British Columbia, Vancouver and lead author of the journal paper.
Scientists involved in the study looked at existing images from brain scans and sought to find a connection between what they saw there and how effective the psychotherapy they received ended up being in alleviating their depression or anxiety. Researchers looked at the neuroimaging markers. They compared what they did to using various lab tests and electrocardiograms to determine treatments for heart condition such as myocardial infarctions. They looked at more than 40 studies of patients with obsessive compulsive disorders, post traumatic stress disorder, MDD and other mental health diagnoses. The studies looked at the structure, anatomy of the brain. Others included functional scans which can detect activity in the brain.
The studies did not pin point one specific area that is affected when a person suffers from any of these mental health disorder, rather researchers found what they call “candidate markers” in the brain that may be helpful to predict what treatment will be the most effective. Two areas of the brain that stood out as important in this were the amygdala and the anterior insula. The amygdala is the part of the brain that is responsible for moods and the anterior insula is responsible for a person’s responses to anxiety, level of trust and physiologic state.
Patients who suffer from MDD who were found to have a more active amygdala appeared to respond better to psychotherapy services. On the flip side, people who suffer from anxiety and have less activity in that region of the brain were also helped by more counseling. In terms of the anterior insula, people who had been diagnosed with MDD and had lower activity in the anterior insula were more helped by counseling while people with anxiety who had a more active anterior insula, were the ones for whom psychotherapy was the most helpful.
Scientists also looked at the part of the brain called the anterior cingulate cortex (ACC). This is another area that is critical to the regulation of emotions. They found that people suffering from MDD who had less active ACC areas were helped more from psychotherapy than people with more active ACC regions.
“Future studies of psychotherapy response may focus further on these individual regions as predictive markers,”said Dr. Chakrabarty. “Additionally, future biomarker studies may focus on pretreatment functional connectivity between these regions, as affective experience is modulated via reciprocal connections between brain areas such as the ACC and amygdala.”
This is an exciting development as conditions involving depression and anxiety can be challenging to treat. More research will need to be done to see how much can be determined by looking at scans of patients’ brains. They may end up helping people get the most from psychotherapy and medication.
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