Photo by Nicholas Rigg/ Photographer's Choice/Getty Images
|
What the Scans Say
By Jim Thornton, May & June 2006
|
Treating depression is a little like skinning the proverbial cat—it
can be effectively accomplished in multiple ways. The two most intensively
studied approaches, medication and short-term psychotherapy, have now amassed
twin peaks of research data proving their respective efficacy. But do these
different approaches work the same on the level of the brain itself?
In a fascinating series of brain scans conducted at the University of
Toronto, neurologist Helen Mayberg, M.D., and her colleagues compared the
brains of patients who'd recovered from drug therapy with those healed by
cognitive therapy.
"We wanted to know if the two approaches triggered the same brain
changes," explains Mayberg. "But lo and behold, in people who got
well by therapy, changes in the brain don't look anything like those that
happen with drug recovery."
One way of conceptualizing depression is that raw, painful emotions trigger
negative thoughts, and the two proceed to intensify each other in a downward
spiral. "Antidepressants," says Mayberg, "appear to be targeting
brain regions that generate and maintain the raw negative emotions. Therapy, on
the other hand, focuses on regions prone to getting 'stuck' endlessly
rehashing negative thoughts."
Though much more work remains to be done to confirm this hypothesis,
Mayberg's work bolsters the experience of many practicing psychiatrists:
the optimum treatment for depression may well be the combination of
antidepressants and therapy.
"Our scans clearly document for the first time that these two different
approaches have complementary, not overlapping, effects in the brain,"
Mayberg says. "More and more, it looks like you can get people out of a
depressive episode a little faster with a drug, but to promote long-term
remission, it really helps to get people trained in a cognitive or
interpersonal therapy, too."
|
