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Harvard Health Blog
Can computer-guided cognitive behavioral therapy improve depression treatment?
- Author: James Cartreine, PhD,
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Agree ! I do not think communing with a computer is going to better a person’s feelings about isolation !
However, it is better than doing nothing and may lead someone to further treatment .
Nothing like a system for treatment for depression in this country that totally misses the forest for the trees.
Why is depression increasing? Why is it the leading cause of disability, and (combining treatment and lost productivity costs), the most expensive disorder facing all Western societies? These don’t have easy answers, but surely part of it is a view of depression, promulgated by big Pharma, that depression is some version of a “chemical imbalance.” The reality is that virtually every neurochemical signaling system that’s been looked at – neuropeptides, hormones, amines, and even cytokines – appears to be altered in depression, mostly by the other players, suggesting that the entire system of modulatory controls rotates or pivots around an axis, and where it’s very hard to find any evidence for a single prime mover. Stress cascades, dynorphin, declining opioids and oxytocin, and the dynorphin mediated shutdown of reward seeking, dovetailing with increased pro-inflammatory signals in the CNS, all appear central. But depression isn’t simply an illness, it’s a conserved mammalian brain mechanism – every single mammal that we studied is capable of depression. So what are we missing?
This “Chemical Imbalance’ meme has successfully atrophied the medical profession’s potential awareness of the enormous body of evidence (mostly from animal models but also from clinical anecdotes) that depression is intimately related to many forms of stress, particularly social loss, social isolation and social defeat. It is also intrinsically related to pro-inflammatory signals. It’s no coincidence that we have pro-inflammatory lifestyle factors running amok in our country (pro-inflammatory diet, sedentary lifestyle, sleep deprivation, as the big three). When you put together our pro-inflammatory lifestyle with our social isolation and our compulsive pursuit of materialism and consumerism, you have a formula for depression on a large scale. We have lost any real sense of connection to others, to nature, and for that matter to our better selves.
So the notion that plunking people down in front of computers – a treatment which only recapitulates the deadly isolation that is pandemic in our society – is a viable treatment for depression is a sad testimony to how badly we have lost our way as a society and as a system of medical care.
” … (pro-inflammatory diet, sedentary lifestyle, sleep deprivation, as the big three). When you put together our pro-inflammatory lifestyle with our social isolation and our compulsive pursuit of materialism and consumerism, you have a formula for depression on a large scale. We have lost any real sense of connection to others, to nature, and for that matter to our better selves.”
A refreshing and insightful comment. Thanks, Dr. Watt! Right on target.
It seems to me that this approach would naturally be less successful. Wouldn’t it lead to feelings such as “I’m such a worthless human being that no other human is interested in me or my problems; I have to talk to a machine.” I can’t believe this is a good solution for a person suffering from depression.
Exactly what I thought as well. It’s hard enough for depressed folks to cope with feeling like they have to pay people to listen to them and give advice without the medical community pawning them off to pills and now machines.
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