Positive Activity Interventions can help relieve depression

Positive Activity Interventions can help relieve depression

By Liz Lockhart

Teaching people to practice positive activities are being proposed as a new, lower cost method of treating depression.  The naturopathic technique is an extension of decades of social psychology research.

Researchers at the University of California, Riverside and Duke University Medical Centre  have proposed this new treatment approach which is called Positive Activity Interventions (PAI) in a paper published in the Journal of Alternative and Complementary Medicine.

PAIs are intentional activities such as practicing optimism, performing acts of kindness and counting one’s blessings. 

The philosophy is based on extended research on how happy and unhappy people are different.

The researchers believe that this new approach has the potential to benefit depressed people who do not respond to pharmacotherapy or are not able or willing to obtain treatment.

The technique has many benefits which include being relatively less time-consuming and has yielded rapid improvement of mood symptoms, holds little or no stigma, carries no side effects and is less expensive to administer.

According to the National Institute of Mental Health about 70% of reported cases of depression either do not receive the recommended level of treatment or do not get treated at all.  The World Health Organisation estimates that depression affects more than 100 million people globally.

While pharmaceuticals can be lifesaving for some people, initial drug therapy produces full benefits to only 30-40% of patients.  After trying two to four different drugs, one third of people will remain depressed – according to this research.

The research team was led by Dr. Sonja Lyubomirsky, professor of psychology and director of the Positive Psychology Laboratory at University of California, Riverside and by Lihong Wang, M.D., and P. Murali Doraiswamy, M.B.B.S., FRCP, of Duke Univrsit. 

They conducted a rigorous review of previous studies of PAIs, including randomized, controlled interventions with thousands of normal women and men and also functional MRI scans in peope with depressive symptoms.

 ‘Over the last several decades, social psychology studies of flourishing individuals who are happy, optimistic and grateful have produced a lot of new information about the benefits of positive activity interventions on mood and well-being,’ Lyubomirsky said.

 ‘Very few psychiatrists collaborate with social scientists and no one in my field ever reads the journals where most happiness studies have been published. It was eye-opening for me as a psychopharmacologist to read this literature,’ Doraiswamy said.

Lyubomirsky said that after she and Doraiswamy exchanged notes, ‘the obvious question that popped up was whether we can tap into the PAI research base to design interventions to galvanize clinically depressed people to move past the point of simply not feeling depressed to the point of flourishing.’

Although the paper found that positive activity interventions are effective in teaching individuals ways to increase their positive thinking, positive affect and positive behaviours, only two studies specifically tested these activities in individuals with mild depression.

Effective PAIs used in the study included writing letters of gratitude, counting one’s blessings, practicing optimism, performing acts of kindness, meditating on positive feelings toward others, and using one’s signature strengths, all of which can be easily implemented into a daily routine at low cost.

People often underestimate the long-term impact of practicing brief, positive activities, Lyubomirsky said.

For example, if a person gets 15 minutes of positive emotions from counting her blessings, she may muster the energy to attend the art class she’d long considered attending, and, while in class, might meet a friend who becomes a companion and confidant for years to come. In this way, even momentary positive feelings can build long-term social, psychological, intellectual, and physical skills and reserves.

During the research a review of brain imaging studies led the investigators to theorise that PAIs may act to boost the dampened reward/pleasure circuit mechanisms and reverse apathy – a key benefit that does not usually arise from treatment with medication alone.

“The positive activities themselves aren’t really new,” said Kristin Layous, a graduate student and the paper’s lead author. “After all, humans have been counting their blessings, dreaming optimistically, writing thank-you notes, and doing acts of kindness for thousands of years. What’s new is the scientific rigor that researchers have applied to measuring benefits and understanding why they work.”

 ‘While PAIs appear to be a potentially promising therapy for mild forms of depression,’ Doraiswamy cautioned, ‘they have not yet been fully studied in people with moderate to severe forms of depression. We need further studies before they can be applied to help such patients.’

On a personal note, I have practiced counting my blessings for quite some time.  Every night, as I drift off to sleep, I think of all the positive things that I have experienced during that day.  Sometimes, when you have had a bad day, that may seem difficult but positive things can be found if you just look hard enough.  It can be something very insignificant like watching a butterfly, enjoying a meal, a surprise telephone call or the sight of a beautiful flower in the garden.  When you fall asleep with positive thoughts in your head, I find that you wake feeling happier the next day.

Source: University of California - Riverside


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