depression

Emotional Yoga: The importance of emotional flexibility for emotional well-being

Tom Hollenstein
Tom Hollenstein

Whether you are frequently wearing Lulu Lemon gear or not, it is difficult to miss the assurgency of yoga as a popular fitness activity. Taking the emphasis away from measurement-based exercise, like marathon running or bench presses, yoga is first and foremost about flexibility. Breathe. Stretch. Relax. Repeat.

In a similar way, one branch of emotion research over the past decade has begun to show the benefits of emotional flexibility.

In the most general sense, flexibility requires change in response to an event. With objects, as with bodies, this is often reflected in bending or changing shape somehow in order to accommodate shifting conditions without losing integrity. The opposite, then, is rigidity, where the object or body resists and retains its pre-existing shape. At its core, the concept of flexibility/rigidity is all about adaptation to local conditions in the environment.

With emotional flexibility, the same distinctions apply.

From moment-to-moment, emotions ebb and flow in a constant stream from one state to the next. A simple ritual of reading the newspaper can create a sequence of anger at a politician, sadness about the passing of a favorite celebrity, and a chuckle from the cartoon on page 12. Interacting with other people also punctuates that ebb and flow through complaints, joking, or interest.

flexible-emotions-Google-SearchA group of researchers led by Peter Kuppens and Peter Koval have examined this ebb and flow as emotional inertia, or the tendency to remain in an emotional state, even when conditions are changing (rigidity). To measure inertia, they use a type of correlation called an autocorrelation, which refers to the degree of correlation between a first moment (let’s call it time 1) with the next moment (let’s call it time 2) and so on. Higher autocorrelations of emotional states means that a person’s emotions are similar across multiple instances and that they are not changing very much. This indicates greater rigidity. Imagine being stuck in an angry mood all day and not reacting positively when you see an old friend. This would be pretty rigid. Now you might think that the reverse could be a good thing—getting stuck in a positive mood in the face of negative events, but this can be rigid too. Imagine you stay positive in the face of a slew of negative events during a really bad day (e.g., you get passed up for a promotion, you learn a friend is sick, you get in a fender-bender on the way home). This might buffer you from the effects of the negative events, but staying positive might also mean that you’re not appropriately reacting to those events or doing anything to change them. It might be more adaptive to get sad or angry when you get passed over for a promotion because it will make you try harder in the future. Consistent with this logic, a series of studies demonstrated that higher inertia, of both positive and negative emotions, has been associated with rumination and low self-esteem, but especially depression and the onset of depression in adolescents. Getting stuck, even in positive states, is not desirable.

But individual’s emotions don’t rise and fall in a vacuum. Most of the time, one’s emotions are ebbing and flowing because of interacting with someone else, whose emotions are also ebbing and flowing. Now add a third person. How can we measure that complexity?

My research group examines emotional flexibility among two or three interacting people by first viewing them as complex dynamic systems. Without getting too technical, the idea is that two people – let’s call them a “dyad” (as opposed to a monad or triad) – form a system of mutual influence on each other. The emotional patterns or “dynamics” of the interaction reveal the nature of that system. At a relatively simple level, we can characterize these dyadic systems as more or less flexible by measuring (1) the range of emotional states experienced; (2) the number of changes in emotional states experienced across time; and (3) the tendency to have short vs. long durations in emotional states. The image below shows the difference between a flexible mother-child dyad discussing a conflict they have at home and a rigid dyad doing the same thing.

Flexible gridrigid grid

Figure from Hollenstein, T. (2013). State Space Grids. New York: Springer.

These state space grids depict all possible emotional states of the mother (horizontal axis) and child (vertical axis) along 5 categories of different types of emotional experiences (e.g., a Hi Pos experience might be feeling excited whereas a Lo Pos experience might be feeling calm). This is simplified for the sake of illustration but can be done with any type of emotional experiences. Each box or cell of the grid represents one state; for example, the bottom left cell is for those moments when both mother and child are in highly negative states (e.g., angry, anxious). The dots and blue lines trace the sequence of those states across the interaction, and the size of the dot indicates how long they were in that particular state. Thus, you can see that the flexible dyad on the left has a greater range of states, (more cells occupied), makes more transitions (more lines), and has shorter durations (smaller dots) than the dyad on the right. The pattern for the flexible dyad on the left is like a movie, with the parent and child sharing and exchanging emotional expressions in fluid motions. The pattern for the rigid dyad on the right is like a series of still photographs, with the parent and child posing for a while and then shifting poses only occasionally. Using this technique, my colleagues and I have been able to show how:

 

Although it is not immediately intuitive, these studies indicate that these effects occur above and beyond emotional intensity or the emotions being experienced – inertia and rigidity in both positive and negative states is problematic. The take home message is clear: experiencing and expressing emotions in a flexible way is generally indicative of healthy functioning in day-to-day life.

Colloquially, it is common to use flexibility and rigidity when describing others. We praise people for going with the flow, chilling out, or rolling with the punches, but then denigrate the stick in the mud or someone stuck in a rut. Perhaps what we are picking up on is a person’s ability to move in and out of emotional states with relative ease. In addition to making sure to do your sun salutations or enough reps, it is just as important to stretch your emotional muscles.

 

Photo credit:http://www.psycholawlogy.com/wp-content/uploads/2013/06/flexible-emotions-Google-Search.png licensed via Creative Commons

 

Understanding the Early-Life Origins of Extreme Anxiety—Role of the Amgydala

Alex Shackman
Alex Shackman

The internalizing disorders—anxiety and depression—are a major human blight. According to the World Health Organization and National Institute of Mental Health, depression is responsible for more years lost to illness and disability than any other medical condition, including such familiar scourges as diabetes and chronic respiratory disorders. Anxiety disorders are the most common family of psychiatric disorder in the United States and rank sixth as a worldwide cause of disability. These disorders, which commonly co-occur, also impose a substantial and largely hidden burden on the global economy: hundreds of billions of dollars in healthcare costs and lost productivity each year. Unfortunately, existing therapeutic approaches are inconsistently effective or, in the case of many pharmaceutical approaches, are associated with significant side effects. Not surprisingly, the internalizing disorders have become an important priority for clinicians, economists, research funding agencies, and policy makers.

The internalizing disorders generally have their roots in the first three decades of life and there is clear evidence that children with a fearful, shy, or anxious temperament are more likely to suffer from anxiety disorders, major depression, or both as they grow older. As a postdoctoral fellow in Ned Kalin’s lab at the University of Wisconsin and, more recently, as the director of my own lab at the University of Maryland, I’ve used a range of tools and techniques to understand the brain systems that contribute to extreme anxiety early in life. Building on a tradition that dates back to pioneering studies at Wisconsin by Harry Harlow, Karl Pribram, and others, much of the work that I conducted as a postdoc used nonhuman primates to model and understand key features of childhood anxiety. Young rhesus monkeys are useful for deciphering the brain circuits that underlie childhood anxiety. Owing to the relatively recent evolutionary divergence of humans and Old World monkeys (~25 million years ago), the brains of monkeys and humans are biologically similar. Similar brains endow monkeys and children with a common repertoire of social and emotional behaviors, which makes it possible to measure anxiety in monkeys using procedures similar to those used with kids. Another virtue of working with monkeys is the opportunity to collect high-resolution measures of brain activity (using positron emission tomography or PET) while the animals freely respond—hiding in the corner, barking, and so on—to naturalistic threats, such as an unfamiliar human ‘intruder’s’ profile. This would be difficult or impossible to do in children and, somewhat surprisingly, has rarely been attempted in adults (most human imaging studies use fMRI, which requires that the subject remain dead still throughout the scan).

Large-scale brain imaging studies, each including hundreds of young monkeys—in humans terms, roughly equivalent to children and teens—show that anxious individuals respond to signs of potential threat with heightened activity in a number of brain regions. For present purposes, I’ll focus on the contribution of the amygdala, a small, almond-shaped region buried beneath the temporal lobe of the brain (the red regions in the accompanying animation).

Collectively, these studies teach us that amygdala activity systematically differs across individuals. Some individuals show chronically elevated activity; others consistently show much lower levels. Notably, elevated activity is associated with exaggerated reactions to potential danger: Monkeys with higher levels of metabolic activity in the amygdala tend to show higher levels of the stress hormone cortisol and to freeze longer (in an attempt to evade detection) in encounters with the human intruder. Like many other qualities that distinguish one individual from another, work by our group demonstrates that amygdala activity is:

1. Consistent over time and context: We can think of amygdala activity as a trait, like personality or IQ.

2. Heritable: Amygdala activity partially reflects the influence of genes. Parents marked by higher levels of amygdala activity are more likely to have offspring with this trait.

Of course, like any brain imaging study, it’s important to remember that these results do not let us to claim that the amygdala causes anxiety. From this perspective, it is reassuring that mechanistic work in monkeys and rodents demonstrates that it does: selective lesions and other biological manipulations of the amygdala sharply reduce (but do not entirely abolish) anxiety (see for example this very recent rodent study). This is consistent with observations of a handful of human patients with near-complete amygdala damage. For example, one relatively well-known patient (identified as ’SM,’ to protect her identity), has normal intellect, but reports a profound lack of fear and anxiety in response to scary movies, haunted houses, tarantulas, and snakes.

According to Justin Feinstein, Ralph Adolphs, and other researchers who have studied SM over the past two decades,

“She has been held up at knife point and at gun point, she was once physically accosted by a woman twice her size, she was nearly killed in an act of domestic violence, and on more than one occasion she has been explicitly threatened with death…What stands out most is that, in many of these situations, SM’s life was in danger, yet her behavior lacked any sense of desperation or urgency. Police reports…corroborate SM’s recollection of these events and paint a picture of an individual who lives in a poverty-stricken area replete with crime, drugs, and danger…Moreover, it is evident that SM has great difficulty detecting looming threats in her environment and learning to avoid dangerous situations.”

This and other evidence—spanning a range of species, populations, and measurement tools—indicates that anxious individuals’ exaggerated distress in the face of potential danger reflects hyper-reactivity in a brain circuit that includes the amygdala. Systematic differences in amygdala activity and connectivity first emerge early in life and can foretell the future development of anxious and depressive symptoms in humans. These and other observations suggest that enduring differences in amygdala function contribute to key features of childhood temperament, like shyness, and confer increased risk for the development of internalizing disorders, particularly among individuals exposed to stress or trauma. More importantly, this work lays a solid, brain-based foundation for developing better strategies for treating or even preventing these debilitating illnesses.

To learn more about the emotional disorders, please visit the Anxiety & Depression Association of America (ADAA) website, which features a number of useful videos, fact sheets, and other resources for patients, clinicians, and researchers.

Photo credit: The amygdala animation was generated by Life Science Databases, obtained from Wikimedia Commons, and is freely used under a Creative Commons license.

 

The way we talk about (and try to understand) suicide

Jasmine Mote
Jasmine Mote

 

Suicide is a difficult topic to talk about. It’s even a difficult topic for psychologists to study. With the tragic passing of Robin Williams, there has been a flurry of grief and thoughtful comments in the media, but there has also been hostility and misinformation. The charitable organization Samaritans, devoted to helping those in distress, recently reminded various media organizations to be cautious of being sensationalist or overly simplistic in their descriptions of suicide. Unfortunately, it is not just artists or famous people or even sad people who deal with suicidal thoughts. The World Health Organization (WHO) reports that roughly one person every 40 seconds dies from suicide, with approximately 10-20 times more people attempting suicide each year. Approximately 38,000 people die each year by suicide in the U.S. alone and, as of 2011, suicide was the 10th leading cause of death according to the Centers for Disease and Control Prevention. The National Alliance of Mental Illness (NAMI) reports that over 90% of people who attempt suicide have been diagnosed with a mental illness, with depression, borderline personality disorder, anorexia nervosa, and bipolar disorder ranking amongst the mental illnesses with the highest risk of suicide. In other words, emotion-related mental health issues put people at risk for suicide.Suicide

For the average person, it’s hard to imagine what would make someone take their own life. It’s similarly difficult to study the factors that contribute to suicide. In scientific studies, psychologists usually form a hypothesis about how a factor contributes to an outcome and then manipulate that factor to assess whether it does in fact have the predicted effect on the outcome. Yet for obvious ethical reasons, researchers cannot manipulate factors and see if it impacts people’s desires to attempt suicide. Instead, researchers who study suicide rely on correlational methods to see what factors tend to be associated with suicide in the general public. Perhaps not surprisingly, some of the major personality traits that are related to suicidal thoughts and behaviors are strongly linked to emotions. Members of the McGill Group for Suicide Studies conducted a systematic review of 90 studies to examine the personality traits related to suicidal thoughts and behavior. They found that the traits that most strongly differentiated people who attempted suicide from those who did not included a tendency to worry and be anxious, to react to everyday stresses with strong negative emotions, and to experience a variety of emotional “ups and downs” in everyday life (all related to a personality trait known as neuroticism). A predisposition towards impulsivity (particularly impulsivity related to aggression) was also strongly associated with attempting suicide. On the other hand, a tendency to be gregarious and experience positive emotions (related to a trait known as extroversion) was the main factor that differentiated people who did not attempt suicide from those who did. The extent to which people say they feel hopeless ­— the persistent feeling that one’s life will never improve, no matter what someone does — also influences the likelihood of suicide. A separate review by Ryan M. Hill and Jeremy W. Pettit at Florida International University showed that people who feel like they are a burden to their loved ones are also more likely to think about and attempt suicide.

So it follows that suicide is closely related to aspects of emotion and perceptions of one’s place in the world. But it is important to note the largest predictor of suicidal behavior is unrelated to current emotion or personality: history of previous attempts (read more here). As a clinician, the first question you ask someone who reports suicidal ideation is whether or not he/she has intentionally tried to harm him/herself in the past, and if so, how many times. Other risk factors include history of physical or sexual abuse and alcohol abuse or dependence (read more here). These are important questions we can be asking our loved ones and, if you are feeling in distress or in trouble, questions we should be answering for ourselves, too.

The more knowledge we gain on why some people attempt suicide does not make it any less tragic. Feeling intense negative emotions, hopelessness that their life will not get any better, and as if their own existence is burdensome to their loved ones, some people might try to harm themselves in an impulse that, if they could take it back the next day, they might. Suicide is a tragedy that can lead to many strong emotional reactions: sadness, anger, confusion, relief, judgment, hostility, shock. While there may never be a concrete or universal answer as to why someone would choose to end his or her own life, there are many researchers and clinicians out there attempting the unenviable task of trying to identify the risk factors and, importantly, understand how we can better prevent such tragedies from occurring.*

*If you or someone you know needs to connect to helpful resources, there are many available. Suicide.org lists many resources and suicide prevention hotlines in the U.S., including the National Suicide Prevention Lifeline (1-800-273-TALK) & the National Hopeline Suicide Prevent Hotline (1-800-SUICIDE, or 784-2433). Additionally, the American Psychological Association maintains a list of research-supported treatments for a variety of mental illnesses. If you are in the UK, you can contact Samaritans. Elsewhere in Europe, you can check to see if your country has a European Union emotional support helpline or you can check the International Association for Suicide Prevention’s website. In Australia, you can contact Suicide Prevention Australia or Lifeline.

 

Does darkness breed creativity?

Kristen Lindquist
Kristen Lindquist

I was inspired this week by the passing of Robin Williams, a comedian whose adroit repartee, clever improvisation, and physical humor touched many lives throughout his career. Williams seems the classic case of the brilliant artist plagued by darkness: he suffered from depression, alcoholism and drug addiction for many years before taking his own life.

We certainly have the idea in our society that brilliance—be it comedic, artistic, or scientific—comes at the cost of happiness. At least anecdotally, many famous individuals suffered bouts of depression or anxiety at one time in their lives and it’s thought that rates of mental illness are 8-10 times higher in writers and artists than in the general population. But does the science of emotion actually bear out the idea that negativity breeds creativity? It turns out, the findings are mixed.14714309947_7e2ae68d07_o

On the one hand, there is evidence that positive, not negative, emotions make you more creative by allowing you to think outside the box. Classic psychology studies reveal that participants who feel positive after watching a funny movie or receiving a gift are more creative on tasks that require broad thinking. One such test is the Remote Associations Test, and it works like this: Participants are given a list of three words and have to think up a fourth that links them all. For instance, they might read, “stool,” “powder,” “ball,” and have to think up a fourth word that is related to them (the answer is “foot”). Positive emotions help you become more creative because they broaden your thoughts, allowing you to see more of the forest and fewer of the individual trees. That’s the good news.

The bad news is that negativity can breed creativity too, particularly for people prone to depression. A study by Modupe Akinola and Wendy Mendes found that negative emotions caused individuals to produce more creative art; this was particularly the case for individuals with a biological vulnerability to depression. The authors first measured participants’ pre-existing levels of a steroid that has been linked to depression called dehydroepiandrosterone-sulfate. (To be clear, merely possessing a biological trait that is linked to depression doesn’t mean you’ll definitely experience depression in your lifetime. Typically you need to have a biological predisposition plus experience a stressful environment to develop clinical depression. See more here.) The authors then caused participants to experience negative, positive, or neutral feelings by giving them unkind, supportive, or no feedback on a mock job interview. Finally, participants were asked to make an artistic collage and real artists later judged the collages for their level of creativity. The authors found that not only did participants in the negative emotion condition produce more creative collages, but that people who had a vulnerability to depression produced the most brilliant work of all when they were feeling negative.

These findings suggest that sadly, darkness can breed creativity. Our hope for the future is that by discovering the links between emotion, creative brilliance, and mental illness, the science of emotion might be better able to help the next generation of Robin Williamses.*

*Sixteen million Americans report symptoms of clinical depression a year and depression is a condition that can be treated. If you are in the United States, and know someone who is severely depressed and might be contemplating suicide, please get in touch with the National Suicide Prevention Lifeline http://www.suicidepreventionlifeline.org 1-800-273-TALK. Many places in the world have similar national hotlines and resources.