Positive Activity Depression Can Be Effective


Positive Activity Interventions (PAI) serves as an effective, low-cost treatment for people suffering from depression, according to a new study.

PAIs are intentional activities such as performing acts of kindness, practicing optimism, and counting one's blessing gleaned from decades of research into how happy and unhappy people are different.

The study by a team of UC Riverside and Duke psychology, neuroscience and psychopharmacology researchers appears in the August 2011 issue of the Journal of Alternative and Complementary Medicine

The new approach has the potential to benefit depressed individuals who don't respond to pharmacotherapy or are not able or willing to obtain treatment, is less expensive to administer, is relatively less time-consuming and promises to yield rapid improvement of mood symptoms, holds little to no stigma, and carries no side effects.

The research team reviewed past PAI studies, including randomized, controlled interventions with thousands of normal men and women as well as functional MRI scans in people 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," says Sonja Lyubomirsky, professor of psychology and director of the Positive Psychology Laboratory at UC Riverside, who was part of the research team.

However, such findings have not yet entered mainstream psychiatric practice.

"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," says P. Murali Doraiswamy, M.B.B.S., FRCP, of Duke University, another team member.

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 behaviors, only two studies specifically tested these activities in individuals with mild depression.

In one of these studies, lasting improvements were found for six months. 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.

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."

More than 16 million U.S. adults – about 8 percent of the population – suffer from either major or chronic depression. About 70 percent of reported cases either do not receive the recommended level of treatment or do not get treated at all, according to the National Institute of Mental Health. Globally, the World Health Organization estimates that depression affects more than 100 million people.

Although antidepressants can be lifesaving for some individuals, initial drug therapy produces full benefits in only 30 percent to 40 percent of patients. Even after trying two to four different drugs, one-third of people will remain depressed.

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