You deserve to know this about depression
Franco Greco • November 5, 2019
Depression is a chronic, recurrent, lifelong condition ... but is this the complete story?
Depression is a chronic, recurrent, lifelong condition. In the main, this is often the conventional, orthodox and public presentation of depression. However is this the complete picture on the enduring impact of depression for all people who suffer from it?
What is the Complete Story?
I read an excellent article in the British Psychological Society Research Digest by Emma Young (https://digest.bps.org.uk/2018/10/30/the-public-deserve-to-know-that-there-is-an-overlooked-subset-of-people-who-thrive-after-major-depression/) , that covered research by team of psychologists led by Jonathan Rottenberg at the University of South Florida on depression.
The research team argued that:
"A significant subset of people recover and thrive after depression, yet research on such individuals has been rare.”
Rottenberg's team agree that long-term studies suggest that a substantial population of people are affected by a burdensome, recurrent form of the disorder.
But the team cite three studies finding that an average of 40 to 50 per cent of people who suffer an episode of depression don’t go on to experience another.
High Functioning After Depression (HFAD) Individuals
They propose a new definition for a subset of individuals - “high functioning after depression” (HFAD). For an individual to be categorised as experiencing HFAD requires more than simply recovering from the symptoms of major depression for at least a year.
Rottenberg and his research team argue that, an individual must also have achieved high end-state functioning – doing well at work and home and socially, and reporting “robust” wellbeing – feeling satisfied with life and enjoying high levels of self-acceptance, for instance.
HFAD individuals - not been a research focus
“This omission, and the field’s lack of focus on good outcomes after depression more broadly, virtually guarantees an unduly pessimistic impression of depression’s course ... ”
The likely driver is that people with recurrent depression are more highly likely to be over-represented in depression studies.
What leads people who exhibit HFAD to become depressed in the first place?
One view is that HFAD individual may represent "a more psycho-social form of depression ... more likely to be precipitated by environmental adversity, such as death, a break up of a romantic relationship or a job loss,” the team suggest.
Whether or not this is the case clearly needs exploring. Emma in her article ponders further questions. Are people who are HFAD more likely to have sought help while they were depressed? Does depression itself play a role in triggering the long-term improvement seen in HFAD? (Something similar has been proposed for trauma). Can we apply what is learnt about HFAD to enhance clinical interventions?
What does HFAD tell us about thriving after other mental disorders?
There are clearly a lot of questions. But here, at least, is a framework for finding potentially useful answers.
“One reason HFAD needs to be discussed,” the researchers write, “is that it is part of the truth, which patients and the broader public are owed. It would be odd if an oncologist did not tell a cancer patient his or her chances of achieving lifetime remission. We submit that a depressed patient also deserves to know. The public deserves to know as well.”
Read more about the article, The Curious Neglect of High Functioning After Psychopathology: The Case of Depression at:
https://journals.sagepub.com/doi/abs/10.1177/1745691618769868
To discuss this article or any feeling of psychological distress
You can contact me at Your Psychologist at the following link:
https://www.yourpsychologist.net.au/appointment-request
What is the Complete Story?
I read an excellent article in the British Psychological Society Research Digest by Emma Young (https://digest.bps.org.uk/2018/10/30/the-public-deserve-to-know-that-there-is-an-overlooked-subset-of-people-who-thrive-after-major-depression/) , that covered research by team of psychologists led by Jonathan Rottenberg at the University of South Florida on depression.
The research team argued that:
"A significant subset of people recover and thrive after depression, yet research on such individuals has been rare.”
Rottenberg's team agree that long-term studies suggest that a substantial population of people are affected by a burdensome, recurrent form of the disorder.
But the team cite three studies finding that an average of 40 to 50 per cent of people who suffer an episode of depression don’t go on to experience another.
High Functioning After Depression (HFAD) Individuals
They propose a new definition for a subset of individuals - “high functioning after depression” (HFAD). For an individual to be categorised as experiencing HFAD requires more than simply recovering from the symptoms of major depression for at least a year.
Rottenberg and his research team argue that, an individual must also have achieved high end-state functioning – doing well at work and home and socially, and reporting “robust” wellbeing – feeling satisfied with life and enjoying high levels of self-acceptance, for instance.
HFAD individuals - not been a research focus
“This omission, and the field’s lack of focus on good outcomes after depression more broadly, virtually guarantees an unduly pessimistic impression of depression’s course ... ”
The likely driver is that people with recurrent depression are more highly likely to be over-represented in depression studies.
What leads people who exhibit HFAD to become depressed in the first place?
One view is that HFAD individual may represent "a more psycho-social form of depression ... more likely to be precipitated by environmental adversity, such as death, a break up of a romantic relationship or a job loss,” the team suggest.
Whether or not this is the case clearly needs exploring. Emma in her article ponders further questions. Are people who are HFAD more likely to have sought help while they were depressed? Does depression itself play a role in triggering the long-term improvement seen in HFAD? (Something similar has been proposed for trauma). Can we apply what is learnt about HFAD to enhance clinical interventions?
What does HFAD tell us about thriving after other mental disorders?
There are clearly a lot of questions. But here, at least, is a framework for finding potentially useful answers.
“One reason HFAD needs to be discussed,” the researchers write, “is that it is part of the truth, which patients and the broader public are owed. It would be odd if an oncologist did not tell a cancer patient his or her chances of achieving lifetime remission. We submit that a depressed patient also deserves to know. The public deserves to know as well.”
Read more about the article, The Curious Neglect of High Functioning After Psychopathology: The Case of Depression at:
https://journals.sagepub.com/doi/abs/10.1177/1745691618769868
To discuss this article or any feeling of psychological distress
You can contact me at Your Psychologist at the following link:
https://www.yourpsychologist.net.au/appointment-request
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