Joyce Ho graduated from the University of Southern California in May 2015 with a Bachelor of Science in Human Biology and a minor in Musical Studies: Piano. As a student, she assisted in research at USC’s Health, Emotion, & Addiction Lab and worked on health policy advocacy with Los Angeles County Medical Association. Holding a Christian perspective on science, she is interested in medical ethics and public health research, as well as providing preventive healthcare to underserved communities.
A recent study on depression in college students led by Dr. Erin Sheets of Colby College revealed that when a depressed individual was faced with a family emergency, increased support from fellow depressed group members prevented worsening of the individual’s condition as well as those of the group members. Past and current studies that focus on the relations between stress and depression reveal correlations between high stress and risk of depression. Yet, in the apparent high stress situation of Dr. Sheets’ study, a shift of focus on the part of the students prevented exacerbation of depression. The reason behind this contradictory occurrence has yet to be investigated. The case study does, nevertheless, imply that the direct effect of stress on depression is not always damaging. Building on this observation, it seems as though the right type of stress could be beneficial. More specifically, stress caused by empathy may positively influence depression, providing for more practical methods of treatment.
While there are many co-symptoms and risk factors for depression, the complete cause of depression is unknown. Medications for depression are labeled “antidepressants” because they target areas of the nervous system in an effort to oppose the effects of depression. Medical treatments that treat illness at its roots, though, do not exist. As a consequence, those who are depressed take antidepressants for as long as they subjectively feel that they need them. The possibility of relapse continues after drug stoppage, showing that current medication does not cure. Combined with correlations between depression and certain aspects of lifestyle, these findings imply that only symptoms, and not causes, of depression are physiological. The proper approach towards treatment thus requires an emphasis on mental and behavioral states.
In today’s business-oriented world, productivity is highly valued, yet long work hours and unstable lifestyles lead to increased daily stress levels. Common health complications caused by chronic anxiety have led to a negative perception of stress (Becker). Co-morbid with this high level of anxiety is an increased risk of major depressive disorder. In fact, almost half of those diagnosed with depression also suffer from some type of stress disorder. Anxiety and depression appear to each worsen the condition of the other, propelling the individual who suffers from both conditions down a path towards psychological and emotional imbalance. Still, stress has an entire compilation of its own distinct symptoms, some that are also normative to depression, and some that are not (Becker). While scientists do not have a physiological explanation for the cause of depression, the intricacies of stress are easier to pinpoint. For this reason, a societal push to lower stress has led to an increase in research on anxiety. Nowadays, public access to intervention strategies and management methods has created readily available resources to provide aid in the battle against stress, including dietary changes, meditation, reorganization of surroundings, and medication. Some careers, such as occupational therapy, build upon the notion of stress relief in efforts to improve health and wellbeing. Because of the wealth of informative articles and preventative measures against anxiety, a great oversight of the potential benefits of stress exists.
Although scientists firmly understand that long term innervation of the sympathetic nervous system is undesirable and detrimental to health, the effects of short term, or acute, stimulation of the nervous system on depression rates are not clearly defined. New pieces of evidence point to possible advantages of acute stress. Anxiety induces release of the hormone epinephrine, which increases one’s awareness and produces a surge of adrenaline to help the individual perform at peak condition; recent studies suggest that acute stress, by way of heightened physiological stimulation, can actually enhance brain performance. A study published by the University of California, Berkeley in 2012 on the influence of acute stress on the adult rat hippocampus demonstrates increased cell proliferation and expression of a certain fibroblast growth factor after exposure to brief stress (Kirby). This highlights the brain’s high capacity for adaptability, and the heightened awareness of one’s environment in response to acute stress. Another experiment recently conducted on reactions to acute stress further demonstrates the potential benefits of responses to stress in affecting reactivity, learning, attention, and overall performance under anxiety-producing circumstances (Jamieson et al.). While researchers must accept that the distinction between various forms of stress and their diverse effects is not fully understood, not all types of stress are harmful to the human body.
By applying the notion of positive, or advantageous, stress to depression, the potential benefits of acute stress can provide aid in relieving symptoms. Symptoms of depression can cause include lethargy, lack of interest, and slowness in physical movement and cognitive function, subsequently leading to difficulty with cognitive skills such as concentration and memory (van Praag et al.). The emotional and psychological issues that are also caused by depression can further lead to measurable physical pain (Zautra). These characteristics of depression, ranging from moderate to extreme in different cases, can eventually become crippling in daily life with regard to the workplace and interpersonal interactions. Acute stress could alleviate these symptoms by exciting the mind and help those who suffer from depression use parts of their brain that would otherwise be underutilized on a day-to-day basis. Synapses, or nerve pathways, in the brain become less effective with lack of persistent usage, but are strengthened and made more effective by frequent stimulation. Targeting areas of neurological arousal through application of stress directly combats degradation of specific brain connections by simply causing usage. Whether the source of acute stress is a favorable or distressing event, a burst of activity nonetheless awakens the depressed individual to greater consciousness.
After acknowledgement of the possible benefits of anxiety, the next challenge lies in applying the method of positive stress healing in a practical and safe way. Clearly, inciting anxiety by causing personal affliction is not a humane or a healthy way to treat an individual who already suffers from psychological, emotional, and physical instability. Additional trauma would certainly worsen the condition of a depressed individual. A more sheltered mode of instigating stress is to appeal to human capacity for empathy. Empathy occurs as a vicarious experience. Studies have shown that merely observing another’s stress can cause one’s own body to produce stress hormones as well, proving that empathy does indeed produce physiological change in the bystander. Additionally, the portion of the brain activated by empathetic experience was shown to be the anterior insular cortex, a region of the brain heavily involved in perception, cognitive function, and interpersonal experience—functions often debilitated by the condition of depression (Gu et al.). By stimulating the area of the brain influenced by depression, empathy holds the potential to curb the effects of the illness by promoting opposing responses.
Empathy works as positive stress because it incites alertness and concern, while also compelling an individual to engage in problem solving and decision-making. Touching upon and drawing out genuine interest or care acts as a strategy that allows an individual to emerge from depressive apathy. Because empathy persuades a person to externally project his or her attention, it draws focus away from characteristic sensations of depression like personal incompetence and pain. Harvard psychologists Matthew A. Killingsworth and Daniel T. Gilbert state that wandering minds—minds filled with continuous thought about things other than immediate circumstances and surroundings—make for unhappy people. Accordingly, one of the symptoms of depression—inattention—may in fact contribute to other emotional attributes of the illness, such as sadness and emptiness. When a depressed person engages in empathy, he or she gathers thoughts and directs them towards the person in need. Killingsworth further explains that even though conditions such as education, income, and marital status do affect happiness, they only explain slight differences in measurement. Rather, the content of “moment-to-moment” experiences, as well as the tendency to “mind-wander,” act as large influencers and predictors of happiness. From this perspective, empathetic experience can affect a depressed person’s level of happiness by persuading him or her to stay grounded in the immediate circumstances of another’s predicament. The situation at hand might not be pleasant and may fail to evoke emotions of joy. However, a simple change in mindset may contribute help alleviate symptoms of depression by lessening one’s feeling of personal unhappiness and emptiness.
Another element of depression that empathy influences is a perceived inability to cope, whether it be dealing with academics, relationships, finances, or another type of traumatic life event. The distraction provided by empathetic projection provides the necessary motivation for a depressed individual to adaptively cope with complications. If a depressed person attempts to cope with his or her own issues, for instance, self-reflection during problem solving rouses an instinctive force of pessimism that weighs down on his or her ability to contemplate freely. This phenomenon, clinically called self-efficacy, means that a person’s actual ability to cope with stress determines the degree to which he or she can solve problems effectively (Nezu & Perri). However, by striving to solve the problem of another person, the focus shifts from personal needs to what can be offered to others, decreasing the helper’s awareness of personal imperfection. The experience of empathy, therefore, places pressure on a depressed person to change his or her perspective from one of self-examination to peer-evaluation. Major life change can also have a detrimental effect on depression by causing a person to feel a loss of control over their environment. Empathy, again, provides a route away from this frame of mind by making one consider another person’s sensation of confusion and uncertainty. The depressed individual may be reassured in the knowledge that others also endure struggles of their own. Comparison based on empathetic perspective may even offer the depressed person a new standard by which to define his or her perception of trouble, lessening the extent of more trivial worries.
Empathy further causes a shift in perspective by persuading one to think in terms of support instead of competition. Certain types of perfectionism tend to combine with stressors to predict or exacerbate depressive states (Hewitt & Gordon). Perfectionism is often described as competition with oneself, and increases the risk of depression due heightened and constant awareness of personal incompetence. Yet, perfectionism cannot exist without the imposition of certain standards upon oneself. These standards are inevitably gauged by observation of social conditions and self-comparison to others. Inherent to perfectionism, then, is competition. Empathy forces a depressed individual to step away from scrutinization of oneself and others. Rather, it encourages one to contemplate ways in which to better the conditions of others. Shifting from the improvement of oneself to that of others gives a depressed person a different sense of purpose. This type of intervention compels the depressed person to overlook what he or she lacks, and prompts awareness of what he or she has to offer. Empathy not only induces a mindset of support and assistance, but it also illuminates a depressed individual to awareness of the capabilities that he or she possesses.
The concept of positive stress through empathy underlies a proposal for more practical methods of treatment for depression. Currently, therapies for anxiety disorders deal with social interaction and problem solving. These types of coping treatments involve altering an individual’s approach to a problem. Essentially, these trainings teach subjects to interpret their own emotions as a means of identifying problems. Once the conditions are established, they are taught to refrain from immediate action, and to instead activate an orderly method of problem solving through an optimistic, structured, and logical lens (Nezu & Perri). In another study of major depression in young adults, researchers built upon the relevance of interpersonal difficulty and cognitive inhibition to depression in their utilization of interpersonal psychotherapy and behavioral therapy towards preventing depressive episode relapse (Sheets et al.). Treatment attempts improved the subject’s ability to cope by instructing patterns of thought and behavior. Current methods focus first on cognitive change, hoping for subsequent external and social results; application of empathy as treatment for depression calls for a less direct or trained approach. By first assuming the social position of observer or even identifying as a fellow victim, empathetic stress brought about by the role will gradually change a depressed individual’s internal perspective. At the same time, the possible harmful impact of the empathetic stressor on the observer is buffered by the fact that the stressful experience is not one’s own reality.
Applied empathy can be put into motion through the notion of service-oriented treatment. This would include activities such as volunteering at community shelters for the homeless, aiding in the immigration process, or providing help at a medical center. The common purpose behind these proposed treatments is to offer those who suffer from depression a chance to engage in conversation and build relationships with people who are struggling from other types of circumstances. Each individual case would generate a burst of acute stress through development of empathy. As a result, interaction with others would increase brain activity, while affecting behavioral attitudes and tendencies of thought. The expectation is that as one begins to think and feel in an empathetic manner, the lifestyle change would alter the plasticity of the brain and naturally inform neurological synapses, essentially instructing the brain to form long-lasting connections that reinforces a shift in perspective.
Empathetic stress provides one explanation as to why an otherwise negative life event, such as a medical family emergency, can actually alleviate depression. Considering the advantages offered by acute stress and empathetic experience, anxiety can benefit depression when channeled in the correct manner. Stirring a depressed individual towards empathy through service-oriented activities offers a systematic way of applying positive stress in the treatment of depression. The effective use of empathetic stress can, if acting on the adaptive nature of the brain, provide holistic and long-lasting benefits for depression.
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