Ergonomics and Depression:

                                                                           Toward an Anabolic Treatment Methodology

By Robert DePaolo

MS Clinical Psychology

　

Abstract

　

This article offers a concise, integrative view of depression by weaving together principles of psychology, biology and energy conservation. It is based on the assumption that, despite the complexity of the human mind and the personality, we operate according to energy dynamics similar those of other mammals, and particularly primates. Some unique dimensions of depression are discussed with suggestions for a treatment methodology.

　

________________________________

　

Most anthropologists would concur with the fact that there are vast anatomical similarities between Homo sapiens and other creatures. For example, the hands, feet and brain structure of a human are unquestionably similar to, if not derived from, the basic primate mind-body template (Holloway Gannon et al 1998), Britten (2002). Beyond the primate anatomical model, it is well known that the genetic makeup of hair, skin, feathers, and scales of various creatures are remarkably similar, making it appear that despite life’s diversity, the core genetic template for all life forms is fairly uniform. (Kautz 1991)

Not all clinicians are comfortable discussing human personality in this context While advocates of Evolutionary Psychology such as Buss (1995) acknowledge the behavioral commonalities among all organisms, others view the connections as limited and functionally negligible, particularly as pertains to normal and pathological human behaviors, moods and thought processes (Wilson & Dietrich 2003). In any case, it raises the question of whether clinicians can treat psychopathology (particularly depression) in terms of fundamental aspects of nature.

Conceivably, we can, particularly as it pertains to factors responsible for the onset of clinical depression. While most clinicians are familiar with various methods for working with depressed clients, I would like to propose a rationale for a brief, focused and natural treatment approach to clinical depression

As an initial premise, consider that while depression can take many forms, including endogenous, acute, chronic and episodic ( as well as overlapping with other syndromes), it has constant features which can be addressed via a brief treatment method. Before outlining a treatment strategy, it might be helpful to describe those features in a psychobiological context.

It would appear that depression involves three core elements. First, there is a disruption of the anabolic/catabolic cycle. (Pomerantz 2006), (Prescott 2007) (Goldapple, Segal et al 2004). That has psychobiological implications. All organisms (including humans) orchestrate mind and body according to a specific sequence. The first step in the sequence involves the buildup and conservation of energy resources — a process typically referred to as the anabolic phase. The second step occurs when energy is expended in the execution of (hopefully) adaptive, problem-solving behaviors. This is called the catabolic phase. At the risk of waxing “cosmic,” all organisms (and energy systems) in nature function according to this principle. It has been noted that the behaviors and emotions of all organisms (whether deemed normal or atypical, adaptive or maladaptive) must revolve primarily around the principle of energy conservation (Ferry & House, 2006) Consequently, consuming more than is conserved will threaten the homeostatic integrity of any organism - including man.

In that context, carnivorous mammals are known for their “hunt and sleep” lifestyles. These creatures are energy systems, and as such, seek ergonomic efficiency. The rest-activation sequence provides that.

Humans are energy systems as well, but human physiology involves a somewhat unique metabolic process. Our brains are inordinately large and consume a much higher percentage of the body’s energy that the brain of any other animal. That suggests we catabolize vast energy resources through cognition, emotion and other covert experiential activities. Our “hunt” can take the form of information-seeking and the internal search for emotional equanimity. This burns energy as much as the motor behavior of predators on the hunt. Whether it take the form of worrying, planning, mental rehearsals or prolonged vigilance we must apportion consumption and conservation to remain psychologically intact. Whereas the hunting mammal (or the physically active human) recognize fatigue fairly easily, the energy consumption arising from internal mental activity is less noticeable. One reason for this is cultural. A notion, ingrained in most human cultures, is that physical work is real work whereas thinking is a passive process requiring minimal expenditure of energy.

That cultural bias (considering the role of mitochondria in cognition, it might also be called a myth) might play a significant role in the onset of psychopathology, particularly with regard to depression.

Depressed clients are often not aware of energy consumption as a causative factor in the disorder. While Freud alluded to clients’ naivete with regard to the origins of their pathology ( ie, a lack of insight which he described as “neurotic stupidity”) clients are perhaps even less aware of the toll constant covert mental activity takes on their soma and overall energy resources. That is because they often tend to have rigid personalities, perfectionist tendencies and compulsions. For example In a research review article, Gregory Hanna of the University of Michigan Depression Center indicated that while OCD is classified as an anxiety disorder, it commonly occurs with depression. Compulsions, narcissistic preoccupations and hopelessness often create a uni-focus, precluding the dual focus on experience and energy expenditure necessary for physical and mental health. That is especially true when covert mental activity dominates the client’s sensorium.

A psychodynamic pattern favoring fantasy, worrying, excessive vigilance over overt problem-solving behavior presents an inherent ergonomic problem, in that much energy is expended while few problems are solved. Since covert activity does not typically solve externally generated (social) problems, the covert activity continues to proliferate because it has a target - the problem still exists. Without overt behavioral resolutions the problem and the covert activity will continue to proliferate, occasionally leading to psychic exhaustion. If there is one thing other animals can teach us about avoiding psychopathology it might be that there must be a fluid, proportionate relationship between overt and covert behavior (for purposes of resolution/energy conservation) and between rest and covert and overt activation.

The assumption here is that non-fluidity between overt and covert behavior as well as activity and rest can implode into depression. Yet it’s not just that energy is lacking. While behavioral hopelessness (i.e. Seligman’s notion that response irrelevance leads to depression (1991) inhibits overt behavior, it doesn’t necessarily inhibit unproductive, internal mental activity. As a result, a negative cycle is set in motion: Behavioral suppression begets internal expenditure of energy, which depletes resources that might otherwise be used to facilitate overt problem-solving behaviors. That energy depletion results in unmet needs and exacerbates the depression.

A byproduct of behavioral suppression and depression (and perhaps its neural source) is non-extenuation. Whether due to faulty neurotransmission, hopeless ideation, nihilistic fantasies or behavioral stagnation, depressed clients lack a capacity for experiential persistence. Just as neurons cannot extend into the nether regions of mind, where perspective and hope can be found, so does experience have a halting, terminal and hopeless topography. When an extension of experience is invoked — whether it be thinking about the future, setting long-term goals or simply sustaining attention to a complicated task — it tends to produce overload and deepen the client’s depression.

Another effect is uncertainty. This is a state in which solutions can’t be found and where stagnation in experiences, relationships and self-appraisal produce noise, leading to a vicious cycle continuance of obsessive covert mental activity.

It involves a cyclic process analogous in which…

A. A penchant for covert energy expenditure becomes obsessive due to the inability of internal activity to resolve problems.

B. Habitual covert activity borrows energy from the soma, precludes overt problem solving and prevents anabolism from occurring so as to re-energize the central nervous system

C. Irresolution resulting from lack of overt problem solving devolves into pervasive uncertainty so that a dual pathology consisting of depression-induced hopelessness and anxiety-induced uncertainty combine to create both despondency and urgency in one pathognomic pattern. As a result the client is compelled to expend energy he does not have, solve problems he cannot solve, except through self injury and ritualistic behaviors.

In light of that rather insidious pathological pattern the counselor interested in short term results could appropriately focus on breaking the cycle, restoring overt/covert balance and emphasizing energy conserving behaviors and life style components in therapy.

In that context, it is possible to discuss a concise set of methods for providing short-term relief to depressed clients. The following are offered as tentative guidelines - though not as a definitive methodology.

Suggested methods

1. The client can anabolize…or conserve energy through a relaxation of goals, behaviors and perceptions.

This involves turning the “experiential zoom lens” down a bit in a minimization phase of counseling by encouraging depressed clients to rest and temporarily abandon futuristic thought and behavior. The support of the counselor is crucial at this stage because the client might resist the idea of taking a “psychic hiatus” and come to equate rest with failure or irresponsibility. Furthermore, depression is often accompanied by anxiety, which can foment tension-driven activity. Still, the benefits of taking this step are considerable. By espousing that the client revert to an anabolic state, the counselor can not only help to reset the psychobiological gauge but also take pressure off the client, who is, in effect, given permission to withdraw for a while.

2. Inform significant people in the person’s environment.

Family members and other influential people in the client’s life should be informed by the client and/or the counselor pending confidentiality issues, that rest is a prerequisite for energy restoration and that their support is crucial. This is important because even a temporary abandonment of goals and social investment can lead to negative social consequences, regardless of how “natural” the rest period might be.

3. Prompt new self-assessments by the client.

SPONSORED LINKS:

In light of the client’s newfound willingness to “shut it down,” a broader, more flexible and tolerant sense of self can begin to emerge and should be encouraged by the counselor. This process can give rise to new information about the self, which can ameliorate the client’s uncertainty and also realign the rest-activity cycle, further helping the client avoid psychic fatigue (anhedonia, psychasthenia) in the future.

4. Wait for the client to become restless and hungry for stimuli.

At some point in the counseling process, the therapist will recognize that the client has sufficiently anabolized and is prepared to enter a catabolic phase, prompting the expression of energy and reasonable goal setting. The counselor can then help the client set small, reachable goals that are not so difficult or ego-syntonic that failure would lead to emotional duress.

5. Set more substantive goals.

This step involves prompting behaviors that are likely to secure social and/or material reinforcers. Depression is linked to neurological transmission deficiencies. Positive reinforcement tends to create links between neurons and nerve branches, and is in itself a good “conductor” of brain activity as well as an extenuator of experience. In other words, as a neurotransmitter in its own right, positive reinforcement can be a reasonably effective substitute and/or adjunct to mood-enhancing medications.

6. Further reduce the client’s entropy or uncertainty.

This step involves the counselor not only supporting a more expansive rest-activation psychological metabolism for the client but also encouraging his/her pursuit of new experiences through reasonable risk taking and a more flexible, resilient self-definition.

These reenergizing strategies are not intended to minimize the importance of social experiences such as trauma, relationship problems or deep-seated feelings of helplessness that should also grist for the mill in counseling. However, they can hopefully prove useful in delving deeply into the psychobiological roots of human nature and addressing the problem of energy depletion in depressed clients.

　

　

　REFERENCES

　

Britten, R. (2002) Divergence Between Samples of Chimpanzee and Human DNA Sequence is 5%. Proceedings of the National Academy of Sciences USA 99, 13633-35

Buss, D.D. (1995) Evolutionary Psychology: A New Paradigm for Psychological Science. Psychological Inquiry 42, 455-491

Ferry, J & C. House (2006) The Stepwise Evolution of Early Life Driven by Energy Conservation. Molecular Biology and Evolution. Vol. 23, 6 1286-1292

Goldapple, K. Z. Segal & C. Garson (2004) Modulation of Cortico-limbic pathways in major depression: treatment specific effects of cognitive behavior therapy. Archives of General Psychiatry 61: 34-41.

Hannah, G Article in University of Michigan Depression Center Newsletter. Feb. 2007.

Holloway, R & Gannon, P (1998) Similarities Found in Human and Chimp Brains, Science Daily. Jan.7, 1998. Article Retrieved Nov 25, 2009

Kautz, P (1991) The Limits of Biological Variation. CRS Quarterly Vol. 28 (1)

123-128.

Prescott, W. (2007) Depression and Metabolic Syndrome. Anxiety-depression-alternative.com

Pomerantz, J (2006) Brain Metabolic Correlates of Depression and Recovery. Psychiatric Times Vol. 23, # 8

Seligman, M.E.P. (1991) Helplessness: On Depression, Development and Death. 2nd Edition, New York, Academic Press

Wilson, D.S. & E. Dietrich (2003) On the inappropriate use of the naturalistic fallacy in evolutionary psychology. Biology and Philosophy, 18, 669-682

　

　

　

　

　

　

　

　

BIOGRAPHY

Robert DePaolo is a Licensed Clinical Mental Health Counselor in New Hampshire. He is former Clinical Director at Spaulding Youth Center, Adjunct Prof. of Clinical Psychology in the NH University System, author of several books on anthropology and psychology, Robert is currently working in private practice, providing clinical assessments, consultation, training and counseling services for schools and agencies in the state of New Hampshire Contact him at

robertde@surfglobal.net.