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Rethinking depression

Courtesy of Binghamton University Magazine

Everyone with risk for depression has red hair and small feet. This statement is wildly untrue, but were it accurate, psychologists would have a much easier time tackling the issue before it became a problem.

The field of psychology is moving away from a “one-size-fits-all” approach to understanding the risks for depression and is leaning toward one that treats the disease as heterogeneous. Brandon Gibb, professor of psychology and director of the Mood Disorders Institute and Center for Affective Science, is helping to spearhead that movement at Binghamton University.

“What we do in our lab that’s somewhat unique is that we try to understand depression across multiple levels of analysis,” Gibb says. “We’re really interested in how genetic, biological, neural, environmental and cognitive influences all come together to increase depression risk.”

Here’s a staggering statistic: Forty percent of people suffering from depression who receive state-of-the-art treatment — whether psychotherapy or medication — remain depressed. This suggests that clinicians need a radically different approach to handling depression, Gibb says. He wants to know what’s going on in the brain, the body and the environment that makes people depressed. The ultimate goal is to use this information to develop better prevention efforts.

“We try to understand depression risk across the lifespan, and so we look at kids, adolescents and adults,” Gibb says. “We’re interested in risk for first onset of depression, but also what increases risk for relapse. We know that up to 80 percent of people who recover from a depressive episode will go on to have another one, so we’re trying to understand, how do you break that cycle?”

It takes a family

Studying depression from so many different angles is daunting. Luckily for Gibb, he’s got a team of undergraduates, post-baccalaureate lab managers, grad students and a post-doc to help him get the job done.

“The way I’ve built my lab is to keep it as small as possible so that it feels as much like a family as it can,” Gibb says.

Every time he takes on a new grad student, it’s because he wants the lab to grow in a certain way. Everyone in the lab has his or her own expertise, and projects are assigned with these strengths in mind.

“They’re part of a broader team, but they have their own unique areas of expertise. There’s no competition in the lab for different things because everyone has his or her own niche,” Gibb says. “The other nice thing that happens is that people learn that psychology is a super-collaborative science. You can’t do really interesting research on your own. So they recognize each other’s strengths and start collaborating, independent of me, and are able to do some really fantastic things.”

Mary Woody, MS ’13, is part of that family. A fifth-year grad student, her expertise is the integration of physiological (e.g., heart-rate variability) and cognitive (attention biases and rumination) risk factors to better understand risk for depression. She was part of a well-publicized study in which eye tracking showed that women whose attention is drawn to angry faces are at a greater risk for depression relapse in the future.

Like her mentor, Woody believes that depression must be examined from a multimethod perspective. “One of the most exciting and yet frustrating aspects of understanding depression is acknowledging it is one of the most heterogeneous brain disorders,” she says.

“Therefore, when you are treating a client, that person’s presentation of depression may look drastically different from other clients’. Thus, by studying depression from multiple theoretical and methodological perspectives, you begin to develop a picture of subtypes of the disorder that you would not have seen without a multimethod lens.” 

Using eye trackers to understand people’s attentional biases is one method. But, as Gibb points out, that’s just one piece in the puzzle.

“What we’re always trying to do is to say, given the outcome of depression and given the heterogeneity of influences, how can we get at all of these things? While we’re studying attention, we’re also looking at people’s behavior. The key part of it is how are you processing the things that are going on around you? When there’s some type of emotional information in your environment, how are you processing it?”

Enter Max Owens. A postdoctoral research fellow in Gibb’s lab, he conducted research looking at the risk for the development of attention biases in children. Examining the genes associated with the body’s response to stress, he found that children who had variants in these genes, and who also had depressed mothers, were more likely to show attention biases, suggesting that children’s genetic risk is, in part, linked to their mother’s depression.

Owens has another paper under review showing that attention biases are related to levels of another well-known risk factor for depression: rumination. He showed that people who ruminate, even if not currently depressed, show biases in attention to emotional information that are characteristic of clinical depression, which may help to explain why some individuals are at risk for depression in the future.

“We found that frequent rumination about sadness does tend to bias a person’s attention to negative information and less to positive information, suggesting increased rumination is a key moderator of risk for depression,” he says. 

A love of research

Gibb became interested in psychology the way lots of people do — he simply wanted to help people. He entered college intending on becoming a clinician. One day he saw an ad to volunteer in a lab. After participating in research, he saw his future.

“Over time, I got more and more excited about research. I think that’s what happens with our undergrads here, as well. They don’t know much about what research looks like [until] they work in a lab and see that they can make a difference on a different scale. They can create new knowledge.”

Katie Burkhouse has worked in Gibb’s lab for six years. She was the lead on a study looking at pupil dilation, which found that how much a child’s pupils dilate in response to seeing an image of a sad face can predict his or her risk of developing depression over the next two years. Gibb thinks that this research could eventually lead to universal screenings in pediatricians’ offices to assess the risk for future depression in children. Like Gibb, Burkhouse was bitten by the research bug, and she’s in it for the long haul.

“One of the main reasons that I applied to Binghamton was to work with Brandon because of his reputation in the field for being a leading depression researcher,” she says. “This career choice was the right decision.”

Just getting started

With so many potential factors at play in depression, Gibb and his research team will be busy for a long time to come. They’re looking at the role of inflammation in depression as well as synchrony of physiological and neural activity during parent-child interactions, to name a couple of their current projects.

“Helping people suffering from depression calls for a multifaceted approach that considers life history, biology and personality, because problems in these areas combine to cause and increase risk for depression, but we aren’t quite sure how,” Owens says. “By conducting studies with multiple levels of analysis that touch on each of these domains, we can begin to piece the puzzle together and learn how to help people suffering from depression by targeting the points where risk develops.”

What Gibb hopes to do with all of this new knowledge has not changed since his early days as a psychology student: He wants to help people.

“It’s always easier to intervene before a problem occurs than to wait for the problem to develop and then try to do something,” Gibb says. “That’s why we’re really focused on the early markers of depression risk and things that you can assess easily, like pupil dilation. I really like the idea of being able to treat mental illness just like any other illness where you have regular checkups with your doctor and there are objective, reliable tests that can be done to judge your level of risk and that point the way to personalized treatment approaches.”

Tags Tags: Binghamton University , Research

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