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Could Positive Activity Interventions treat depression better than drugs?

Kathleen Blanchard's picture
Positive Activity Intervention

Teaching optimism, gratitude and kindness might alleviate depression.

It may be possible to treat depression by delivering happiness to people with depression, suggested by researchers at University of California, Riverside and Duke University Medical Center. Rather than focusing on medications, the scientists propose using Positive Activity Intervention, or PAI as depression therapy.

In their paper, "Delivering Happiness: Translating Positive Psychology Intervention Research for Treating Major and Minor Depressive Disorders”, the researchers honed in on the differences between happy and unhappy people.

Happy people are grateful and more optimistic than unhappy people – observations that come from decades of research. They tend to count their blessings and find it easier to be kind.

Encouraging random acts of kindness, practicing optimism and teaching depressed patients to count their blessings could be an inexpensive therapy without the side effects of drug treatment and minus the stigma of traditional treatment, suggest the researchers.

Kristin Layous and Joseph Chancellor, graduate students at UC Riverside; Sonja Lyubomirsky, professor of psychology and director of the Positive Psychology Laboratory at UC Riverside; and Lihong Wang, M.D., and P. Murali Doraiswamy, M.B.B.S., FRCP, of Duke University collaborated on the study.

The team performed a rigorous review of previous studies involving PAI and depression outcomes. They also looked at functional MRI scan results in people with symptoms of depression.

"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," Doraiswamy said.

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Their review showed Positive Activity Intervention can teach people how to increase their own positive thinking and behaviors, yet only two studies tested the effect of PAI in people with mild depression.

In one study, the benefits of positive activity interventions, which included writing letters of gratitude, counting individual blessings, practicing optimism, acts of kindness, meditating on positive emotions felt toward others, and focusing on individual strengths, persisted for six months.

Lyubomirsky said practicing brief, positive activities, is underestimated by people. Feeling positive for fifteen minutes can lead to energy needed to participate in other activities that build social skills and support systems.

Layous, the paper's lead author said, …”humans have been counting their blessings, dreaming optimistically, writing thank you notes, and doing acts of kindness for thousands of years. What's new is the scientific rigor that researchers have applied to measuring benefits and understanding why they work."

Even though there are dozens of studies showing how happy people flourish, none of the results have been applied to mainstream psychiatric practice, Lyubomirsky said.

The authors caution that more studies are needed to find out if Positive Activity Interventions can help people with moderate or severe depression.

According to the National Institute of Mental Health, 70 percent of depressed individuals do not get recommended treatment. Medications, though they can be lifesaving, work 30 to 40 percent of the time for completely relieving symptoms.

The paper suggests a new approach is needed for treating depression. They propose exploring PAI or Positive Activity Intervention as an alternative for improving mood and well-being among people with symptoms of depression.

The Journal of Complementary and Alternative Medicine
Delivering Happiness: Translating Positive Psychology Intervention Research for Treating Major and Minor Depressive Disorders
DOI: 10.1089/acm.2011.013
Kristin Layous, MA, et al.; August, 2011

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