A new study published in JAMA Network Open is challenging one of the most fundamental assumptions in depression treatment: that the goal is to reduce negative emotions. Researchers at Southern Methodist University and UCLA argue that this approach has been missing the most debilitating symptom of depression all along, a condition called anhedonia, which is the inability to feel positive emotions, pleasure, or joy, and which affects nearly 90 percent of people with major depression. Anhedonia is linked to longer illness, slower recovery, and is one of the strongest predictors of suicidal behavior, yet most conventional therapies do not directly target it because they were designed to reduce negative affect rather than rebuild positive affect. The lead researcher put the distinction simply: there is a difference between feeling helpless and feeling hopeless, and taking away negative emotions does not fix the second one.

The research brings together more than a decade of clinical trials on a 15-session psychotherapy called Positive Affect Treatment, or PAT, which was specifically designed to target the brain's reward system and rebuild a patient's capacity for joy, purpose, motivation, and sensitivity to positive experiences. In a randomized controlled trial of 98 adults with severe anhedonia, depression, and anxiety, PAT produced greater improvements in overall clinical status than a conventional therapy focused on reducing negative emotions, and that advantage held at the one-month follow-up. Patients also showed meaningful reductions in depression and anxiety symptoms. The researchers found that the improvements were mediated by measurable changes in how the brain processes reward and threat, suggesting the therapy is doing exactly what it was designed to do at a neurological level. For patients who say their primary goal is not to feel less sad but to feel something good again, this approach may be the most direct path forward that research has yet produced.

Source:https://scitechdaily.com/new-therapy-rewires-the-brain-to-restore-joy-in-depression-patients/