This is your brain on drugs/psychotherapy

Posted: Dec 22, 2015 in December 2015

Brain Imaging and Behaviour recently published a meta analysis (research that looks at the results of a number of different studies) focusing on Major Depressive Disorder. These researchers studied the brain scans of people diagnosed with depression across 38 different studies. These studies looked at hundreds of people's brain activity before treatment and after treatment. While there were some overlapping changes, the differences are fascinating:

Medication: most people were taking a type of drug called a selective serotonin reuptake inhibitor or SSRI (Prozac is a well known example of this category of drug). Brain scans showed increased activity in parts of the brain associated, generally speaking, with emotional processing and representing internal bodily sensations (limbic system and other sub-cortical structures including the amygdala). The researchers described the pattern of effects as “bottom up” noting that they may be linked to the alleviation of physical symptoms like fatigue.

Psychotherapy: this was mainly Cognitive Behavior Therapy (CBT). Brain scans showed increased activity in the parts of the brain associated, generally speaking, with processing and storing information/memories as well as thinking about ourselves (frontal cortex and temporal cortex).  The researchers described the changes they noted as “top down”.  This is in keeping with one of the goals of CBT: understanding how we interpret and make sense of the world.

These findings suggest that these two forms of treatment have different, though complementary patterns of impact on the brain. Indeed, this may explain why some research suggests that in Major Depressive Disorder, the combination of psychotherapy and medication may lead to a longer and more successful recovery.