Are New Treatments for Depression Right Under Our Nose?
“The air of ideas is the only air worth breathing.” – Edith Wharton
Yogic breathing, a phone app, and laughing gas may be some of the best new remedies for depression.
Some interesting pilot studies in 2014 are providing hope for the future of depression. Curiously, these new possibilities all involve the mouth and nose. Breathing a certain way, speaking a certain way, and inhaling nitrous oxide all may have potential in reducing symptoms and breaking the cycle of depression.
Waiting to exhale
A breathing-based meditation practice derived from Sudarshan Kriya Yoga, which helped survivors of a tsunami, may be an effective treatment option for veterans. The combat veterans face in battle often becomes internal in the form of symptoms of post-traumatic stress disorder (PTSD). Depression, anxiety, rumination about the causal event, and hyperarousal all are classic indications.
A study in the 2014 Journal of Traumatic Stress found that 47 percent of the veterans in their pilot study improved their PTSD symptoms after an 11-week period of learning to alternate the duration of inhalation and exhalation. Prior research using more conventional methods, such as antidepressant medications and psychotherapy, have had mixed results.
Hyperarousal in PTSD is an overreaction to stimuli that is harmless, but triggers a startle response, causing the person to become vigilant and on guard. The current research focused on the benefits of controlled breathing on autonomic nervous system responses (such as eye-blink, startle magnitude, and respiration rates) in response to sudden noises.
The study included 21 soldiers, with 11 receiving a week-long training on Sudarshan Kriya Yoga breathing, compared with a control group of 10. Those who were trained had reduced anxiety, respiration rates, and symptoms of PTSD. This technique possibly will add to the growing list of trauma and depression treatments such as EMDR, CBT, and MBSR.
Can you hear me now?
Intuitively, we all know that our voice changes when our mood changes. Research at the University of Maryland is now adding science to that insight. At the October 2014 meeting of the Acoustical Society of America (ASA), a study was reported that found a correlation between depression and certain measurable acoustic properties.
In 2007, researchers had looked at the link between speech patterns and depression and noted that when our mood changes, our voice changes. They monitored patient depression levels while recording them speaking without restrictions about their day.
The current research followed six patients from the previous study whose moods fluctuated. They found that when the patients reported being depressed, their speech was slower and breathier. There also were acoustic fluctuations in frequency and amplitude, which are respectively referred to as jitter and shimmer. The more depressed patients were, the higher their jitter and shimmer, and the more their voices sounded hoarse or rough.
The researchers are hoping eventually to create an acoustic profile of depression-typical speech with the longer-range goal of creating a phone app. They are thinking that an app analyzing speech would be useful for self-monitoring emotional states and popular with teens and young adults. It also will be valuable for those who may not realize they are depressed.
Take a deep breath…
About a third of depressed patients do not improve using existing medical and psychological treatments, and most antidepressant and even rapid forms of psychotherapy, such as CBT, can take weeks to work. The search for new interventions to alleviate the effects of depression safely and effectively is relentless.
Enter nitrous oxide. “Laughing gas” has been used in the fields of medicine and dentistry as an anesthetic for more than a century and a half. However, in the December 2014 issue of Biological Psychiatry, research was reported on the use of nitrous oxide on patients with severe symptoms of depression who had not responded to regular therapies.
Twenty patients received oxygen and nitrous oxide and were evaluated both on the date of the treatment and the following day. Two-thirds reported improvement. When inhaling a placebo of oxygen and nitrogen, only a third of the same patients changed for the better. In this double-blind study, neither the researchers nor the patients knew when the nitrous oxide was being inhaled, or when it was the placebo.
What is attractive about these findings is that a fast-acting treatment could be very helpful for patients with severe depression at risk for suicide, or for temporary relief until methods that are more standard start to work.
The good news is these results are promising. But although the outcomes are hopeful, they were conducted with very few patients. In every instance the researchers called for the need for a larger number of participants to further validate these results.
Nagele, P., Duma, A., Kopec, M., Gebara, M.A., Parsoei, A., Walker, M., Janski, A., … Conway, C. Nitrous Oxide for Treatment-Resistant Major Depression: a Proof-of-Concept Trial. Biological Psychiatry, 2014; doi: 10.1016/j.biopsych.2014.11.016
Seppälä, E.M., Nitschke, J.B., Tudorascu, D.L., Hayes, A., Goldstein, M.R., Nguyen, D.T.H., Perlman, D., Davidson, R.J. Breathing-Based Meditation Decreases Posttraumatic Stress Disorder Symptoms in U.S. Military Veterans: A Randomized Controlled Longitudinal Study. Journal of Traumatic Stress, 2014; 27 (4): 397 DOI: 10.1002/jts.21936
Presentation #5aSC12, “Effects of depression on speech,” by Saurabh Sahu and Carol Espy-Wilson was presented during a poster session on Friday, October 31, 2014, from 8:00 AM to noon in Marriott 5. The abstract can be found by searching for the presentation number here: https://asa2014fall.abstractcentral.com/planner.jsp
Tomasulo, D. (2018). Are New Treatments for Depression Right Under Our Nose?. Psych Central. Retrieved on March 31, 2020, from https://psychcentral.com/blog/are-new-treatments-for-depression-right-under-our-nose/