Being depressed disconnects the brain’s "hate circuit"

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Depression is the most common mental illness, but there's still a lot we don't know about how the condition affects the brain. But now, a new MRI study reveals that depression deactivates vital pieces of brain circuitry... including, surprisingly, the region that controls hatred.

Researchers at the UK's University of Warwick performed MRI scans on 39 depressed people and 37 control subjects who didn't have the condition. They were able to pinpoint several key differences in the brain circuitry between the two groups. Most of these centered on the uncoupling of connections between various parts of the brain. Normally, these connections form circuits that allow the different areas to work together to produce more complex mental processes. With the circuits uncoupled, the brain should have a harder time performing the related mental tasks.

That's why it's so strange that the so-called "hate circuit" - a circuit connecting the superior frontal gyrus, insula, and putamen that was shown in 2008 to be strongly associated with feelings of hatred - was often uncoupled in the depressed subjects. The researchers discovered this by showing the subjects pictures of people they hated. While the non-depressed people showed clear activity in this hate circuit, most of the depressed people showed no such response. In fact, the hate circuit was 92% more likely to be decoupled in the depressed subjects.

There were similarly high odds of deactivation for the risk and action circuit (92%) and the emotion and reward circuit (82%), but neither of those is really surprising in terms of the general behavior patterns of people dealing with depression, which is often associated with an unwillingness to take risks and difficulty feeling positive emotions. But since depression is known to be associated with self-loathing - which is very much a form of hatred - then how could that fit with the hate circuit being deactivated?

Researcher Jianfeng Feng has a theory:

"The results are clear but at first sight are puzzling as we know that depression is often characterized by intense self loathing and there is no obvious indication that depressives are less prone to hate others. One possibility is that the uncoupling of this hate circuit could be associated with impaired ability to control and learn from social or other situations which provoke feelings of hate towards self or others. This in turn could lead to an inability to deal appropriately with feelings of hate and an increased likelihood of both uncontrolled self-loathing and withdrawal from social interactions. It may be that this is a neurological indication that is more normal to have occasion to hate others rather than hate ourselves."

Via Molecular Psychiatry. Image by Viktoriya/Shutterstock.

Suicide in America

Suicide is a major public health concern. Around 30,000 people die by suicide each year in the United States. More people die by suicide each year than by homicide.

Suicide is tragic. But it is often preventable. Knowing the risk factors for suicide and who is at risk can help reduce the suicide rate.

Who is at risk for suicide?

Suicide does not discriminate. People of all genders, ages, and ethnicities are at risk for suicide. But people most at risk tend to share certain characteristics. The main risk factors for suicide are:

--Depression, other mental disorders, or substance abuse order
--A prior suicide attempt
--Family history of mental disorder or substance abuse
--Family history of suicide
--Family violence, including physical or sexual abuse
--Having guns or other firearms in the home
--Incarceration, being in prison or jail
--Being exposed to others' suicidal behavior, such as that of family members, peers, or media figures

The risk for suicidal behavior also is associate with changes in brain chemicals called neurotransmitters, including serotonin, which is also associated with depression. Lower levels of serotonin have been found in the brains of people with a history of suicide attempts.

Many people have some of these risk factors but do not attempt suicide. Suicide is not a normal response to stress. It is however, a sign of extreme distress, not a harmless bid for attention.

What about gender?
Men are more likely to die by suicide than women, but women are more likely to attempt suicide. Men are more likely to use deadlier methods, such as firearms or suffocation. Women are more likely than men to attempt suicide by poisoning.

What about children?
Children and young people are at risk for suicide. Year after year, suicide remains one of the top three leading causes of death for young people ages 15 to 24.

What about older adults?
Older adults are at risk for suicide, too. In fact, white males age 85 and older consistently have the highest suicide risk than any other age and ethnic group.

What about different ethnic groups?
Among ethnicities, American Indians and Alaska Natives tend to have the highest rate of suicides, followed by non-Hispanic Whites. Hispanics tend to have the lowest rate of suicides, while African Americans tend to have the second lowest rate.

How can suicide be prevented?
Effective suicide prevention is based on sound research. Programs that work take in account people's risk factors and promote interventions that are appropriate to specific groups of people. For example, research has shown that mental and substance abuse disorders are risk factors for suicide. Therefore, many programs focus on treating these disorders in addition to addressing suicide risk specifically.

Psychotherapy, or "talk therapy," can effectively reduce suicide risk. One type is called cognitive behavioral therapy (CBT). CBT can help people learn new ways of dealing with stressful experiences by training them to consider alternative actions when thoughts of suicide arise.

Another type of psychotherapy called dialectical behavior therapy (DBT) has been shown to reduce the rate of suicide among people with borderline personality disorder, a serious mental illness characterized by unstable moods, relationships, self-image, and behavior. A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and teaches the skills needed to deal better with upsetting situations.

Some medications may also help. For example, the anti-psychotic medication clozapine is approved by the U.S. Food and Drug Administration for suicide prevention in people with schizophrenia. Other promising medications and psychosocial treatments for suicidal people are being tested.

Still other research has found that many older adults and women who die by suicide saw their primary care providers in the year before death. Training doctors to recognize signs that a person may be considering suicide may help prevent even more suicides.

What should I do if someone I know is considering suicide?
If you know someone who is considering suicide, do not leave him or her alone. Try to get your loved one to seek immediate help from his or her doctor or the nearest hospital emergency room, or call 911. Remove any access he or she may have to firearms or other potential tools for suicide, including medications.

If you are in crisis
Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.

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