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I chose this topic because I understand what it's like to suffer in silence, so gathering resources for people like me is something I am passionate about. Normalizing and destigmatizing other forms of treatments besides medication and physical activity is important.

“Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say ‘My heart is broken.’”

― C.S. Lewis, “The Problem of Pain”

How do depression and mental illnesses affect our motivation to seek treatment, and how can these individuals find treatment?

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The article "Exercise and Mental Health" was excellent; it presented a scientific claim and then backed it up with scientific evidence. However, there are gaps in the research. While the claim is that exercising helps mental health, the authors also should have factored in how difficult it may feel to do activities such as those while suffering from mental illnesses.

How does suffering from depression and mental illness challenge the body and fight the mind about doing basic tasks, such as exercising? This duality in IL-6's function illustrates the body's complex response to exercise, showing that "larger amounts of IL-6 are produced in response to exercise than any other cytokine" (K. Mikkelsen et al. 53). This use of evidence explains the logical benefits of regular exercise in improving both physical and mental health. This is a great point; it establishes the thought well and backs it up. However, depression is not just a mental or emotional condition; it has significant physical side effects as well. Individuals suffering from mental illnesses or depression often experience fatigue, muscle aches, and a general lack of energy. These symptoms make the idea of engaging in physical activity unappealing. The body's physical resistance due to these symptoms creates a substantial barrier to initiating and maintaining an exercise routine.

Mental illnesses like depression and anxiety often involve negative thought patterns. These can include self-doubt and a lack of motivation. The cognitive effort required to hurdle these negative thoughts can be overwhelming. For example, an individual with depression might feel that they lack the strength or worthiness to exercise, or they might be paralyzed by anxiety at the thought of going to a gym or exercising in public. Furthermore, the social and environmental context plays an important role. People with mental illnesses often face judgment and may lack social support, which can discourage them from engaging in physical activities. For instance, the fear of being judged or misunderstood can deter someone from joining group exercise classes or even walking in their neighborhood. This social isolation hardens the challenge, making it harder for individuals to take the first step toward incorporating exercise into their routines. Addressing these barriers requires a multifaceted approach. Healthcare providers should consider personalized exercise programs that start with small, manageable goals and gradually increase intensity. This approach can help people build confidence and develop a sense of accomplishment. Integrating mental health support with physical activity programs can also encourage. For instance, cognitive-behavioral strategies can help individuals reframe negative thoughts and build a positive view toward exercise. While exercise undeniably has mental health benefits, it is essential to recognize the challenges faced by individuals with mental illnesses. The physical symptoms of depression, coupled with negative thought patterns and social barriers, make it difficult for these individuals to engage in regular physical activity. By addressing these challenges through personalized programs, mental health support, and inclusive communities, we can better support individuals in pushing past these barriers and gaining the benefits of exercise for physical and psychological health.

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The article "Motivation and Cognitive Control in Depression" addresses various aspects of cognitive control and motivation in depression but shows several gaps regarding treatments. The introduction intros discussing cognitive and motivational deficits in depression but lacks a clear outline of how the paper will address treatments for these issues. For example, the article states, "Current understanding of cognitive control in depression is predominately descriptive, and research is focused on detecting deficits in specific cognitive processes, such as the inhibition of negative material" ” (Grahek et al.1). This indicates a gap in identifying the underlying causes of these deficits, rather than merely documenting their presence.

Furthermore, the article highlights the need to integrate cognitive, motivational, and emotional impairments in the existing literature. The authors argue that research often isolates these factors instead of considering their relation. As noted, "Research on cognitive control in depression has been focused on charting deficits in different cognitive control processes... These deficits are commonly thought of as the lowered ability to inhibit certain thoughts or stimuli, shift attention away from them, or update the contents of working memory" ” (Grahek et al.2). This fails to account for how these processes might interact to contribute to the broader cognitive impairments observed in depression.

Another significant gap is the reliance on small sample sizes in neuroimaging studies, which leads to heterogeneous results and limits the generalizability of findings. The authors state, "However, the neuroimaging studies have often been conducted on very small samples, and there is considerable heterogeneity in their results" ” (Grahek et al.2). This variability underscores the need for larger, more robust studies to confirm and extend these findings. By reiterating the call for larger studies, the article aims to make the audience feel empowered and capable of making a significant contribution to the field.

In summary, the article emphasizes the potential impact of filling these gaps. The need for mechanistic models, the integration of cognitive, motivational, and emotional factors, and the exploration of motivational deficits are all areas that require attention. By reiterating the urgency of addressing these gaps and the potential benefits of doing so, the article aims to instill a sense of responsibility in the audience.

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The research on the treatment of depression has made progress, yet several gaps remain that require further exploration. For example, while “newer psychotherapeutic techniques have been introduced that may be just as good at alleviating acute distress,” there is a small amount of long-term studies assessing the efficacy of these therapies versus medication.(Hollon et al. 36) Most current studies focus on immediate symptom relief. Individual variability in treatment response suggests a need for personalized approaches, yet robust guidelines to tailor treatments to individual needs are lacking.

One significant gap is the limited comparative data on various forms of psychotherapy, such as cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and mindfulness-based cognitive therapy (MBCT). Some evidence suggests CBT may effectively reduce relapse rates, but it remains unclear if this holds across diverse populations and long-term scenarios. The research does not fully describe the mechanisms by which therapies improve life quality beyond mere symptom relief. Understanding how these therapies “improve the quality of relationships or reduce the risk that symptoms will return” after treatment ends could optimize their use. (Hollon et al. 37)

Another critical gap is the under-representation of diverse demographic groups in clinical trials. Current studies often feature participants from specific age groups, socioeconomic statuses, and ethnic backgrounds, leaving gaps in understanding treatment efficacy across diverse populations. For example, the unique stressors and cultural contexts of minority groups may affect depression and treatment response. Without inclusive research, treatment guidelines may remain generalized, overlooking things that could enhance treatment efficacy for underrepresented groups.

Moreover, the research frequently overlooks patient experiences and preferences. While clinical outcomes are crucial, understanding patients’ subjective experiences with treatments can provide valuable insights into adherence and long-term success. Some patients “would prefer not to have to take the pills” due to side effects or a desire for more control over their treatment. (Hollon et al. 36) Addressing these gaps through targeted research could significantly enhance the effectiveness of depression treatments, ultimately leading to better patient outcomes. Combining “prescriptions to reduce acute symptoms quickly and psychotherapy to broaden their effects” may offer the best chance for a full recovery without recurring problems. (Hollon et al. 36)

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Depression and other mental illnesses impact motivation to seek treatment, often influenced by neurobiological factors explained through advancements in brain imaging technology. For instance, chronic stress induces low serotonin levels, correlating with an increased risk of severe outcomes like suicide attempts, as "low brain serotonin activity correlates with a higher risk for more violent attempted and successful suicides." Similarly, dopamine, crucial for motivation and goal-directed behavior, is reduced in depression, contributing to reduced initiative and drive to seek help. The role of neurotransmitters like serotonin and dopamine emphasizes the complexity of treatment responses, where standard antidepressants aim to alleviate symptoms by increasing serotonin availability but "only work in some cases."(Garcia-Arocena 2)

Treatments are complicated by the patient responses and the ineffectiveness for a portion of people, as "30% to 40% of depressed patients... do not respond to standard antidepressant treatments." (Garcia-Arocena 2) Emerging therapies like ketamine offer promising alternatives, rapidly alleviating symptoms in treatment-resistant cases, yet their long-term efficacy and safety remain under concern. Environmental factors such as early trauma or chronic stress worsen depressive symptoms, accentuating the need for personalized treatment strategies that address individual profiles and life experiences.

Despite significant strides in depression's neurobiology, societal responses to mental health challenges often lag. Depression, affecting nearly 10% of the US population, remains a pressing public health concern, yet its physiological basis and treatment have been misunderstood or overlooked. Increased funding and research initiatives promise to advance treatment modalities and foster a more nuanced approach to mental health care. By investing in comprehensive research and personalized treatment approaches, society can better support individuals struggling with depression, ensuring personal interventions that promote long-term recovery and well-being.

Integrating neuroscientific insights with holistic approaches to mental health underscores the potential for individualized care that considers biological and environmental factors. This approach not only enhances treatment effectiveness but also addresses the stigma and societal neglect often associated with mental illness. By embracing a multifaceted understanding of depression and mental health disorders, clinicians and policymakers can forge pathways toward accessible, effective, and compassionate care that empowers individuals to seek and sustain recovery.

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In her insightful TED Talk, Heidi Grant emphasizes the challenge and importance of asking for help daily despite its often uncomfortable nature. Grant humorously illustrates many people's reluctance towards seeking assistance, likening it to fears of public speaking and death. Drawing from personal experiences, such as her father's refusal to ask for directions when lost, she highlights the typical avoidance of admitting vulnerability and needing help. Grant highlights the necessity of hurdling this hesitation, asserting that effective requests for help are crucial for obtaining support from others. She provides practical advice, advocating for clarity and specificity when asking for assistance, as vague requests often lead to confusion and ineffective help.

Additionally, she discourages disclaimers, apologies, and bribes, which can diminish the willingness of others to assist. Grant urges making requests in person or via direct communication to improve the odds of a positive response. She stresses the significance of acknowledging and appreciating the help received, as it reinforces the helper's sense of efficacy and motivates continued support. Grant encourages embracing the reality that success and well-being often depend on collaboration and support from others, urging individuals to confidently and graciously seek help when needed, fostering mutual benefit and growth in relationships. Her insights provide a compelling framework for navigating the dynamics of asking for and receiving assistance in personal and professional contexts.

Grant's TED Talk empowers those who have grappled with the reluctance to ask for help. By weaving personal stories with psychological insights, she shows the psychological barriers that hinder effective communication of needs. Her emphasis on the illusion of transparency highlights a common misconception—assuming others can know our needs without communication. This misconception often leads to missed opportunities for support.

In a world where interdependence is increasingly essential, Grant's message is a beacon of hope. She reminds us that vulnerability in asking for help is not a weakness but a strength that strengthens connections and promotes mutual growth. Her talk encourages a shift towards respectful communication, ensuring both parties benefit from the exchange. By embracing these principles, individuals can develop more supportive environments where asking for help is met with understanding, willingness, and genuine assistance, promoting a sense of hope for a more collaborative and supportive future.

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How to ask for help -- and get a "yes" | Heidi Grant

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Grahek, Ivan, Shenhav A, Musslick S, Krebs RM, Koster EHW . “Motivation and Cognitive Control in Depression.” Neuroscience and Biobehavioral Reviews, U.S. National Library of Medicine, 27 May 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6642074/.

Mikkelsen, Kathleen, et al. "Exercise and mental health." Maturitas 106 (2017): 48-56

Garcia-Arocena, Dolores. “Happy or SAD: The Chemistry behind Depression.” The Jackson Laboratory, 22 Dec. 2015, www.jax.org/news-and-insights/jaxblog/2015/december/happy-or-sad-the-chemistry-behind-depression#.

Steven D. Hollon, Micheal E. Thase AND John C. Markowitz. “Treating Depression: Pills or Talk?” Scientific American Mind, vol. 14, no. 5, 2004, pp. 34–39. JSTOR, http://www.jstor.org/stable/24997552. Accessed 29 May 2024.

Ted. “How to Ask for Help -- and Get a ‘Yes’ | Heidi Grant.” YouTube, YouTube, 25 July 2019, www.youtube.com/watch?v=h-TIRIxhq6E.

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Reflection

This entire semester, I have been focused on the mental health side of things, as this is something I am very passionate about. I am happy I decided to delve into it further. Throughout this semester I have learned from the countless scans and read throughs of scholarly articles and my peers that mental health is a lot deeper than I originally thought. Things like this make me more passionate about a topic, which promotes me to further my own research and learn more, which I have also done this semester. While going through all the articles we have this semester I have learned a lot, from treatment methods to the mechanics of mental illnesses. Being able to absorb this much information about a single topic has been extremely exciting. I am also excited to apply this new knowledge to my life and hopefully assist my peers and family.

Conclusion:

When looking at all the research done, it’s easy to say this is not an ignored category of research. Why should we assist everyone? Why should there be less generalized research? Helping the community of lesser assisted individuals struggling with mental health is vital as it showcases an understanding of their unique issues. Ignoring those issues and generalizing studies is not an efficient way to assist everyone that needs help. By opening research to the diverse population, it will be easier to gain more reliable information that can be built on in the future as studies progress and grow. Overall, broadening the studies and assisting people when they need genuine help is important in gathering information that is worthwhile.