The MDC influences the training of staff delivering psychological therapies through the Improving Access to Psychological Therapies (IAPT) programme.

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Beating the January blues and other mood disorders

The partying and excesses of the festive season are over and for many it's back to work. It is no wonder that January can feel to some like the gloomiest month of the year.

Add to that wind, rain and cold weather, Christmas debts and failed New Year’s resolutions, and it's no surprise people can find themselves feeling miserable and low at this time of year.

But the good news is that psychological research can help explain these feelings as Prof Ed Watkins, Director of the University of Exeter’s Mood Disorders Centre (MDC), explained.

He said: “Depressed mood is often exacerbated by a perception of a gap between how someone wants things to be and how they actually are. These actual-ideal discrepancies are highlighted at this time of year.”

“There are all these cultural messages around Christmas and the New Year about goodwill to all people, the importance of spending time with close friends and family, having fun, and making new starts. However, for people who are isolated or finding these activities difficult for whatever reason, this stark contrast can make them feel inadequate and blue.”

“Some people can also negatively compare how they are now with what they used to be able to do or what they hoped they would have achieved by now and this can lower their mood.”

Prof Watkins, a Professor of Experimental and Applied Clinical Psychology, even has some advice on how to overcome the January blues.

He revealed: “There is good evidence that being more active – physically and mentally - connecting with other people, getting absorbed in interesting activities, becoming more concrete and specific in your thinking (eg, by asking how?) rather than thinking about meanings and implications (eg, asking why?) all help people to feel better.”

These approaches to overcoming the January blues are based on research into improving the psychological treatment of depression, a key focus of the MDC, a partnership between the University and the NHS.

Research at the MDC looks at mood disorders such as depression, bipolar disorder, and anxiety disorders and has three overlapping aims.

The first is to understand the underlying psychological mechanisms of these disorders by studying how the thoughts, feelings, and actions of people cause the onset or maintenance of depression.

Secondly researchers at the Centre aim to translate that knowledge into more effective and potent psychological treatments and evaluate them in randomised controlled trials.

The third aim is to increase the accessibility of evidence-based treatments – to get treatments that work to as many as people as possible as cost-effectively as possible.

Prof Watkins used his own research as an example of this process.

He said: “My work starts with the mechanisms underpinning depression. We know that rumination and worry are common factors causing depression. My experimental lab research has sought to understand rumination and has shown that you can get people to ruminate in a helpful way by shifting the way they think.

“This in turn led to the development of treatments that explicitly target rumination by training people into more helpful ways of thinking. Clinical trials have shown that this approach is effective at reducing depression in patients with major depression.

“The next step is to increase availability and accessibility of this treatment by delivering it via the internet and by using it to prevent depression before it occurs.”

He added: “Prevention of depression is important because it is a recurrent illness – therefore, stopping initial onset is much more effective at reducing the frequency and burden of depression.

“We are working with Dutch colleagues in a randomised controlled trial providing the internet treatment for young adults who are at high risk of depression because they ruminate and worry a lot. Preliminary data shows that the internet-based treatment reduces the risk of depression by a third and works as well as face-to-face treatment.”

This work has been so successful that Prof Watkins and his team will now implement versions of this internet treatment with the Cornwall NHS Partnership Foundation Trust, and international versions are being developed with researchers in Tokyo and Hong Kong.

The work with the NHS in Cornwall will see the implementation of an innovative fractional factorial trial with 1,000 patients to unpack for the first time the active ingredients of therapy.

The MDC is also working with charity Help for Heroes to support the mental health of military veterans and their families.

Prof Watkins explained: “Help for Heroes have received more than £2.7million grant funding from the Government Libor Fund to develop and evaluate bespoke low-intensity psychological interventions for anxiety and depression in military veterans and their families, for which the MDC is the sole academic partner.

“We will work with them to adapt and test out existing treatment materials and services so they are engaging and accessible for this particular community.”

Amongst the other high profile projects being run by the MDC is the largest international trial to date of whether mindfulness-based cognitive-behavioural therapy, which uses meditation practice, can reduce the risk of relapse in patients with a history of repeated depression, and whether it outperforms ongoing antidepressant treatment.

The MDC is also closely involved in the largest international trial comparing behavioural activation - a simpler and potentially more cost-effective treatment - with cognitive therapy, in the treatment of depression. In a five-year €9million project, the Centre will also investigate the links between diet, lifestyle, and depression across Europe.

The MDC also carries out extensive work with the public including opportunities to take part in research studies.

Central to this is the Lived Experience Group, made up of individuals with experience of mood disorders and their carers, whom inform MDC research, ensure that it is meaningful and relevant to patients. This includes an annual information day to help people find out more about mood disorders.

Recently, Leverhulme Trust-funded artist-in-residence Daniel Jamieson produced an audio-visual display – Mindflow - to show what living with depression is like.