Depression is a serious and sometimes devastating health problem which affects millions of people worldwide. In her previous work with depressed patients, Rachel Maddux often felt frustrated that treatments were not helpful for all of those diagnosed with depression. The main focus of her thesis therefore asked the question: why is it that some people are helped but others are not?
Her hypothesis was that those with depressive personality traits – chronic melancholics – are more difficult to treat, especially when they suffer from depression. These people generally feel down and worried, have low self-esteem and are dissatisfied with their lives and environment.
Rachel Maddux found that 13 per cent of residents in Lund have these personality traits.
“This is a very large number, but the results are in line with other studies carried out in the US and Canada.”
The next study looked at how many of those who seek help from a psychologist have depressive personality traits – a large portion, 44 per cent. These people were more seriously ill than other patients when they sought specialist help, according to Rachel Maddux.
Contrary to what she had believed, psychotherapy – both cognitive-behavioural and psychodynamic therapy – helped the depressive personality types as much as those without the disposition.
“The interesting thing was that therapy not only improved the depression itself, it also ameliorated the pervasive depressive traits”, says Rachel Maddux.
She cannot say whether the effect is maintained over time. However, she thinks the study indicates that therapy is good for people with this characteristic manner of depressive thinking and behaviour, even if they are not suffering from acute depression.
The main issue for Rachel Maddux’s research still remains: why aren’t all those diagnosed with depression helped by the treatment they receive? Why do antidepressants or talk therapy work for some but not others?
“But now I know that there is hope for those with depressive personality”, says Rachel Maddux. “The next step will be to study other factors that could affect the outcome of treatment; biology, childhood and development, trauma, etc.”
Rachel Maddux’s thesis is entitled Depressive Personality Disorder: Construct, measurement, clinical correlates, and treatment outcome.