Social Acceptance Response in Depressed Patients

Taylor Swift’s song “Shake It Off” might just be onto something, according to a study published in Molecular Psychiatry about major depressive disorder.

Researchers from the University of Michigan Health System compared 17 patients with major depressive disorder to 18 health controls in a study about simply “shaking it off” in response to social rejection or acceptance. This study was conducted in order to test the hypothesis that mu opioid receptor system in the brain — which is also linked to physical pain response – in response to social rejection and acceptance is altered in medication free diagnosed patients with major depressive disorder compared to health controls.

Using a positron emission tomography (PET) scan, the researchers studied the participants after they had viewed photos and profiles of hundreds of other adults. The participants were instructed to select profiles/ photos of people they were most interested in romantically — in a similar way that online dating works – and were told that it was only a simulation. The patients were then informed, during the brain scan, if the individuals they found attractive and/ or interested in were not interested them in return. The PET scans were used to measure the moment of rejection through the amount and location of opioid response.

The investigators noted a decreased opioid response in the brains of the depressed patients, especially in regions which regulate stress, mood, and motivation.

In a social acceptance model of the study, where patients were informed their choices were mutually interested in them, both depressed and healthy participants reported feelings of happiness and acceptance. This was a surprising finding, the authors noted, because they had previously anticipated a dulled response from the depressed patients. The positive feeling that comes along with social acceptance disappeared more quickly in the depressed individuals, but was still present. The researchers attributed the faster disappearance of the feelings to the altered brain response. Only the healthy participants reported feeling motivated to connect with the adults in the profiles, however.

“Our findings suggest that a depressed person’s ability to regulate emotions during these interactions is compromised, potentially because of an altered opioid system,” lead author David Hsu, PhD explained in a press release. “This may be one reason for depression’s tendency to linger or return, especially in a negative social environment. This builds on our growing understanding that the brain’s opioid system may help an individual feel better after negative social interactions, and sustain good feelings after positive social interactions.”

Follow up studies on the patients who were more sensitive to social stress, and therefore more vulnerable to disorders like social anxiety and depression. The researchers want to test different methods of increasing the opioid response in the brain.

“Of course, everyone responds differently to their social environment,” continued Hsu. “To help us understand who is most affected by social stressors, we’re planning to investigate the influence of genes, personality, and the environment on the brain’s ability to release opioids during rejection and acceptance.”