‘Melancholia’ depression can be spotted in someone’s facial cues while watching TV, experts say

THE most severe form of depression could be spotted while watching a film, a new study has found.

Melancholia depression is a serious type of depression that can cause a person to lose interest in almost all activities.

Treating the condition can be difficult because standard treatments don’t usually work – it often requires a different treatment approach.

But the findings of a new study offer hope for earlier diagnosis and to help patients get the right treatment quickly.

It could also avoid more invasive interventions that might be required if the diagnosis is delayed.

As part of the study, patients watched emotionally evocative films, and the responses of people with melancholia depression were found to be distinctly different from those of patients with a less severe form of the depression.

Neuropsychiatrist Philip Mosley of QIMR Berghofer Medical Research Institute in Australia told ScienceAlert: “For basically as long as depression has been recognised as a condition, as far back as the times of the ancient Greeks, it’s been noted that there are some people with depression that seem to get a very physical presentation.

“So they stop eating, they lose the ability to sleep, they seem slowed down as if they’re walking through concrete. Their speed of thought reduces markedly, and they are often very sick.”

Mosley described the research as an effort to create a toolbox that allows specialists to diagnosed types of depression with a degree of precision that permits a prompt, tailored approach.

How the study was carried out

The study involved 70 patients with depression, 30 with melancholic depression and 40 with non-melancholic depression.

They were shown two videos, a funny video of a comedian’s set carefully edited to remove offensive material (Ricky Gervais‘ Animals, for the curious), and a short film about a travelling circus called The Butterfly Circus, which Mosley describes as “quite moving” and elicits a lots of brain activity.

While the patients watched the videos, their facial and brain activity was recorded.

A camera tracked every minute muscle twitch during the Gervais set and an MRI machine monitored brain activity while watching The Butterfly Circus.

There was a big difference between the two patient sets – for the Gervais video, the patients with non-melancholic depression were still depressed but responded with facial expressions and giggles.

The patients with melancholic depression were completely impassive.

Mosley described them as being like “statues” with “no facial movement at all, no smiling, no chuckling”.

The MRI machine found the brains of patients with non-melancholic depression lit up, particularly in the cerebellum, which is involved with automatic emotional responses.

Mosley said: “With people with melancholic depression, those emotional regions of the brain – the ones involved in detecting and responding to stimuli with an emotional tone – were just doing their own thing, disconnected, not integrated with the rest of the brain, not involved in processing with other regions of the brain that are relevant in these tasks.”

The difference between the two levels of responses could be a useful diagnostic tool that can be performed quickly and non-invasively.

Rather than waiting months to see a psychiatrist, the time could be used obtaining the right treatment for the type of depression a patient suffers.

Mosley said: “In this study, we’ve shown that melancholia, which has long been considered a separate type of depression right back through literary times and even the ancient Greeks wrote about it, really does differ in terms of the brain and physical manifestations of depression, which then leads us to think, well, maybe we should be approaching this in a different way to get people better quicker.”

If melancholia is diagnosed late

If melancholia is diagnosed late, the patient may need stronger treatments such as electroconvulsive therapy or transcranial magnetic stimulation.

Electroconvulsive therapy is a treatment that involves sending an electric current through your brain.

This causes a brief surge of electrical activity within your brain, also known as a seizure.

The procedure is given under general anaesthetic, meaning you’re not awake during the treatment.

Transcranial magnetic stimulation is often used when other treatments, such as antidepressants or psychological therapies have not been effective.

A coil is held against the scalp to deliver magnetic pulses to the brain.

While these treatments can be very effective, they can also feel intimidating and invasive.

But for earlier diagnoses, medication can be effective, which is what Mosley and his colleagues are striving for.

The study’s findings have been published in Molecular Psychiatry.