Inverse - 🧠 Let’s talk about treating trauma

Sarah Sloat

Sunday Scaries

Hello! My name is Sarah Sloat and welcome to Sunday Scaries #169. Thanks for reading this chill newsletter for not-chill people.

I hope your weekend has been restorative — but not too restful.

This week’s chill icon

This week’s chill icon is Lucky, a ten-year-old pup that Sunday Scaries reader Freddi says “chills professionally.”

Have you encountered a chill icon (or icons) IRL or during your internet browsing? If so, I want to hear from you. Send an email over to sundayscaries@inverse.com and you might see them in next week’s newsletter.

Let’s talk about treating trauma

About 46 percent of adults diagnosed with depression endured childhood trauma. The experience is linked to more severe and persistent systems. In turn, a history of childhood trauma is likelier among people with chronic depression.

People with childhood trauma are less likely to benefit from standard depression treatments — such as therapy and medication — than those without trauma. Studies suggest that this population is 1.5 times more likely to not respond or remit after these standard first-line interventions. Because there is no specific treatment designed for this population, some experts believe we need to create new, personalized therapies.

If you are someone who shares these experiences, then you would be forgiven for pausing before trying the standard treatment interventions. But a new study suggests claims of unhelpfulness have been overstated. In a new paper published in the journal The Lancet Psychiatry, researchers report that adults with a history of childhood trauma do experience symptom improvement after commonly-used medication and therapy.

This reevaluation is based on an analysis of 29 clinical trials involving 6,830 individuals. Within this group, nearly 63 percent reported a history of childhood trauma.

Erika Kuzminskaite is a Ph.D. student at Amsterdam UMC and the study’s first author. She says this study is the first to compare the effect of active treatments to control conditions, such as a waitlist or a placebo.

Before now, “the evidence on poorer treatment outcomes has not been definitive and a comprehensive meta-analysis of available findings has been lacking,” Kuzminskaite says.

She hopes the results broadcast the potential benefits of pharmacotherapy, psychotherapy, or a combination to adults with major depression and a history of childhood trauma.

But she also notes that these results do not imply that everyone will improve in the same ways r to the same extent. Some people will likely experience residual symptoms in the long term. The aim of the study isn’t to show that first-line depression treatments are a cure. Rather, they can be helpful first steps and bring the possibility of eased symptoms.

Kuzminskaite says the paper highlights “the importance of screening for childhood trauma to identify individuals at risk for a more severe course of the disorder and post-treatment residual symptoms, as additional interventions may still be needed.”

For example, the ongoing RESET study in the Netherlands is evaluating whether the drug mifepristone — which is currently not used in psychiatry but has been evaluated in studies on depression — can help people with childhood trauma because of its interaction with the body’s stress system. The study is also evaluating two types of therapy, Eye Movement Desensitization and Reprocessing (EMDR) and Imaginary Rescripting.

Kuzminskaite and her colleagues write that further study and collaboration across disciplines are necessary to gain a better idea of how to examine and treat long-term outcomes, residual symptoms, and the underlying mechanisms that drive forward the long-lasting effects of childhood trauma. For now, it’s thought that several neurobiological and psychological pathways are altered by trauma, and this may explain why depression symptoms experienced by this population can last for so long.

But for now “evidence-based psychotherapy and pharmacotherapy should be offered to patients with major depressive disorder regardless of childhood trauma status,” the study team writes.

Now look at this oddly satisfying thing

The most relaxing thing you can do is watch this person … refill their ice drawer. Seriously.

Have you seen something strangely satisfying online or IRL? Then send your best examples to sundayscaries@inverse.com for consideration for next week.

What I’m reading this week

Distract yourself from the scaries with these reads:

China’s Mars rover finds new evidence of an ancient waterway on the Red Planet. Once-hospitable conditions on Mars are a real possibility.

Can science prevent a pandemic? Here’s how we’ll find out.

How to help a loved one through a medical crisis. Trauma experts advise on how to navigate this difficult situation.

And if it’s midnight and you’re still feeling the scaries…

Watch a spacecraft crash into the moon of an asteroid — on purpose.

Thank you very much for reading Sunday Scaries! If you like it, consider recommending it to a friend. You can also find me on Twitter.

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Inverse - 🧠 Let’s talk about treating trauma

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