Oh, The Guilt! Why You Blame Yourself For Everything When You’re Depressed

2013-04-23

Alice G. Walton, Contributor

Anybody who’s been depressed can tell you that feelings of guilt and self-blame can be overwhelming. In fact, the tendency to blame oneself excessively (and inappropriately) is a key factor in depression. Over a century ago, Sigmund Freud suggested that depression was fundamentally different from “normal sadness” in that very factor. Now, a new study shows exactly why he was right: The brains of depressed people have a “gap” in the communication between two key areas, which may explain why depression is so hard to overcome, and relapse so common.

In depression, excessive self-blame is often accompanied by the equally maladaptive tendency to overgeneralize. That is, depressed people often have a knack for (erroneously) generalizing specific situations to reflect their own self worth in a larger sense: For example, the authors say that a depressed person might think to him or herself, “If I fail at sports matches, it means I am a total failure.” Exactly how people make the leap from specific, external situations to general, internal ones has been a mystery until now.

The team at the University of Manchester had people who were in remission from depression and people who had never been depressed evaluate statements that might trigger feelings of guilt for people who are susceptible to it. Other types of sentences were designed to trigger indignation. For instance, a participant named Tom would read sentences like “Tom acts greedily toward Sam [his best friend]” or, conversely, “Sam acts greedily toward Tom.”

The participants underwent MRI scans while they read these statements, so that the researchers could see whether the brains of formerly depressed people fired differently from those of never-depressed participants.

In the never-depressed people, there was a synchrony in the firing of two brain regions, one involving socially appropriate behavior (the anterior temporal lobe) and the other involving feelings of guilt (the subgenual cingulate cortex and nearby septal region, or SCSR). These two regions fired together whether the person was experiencing guilt or indignation. But the brains of formerly-depressed people had a kink: The two regions fired together when experiencing indignation, but during guilt, the activation of the two regions was “uncoupled” so that they did not communicate with each other. People who had higher levels of self-blame also had more “decoupling” of the two brain regions, which suggests a strong connection between what’s going on in the brain and the specific behavior.

“The scans revealed that the people with a history of depression did not ‘couple’ the brain regions associated with guilt and knowledge of appropriate behaviour together as strongly as the never depressed control group do,” said author Roland Zahn. “Interestingly, this ‘decoupling’ only occurs when people prone to depression feel guilty or blame themselves, but not when they feel angry or blame others. This could reflect a lack of access to details about what exactly was inappropriate about their behaviour when feeling guilty, thereby extending guilt to things they are not responsible for and feeling guilty for everything.”

The study is important because it’s one of the first to show the brain connections that might be behind these key tendencies in depression. Whether depression causes these brain differences to develop, or the brain differences lead to the development of depression is unclear. Luckily, the brain is remarkably capable of rewiring itself, and the links between the two areas studied here are specifically known to be influenced by learning, Zahn told LiveScience. This explains why talk therapy or cognitive behavior therapy, which teaches a person to replace old, destructive thought patterns with new, more productive ones, can be effective ways to treat depression. Understanding more about how faulty wiring in the brain contributes to the symptoms of depression will, hopefully, lead to more effective ways to combat it.