Mood and Emotion in Major Depression

Nothing is more familiar to people than their moods and emotions. Oddly, however, it is not clear how these two kinds of affective processes are related. Intuitively, it makes sense that emotional reactions are stronger when they are congruent with a preexisting mood, an idea reinforced by contemporary emotion theory. Yet empirically, it is uncertain whether moods actually facilitate emotional reactivity to mood-congruent stimuli. One approach to the question of how moods affect emotions is to study mood-disturbed individuals. This review describes recent experimental studies of emotional reactivity conducted with individuals suffering from major depression. Counter to intuitions, major depression is associated with reduced emotional reactivity to sad contexts. A novel account of emotions in depression is advanced to assimilate these findings. Implications for the study of depression and normal mood variation are considered. KEYWORDS—depression; emotion; mood; affect; reactivity Isn’t it a common experience that moods make people more emotionally volatile? For example, don’t irritable moods make it easier for even a minor slight to trigger outbursts of rage? Don’t anxious moods make people so jumpy that a few strange noises in the night will provoke full panic and terror? This article considers the interplay of moods and emotions, by focusing on studies that examine one mood (depressed mood) and one emotion (sadness) in one population (clinically depressed persons). I first consider the intuitive hypothesis that major depression facilitates sad emotional reactions. Second, I describe a series of experiments that yielded results largely inconsistent with this idea. Third, I assimilate these novel findings into an alternative framework for understanding emotions in major depression. Finally, I highlight three directions for future research on the interaction between mood and emotion. DOES DEPRESSED MOOD FACILITATE SAD EMOTIONAL REACTIONS? One approach to studying mood–emotion interaction is to examine mood-disturbed individuals. People who suffer from major depressive disorder, commonly known as major depression, have a markedly severe type of mood disturbance. Major depression is the leading cause of psychiatric hospitalization; it is estimated to affect nearly one out of seven people and is associated with several adverse consequences, including increased risk of suicide. Major depression is defined as a 2-week period of persistent sad mood and/or a loss of interest or pleasure in daily activities, as well as four or more additional symptoms, such as marked changes in weight or appetite, sleep disturbance, pervasive guilt, fatigue, and difficulty concentrating. Although major depression is a complex package of symptoms, a profound change in mood is its most characteristic feature. Major depression thus provides a rich context for exploring the ways that mood alters emotional reactivity. In considering mood–emotion interaction in depression, the first problem arises from the very slipperiness of the core terms, mood and emotion. Indeed, some researchers, clinicians, and laypeople have used these terms in confusing and incommensurate ways. For clarity and to follow current practices in affective science (Watson, 2000; Rottenberg & Gross, 2003), I here use moods to mean diffuse, slow-moving feeling states that are weakly tied to specific objects or situations. By contrast, emotions are quick-moving reactions that occur when organisms encounter meaningful stimuli that call for adaptive responses. Emotional reactions typically involve coordinated changes in feeling state, behavior, and physiology, and last seconds or minutes. Moods, by contrast, exert their clearest effects on feeling states and cognitions (as opposed to behavior and physiology) and last hours or days. When mood and emotion are distinguished in this way, it becomes apparent that depression, by definition, involves changes in moods but does not necessarily involve changes in emotional reactions. Emotion theorists have posited that moods facilitate emotional reactions when the mood and the emotion are similar in nature Address correspondence to Jonathan Rottenberg, Department of Psychology, University of South Florida, 4202 E. Fowler Ave., PCD 4118G, Tampa, FL 33620-7200; e-mail: [email protected]. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE Volume 14—Number 3 167 Copyright r 2005 American Psychological Society (e.g., Rosenberg, 1998). Does depressed mood facilitate sad emotional reactions? Circumstantial evidence suggests it does. From early psychoanalytic formulations of depression to contemporary cognitive conceptualizations, depression scholars have noted an increased expression of negative thoughts and feelings in this disorder. Depressed persons’ increased report and display of negative feelings is apparent in several settings. For example, depressed persons typically report (in interviews and on questionnaires) strong sadness behaviors such as crying spells. These self-reports of increased tearfulness are corroborated by the observationsofmentalhealth professionals,whonote that depressed persons are prone to cry in therapeutic settings. Although these clinical observations are consistent with the mood-facilitation hypothesis, they do not in themselves establish that depressed persons react more strongly than other people to sad stimuli. For example, observations of notable crying in clinical contexts could reflect changes in depressed persons’ social behavior, such as a tendency to seek comfort from potentially sympathetic others (Coyne, 1976). Likewise, increased crying could reflect that depressed persons are exposed to more sad stimuli in their everyday environments than are healthy individuals. Indeed, depressed persons are almost certainly faced with a different world of emotion-generative stimuli than healthy individuals are. For these reasons, a better way to test the moodfacilitation hypothesis is to assess depressed and healthy individuals’ emotional reactivity to controlled sadness-eliciting stimuli in the laboratory. Testing the Mood-Facilitation Hypothesis To test the mood-facilitation hypothesis, my colleagues and I created short films, using material taken from commercially available movies; our films were designed to elicit specific emotional states, and we pretested them in healthy populations. Of particular interest were responses to films that were edited either to elicit sadness or a neutral state (i.e., few reports or displays of emotion in healthy participants; Rottenberg, Kasch, Gross, & Gotlib, 2002). The sad film dramatized a death scene and revolved around themes of loss and grief; the neutral film depicted relatively innocuous landscape scenery. We recorded depressed and nondepressed participants’ self-reported emotional experience and their observed expressive behavioral reactions and physiological reactions to the films. Surprisingly, the results from this study did not support the mood-facilitation hypothesis. First, depressed individuals’ experiential, behavioral, and physiological reactions to the sad film were of similar magnitude to those of healthy people. Second, depressed participants reported greater sadness than healthy participants in response to the neutral film. Third, and most strikingly, when responses to the neutral film were used as a reference point, a typical practice in studies of emotional reactivity, depressed subjects actually reported smaller increases in sad feelings in response to the sad film than healthy controls did. Finally, this group difference did not appear to be a ceiling effect—that is, a consequence of depressed persons’sadness already being at an upper limit of measure while watching the neutral film. The difference remained significant even after depressed participants who had reported very high levels of sadness to the neutral film were removed from the analysis. Further Violations of the Mood-Facilitation Hypothesis in Depression Although a single violation of the mood-facilitation hypothesis is not decisive in itself, the lack of any support for the hypothesis in our first analysis gave us pause. Were our results an anomaly? To find out, we sought to test the mood-facilitation hypothesis under conditions that we expected to favor its confirmation.