Psychotherapy for depression under the assumption of a "depression memory" due to a structural change in the neurobiological reward system- first empirical dates

Scientific studies show that not only drugs can cause profound structural physiological changes in the reward system, but also behavior. This can be done through positive (adding something pleasant = C+) and negative reinforcement (taking away something unpleasant = C- /) of a behavior that leads to a reduction in emotional distress. Based on a cognitive-behavioral-biological approach, Depression is seen here as a failed attempt to deal appropriately with emotional stress. A short-term, strong but of short duration emotional relief is achieved by avoiding action-activities that are associated with the stressful situation. It is assumed that operant conditioning processes, when this strategy is used frequently and over a longer period, lead to a restructuring of the neurobiological reward system. A neurobiological "representance" develops of the conditioning process can be described as a persistent "depression memory" and previous "relief strategies" are automatically triggered without any conscious intention. Previous other more favorable emotional regulations are declining. The “actionalinactivity” dominate the reward system and is the later behavior symptom of depression. The underactivity in the brain executive is accompanied by a cognitive overactivity to the point of brooding. Initial empirical results from an IAS-Questionnaire study show that depression (and other mental disorders) is associated with a decline in interests and activities that constructively improve psychological state. This is accompanied by a decrease in life satisfaction, social competence, and other important psychological parameters. The dysfunctionality of the reward system represents a particular challenge for the therapist. In this context the therapeutic goal is to replace the risky behavior through constructive, highly rewarding alternatives. Therapeutic help should not be terminated until activity to cope with stressful situations, exercise in general, a variety of constructive affect regulation strategies and interests are established as stable habits. So that the reward system provides impulses to use alternatives for affect regulation instead of risky behavior.