For depression, changing personality with a pill might work best

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A new study suggests that if you want to chase away depression and keep it at bay, you’d do well to change your personality to become more positive, outgoing and friendly.

But such change is generally neither easy nor fast -- left to our own devices, most of us change very little after the age of 30 on dimensions of personality such as extraversion and neuroticism. But the study, funded by the National Institute of Mental Health and published in the Archives of General Psychiatry released today, found that SSRI antidepressants effect profound and rapid personality changes in those who respond to them. Compared to a group of depressed patients doing talk therapy and another taking a placebo drug, the subjects who took the SSRI paroxetine (marketed as Paxil) and reported some depression relief had more dramatic personality changes, becoming less negative and emotional, less easily discouraged or embarrassed and more self-confident and assertive.

That’s a big claim for a medication taken by some 7% of Americans.

Mental health professionals have long dismissed patients’ reports of personality change as a pleasant side effect of depression relief. But psychologist Tony Z. Tang, lead author of the study, said his group’s finding suggest it works the other way around: The changes in neuroticism and extraversion observed in subjects who responded to SSRIs appear to be what cleared the depression and drove down the likelihood it would come back during a yearlong follow-up period.

In short, Tang surmises that the drug-induced changes in trial subjects’ high levels of neuroticism and low levels of extraversion effectively ‘shut off’ the flow of negative thoughts feeding these subjects’ depression, causing the depression itself to wither away. Lots of trial subjects who were given a placebo drug reported that their depression had lifted somewhat, Tang said. But those subjects’ measures of extraversion and neuroticism ‘didn’t budge,’ said Tang. During the year follow-up, those subjects were more likely to relapse into depression.

There’s another way for depressed patients to make changes to their personalities, Tang found: His study found significant personality changes in subjects who got talk therapy, which aims to correct negative ways of thinking and equip patients with strategies to cope with setbacks. But compared to those patients responding to the drug Paxil, depressed patients getting cognitive therapy alone changed less dramatically in extraversion and neuroticism. And the less those measures changed, the higher the probability that depression would come back.

Researchers not involved in the study hailed it as important evidence that personality, considered 50% to 60% the result of genetic heredity -- played a key role in a person’s risk of developing depression, and that it could be nudged powerfully by medications that changed brain chemistry. The big question is whether the personality changes wrought by Paxil -- or by cognitive therapy, for that matter -- persist after a patient stops taking the drug or attending sessions with a therapist.

-- Melissa Healy