Immunization Essay

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Psychiatry 74(1) Spring 2011 Why Does Depression Hurt? Panksepp and Watt 5 Why Does Depression Hurt? Ancestral PrimaryProcess Separation-Distress (PAnIc/GRIef) and Diminished Brain Reward (SeeKInG) Processes in the Genesis of Depressive Affect Jaak Panksepp and Douglas Watt What can affective neuroscience add to the discussion of the genesis of depression? Among other contributions, it may begin to answer the question of why depression feels so bad. Since it is the only basic neuroscience approach that specifically aims to take the affective infrastructure of the evolved mind as its central focus, it offers testable hypotheses concerning the affective imbalances that contribute to clinical depression (Solms & Panksepp, 2011). A critical question about genesis of depression is: Which negative affect-generating networks of mammalian brains are most important for understanding depressive “pain” and what new therapeutics might such knowledge engender? Affective neuroscience has outlined seven primary process (i.e., genetically provided) emotional systems. All are subcortically situated (Panksepp, 1998), where animal models allow causal (vs. correlational) analysis, not afforded by human research, including modern brain imaging. These primary functions consist of SEEKING, RAGE, FEAR, sexual LUST, maternal CARE, separation-distress PANIC/GRIEF (henceforth, simply PANIC) and joyful PLAY (neural systems are capitalized to highlight their primary-process nature). Although every aspect of the affective life can be influenced by depression, depression is intimately related to 1) sustained overactivity of the separation-distress PANIC system that can, if prolonged, lead to a downward cascade of psychological despair (a theoretical view originally formulated by John Bowlby); and 2) the despair phase that follows the acute PANIC response which is characterized by

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