Depression, Mental Pain, Suicide And Associated Brain Regions

We have seen that those who suffer severe and protracted childhood trauma are at increased risk of suffering from depression in adulthood. We know that depression can lead to physical pain but it can also lead to excruciating emotional pain. One such type of emotional pain was described by Eisenberger and  Lieberman (2005) as ‘social pain’ which is associated with social rejection  (rejection in childhood by emotionally significant others is frequently one of the key causes of childhood trauma) and this type of pain, it is hypothesized, may have developed for evolutionary reasons enabling our ancestors to recognize when they were at danger of being socially excluded and take appropriate measures. to try to prevent it.

Whilst the severity of mental pain an individual suffers, according to Heeringen et al. (2007), in order for such measures to be implemented, certain parts of the brain that control emotional regulation need to be correctly operating but, in those suffering from depression, relevant brain regions that would facilitate this are impaired (including the dorsolateral prefrontal and anterior cingulate cortex).

To investigate the relationship between depression, mental pain, and brain regions, Heeringen et al. (2007) carried out a study involving 17 male and 22 female in-patients being treated for depression.

The data from this study suggested (perhaps surprisingly) that the experience of mental pain (as measured by the Orbach and Mikulincer Mental Pain Scale) was not associated with the severity of individuals’ depression (as measured by the Beck Depression Inventory) but was (unsurprisingly) associated with an elevated risk of suicide. Results of the study also suggested that those found to experience high levels of mental pain showed abnormal blood flow in areas of the brain involved in regulating emotions, including the dorsomedial and dorsolateral prefrontal cortex).

In light of these findings, the researchers suggested that future research could build on the foundations their study has put in place to investigate whether these changes in blood flow in the prefrontal cortex have an effect on the cognitive control of emotions and, if so, what kinds of treatment might be most effective in correcting the problem.



Heeringen et al., Psychiatry Research: Neuroimaging, functional neuroanatomy of mental pain in depression. 2007

Eisenberger, N.I., Lieberman, M.D., Williams, K.D., 2003. Does rejection hurt? An fMRI
study of social exclusion. Science 302, 290–292