subject has depressive thoughts such as worthlessness, hopelessness and sadness, but able to hide them behind a happy exterior
An extensive review by Chinese researchers at Changchun University directed by Xuefeng Sun just published in Brain & Behavior examined 29 studies through the PubMed, Cochrane Library, Web of Science, Embase and CINAHL databases to verify how much and if the so-called therapy” has an effect on those suffering from depression and anxiety, that is, said in minimal terms: if a joke manages to make even those who are depressed laugh. Nearly 3,000 subjects from studies in Australia, China, Germany, Iran, Israel, Italy, South Korea, Turkey and the USA were evaluated. These were minors undergoing surgery with anesthesia, elderly people in nursing homes, patients with Parkinson’s, tumors, mental illnesses, dialysis patients, while students and healthy retired women were used as controls.
The main types of humor therapy in the studies were laughter therapy/yoga and clown therapy. The first is a technique in which the subject mimics laughter by doing yoga breathing exercises designed to be similar to those that are activated when we burst out laughing and which, by bringing more oxygen to the brain, give a feeling of greater energy and serenity. Clown therapy, also called smile therapy, made famous by Robin Williams with the film Patch Adams, practiced by doctors, nurses or volunteers who use clown techniques and clothing to improve the mood of hospitalized patients, especially minors, and their families .
result that humor therapy has remarkable prospects for development and efficacy in the treatment of mild forms of anxiety and depression and its efficacy in severe forms will be further investigated. It has a significant impact on perception, attitude, judgment and mood, which in turn affect physical and mental well-being. Even if most of the studies confirm its benefits, it seems however that the intervention period may have so far been too short to fully obtain the positive effects it can induce. One of the main problems with the implementation of this therapy is the attitude of the medical and paramedical staff who sometimes perceive it as a disturbance in their routine work. On the other hand, the idea that humor therapy can relieve pain, reduce the negative effects of treatment and have a positive impact on the patient’s overall recovery is beginning to gain ground. It still remains to be seen whether it will also have an application in severe forms such as major depression or the old dysthymia now called persistent depression.
In the 4th edition of the DSM, the bible of psychiatrists, the dysthymia defined a milder depression, but always present, at least for 2 years. In DSM 5 and DSM 5TR released a month ago it became persistent depression and indicates at least one year of depressed mood, most of the day, more days yes than no. Carlo Lorenzo Cazzullo, the father of Italian psychiatry so much so that the law 238/76 which gave birth to this discipline in our country separating it from neurology of which it was until then the younger sister, is called the Cazzullo Law, he used to say in his master classes at State University of Milan: If you want to distinguish a dysthymic person from a depressed person, ask him if he remembers ever being happy. The depressed will tell you there was a time when I was happy. The dysthymic, on the other hand, will answer that he does not remember any period in which he was ever happy
Again Professor Cazzullo, to explain what is called smiling depressiononce told students an anecdote that speaks volumes about humor therapy: A psychiatrist was treating a patient who was unable to get out of his depression in any way – Cazzullo said – One day he had an idea and said to him: they told me that in the city there is a circus where an irresistible clown performs: why don’t you go see him, maybe he can make you laugh too… The patient then replied : “Doctor, thank you for the advice, but look, that clown is me”
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This depression, which in Italian we could translate as smiling depressiona form not included as such in the DSM but only described as atypical depression where subject has depressive thoughts such as worthlessness, hopelessness and sadness, but able to hide them behind a happy exterior. Unlike the dysthymic who always has a sad look and never feel joy, those with this depression can savor fleeting moments of happiness when good things happen to them, but if they are in a depressive episode this happiness is ephemeral and does not last long. Meanwhile, perhaps most of the time, he’s wearing a nice smile, no matter what he’s going through inside and it’s hard to tell.
July 11, 2023 (change July 11, 2023 | 09:00)
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