A self-guided computer-based treatment may soon help depressed people fight the blues without paying their doctor a visit.
Researchers at the National Space Biomedical Research Institute (NSBRI) are developing an interactive, multi-media program that will assist astronauts in recognizing and effectively managing depression and other psychosocial problems.
Such problems usually pose a substantial threat to crew safety and mission operations during long-duration spaceflights.
"This project has great potential as a self-guided treatment for many people. Depression is the number one cause of disability days in the United States, but it's not only about days lost. Depression also results in presenteeism - showing up for work but not really working," said Cartreine, a member of NSBRI's Neurobehavioral and Psychosocial Factors Team.
The depression treatment is part of the Virtual Space Station, a multi-media program that caters to multiple types of potential psychosocial problems and can be used for training before, and for assistance during, missions. Other problems being addressed via the Virtual Space Station include interpersonal conflict, and stress and anxiety.
Accoridng to Cartreine, the Virtual Space Station will make effective therapeutic depression treatment more easily accessible to astronauts aboard the International Space Station and proposed missions to the moon and Mars.
Right now, astronauts do have audio and video access to psychologists but that's only when communication links are available.
Project co-investigator and former astronaut Dr. Jay Buckey said long-duration spaceflight can be tough on astronauts.
"While astronauts are not particularly prone to psychological problems, the environment is very demanding. On a mission, they face a lot of challenges that could lead to depression. These are unique NSBRI products that did not exist before. The Virtual Space Station is based on proven treatment programs and is a very helpful way to work on problems in general," said Buckey.
The system's multi-media approach for depression includes graphics and video featuring a psychologist who leads the user through a straightforward process called Problem-Solving Treatment. The system provides feedback based upon the information provided when answering a series of questions.
The first step of the process is to make a problem list and select a problem on which to work. The second and third steps are setting goals and brainstorming ways to reach them. The final two steps are assessing the pros and cons of possible solutions and making an action plan to implement them.
It will also help users plan and schedule enjoyable activities, which people who have depression often stop doing. Besides, the program provides preventative and educational information on depression.
The researchers received input from 29 current and former astronauts while designing the Virtual Space Station.
They said that some of the system's other benefits include its portability and privacy.
"It can be delivered to the International Space Station on a flash drive and run directly from that drive, so that the astronaut has complete control over his or her data. The system is private and secure. The user is the only one who can share the information with others," said Cartreine.
A previous version of the depression treatment system was beta-tested on research stations in Antarctica. According to Cartreine, feedback from that early test run has been positive, and a clinical evaluation of the latest version on 68 Boston-area volunteers would begin soon.
Finally, the researchers want to adapt the system for use in many different settings, giving people access to treatment they may not have now.
For example, people with depression often seek treatment by going to their primary care physician, so the researchers hope to adapt it for use at the doctor's office or in a person's home.
The system could also be beneficial in rural areas where clinical help is in short supply or nonexistent. Other possible locations for use include schools, social service offices, places of worship, military bases, prisons, commercial ships, oil rigs and underwater research stations.