When you’re going through a period of anxiety or depression it can be difficult to make decisions, whether those are significant life changes or more mundane, everyday choices about prioritising tasks or time management. And those with generalised anxiety disorder or mood disorders often report feeling uncomfortable with or distressed by feelings of uncertainty — which doesn’t help when you need to make a decision, big or small.
Now in a new study in the journal eLife, Christopher Gagne from UC Berkeley and colleagues find that people with higher levels of anxiety and depression are less able to adapt to fast-changing situations. But the authors suggest that with the right intervention there may be ways to not only mitigate this distress, but to help those with anxiety or depression make better decisions in the moment.
Participants were aged between 18 and 55; some had diagnoses of generalised anxiety disorder or major depressive disorder, some had symptoms of both or either disorder but no formal diagnosis, while others had no history of mental illness at all. Those taking medication were excluded from the study, as were those with other diagnoses including OCD, PTSD and bipolar disorder.
In the first study, after filling in measures related to anxiety, depression, worry and personality, 86 participants took part in a video game. In each round, they were asked to choose between two shapes: picking one shape resulted in a small monetary reward, while the other delivered an electric shock ranging from mild to moderate.
The task took place in two blocks — one stable, in which one shape was associated with a reward 75% of the time and the other 25% of the time, and one volatile, in which the shape with a higher probability of resulting in reward switched every twenty trials. In the volatile blocks, therefore, the participants had to keep adjusting their responses as the probabilities change..
Those participants who either had a diagnosis of depression or anxiety, or who exhibited higher levels of associated symptoms, were slower to adjust their responses to the changes in probabilities. This suggests that mood disorders are associated with difficulties making decisions in changing circumstances.
A second experiment replicated the first — only this time, instead of being shocked when they chose the wrong shape, participants lost money. And, again, results showed that those with symptoms of anxiety or depression were slower to adapt to changing rules in the face of unpredictability.
So what does this mean for those with anxiety and depression when faced with a big decision? Senior author Sonia Bishop argues that those participants who adapted quickly did so because of their emotional resilience. “Emotionally resilient people tend to focus on what gave them a good outcome, and in many real-world situations that might be key to learning to make good decisions,” she says. Bishop’s previous research has found similar results: in one 2015 study, those with anxiety were more likely to make mistakes in decision-making in rapidly changing circumstances, while those with low levels of anxiety were able to quickly adapt to the task.
The team suggests that cognitive-based therapies which encourage people to focus on past successes rather than failures could therefore be a useful behavioural intervention, making those difficult decisions that bit less tricky.