Mental Health Overhaul

We tend to talk about anxiety and depression much more openly since the pandemic, but this openness doesn’t yet to extend to all mental health conditions – and that can mean many people still don’t seek the support they need.

“There’s much less stigmatisation now around saying that you have an anxiety disorder or depression than there used to be,” says Amy Milton, Professor of Behavioural Neuroscience in the University of Cambridge’s Department of Psychology, “but there’s still a strong stigma attached to drug addiction, which is my opinion is unfair, because it’s also largely driven by biological mechanisms.”

Professor Amy Milton. Credit: Jacqueline Garget

Professor Amy Milton. Credit: Jacqueline Garget

Milton is studying disorders including drug addiction, post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder, all of which seem to be driven, at least in part, by malfunctions in emotional memories – those where our brain links an emotional response to an experience.

We’re more likely to remember emotionally charged images, like someone shouting at us, than neutral ones. But when they’re formed under very traumatic circumstances this can leave lasting damage – even years later when there’s no longer any danger, particular stimuli can trigger the memories and cause the same strong emotional response. This is what happens in PTSD; Milton is trying to work out what’s going on in a bid to stop it. She says:

“Our memories aren’t fixed – we know they drift and change, and under the right conditions they can be updated. If emotional memories contribute to the persistence of PTSD, can we target them in some way?”

Memories are very stable when they’re in an inactive state not being used, and they switch to an active state as we do something that uses them. As they move between the two, they destabilise.

“Our idea is that if we give a person with PTSD a reminder of their trigger stimulus to activate the associated emotional memory, together with a drug that blocks that memory from restabilising, then the memory will disappear,” says Milton. “We already know it works in rats. If we could get rid of a person’s distressing emotional reaction without them forgetting the event, that’s really exciting.”

Milton has found that problems with emotional memory are also involved, in different ways, in drug addiction and obsessive-compulsive disorder. While they are just one component of all three disorders, she says that targeting the mechanism of the emotional memories could become an important part of wider treatment packages.

“It may be that the same mechanisms are affected in different mental health disorders,” she says. “Our ideal approach would be to try and work out which symptoms are causing problems for any individual patient, and treat the processes that give rise to those symptoms. Similar to Rebecca’s approach this is more flexible and personalised, and should have much better outcomes.”


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