Guest editorial: hypnosis in treating depression: the despair of young people

The topic of “Hypnosis in Treating Depression” remains underdeveloped in the scientific literature. I’m grateful to the journal’s Editor-in-Chief, Stephen R. Lankton, for recognizing this gap and encouraging the development of two special issues highlighting the relevance of hypnosis in treating this pervasive and debilitating disorder. The first Special Issue was released in January (2024) as this Journal transitioned from hard copy to being published digitally online. This is the second of the two-issue series that I am honored to have guest edited. I earnestly hope those of us in this field will continue to expand our knowledge of ways hypnosis can help provide relief to those who are suffering. New insights and approaches will be critically important to develop and include in future issues.

The dramatic rise in the prevalence of depression across the world continues in all age groups but it is striking younger and younger targets with each passing year. In this editorial, I want to focus on the shocking statistics that tell us, if we’re willing to listen, that we need to pay greater attention to helping upcoming generations better manage their mental health. The rising rate of depression in young people was evident even before the onset of COVID-19, but the pandemic was an accelerant and highlighted many of the social factors contributing to depression. The number of teens (ages 12–17) and young adults (ages 18–25) suffering a diagnosable depression doubled in just one decade, from 2011–2021 (Charmaraman et al., 2022). The rates of teen and pre-teen (ages 10–14) episodes of self-harm quadrupled during this same decade, and the rate of suicide tripled (Centers for Disease Control, 2023).

These statistics lend strong support to the position I spelled out in the previous issue of the journal as to why a biological explanation (such as the popular but largely disproven “shortage of serotonin” theory) was an entirely inadequate explanation for the rising rates of depression seen in every age group (Harrington, 2020; Moncrieff et al., 2022). Instead, research and clinical evidence make it clear that, for most people, depression is primarily (not exclusively) a social problem, not a medical one. Clinical hypnosis serves this perspective especially well as the articles in this issue attest. All emphasize the value of a therapeutic relationship in which new perspectives and skills can be taught experientially and integrated more readily.

When nearly half of the 50,000 teens surveyed recently say they agree with such global and depressing phrases as, “I can’t do anything right” or “My life isn’t useful,” a number nearly twice that of a decade ago, we can plainly see the harsh impact of a changing world that leaves too many teens emotionally unprepared and sadly vulnerable (Twenge, 2017, 2023). There are many reasons, of course, for the despair so many young people feel. Many of the hurtful issues are not new and include the familiar problems of families splitting apart, economic uncertainties, suffering abuse of one kind or another, lack of social support, and other factors as well. Perhaps the most powerful influence, though, suggested by many research studies is the relationship between the rise of depression and the parallel rise of smart phones and heavy reliance on social media (Cunningham et al., 2021; Orben & Blakemore, 2023; Twenge, 2017). Consider this: Those born after 1995 have never known a world without the internet. The iPhone came out in 2007, and by 2012 fully half of Americans owned a smartphone, making it the fastest adoption of any technology ever. And now, nearly every teen has access to a smartphone: According to the Pew Research Center, fully 95% of teens in the U.S. have full access to smart phones (Vogels et al., 2022).

The benefits of smart phones are obvious: they offer a means for positive social interaction and support, for sharing important information quickly, and they have all the advantages of a powerful computer in your hands wherever and whenever you need it. But the liabilities are equally obvious: smart phones can be a means of social avoidance when people would rather text than talk to someone in-person or choose to “ghost” someone they just don’t want to deal with. The smart phone can lead to loneliness, an irony in this terribly overcrowded world, and loneliness is a reliable precursor to depression. Smart phones can give rise to sleep deprivation, an especially important issue for young people who can, to their physical and emotional detriment, prioritize scrolling and texting and surfing over getting adequate sleep. Smart phones put social media in everyone’s hands 24/7 leading to unfortunate global comparisons of how “everyone else’s life is (apparently) going well and mine is lousy.” Smartphones can make bullying online a 24-hour-a-day activity, and the viciousness of the trolls can’t be overstated and have even led some teens to suicide. The relationship between bullying in adolescence and later depression is well established (Anderson et al., 2022).

There are no easy answers to these issues, of course. The technology is not going to go away. But given what we already know about the trans-generational risk factors for depression that highlight that depression grows in both prevalence and severity from one generation to the next, we are right to be concerned about how our young people are faring. We should be concerned about them now, and we should also be concerned for what will happen years from now when they have their own children. It’s one thing to want to have children. But it’s considerably more demanding to want to be a good parent. That’s why finding ways to help the adolescents of today who are going to be the future parents of tomorrow is another reason to want to use every tool we have available to us to help them now.

Helping individuals acquire the resources they will need to manage the complexities and challenges of today’s world has never been more important and our services never more in demand. It is easy to predict, unfortunately, that the demand for mental health services will continue to increase. Having ways to help that are efficient, timely, and effective is vital. Addressing the larger societal, political, and technological issues on a higher level of activism with the intent to improve how we function as a society would be ideal, but as clinicians we’re far more likely to keep our focus on the individual who is suffering. That point brings us to the articles in this issue of the Journal.

The lead article was written by Barbara McCann and Arin Collin. It highlights the role of an action orientation in treatment, called behavioral activation. They review the strong evidence that the more active one is in the treatment process, the better the rate and quality of one’s recovery. Building in an action orientation to one’s hypnosis sessions, i.e., encouraging a willingness to actively do things that will help develop positive perspectives and better skills (e.g., coping, problem-solving, social, etc.), seems an essential part of any meaningful intervention.

The next article, written by Moshe Torem, approaches the same idea with a different focus, namely on helping the client develop a future orientation. Depression, by its very nature, is typically a past-oriented phenomenon that features reviewing and re-hashing past hurts, failures, disappointments, rejections, and the like. Torem is right to want to shift the focus to the positive potentials of the future, the possibilities of what can be, not what has been. His use of hypnosis to facilitate age progressions is a powerful way to promote experiential learning as well as a pathway out of the hurtful past. His article details some of these approaches.

Anita Jung wrote the next article and shares her expertise in the use of music as a hypnotic complement. Jung’s perspective and place in the hypnosis community is quite unique and richly deserves our attention. It is a given that music sets an emotional tone, a lesson that filmmakers know very well as they move viewers up and down the emotional spectrum through their music scores. Hypnosis practitioners have long emphasized the nonverbal aspects of conducting hypnosis sessions, including pacing, rhythm, and tonality. Jung provides a detailed perspective and case examples that give voice to the power of music as a potential ally in treatment.

Tobi Goldfus has contributed an important article on the role of social media and its impact on the mental health of young people. Beyond identifying the problems associated with the use of social media, Goldfus articulates how hypnosis practitioners can not only address the salient issues but can strive to insulate the young client against the negative influences. The technology is obviously not going away but learning how to better manage it is going to be critically important for young people – and their parents. Goldfus provides some very valuable ideas and examples in this regard with an emphasis on the role hypnosis can play.

Given that antidepressants continue to be the most common form of treatment for depression despite substantial evidence that they are not as safe or effective as generally believed, I wanted to include some thoughts on the topic. Therefore, the final article in this special issue is the transcript of a thought-provoking webinar discussion that Dr. Irving Kirsch and I had to discuss some of the concerning issues associated with their widespread usage. We each have expertise with depression as a problem and hypnosis as a vehicle of treatment. Dr. Kirsch’s placebo work was highly relevant and so our discussion was both interesting and enlightening. Full disclosure: Dr. Kirsch and I are both scientific advisory board members of the webinar sponsor, Mindset Health, an online company that provides digital hypnosis programs promoting better health.

Again, my thanks to Steve Lankton for inviting me to serve as a guest editor for these two Special Issues of the Journal. And a very special thank you to each of the authors who so generously gave of their time and expertise in preparing their excellent articles for inclusion.

Individually and collectively, it is clear that we as hypnosis practitioners have a lot to offer in terms of perspectives and approaches to life that can make a positive difference. Let’s continue to make that clear and available to all those who need or want a better quality of life!