Updated: Sep 21, 2020
One must wonder what's really happening when you are depressed.
We sporadically come across articles that state depression as the leading cause of disability around the world and we recognize that it is more difficult to concede because of it being a "mental illness", unlike high cholesterol which even my 12-year-old cousin learns in his science classes. But do we understand yet, what the science behind this rampant condition is?
Let us start with listing the basics we understand about depression:
We understand that depression is not something that can be treated with a day in the spa or the pool. We know that the feelings of melancholy last at least for 2 consecutive weeks. This feeling of woe interferes with one's work, play, and love. We also understand the symptoms that include loss of interest in the things you used to enjoy, appetite loss, feelings of worthlessness, change in sleeping habits like sleeping too much or too little, a kind of slowness in performing any activity, restlessness, loss of energy, and in some cases recurring thoughts of suicide.
Did you know it takes about over 10 years for a person experiencing depression to ask for help?
Depression is not just behavioral symptoms but physical manifestations in the brain as well. It is contemplated as a compound of chemical imbalance + medical conditions + traumatic life events + genes.
Depletion of neurotransmitters such as serotonin, norepinephrine, and dopamine are observed in a depressed brain.
Serotonin also called a "happy chemical" maintains sleep, mood, and happiness.
A decrease in norepinephrine causes lethargy, lack of attention, focus, and concentration.
Dopamine is another important transmitter, and low levels of this may negatively affect your mood, motivation, and memory.
Brain cell growth and connections play a large part in this subject too. Brain imaging studies show that depression is connected to changes in several parts of the brain. The three main parts of the brain that get affected due to depression are the hippocampus, amygdala, and the thalamus.
When we look at the brain of a depressed person, studies have shown that the hippocampus, which controls the memory and emotion is much smaller than usual. It additionally regulates stress hormones like cortisol, and excess cortisol can stunt the growth of neurons creating poor mood and memory.
Thalamus helps link sensory information to good and bad feelings which starts decimating when depressed.
Amygdala regulates emotions like anger, pleasure, and fear. When a person is depressed the amygdala becomes overactive, causing problems with sleep and behavior, and imbalance of hormones.
Neurons and chemicals are the direct influencers and many genetic factors have also been discovered. In some people, certain genetic variations involving the serotonin transporter are said to be more susceptible to depression after stressful life events. Studies show that people with one short serotonin transporter gene are 33% likely to be depressed and people with two short genes were comparatively more likely to be depressed and people with two long genes are said to be the least likely to experience depression. Some more research has found that in patients with a family history of depression, a deliberate reduction of proteins affects their mood.
Although there are known, effective treatments for mental disorders, between 76% and 85% of people in low- and middle-income countries receive no treatment for their disorder, and one of the main reasons for this is social stigma.
There is a huge list of other variables that may come in to play. But we still can't pinpoint what exactly causes depression but it seems to be a complex interaction between genes and the environment. It is important to remember that depression is based on biological features along with the psychological and sociological associations.
Medication and therapy complement each other to boost brain chemicals. In extreme cases, electroconvulsive therapy is introduced, which is like controlled seizures that help keep depression at bay. New technologies like transcranial magnetic stimulation are being researched for effective treatment.
If you or anyone you know is struggling with depression, seek help/ encourage them to seek help (gently and mindfully).
You can help them by finding therapists nearby or even by listing the questions they can ask their therapist because even these first steps might seem insurmountable to them.
Some claim Depression as a hidden illness because the symptoms are intangible. Some people can seem upbeat and cheerful, but inside they’re struggling with the symptoms of depression. So hold your judgment when someone comes to you for comfort.
If you have not experienced depression yourself avoid comparing it to times you have felt down. Comparing what they're experiencing to normal temporary feelings of sadness can make them feel guilty for struggling. It is a medical condition it is not something we can just get over, just like you can't get over a broken arm.
Open conversations about mental illness will help obstinate stigma and make it easier for people to ask help, as more people seek help, doctors can learn more and we can reach better solutions to tackle monstrosities like depression.