Maintaining Mental Health

Happy Mental Health Awareness Month!

Depression is one of those things that seemingly has no rhyme or reason as to when it decides to rear its ugly head. Sure, it’s always more or less prevalent in the lives of those who suffer from it, but there are times when it decides to take over every aspect of the way you think, feel, and view the world. It’s rather well-known by now that depression is largely based in the makeup of brain chemicals.

In short, depression (chemically) stems from a lack of dopamine and hypo sensitivity to serotonin in the brain. Dopamine, known as the “happy chemical,” is essential to keeping our motivation going. In other words, when you feel little to no excitement over doing things that once pleased you, there is a good chance this is related to a dopamine deficiency. The relationship between serotonin and the brain in someone who’s depressed is a bit more complex. More often than not, someone who suffers from depression is not deficient in serotonin, but rather the neurotransmitters in the brain are not accepting and absorbing the chemical. Serotonin is thought to regulate things such as a constant sleep schedule and appetite, which are two things that are often lacking in depression sufferers. If you’re interested, I wrote a post a while back on the more technical aspects of depression here: Clinical Depression, broken down.

Since depression is oftentimes so rooted in chemical imbalances, it rarely “goes away.” Medication can help to alleviate symptoms and bring some stability to the chemicals in the brain, and therapy can help with the more apparent effects of the depression, but to expect such a mentally crippling illness to simply disappear is uncommon, as nice as it would be. So why, then, does depression seem to hit us harder at some moments than others? Personally, I can go weeks without feeling like my depression is keeping me from doing things – I can hang out with friends and genuinely enjoy myself, get out of bed at a reasonable time, and eat all three meals in a day as opposed to just snacking far too much at one point in the day.

Of course, I’ve experienced the flip side of this more often than I can count. I’ve gone months without doing anything social with friends, had no discernible eating pattern, and my sleep schedule has been so out of whack that I was closer to nocturnal creature than human.

And whilst I’ve experienced both ends of the spectrum of depression, far more often, I’m somewhere in the middle of these two extremes. Not terribly depressed, not carefree, but simply feeling average. So again, I ask, what causes depression to go one way or another? For those who have it, it’s always there, but it seems to be a matter of chance whether it’ll get worse or lessen.

I’m far from an expert. I don’t have a degree in psychology or a doctorate; any opinions I state here are from talking to others with depression and my own experiences. From what I can tell, depression is affected by what goes on outside of the brain, in our lives, just as much as (if not more than) what chemical imbalances there are in our brains. Our social lives, our sleep schedule, our establishment of a somewhat consistent (at least) schedule…the list goes on. This may seem obvious to some, but for those whose lives can be overtaken at a moment’s notice by depression, it can be quite easy to lose grasp of this seemingly simple concept.

I think of maintaining your mental health like maintaining a garden. You can go out and buy the highest quality seeds possible, and plant them in the most fertile, open land you can find. The setup is ripe with success. However, if you don’t water and cultivate those seeds, working to remove any weeds that spring up, those seeds won’t grow and bloom into something as beautiful as they have the potential to be. The land in which you plant those seeds are the environment you’re in, i.e. the people who support you in the form of healthy relationships. Maintaining your garden after it’s planted is taking the steps needed to keep yourself mentally healthy – keeping a consistent sleeping and eating schedule, making an effort to go out and be social at least occasionally, staying active, and attending therapy and taking medication prescribed to you, if you feel that’s what you need to keep yourself afloat. Picking weeds is removing any unhealthy habits and influences from your life, especially those that tend to make depression worse – smoking, drinking, and overeating. These habits are nothing but temporary relief, trading a moment of peace for tougher consequences later on down the line.

A mistake often made by those suffering from depression is thinking that because they may be in one of their moments of (for lack of a better term) not-so-apparent depression, they can fall off of their mentally healthy habits without any type of fallout. They begin to go to bed a bit later, eat a bit more, consume alcohol more often…and they fall back into a deep depression, because they let their “mental guard” down and allowed depression to reestablish control over them. It’s a vicious cycle – feel good because the depression isn’t acting up as much, fall back into unhealthy habits because it feels fine, deep depression creeps back in because of a lack of care, work to re-cultivate a healthy lifestyle, and the cycle begins anew. The key is to find the sweet spot, so that you find a way to re-cultivate a healthy lifestyle,and keep it that way.

I may make it sound easy here. It isn’t. I struggle with this every single day, as does nearly every individual who struggles with depression. If you know somebody who is so skilled at keeping their depression in check that it’s like they don’t have it at all, even in the privacy of their own home, kudos to them. You know one of the few. If mental health was so easy to maintain, I guarantee it wouldn’t get nearly as much attention as it does. A benefit to this is the amount of resources now made available to everyone, free of charge. At the end of this post, I’ll have a list of numbers available to those suffering from depression and things often tied to it.

If there’s any one point I’m trying to make with this post, it’s this: having a mentally healthy lifestyle is a balance of monitoring brain chemicals, mostly through medication, and maintaining a lifestyle which supports your intention to be happy. Being physical is as important for your mental health as it is physical health. Licensed therapists are such an underused resource for mental health, as many people attach a stigma to them; some people see them as a resource for those too weak to take care of themselves. This isn’t true in the slightest. I see a therapist every week, not because I can’t maintain a healthy lifestyle independently – I can. I see him because having him as resource, especially for those times my depression is acting up more than usual, is invaluable to me.

You deserve to be happy. Not just putting on a smile for those who see you, but genuinely happy. Depression doesn’t want you to be happy – it’s in the name. But by maintaining as many aspects of your life as you can, you can be stronger than the illness. As always, whether I know you or not, feel free to send me a message if you want to talk – I’m happy to do whatever I can to help lessen the burden of depression, if I can.

US Suicide Hotline —— 1-800-784-2433

NDMDA Depression Hotline – Support Group ————– 800-826-3632

Suicide Prevention Services Crisis Hotline ———- 800-784-2433

Suicide Prevention Services Depression Hotline ——– 630-482-9696

Parental Stress Hotline – Help for Parents ——— 800-632-8188

Suicide & Depression Hotline – Covenant House ——— 800-999-9999

National Youth Crisis Hotline ——– 800-448-4663

Source: Telephone Hotlines and Helplines

Note: All numbers listed above are U.S. numbers. A quick Google search can give any available hotlines for your country of residence. A few UK numbers are listed in the source link above.

Stay strong.

– Ryan

Clinical Depression, broken down

Depression is known for its unfortunate ability to “override” any good thought that decides to come our way. Even if there is evidence in our lives supporting the fact that we shouldn’t be having depressive thoughts, our minds still find a way to push that logic to the side. With major depression affecting so many aspects of our lives from sleeping all day, to being reclusive, to suicidal thoughts, it’s almost hard to believe that all of these symptoms stem from a simple glitch in brain chemistry.

Unlike some mental illnesses such as Parkinson’s Disease, clinical depression affects multiple areas of the brain as opposed to just one. In a nutshell, depression stems from abnormalities in the interactions between hormones and neurotransmitters in the brain, such as the ones controlling serotonin and dopamine regulation. In order to understand why brain chemicals such as serotonin and dopamine are important in the diagnosis of clinical depression, it’s important to understand what they actually do.

Serotonin is thought to regulate sleep, pain sensitivity, sexual function, and appetite. Looking at some of the symptoms of depression, including sleeping for long periods of time (or not at all), overeating, or loss of ability to perform sexually, it’s no surprise that serotonin plays a big role in regulating depression. However, depression symptoms are not caused by a serotonin deficiency, but rather by the neurotransmitters in the brain being hypo responsive (under-responsive) to the serotonin provided to them.

Dopamine is known as being the “happy” chemical. It’s responsible for regulating motor function, reward and motivation centers, memory, and attention. Even more symptoms of depression include loss of motivation, loss of interest in things that once excited you, and a feeling of sluggishness. On the flipside of serotonin receptors, the neurotransmitters responsible for receiving dopamine are hyper responsive, basically overreacting to stress and fear stimuli.

neurotransmitters depressionThese hypo and hyper reactive receptors can be caused by a multitude of reasons, from excess stress to overeating. While genetics can certainly play a role in the risk of developing depression, it’s only about half that of the risk stemming from individual lifestyle factors. Of course, depression can stem from a combination of the two as well.

anatomy of depressionThis is another fact that makes clinical depression unique among many illnesses. While many diseases are purely genetic (you have to be born with the right makeup of genes, chemicals, etc.), depression affects us physiologically even if we aren’t born with it. Regardless of the cause, chemicals in the brain are put all out of whack.

So…why does any of this even matter? If you’re sad, you’re sad, who cares about the brain chemistry, right? It matters, because understanding the brain chemistry has played a big part in recent years in our understanding and treatment of depression. If you were to go back in time 50 years and tell someone that you’re depressed, chances are you’d get a response somewhere along the lines of “you’ll get over it soon.” 50 years ago, most people weren’t worried about the causes of depression, simply because most people weren’t worried about depression. Depression has been “diagnosed” in many individuals since the time of Mesopotamia (its original name is melancholia), but understanding it as an actual medical problem didn’t come until much later. If an individual was feeling depressed, it was considered nothing more than “being in a funk.” Everyone feels sad sometimes, why should we pay any more attention to people who feel sad a bit more often? Now, knowing what we know about brain chemistry and physiology, we’ve finally come to the realization that depression is an actual, medical problem, and it is worthy of our time and attention. Through our new understanding, we are more equipped than ever to deal with it.

depression wheel
A small correction to this graph: under Situations, as aforementioned, a bullet point should say “genetics.”

For me, nothing says it better: “Depression is a flaw in chemistry, not character.” Flaw is such a key word here, as depression has the ability to make anybody dealing with it feel like a flaw of life. I’m dumb, I’m ugly, I’m sad, I’m flawed. No, you are not flawed. You are as much of a person as anyone else, worthy of feeling happiness, joy, and love; a slight mix-up of brain chemicals doesn’t change that simple (yet irrefutable) fact.

We live in a time where we’re lucky enough to have, at the very least, a rudimentary understanding of clinical depression and its causes. By understanding the root of depression, we’re that much closer to finding a way to cut the stem before it sprouts. If we do nothing with the information we’ve learned, combating depression (and mental health in general) will be at a standstill for far too long. As someone who suffers from clinical depression, I feel a responsibility to use what power I have to make sure that doesn’t happen.

Stay strong.

– Ryan