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