More than just blues
Jan 14 2013
There is more to depression than what meets the psyche. Depression is no pleasant feeling. It affects millions of people to varying degrees
Depression is no pleasant feeling, much less an agreeable expression. It affects millions of people to varying degrees. It has a tendency, in a manner born, to attack without any apparent reason, albeit contemporary research supports the view that complex psychological, environmental and biochemical factors may trigger, or engender, our initial mood swing.
Depression is increasingly believed to be an inherited condition, notwithstanding the fact that grief and a host of other negative feelings are all normal reactions to loss and/or sad event. Everyone suffers, now and again, from commonplace triggers such as disappointment — a mild case of blues. Be that as it may, things often reach the crescendo when depression persists to a point where it interferes with your daily life, causing imbalance, even turmoil, in your ability to live normally.
The cause of chronic, or long-standing, depression isn’t precisely known. Yet, what could pull the prompt is a sad or traumatic event. What also compounds the problem is not just stress, but also certain prescription medications — they could cumulatively bring on a bout of depression. In addition, a severe lowering of mood can occur, as a reaction to lack of sunlight during winter months, besides inherent variations in the inner biological clock that runs us all — not to speak of emotional changes during new, or full moon nights.
Psychiatrists suggest that depression is biologically -- or genetically-programmed. Neurotransmitters in the brain have, likewise, received as much attention for being a possible cause of depression. Neurotransmitters are chemicals released across synapse — a small space between a neuron and the receptive site of another neuron, the basic unit of the nervous system. To cull an example, norepinephrine, a neurotransmitter, seems to be notably imperative in depression. A premise states that insufficient norepinephrine levels at the receptor sites could be a likely cause of depression. This is precisely the reason why research has also shown that if the substance’s level at the location is increased, depression eases to a tangible extent. This is not all. New research implicates dopamine — a brain chemical — in producing and relieving diverse depression-related symptoms.
Sickness of the mind, or the body, often reveals how our systems work — and, why loss of equilibrium often leads to a breakdown, or depression. To bring a sense of cadence, or measure, to this element, we’d draw on a wealth of information related to the latest medical findings, especially in our age run amuck by stress, or psychosomatic illnesses, and in the light of the glorious connections that already exist between ancient puzzles, the brain, behaviour, immunity and disease. A case in point — although the fantasies of novelists aren’t exactly the same as solid scientific verification, albeit there’s plenty of it as well — the sharp divide between those that proffer psychological explanations of disease and those that reject such theories, in favour of purely physical causes, is reflected in our attitudes towards two particular disorders, tuberculosis and chronic fatigue syndrome (CFS).
As Peter Medawar, the Nobel Prize-winning immunologist and virtuoso writer, put it, “(Tuberculosis) is an affliction in which the psychosomatic element is admitted even by those who contemptuously dismiss it in the context of any other ailment.” Not surprisingly, there’s abundant evidence, dating back to hundreds of years, that the course and progression of tuberculosis are often influenced by the individual’s emotional state.
It is also evidenced that the individual who is infected with mycobacterium tuberculosis often develops a protective immune response that could hold the bacteria in check and prevent them from multiplying. The resultant impasse between the body and bacteria could mean that the disease will remain quiescent for years. But, if something were to happen to compromise, or weaken, the body’s immune defences, the bacteria can run riot and cause a resurgence of the disease.
Stress, depression and other psychological factors can just as well alter our vulnerability to several other illnesses, including viral infections, heart disease, diabetes and cancer. The supposition is — the relationship between mind and health, for more reasons than one, is construed to be ‘mediated,’ not only by our behaviour, but also by the biological connections that exist between the brain and the immune system. Such connections work in both directions. Result — our physical health can influence our emotional state and vice versa.
Research suggests that people who are depressed have learned to be depressed. Studies also contend that a person who develops symptoms of depression may have few close relationships, and get little social support from those that do exist. Social support, as psychiatrists observe, in the form of family and friends, often acts as a cushion against stress.
While depression is as old as the hills, many of us experience occasional stress — a known trigger for depression. Most often, the resultant effect is a feeling that life has no meaning at all. When this condition, or emotional response, turns to melancholy, a change occurs in the individual’s behaviour. The person, who is bogged down by such a state, is now said to be in a depressive state.
The symptoms of depression are varied — from mild, moderate to the extreme. Severe depression, a disorder characterised by loss of interest in almost all usual, or normal, activities, for instance, is evidenced by a sad, hopeless or discouraged mood. Its other symptoms may include loss of sleep, loss of appetite, loss of energy, or feelings of worthlessness and guilt. Depression, in certain instances, may also lead to social withdrawal, gastrointestinal disturbances and relentless gloom. Patients with true depression are potential suicide risks.
Individuals with a history of clinical depression also have lower levels of brain activity. They find in alcohol, or drugs, a soothing potion, an emotional palliative. That the addictive ‘duo’ does much more than anything else to calm anxiety or depression is a flawed perspective — witness, their several side-effects, inherent health and other risks. Depression seems to also pose a particularly grave hazard for heart attack survivors. It increases five-fold the likelihood of dying after being treated for heart attack. This calls for aggressive and effective medical treatment. To highlight a research finding, “The clear demonstration that psychological factors like depression and social isolation distinguish coronary heart disease (CHD) patients at highest risk means it would be unethical not to start trying to treat such factors.”
There is also, again, more to depression than what we all seem to know — especially in the young, where it is a pressing problem. Psychiatrists suggest that depression should not be treated, but prevented, in children. This is based on an alarming discovery — even mild episodes of depression in a child can augur more severe episodes later in life. What compounds such a depressive response? As Maria Kovacs, a psychiatrist, puts it, “Imagine you’re already feeling depressed, and you start flunking out of school, and you sit (at) home by yourself, instead of playing with other kids.”
What compounds the trauma of depression is that unhappy children and teenagers — including grown-ups — may be habitually unable or unwilling to talk about their sadness, which disturbs learning and relationship skills. The following symptoms are characteristic, in such cases:
Negativity in all aspects of life — a feeling of pessimism, a belief that nothing can make your life better.
Changes in sleep patterns — disturbed sleep, getting up too early, or sleeping more than is necessary.
Change in eating patterns — lack of or change in appetite, or eating too little, or too much.
Fatigue, difficulty in concentrating or making decisions.
Isolation, withdrawal from people, and neglecting one’s appearance.
Persistent sadness and self-loathing.
Studies have shown that some individuals are more prone to depression, at certain times, in life. Depression in women, for instance, may first occur during adolescence, because of the pressures of becoming a young woman. The question of ‘breaking away,’ likewise, from the family and facing adulthood also causes teenagers and young adults to doubt themselves and turn inwards. Marital problems, divorce, personal disappointments, a limited work horizon, job loss, past unresolved grief, rage and abuse may bring on depression in the middle years. Depression among the elderly is, no less, common. This may be attributed to the death of friends and loved ones, physical and mental limitations, and thoughts of impending demise. Statistics suggests that women experience depression twice as frequently as men — they are especially predisposed to experiencing it in association with hormonal changes in the body, not to speak of sexual harassment at the workplace, domestic violence and rape in a world that is no longer safe.
Thank human resilience for big mercies. We are fortunate that symptoms of depressed ‘turbulence’ do not often affect the majority among us, because the human species is remarkably pliant in managing, or handling, emotional ups and downs of life successfully on its own — notwithstanding a sequence of blues, sometime or the other. Besides, not all types of mild, short-term episodes of anxiety, or depression, merit aggressive treatment. So also occasional moodiness and depression — they are not entirely symptomatic of emotional upheavals, but just a part of everyday life.
Well, if you are depressed for a while and/or are trying frantically to gaining control over your emotions and life, it’d only be imperative to not lose time, mull endlessly or brood. When you sense mood difficulties or unhealthy emotional changes — even if they sound trivial on the surface — communicate clearly with the important people in your life, including your doctor. It will all help positively — to drive away the blues from your mind and life.
(The writer is a wellness physician and author)