Depression

[Diplomat]

Re: Depression

Mully: For someone to insist on chemical changes being the cause of depression suggests that the most viable treatment available is medical, which is where SSRIs (Selective Serotonin Reuptake Inhibitors), a class of antidepressants, comes into play. I believe that in some cases, the use of antidepressants simply serves to mask the root problems by increasing the level of serotonin in the brain, which is believed to help to relieve the symptoms of depression. Unless the root case is biological/genetic, artificially altering brain chemical to produce a desired effect, while noble, does absolutely nothing for the root cause(s) of the problem.

Obviously I do not understand the complexities of the brain, or how external factors produce stresses that alters the chemical workings of the body. What I do know is that where depression is present, all possible contributing factors should be explored. Drug treatment should not be the first course of treatment unless one is chronically depressed, or suffering from chronic post-traumatic stress disorder.

I recall a psychologist telling me that in a high number of the patients he sees, the common problem was one of how they perceived their respective situations. A positive change in that perspective as a result of effective counseling and the patients' desire to confront and deal with their various issues, were significant factors in them regaining their zest for life. I found that drug free approach very refreshing, and as a Christian, very Biblical.

[Guest]

Re: Depression

Originally posted by CEW:
[qb] Mully: For someone to insist on chemical changes being the cause of depression suggests that the most viable treatment available is medical, which is where SSRIs (Selective Serotonin Reuptake Inhibitors), a class of antidepressants, comes into play. I believe that in some cases, the use of antidepressants simply serves to mask the root problems by increasing the level of serotonin in the brain, which is believed to help to relieve the symptoms of depression. [/qb]

We actually agree more than we disagree here. I don't for a minute believe that prescription drugs are the only route to the release of "happy" chemicals. Exercise, chocolate, sex, etc are execellent substitutes.

I believe that the body's balance has to be restored and that need not be by the use of SSRIs, TCAs, Aminoketones, etc. But some route to chemical balance is required.

If mood changes are not the result of chemical interractions in the body, what is the vehicle?

[Guest]

Re: Depression

Originally posted by Mutty - The return:
[qb] Not meaning to change the subject, but can these biological causes also apply to people who are gay? [/qb]

From the research I've seen, absolutely.

[Diplomat]

Re: Depression

Originally posted by Mulligan:

If mood changes are not the result of chemical interractions in the body, what is the vehicle?

As per the info in post below, no one really knows. I find it interesting however that distinctions are made between the various probable causes. The sentence bolded is also interesting food for thought. I do believe however that regardless of what the conduit(s) might be, the ramifications of the disease for the patient, and those who care, are very significant, and those are the issues I want us to focus on in this discussion.

Causes of Depression
Theories About Causes

Medical research has contributed much to our understanding of depression. However, scientists do not know the exact mechanism that triggers depressive illness. Probably no single cause gives rise to the illness, and researchers continue to piece the puzzle together.

In the past, doctors believed that depression was the result of thoughts or emotions that were troubling for a person. More recently, experts realize that there can be several factors working together that will lead a person to become depressed. The three most important of these are biological, genetic, and environmental factors.

Biological causes are due to changes in the chemistry of the brain, such as fluctuations in the levels of important hormones. Genetic causes are the result of what you inherit from your parents. If one or both of your parents have a vulnerability to depression, then it can be transmitted to you. Environmental factors (also called emotional factors) result from stressful emotional situations, such as a lack of loving parents or the death of a parent during childhood. To make it even more complicated, depression can also occur as a result of a combination of the three factors just mentioned. If you inherited a vulnerability to depression from one of your parents, your brain may react to a stressful event in a way that causes you to get depressed.

Depression can also develop due to a physical illness, a reaction to a medication that you are taking, or as an outcome of substance abuse. In these cases, when the cause is successfully treated, the depression will end.

Genetic Factors

Scientists believe genetic factors play a role in some depressions. Researchers are hopeful, for instance, that they are closing in on genetic markers for susceptibility to manic-depressive disorder.

Recent genetic research also supports earlier studies reporting family links in depression. For example, if one identical twin suffers from depression or manic-depressive disorder, the other twin has a 70 percent chance of also having the illness. Other studies that looked at the rate of depression among adopted children supported this finding. Depressive illnesses among adoptive family members had little effect on a child's risk of depression; however, the disorder was three times more common among adopted children whose biological relatives suffered depression.

Biological Causes

Additional research data indicate that people suffering from depression have imbalances of neurotransmitters, natural substances that allow brain cells to communicate with one another. Two transmitters implicated in depression are serotonin and norepinephrine. Scientists think a deficiency in serotonin may cause the sleep problems, irritability, and anxiety associated with depression. Likewise, a decreased amount of norepinephrine, which regulates alertness and arousal, may contribute to the fatigue and depressed mood of the illness.

Other body chemicals also may be altered in depressed people. Among them is cortisol, a hormone that the body produces in response to stress, anger, or fear. In normal people the level of cortisol in the bloodstream peaks in the morning, then decreases as the day progresses. In depressed people, however, cortisol peaks earlier in the morning and does not level off or decrease in the afternoon or evening.

Researchers don't know if these imbalances cause the disease or if the illness gives rise to the imbalances. They do know that cortisol levels will increase in anyone who must live with long-term stress.

Environmental Situations

Certain environmental situations, such as stress or breakup of important attachments, also may precipitate depression, especially in vulnerable persons.

Research continues to better understand the interaction of genes and environment, and precisely what is inherited.

Source: Causes of Depression

[Diplomat]

Re: Depression

More Thoughts...

The group of symptoms which doctors and therapists use to diagnose depression ("depressive symptoms"), which includes the important proviso that the symptoms have manifested for more than a few weeks and that they are interfering with normal life, are the result of an alteration in brain chemistry. This alteration is similar to temporary, normal variations in brain chemistry which can be triggered by illness, stress, frustration, or grief, but it differs in that it is self-sustaining and does not resolve itself upon removal of such triggering events (if any such trigger can be found at all, which is not always the case.)

Instead, the alteration continues, producing depressive symptoms and through those symptoms, enormous new stresses on the person: unhappiness, sleep disorders, lack of concentration, difficulty in doing one's job, inability to care for one's physical and emotional needs, strain on existing relationships with friends and family. These new stresses may be sufficient to act as triggers for continuing brain chemistry alteration, or they may simply prevent the resolution of the difficulties which may have triggered the initial alteration, or both.

The depressive brain chemistry alteration seems to be self-limiting in most cases: after one to three years, a more normal chemistry reappears, even without medical treatment. However, if the alteration is profound enough to cause suicidal impulses, a majority of untreated depressed people will, in fact, attempt suicide, and as many as 17% will eventually succeed. Therefore, depression must be thought of as a potentially fatal illness.

...

What initiates the alteration in brain chemistry?

It can be either a psychological or a physical event. On the physical side, a hormonal change may provide the initial trigger: some women dip into depression briefly each month during their premenstrual phase; some find that the hormone balance created by oral contraceptives disposes them to depression; pregnancy, the end of pregnancy, and menopause have also been cited. Men's hormone levels fluctuate as deeply but less obviously.

It is well known that certain chronic illnesses have depression as a frequent consequence: some forms of heart disease, for example, and Parkinsonism. This seems to be the result of a chemical effect rather than a purely psychological one, since other, equally traumatic and serious illnesses don't show the same high risk of depression.

The typical chemical changes that characterize depression can also be caused by psychosocial factors.

Is a tendency towards depression inherited?

It seems there are some people whose brain chemistry is predisposed to the depressive response, and others who are at much lower risk of depression even if exposed to the same physical or psychological triggers. The close relatives of manic-depressives are at a higher risk for unipolar depression than the population at large or their adopted/by marriage relations.

There seems to be a link between high creativity and the gene for manic-depression: artists and writers often are not manic-depressive themselves, but have a family member who is. Studies of families in which members of each generation develop manic-depressive illness found that those with the illness have a somewhat different genetic make-up than those who do not get ill. However, the reverse is not true: not everybody with the genetic make-up that causes vulnerability to manic-depressive illness has the disorder. Apparently additional factors, possibly a stressful environment, are involved in its onset.

Major depression also seems to occur, generation after generation, in some families. However, depression can occur in people with no family history of any form of mental illness. And there probably is no human who is entirely immune to depression if stressed enough.
Psychological triggers

Many, if not most, people with depression can point to some incident or condition which they believe is responsible for their unhappiness. Of course, people with severe depression are prone to astonishingly virulent and inappropriate guilt and self-hatred. So what they identify as a cause of the depression is not the true cause. Also people are generally more comfortable thinking that their depressions had a specific trigger rather than thinking of them as occurring for no specific reason.

The (genuine) life events that are most often associated with depression are varied, but the distinguishing features of such events are: loss of self-determination, of empowerment, of self-confidence. More profoundly: a loss of self, of the abilities or activities that a person identifies with herself.

...

The question, "Is depression mostly physical or psychological," is rather beside the point. There is only one of you, not a separate physical you, and a psychological you. Depression may be triggered by either physical or psychological events. Most commonly, both seem to be involved, though it is often difficult to separate the two when one is talking about psychology and neurochemistry. However it begins, depression quickly develops into a set of physical and psychological problems which feed on each other and grow. This is why a combination of physical and psychological intervention has been shown to give the best results for many patients, regardless of any diagnosis.

Source

[Guest]

Re: Depression

Yes, the bolded sentence was pretty much what I was thinking when I wrote:

Did the depression lead to the chemical change? Or did the chemical change lead to the depression?

Very interesting read. Thank you.

Having suffered from depression myself at one time I, too, have studied the subject in depth and am left a little perplexed. Further, I agree that whatever the process, solutions must be the focus.

I'm not suprised, however, that God always leaves exciting knowledge for future generations to discover. A million years from now, God will still be rewarding the inquiring mind.

[Guest]

Re: Depression

Bumpity Bump