“It’s all in your head.”
“It’s not like you are actually in pain”
“I’m sorry I can’t see what is wrong with you”
“Oh, I wouldn’t take a sick day unless I was really sick”-Well Meaning People
All of these quotes are things people have told me, either about my own depression, or about theirs. All of these have the same sub-text. Depression isn’t a ‘real’ condition, or illness. The ‘fake’ illness they talk about impacts nearly 15 million Americans’ daily lives; and nearly 4% of American adults reported having a suicidal ideation in 2018.
Let that sink in.
Millions of people every day are suffering from a disease that their peers belief isn’t real. Sometimes I compare this to me telling someone who broke their arm to ‘hold this’ because ‘well you still have an arm’. We would all agree that is cruel and borderline sadistic. But with mental disorders we can’t see the injury, so discount it as fake.
The Guest Your Brain Doesn’t need
Depression causes three fundamental changes in our brain, a resizing of core components, rewriting neural pathways and inflammation. Research is ongoing to determine if brain inflammation causes depression, or if it is a symptom the disease itself due to a change in how the brain absorbs oxygen.
While changes typically take a minimum of eight months to develop. The potential for near permanent dysfunction in memory, executive function, attention, mood, and emotional regulation exist after bouts of longer-lasting depression.
The Sizing Changes
A 2016 international study published in the journal Molecular Psychiatry reports that 65% of all depressed patients have a smaller hippocampus. This is the region in the brain that controls emotions, learning and memory. According to PsychEducation.org, this shrinkage occurs because of the way depression kills existing hippocampal cells and prevents new ones from growing efficiently.
The report in Molecular Psychiatry goes on to say that this change is most pronounced in people with extended or recurring bouts of depression. So then, the longer someone goes without treating their depression, the harder it becomes to remember, and learn.
This is a bigger deal than it sounds because recovery from depression requires a relearning of how to feel; while a common treatment for the disease involves remembering. So in effect this disease attacks the very parts of the brain which would be most able to combat it.
Remember that next time you feel the need to tell a friend to ‘pull themselves out of it’.
The prefrontal cortex is the part of the brain that handles dopamine, norepinephrine and serotonin – hormones that control mood.As reported by Live Science, individuals with depression tend to experience shrinkage in this area due to the high amount of cortisol associated with depression. Depression also causes cells in the prefrontal cortex to become less dense.
Another study published in the journal Molecular Psychiatry reports that major depressive disorder causes the amygdala to swell. This often results in sleep disturbances and makes the body’s hormone release process go haywire. At the root of this is the high levels of cortisol associated with depressive symptoms (and a key driver of our stress response).
There are links being made between inflammation and depression. It’s still not clear, as I mentioned above, whether inflammation causes depression or vice versa.
But brain inflammation during depression is linked to the amount of time a person has been depressed. The study I cited above shows that people depressed for more than 10 years showed 30 percent more inflammation compared to people depressed for less time.
Because brain inflammation can cause the cells of the brain to die, this can lead to a number of complications, including:
- sizing changes
- decreased function of neurotransmitters
- reduced ability of the brain to change as the person ages (neuroplasticity)
These complications make it hard for people to learn, affect mood, and cause loss to memory. Young adults suffering from depression face the risk of severe mental limitations due to how rapidly their brains should be growing and changing.
Depression has been linked to reduced oxygen in the body. These changes may be due to changes in breathing caused by depression. But like with inflammation which comes first and causes the other remains unknown.
Overall, the brain is highly sensitive to reductions in oxygen, which can lead to:
- brain cell injury
- brain cell death
Inflammation and cell death can lead to a host of symptoms associated with development, learning, memory, and mood. Even short-term hypoxia (brain lacking oxygen) can lead to confusion, much like what’s observed with high altitude hikers (clearly a reason to not hike 🙂 ).
We will explore herbal remedies later, but there are also other, non-prescription treatments which have see excellent results in clinical studies. While these treatments are very effective, they should absolutely never be used INSTEAD of seeing a trained and trusted mental health provider. I did that, and it led to the first of my suicidal ideations.
According to Dr. Majid Fotuhi, the best way to restore your hippocampus is to exercise. Research has shown that walking one mile a day lowers the risk of Alzheimer’s (another hippocampal shrinkage-related disease) by 48%. Another way to support your hippocampus is by getting lots of omega-3 fatty acids.
Gratitude activates your prefrontal cortex and gets its cells firing. This is super helpful when you’re suffering from a depressive disorder. It doesn’t have to be complex – just spend a few minutes at the end of each day writing what you are grateful for.
Hyperbaric oxygen chamber treatments, which increase oxygen circulation, have been shown to relieve symptoms of depression.
If you’re depressed, know that you’re not alone and that there are a number of helpful resources out there. Check out:
The next few posts will be more about depression as a disorder, and ways we can treat it, or help others who are suffering from it. Odds are that at least 2-3 people you know suffer from depression, and almost none feel safe talking about it.
Do you want more about inflammation and its harm to the body? Check out some older posts here and here. We here at Fully Human have not yet launched our supplement to combat the symptoms of depression. But we hope to do so by the end of 2019. If you are one of the millions suffering from ‘regular’ inflammation, check out Freedom, the first supplement to combine clinical dosing, clinical timing and clinical frequency.