Beyond the Basic Blues

GorskiMonday, I mentioned briefly how depression has a physiological aspect to it, but was rather vague about what that was. Well, the reason for that is because depression is actually one of the more complicated mental illnesses out there. Depression has a number of different theories behind the causes, and as of yet, they all seem to be right… but only for some people. To be more specific, depression seems to have a series of potential causes, and what specific trigger causes it varies from person to person. Some people don’t have enough serotonin, a neurotransmitter tied to a ton of various things: mood regulation, eating, sleep, arousal, even pain regulation. Others don’t have enough norepinephrine (adrenaline), while others still don’t have enough dopamine (tied to both excitation and inhibition depending on where it’s used in the brain). Even more complicated is the fact that there are a number of areas in the brain where any one of these being imbalanced can cause depression. And even more complicated than that is the fact that there’s actually a number of varieties of these. As I mentioned with dopamine, it can be used to excite or inhibit, depending on where it hits. Think of it this way, each of these neurotransmitters is like a master key to a series of locks. Which lock the key is inserted into depends on the effect it gives. However, with medications, we can’t copy the master key, we just have to try for individual locks. This is why there are so many different types of medical treatments for depression, but only a select few are ever effective for any one person.

Let me give you an example from my own past. When I first started out trying antidepressants, my doctor recommended we start with Wellbutrin, a drug created to help people stop smoking, but that was noticed to also have antidepressant functions. For some who also have anxiety issues, it will help ease out the anxiety as well. However, when I took it, it made my anxiety far, FAR worse, to the point that I was having panic attacks from just sitting at my desk reading webcomics. However, once I got switched over to Zoloft, there were more pleasant changes noticeable. While Wellbutrin works fine for my aunt, it made things worse for me. So even though we share the same biological predilection for depression, the way our actual depression presents itself, even in our biology, is vastly different.

This widely different biological factors for depression also leads to wifely different symptoms. Depression isn’t always just intense sadness. It can take shape through increased irritability and anger, or through a complete lack of emotions, flat affect. It’s often associated with a lack of desire to do anything, called avolition, as well as an inability to feel pleasure, called anhedonia. This last bit is important, because even when not in a depressive episode, a person who suffers from depression is chemically set such that it is more difficult for them to feel pleasure, ever. This includes receiving less pleasure during a depressive episode from things that normally bring them pleasure (like gaming, for me).

And these are just some of the major symptoms. Others (which often vary wildly from person to person) are sudden weight gain/loss, insomnia/hypersomnia (inability to sleep or sleeping more than normal), fatigue, inability to think… and so much more. What’s more, in children, depression can manifest with episodes of hyperactivity. Yeah, take that along with the last symptom I mentioned before it, and it sounds kind of familiar, right? That’s right, only about half of the kids diagnosed with ADD/ADHD actually have it, others have something else, like depression or PTSD, that manifest themselves with hyperactivity in children. In adults, that hyperactivity can take the form of restlessness (such as with insomnia).

So as with PTSD (and every other mental illness), if you find yourself thinking someone needs to just “get over it,” then you can get over yourself. Mental illness is physical illness, just hidden from plain sight, like lupus or fibromyalgia. Until next time.

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