About Depression

I’m somewhat pissed off as I’m writing this…

When talking about depression you very often tend to hear comments like “you need to cheer up” (no shit?) and so on. Lots of people feel need to come to you and tell their, usually very aggressive, opinion about depression. And they all seem to have one common thing: they think they know your life and situation so much better than you without even knowing what depression is.

They dont understand that a person with a long term depression is not depressed because s/he is too stupid to cheer up, but because s/he is unable to.

Problem with depression is that the symptom and sickness has same name. When you feel down and sad, you are depressed. Usually it will be due some reason and go away quickly (or at least in days or weeks). It is something that can be dealt with “cheering up”.

However the sickness called depression (I’m not totally familiar with official medical names though) is a bit different. Brain is a huge network of connected neurons. Thinking is a result of electrical messages being transmitted from a neuron to another. Brains can learn and adapt – new connections grow between neurons and old, frequently used ones, grow stronger. Some chemicals affect a lot in both, transmitting signals and growth of connections.

What happens in long term depression is that brains adapt to depressed state. This means that neural connections that support or participate in depressed state grow stronger and connections participating in non-depressed state get weaker.

In theory it is possible to get over long term depression just by cheering up or thinking positively. It is - if you manage to do it couple years in row. If you are one those who swear in the name of it, do try it yourself: Start now to think positively and do not get sad, stressed, upset, angry or anything until 2008 or so. Then you can come to me and tell that you can cure long term depression by just thinking positively.

Depression has been studied quite a lot lately as science now offers ways to see what happens inside brains. Depression is one of the first things where there have been clear proofs how physical and psychological worlds come together. Most doctors who follow this are seems to agree that difficult depression is best treated with medication and therapy. Also statistics support this.

Most common “anti-depressants” used today are so called ssri-medicines (selective serotonin retake inhibitors). As name suggests they prevent serotonin from leaving brains. They usually have effect on two to three different chemicals in brains and generally help those weak connections (“non-depressed connections”) enabling better signaling and speeding up growth.

The “depressed connections” stay strong for long time – even for years. During that time depression can come back very easily since brains still have all the old connections alive. That again speaks against getting over long term depression since basically all it needs is a one slip and you are back where you started.

One common argument against medicines is that they change who you are or affect your personality. That’s not really the case in common sense. They just affect some chemicals in brains. You still are same person with same experiences and memories. However a depression does change who you are, would be reasonable to think that a medicine has to change something if it helps for depression.

When comparing to other sicknesses that are more familiar to people, it would feel plain stupid if a person with a cancer would be told to “just bear it without help” or “don’t take medicines but wait for your body to heal itself”.