Looking for theories on the cause of depression

[basildev]

Hi everyone,

 

I apologise in advance if this thread was not created in the right section. I wasn't sure where to post this question to be honest.

 

So my question is: I was wondering if anybody could shed some light on the whole 'chemical imbalance' debate for me.

 

The reason I ask is that over 10 years ago, I suffered a debilitating bout of depression brought on by a marriage breakdown. I was unable to sleep, eat or function, and could not get into see a psychiatrist for one month so had no support or professional help at hand. It really blew me away and I had never experienced something so debilitating before in my life. I was very scared.

 

At that time, my sister, who is a doctor, gave me a sample pack of citalopram and not knowing what else to do, I took them. I have to say they made an immediate positive difference (and I had no expectations either way). Personally I don't believe it was a placebo effect. They really did help me to function normally (especially with sleep). Under the advice of doctors and psychiatrists over the years I was told that if you have more than 3 relapses then you have to take antidepressants for the rest of your life.

 

I took this advice in good faith and...well...you can see my history in my sig box. A part of me has always wanted to be drug free. But like it or not I DO seem to be prone to prolonged, debilitating depression, especially when I experience grief of loss. My diet is excellent, my life is great and I get heaps of sleep. So I'm doing everything (Physiologically) that I can.

 

But if the cause of my depression wasn't (and isn't) a chemical imbalance, why did the citalopram work so quickly and effectively for me each time?

 

I know there are people on this forum who have heaps of knowledge on this subject so would love to hear your theories. Why are some of us more prone to depression than others and what can we do to stay strong? Bear in mind I've had years of counselling and hypnotherapy so I'm pretty self-aware and have no underlying issues that need to be dealt with. So why has is been so hard for me to I stay off the meds long-term?

 

Any input would be greatly appreciated.

 

Thanks:)

[Skyler]

I know there are people on this forum who have heaps of knowledge on this subject so would love to hear your theories. Why are some of us more prone to depression than others and what can we do to stay strong? Bear in mind I've had years of counselling and hypnotherapy so I'm pretty self-aware and have no underlying issues that need to be dealt with. So why has is been so hard for me to I stay off the meds long-term?

 

Any input would be greatly appreciated.

 

Thanks:)

Hi Basil, the easiest way to search this site is to use google. Put the following in and see what you come up with.. site:survivingantidepressants.org chemical imbalance

It sounds like you are ready to read Robert Whitaker's book Anatomy of an Epidemic. The narrative, which is riveting and reads like a suspense thriller, will answer a lot of the more generic questions about how you came to the place you are.

 

PS.. this is not the right section, but one of the mods will migrate this post to it's rightful home. Glad to see you are reading some of the info available here, it's a veritable treasure trove.

[alexjuice]

The cause of depression is probably not to be found in a single theory. I don't know that depression is one thing. And, clearly, many people don't suffer from a mental illness but do experience periodic downturns in life which tax or overwhelm their support systems and abilities to cope.

 

However, since you are curious for a theory, I'll jump in and oblige. Here's one hypothesis:

 

Given the manifold ways that depression impairs Darwinian fitness, the persistence in the

human genome of risk alleles for the disorder remains a much debated mystery. Evolutionary

theories that view depressive symptoms as adaptive fail to provide parsimonious explanations

for why even mild depressive symptoms impair fitness-relevant social functioning, whereas

theories that suggest that depression is maladaptive fail to account for the high prevalence of

depression risk alleles in human populations. These limitations warrant novel explanations for

the origin and persistence of depression risk alleles. Accordingly, studies on risk alleles for

depression were identified using PubMed and Ovid MEDLINE to examine data supporting the

hypothesis that risk alleles for depression originated and have been retained in the human

genome because these alleles promote pathogen host defense, which includes an integrated

suite of immunological and behavioral responses to infection.

 

Depression risk alleles identified by both candidate gene and genome-wide association study (GWAS) methodologies

were found to be regularly associated with immune responses to infection that were likely to

enhance survival in the ancestral environment. Moreover, data support the role of specific

depressive symptoms in pathogen host defense including hyperthermia, reduced bodily iron

stores, conservation/withdrawal behavior, hypervigilance and anorexia. By shifting the

adaptive context of depression risk alleles from relations with conspecifics to relations with

the microbial world, the Pathogen Host Defense (PATHOS-D) hypothesis provides a novel

explanation for how depression can be nonadaptive in the social realm, whereas its

its risk alleles are nonetheless represented at prevalence rates that bespeak an adaptive function.

 

Molecular Psychiatry advance online publication, 31 January 2012; doi:10.1038/mp.2012.2

 

http://www.nature.com/mp/journal/vaop/ncurrent/pdf/mp20122a.pdf

 

I haven't read it, but it's a theory for the cause of depression...

 

Good luck,

Alex

[basildev]

that's great, thank you guys.

 

I did search the forum and couldn't find anything, but will search google.

 

PS: Just bought 'Anatomy of an Epidemic' for my Kindle. Look forward to reading it, thanks for the tip.

 

thanks

[Altostrata]

One thing depression is NOT: A chemical imbalance.

 

http://www.psychologytoday.com/blog/charting-the-depths/201007/the-serotonin-theory-depression-is-collapsing

 

http://www.newscientist.com/article/mg20727703.300-serotonin-cell-discoveries-mean-rethink-of-depression.html

 

http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020392

 

Also

 

NICE National Clinical Practice Guideline Depression in adults (update) (CG90)

2.2 AETIOLOGY

 

mentions not a word about low serotonin, serotonin deficiency, neurotransmitter imbalance, or chemical imbalance. In the entire document, the word "serotonin" appears only in reference to selective serotonin reuptake inhibitors and other antidepressants.

 

 

In fact, the "chemical imbalance" theory has become an embarrassment for medicine and psychiatry has disavowed it.

 

See this June 2011 article in the professional publication Psychiatric Times by its editor emeritus Ron Pies: Psychiatry’s New Brain-Mind and the Legend of the “Chemical Imbalance” http://www.psychiatrictimes.com/blog/couchincrisis/content/article/10168/1902106 (free registration required) in which Dr. Pies claims:

 

I am not one who easily loses his temper, but I confess to experiencing markedly increased limbic activity whenever I hear someone proclaim, “Psychiatrists think all mental disorders are due to a chemical imbalance!” In the past 30 years, I don’t believe I have ever heard a knowledgeable, well-trained psychiatrist make such a preposterous claim, except perhaps to mock it. On the other hand, the “chemical imbalance” trope has been tossed around a great deal by opponents of psychiatry, who mendaciously attribute the phrase to psychiatrists themselves....

(Note that Dr. Pies, editor emeritus of Psychiatric Times, calls the "chemical imbalance" theory an "urban legend." That is, in fact, what it is, and why it is so widely believed.)

 

But why did psychiatrists almost universally tell their patients they were suffering from a "chemical imbalance"? In August 2011, on the public PsychCentral.com Dr. Pies published Doctor, Is My Mood Disorder Due to a Chemical Imbalance? http://psychcentral.com/blog/archives/2011/08/04/doctor-is-my-mood-disorder-due-to-a-chemical-imbalance/ in which he carefully explains:

 

....some doctors believe that they will help the patient feel less blameworthy by telling them, “You have a chemical imbalance causing your problem.” It’s easy to think you are doing the patient a favor by providing this kind of “explanation”, but often, this isn’t the case. Most of the time, the doctor knows that the “chemical balance” business is a vast oversimplification.

 

My impression is that most psychiatrists who use this expression feel uncomfortable and a little embarrassed when they do so. It’s a kind of bumper-sticker phrase that saves time, and allows the physician to write out that prescription while feeling that the patient has been “educated.” If you are thinking that this is a little lazy on the doctor’s part, you are right....

Having to choose between admitting psychiatrists are fools for believing an urban legend or liars deliberately misrepresenting a medical condition to patients, Dr. Pies copped to deliberate misrepresentation.

 

Pies's articles are valuable in that they show the "chemical imbalance" theory is a fallacy that has become an embarrassment to psychiatry and psychiatry is disavowing it. (Also, they show psychiatrists will happily throw informed consent under the bus to convince a patient to take medication.)

 

Now, they need something to replace the "chemical imbalance" theory because it justified the reflexive prescription of drugs, such as:

• Mood disorders are caused by inflammation, and antidepressants reduce inflammation.
• Mood disorders are caused by brain contraction, and antidepressants induce neurogenesis.
• Psychiatric disorders are caused by bad brain circuits, and psychiatric drugs somehow correct them.
• Psychiatric disorders are caused by bad genetics, and psychiatric drugs somehow compensate for them.

There is no evidence for any of these theories, and plenty of evidence arguing against them, not the least being the poor track record for efficacy of any psychiatric drug.

 

The theories that have the most support are

• Abuse in childhood
• Unhappy family history
• Stressful situations

There remains, and always has been, a very small number of people who might suffer from "major depression," a profoundly paralyzing condition where the person might not be able to eat, talk, socialize, or do much of anything over a long period of time. This is thought possibly to have some metabolic origin.

 

If you can surf the Web, YOU DO NOT HAVE THIS.

[basildev]

Oooooh, thanks so much for all this info Alto!

 

I'm going to read through it all.

 

You're a legend:)

[jr1985]

Some evolutionary psychologists believe depression allows you to slow down and ruminate on your problems, to help you find possible solutions. In other words, it's letting you know something is wrong in your life and you need to change it.

 

But now, if people are depressed due to work related stress, people want to treat the symptoms with antidepressants, rather than cure it by doing something less stressful (switching jobs, roles, etc), because it takes less effort.

[Barbarannamated]

Interesting thread. Thanks.

[basildev]

Thanks Barb.

 

Yeah jr, I know there was a definite reason for my depression when it happened. I needed to make some changes and I did. I had (lots of) therapy, changed my eating habits and found the courage to change my career.

 

But there's no reason for me to be depressed now. My life is great. I really did believe in the chemical imbalance theory until I came across this site. I guess it just made sense since the depression 'came back' each time.

 

But since reading Whitakers book I can see that I have actually stuffed up my brain by taking these things. I only hope that I can un-stuff it and get it back to the way it was pre-meds. Tapering is my last hope.

[areyouthere]

I think this is funny:

 

There remains, and always has been, a very small number of people who might suffer from "major depression," a profoundly paralyzing condition where the person might not be able to eat, talk, socialize, or do much of anything over a long period of time. This is thought possibly to have some metabolic origin.

 

If you can surf the Web, YOU DO NOT HAVE THIS.

 

And I don't think I have a chemical imbalance. My childhood sucked apple juice. And I am pissed that I felt like **** then and because of incompetence feel like **** now. I can see why some people give up. Sad

[basildev]

It IS funny isn't it, areyouthere?

 

It's really sad that people aren't given (or can't find) proper resources and aren't given the full story before they go in meds.

 

Plus, therapy is so expensive! And good therapists are rare as hen's teeth. So I can see why so many people give up.

[bubbles]

You've probably already read the other threads; there are various physical illnesses that have depression as part of their symptoms. Also, some deficiences (vitamin/mineral) also seem to have depression as a symptom.

 

B

[basildev]

Thanks bubbles,

 

I had a full blood test today. We'll see what comes back:)

[Nadia]

I agree with Alex. I think asking what the cause of depression is is like asking what causes weight gain. The causes can be multiple... maybe it's not enough exercise, maybe it's overeating, maybe it's eating the wrong foods, maybe it's a thyroid problem, maybe it's a genetic predisposition, maybe its parasites...

 

I think of taking antidepressants for depression as being like taking amphetamines to lose weight. Yeah, maybe you'll lose weight, but it doesn't mean you are addressing the original cause and you're playing with fire. (Same for benzos for anxiety.)

 

I too got relief at first from taking ADs, so like you I don't think it's a placebo effect (though for many it might be, or there may be no effect at all). If it was just placebo, any antidepressant would have worked. As it is, each one I've tried has had a different effect. Prozac, for example, did absolutely nothing for me. Paxil made me shaky and overagitated. Celexa made me flat and cold. Zoloft was the only one that seemed to hit the spot, and down the line, that may have only been because it was the one my brain had adapted to.

 

Probably in the beginning, having some extra serotonin had a positive effect on my mood and made me feel less inhibited. I also felt really good when I took MDMA, though.

 

It doesn't have to be just a placebo effect to debunk the "chemical imbalance" theory. Brains are complicated places. Many scientists say the brain is the most complicated thing we know of in the universe. Do you really want to mess with that delicate balance? Also, the brain does not exist separate from the rest of the body. Mood is regulated by too many factors... maybe one day we'll have a better understanding of them, but there is also a ton of individual variation.

 

I do think some of us are more predisposed to feeling sad, depressed, anxious, etc., and that this has to do with both environmental factors AND genetic/brain structure and chemistry factors. I didn't have any major stressors in my childhood, no trauma, and yet I had a tendency to get down easily, and have always been very sensitive. My dad was the same way and he also had a pretty ideal childhood and life. Everyone is different. Some people smile a ton, some people are serious, some people just seem naturally optimistic, some are more intelligent than others, some are good at science, some are good at art... each of us is a unique package. Since I believe that all of this is contained in our brain and body (you can't isolate the brain), I do think there can be correlations found between some mental states and brain biology/chemistry. But this doesn't mean there is ONE SIMPLE EXPLANATION that can cover everyone.

 

This is so with other bodily functions. Your high pressure med may not work for me. You may get high cholesterol following my same lifestyle and I don't, etc.

 

The absolutely maddening and unconscionable thing is that the drug industry is pushing antidepressants that are poorly understood and studied for just about everything under the sun. Depression, anxiety, pain, fibromyalgia, exhaustion, grief. Most of the time without ever testing to find out if there is a physical cause that can be addressed, or seeking other avenues of treatment. Even if there isn't a treatable illness underneath, enough evidence has surfaced now to prove that IT'S A REALLY BAD IDEA to be messing with brain chemistry in such a radical manner.

 

So, just because you had a good reaction to your antidepressant doesn't mean it's the solution to your problems, nor does it lend any credence to the chemical imbalance idea.

 

Even IF the chemical imbalance thing were somehow right for some people, albeit in a less ridiculously simplistic way than it's been presented, the drugs still have side effects and problems and are so poorly understood that it's like playing Russian roulette to use them. If there are people who have gotten away with being on them and have not been majorly harmed, I think it is a testament to the resilience of the human body, not any kind of evidence that the drugs are harmless.

[Nadia]

Yeah jr, I know there was a definite reason for my depression when it happened. I needed to make some changes and I did. I had (lots of) therapy, changed my eating habits and found the courage to change my career.

 

But there's no reason for me to be depressed now. My life is great. I really did believe in the chemical imbalance theory until I came across this site. I guess it just made sense since the depression 'came back' each time.

 

Well there seems to be more and more evidence that taking antidepressants can eventually cause iatrogenic depression. Whitaker's concept of tardive dysphoria tries to account for that phenomenon. I for sure feel like I am way worse off now than I was prior to meds, and that much of this has to do with they physical state they left my brain in, not an environmental factor.

 

The big problem here is that most doctors, psychiatrists or not, think that any "mental disorder" that creeps up for you is par for the course if you were EVER diagnosed with ANY mental disorder previously. So they are blinded to what these drugs are actually doing.

[basildev]

I agree with you Nadia;

 

Instead of fixing a chemical imbalance I have been creating one all these years.

 

I've just finished reading Whitaker's book. I feel completely duped. I mean if we can't trust our doctors, who can we trust?

 

Now that I know all this I feel determined to get off them and stay off them. I spent many years taking the meds because I thought they 'took the edge off'. I've always been prone to be a bit grumpy and a bit sensitive.

 

But really I have no idea if they do actually take the edge off any more. Plus I need a lot of sleep, have no libido and have sporadic night terrors exactly one hour after I fall asleep (weird I know).

 

None of this has, in the past, been so bad that I have wanted to risk the awful WD symptoms. Yet I have always been uncomfortable with staying on the meds long term.

 

Now my eyes have been opened.

 

Thanks for your comments

[Nadia]

Instead of fixing a chemical imbalance I have been creating one all these years.

 

Excellent way of putting it!

 

I know exactly what you mean about taking the edge off. And I know what you mean about waking up with terror. That happens to me, too, but it only started after I cold turkeyed.

 

If you're going to go off, remember to go really, really slow! I mean, take a few years to do it! I so wish I had...

 

N.

[Altostrata]

Great posts, Nadia.

[basildev]

I hear you Nadia.

 

Have started on a 5% taper a week ago and waiting 3 weeks to see what happens. I'm in no hurry:)

[aza]

Hi everyone,

 

I apologise in advance if this thread was not created in the right section. I wasn't sure where to post this question to be honest.

 

So my question is: I was wondering if anybody could shed some light on the whole 'chemical imbalance' debate for me.

 

The reason I ask is that over 10 years ago, I suffered a debilitating bout of depression brought on by a marriage breakdown. I was unable to sleep, eat or function, and could not get into see a psychiatrist for one month so had no support or professional help at hand. It really blew me away and I had never experienced something so debilitating before in my life. I was very scared.

 

At that time, my sister, who is a doctor, gave me a sample pack of citalopram and not knowing what else to do, I took them. I have to say they made an immediate positive difference (and I had no expectations either way). Personally I don't believe it was a placebo effect. They really did help me to function normally (especially with sleep). Under the advice of doctors and psychiatrists over the years I was told that if you have more than 3 relapses then you have to take antidepressants for the rest of your life.

 

I took this advice in good faith and...well...you can see my history in my sig box. A part of me has always wanted to be drug free. But like it or not I DO seem to be prone to prolonged, debilitating depression, especially when I experience grief of loss. My diet is excellent, my life is great and I get heaps of sleep. So I'm doing everything (Physiologically) that I can.

 

But if the cause of my depression wasn't (and isn't) a chemical imbalance, why did the citalopram work so quickly and effectively for me each time?

 

I know there are people on this forum who have heaps of knowledge on this subject so would love to hear your theories. Why are some of us more prone to depression than others and what can we do to stay strong? Bear in mind I've had years of counselling and hypnotherapy so I'm pretty self-aware and have no underlying issues that need to be dealt with. So why has is been so hard for me to I stay off the meds long-term?

 

Any input would be greatly appreciated.

 

Thanks:)

 

Hi, I was in the middle of doing a google search on "connection magnesium depression" when I decided to check out taurine on this forum and instead I ended up here at this thread, and I found this fairly quickly when I did my search. connection magnesium depression

 

Seems like a good candidate for this thread.

 

I started taking a vitamin and magnesium supplement (Ionic fizz magnesium plus)to help with the withdrawal I was experiencing from tapering off of gabapentin which I was taking as a mood stabalizer and or (depression) ?? oxymoron ??

 

I found the vitamin/magnesium supplement eliminated most of my gabaoentin withdrawal and allso eliminated much of my depression. This PDF file is really interesting.

 

Since I started reading about calcium and magnesium I have added a small amount of calcium supplement as well, 200 mg. (Cal Mag Supreme)

 

Interesting question.

[Narcissus]

"Chronic pain and depression, often linked and occasionally even regarded as a single disorder, constitute an immense crisis at the center of postmodern life."

 

^There you have it, your cause. Modern (or if you like, post-modern) life.

 

We're all in it together.

[Jackson]

Hi Basildev

 

I'd like to share my view of depression with you, having been through existential depression myself, as well as having talked to a lot of people and done quite some research on the subject.

 

Depression is a state of both the mind and the body. It's not a general feeling like anxiety or anger, it's more like a pattern of feelings that affects your thinking, your behavior and your biology. When you are in this state of depression, your brain chemistry is changed as a result. Much like "being in love", being infatuated, it is a state of being that almost seems to take over your entire organism. It's state of overly negative/positive emotions that elicits powerful chemical responses in your brain.

 

But how do you become depressed in the first place? How does one ENTER this state of mind to begin with? Well, we all know that certain life events can often result in depressive states in a lot of people, such as trauma, loss of loved ones, loss of job or finances, injury or accidents, serious illnesses and other external/circumstancial triggers.

 

But again, how does the event itself trigger chemical changes in the brain that causes us to enter the depressive state? What is the REAL cause of the depression? What is the link between the external event and the chemical changes in the brain?

 

I couldn't understand this at first, but I believe I've come to find a lot of the answers. The psychological mechanisms that are behind depression is not that well understood by today's science. However, I stumbled upon a resource called Mindfield's college that explained it like this, and it all started to make complete sense to me:

 

Whenever we are faced with a difficult external event or circumstancial trigger, we are very prone to engage in a lot of excessive WORRY, RUMINATION and INTROSPECTION. This causes a lot of emotional stress in the brain, which it somehow needs to deactivate or "flush out". Usually you will get relief from these feelings by acting them out or acting upon them. However, if you do NOT act out these feelings naturally, they will keep adding up the emotional arousal in your brain - they become "suppressed" feelings if you will.

 

What the brain then tries to do, is flush all of the emotional arousal that you created during the day through intense worrying and rumination, out AT NIGHT instead. Our dreaming is a natural way for our brain to try and organize or clean up our emotional responses from throughout the day. Thus when there is a lot to clean up, you will end up dreaming a lot as a result.

 

This does two thing:

 

1) you will spend a long time in REM state of sleep (dream sleep)

2) You will spend shorter time in deep sleep (which is the restorative sleep)

 

However, the REM sleep is very tolling on the brains resources, which means you might wake up early in the morning feeling very exhausted and very depressed. I believe it also creates a cortisol response, which is a stress hormonr that is very bad for your biology and neurochemistry in the long term. Furthermore, you will lack deep sleep, which helps the brain renew itself and regain strenght to handle the day. That means the negative cycle of depression has begun. Because you will then go on the next day, not feeling well, worrying about why you are feeling like crap, why you can't sleep (or sleep all the time), why you are depressed and so on, thus creating more emotional arousal than you brain can handle.

 

So the short version is, depression is a state of mind, which in most cases, can actually lifted or reversed rather quickly - if you can just manage to become AWARE of the underlying mechanisms and break the cycle in as many ways possible.

 

The major problem for a lot of people, is that the negative rumination and excessive worrying has become such an INGRAINED part of their normal thinking patterns, that they have to re-learn (or be reminded) how to think differently. It becomes habitual. It might sound weird, but the more time you spend in a certain emotional state, the more likely you are to stay in that state. You need to break this cycle to get rid of depression. The majority of depressed people can not do it on their own - because it is very difficult to manually re-wire your thinking if it's become a habit that you are not aware that you are engaging in, or because you feel like you do not have the resources to do so. Your thinking is clouded and obscured.

 

This is where therapy comes into the picture. The reason why Cognitive Behavorial Therapy is so effective in the treatment of depression, is because it is designed to DIRECTLY target the negative thought patterns that are the real cause of depression. Depression is very malicious, because depression itself leads to more worrying and rumination, and the more you worry and ruminate, the more depressed you will become. Once you realize this, you will be much better armed in fighting off the depressive state.

 

Your brain is perfectly able to feel great. You just have to "teach" it how to do it. I make it sound easy, but I know it is definately not. But once the negative thought patterns starts to dissolve, your sleep pattern will also regulate itself more and more back to normalcy. Once the stress response has been stopped, your body and brain chemistry will return to normal, and suddenly you will start seeing your energy and mood will improve, and the worrying and rumination will become less intense and easier to handle as well. This is when depression is lifted and your mood returns to normal.

 

This is why you must understand that antidepressants are not treating the CAUSE of depression, it's merely treating the symptoms. Altering the brains synaptic levels of serotonine might lead to, say, better sleep, and this may or may not artificially help get you out of the depressive cycle. Sometimes, however, the emotional arousal you create during the day is simply so OVERWHELMING, that even antidepressants cant lift you from it. Not to mention the myriad harmful effects they can have on your brain and nervous system.

 

I know it might sound complicated, and I know it's only a simplification of what exactly goes on in the brain and body, but according to Mindfield's, recent studies in dreaming in depressed patients shows this link between REM sleep and daily emotional agitation.

 

You can read a LOT more about this theory and a lot more details here:

 

www.clinical-depression.co.uk

 

Read through their Learning Path program. Everything I wrote about is explained in greater detail there.

 

If you have any questions regarding what I just wrote, feel free to ask. I'll be happy to share what I know.

[basildev]

Thanks for the detailed account Jackson.

 

I've done a lot of research (and study) into the workings of the mind myself.

 

Your explanation re the chemical side of things was new to me, though. That makes a lot of sense.

 

If I'd known what I now about mind states and brain neuroplasticity now I wouldn't have gone on the meds. At the time though, I didn't have any resources to turn to other than my doctors.

 

Hindsight is a wonderful thing!

[starlitegirlx]

I know for me stress and situational stuff triggers depression. From there it can snowball into ongoing depression. In fact, looking back, it seems that the issue for me was that I'm not like most people in that I can only handle less stress than most. Just like how some can handle far more. So this opens the door to triggering depression right off the bat. Then when a situation comes up that maxes my stress quota, I begin to slip into a depression - it's not straight out depression but a mix of being overwhelmed and down. As the situation continues or grows, the depression truly takes hold. There's also the rumination factor. I did research at the best mental health hospital in my state regarding ruminating over things, thinking about them over and over beyond any kind of norm is also a contributing factor. For me it's > low stress tolerance + situation not wanted = downward spiral. Then it's > rumination of situation + continued maxed out stress factor + ongoing situation = depression. From there I can land into a hardcore deep depression that lasts for months or even years. Also, a lot of it is thought process related (for me anyway), and by that I mean that a sense of being trapped with no choices can add to the downward spiral into depression and then the continuation of depression. Anything that connect to choices, option and even hope or lack thereof exacerbates the cycle.

 

I tend to think that it's this was to some degree for most people. I don't think the norm of even most people with depressive disorders (as diagnosed) is that they have these disorders but rather that we've never been taught coping skills to help handle and accept things we don't like or want or that are stressful. I also thing the trigger is most always situational in some way only we might not even realize what the situation is. It could even be multiple situations that are minor but together they tax you and get you down. Then you're thrown into some version of the cycle I described which leads to depression. I wish someone would conduct a study on all people with depression and see if there is a correlation to coping skills (how they cope), tolerance for stress and even major backtracking to see if there was something or things that started it all. I think sometimes we don't see how some things could have started the depression or been the catalyst because they don't seem to have as strong an impact at first, like say some aggravations at work. That's normal for most people, but over a prolonged period and let's say you can't leave because there are no jobs around then that is the beginnings of depression. Then the dissatisfaction would lead to rumination about the situation which would increase stress. I've seen this happen in more people that I can count.

 

Just my two cents on the topic though.

[Ariel56]

Depression in many cases is a chemical imbalance in the brain ! The levels of Serotonin, Dopamine, Gluttamate and many more undiscovered brain nuero transmitters have become out of whack for many reasons. Alo where do you come up with some of this

[starlitegirlx]

Depression in many cases is a chemical imbalance in the brain ! The levels of Serotonin, Dopamine, Gluttamate and many more undiscovered brain nuero transmitters have become out of whack for many reasons. Alo where do you come up with some of this

 

I've seen other things factor into it. If stress is a trigger then stress is a factor. If situations that cause stress are triggers then situations are a factor. Only in the last few though have people begun to seriously consider stress and coping skills and life situations as other key components to factor into it. I know because I worked with a researcher who did some ground breaking work on stress at a trigger for bipolars back in 1992. We spent over a year studying life events of people who had relapses that landed in the hospital (one of the best in the state - major research used to come out of there) and statistical analyses correlated life stress to relapses. At the time, life stress was rarely taken into consideration. It was 'take your meds, and you'll be fine'. We're all here because that turned out so well.

 

I want to add that I always wondered how they knew it was a chemical imbalance because I've never seen one test or way of testing for any kind of chemical imbalance. So it's THEORY until they can come up with a way to measure and test regarding neurotransmitters. Why on earth do you think they play russian roulette with meds before finding one that works for people? Because it's not science. It's theory. Witchdoctors in the middle ages did better. And why do you think SSRIs became the norm? Because boosting serotonin makes people feel better, so they started passing them out like pez candies with zero regard for what long term boosting of serotonin would do. Anyone with a strong base of knowledge regarding human physiology should know that our bodies are not meant to have something continually taxed or pushed in this way. It's dangerous. It's dumb. It's negligent.

[Ariel56]

You know I think in 2012 there is still so much they don't know about the brain. I am sure what is called depression is so very very complex, taking in so many factors.

[GiaK]

Chemical imbalance myth takes a big public fall (no, antidepressants do NOT correct an imbalance of serotonin, nor do other psychiatric drugs correct anything at all)

 

http://beyondmeds.com/2012/01/25/chemicalimbalancemythfalls/

 

At this point even psychiatrists are acknowledging (in droves) that the chemical imbalance theory is fatally flawed.

[Narcissus]

^Thank you. I'm really getting tired of people casually throwing around the imbalance theories.

[alexjuice]

Acupuncturist Chris Kresser discusses cause of depression, and related issues, on his podcast. (So here's another theory for the original poster)

 

Is 5-HTP safer than SSRIs for anxiety and depression?

 

Steve Wright: All right, this one’s from Breaking All Illusions. “What do you think about the use of 5-HTP as a natural supplement for anxiety and depression? Do you consider it safer or more effective than SSRIs? And do you consider it safe/effective at all? If so, how would you recommend using it?”

 

Chris Kresser: OK, so 5-HTP is an intermediate in the conversion of tryptophan to serotonin, so tryptophan gets converted to 5-HTP, and then 5-HTP gets converted to serotonin. As I’m sure many people know, some people who are depressed have issues with serotonin synthesis or metabolism, and that can cause depression, and in those cases, 5-HTP might be helpful. There is some research that’s fairly promising, but I think the jury is still out on it. But as I pointed out, I wrote an entire series on depression, ChrisKresser.com/depression. Hopefully that will be updated soon because there’s a lot that I’ve learned since I wrote that. It’s all still completely valid, but I want to add some information about the inflammatory cytokine model of depression, which I’m gonna talk about in a minute. But in that series, I pointed out that not all depression is as simple as being a serotonin deficiency, and that is really just a convenient fiction that’s been manufactured by drug companies to sell more antidepressants.

 

Doctors in 2009 wrote 235 million prescriptions for antidepressants, which is just a mind-boggling number. It’s a 14 billion dollar market for antidepressant drugs, so it’s a huge business, and the drug companies know that if they create a really simple model for depression, which is basically depression equals serotonin deficiency; therefore, if you take a drug that raises serotonin, that will cure and treat depression. But the reality is a lot more complex than that, as anybody who works with depression knows or who has experienced it knows, and the drug trials on antidepressants, when you really look at them and you look at careful meta-analyses that have been performed by Kirsch and colleagues and others, you see that for mild to moderate depression and even fairly severe depression, antidepressants are often no more effective than placebo. And a lot of the natural treatments, which we’re gonna talk about here in a second, are just as effective as antidepressants, with far fewer side effects.

 

So, 5-HTP may be one of those, but it doesn’t have the research behind it that some of these other natural therapies do. So, if you’re gonna try 5-HTP, I would recommend starting with a pretty low dose, which would be maybe 20 mg in the morning, and it’s important to take it on an empty stomach. And then you can continue to increase your dose every few days up to 100 mg, and I wouldn’t go above 100 mg. Some people out there, some of the studies recommend 200 or 300 mg, but I don’t recommend that for a number of reasons. So, somewhere between 20 and 100 mg. If you take it before bed, it can sometimes help with sleep, so that’s another possibility, but I’ve found with patients that it’s more effective for depression if you take it in the morning. But that’s not the first thing I would try with depression, and in fact, these days I’m looking at it much more as an inflammatory condition, which again I’ll come back to in a moment. I wanna talk a little bit about some of the natural treatments that have been proven to be effective. Psychotherapy is, of course, one of them, and it’s often left out when we talk about natural treatments for depression because I think a lot of times we’re thinking of, you know, nutrients or herbs or pills or things that we can take, but psychotherapy, particularly cognitive behavioral therapy, which is a specific type of psychotherapy, has compared favorably with antidepressant drugs in a lot of trials, especially in the short term, even when the depression is severe, and over the long term, it actually appears to be superior to medications. And then some studies have looked at medication plus psychotherapy versus just medication alone, and of course, that’s almost always more effective, so that’s something to certainly consider, and I would definitely recommend it as part of a protocol for depression in any case.

 

Steve Wright: When you say medication, are you talking about SSRIs and SNRIs?

 

Chris Kresser: I’m talking, yeah, about both, but primarily SSRIs. They’re the bigger drug class by far still even though there has been more of a trend to SNRIs lately, but a lot of the research that has been done in the comparisons has been more with SSRIs. Exercise is at least as effective as antidepressants in treating depression, according to the research literature, and the good news about exercise is the only side effects of exercise are usually other health benefits and reducing your risk for a number of other diseases. Light therapy, and there was a study in 2005 in The American Journal of Psychiatry that found that it was just as effective as antidepressants. One of the arguments about that study was that it could have been placebo, and that’s true, but if that’s the case, you know, who cares? If there’s no negative impact other than spending the 75 bucks or whatever on the machine, actually maybe we can put that in the show notes. There’s a machine that I recommend on Amazon; I think it’s about 75 bucks. You know, the only thing you might lose is a little bit of time in the morning and a little bit of money to buy the machine, but there really aren’t any significant side effects associated with it.

 

St. John’s wort, which I’m sure a number of people have heard of, it’s probably the most popular treatment for depression in Europe. It’s just as effective as antidepressants in clinical studies, but it has 10 times fewer side effects. One important thing to keep in kind with St. John’s wort is that it takes several weeks often for the effect to come on fully, so it’s not something that you just start taking and you feel the benefit right away. It takes about three to four weeks to really get the effect. Another thing I’ll mention is not to mix these treatments together with drugs. I mean, exercise and psychotherapy, of course, is fine, and even light therapy, but I would not recommend combining St. John’s wort with antidepressants without supervision. That can be dangerous. And the same with 5-HTP and any other nutrient-based or herbal-based remedy. Acupuncture has been shown to be pretty effective for depression. In fact, there was a Cochrane review, Cochrane being one of the prestigious group that does meta-analyses of available research on a particular subject. They found, “There is no evidence that medication was better than acupuncture in reducing the severity of depression.” And again, just like exercise, acupuncture has very few side effects except feeling better in other ways. So, those are a number of options for someone who is dealing with depression and doesn’t want to take the drugs or eventually wants to get off the drugs.

 

Again, it’s really, really important if you are taking a medication for depression not to stop taking it abruptly and to do it under the supervision of someone who is experienced in getting people off SSRIs and other forms of antidepressants, because stopping them cold turkey can really wreak havoc with your brain chemistry, and the problems with suicide that are associated with antidepressants most often occur when people are just starting the medication or just coming off of it. So, it’s not something to play around with, and it’s really important to find someone who has experience getting people off of those drugs, if you choose to come off of it.

 

Why antidepressants could permanently alter your brain chemistry… in a bad way

 

Steve Wright: Is there also a long-term consequence of staying on the drugs for a number of years?

 

Chris Kresser: I think there is, and I wrote about this in my series. There’s a lot of pretty disturbing research that shows that SSRIs can cause permanent changes in brain chemistry, and it’s difficult to talk about this because, you know, a lot of people are on antidepressants, and some people are helped by them. Even though the research is pretty equivocal, you have to consider that research is about averages. You know, when you do a study and statistically at the end of the study there was no difference between placebo and the intervention, in this case an antidepressant, it doesn’t mean that there weren’t some people that benefited from the antidepressant in the study. It just means that on average, when you take all the results together, there was no statistically significant difference between the two treatments. I know people that have taken antidepressants and that have benefited from them, and of course, I know people that haven’t, so I’m not saying they never work. I’m just saying that statistically speaking, from a research perspective, they are not better than other treatments, in general, except in the cases of very severe depression. So, I’m not making any judgements of anyone who chooses to take antidepressants, and it’s a little bit scary to tell someone that a drug that they’re taking can cause permanent changes in brain chemistry, but I also feel it’s important to get the word out about this so that people think really carefully about going on these drugs before they choose to do so. So, the research shows essentially that those changes that are made in the brain can basically predispose you to depression more for the rest of your life. So, they create changes in the brain that make it more likely that you’ll need to be on an antidepressant or have some other kind of treatment for depression indefinitely, and that’s what scares me the most about these drugs, and unfortunately that is not, you know, very few patients are told that before they go on a drug. I think very few doctors even know about that research, but I wrote about it pretty extensively in the Depression Series. There are a lot of references there, and there are some great books that I linked to as well, where you can read all about that research if you’re interested in it.

The surprising cause of depression (and no, it’s not low serotonin)

 

Chris Kresser: So, before we finish up with this question, I want to talk a little bit about a newer perspective on depression that we discussed in an earlier show. We talked about it in the gut-brain axis program, and this is known as the inflammatory cytokine model of depression, and the theory essentially is that inflammation, which often originates from the gut, produces inflammatory cytokines, and these cytokines travel through the blood, they cross the blood-brain barrier, and then they suppress activity in the frontal cortex, and then that, of course, causes depression, the frontal cortex being responsible for some of the higher brain function. So, one of the most important things you can do if you’re dealing with depression, if you haven’t already done this, is eat an anti-inflammatory diet and fix your gut. Anti-inflammatory diet being a Paleo-ish diet, a Personal Paleo Code-ish type of diet, and then all of the steps that we have discussed lots of different times towards healing your gut, and I think that those are kind of the first steps that should be done when somebody is dealing with depression, and then if you eat that diet and you fix the gut and deal with any other potential sources of inflammation like a chronic infection; for example, a viral infection or a bacterial infection that may not be in the gut but outside of the gut. So, if you deal with all of those sources of inflammation and you’re still experiencing depression, that’s when I would turn to some of these other natural remedies.

 

Steve Wright: So, when you start fixing the gut, it’s not necessarily advisable to look towards trying to replace any neurotransmitter losses in the dopamine or serotonin areas?

 

Chris Kresser: That’s kind of the last step, maybe. You know, it’s like fix the gut, reduce inflammation, any other sources of inflammation, then consider some of these other natural treatments that we just talked about that would indirectly regulate brain chemistry: psychotherapy, acupuncture, St. John’s wort, light therapy, exercise, possibly 5-HTP. And then there are some products that I might use that improve serotonin or dopamine or acetylcholine or GABA synthesis and metabolism, but even then, they’re a milder, safer, and more natural approach than SSRIs or SNRIs. I consider those drugs to be a last resort.

 

http://chriskresser.com/rhr-could-copper-zinc-imbalance-be-making-you-sick

[basildev]

Hey thanks Alex!

[Altostrata]

Chris Kresser: That’s kind of the last step, maybe. You know, it’s like fix the gut, reduce inflammation, any other sources of inflammation, then consider some of these other natural treatments that we just talked about that would indirectly regulate brain chemistry: psychotherapy, acupuncture, St. John’s wort, light therapy, exercise, possibly 5-HTP. And then there are some products that I might use that improve serotonin or dopamine or acetylcholine or GABA synthesis and metabolism, but even then, they’re a milder, safer, and more natural approach than SSRIs or SNRIs. I consider those drugs to be a last resort.

Seems to me the purported benefits of 5-HTP might just as well be placebo effect. St. John's Wort is a stimulant.

 

I think Kresser is still lost in the neurohormone weeds. And, I'm dubious that "depression" is caused by inflammation. There is no physical condition that can be defined as "depression." It seems to be related to unhappiness. How could a natural reaction, an emotional condition, such as unhappiness be inflammation? It's so common, evolution would have weeded it out instead of wiring it in.

[GiaK]

I think inflammation is a piece of the puzzle for some people. Absolutely. We are holistic beings...many things go into a total sense of well-being. And that particular combination of things will differ from person to person.

[alexjuice]

Kresser, for those who may not know, is a Jack of all Trades health blogger, practitioner and marketer of several internet products. His health podcasts, which I don't listen but will often scan a transcript, discuss a range of conditions, a wide range. They also reflect his own perspective which is based on the 'Paleo' paradigm, largely evolutionary nutrition in basis.

 

I've never heard Kresser flesh out his inflammation theory. I more or less subscribe to the same evolutionary paradigm as Kresser, though.

 

At this point, at least for me, the cause of the condition that, 15 years ago, led me to seek medical treatment is not that relevant. In retrospect it's tough for me to honestly classify my 'depression/anxiety' as a medical condition at all.

 

I do think infection plays a large role in my current health issues, but as for the original 'mental illness'... I'm not sure in my case. It followed some very tragic attachment-type trauma around my family of origin, so whether that resulted in an inflammatory response or not, the ultimate cause seems still then the trauma. Who knows? I'd like a chance to go back in time and try something else, for sure!

 

I now believe that if I'd embarked on a healthful therapeutic protocol -- tried to nurture supportive relationships, devoted time to learn health basics (sleep, food, exercise and drug fundies), and developed a respect for purpose and perspective ... that I would have overcome my 'mental illness' and averted the catastrophe that followed the introduction of Drugs.

 

It's all relative though. And it's only in comparison to the aftermath of 'treatment' that the original problem seems rather human and likely transient. At the time, of course, I felt very distressed.

[Narcissus]

There is no physical condition that can be defined as "depression." It seems to be related to unhappiness.

Exactly.

[Narcissus]

I find it helpful (and certainly less alienating) to see depression as a cultural problem versus a purely individual problem, and I strongly encourage others to look at it this way. The separation of the individual from his or her culture is as reductive and superficial as the separation of certain isolated neurological systems from the rest of the body. By the time we reach the neurological model of depression we've made dozens of messy reductions for the sake of convenience and standardization of 'treatment'. Resist this reductive view and things become much more interesting.