Thursday, April 20, 2017

An Introduction to Depression - A Summary of Video Lecture




This post is a summary of the discussion points from the video lecture on an introduction to understanding depression. 




I spoke quite a bit about the semantics of the word "depression". Most people's natural tendency will be to frame their understanding of the condition through their own experience along with what makes up popularly held understandings of the term. This is very unhelpful for understanding any one case of depression - tragically perhaps most often in oneself or in close friends or loved ones - so I have to really emphasize that to get a better, deeper and broader understanding, I need to ask individuals to get past that (even if you understand a great deal of what I present here). There are simply too many variables in the individual, life conditions and body and brain biology and physiology for there to be any one definition of or framework for any one case. 

What I present in this talk is regarding the much more serious end of the scale.

I have many approaches to understanding the brain and the mind and how these produce the experience of depression. 

In the preliminary part of the talk I mentioned the following posts as relevant. These are references only. While it is not necessary to read through them all, they are handy to understand certain points I make during the lecture. 

A note first, however. Many people, I've found, tend to get intimidated by terms and concepts I present here. This is quite understandable but I feel very confident that you can do it. There are no tests or anything to get anxious about. So just relax, take your time and let your brain do its thing - if you let it, it'll absorb this in a way that works for you. 

Neuroanatomy 101 - this lays out some of the very basics of brain anatomy and some of the biology.

Brains as Reality Creators  - every brain creates a unique perception and view of the world. This is very important to grasp and accept when we try to understand other people's experiences and even our own mind and the different "realities" it can create. For example (and I mention this in the video), our "normal" state and a "depressed" state are like two different realities and change the way we perceive the world and our selves. 

An Introduction to Neuroplasticity - this is critical for understanding change and to build belief and confidence in the possibility of change within ourselves. 

An Introduction to the Stress Response System - I will make the argument as we go along that any case of depression or psychiatric disorder will involve or be rooted in the stress response system. As I mention in the video, I really need to ask everyone to put aside their previous notions of stress, how it's created and how it affects brain function and mood and open their minds to a new understanding. 

Genetic and Environmental Factors in Individual Brain Development - one of the main legs to my approach is getting past blame, guilt and shame for "who we are" and all these faults and states we beat ourselves up for. I wrote this post to give some understanding into the basic factors that create the brain that will in turn create "you" (as weird as this sounds, this is in fact what happens). This is my basis for compassion for myself - and for others going through difficulties. We did not create this, folks - this process did. 

Again, it is not necessary to read through all these (though I'd be so thrilled if you did!) but they are handy references to help understand a) the basis for my approach and b) to understand the points I make

Symptoms

These are some of the most significant symptoms. I realize these may not be all symptoms - I'm sure I missed some - but they are enough to give us a better basis for understanding. 

 
  • grief
  • guilt/rumination
  • distorted thinking/perspective
  • dark thoughts
  • sensory changes
  • intense introspection
  • sleep disruption (1)
  • fatigue
  • body aches
  • loss of general motivation and will
  • vegetative or catatonic states
  • anedonia
  • self-harm, suicidal ideation, suicidal planning, actions and attempts
  • loss of interest in self-care
  • psychomotor retardation


[(1) towards the end of the time I'm talking about sleep disruption I misspoke and said "sleep depression" when I of course meant to say sleep disruption] 

While I won't go over again here what I talked about in the broadcast, I do want to mention something about fatigue. This is another word loaded with semantic misunderstandings and I'm afraid I neglected to make that clear. By "fatigue" here, I am not talking about the normal everyday experience of it all people will have - this is a huge stumbling block for understanding the clinical fatigue in many people with depression and other mental health disorders. What I talk about here is something very different with different biological underpinnings. 

While I originally researched and wrote this series on the understanding of the well known symptom of fatigue in the depressive phase of bipolar disorder, I've since come across enough evidence to convince me that what I talk about in this series applies to many other disorders in which fatigue, psychomotor retardation, loss of motivation, issues with self-care, vegetative or catatonic states and so on are involved. 

What I briefly touch on is how "energy" is produced at the cellular level by mitochondria. This is a highly acclaimed series and will give you a very good basic understanding of mitochondrial dysfunction and its role in many of the symptoms discussed. 





Possible Factors



  • biological
  • anatomical differences in brain
  • genetic and environmental
  • current or past life events and/or circumstances
  • stress response
  • GI tract
  • energy
  • the human condition

I spoke of some of the biology and neurotransmitters. Here are the posts where I introduce these and look at two of the main ones thought to play roles in depression and other psychiatric disorders. 

Neurochemical in Focus - Serotonin  

Neurochemical in Focus - Dopamine  


Again, this list does not include every possible factor but outlines some of those commonly accepted as factors and some which my own study and research has shown may be significant. 

A point I feel is very important which I was trying to make at the end but which I see I failed to make clear was the distinction between depression as part of the human experience and the more serious clinical and medical cases.

What I see are cases that might be part of the human experience - as enormously difficult as they may be to experience and go through or to witness as a loved one - that are treated under the "disease model" and tragically become much worse and entrenched than they need to be. 

On the other hand, there are cases with biological and anatomical basis that are looked at as just part of the human experience and these become tragically untreated or treated in the wrong way which leads to enormous amounts of additional and unnecessary suffering. 

It's also possible that it could be a combination of the two (life experience plus biological and anatomical factors).

It's my position that without someone very skilled and knowledgeable in looking into a person's background and able to look into some of these factors, it's very hard to untangle what the best diagnosis and approach may be. 


I hope this was useful. If you have any questions, please join us for the webinar this coming Sunday! 



Below is the Sunday, April 23rd Q&A session following my talk introducing a new understanding of depression. This whole webinar thing is still very much in its infancy so the process for viewer questions hasn't quite emerged yet and as such no questions were asked in the broadcast itself. But I also receive questions via email, one of which I chose to address in this broadcast. The question was:


What can I do to avoid getting sooooo exhausted when there are other people around me? Even if it is just one old friend, it seems as if I spring a leak and my energy is just sucked out.
Is there a way to "shield" myself, from other people 's energy? In public places, for instance. 
I don't live somewhere where i can withdraw from people. No place I can find 'quiet' and I sometimes feel I am gonna explode. What can I do? Please help.  
I am always so tired. Too tired to pick up the remote 5 feet away. I will stare at the TV at something I don’t want to watch bc I can't move. It's a horrible feeling.


While at first glance one might wonder what this has to do with depression this actually ties in very much with the fatigue, vegetative states, and psychomotor retardation symptoms discussed in the talk I gave. Furthermore, it allows us to examine a very unique subset of depression and anxiety sufferers that come from what are known as "highly empathetic people" or "empaths". 

I also address the culture of silence around things like depression and the role of communication in mood and psychiatric disorders.