Major Depressive Disorder: it isn’t just “all in your head.”
I have spent quite a bit of time in the last week looking at a paper: Pathophysiology of Depression: Do We Have Any Solid Evidence of Interest to Clinicians? By Gregor Hasler.
This paper discusses seven research areas relating to the neurobiology of major depressive disorder (MDD). In other words, it talks about the biological evidence of depression, mental illness. It discusses the strengths and weaknesses of biological theories of depression via evidence and aims to point out some of the reasons our current treatment isn’t as successful as it should be. Hasler’s article talks about the neurobiology of mental illness and how depression treatment effects that neurobiology.
The paper cites 88 other studies and was published in the Journal of World Psychiatry in 2010. It’s pretty educational.
Neurobiology of Depression – Depression Is In the Brain
The neurobiology (biology of the brain) of major depression research areas discussed include:
- Psychosocial stress and stress hormones
- Neurotransmitters such as serotonin, norepinephrine, dopamine, glutamate and gamma-aminobutyric acid (GABA)
- Neurocircuitry (neuroimaging)
- Neurotrophic factors
- Circadian rhythms
(That brain scan for mental illness stuff I mentioned a little while ago is covered in more detail in the article.)
Biological Evidence for Depression Layperson’s Articles Available
I wrote a layperson’s version of the article on Breaking Bipolar at HealthyPlace: Biological Evidence for Depression – Mental Illness exists, part 1 and part 2. I take out the big words and try to explain the crux of central ideas in English rather than scientist. (And if you’re super lazy, there is a table in the article that summarizes the neurobiological theories of depression along with their strengths and weaknesses.)
Here are a couple of notes that didn’t make the Breaking Bipolar article.
Aspirin May Make Antidepressants Work Faster
This very small cited study suggests acetylsalicylic acid (ASA) (also known as aspirin) taken with a selective serotonin reuptake inhibitor (SSRI antidepressant) can make antidepressants work more quickly. This is pre-clinical data so it may end up meaning nothing, but it is interesting. It’s discussed in Stress Hormones and Cytokines section of Hasler’s article.
Protein Involved in Stress Response, Neurogenesis and Depression
(How do Antidepressants Encourage Brain Cell Growth?)
Consistently, studies show parts of untreated depressed brains shrink, but we don’t really know why. We also know antidepressants (and electroconvulsive therapy) increase neurogenesis (making of new brain cells) but again, we aren’t sure why.
Hasler’s article discusses glucocorticoid receptors. It mentions their possible role in depression, specifically, in The Neurotrophic Hypotheses of Depression section it mentions glucocorticoid neurotoxicity as a possible mechanism of brain volume loss seen in depression.
Interestingly enough, scientists have just figured out the glucocorticoid receptors are essential for neurogenesis and they “turn immature stem cells into adult brain cells.” And what’s more, antidepressants activate these glucocorticoid receptors.
Why Care About Biological Evidence of Depression?
The answer to this one is pretty obvious if you read the comments here: people think mental illness, depression, bipolar don’t exist as diseases. People think mental illness isn’t biological. People think there is no evidence of physical mental illness. People say there is no science behind mental illness. People say there is no science behind mental illness treatment.
Well, they’re just wrong.
I recommend you read the whole paper, or read my layperson’s translation. Reading about the real studies, the real people, the real images and the real research behind the biology of mental illness brought me back to reality.
I am a 66 year old woman who has just come to terms with the abuse & neglect suffered as a child. All these years I have experienced guilt over my depression and it has helped me to recognize that the problem has a cause. I have done so much self harm without recognizing what itwasorwhy I was doing it.
Can you help direct me to help. I don’t have the $ for analysis. Would group work be of any help? I was looking for a church or .org that has a group like AA. Can I find someone who is doing research?
I am tired of this self destruct mode I find myself in and am desperate t opera handle on it. I am hoping that my new awareness will work as a damper on further actions.
Thank you so much for your work and insight.
Regards,
wendy
the neurogenesis has several mechanisms apparently…all the job of glial cells. they are “the other brain” in book of that title by R.Douglas Fields. .who is involved neropasticity with NIH and a prof U ofMaryland and founder and editor of Neuron Glia Biology. he associates glial abormalities ( growing and pruning and actions of those steroids ) with SMI/sz and mdd included!..via lab results
of course mental illness is real. it is an illness of the brain and i firmly believe the brain can often cure its self. acter using lithium for 32years i sent off it 14 months ago and i have never felt better. i am training my brain to be positive and proactive. could i relapse to a bipolat state my therapist says may be not.i am convinced i can sustain my good feelings indefinitely
Hi Ken,
“of course mental illness is real. it is an illness of the brain and i firmly believe the brain can often cure its self.”
Sometimes it can, sometimes it can’t. For example, take someone with another brain illness or injury, they certainly can’t be expected to fix their own brain.
It’s great that you have found your way, many people do. But mental illness comes in many severities and many types and just because one way worked for yours, it doesn’t mean it will work for others. Part of understanding mental illness is understanding that we’re all different. I don’t know what it’s like to be psychotic, and I recognize that.
– Natasha Tracy
This is great, thank you. I’m always interested in learning more about how my brain with depression works!
Hi Jamie,
Happy to help. There are also really useful resources here: https://natashatracy.com/bipolar-and-mental-health-resources/
Particularly check out the brain from top to bottom. It takes you through all kinds of system and you can dial up or dial down the complexities.
– Natasha Tracy
What a great article, thanks a lot for summarizing your research in such a simple manner that all of us can get a grasp on this information. I am myself bipolar and am always looking for this kind of material to better get a handle on what I am going through.
Thanks again,
Moopz
Thanks Moopz, I’m glad you liked it. I know how hard it is to find credible, medical information on mental illness that doesn’t either dumb it down so far it’s useless or is so technical it’s only understood by neurologists. I try to bridge the gap when I can.
I do put a lot of work into these articles so it’s good to know people are benefiting.
– Natasha Tracy
Just found your blog. Great post. The brain is the most complex organ in the human body and it always amazes me that some people believe that mental illness is not real. We just don’t understand the brain well enough, but mental illness is as real as any other illness.
Hi Adam,
Thank-you. And thanks for dropping by.
You know, when first figured out I had bipolar, I thought it was my fault. Then I became educated and realized it was a biological disease.
Then anti-psychiatry and anti-mental illness people came around and made me doubt my education.
But I, personally, have to not have such an open mind “that my brain falls out.” (Can’t remember who said that.) Because you’re right, of course, mental illness is as real as any other disease. Just because we don’t have every answer, it doesn’t mean the problem isn’t there.
And the brain is incredibly complex, and in spite of what Grey’s Anatomy would have you believe (they’re always opening someone’s skull), we know very little about it. We’re fumbling around for a light switch, but that doesn’t mean it isn’t dark.
– Natasha Tracy
Dear Natasha,
As always I enjoy your writings and abilities to focus on the realities of these illnesses and often times the brutal nature of the symptoms.
I also marvel at some of the archaic thoughts and responses you receive i.e. Ms. Emma Goldman who think and express the dogma of those groups believing the very serious nature of these illnesses have no relationship to medical disorders and as if all research had stopped since Drs. Loren Mosher and Peter Breggin made their pronouncements.
Amongst much ongoing research I would suggest some of readers investigating NARSAD and the funding of grants for research into these many disorders. I’ve also included a link below that should be a helpful follow up to your writings giving the layperson an additional understanding to what you are trying to convey.
“NARSAD 2009 Baer Prize Recipient, Daniel Wolf, M.D., Ph.D., of University of Pennsylvania, explains the process of“translational research,” how research findings make their way into the clinical setting to help patients.”
http://www.youtube.com/watch?v=2XVwiHkIMG8&feature=player_embedded#at=12
Please keep up the outstanding writings and presentations you offer to all who are interested while at the same time I hope you too find something that will yield you the remission and better quality of life you’ve been seeking.
Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com/
As always Herb, thank-you for the compliments.
I think it’s hard for people to know what’s going on because research is _so_hard_ to understand for most people. When I really look into it, like I did here, it takes quite a bit of effort and looking up other studies and finding definitions and reminding myself of certain neurobiological issues. It’s not cake.
Which, of course, is why I wrote the articles. Everyone should have an _idea_ even if the details are a bit fuzzy.
And I didn’t talk much about it, but another issue is how this research makes it into our every day treatments, as you’ve noted in the link above. That is a whole other kettle of… kettles.
Hey, I do what I can.
– Natasha Tracy
Great article. There is so much about the brain that we just don’t know and don’t understand. It’s great to see they are looking into this. Thanks for sharing this article.
Thanks Maasiyat.
I tell people scientists are working on these things and for some reason people don’t believe me. But they are. Really. It’s just that it’s really hard. We really do know more every day. I didn’t just make that up.
There is a whole whack we don’t know, but it’s nice to know we’re making inroads. Honestly, analyzing the article made me feel better. I’m a science-y kind of gal.
– Natasha Tracy