One of my biggest frustrations in my line of work is the stigma in our society regarding the words “depression” and “mental health”. People think that anyone who goes to counseling is “weak”; they aren’t smart enough to solve their own problems; they will be looked at as “crazy”. Of course, these prejudices prevent people from understanding their condition and getting help, unfortunately, and that’s a problem.
The most important thing is to help people understand that “mental illness” is NOT a personal weakness. Rather, in its many forms (Depression, Bipolar Disorder, Schizophrenia, etc.), it is a physiological change in brain function. In clinical language, “mental illness” should be called Neuro-Biological Disorders: Disorders of the biology of neurons (nerve cells). So for the rest of this article I will use those words, or an abbreviation: NBD.
I am going to give a brief science lesson here to get people to believe me about this. I am not a doctor or scientist so I will be using a very simplified way to talk about the neuro-biology of depression, the most common form of NBD. To any neurobiologists reading this article, bear with me.
Our brains and spinal cords are made up of nerves. Nerves look like spaghetti and act like electrical wires. They send electronic messages from the brain to the rest of the body, telling it what to do. Our ability to think is also an electronic process. Every thought and feeling we have is actually electricity running along a certain pattern of neurons.
However, there is a large problem with our “electrical system”. We have approximately 300 billion nerve cells and no two of them touch. So, we have an electrical system with 300 billion shorts. The reason it works is that we have natural chemicals in the nervous system (neurotransmitters) that act like a pool of water, allowing for a smooth and rapid conduction of current.
When we have the right amounts of chemicals, we can think quickly, problem solve, concentrate and remember things. If the chemicals get out of balance the electricity slows down and we get symptoms of depression: difficulty concentrating, reduced performance at work and school, loss of interest in things we normally like to do, low self esteem, irritability, loss of energy, sleep problems, sadness and hopelessness.
The imbalance will occur in 20 to 25 percent of people at some time in their lives. It can be situational or permanent. The imbalances occur for a variety of reasons: it may be genetic, hormonal changes, diseases and their treatments, substance abuse, brain injury, traumatic events and high levels of stress, including being bullied.
For some, the chemical imbalance will correct itself over time (one month to two years). Others benefit from treatments that reduce the number and intensity of symptoms. If the depression is mild, life style changes can be very effective: aerobic exercise, 8 hours of sleep, 20 minutes of sunlight each day, limiting foods that are high in simple carbohydrates, and few or no mind altering substances. These behaviors can also create brain health in people who don’t have depression, which may prevent brain chemistry changes.
If the depression is more severe, people may not have the energy to make those lifestyle changes. The next option is counseling, which actually has an affect on brain chemistry. Identifying negative thought patterns and developing new perspectives lowers anxiety and secretion of adrenaline (cortisol), which can have the effect of re-balancing brain chemistry.
Medications can also be very helpful in reducing symptoms, and research has shown that the combination of counseling and medication are the most effective treatment in moderate to severe cases.
Ok, the science lesson is almost over but I have to address the bad rap that antidepressants get. They are not “happy pills” that cause emotional numbness or cover up problems. Antidepressants promote normal brain chemistry, so the speed of electrical messages return to a normal level. That allows us to feel more like ourselves with normal abilities to think, problem solve, concentrate and have energy. Sometimes, using the above-mentioned lifestyle habits can reduce the amount of medication needed. It can be a frustrating process to find the right medication and dosage, but once you get it right, it can be a life changer. If you are considering this treatment, make sure you are working with a doctor who can see you often enough to get it right.
If severe depression goes untreated, it can affect more areas of the brain and lead to a sense of hopelessness that may lead to suicide. Suicide is a big problem in Steamboat Springs. In our little paradise in 2004, there were 11 suicides and 95 attempts in 2010. Yet, each one of us, with a little information, can be very effective in preventing tragedy. Please recognize these symptoms in friends and family and talk to them about your concerns. Maybe having them read this article will soften the stigma and they may be more likely to get help. Equally important, recognize the symptoms in yourself and take action.