https://news.weill.cornell.edu/news/2024/09/brain-scanning-approach-shows-wiring-of-depression
Brain Scanning Approach Shows Wiring of Depression
Could Anti-Inflammatory Drugs Target Depression?
Millennial Applauded for Sharing Reality of Depression in Your 20’s
Postpartum Mental Health Care Still Out of Reach for Many Despite Destigmatization Efforts
Unpacking Depression with Dr. Margaret Wehrenberg
Dr. Margaret Wehrenberg is a clinical psychologist in Naperville, Illinois. She is the author of six books on the treatment of anxiety and depression published by W.W. Norton, including, “The Ten Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It” and “Anxiety + Depression: Effective Treatment of the Big Two Co-Occurring Disorders.” An international trainer of mental health professionals, Dr. Wehrenberg coaches people with anxiety via the internet and phone. She’s a frequent contributor to the award-winning magazine Psychotherapy Networker and blogs on depression for Psychology Today.
Dan:
What is the difference between sadness and depression , and why do people confuse the two so often?
Dr. Wehrenberg:
Because depression comprises sadness, sadness is a response to a specific situation in which we usually have some loss—the loss of self-esteem, a loss of a loved one, the loss of a desired goal. Depression is more about the energy – whether it’s mental energy or physical energy – to make an effective response. So, sadness is an appropriate and transient emotion, but depression sticks around and affects all of our daily behaviors and interactions.
Dan:
What causes depression? Sadness, as you say, is an appropriate response to loss. What is depression a reaction to? What are the causes of depression?
Dr. Wehrenberg:
Throughout my career, I’ve developed the idea that there are four potential causes of depression. This comes from working with people for forty years and reading a lot of research.
The first part is genetics. You are born with a brain that is going to tend toward depression because of the function of neurotransmitters in your brain. It’s a genetic predisposition towards depression. With poor self-care and poor nutrition, you may end up stimulating or starting that feeling of low energy and interest in the world around you. Then, if you pull back from the world around you, you begin to have fewer experiences that keep you interested in the world.
Another possible and probable cause is with people experiencing situational stress that goes on and on. That could be the stress of not being able to earn enough money, and you’ve got two jobs, and kids, and a life filled with stress. It could be the stress that comes on while caring for someone in your family circle who’s got a disability or a chronic illness that increases with severity over time. So, you’re stuck in stress, and you deplete yourself. And you can become depressed.
Putting Pen to Paper: Writers on Depression
That terrible mood of depression, whether it’s any good or not, is what is known as The Artist’s Reward. Ernest Hemmingway
Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know, and they know that you are tedious beyond belief: you are irritable and paranoid and humorless and lifeless and critical and demanding, and no reassurance is ever enough. You’re frightened, and you’re frightening, and you’re “not at all like yourself but will be soon,” but you know you won’t. Kay Redfield Jamison, Night Falls Fast
That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. Elizabeth Wurtzel, Prozac Nation: Young and Depressed in America
In depression . . . faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come – – not in a day, an hour, a month, or a minute . . . It is hopelessness even more than pain that crushes the soul. William Styron, Darkness Visible: A Memoir of Madness
They flank me-Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well. …then they frisk me. They empty my pockets of any joy I had been carrying there. Depression even confiscates my identity; but he always does that. Elizabeth Gilbert, Eat, Pray, Love
The Depression Journey: Walking the Rocky Trail with a Therapist
A friend recommended me to the man who would become my therapist for the next twenty years. Jerry was a psychology professor at Buffalo State College. From the Bronx, he has a beautiful, salty sense of humor. Not only was he brilliant, but he was also warm and engaging. I felt at home, and we quickly bonded.
Is therapy effective?
A recent article in The New York Times explored whether therapy, based on the most current research, really works. What the studies show, and this has been both my experience and hundreds of others I’ve been privileged to meet over the years who struggle, is that it’s the combination of a good therapist and antidepressant medication that is the most effective treatment. In my case, I have been on Cymbalta (an antidepressant) and Lamictal (a mood stabilizer) for the past fifteen years. The meds quieted the physical symptoms enough so that I could benefit from my therapy with Jerry. Without the medications, I found that my time with Jerry was not as effective because his insights could not penetrate the hard shell of the physical side of depression that my brain was generating.
Some have told me I was lucky to find a therapist as good as Jerry. Others have said that they’ve had therapists who have been real duds or ineffective. As The Times article points out, it’s not always the educational background that matters (Jerry had a Ph.D., but many other therapists have M.S.W.), but, interestingly, if a patient emotionally bonds with a therapist. Bonding and its relationship to the efficacy of the therapy was challenging to measure in all the studies reviewed for the piece. The article reviewed some research that suggests how therapists react to the negativity of a patient that matters. For example, while this was not the case with Jerry and me, many patients can and do blame their therapists for they find the therapy not helping. Sometimes, they outright say this to them. If a therapist responds with empathy rather than being defensive, that is the key.
The Twin Pillars of Depression
“Once you choose hope, anything is possible.” – Christopher Reeve
There are two pillars upon which depression rests.
Helplessness
When in the grip of depression, we feel helpless despite our efforts to pull out. The more we struggle, the more exhausted we become. In her book Eat, Pray, Love, Elizabeth Gilbert writes, “They flank me – Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well, but then they frisk me. They empty my pockets of any joy I had been carrying there.”
Hopelessness
Helplessness often leads to profound hopelessness about the future. In her book Prozac Nation, Elizabeth Wurtzel writes, “That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious and compounds daily that it’s impossible ever to see the end.”
What I have learned over the past twenty years of living with depression is we need to chisel away at these twin pillars. I began to discover helplessness and hopelessness are disempowering: I had no choice but to live my days under this rock of sadness. My healing involved learning that I did have options in how I related to life when depressed. And I found this power to choose empowering and life-affirming.
How did I leave helplessness and hopelessness behind?
Built by Staple Creative. | Buffalo Skyline photo by Nick Amoscato - CC 2.0