Depression is a highly misunderstood mental illness that has a major impact on our brain and body functions. Scientists still don’t understand the pathology of depression but are utilizing MRIs to understand what happens to people with major depressive disorder. The more subjects they can study, the better they can understand how depression affects our brain. So why don’t we take a journey through what has been learned so far?
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What part of the brain does depression affect?
It is important to understand that some parts of the brain shrink in people with a mood disorder. This is because they lose gray matter volume, which is best defined as tissue with many brain cells. With the loss of brain cells comes the inability for normal functions. The parts of the brain most affected include:
- Prefrontal Cortex
- Caudate Nucleus
The hippocampus is the part that is deeply embedded in the center of the brain. It is the part that is responsible for learning and memory. Unfortunately, it is a vulnerable part of the brain despite it being in the middle. It can be damaged from a wide range of stimuli from mental health problems and physical illness or injury.
The prefrontal cortex is located in the front of your brain, just behind your forehead and eyes. This area is responsible for cognitive control functions. The prefrontal cortex responds to dopamine in a variety of ways. An appropriate amount of dopamine means we can hold our attention, inhibit impulsive behavior, and remember to perform duties in the future.
Parts Of The Brain Are Shrinking
Around the hippocampus are three parts that will shrink when someone has depression. Each of these affects various functions necessary for day-to-day life. These parts are:
- Thalamus – this area controls arousal, emotion, memory, motor function, and physical sensations (such as pain, touch, and temperature).
- Caudate nucleus – controls planning the execution of movement, romantic interactions, emotion, learning, memory, and motivation.
- Insula – it controls the sympathetic and parasympathetic systems. These are better known as “rest and digest” and “fight or flight” systems. It also regulates the immune system.
Changing In Brain Parts Causes
As you can see, those with symptoms of depression have the struggle with shrinking in areas that control important functions for a mundane life. Those symptoms are a reflection of the changes in the brain. They include:
- Memory problems – being forgetful and not having memories are big issues for patients with mood disorders. With fewer brain cells to perform the normal functions, these diminish with it.
- Trouble thinking clearly – if people are struggling with memories, they are also struggling with thinking. For example, someone may forget what they are talking about mid-sentence or struggle to solve a simple problem.
- Guilt or hopelessness – with emotional dysregulation comes guilt and hopelessness. People will often have these emotions outside of normal instances.
- No motivation – when the chemical messengers aren’t making their way to the inner brain, motivation becomes a problem. This will look like an inability to get out of bed. No desire to go to work. No desire to make a meal.
- Sleep or appetite problems – the shrinking of the thalamus and the insula have a big impact on our ability to sleep and our gastrointestinal system. As a result, depressed people often struggle to fall or stay asleep. As a result, many experience weight loss or weight gain, depending on their reaction.
- Anxiety – patients usually have depression and anxiety together. Between decreased brain function and the stress that comes with it, anxiety disorders are prevalent.
While we have discussed brain shrinking, it is also important to understand that the brain is also inflamed because of translocator proteins being off balance. Firstly, inflammation is a normal response our body does to illness and injury. While inflammation is uncomfortable, it is often seen as a sign of a healthy body staving off danger.
Unfortunately, studies show these proteins are even higher in patients who’ve had untreated major depressive disorder for 10 years or longer. Excessive amounts of proteins can cause uncontrolled brain inflammation. Other problems posed by the translocator proteins include:
- Hurt or kill brain cells
- Prevent new brain cells from growing
- Cause thinking problems
- Speed up brain aging
What is most interesting is that there are concerns that it is also known that inflammation causes depression in patients with chronic illnesses. For some of these folks, it isn’t known which has come first to cause the other.
Oxygen restriction is common with mental illness and other health conditions that may be co-occurring. There are several theories as to why that may be. On the one hand, many depressed individuals have anxiety and panic disorders as well. Those dysregulate breathing, and that leads to less oxygen in the blood. On the other hand, however, studies have shown that with brain changes come cellular changes that affect the body’s breathing patterns.
A lack of breathing can cause numerous problems to our physical health. Within the brain, it contributes to:
- Brain cell injury
- Brain cell death
Now combine that with the shrinking of the brain and loss of brain cells there, the patients are losing brain cells faster than the average aging adult. Suicide rates are high for those with depression, and we can safely say that it is a physical medical condition aside from the mental aspect.
Are the Changes Permanent?
The shrinking and inflammation of the brain create long-term changes to the hippocampus. The longer a patient goes undiagnosed and without effective treatment, the more damage that occurs. This type of stress can make treatment difficult. Depending on the severity of the mood disorder, some people will not completely heal their brains but they can learn and implement strategies to minimize the impact.
Fortunately, some changes can be reversed, and a small number of folks can completely heal the brain. This is more likely when the diagnosis is established early in the condition, such as teen mental health disorders.
Common Depression Treatments For Major Depressive Disorder
Research has shown that antidepressants and cognitive behavior therapy (CBT) effectively reverse some of the damage. They help the brain reroute thoughts and functions and promote new brain cell growth. Here is more information regarding these treatments.
There are several types of antidepressants, and those include:
- SSRIs – these include brands like Zoloft, Celexa, and Prozac. These are often where doctors start to treat major depressive disorder. This is because they have few side effects and can be given in higher doses than their counterparts.
- SNRIs – these medications are associated with norepinephrine and serotonin. Brand names include Cymbalta, Pristiq, and Fetzima.
- Atypical – these are medications that don’t fit in the other categories. Here you will find Trazadone, Wellbutrin, and Viibyrd. Wellbutrin is one of the few antidepressants that do not cause sexual dysfunction.
- Tricyclic – these have a high rate of side effects and are often not prescribed until other categories have been tried and found unsuccessful. Here you will find Norpramin, Pamelor, and Tofranil.
- MAOIs – these are the most dangerous antidepressants on the market and are often the last resort when all others have failed. They come with dietary restrictions because of the severity of food and drug interactions. Brands include Nardil and Marplan.
Cognitive behavior therapy (CBT)
Cognitive behavior therapy (CBT) is a type of therapy used for a wide range of disorders. It is proven to be effective for improving the quality of life and functioning in society. It’s a series of learned skills that change thought patterns and beliefs to relieve depression symptoms. Many folks learn unhealthy behaviors, but they can be unlearned if the patient is ready to do the work. It is often used in group therapy settings with peers who have similar diagnoses and like experiences. This helps individuals practice what they learn and make real connections with people who positively impact their outlook in life.
These are the two most popular treatment modalities used, yet there are other options to enhance a patient’s recovery.
Different Treatment Options For Major Depression
Getting to a doctor for medical advice is incredibly important when you consider that you may have a depressive disorder. The sooner the diagnosis, the sooner treatment can begin, and relief can be around the corner. First, your doctor will be able to determine your diagnosis and if you need medication. From there, you will be recommended to a therapist or psychiatrist for other forms of treatment. Those include:
- Talk therapy
- Short-term use of Spravato
- Brain stimulation
- Healthy diet change
Talk therapy is one form of treatment that must be utilized at every chance possible. Sitting with a therapist and just unloading your thoughts is extremely helpful to the brain and its functions. Learning how to process how you feel about things and your experience with CBT reinforces a positive outlook on yourself and the world around you. Talking is a scary endeavor, and many people avoid it out of fear of being accused of being dramatic or seeking attention. This is due to the stigma that surrounds mental illness and the need for treatment. Most patients will tell you that they got through some real hard feelings by going to talk therapy with someone they liked and trusted.
Short-Term Use Of Ketamine (Spravato)
Ketamine is an anesthetic that has been used on animals and military personnel for the past 50 years. Many first responders also started giving it to agitated persons they rescued from suicide attempts. That led to the realization that it has the potential to be useful for mood disorders.
Ketamine is FDA-approved for short-term and medically supervised use in patients with depression and suicidal thoughts. It is for folks who have tried other treatments without success.
For those with treatment-resistant depression, brain stimulation is an option. TMS is most commonly used and uses magnetic fields to send pulses into the brain. In a way, it resets the brain over a period of time for treatment. The other option is ECT (formerly known as electroshock therapy) which is different from TMS and is more intrusive and costly. As a result, ECT it’s often used as a last resort treatment.
Exercise releases dopamine into the body. A quick 15-minute walk a day can help relieve symptoms, and the fresh air does a lot of physical good. Many people find that going to the gym can help as part of treatment.
Meditation can certainly help with the dangerous thoughts that many people deal with and oxygen levels in the brain. Meditation requires a person to leave everything else behind and be in the moment. Slow breathing can help regulate the oxygen in the blood, slow the heartbeat, and allow the patient to relax.
Healthy Diet Change
Making conscious changes to the diet can be a great way to feel better. Unfortunately, sodas, processed foods, and excessive sugar contribute to depression symptoms and lead to an ugly cycle of suffering. Many doctors recommend changing just one thing at a time to not overwhelm yourself with all the forms of treatments you are embracing. If you are making a point to exercise frequently, the diet change can be easier as you feel better.
It is important to note that exercise, meditation, and dietary changes are often used in a toxic manner to deprive someone of appropriate mental health care. If you require medication, do not stop taking it because you feel better now that you eat better. Likewise, please do not stop taking it because you feel better now that you can relax in meditation. Some people cannot go without their meds the first time they feel relief. Some will be on medications for the rest of their lives, and others will be able to wean themselves off with the help of their doctor.