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Scientific Facts behind depression (1) (1)

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Scientific Facts behind depression (1).docx

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https://docs.google.com/document/d/1zewil3DIeR_VdwTUprgHCXFsZwtsg7hI8ITeUnC6pUY/edit?usp=sharing

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Create a new document and edit with others at the same time -- from your computer, phone or tablet. Get stuff done with or without an internet connection. Use Docs to edit Word files. Free from Google.

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Scientific Facts behind depression (1).docx

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How your brain works when you´re depressed. 

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How your brain works when you´re depressed. 

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How Your Brain Works When You're Depressed | Better | NBC News

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Reducing Suicide Risk: The Role of Psychotherapy

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Reducing Suicide Risk: The Role of Psychotherapy

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A different perspective on suicide preventive treatments.

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In the past 30 years, a considerable body of research has been amassed regarding the use of psychotherapy to manage suicidal behavior. Much of this research included the premise that suicidal behavior must be dealt with as a problem separate from a primary diagnosis (eg, depression) and that techniques must be used to both manage the risk in the present and prevent recurrences in the future. Most clinicians are not aware that suicide risk should be addressed specifically and separately from the primary psychiatric diagnosis. Practical, evidence-based approaches have been developed that decrease the risk of present and future attempts. We aim to provide a brief synopsis of the research evidence, followed by several examples of strategies that such treatment employs.
Cognitive behavioral therapy for suicide
Several systematic reviews have analyzed existing data on the effect of therapeutic interventions to reduce suicide risk. In 2008, Tarrier et al ¹ examined 28 randomized controlled trials (RCTs) involving adults and adolescents. The researchers concluded that cognitive behavioral therapy (CBT)-based interventions demonstrated effectiveness in reducing suicidal behavior. A subsequent systematic review by Mewton and Andrews 2 in 2016 limited its focus to RCTs examining the benefits of standard CBT in adults. Their conclusion agreed with the observation of Tarrier et al ¹: Treatment is more effective when directly targeting suicidal thoughts and behavior as opposed to when treatment is designed to address mental illness with the assumption that benefits will also impact suicidal behavior. Hence, the literature underscores the need for specific interventions targeting suicidal behavior.

The meta-analysis by Ougrin and colleagues ³ in 2015 supported the effectiveness of therapeutic interventions including CBT, dialectical behavior therapy (DBT), and mentalization-based therapy in reducing self-harm in adolescents. The dearth of independently replicated studies impeded drawing firm conclusions on the comparative benefit of specific therapeutic strategies. Independent trials have looked at the effectiveness of DBT in adolescents who are at high risk for suicide. The RCT by Mehlum et al ⁴ in 2014 and the recently published RCT by McCauley and colleagues ⁵ suggest definite benefits of short-term DBT in adolescents with borderline personality traits who had engaged in prior self-harm and suicide attempts. The latter study also showed superiority of DBT with respect to treatment retention.

Engagement and retention of patients is a significant challenge in managing suicidal behavior. Often, such patients do not seek outpatient therapy and present for emergency care with suicidal crises. The emergency department (ED) must therefore be a key site for intervention. The Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study by Miller and colleagues ⁶ designed interventions for screening and provision of safety plans with follow-up phone calls to patients and significant others. Stanley et al ⁷ discussed the benefits of such ED-based interventions in reducing suicidal risk. Their comparative cohort study showed that safety-planning interventions coupled with structured follow-up reduced the risk of suicidal behavior by 50% and achieved a twofold increase in the odds of treatment engagement over a 6-month period. The safety-planning intervention consisted of six specific strategies: identifying early warning signs, encouraging internal coping strategies, reaching out to family/friends, identifying other individuals who can provide support during suicidal crises, contacting mental health professionals, and lethal means planning. This large-scale study illustrates a feasible, pragmatic approach to suicidal behavior that does not demand extensive resources and can be easily delivered in an ED setting.

Cognitive behavioral therapy for suicide prevention is another short-term intervention designed to specifically address suicidal behavior that has significant effects in reducing future suicide attempts. ⁸ It is composed of three phases: an initial phase promoting treatment engagement, an intermediate phase focused on cognitive and behavioral strategies targeting suicidal thoughts and mobilizing reasons to live, and a final phase that targets relapse prevention and consolidates the ability to effectively use strategies in the setting of future suicidal crises.

Each of the preceding studies have common psychotherapeutic strategies that may be employed by any clinician. All are rooted in the fundamental principle of the therapist as an empathic partner who forms a strong therapeutic alliance with patients and who acknowledges their suicidal thoughts and behaviors as a response to intolerable pain or acute subjective distress. The patient is enlisted as an active partner in the process of understanding personal risks for future suicide crises and developing remedies for such occurrences.

The following section describes four specific strategies common to these approaches, including lethal means reduction, safety planning, developing reasons for hope, and inspiring delay.
Lethal means reduction
Lethal means reduction is the process of assessing whether patients have access to firearms or other lethal means to commit suicide and then working with them and their support network to restrict access to such means. It is one of the most important and most supported interventions to reduce suicide attempts. Collaborating with the patient by expressing genuine concern about his or her safety, explaining that reducing access will lower the risk of suicidal actions, and then negotiating with the patient and supportive others to make the environment safer is critical for success. In the event that the lethal means available is a firearm, one must assess for multiple firearms and then advocate for removal of all of them. Gunlocks, removal of ammunition, or gun safes are also possible ways to restrict access if the patient refuses to remove the gun(s) from the home.

Methodical inquiry about possible methods and what might limit the ability of the patient/family to remove them is the central task for the clinician. If the patient is hesitant, it helps to assess the pros and cons of restricted access, reminding the patient that this may be time-limited. As in all work with suicidal patients, the more collaboration that is possible with supportive others, the better.
Safety planning
Generally, suicidal behavior occurs as a reflexive response to certain triggers. It is common for patients who engage in such behavior to regard suicide as a means of solving problems that they view as insolvable. Such patients often have significant problem-solving deficits. When patients have no relief from relentless worry or concern about problems, and they think of suicide, the relief it may provide reinforces suicidal thinking and increases the risk for further action. Skill deficiencies that patients have-in problem solving, distress tolerance, emotion regulation, and conflict resolution-may increase their risk for future vulnerability to suicidal behavior.

A particularly good strategy is to plan alternatives that keep the patient safe until skills can be learned or other solutions put into place. Safety planning, as described by Stanley and colleagues, ⁷ is an intervention with which the clinician actively and collaboratively determines with the patient a prioritized and personalized list of warning signs that a crisis is beginning to occur. The clinician then finds coping strategies and internal and external resources that the patient can use at this time. This plan is derived from a risk assessment and the narrative description of the patient's crisis. It is designed to be over practiced (like a fire drill) so that the plan will be available for use during a suicide emergency. Making a safety plan begins with a chain analysis of the minute-by-minute thoughts, emotions, and behaviors that led to suicidal thoughts or an attempt and the subsequent consequences. The patient must understand that suicidal thoughts are transient and vary in intensity.

The plan provides time for these urges to decrease before permanent harm occurs. The patient is consulted as the expert on his or her own suicidal behavior: "What have you done on your own to decrease suicide urges?" and "How do you get your mind off of it?" If the patient cannot generate options, the clinician may provide suggestions. These may include distracting activities, alternative thoughts, or strategies to decrease painful emotions. After formulating a plan for distractions, the patient is asked to identify two groups of social contacts: a group with whom she or he may be distracted from the suicidal thoughts, and a group that can help with suicidal thoughts. Finally, emergency services are identified that the patient can access if a crisis is imminent.

At each step of the safety planning intervention, the patient is asked about the likelihood of using the intervention, the obstacles he or she anticipates to its use, and those obstacles solved. If the patient cannot solve obstacles or commit to the use of the plan, then more restrictive care is indicated. Once the plan is completed, the written plan is given to the patient and the patient is asked where it will be kept for review and use.

In later sessions, the therapist may provide training in skills that are absent and that increase the patient's vulnerability to suicide and then mentally rehearse the deployment of those skills in a similar setting in the future. Patients must repeatedly practice new ways of thinking and behavior so that they have other solutions besides suicide available at times of future stress. Patients who develop better ways of coping in a crisis and repeatedly practice such skills (even in their imagination) have greater resilience during stressful circumstances and reduce their reliance on suicide as a solution.
CASE VIGNETTE
A 45-year-old construction worker sustained a crush injury of his right arm 2 years ago. He has had four surgical procedures and extensive physical therapy, but has continued to experience intractable pain and has been unable to return to work. His family has struggled to make ends meet. He has used opiate pain medication since the accident but never exceeds what is recommended. He needs help with all of his activities of daily living, including dressing.

After his last surgery, he has been more despondent. He meets the full criteria for major depression. He has started to drink to fall asleep at night. His wife brought him to the ED after he told her that he thought she and the family would be better off without him.

After assessing him in the ED, the psychiatrist determines that there are no weapons in the home. The patient indicates that he had plans to overdose on his oxycodone when he got his monthly prescription this week. He and his wife agree that she will keep the pills locked at her place of work and give him access to only a day at a time. The psychiatrist then turns her attention to making a safety plan with her husband. They first discuss all the triggers that produce his intense thoughts of suicide. The patient is asked what would prevent him from using the plan. He says that if he were unable to contact a friend or his wife, he might have trouble. They review professional help that he can contact. He discusses his feeling that this makes him "weak" but eventually commits to doing so.

When asked for reasons to stay alive, the patient says, "My children." The psychiatrist asks for more detail: "What is important to your children that you do together? What do you value about being with your children? What would you miss in your children's lives if you died today?" As he describes more about their relationship, he becomes tearful, and the psychiatrist probes further about what he might miss in the future with his children were he to die. He is much more certain about using the safety plan reliably after this discussion.
Developing reasons for hope
Most CBT/DBT interventions approach suicidal patients with an eye toward managing hopelessness. A cornerstone of DBT is the idea that the patient must build a life worth living, even when the patient has many life problems and a wish to die. In CBT, a core premise is monitoring and managing hopelessness, because the presence of hopelessness is a significant risk factor for suicide even in the absence of depression.

Methods that improve hopelessness generally connect patients to core values and attachments to inspire the patient to tolerate current pain and stay alive. Making a list of reasons to live generally is a part of the safety plan. The psychiatrist must ask the patient to describe vividly the attachment the patient has to these reasons to strengthen resolve.

Another technique is to build a hope box. This is a tangible collection of items that remind the patient of reasons to stay alive. It may include photographs, inspirational scripture or quotes, poetry, letters, meaningful mementos, and reminders of things that the patient wants to do in the future. These items inspire more emotional connections to the commitment to stay alive. Such items can be actual or virtual (ie, in a phone app) so that the patient has easy access.
Inspiring delay
Generally, the impulse to suicide is momentary. If the patient can delay action on the impulse, it may be life-saving. Several strategies facilitate delay. First, the patient can be asked to reflect on the things that will be missed if they die, year by year. This brings to light the finality of death and the reality of what the patient will miss. Second, the patient can be asked to commit to "taking suicide off the table." Many patients who are suicidal are beset with a significant number of psychosocial problems and experience relief when they think about dying as an escape. The patient needs time to begin to resolve these problems. Working with such patients is a challenge because it is impossible to discuss anything except suicide if that is a genuine possibility. Thus, it is often necessary to agree that the patient will commit to a delay to determine if things can improve enough to allow work on psychosocial problems to occur.
Conclusion
These are just a few examples of how it is possible to use psychotherapeutic interventions to more effectively manage the patient with suicidal thinking and behavior. Although these patients are challenging, there are some tools that we know make a difference.

Disclosures:
Dr Sudak is Professor and Vice Chair for Education, Drexel University, Philadelphia, PA, and Dr Rajalakshmi is a Resident, Department of Psychiatry, Drexel University, Philadelphia, PA. The authors report no conflicts of interest concerning the subject matter of this article.
References:

1. Tarrier N, Taylor K, Gooding P. Cognitive-behavioral interventions to reduce suicide behavior: a systematic review and meta-analysis. Behav Modif. 2008;32:77-108.

2. Mewton L, Andrews G. Cognitive behavioral therapy for suicidal behaviors: improving patient outcomes. Psychol Res Behav Manag. 2016;9:21-29.

3. Ougrin D, Tranah T, Stahl D, et al. Therapeutic interventions for suicide attempts and self-harm in adolescents: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2015;54:97-107.e2.

4. Mehlum L, TÃ¸rmoen AJ, Ramberg M, et al. Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial. J Am Acad Child Adolesc Psychiatry. 2014;53:1082-1091.

5. McCauley E, Berk MS, Asarnow JR, et al. Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: a randomized clinical trial. JAMA Psychiatry. 2018;75:777-785.

6. Miller IW, Camargo CA Jr, Arias SA, et al; ED-SAFE Investigators. Suicide prevention in an emergency department population: the ED-SAFE study. JAMA Psychiatry. 2017;74:563-570.

7. Stanley B, Brown GK, Brenner LA, et al. Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry. 2018;75:894-900.

8. Wenzel A, Brown GK, Beck AT. Cognitive Therapy for Suicidal Patients: Scientific and Clinical Applications. Washington, DC: APA Books; 2009.

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Reducing Suicide Risk: The Role of Psychotherapy

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In the past 30 years, a considerable body of research has been amassed regarding the use of psychotherapy to manage suicidal behavior. Much of this research included the premise that suicidal behavior must be dealt with as a problem separate from a primary diagnosis (eg, depression) and that techniques must be used to both manage the risk in the present and prevent recurrences in the future.

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How Does a Doctor Make a Depression Diagnosis?

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How Does a Doctor Make a Depression Diagnosis?

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Do you think you have clinical depression? WebMD explains how this condition is diagnosed.

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Physical Effects of Depression on the Brain

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Physical Effects of Depression on the Brain

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Depression is more than feeling down. It may physically change your brain.

This can affect how you think, feel, and act. Experts aren't sure what causes these changes. They think genetics, stress, and inflammation might play a role.

It's important to get help for your depression. That's because repeat episodes seem to damage your brain more and more over time. Early treatment might help you avoid or ease some of the following changes.

Are the Changes Permanent?

Scientists are still trying to answer that question. Ongoing depression likely causes long-term changes to the brain, especially in the hippocampus. That might be why depression is so hard to treat in some people. But researchers also found less gray matter volume in people who were diagnosed with lifelong major depressive disorder but hadn't had depression in years.

While more research is needed, there's hope that current or new treatments might help reverse or ward off some brain changes.

Here's what research says about two common depression treatments:

Antidepressants. These work on the chemicals in your brain that control stress and emotions. There's evidence these drugs can help your brain form new connections and lower inflammation.

Cognitive behavior therapy (CBT). Experts think CBT promotes neuroplasticity. That means you can change your brain in a way that helps your depression.

How to Get Help

Tell your doctor if you have symptoms of depression. They'll want to rule out other health conditions so they can find you the right treatment. You might need to make some lifestyle changes, take medicine, or talk to a mental health specialist. Some people benefit from a mix of all three.

Continued

Some treatments for mild or serious depression include:

Suicide is a serious symptom of depression. Get help right away if you're thinking about hurting yourself. You can reach someone at the National Suicide Prevention Lifeline at 1-800-273-8255. They're available anytime, day or night.

Brain Size

There's some debate about which areas are affected and how much. There's growing evidence that several parts of the brain shrink in people with depression. Specifically, these areas lose gray matter volume (GMV). That's tissue with a lot of brain cells. GMV loss seems to be higher in people who have regular or ongoing depression with serious symptoms.

Studies show depression can lower GMV in these areas:

Hippocampus. That part of your brain is important for learning and memory. It connects to other parts of your brain that control emotion and is responsive to stress hormones. That makes it vulnerable to depression.

Continued

Prefrontal cortex. This area plays a role in your higher-level thinking and planning.

There's also evidence these parts of your brain get smaller:

Results are mixed on how depression affects the amygdala. That's your fear center. Some studies show it gets smaller. Others found that stress and depression might boost its GMV. The more severe the depression, the higher the GMV.

When these areas don't work the right way, you might have:

Memory problems

Trouble thinking clearly

Guilt or hopelessness

No motivation

Sleep or appetite problems

You might also move or talk slowly, or overreact to negative emotions.

Brain Inflammation

Experts aren't sure if depression or inflammation comes first. But people who have a major depressive episode have higher levels of translocator proteins. Those are chemicals linked to brain inflammation. Studies show these proteins are even higher in people who've had untreated major depressive disorder for 10 years or longer.

Uncontrolled brain inflammation can:

Hurt or kill brain cells

Prevent new brain cells from growing

Cause thinking problems

Speed up brain aging

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Physical Effects of Depression on the Brain

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Depression is more than feeling down. It may physically change your brain. This can affect how you think, feel, and act. Experts aren't sure what causes these changes. They think genetics, stress, and inflammation might play a role. It's important to get help for your depression.

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Emotional side effects are not uncommon after an abortion, or pregnancy termination, whether it was planned or not. In some cases, depression can occur. However, the link between pregnancy termination and depression remains unclear.

The decision to terminate a pregnancy is rarely an easy one, and it is not always the individual's preferred choice. Whether they choose a termination freely or not, they can have mixed feelings after the procedure.

In the United States, around half of all pregnancies are unplanned. This is one reason for choosing a termination. However, the reasons for not wanting to continue a pregnancy are varied.

Reasons include, but are by no means limited to, social, financial, or relationship pressures and physical or mental health problems in the parent or unborn child.

Regardless of the reason, the emotional response to a termination can range from relief, calm, and happiness to sadness, grief, loss, and regret, depending on the individual's situation.

If negative feelings are severe and persistent, they could be a sign of depression.

The issue of planned termination is a controversial one, and so is the question of mental health following a termination.

The important thing to remember is that each person's experience and response will be different.

As researchers for the American Psychological Association (APA) said in 2009, "it is important that women's varied experiences of abortion be recognized, validated, and understood."

For many people, terminating a pregnancy can be a stressful life event.

It is not unusual to experience a range of psychological and emotional responses.

Some people may feel relief at having made the right choice for them and taken action to resolve a difficult situation, while others may experience a range of negative emotions.

Any pregnancy loss will lead to an interruption in the hormone cycle. The negative feelings that occur after a planned termination may be at least partly due to hormonal changes, which are similar to those that occur after an unplanned pregnancy loss.

According to the American Pregnancy Association, common negative feelings include:

guilt

anger

shame

remorse or regret

loss of self-esteem or self-confidence

feelings of isolation and loneliness

sleep problems and bad dreams

relationship problems

thoughts of suicide

In addition, some people may experience grief, stress, or a sense of loss and may feel less able to cope. If suicidal thoughts or self-harm occur, the person should seek urgent help.
The National Suicide Prevention Lifeline offers free and confidential support 24/7. The number to call is 1-800-273-8255.
Religious beliefs, relationship problems, and social stigma can make it harder to cope, especially if these mean that the individual has nobody to talk to about what has happened.

In most cases, as time passes, these negative feelings will subside.

However, if there are additional issues, such as a sense of isolation or previous history of mental health problems, there may be a higher chance of depression occurring.

Depression is a mental health condition and mood disorder.

People with depression may have these signs and symptoms:

feeling low or sad

having difficulty thinking, focusing, and making decisions

feeling irritable

lacking energy

sleeping too much or too little

loss of interest in sex

loss of interest in activities that they previously enjoyed

There may also be feelings of guilt and low self-esteem.

Depression can make it hard to work or carry out daily chores. Complications can include relationship breakdown and job loss. For some people, psychotic symptoms may develop.

Depression versus grief

The grief that follows the loss of a loved one can lead to sadness and other symptoms similar to those of depression.

Feelings of grief, sadness, loss, and regret can also occur after a termination or pregnancy loss.

If a person's symptoms gradually improve with time, it is unlikely that they have depression.

However, symptoms that persist or worsen could indicate depression, in which case it is essential to seek medical help.

Counseling and support can help people cope with the emotional upheaval.

Anyone who experiences distress after a termination may find it helpful to seek the support of family, friends, or a community group.

This can help prevent feelings of grief and sadness from developing into depression.

If depression occurs, it is a treatable condition.

Treatment may involve:

Lifestyle factors that may help include:

eating a healthful diet

taking regular exercise

reducing stress as far as possible

learning relaxation techniques, such as yoga or meditation

Reducing the risk

Before deciding on a termination, it is advisable to try the following:

speaking to people who you can trust

weighing up all your options

seeking medical help and asking a health worker as many questions as you can

trying to avoid isolation, as this can lead to depression

avoiding giving in to pressure to do something you do not want to do, whether this is the termination or continuation of the pregnancy

Terminating a pregnancy can also involve some physical risks, in the same way as any other medical or surgical procedure.

It is vital to seek treatment in a registered facility with qualified and experienced professionals to reduce the risk of harm.

Finding someone to talk to and ensuring your make your own decision may help to reduce the risk of depression.

The existence of a link between a planned termination and depression remains controversial.

A study published in 2015 suggested that people who have mental health problems before pregnancy may have a higher risk of experiencing negative emotions after a termination.

Research published in 2011 concluded that there was a "moderate to highly increased risk of mental health problems after abortion." The researchers suggested that undergoing a termination increased the risk by 81 percent and attributed 10 percent of this risk to the termination itself.

Other scientists, reporting in 2008 on a 30-year study, estimated that abortion increased women's risk of mental health disorders by between 1.5 and 5.5 percent.

In 2008, the American Psychological Association (APA) Task Force on Mental Health and Abortion found that certain conditions appeared to increase the risk of depression after a range of pregnancy outcomes, including a planned termination.

These conditions included:

poverty

a history of violence or emotional problems

a history of drug or alcohol use

previous unwanted childbirth

The APA have also identified the following risk factors for depression following a termination:

perceived stigma and lack of social support

a history of mental health problems

personality traits, such as low self-esteem

features of the pregnancy, including whether the individual wanted it or not

The most important factor appears to be whether or not the mental health problems were already present before the pregnancy.

The American Pregnancy Association add the following as factors that might increase the risk of depression:

having a termination due to coercion or persuasion by others

moral or ethical conflict due to religious beliefs or personal views

having a termination in the later stages of pregnancy

lacking support from a partner or significant others

ending a pregnancy because of genetic or fetal abnormalities

Genetic factors and life events, such as the loss of a loved one, may also increase the risk of depression.

Other possible risk factors for depression include:

a reduced ability to cope with life's pressures

being female

exposure to factors that cause stress daily, such as financial or relationship insecurity

However, the exact causes of depression, including pregnancy-related depression, are not known.

In 2009, researchers for the APA noted that the risk of poor mental health was the same whether people chose to terminate or continue their pregnancy.

A study published in The BMJ in 2016 concluded that the likelihood of post-traumatic stress symptoms (PTSS) up to 4 years after a termination was no higher for those who had the procedure than for those who were not allowed to have a termination due to advanced gestational age.

A Swedish study found that few women experienced post-traumatic stress disorder (PTSD) after a termination. They also noted that those who did had experienced trauma unrelated to the procedure.

In August 2018, researchers published findings of a study involving nearly 400,000 women in Denmark. The results suggested that, although women who have an abortion are more likely to use antidepressants, the risk factors leading to this are likely to stem from causes other than the termination.

The researchers conclude: "Policies based on the notion that abortion harms women's mental health may be misinformed."

People should also weigh the risk of depression after a termination against the possible health risks of continuing with a pregnancy.

One study, for example, included women who wanted to have a termination but were not able to. Some of these women experienced a range of potentially life-threatening health consequences, such as eclampsia and hemorrhage.

Researchers need to carry out more research to fully understand any links between pregnancy termination and depression.

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Depression after abortion: Understanding and coping

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Most women will feel emotional after an abortion, but research into the psychological effects is limited. As a result, there is controversy around the issue of depression after an abortion. Abortion may cause sadness, grief, or regret, but this may not be depression. We discuss this topic in more detail here.

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What is the Amygdala? and What does it do?

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What is the Amygdala? and What does it do?

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The amygdala is a collection of nuclei found deep within the temporal lobe.
The amygdala has become best known for its role in fear processing
Research suggests that information about potentially frightening things in the environment can reach the amygdala before we are even consciously aware that there’s anything to be afraid of

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Depression causes the hippocampus to raise its cortisol levels, impeding the development of neurons in your brain. The shrinkage of brain circuits is closely connected to the reduction of the affected part’s function.

While other cerebral areas shrink due to high levels of cortisol, the amygdala enlarges.

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Mental health conditions like depression can change your brain chemistry. If you want to have a better grasp on your mental state and what kind of treatment you need, you must understand how your brain reacts to depression.

In this overview, we cover key health information on the effects of depression on your brain and how these translate to changes in both mental and physical health.

Why Does A Major Depressive Disorder Change Your Brain?

When you suffer from depression, your brain is physically changed. Research by the National Institutes of Health shows that you lose gray matter volume (GMV) when you suffer from depression. This loss is caused by parts of your brain shrinking due to the hormone cortisol impeding the growth of your brain cells.

The more serious depression a person suffers, the more GMV they lose. Since GMV contains most of your neurons or nerve cells, slowed growth means that your cognitive capabilities are at risk of impairment.

Brain Changes On Depression Patients

A depressed person's brain goes through many changes due to the influx of brain chemicals and loss of matter. In this section, we break down the three major things that happen to a depressed person's brain.

Shrinkage Of Several Brain Regions

One of the most common changes seen in a depressed patient's brain is shrinkage, especially in the hippocampus, thalamus, frontal cortex, and prefrontal cortex. How much these brain areas shrink depends on the length and severity of your depression.

A chemical imbalance caused by the hormone cortisol - a.k.a. the stress hormone - is what triggers this shrinkage. Depression causes the hippocampus to raise its cortisol levels, impeding the development of neurons in your brain. The shrinkage of brain circuits is closely connected to the reduction of the affected part's function.

While other cerebral areas shrink due to high levels of cortisol, the amygdala enlarges. The amygdala controls emotion, so this may cause issues like sleep disturbances, mood swings, and other hormone-related problems. An enlarged amygdala is also linked to the development of bipolar disorder.

Brain Inflammation

Major depression is linked to cerebral inflammation. While there's no solid evidence from experts on whether depression causes cerebral inflammation or vice versa, researchers have posited that these two are closely linked. Studies found that people who have suffered depression for over ten years experience 30% more cerebral inflammation compared to those who suffer from a shorter period of depression.

Since cerebral inflammation kills neurons, it can lead to many complications. The death of neurons and neurotransmitters may lead to shrinkage as well as reduce a person's neuroplasticity - the ability of brains to change as the person ages. Since new neurons and neurotransmitters will have a tougher time growing, this leads to cognitive problems in the affected person.

Restricted Oxygen Intake

Although researchers have yet to prove a conclusive link, major depression may reduce your oxygen intake. The leading theory is that depression induces a change in your breathing patterns, which can lead to oxygen restriction or hypoxia.

Even minor hypoxia can impede your cerebral function. People who suffer from minor hypoxia exhibit poor judgment, a decrease in motor skills, and memory loss. If sustained for long periods, reduced oxygen intake can lead to inflammation and brain cell damage.
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The Effects Of Depression-Induced Cerebral Damage

These changes in your cerebral matter can severely affect your mental and physical health. Here are the three most common effects of depression-induced brain damage:

Sleep Disturbances And Emotional Issues

The cortisol influx caused by depression can cause your amygdala to enlarge, increasing its activity. Since it helps control your emotions, damage to your amygdala can throw your emotions off balance. You may experience uncontrollable mood fluctuations as a result, causing you to experience both negative and positive emotions very intensely.

An enlarged amygdala doesn't just impede your emotional health and your mood stability - its increased activity can also cause other issues, like sleep issues and disturbances. Sleep deprivation, in turn, can worsen your overreactions to stimuli. Poor sleep also causes you to develop a more negative mood and mindset, which can cause your depression to worsen.

Since this creates a feedback loop, issues with your amygdala can be one of the most dangerous things about major depressive disorder.

Lower Cognitive Capabilities

Cerebral damage found in major depressive disorder patients can lead to weaker cognitive functions. Cognitive function loss happens due to the degradation of their neurons.

Increased release of stress hormones is the main cause of this issue. Long-term cortisol hormone exposure causes neuron development to slow or stop, leading to shrinkage.

Hippocampus damage leads to memory problems, trouble with concentration, and executive dysfunction. These depression symptoms are usually worse in people that have been afflicted by degenerative conditions like Alzheimer's disease and Parkinson's disease.

Susceptibility To Physical Health Issues And Illness

Stress hormones make your heart beat faster as if you're constantly in danger. Because your heart isn't meant to beat at high speeds for extended periods, this could lead to a life-threatening heart illness in the future.

Depression also impacts your digestive system's health, especially if you binge eat or take antidepressant medications. If you rapidly gain weight during a depressive episode, you're more likely to develop diseases closely tied to obesity, like diabetes. Conversely, depression may also cause someone to lose their appetite for food and experience rapid weight loss, which can be equally harmful to the body.

Some people may use drugs or alcohol as a way to deal with their symptoms of depression, leading to substance use disorders. In some cases, this substance abuse issue can develop into life-threatening addictions.
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Conclusion

Depression alters both your mind and body, and almost always for the worse. The hormones released during episodes of depression can cause cerebral damage, emotional instability, sleep disorders, and impaired cognitive abilities.

Fortunately, you don't have to deal with mental health issues alone. If you or a loved one is suffering from depression, contact us for more information on how we can help with our depression treatment programs.

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What Happens To The Brain During Depression - Transformations Center

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Depression not only affects your mental wellbeing - it affects your brain, too. In this guide, we go over the changes you may be experiencing and explain why.

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What happens to our Brain during depression? 

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What happens to our Brain during depression? 