Depression is a mental health condition that affects the way in which you feel, think, and behave. Depression is typically a mood disorder that causes feelings of extreme and persistent sadness or hopelessness. This can last for a couple of days to even a few years. Depression is not the same thing as being upset over a minor setback or having a disappointing day. While some people suffer from mild cases of depression occasionally in their life, others have to battle with bouts of severe depression their entire life. The intense and long-term form of depression is known as a major depressive disorder (MDD). People of any age can suffer from depression, though the average onset age is believed to be around 30-32. There is really no cure for depression and the condition is managed with psychological counseling and antidepressant medications, or combination therapies using both counseling and medications. Research has been going on for many years now about how depression affects the brain and today we try to understand exactly how depression physically affects the brain.
What are the Causes of Major Depressive Disorder?
Till date, researchers do not exactly know the reason as to why some people develop Major Depressive Disorder and some only develop mild to moderate depression. The following factors are believed to play a role in causing Major Depressive Disorder:
Hormonal Imbalances- It’s believed that certain changes in the levels of hormones or the balance of hormones in the body, especially during and after pregnancy, or during menopause may trigger Major Depressive Disorder in some woman. (1)
Genetics- People who have a family history of Major Depressive Disorder are more likely to develop Major Depressive Disorder than others. (2)
Stress– High levels of stress or a stressful life event, such as the death of a loved one or a divorce, can also lead to an episode of Major Depressive Disorder. (3)
Biochemical Reactions- Chemicals that are present in the brain of people having Major Depressive Disorder have been observed to function differently than those in the brains of people who do not have this disorder.
How Does Depression Affect the Brain?
There are three parts of the brain that are known to show some distinct characteristics in people who suffer from depression. This is believed to have a role to play in the development of Major Depressive Disorder.
Hippocampus- The hippocampus is the part of the brain that stores memories and is also responsible for producing a hormone known as cortisol (4). Found at the center of the brain, the hippocampus releases cortisol when the body undergoes physical or mental stress. During times of extreme stress or during a chemical imbalance, the hippocampus can release extra amounts of cortisol. The release of excessive cortisol in depression causes the neurons in the hippocampus to shrink, slowing down the production of new neurons. This is believed to be the reason why so many people having depression struggle with concentration and memory.
Prefrontal Cortex: The prefrontal cortex is located at the front of the brain. The prefrontal cortex is the part of the brain that regulates emotions and is also involved in memory formation and decision making. (5) When there is an excessive production of cortisol by the hippocampus, the prefrontal cortex also shrinks in depression.
Amygdala- The amygdala allows you to feel emotions such as fear or pleasure. Once the hippocampus releases excess amounts of cortisol, in people having depression or Major Depressive Disorder, we observe an enlarged and hyperactive amygdala due to being exposed to constant high levels of cortisol. This can disturb your sleep patterns and also cause the body to release imbalanced amounts of other chemicals and hormones that can lead to other types of issues.
Research believes that such high levels of cortisol have a big role to play in changing the actual physical structure as well as the chemical activities of the brain, which is what triggers the onset of depression or Major Depressive Disorder. In people who do not have Major Depressive Disorder, cortisol levels are at their peak in the morning and then decrease by the night. However, in people having Major Depressive Disorder, cortisol levels remain elevated at times even during the night.
Can Treatment Help Depression and Reverse the Effects of Depression on the Brain?
Studies have found that by balancing the levels of cortisol along with other chemicals in the brain, it is possible to reverse the shrinkage of the hippocampus and any other parts of the brain. (6) This can treat memory problems that depression might have caused and helps in correcting the chemical levels in the body can also lower some of the symptoms of Major Depressive Disorder.
There are many medications that fight off the negative impact of depression on the brain and helps restore the balance of chemicals in the brain and also help in reversing the affects of depression on the brain. Some of these common medications include:
SSRIs (Selective Serotonin Uptake Inhibitors)- SSRIs are medications that help provide relief in the symptoms of Major Depressive Disorder by causing a change in the levels of a compound known serotonin in the brain. (7) Some commonly used SSRIs include Paxil (paroxetine), Celexa (citalopram), and Prozac (fluoxetine).
Tricyclic Antidepressants and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)- When used in combination, both these medications are known to alleviate Major Depressive Disorder symptoms, as they change the amounts of norepinephrine and serotonin in the brain. Both these chemicals are known to boost energy and mood levels. Some common SNRIs include Cymbalta (duloxetine) and Effexor XR (venlafaxine). Tofranil (imipramine), Surmontil (trimipramine), and Pamelor (nortriptyline) are some commonly used examples of tricyclic antidepressants, which help relieve depression.
MAOIs (Monoamine Oxidase Inhibitors)- These medications help provide relief in the symptoms of Major Depressive Disorder by boosting the levels of serotonin, norepinephrine, and dopamine in the brain. Monoamine Oxidase Inhibitors also help in improving brain cell communication.
NDRIs (Norepinephrine-Dopamine Reuptake Inhibitors)- Norepinephrine-Dopamine Reuptake Inhibitors help Major Depressive Disorder sufferers by increasing the levels of dopamine and norepinephrine, both of which are mood-boosting compounds in the brain. Wellbutrin (bupropion) is a common NDRI that is prescribed by doctors for treatment of depression.
Atypical Antidepressants- This class of drugs includes mood stabilizers, antipsychotics and tranquilizers. Atypical Antidepressants work by blocking brain cell communication, which allows the body to relax.
Medical Procedures Which Affect the Brain and Help With Depression
Apart from using medications, there are also some other medical procedures that affect the brain and help ease the symptoms of Major Depressive Disorder. These medical procedures include:
Transcranial Magnetic Stimulation (TMS)- Transcranial Magnetic Stimulation is a process that involves sending electrical pulses directly to the brain cells for regulating mood.
Electroconvulsive Therapy (ECT)- Electroconvulsive Therapy involves passing electrical currents throughout the brain in order to increase the level of communication between the brain cells, which helps with depression.
Researchers and experts also believe that psychotherapy also has a role to play in altering the structure of the brain, thus relieving the symptoms of Major Depressive Disorder. Psychotherapy especially helps in strengthening the prefrontal cortex of the brain.
Boosting brain health is one way to help recover and manage the symptoms of Major Depressive Disorder without any medical intervention. However, please keep in mind that after a certain level, depression can only be treated with the help of medications and therapy. Some ways you can boost your brain health include:
Getting a good night’s sleep which will help grow and repair your brain cells. (8)
Eating healthy foods and remaining active by exercising regularly stimulates the brain cells and also increases the communication between the brain cells. (9)
By avoiding illegal drugs and alcohol, which actually destroy the brain cells. (10)
Consult your doctor to find out which treatment option is the best for you and get the help you require for dealing with your depression.
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