Depression

By Stu Whitley | Bio


No voice divine the storm allay’d,
No light propitious shone;
When snatch’d from all effectual aid,
We perish’d, each alone:
But I beneath a rougher sea,
And whelm’d in deeper gulphs than he
—William Cowper, The Castaway

There
are probably more things at work in the human mind than we will ever
know. Too often the turmoil we confront in our daily lives gets the
better of
us, and we succumb to a depressed state for a day, a month, or perhaps
longer*. The above stanza brilliantly captures the sense of isolation,
despair and torment in the mind of someone who is incapable of seeing
the world with a balanced perspective. Cowper, who was not capable of
being diagnosed as such in the 18th century, probably suffered from
recurrent depression.

Science
has unearthed a variety of potential causes for depression—from
pesticides and thyroid conditions to lower counts of stress hormones
(such as corticotrophin-releasing hormone), a higher body mass index
(suggesting that fat and ‘jolly’ do not always go together) and sleep
disorders. But the causes for the majority of instances where
depression captures the imagination remain elusive. We do know that,
equally, most of these cases are transitory, just as we know that, for
sufferers, the night seems endless.

Much has been written about
the condition, particularly by those who have experienced it. In 1936,
F. Scott Fitzgerald published three essays about his spiritual
depletion in Esquire, which he later consolidated in a larger work titled The Crack-Up.
There he asserted that it takes great acumen to ponder conflicting
truths without going mad. “The test of a first-rate intelligence is the
ability to hold two opposed ideas in mind at the same time and still
retain the ability to function.”

William Styron, author of Sophie’s Choice, wrote a short memoir of his own emotional descent called Darkness Visible (1989). Styron was not in favour of the term ‘depression’; he said it was “a true wimp of a word for such a major illness.”

Donald McCullough wrote a chronicle of his own battle with depression in The Wisdom of Pelicans (2002).
In the aftermath of a scandal borne of an affair while he was married,
he lost much of what sustained him, including his reputation for
honourable conduct. He settled into a depression which eluded the best
advice he could get. “I have lost much, and loss leads naturally to
grief, and grief leads naturally to depression,” he wrote. “Emotions
just are: they’re present whether you want them or not, unbidden, with
an annoying will of their own.” Many others have written of the
encompassing darkness, the blackness that overtakes the will. ‘Going
through the motions’ is another way to express the despondency.

From
a biological perspective, negative feelings, communications or
perceptions release the hormones that are commonly associated with
stress. Our brain’s autonomic responses, rooted in the limbic system,
trigger which biochemicals are released. Current thinking on this
subject is that low levels of “good” stress may cause beneficial
changes. However, if continued for sustained periods, those stress
hormones can actually cause damage to the brain.

The body
possesses a feedback system for regulating the amount of cortisol in
the bloodstream. The pituitary gland makes and secretes a hormone known
as adrenocorticotropic hormone (ACTH). Secretion of ACTH signals the
adrenal glands to increase cortisol production and secretion. The
pituitary, in turn, receives signals from the hypothalamus in the form
of the hormone CRH, or corticotrophin-releasing hormone, which signals
the pituitary to release ACTH. Almost immediately after a stressful
event, the levels of the regulatory hormones ACTH and CRH increase,
causing an immediate rise in cortisol levels. When cortisol is present
in adequate or excess amounts, a negative feedback alerts the pituitary
gland and hypothalamus to reduce the output of ACTH and CRH in order to
reduce cortisol secretion.

New research is examining a
stress-related molecule called “corticotropin releasing factor” (CRF).
CRF was initially thought to be a cue from the hypothalamus to the
pituitary, which governs the brain’s hormone-releasing system, causing
it to release ACTH , which in turn tells the adrenal cortex to release
adrenalin (epinephrine). However, there are other sites in the brain
that make and release CRF. CRF is not merely the medium from brain to
body; it is central to the entire stress response within the brain
prior to the discharge of adrenalin.

It appears that constant
stress or worry can ruin the internal physiological mechanism that
regulates our responses to stress. Damage to the brain seems to occur
within the hippocampus,
which appears to be vulnerable in two ways: first, stress may shrink it
directly (probably by promoting cell death there), or by interfering
with the brain’s normal stress-prevention/relieving capacities. These
new discoveries make it more urgent to develop strategies to deal with
depression that are not pharmacologically based or otherwise invasive.


* According to the 1994-95 National Population Health Survey
of Health Statistics Division of Statistics Canada, close to 6% of
Canadians aged 18 and over had experienced a major depressive episode
in the previous 12 months. Univariate analysis shows that the
prevalence of depression was higher among women than among men, but
tended to decline at older ages in both sexes. The prevalence of
depression was also related to a number of socioeconomic
characteristics such as marital status, education, and household
income, and to several measures of stress, psychological resources and
social support. However, multivariate analysis shows that not all of
these variables were significantly associated with the odds of
experiencing depression. In some instances, factors that increased the
risk differed for men and women. For both sexes, chronic strain, recent
negative events, lack of closeness, and low self-esteem increased the
odds of depression. Traumatic events in childhood or young adulthood
and a low sense of mastery were associated with a higher risk of
depression for women, but not men. For men, being single and having
moderate self-esteem heightened the risk of depression. A substantial
proportion of both men and women who had suffered depression reported
using drugs. As well, a notable share of people who had been depressed
sought professional health care for emotional or mental problems.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.