There has been a lot of speculation going around regarding depression and what causes it, but it is important to understand that it might be caused by a variety of things rather than just one factor. There are many, many circumstances that could lead a person to suffer from depression, which makes it a very complex topic. From stress, anxiety, social status, and difficult life circumstances, to changes in hormone levels and genetics, there are plenty of factors that can have certain effects over one’s mental health. However, hearing people talk about chemical imbalances in the brain as the main factor causing depression and other mental disorders made me wonder: how do you combat depression if not with medication?
The chemical imbalance theory made its first appearance during the late 1950’s, and at first it was only related to the norepinephrine neurotransmitter, until later the focus shifted to serotonin in the brain. Low levels of serotonin are usually related to depression, which is why it is believed to be the cause. Nevertheless, even with the fact that these chemical imbalances are directly related to this mental disorder, it would be a mistake to say that they are its causative factor. It is possible to say that a depressed person developed a chemical imbalance, but it wouldn’t be safe to say that it was caused by a genetic factor and not environmental ones. In other words, the origins of these imbalances are uncertain. It would even be inaccurate to say that chemical imbalances maintain that state of hopelessness, because even though they are strictly related, our choices, perceptions, emotional strategies, and social relations play a big part in our mental health. This is why it is more accurate to say that it is a two-way street: your brain chemicals affect your thoughts and emotions just the same as your thoughts and emotions affect your brain chemicals.
The common misconception about chemical imbalances can create a lot of confusion in the population and that can lead to a lot of problems. As it is a biomedical explanation, it gives people a sense of hopelessness, as they start believing that their brain chemistry has power over their moods and thoughts, rather than the other way around, which then creates a dependency in medication and moves them to think that other techniques or coping mechanisms may never be helpful. At first, even psychiatrists started treating depression as if it was a result from low serotonin levels rather than a response to other factors related to the person’s life. This demonstrates how the chemical imbalance theory (one that came from studies that related low serotonin levels to lower moods) is able to change people’s perception on depression, which then results in changes in how it’s treated. Studies showed that serotonin levels could be manipulated by some drugs, either to lower them or to elevate them, and that is how Selective Serotonin Reuptake Inhibitors (SSRI) came into the pharmaceutical industry. These drugs were believed to target the cause for depression, especially after being advertised that way, but there was no evidence to support this claim, much less to talk about SSRIs as a cure. But even now, it is still very common to see the media talk about chemical imbalances as the sole cause for depression.
Now, its important to understand that SSRIs are mood-altering drugs that aim to elevate serotonin levels in the brain (as do some illicit drugs), which means that it is not a permanent solution unless it’s taken repeatedly for the rest of your life. It also means that SSRI’s can have an effect on anybody, depressed or not. And it also means that SSRIs do not target a chemical imbalance, they alter your brain chemicals. When a psychiatrist prescribes an antidepressant, the patient doesn’t get tested to see if they have a biological deficit. There is no test in existence that evaluates the patient’s brain chemicals to see if they are depressed, or if they have an anxiety disorder. So antidepressants do not target a chemical deficit, they just improve what’s already there. SSRIs are a good alternative to help treat depression, but if your goal is to be able to exist without them at some point, there are other ways to improve your mental health.
The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. And as you must know, a person’s mood can and will have an effect in their physical state. When someone is mad they may experience dizziness, headaches, increased heart rate, and other symptoms, while sadness may present itself in the body with nausea, exhaustion, changes in sleeping habits, changes in appetite, and much more. Your emotions have many, many effects on your body, even so that some diseases can be worsened by emotion, like heart diseases by hostility. But they also have many effects on your social life, which then affects your emotional well being. Hostility, aggressiveness, and being impulsive can all lead to isolation, while agreeableness (being kind and sympathetic) and thoughtfulness can lead to a better social support base and improved moods. So learning to manage and control your emotions and learning to interact with others can be key to maintaining a good physical and emotional health state.
Another method to consider is exercise. Studies have shown that exercise can have antidepressant and anxiolytic effects, and can improve mood in patients with mild depression as well as in patients with chronic depression. Neuroscientists have found that depressed people tend to have a smaller hippocampus, the part of the brain that regulates your mood, and physical activity is known to stimulate cell growth in this area of the brain. Exercise is also known to release endorphins, a group of hormones with analgesic effects on the body, which can help improve a person’s mood. It also protects you against many diseases, helps improve sleeping habits, lowers blood pressure, increases energy, along with many other benefits. For someone suffering from depression, finding the energy and motivation to start exercising might be difficult,but starting by at least 5 minutes of physical activity and then increasing time gradually day by day can be very helpful. Of course, exercise alone might not do the trick, but it is a great method to release stress and anxiety, as well as improve your overall health.
Diet is another mechanism used to cause a positive influence on emotional health. Felice Jacka PhD, published a study in 2017 that demonstrated the effects of a healthy diet in people with moderate to severe depression. For the study, 67 people with depression were recruited, and after grading their symptoms with the MADRS scale test, half of them were put on the Mediterranean diet for twelve weeks while the other half were required to attend support groups for the same amount of time. When the twelve weeks concluded, all 67 people took the MADRS test again, and the results showed that 32% of the group with the diet no longer met the criteria for depression (a very significant decrease), while in the other group, only 8% of the people achieved this. The diet consists in a high intake of vegetables, grains, fruits, other plant-based fruits, and oil, a moderate intake of fish and chicken, and low intakes of dairy products, red meat, sweets, alcohol, and fast foods. Of course, diet is a personal choice, but it is encouraged to lower or regulate the intake of unhealthy foods.
Lastly, exposure to bright light can be another way to increase serotonin. Bright light is used as treatment for seasonal depression, but it can also work for nonseasonal depression and other disorders. Small changes like going outside, letting light go into your room and using brighter colors in your walls can have a positive impact in your well being.
So, as we can see, depression is not just about a chemical imbalance, and there are different ways to treat it that may or may not involve medication. Of course, every person is different, so what works for some might not work for others, but combining these mechanisms and working to improve your life quality is a very good way to help treating this mental disorder. It is also good to research other options like placebos, SSRIs, or Cognitive Behavioral Therapy to help treat depression. However, never take off the table learning to take care of your overall health.
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