Roughly 1 in 10 Americans suffer from depression and it is the leading cause of disability for ages 15-44. It is the primary reason why someone dies of suicide about every 12 minutes. These numbers do not include all of those who may have depressive symptoms and do not report or know that they meet the criteria for a depressive disorder. Depression itself is a mood classification of excessive sadness, loneliness, hopelessness about the future, and withdrawal from activities that one used to enjoy. There are several disorders that are comprised of depressive symptoms other than the commonly known, Major Depressive Disorder.
As with all of my blogs, this post is aimed to be psychoeducational. The first portion of this blog may be viewed as bleak but stay tuned until the end where I share tips on how to heal from depressive symptoms. Healing is possible and starts with understanding why the pain or symptom is there in the first place.
PATHOLOGY
There are many different ways to look at the pathology of depression. There is the genetic or neurobiology model, the trauma or stressor model, and the lifestyle/ environmental model. Oftentimes, depression manifests as a result of a combination of several factors. I'll expand on these few viewpoints for you to understand how depression may have manifested for you or someone you love.
Genetic or neurobiology model:
With this model, the brain is believed to have genetic predispositions that affect the wiring of the brain. When researchers look at various brain scans of depressed individuals or mammals, neuroimaging shows that the brain regions that normally regulate mood are overactive in their response to negative events. One of these brain areas is called the amygdala which is responsible for emotions and mood. It is estimated that as people age, the number of mature neurons in the brain increases. For individuals with depressive symptoms, and other brain health issues, the number of mature neurons actually declines with age when individuals do not receive proper interventions. The other brain area that is responsible for depressive symptoms is the nucleus accumbens. This area is known as the "reward center" of the brain. It is responsible for activating and releasing the neurotransmitter, dopamine to reward a behavior or to experience pleasure. Brain scans show that individuals with depressive symptoms need a bigger reward to reinforce the same task as non-depressed individuals. So this area of the brain is far less active which contributes to the lack of pleasure and depressive symptoms.
Trauma/ stressor model:
When children experience trauma, their brains become hard-wired to accommodate the negative events. Individuals who do not experience trauma and live in a nurturing and safe environment are able to see the world through a positive and safe lens. When trauma occurs, children refocus their lenses to see the world with more skepticism. What used to be a world that is safe and innocent is now dangerous or can result in pain or suffering. When children make this shift in their view of self or the world, the brain becomes more susceptible to "looking at the glass half empty," so to speak. When the brain absorbs information from the environment (through the senses), it is more likely to perceive information as a potential threat. This causes a spiral of negative thoughts which triggers unpleasant emotions and then unhealthy behaviors. Staying in this pattern for a long period of time causes the amygdala to be overactive and contributes to neurodegeneration.
Lifestyle/environmental model:
With this model of pathology, an individual may have established years of unhealthy habits that contributed to brain health decline. For example, lifestyles that consist of poor food choices, lack of movement and exercise, poor sleep, burnout, reduction of time engaging in fun activities, and substance use naturally contribute to depressive symptoms. This is because when the body isn't taken care of properly, the body perceives these behaviors as a threat and sends out an inflammatory response. When the body does this, digestion, cognition, movement, and mood, among others, all become compromised.
With any of these pathologies, an individual would naturally feel more depressed. The brain becomes stuck in patterns of feeling sad, lonely, and withdrawn if the smallest unpleasant situation happens. These feelings then affect one's thoughts. The inner dialogue may become clouded with thoughts such as:
"Things are never going to get better."
"Bad things always happen to me."
"No one will care if I don't show up."
"What's the point in trying now?"
"There is no meaning to my life."
HOW TO REVERSE THE CYCLE
The good news is that the brain is, for the most part, malleable, and these systems and processes that seem fixed can be adapted. Here are the primary new behavioral patterns or actions that would be required to reverse or prevent the exacerbation of depressive symptoms.
EAT WELL
The reason nutrition is so heavily stressed in every wellness facet is because our "second brain" lies in our gut. Our "gut brain" consists of millions of neurons that communicate with our central nervous system. Inflammation is the body's first line of defense and the first step in healing. Since the gut is one of the many initial points of inflammation, it is something that requires understanding and attention. The gut thrives off of a diverse microbiome. The cells in the gut are constantly judging particles as toxic or non-toxic. Whenever the gut cells identify something as toxic, it sends out the alarm system to the rest of the body which turns on the inflammatory response which, in turn, triggers the central nervous system to feel threatened and activates the sympathetic nervous system (fight, flight, freeze fawn system). In terms of food, the more diversity you're consuming, the more balanced your body will be and the less likely it is to be in dysbiosis (imbalance). Another thing to note is that each food item we consume produces different neurotransmitters (chemical messengers). There are neurotransmitters that contribute to feeling pleasure such as dopamine, oxytocin, serotonin, and GABA, and ones that initiate unpleasant responses including adrenaline, norepinephrine, and cortisol. 90% of serotonin cells are found in the gut lining and only 10% are actually found in the brain. This illustrates how influential nutrition is on our mood.
Eating these foods (in their most pure form) can help mitigate depressive symptoms because they produce pleasant neurotransmitters and/or help foster a diverse microbiome which decreases the likelihood of inflammation or stress response:
fruits
vegetables
whole grains
nuts
seeds
high-quality dairy
seafood
poultry
limited red meat
SLEEP WELL
Sleep is also directly related to mood. This is because the lack of sleep or poor sleep hygiene does not allow your brain to restore itself or clean out toxins by reducing cellular waste. Sleep is known as the restorative element of living. If we aren't restoring ourselves, we aren't living well. Sleep governs the endocrine system, immune system, and metabolism. Sleep also has a bi-directional relationship with stress which means it also contributes to increased inflammation.
These sleep hygiene tips can help enhance your sleep quality and mood and maintain a consistent sleep schedule. Please note that if you work nights or do shift work, ensure that you are researching specific tips for your profession. Examples of shift-work sleep hygiene may include, exercising on your off-work days. Finding blocks of time to get in longer naps or sleep. Using natural light to set the circadian rhythm, and limiting caffeine use on days or hours not working. If you do consume caffeine, try having it in smaller doses rather than large quantities during shift work.
General sleep hygiene tips include:
Be consistent with the time you wake up and go to bed.
Limit caffeine use at least 8 hours prior to bedtime.
Limit blue light exposure before bed and when you wake up.
Get natural light exposure first thing in the morning.
Omit processed and sugary foods before bed.
Establish at least one relaxation technique for when you have difficulty falling or staying asleep.
MOVE WELL
Research shows that both low-intensity and high-intensity movement can result in enhancing brain function. High-intensity movement provides a quick release of feel-good hormones like endorphins that influence our mood. Various clinical trials show that those with depressive symptoms have better outcomes in managing and reducing depressive symptoms when incorporating movement goals than those on anti-depressant medications. Consistent low-intensity movements like walking, biking, swimming, yoga, etc. are linked to the release of neurotrophic proteins that aid in the production of new neural pathways. The new neural pathways contribute to the survival, growth, and function of neurons. Some ways to move well include:
Identify a realistic move goal.
Stick to that goal unless you are ill or physically unable due to an injury that disrupts the specific move goal. Things like being "too busy" are not an excuse to put the move goal on the back burner. Everyone can create 5-10 minutes for high-intensity movement if they can't fit in 30 minutes of low to moderate activity daily.
Focus on mind-to-body muscle connection in addition to proper breath work.
for additional resources, you can read my blog post on exercise and brain health.
IDENTIFY YOUR PURPOSE FOR LIVING
When we do not feel connected to a purpose for living and hone in on what we enjoy in life, we can get lost in the day-to-day stress and have difficulty seeing the end goal.
Here are some tips for identifying your purpose:
Make a list of the experiences that have brought you the most joy.
Imagine your dream lifestyle.
Work backward to establish small goals on how you can work towards creating that dream lifestyle.
Enjoy the smaller things in life. Create a list of things that make you smile. This often will coincide with your values and help you develop your passion and purpose.
If you smile at hearing a story of someone helping another person, you may have high empathy and compassion and you may feel connected to a purpose involved in doing good and helping others. If you enjoy being in nature, you may intentionally set aside time to be outdoors and soak up the moment rather than dwelling on the fact that you sit inside an office all day because you don't have a job that allows you to be outside.
Conceptualize how you view the world and define what purpose and passion mean to you. Everyone is different and everyone's journey to self-fulfillment is different too.
GET SUPPORT
Social support is a factor in many positive health outcomes. Individuals that experience depressive or anxiety symptoms may struggle to get out of their comfort zone to engage in social interaction. Social interaction allows us to feel a sense of belonging and have people to turn to when we feel sad, lonely, or need emotional support.
Identify at least 3 people you can turn to in times of distress.
Identify individuals that contribute to you feeling joy when you're around them and initiate more interaction with those individuals.
Set healthy boundaries with individuals who do not foster growth or joy in you.
If you feel alone, seek professional support. Your therapist or professional you are working with can work with you on establishing a healthy support system and be there for you in the meantime.
HAVE FUN
Engaging in healthy activities that are "fun" allows the "inner child" aspect of self to heal from past trauma. Having fun can increase the release of endorphins and can combat unpleasant emotions, thoughts, and behaviors. Having fun allows for our prefrontal cortex to clean out any stress or cortisol that was clogging the ability to think and feel pleasant emotions. It serves as a healthy stress reliever and combats inflammation.
Try new things.
Learn to laugh at yourself.
Be mindful and appreciate small and big moments of laughter and joy.
Put the phone down.
Make time for things you enjoy or used to enjoy.
Be silly.
Try not to overthink the art of having fun.
As always, thank's for reading this post! You can follow me on Instagram (the_healthycoconut) or continue to check out my blog for more self-help tools. These tools are always meant to be used if you feel safe to do so independently. If thoughts of harming yourself or others surface, call 911 immediately. Or if some of the information that is shared in these blogs becomes triggering, stop reading, and reach out for support. Call a friend or healthcare professional so you are not alone.
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