Brain Regions And Mood
Popular lore has it that emotions reside in the heart. Science, though, tracks the seat of your emotions to the brain. Certain areas of the brain help regulate mood. Researchers believe that more important than levels of specific brain chemicals nerve cell connections, nerve cell growth, and the functioning of nerve circuits have a major impact on depression.
Increasingly sophisticated forms of brain imaging such as positron emission tomography , single-photon emission computed tomography , and functional magnetic resonance imaging permit a much closer look at the working brain than was possible in the past. An fMRI scan, for example, can track changes that take place when a region of the brain responds during various tasks. A PET or SPECT scan can map the brain by measuring the distribution and density of neurotransmitter receptors in certain areas.
Use of this technology has led to a better understanding of which brain regions regulate mood and how other functions, such as memory, may be affected by depression. Areas that play a significant role in depression are the amygdala, the thalamus, and the hippocampus .
Figure 1: Areas of the brain involved with depression
The regions shown here are mirrored in both hemispheres of the brain. Also, these structures are interlocking the illustration suggests relative position but not precise location.
What If My Symptoms Dont Improve
If youre not responding to treatment, you may live with treatment resistant depression. This is when your symptoms have not improved after at least 2 standard treatments. This can also be known as treatment-refractory depression.
There is currently no official criteria used to diagnose treatment resistant depression.
What treatment is available for treatment-resistant depression?There are treatment options for treatment resistant depression. Even if antidepressants have not worked already for you, your doctor may suggest a different antidepressant from a different class.
The new antidepressant you are offered will depend on the first antidepressant you were given.
Sometimes your doctor can prescribe a second type of medication to go with your antidepressant. This can sometimes help the antidepressant work better than it does by itself.
Where antidepressants have not worked, your doctor may suggest talking therapies, ECT or brain stimulation treatments. See the previous section for more information on these.
What is an implanted vagus nerve stimulator, and how is it used in treatment resistant depression?If you live with treatment resistant depression, and youve not responded to other treatments, you may be able ask for an implanted vagus nerve stimulator.
Please speak to your doctor if youre interested in this treatment and for more information. You may be able to get this treatment funded through an Individual Funding Request.
- NHS – Your Rights by clicking here.
Are There Other Therapies To Treat Symptoms Of Depression
Yes. Another treatment is transcranial magnetic stimulation . It involves using a noninvasive device thatâs held above your head to create a magnetic field. It targets a specific part of your brain that can trigger your depression.
Vagus nerve stimulation is another treatment option. A pacemaker-like device is surgically implanted under your collarbone to deliver regular impulses to your brain.
A medication called ketamine may also be used for hard-to-treat depression. It is given through an infusion or as nasal spray.
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So What Do We Do To Win Against Depression
Waking up one morning and realizing your depression has magically disappeared isnt likely to happen. I desperately want it to work like that, believe me. Ive laid in bed for hours, staring at my ceiling. Ive slept more than Ive been awake because sleeping is the only full escape I have.
My depression is never gone when I wake up.
Depression is a formidable foe, and like all adversaries, I cant avoid it. I have to find the strength to stand against it.
How Is Depression Treated
Depression treatment typically involves medication, psychotherapy, or both. If these treatments do not reduce symptoms, brain stimulation therapy may be another treatment option. In milder cases of depression, treatment might begin with psychotherapy alone, and medication added if the individual continues to experience symptoms. For moderate or severe depression, many mental health professionals recommend a combination of medication and therapy at the start of treatment.
Choosing the right treatment plan should be based on a persons individual needs and medical situation under a providers care. It may take some trial and error to find the treatment that works best for you. You can learn more about the different types of treatment, including psychotherapy, medication, and brain stimulation therapies on the NIMH’s depression webpage. For information on finding a mental health professional and questions to ask when considering therapy, visit NIMHs psychotherapies webpage.
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How Can I Help A Loved One Who Is Depressed
If someone you know has depression, help them see a health care provider or mental health professional. You also can:
- Offer support, understanding, patience, and encouragement.
- Invite them out for walks, outings, and other activities.
- Help them stick to their treatment plan, such as setting reminders to take prescribed medications.
- Make sure they have transportation to therapy appointments.
- Remind them that, with time and treatment, the depression will lift.
Take comments about suicide seriously, and report them to your loved ones health care provider or therapist. If they are in immediate distress or thinking about hurting themselves, call 911 for emergency services or go to the nearest hospital emergency room.
How Do I Know If Im Depressed
People often say things like I feel so depressed or thats depressing, but the truth is that depression is a well defined mental disorder, including nine different symptoms. Worth noting is that its not enough to experience the symptoms to be diagnosed with depression. There are several depression criteria to consider.
Well start with the symptoms of depression. The DSM-5 is a handbook, frequently used by mental health professionals in the US and all over Europe. It contains lots of facts about depression, including the symptoms:
- Depressed mood: Feeling blue most of the day, nearly every day.
- Loss of interest and pleasure: Markedly reduced interest/pleasure in all activities most of the day.
- Changed appetite or weight .
- Sleep disturbance .
- Moving more slowly than usual or making meaningless movements due to anxiety .
- Lacking energy: Feeling tired nearly every day.
- Having difficulty concentrating and/or making decisions.
- Having suicidal thoughts or sometimes wishing you were dead.
Lets continue with the depression criteria. Its not enough to experience some of the symptoms to receive a diagnosis of depression. The following conditions also apply:
Depression can be tricky to recognise and diagnose because there are so many symptoms and criteria to consider. The next paragraph includes a commonly used online depression test, which gives you an indication of the severity of your depressive symptoms.
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Untreated Depression Is A Common Cause Of Suicide
The National Alliance on Mental Illness reports that 45% of those who die by suicide are suffering from some sort of mental illness. This includes people with undiagnosed, untreated, or under-treated depression.
Many of the warning signs of suicide are also signs of depression. Proper depression diagnosis and treatment are extremely important for preventing suicidal thoughts, ideations, or actions.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
Children Are Not Immune To Depression
It’s a myth that childhood is always a joyful, carefree time. While children may not experience the same issues as adults, such as work-related stress or financial pressures, this doesn’t mean that they can’t become depressed.
The Centers for Disease Control and Prevention says that 4.4% of children aged 3 to 17 are diagnosed with depression, or roughly 2.7 million in total. Additionally, 73.8% of children with depression also have anxiety and 47.2% have behavior problems.
Childhood brings its own unique set of stressors, such as bullying and the struggle for peer acceptance. Children can also feel stressed about schoolwork, sports, bodily changes, or issues going on at home, like if their parents are going through a separation or divorce.
Signs of depression in children include:
- Changes in eating habits
- No longer enjoying activities they once loved
- Reduced energy levels
- Trouble at school
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Other Conditions That Cause Depression Symptoms
Depression can be a symptom of other health conditions. It’s important you get the right diagnosis and the best treatment. Some disorders that can cause depression include:
- Bipolar I and II disorders. These mood disorders include swings of highs to lows . It can be tricky to tell the difference between bipolar disorder and depression.
- Cyclothymic disorder. This involves mood swings that are milder than those of bipolar disorder.
- Other depression disorders. These include depression caused by the use of recreational drugs, some prescribed medications, or another medical condition.
Reacting To Life Situations
Life is full of ups and downs. Stress, hassles, and setbacks happen . How we react to life’s struggles matters a lot. A person’s outlook can contribute to depression or it can help guard against it.
Research shows that a positive outlook acts as a protection against depression, even for people who have the genes, brain chemistry, or life situations that put them at risk for developing it. The opposite is also true: People who tend to think more negatively may be more at risk for developing depression.
We can’t control our genes, brain chemistry, or some of the other things that contribute to depression. But we do have control over how we see situations and how we cope.
Making an effort to think positively like believing there’s a way around any problem helps ward off depression. So does developing coping skills and a support system of positive relationships. These things help build resilience .
Here are three ways to build resilience:
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We Dont Have To Feel This Way
Learning I wasnt alone in my depression was the first step in a long process of discovery. The second revelation I had was that I didnt have to feel that way.
I dont have to be stuck. I dont have to feel consumed by despair or indifference.
I can feel better.
Theres nothing stopping me other than the voice in my head telling me that its pointless to try. Once I realize I dont have to feel bad all the time, I can start actively looking down that road of recovery.
When To Seek Professional Help
If support from family and friends and positive lifestyle changes arent enough, it may be time to seek help from a mental health professional. There are many effective treatments for depression, including:
Therapy. Consulting a therapist can provide you tools to treat depression from a variety of angles and motivate you to take the action necessary. Therapy can also offer you the skills and insight to prevent the problem from coming back.
Atypical Depression: Whats in a Name? Article on the symptoms, diagnosis, and treatment of atypical depression.
Depression and Other Illnesses An overview of the mental and physical illnesses that often co-exist with depression, and how this impacts treatment.
Depression support & suicide prevention help
Depression support
In the U.S.: Find DBSA Chapters/Support Groups or call the NAMI Helpline for support and referrals at 1-800-950-6264
UK: Find Depression support groups in-person and online or call the Mind Infoline at 0300 123 3393
Australia: Find Support Groups and regional resources or call the SANE Help Centre at 1800 18 7263
India: Call the Vandrevala Foundation Helpline at 1860 2662 345 or 1800 2333 330
Suicide prevention help
In the U.S.: Call National Suicide Prevention Lifeline at 1-800-273-8255
UK and Ireland: Call Samaritans UK at 116 123
Australia: Call Lifeline Australia at 13 11 14
Other countries: Visit IASP or International Suicide Hotlines to find a helpline near you
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Common Causes And Risk Factors
Several factors can cause depression. Though depression may not have one single cause, experts recognize the following as possible risk factors:
- Genetics: Depression and other mood disorders can run in families, though family history alone does not mean a person will get depression.
- Life events: Major life changes and stressful events may trigger depression. These events include divorce, the death of a loved one, job loss, or financial problems.
- Hormonal changes: Research
This section looks at the different types of depression.
Whats The Difference Between Sadness And Depression
Depression is about being sad, surebut its more than that. Depression is a mental illness that involves a lot of symptoms, like feeling exhausted all the time, losing interest in activities you normally enjoy, or thoughts of death and suicide. Episodes of depression last at least 2 weeks at a time. They can be triggered by a sad event or they can seemingly come of out of nowhere.
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Changes After Giving Birth
After having a baby, it’s common for new moms to experience feelings of sadness and anxiety this emotional response is often referred to as the baby blues. But in more serious cases, these feelings last longer than a few days and may be a form of depression called postpartum depression.
Studies estimate that postpartum depression affects 10%15% of new mothers, but Kathleen Kendall-Tackett, PhD, a psychologist and lactation consultant who specializes in postpartum depression, previously told Health it may actually be as high as 25%.
They Could Have A Tough Time Responding To Affection And Concern
The main misconception about depression, which has been hinted at in the paragraphs above, is that its about feeling sad.
On the contrary, depression is mostly not feeling anything, or only partially and briefly experiencing emotions. It depends on the individual, but some people with depression report feeling almost numb, and the closest thing to an emotion they experience is a kind of sadness and/or irritation.
Because of this, appropriately responding to gestures or words of affection will be difficult for them, or they just dont think about it any more.
They may even get irrationally irritated or annoyed with you over it, because it may simply be too difficult for their brains to process and respond to your loving gestures.
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Looking After Someone Who Has Depression
If you’re close to someone with depression, their condition can affect you too. Your relationship, and family life in general, can be strained, and you might not know what to do or how to help.
Talking about the situation can help. Finding a support group, or talking to other people in a similar situation, can make it easier to cope. If the condition is causing difficulties in your relationship with your partner, you could contact a relationship counsellor who can talk things through with both of you.
When suffering from depression, men are less likely to ask for help than women. They’re also more likely to turn to drugs and alcohol to cope with the symptoms.
Alcohol Tobacco And Other Drugs
The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. SAMHSAs 2020 National Survey on Drug Use and Health reports that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.
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Depression And Suicide Risk
Depression is a major risk factor for suicide. Deep despair and hopelessness can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and watch for the warning signs:
- Talking about killing or harming one’s self.
- Expressing strong feelings of hopelessness or being trapped.
- An unusual preoccupation with death or dying.
- Acting recklessly, as if they have a death wish .
- Getting affairs in order .
- Saying things like Everyone would be better off without me, or I want out.
- A sudden switch from being extremely down to acting calm and happy.
If you think a friend or family member is considering suicide, express your concern and seek help immediately. Talking openly about suicidal thoughts and feelings can save a life.
If you are feeling suicidal
When you’re feeling suicidal, your problems don’t seem temporarythey seem overwhelming and permanent. But with time, you will feel better, especially if you get help. There are many people who want to support you during this difficult time, so please reach out!
ReadAre You Feeling Suicidal?, call 988 in the U.S., or visit IASP or Suicide.org to find a helpline in your country.
When To Get Emergency Help
Anybody thinking or talking about harming themselves should be taken seriously. Itâs time for immediate action.
If youâre thinking about hurting yourself or attempting suicide, or if you know someone whoâs in danger of suicide, call 911 or your local emergency number right away.
And if youâre having suicidal thoughts:
- Reach out to a close friend or loved one.
- Contact a minister, spiritual leader, or someone else in your faith community.
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