In the following article I will explain how depression is associated with a cluster of troubling symptoms and without proper support, depression can negatively impact important life decisions.
Today I would like to invite you to a discussion about that dark cloud of Depression which seems to loom over all of us from time to time. Unfortunately, for some this dark misery can be last months and leave one paralyzed with such an overpowering presence that all pleasures which were once experienced seem to be absent. Clinicians trained in Mental Health define Depression by a cluster of symptoms which seem to coexist. I will list these symptoms for you as they appear in The Diagnostic Statistical Manual (DSM), the standard that guides treatment for Mental Health.
1. Depressed mood most of the day, almost every day, indicated by your own subjective report or by the report of others. This mood might be characterized by sadness, emptiness, or hopelessness.
2. Markedly diminished interest or pleasure in all or almost all activities most of the day nearly every day.
3. Significant weight loss when not dieting or weight gain.
4. Inability to sleep or oversleeping nearly every day.
5. Psychomotor agitation or retardation nearly every day.
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day.
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Again, feeling depressed is fairly common. The cause of depressed feelings can arise from a variety of sources, from disappointments, loss, grief and stressors. It is also commonly experienced with illness, pain, trauma and diseases. But what I wish to explore with you today is a how a very small part of the brain seems to play a very significant part of most of the symptoms associated with depression. So let us turn our attention to the parting curtain on stage.
Ladies and gentlemen, I would like to present to you the Habenula.
In neuroanatomy, the habenula (diminutive of Latin habena meaning rein) originally referred to the stalk of the pineal gland (pineal habenula; pedunculus of pineal body)
Now, the reason why I am fascinated by the Habenula is because it presents a puzzling, yet an interesting role. You see, it has been discovered that this small part of the brain plays a significant role in avoidance. When a threat is experienced, like for example you suddenly encounter an angry large dog growling and postured to attack you. What is your first reaction? You stand fixed, unable to move and aware that any sudden movement will likely result in an attack.
This freezing motion is primarily the activity of the habenula. It has a general function in negative rewards, as avoidance of movement which would be harmful. So it has a preventive and protective function. By “not doing X” you are “rewarded”.
Now it gets more interesting. Since activating the habenula is related to avoidance, you would probably expect that people suffering depression would have a very active habenula baseline compared to a someone who is not depressed. But this was not the case!
In fact, when a group of depressed subjects were compared to non-depressed subjects, there was little difference in habenula activity. Then the groups were presented images on cards. Some images were paired with a mild electrical shock. Now when the subjects were presented with an image on a card that was paired with a mild shock, normal test subjects revealed increased activity from the habenula, which you would expect. But what was not expected was that depressed people had decreased activity from the habenula when presented with a card associated with a shock. It seemed that the anticipation of harm was not preparing depressed individuals for the shock they knew would follow.
Some researchers proposed that chronically depressed patients have often experienced numerous traumatic events or abuses, which diminished the role of the habenula. Further, if you were aware that your options of escape were limited and abuse could not be avoided, then this role would no longer be essential.
Consider the following illustrations. Let us say the Habenula is a pail of water. The activity of the habenula is like a leak in the pail. If the habenula pail loses significant water by multiple punctures, it loses its avoidant function for safety.
The neurological impact avoidant behavior from stress induced habenula activity leads to an imbalance of weighted activity. Since it was discovered that dopamine (DA), the reward neurotransmitter is decreased by elevated habenula activity, it can then be perceived as depicted above. Chronic traumas which confront a person over a long duration may, in fact, lead to chronically “low reward “states and chronically “low energy”. Thus it addresses the symptoms of depression mentioned above, i.e. low energy and anhedonia.
Another aspect of the habenula is through negotiating serotonin signaling. This then accounts for appetite and sleeping problems.
Now that we can see how chronic repeated abuses or traumas may lead to this clinical depression cluster, we have to consider what the research was suggesting. If the negative reward is unhooked from judgment, then the capacity to “halt” and evaluate a situation is impacted. This would introduce impulsivity and rage as very real strategies to problems, where strategies in avoiding conflict could be exercised. One can see how, without the right regulating mechanics poor decisions by those who have been abused and suffering depression can, in fact, produce an ongoing cycle of maladaptive strategies. Poor choices will bring poor results, which continue to poor choices. Until a strategy is employed to arrest the cycle of impulsivity and rage, it is doomed to fail.
There is another lesson here about the essential role and responsibility of guardians and parents. The best cure is prevention. If a repeated trauma or abuse has left one of my readers challenged with chronic depression, seek help from a professional to address this hold in your life. If you raise children, it is especially important that you get the help you need; as it will not only restore your life but assure that any abuse you may have suffered will not continue to impact those you love and protect in your care.
Thank you for allowing me to share with you this wonderful topic dear reader.