How Does The Brain Regulate Mood
Emotions are fleeting responses to stimuli mood is a more sustained state of emotion. Like emotions, mood probably originates with activity of the amygdala, where emotions are coded. But it also involves the prefrontal cortex, which, through bundles of two-way circuitry with the amygdala, helps regulate emotional response and influences the general state of reactivity of the amygdala.
Under normal conditions, moods are relatively stable. But the persistence of negative mood in major depression suggests something is amiss in the nerve pathways between the amygdala and cortex.
Another important influence on mood is the circadian rhythm that governs the timing of much physiological activity, most prominently the sleep-wake cycle. Disturbances in biological rhythms are known to disrupt mood, and studies of depressed patients find that they exhibit abnormal patterns of many body functions, from temperature regulation to hormone secretion.
Enhancing Healthcare Team Outcomes
An interdisciplinary approach is essential for the effective and successful treatment of MDD. Primary care physicians and psychiatrists, along with nurses, therapists, social workers, and case managers, form an integral part of these collaborated services. In the majority of cases, PCPs are the first providers to whom individuals with MDD present mostly with somatic complaints. Depression screening in primary care settings is very imperative. The regular screening of the patients using depression rating scales such as PHQ-9 can be very helpful in the early diagnosis and intervention, thus improving the overall outcome of MDD. Psychoeducation plays a significant role in improving patient compliance and medication adherence. Recent evidence also supports that lifestyle modification, including moderate exercises, can help to improve mild-to-moderate depression. Suicide screening at each psychiatric visit can be helpful to lower suicide incidence. Since patients with MDD are at increased risk of suicide, close monitoring, and follow up by mental health workers becomes necessary to ensure safety and compliance with mental health treatment. The involvement of families can further add to a better outcome of the overall mental health treatment. Meta-analyses of randomized trials have shown that depression outcomes are superior when using collaborative care as compared with usual care.
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Do Adverse Experiences Always Result In Depression
Research documents that there is a strong relationship between adverse experience in childhoodsuch as verbal or physical abuse or household dysfunction caused by a mentally ill parentand the lifetime risk of depression. Studies show that verbal abuse more than doubles the lifetime risk of depression. Adverse experiences are a significant source of stress.
But whether they summon resources for successful coping or lead to despair depends in part on the situation and in part on the person. A child facing verbally or physically abusive treatment at home or school who has no means of escaping continuing injury is at elevated risk for developing depression. Situations may not be subject to changebut attitudes, interpretation, and meaning of experience are always under individual control and can confer resistance to depression and other disorders..
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What Is The Outlook For Someone With Major Depressive Disorder
While someone with MDD can feel hopeless at times, its important to remember that the disorder can be treated successfully. There is hope.
To improve your outlook, its critical to stick with your treatment plan. Dont miss therapy sessions or follow-up appointments with your healthcare professional.
Never stop taking your medications unless your therapist or healthcare professional advises you to.
On days when you feel particularly depressed despite treatment, it can be helpful to call a local crisis or mental health service or the National Suicide Prevention Lifeline. Resources are available.
A friendly, supportive voice could be just what you need to get you through a difficult time.
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How Does Childhood Stress Affect Adult Brain Function
Severe or sustained early life adversity shifts the course of brain development and can lastingly impair emotion regulation and cognitive development. Excessive or prolonged activation of the stress response in childhood, studies show, can sensitize the stress response system so that it overresponds to minimal levels of threat, making people feel easily overwhelmed by lifes normal difficulties.
Severe or prolonged childhood adversity can affect the function of genes important for the wiring of the brain, so that emotional control is difficultoverproducing neural connections in regions such as the amygdala that signal threat and other negative emotions while underendowing neural connectivity in brain areas responsible for behavioral control, reasoning, and planning.
Nevertheless, adult brains retain the capacity for neuroplasticity. Although it takes effort, and often the guidance of psychotherapy, people can learn to overcome many of the ill effects of early adversity.
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Can Certain Drugs Cause Depression
In certain people, drugs may lead to depression. For example, medications such as barbiturates, benzodiazepines, and the acne drug isotretinoin have sometimes been linked with depression, especially in older people. Likewise, medications such as corticosteroids, opioids , and anticholinergics taken to relieve stomach cramping can sometimes cause changes and fluctuations in mood. Even blood pressure medications called beta-blockers have been linked to depression.
Personal Vulnerabilities To Depression
As noted earlier, etiological approaches to depression commonly invoke diathesis-stress models, in which stress precipitates depressive reactions among those with particular vulnerabilities. In this section, several nonbiological vulnerabilities are discussed: cognitive, interpersonal, and personality factors. As with biological factors, psychosocial vulnerabilities may contribute to the development of depression and also may be consequences of depressive states in a bidirectional process.
Cognitive Vulnerability to Depression
Considerable research on depression in the past 40 years has focused on three variants of cognitive models of depressionthe classical cognitive triad model of Aaron Beck , the versions of the helplessness/hopelessness cognitive style models of Seligman, Abramson, Alloy, and colleagues , and information-processing perspectives .
The information-processing approach to cognitive vulnerability refers to dysfunctional cognitive processes, such as biases in attention and memory, and overgeneralized thinking style . Such biases may result in selective attention to negative information and reduced access to positive memories, increasing the likelihood of dysphoric reactions to negative events.
Interpersonal Vulnerabilities to Depression
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Biological Explanation Of Depression: Chemical Imbalance
As we mentioned above, neurotransmitters are involved in the communication between neurons, and in depression, we are explicitly focused on serotonin and norepinephrine. That’s not to say other neurotransmitters are not involved in depression for instance, dopamine is also associated with the disorder, but for your exam, we will focus on the first two.
Overall, the theory on neurotransmitters and depression suggests that an imbalance in neurotransmitters in the brain, such as having too much or too little, can cause depression.
Understanding The Biological Causes Of Depression Can Help Us Unlock New Approaches To Treatment
There is still a lot that we dont understand about the biological causes of depression. However, with each breakthrough, we unlock new approaches to treatment. By understanding where depression comes from, we will find greater success in the treatment of each individual patient. At Southern California Sunrise Recovery Center, we stay up to date on the science behind depression. We employ research-based methods of treatment to provide our patients with the best possible tools for recovery. To find out more about what we can do for you, contact us today.
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Are There Risk Factors For Depression
While genetics is believed to confer some susceptibility, there is no single gene or set of genes implicated so far, it appears that a very large number of geneslikely modifiable by diet or behavioreach contributes a very tiny degree of vulnerability that could precipitate depression under conditions of stress. People can also be at risk of depression because of their personality attributes, particularly if they have a tendency to worry a lot, have low self-esteem, are perfectionists, are sensitive to personal criticism, or are self-critical and negative. Of the Big Five personality dimensions, the one most consistently associated with depression susceptibility is the trait of neuroticism. It denotes the degree to which the negative affect system is readily activated. People high in trait neuroticism are inclined to find experiences distressing, to worry, and to doubt themselves disproportionate to the circumstances they are in. In addition, studies indicate that women are at especially high risk for depression after divorce and men are at high risk following following financial, occupational, or legal problems.
What Are The Biological Causes Of Depression
Now that weve explored the many social and environmental factors that contribute to depression, its time to explore the biological causes of depression. The fact that biology isnt the sole cause of depression doesnt mean there arent very real biological factors at play in the disease. The two most important biological factors that influence depression are neuroplasticity and genetics.
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Which People Are At High Risk Of Bipolar I Disorder
Bipolar I disorder may affect almost everyone. This affects around 2.5 per cent of the total United States population or nearly 7 million individuals.
Because when most persons first experience symptoms with bipolar disorder, they are in their late teens or early twenties. Almost everyone who gets bipolar I disorder does it before 50. Individuals with a close family member who has bipolar disorder are at an increased risk.
How Does Lack Of Sleep Alter Brain Function
Disruption of the sleep-wake cycle is one of the hallmarks of depression and is a major source the mood disturbance in major depression. Lack of sleep upsets the bodys circadian clock that orchestrates the natural daily rhythm of most biological functions, including patterns of secretion, release, and activity of many neurochemicals in the brain.
Sleep deprivation is thought to impede the transmission of neural signals. One result is that sleep deprivation makes people emotionally reactive, increasing activity in the amygdala and decreasing it in the emotion regulation center of the prefrontal cortex. Sleep deprivation impairs the brains ability to control negative thoughts.
Mistimed light input resulting from sleep disturbance also disrupts the dopamine-sensitive nucleus accumbens. Studies show that people with mood disorders benefit from maintaining a strict sleep/wake routine, rising in the morning and going to sleep at night at the same time every day.
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Are Women More Susceptible To Depression Than Men
Around the world, women are 1.7 times more likely to develop depression than are men, and the difference in susceptibility emerges in adolescence. Among younger women, the gender gap in depression is even greater, although before puberty, males and females have equal rates of depression. Studies pinpoint social and cultural reasons as well as biological ones.
Women more often experience internalizing symptoms, reflected in physical pain and other somatic complaints, social withdrawal, and self-blame, while men present with externalizing behaviors, reflected in irritability, anger, aggression, and substance use. In addition, childbirth is associated with a particular form of depression susceptibility is thought to be related in part to the rapid hormonal shifts that occur postpartum in combination with the vastly increased demands of new motherhood.
Can Stress Bring On Depression
Studies show that one factor consistently associated with depression is the number and degree of major stresses experienced in life. Poverty, for example, is a significant, enduring stressor, not easily modifiable, highly linked to depression risk. But to a degree still under study, attitude plays a major role in the perception of stress.
Some stress is necessary to keep people alert. It isnt just that situations differ in the degree to which they stress human systems much depends on how people regard some situationssay, taking final exams. People who see stress as a challenge rather than as a plague recruit positive rather than negative emotions. Whats more, they do not experience the harmful effects of stress hormones on body and brain.
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How Does Learned Helplessness Contribute To Depression
Learned helplessness is a state of mind in which people come to believe that they have no way of escaping difficult or painful circumstances and therefore exert no effort to change distressing situations even when it is possible to do so. The resulting passivity can keep people from taking any measures to avoid a problem or to help themselves when one arises, or to seek help from others, compounding their own suffering and precipitating such feelings as hopelessness that are the hallmarks of depression. Because the helplessness is learned, the belief that no action matters can be unlearned part of the cure is also gaining a realistic understanding of what can and cant be controlled in life.
Is Depression Biological Or Psychological
Arguments for both origins of depression, as evidence exists for biological explanations for depression and psychological explanations for depression . Both also offer methods of treatment proven to be effective biological treatments include SSRIs and SNRIs, and psychological therapies include cognitive behavioural therapy .
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Genetic Findings In Major Depression
Studies of variants associated with single genes are mostly equivocal in terms of effect sizes and specificity. For instance, studies of the promoter polymorphism of the serotonin transporter suggest a weak moderating effect on major depression and associated traits and more robust effects on neural endophenotypes that relate to general risk for psychopathology and vulnerability to affective disorders . Conversely, rare coding or gain-or-function mutation in genes such as SERT , monoamine oxidase A and disrupted in schizophrenia implicate single genes in severe major mental illnesses, but the observed phenotypes are complex, mixed and often severe, including combinations of depression, obsessive-compulsive disorder, substance abuse disorders, with aggression, schizoaffective and psychotic features, and in some cases suggesting strong developmental contributions. Together these studies significantly contributed to lowering boundaries between major depression and other categorical psychiatric disorders and provided leads for investigating pathophysiological mechanisms with implications beyond their original areas of investigation .
What Is The Role Of Inflammation In Depression
There is growing evidence that depression gives rise to inflammation and the inflammatory response creates or exacerbates depression. Neuroscientists know that there is lots of crosstalk in the brain between neural circuits and inflammatory pathways. Negative thoughts are a source of psychological pain.
Like all signs of injury, pain mobilizes various immune cells to help subdue the source, and that mobilization creates inflammation. Stress is known to activate an inflammatory response. The presence of inflammatory cells in the brain may be one reason many drug treatments for depression fail they do not target inflammation.
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What Does Brain Imaging Look At In Depression
Some types of brain imaging, such as CT scans and magnetic resonance imaging , take static pictures of the brain to determine whether any specific structures are larger or smaller than normal in depressed patients. Positron emission tomography scans and functional magnetic resonance imaging look at the brain in action, to see whether and where there are problems in the way the brain processes specific types of information.
In fMRI studies, normal controls and depressed patents are typically given some task to perform in the scanner. For example, subjects may be asked to look at a series of pictures, some of them with emotionally disturbing content, to see how the brain handles negative stimuli. The brain scanners measure blood flow or metabolic activity, based on the concentration of agents earlier injected into the bloodstream. Comparison of hot spots and dead spots of activity between controls and depressed patients highlight areas of the brain that malfunction in response to challenging stimuli.
Can Genes For Depression Be Modified
Scientists know that the expression and function of many genes can be altered without doing the near-impossiblemaking any changes to the gene structure itself. Such changes are known as epigenetic modifications. Some life experiences can create vulnerability to depression through epigenetic changes. For example, in rat pups, lack of maternal care can permanently reset the sensitivity of receptors to stress hormones. If their mothers fail to lick and groom them, they grow up to display an exaggerated response to stress hormones and develop depression-like behavior in response to stress.
But there are also ways to strategically induce epigenetic changes to reverse symptoms of depression. For example, the nutritional supplement SAM-e, a synthetic version of a compound found in the body, contains a substance that chemically augments the activation and deactivation of genes. Some studies show it is effective against symptoms of depression.
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How Is Depression Related To Anxiety
Depression and anxiety are considered two faces of the same coin. Both involve brooding over experiencein depression, things that happened in the past in anxiety, things that might happen in the future. Depression is also thought to result from sustained anxiety. More than half of all people with major depression also suffer from persistent anxiety. The two conditions share many symptoms, including insomnia, difficulty concentrating, negative thinking, and loss of appetite. Many treatments that relieve depression also relieve anxiety.
Is Bipolar Disorder Preventable
The reasons for bipolar disease remain unknown. It is unknown if Bipolar I and bipolar II illness may clear themselves in various ways. Completely prevented.
Regular counselling sessions with a neurologist or professional counsellor can assist individuals in identifying contributing factors to mood instability, such as weak medication adherence, lack of sleep, substance or alcoholism, and inadequate stress reduction. Regular medication use may help avoid future manic or depressed symptoms.
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Biology Of Depression Neurotransmitters
Biology of Depression
You may have heard that depression is the result of a simple imbalance of brain chemicals. Although brain chemicals are certainly part of the cause, this explanation is too simplistic. Even just considering the biological dimension of depression, the brain has multiple layers of complexity.
Neurochemistry
Neurotransmitters
The brain uses a number of chemicals as messengers to communicate with other parts of itself and with the nervous system. These chemical messengers, called neurotransmitters, are released and received by the brain’s many nerve cells, which are also called neurons. Neurons are constantly communicating with each other by way of exchanging neurotransmitters. This communication system is essential to all of the brain’s functions.
Depression has been linked to problems or imbalances in the brain with regard to the neurotransmitters serotonin, norepinephrine, and dopamine. The evidence is somewhat indirect on these points because it is very difficult to actually measure the level of neurotransmitter in a person’s brain. What we do know is that antidepressant medications are known to act upon these particular neurotransmitters and their receptors. We’ll talk more about antidepressant medications in the treatment section of this article.
Recently, another neurotransmitter, glutamate, has been implicated in depression as well, but more research is necessary at this time to determine the nature of this relationship.