Depression leads to brain changes lead to depression leads to...

October 1, 2001 3:27 PM

Depression leads to brain changes lead to depression leads to... Augh! Is anyone else aggravated by an article that starts right out by sounding confused?

"Antidepressant therapy may reverse the structural changes that take place in the brain as a result of depression... Researchers are unclear about the exact brain changes that lead to depression..."
posted by Tubes (30 comments total)

What is so confusing? Prolonged depression can and often does produce changes in brain chemistry. Evidently what this particular antidepressant does according to the article is reverse some of the changes to the brain.

There is still a lot we do not know about what causes and what relieves depression, but treatment for it has certainly come a long way, baby.........
posted by bunnyfire at 3:40 PM on October 1, 2001

I don't consider numbing depression with various anti-depressant drugs a good treatment.

Most of the time, depression happens because of stress, personal problems, and a generally crappy life - using drugs just masks the actual causes, in my opinion.

Of course, I don't have scientific data performed on rats to prove to me the true causes of depression. That is obviously much more important than actual human experience...

(er, sorry for ranting a bit. I just get pissed off when people try to find easy answers (drugs) to complicated problems.)
posted by mkn at 3:50 PM on October 1, 2001

Mkn, people take pain relievers if they have, say, a massive burn, not to heal the burn, but to get through that period of excrutiating pain. Same deal with anti-depressants. Because, ultimately, trying to get out of bed is often hard for someone with depression, let alone fixing a crappy life, or dealing with whatever stresses they are under.
posted by Doug at 3:55 PM on October 1, 2001

Most of the time, depression happens because of stress, personal problems, and a generally crappy life - using drugs just masks the actual causes, in my opinion.

Its normal to experience depression after the reasons you cited but what we're talking about here is major/clinical depression: months on end of depression for no apparent reason.

The actual causes in clinical depression are not well known and popular theories have to do with brain structure and neurotransmitters. If anti-depressants worked like in the way you suggest then they would be the drug of choice for recreation. Instead they take weeks and even months to even feel an effect and that effect isn't bliss its an attempt at normalizing so that thoughts of helplessness, suicide, etc go away and the patient can go on with her life.

I just get pissed off when people try to find easy answers (drugs) to complicated problems.)

There is no easy way out of major depression. Maybe now you won't feel so pissed and develop sympathy for the mentally ill.
posted by skallas at 4:10 PM on October 1, 2001

As a bipolar depressive who depends on these medications in order to have a life, i would like you all to understand that the kind of depressions we are referring to here are caused by defective brain chemistry. People with these disorders have a higher death rate than those with heart disease(because of suicide). Because I want to live, I take my meds. And frankly I am sick and tired of people who want to call my legitimate medical treatment an "easy answer". It would be easier and cheaper not to take my meds but it would be horribly selfish because of what my family would have to deal with. As it stands now they have a functioning wife and mom who can work full time and has time for church and family activities as well, instead of a crying zombie in the corner.
If there are people with emotional head colds medicating themselves, big hairy deal.
posted by bunnyfire at 4:25 PM on October 1, 2001

My experience with antidepressants and situational depression was that the drugs allowed me to see my problems as soluble, which is the first step to solving them. Once I solved the problems, of course, I didn't need the drugs anymore.

Yeah, sure it was a crutch. But when you have a broken leg, you don't refuse the crutch merely because it's a crutch. You use it for its intended purpose until you're healed.
posted by kindall at 4:39 PM on October 1, 2001

This is a topic that MeFi has been really good at exploring: it's well worth digging out earlier threads.

Is anyone else aggravated by an article that starts right out by sounding confused?

Not really, you'd be surprised to know. I've read medical treatises from the 1720s that say much the same thing: that mental actions have physical reactions that have mental re-reactions and so on. And modern neuroscience isn't that much the wiser.
posted by holgate at 4:43 PM on October 1, 2001

i know this thread isn't the best particular place to start a more personal discussion about clinical depression, so i'll simply ask: does anybody know of any good online resources (message boards, support groups, medical info) that deal with the topic? i've been on and off zoloft in the past year and lately i feel like it's all reaching that same old hysterical pitch again. most of the online resources i've discovered are hit-or-miss in their usefulness. any hidden gems out there?
posted by damn yankee at 4:56 PM on October 1, 2001

but treatment for it has certainly come a long way, baby.........

I suppose you'd call that "better living through chemistry"
posted by eyere at 5:00 PM on October 1, 2001

damn yankee, try usenet. I think the alt.support hierarchy is pretty active. Try alt.support.depression.

Wow, the on-line spellchecker doesn't consider usenet a word.
posted by skallas at 5:17 PM on October 1, 2001

(er, sorry for ranting a bit. I just get pissed off when people try to find easy answers (drugs) to complicated problems.)

I had this rather lengthy explanation all written out and ready to post on clinical depression (and other mental illnesses in general) and how medicating a serious, legitimate illness isn't "taking the easy way out" by any means-- then I realized that mkn's comment was a rather obvious troll. Either a troll, or simply ignorant. So instead, I'll just say:

Try actually doing research on a sickness before you condemn the people who have it for trying to help themselves.
posted by precocious at 5:41 PM on October 1, 2001

I wish everyone who complained about depression and other such could get to experience them. I had a drug-induced case of depression, pretty mild. I only noticed something was wrong, when my life was going great, and I still felt bad, I still felt like I wanted to die, and I realized that something was wrong.

I would be just sitting calmly, and realize that I was thinking of various ways to kill myself. It was almost like mind was thinking without me. Ever since all that happened to me, I've been a lot more openminded. You don't realize how really BAD it is, until you go through it.
posted by stoneegg21 at 6:04 PM on October 1, 2001

Bunnyfire has it exactly right: This article is talking about major clinical depression, which is a medical condition, and something essentially different from simply "feeling blue."

When I was beginning my junior year in college, I plunged into what I came to learn was a major clinical depression. I couldn't concentrate; you know that feeling when you're taking a test, and your mind begins to drift off, and your eyes pass over a question without taking anything in, so you have to re-read it? Well, that's what would happen any time I tried to read anything during that period, until my newly prescribed antidepressant medication began taking effect (which was about 3-4 weeks from the time I started taking it; needless to say, that semester was kind of a wash).

And that was only one of several classic symptoms I experienced, including sleeplessness, lack of appetite, daydreams that were more real and hallucinatory than anything I've experienced before or since, etc.

The docs still don't know much about what causes or cures clinical depression; just through experimentation, they've found that certain substances seem to have a positive effect, but can't really explain why. The best lay explanation I was given is that in a clinical depression, some of the synapses in your brain just decide, for reasons we don't know, to shut down for awhile; it's like they sit out a few plays on the bench along the sidelines. Certain medications help to reactivate those "lazy" synapses, and/or make the most of the ones that are still "in the game."

The result: merely a return to "normal" functioning. The pills don't make you feel happy, or dull your pain; they just enable you to return to (or close to) the level of functionality you were at before the depression began. That's the plan, and that's certainly what happened in my experience.

I had no understanding of or real compassion for mentally ill people before this happened to me; I sure do now. Like a lot of things in life, it had to touch me personally for me to really appreciate what it was about -- so I understand why a lot of people don't have a better appreciation of it than they do. But there's been major media coverage in popular, large-readership publications over the last couple decades about mental illness in the US, and the (what I'd like to think of as) more enlightened folks who follow MeFi should really know better than to confuse "feeling blue" (a passing emotional state) with "clinical depression" (the medical condition).
posted by verdezza at 6:13 PM on October 1, 2001

My grandmother has clinical depression.

I went to my friend's church once when I was staying at her house. The sermon (accompanied with a nice little Power Point presentation) told us that depression is really a symptom. Of not being truly saved. If you are, presumably, you would not have mental problems.

I did not tell this to my grandmother. She has been held back by having this belief engrained in her anyway. Obviously the guilt and sense of inferiority only exacerbates the condition, leading into one of those vicious circle thingies.


On the other hand, my mother told me once that, because I was not perky like Meg Ryan, I should be medicated.

She had cheated on my father, left him without any real cause to live with this guy. I had to spend my weekends with them and my grandmother. And my mother always yelling at me about stupid shit. And basically leading a crappy jr. high experience.

I'm glad my father had enough sense not to let me be drugged up for being an adolescent going through a bad time in her life.
posted by dagnyscott at 6:49 PM on October 1, 2001

Sorry if I seem like a troll, but as I said, I was speaking from experience. I was making a general statement, and I do know that there are severe clinical cases that do require treatment, but the majority of cases are not like that.

Try actually doing research on a sickness before you condemn the people who have it for trying to help themselves.

Personal experience is all the research I need. I've had it for years, I think I'm still recovering - I have constant troubles with sleeplessness, appetite, focus, and just general blahs.

But I don't think drugs are the answer in anyway. As mentioned above, "better living through chemistry" is not my idea of better living.

I think that both patients and prescribers are too eager to rely on drugs. Feeling blue? Take this. Can't sleep? Take this. Can't pay attention? Take this. Child too hyper? Give them this.

I guess easier do deal with drugs than actual problems, or just talking to people...
posted by mkn at 6:49 PM on October 1, 2001

That should be:

I guess it's easier to deal with drugs than with actual problems, or just talking to people that can help...
posted by mkn at 6:51 PM on October 1, 2001

actually....

but treatment for it has certainly come a long way, baby.........

I suppose you'd call that "better living through chemistry"

was a (possibly in poor taste) pun on two Fatboy Slim album names
posted by eyere at 7:02 PM on October 1, 2001

I just finished reading a really good book if you are looking to get an in depth study into depression, it's really up to date and filled with personal stories as well as clinical info. Current medications definitely save lives, but I do think too little talk therapy as well as overmedication in mild cases are problems.
posted by chrismc at 7:07 PM on October 1, 2001

And a 'p.s.' to those in recovery from this debilitating affliction (i.e. using Prozac, etc...)
Tell your partner! Even if it's a fairly new relationship, tell them. (What?? No, I have no personal experience with this, why do you ask?)
posted by BlueScreen at 8:16 PM on October 1, 2001

Another aspect to consider in the drug v. no drug vein:
The majority of insurance companies offer little to no coverage for psychological counseling, but they will cover a visit to a physician and (if appropriate) an antidepressant prescription said physician writes.

Some people utilize what few options are available to them.
posted by sillygit at 8:34 PM on October 1, 2001

As yet another afflicted by depression I'd like to agree with chrismc - the drugs allow you to function while the therapy teaches you how to stop thinking that way (personal choice, Cognitive Therapy, but whatever works for you ...)

Incidentally - the drugs (paxil in my case) let me continue working and generally functioning through a hard time. If I had not had access to them I suspect my marriage would have failed and for a fact I know I would have lost my job.

No food for the kids, no money for the mortgage, but I wouldn't have been using a chemical crutch would I?

So I guess I would have been a more worthy person?
posted by thatwhichfalls at 8:56 PM on October 1, 2001

If you've never experienced the ravages of depression (or anxiety disorder, obsessive compulsive disorder, or similar condition) you've no right to weigh in with platitudes about the treatment plans people choose to follow.

The decision to persue a course of medication is not an easy one - it means admitting that there's something seriously wrong. Don't for a second think that there are people who want to be medicated.
posted by aladfar at 9:21 PM on October 1, 2001

I guess it's easier to deal with drugs than with actual problems, or just talking to people that can help...

Well, yes, it's easier. That's the whole point of not living in caves, isn't it? It's not as if suffering is inherently noble or anything. I know of no evidence that working through a depression without drugs will somehow make you a better person or improve your character compared to the person who took the "easy" way out.

Modern medicine lowers you a ladder, and you insist on scrabbling up the walls of your pit of despair with your raw, bloody hands? Fine, your choice. I think you're a bit of a masochist, but then, there are some people who won't take an aspirin for their headaches, and I don't understand them, either. Hell, I sometimes feel like I don't understand 99% of the people on the planet, which is part of the reason I was depressed. But I digress. I took the offered ladder and do not regret it, and most of the people who make the same choice feel the same way.
posted by kindall at 9:54 PM on October 1, 2001

Actually usenet is worse than useless-been there and was up to my ears in trolls. Better to go to About.com-they have excellent forums plus all kinds of articles and links to useful info. That is definitely the first place I would send anyone to.
posted by bunnyfire at 3:01 AM on October 2, 2001

If you've never experienced the ravages of depression (or anxiety disorder, obsessive compulsive disorder, or similar condition) you've no right to weigh in with platitudes about the treatment plans people choose to follow.

I don't like that line of thinking, because it implies that direct experience is the only way to understand another person's point of view, and that's a little too close to solipsism for comfort. I agree that it gets tiresome listening to people go on with their oh-so-earnest uninformed bletchery, and I want to shake them sometimes and yell If it was so bloody easy don't you think people would DO it? ....

-Mars
posted by Mars Saxman at 8:06 AM on October 2, 2001

It would just be nice if people had some experience. If they don't have the disease, maybe if they knew someone who did, such as a friend or family member, or just get to talk to someone who did. Perhaps even a video or a book might work. It's hard to see how something really affects a person until you can see it yourself.

Initially, you almost think they're faking it, that it can't be that bad. It's only after experience you realize how bad it is. I watched a video of a schizophrenic with hallucinations. It was really hard to tell, he looked and talked perfectly normal. Until the interviewer asked him about his hallucinations, and he started talking about what his hallucinations wanted him to do.
posted by stoneegg21 at 2:26 PM on October 2, 2001

This thread has degenerated into the same old diisputations about depression and its treatment and, in so doing, misses the point of the research report in the link that started it. The pendulum has always swung between the life-experience-causes-brain-changes and the brain-changes-cause-depression poles (ignoring for a moment those who, hopelessly, cling to the it's-got-nothing-to-do-with-chemistry position). Be cynical about whether it's meaningful if you like, but make no mistake about it -- neuroscience *does* know much more now than in previous iterations of the dialectic -- recent research is clarifying the neruochemical mechanisms contributing to dysfunctional brain changes caused by stress in areas like the hippocampus, and the way in which, on an intracellular level, the changes brought about by antidepressants -- not just one agent, as someone asserted above, but the SSRI class of modern antidepressants as a whole -- are neuroprotective and neuroreparative. -- Eliot Gelwan MD
posted by emg at 8:36 PM on October 3, 2001