Depressive symptoms are common in over 30% of women and 20% of men. Anxiety is seen in over 20% of men and women. Heritability for depression is around 40%, meaning that it often travels in families. Of those with depression, roughly 60% also have anxiety. Depression can range from melancholy moods to compulsive suicidal behavior. Anxiety can range from jitteriness to a crippling anxiety that prevents a person from performing normal life functions.
Depression and anxiety are the leading causes of disability worldwide . Within work environments, depression and anxiety have been associated with decreased productivity for employees through absenteeism, presenteeism, increased disability leave, or sick leave [2-4]. Although effective psychological treatments for depression and anxiety exist, they are difficult to access for many individuals [5,6]. Approximately half of the individuals meeting criteria for major depressive disorder in a given year remain untreated or under-treated . __ Journal of Medical Internet Research
The debilitating scourge of depression and anxiety will affect hundreds of millions over their lifetimes around the world. It shows no sign of slowing down. In fact, in the age of social media and continuous at-the-fingertip-news, these crippling curses have never been more prevalent.
The Chemical Imbalance Theory
These days, everybody wants an instant cure for the thing that they imagine ails them. And when that cure puts them into an even worse place, they want an instant cure for the previous cure!
When I was in graduate school I thought the chemical imbalance theory was true. So when I reviewed a wide range of potential risk factors for depression, I expected to find many studies confirming the link between depression and low serotonin. I was in for a shock. It turned out there was no good evidence for the chemical imbalance theory. What had seemed like solid science was in fact unsupported by research.
Nevertheless, this explanation infused our collective understanding of depression and other psychiatric conditions, so much so that it’s still widely believed. __ https://www.psychologytoday.com/us/blog/think-act-be/201705/what-is-the-best-way-treat-depression
Drug companies were quick to take advantage of the popular demand for quick cures, and have produced a wide range of antidepressants and anti-anxiety medications. But these
quack quick cures don’t always work, and sometimes they cripple or even kill.
Even though some pharmacological interventions show little efficacy, and even though Xanax, an addictive and destructive benzodiazepine that only showed short-term (four weeks) efficacy in clinical trials, is being prescribed for many months and years, doctors continue to use the language of clinical neuroscience to describe mental health issues. If chemistry is the problem, people will turn to chemistry for the solution.
Perhaps we should, as psychiatrist Dean Schuyler writes in a 1974 book, recognize that most depressive episodes “will run their course and terminate with virtually complete recovery without specific intervention.” The problem is that idea isn’t profitable. As long as the gatekeepers continue to use the language of chemical imbalances to describe what for many is just an episodic case of the “blahs,” we’ll continue creating more problems than we solve. __ Source
Here are some other thoughts on underlying causes of depression/anxiety:
Researchers have found that mitochondria are often anchored at key positions within neurons, such as near the synapses, apparently to help their function. Mitochondrial effects might also be exerted through the brain’s non-neuronal glial cells, such as the oligodendrocytes that sheath neurons in myelin and the astrocytes that support neurons’ health. Neurons sometimes eliminate damaged mitochondria by passing them to astrocytes, and astrocytes send them healthy mitochondria. If stress disrupts any of these processes in brain areas such as the nucleus accumbens, it could have an impact on anxiety [ed: and depressive] disorders.
Convergent evidence indicates that neuroplastic mechanisms involving BDNF are deleteriously altered in major depressive disorder (MDD) and animal models of stress. Herein, clinical and preclinical evidence provided that stress-induced depressive pathology contributes to altered BDNF level and function in persons with MDD and, thereby, disruptions in neuroplasticity at the regional and circuit level. Conversely, effective therapeutics that mitigate depressive-related symptoms (e.g., antidepressants and physical activity) optimize BDNF in key brain regions, promote neuronal health and recovery of function in MDD-related circuits, and enhance pharmacotherapeutic response. A greater knowledge of the interrelationship between BDNF, depression, therapeutic mechanisms of action, and neuroplasticity is important as it necessarily precedes the derivation and deployment of more efficacious treatments.
And Much More
Researchers know that if depression runs in your family, you have a higher chance of becoming depressed. But genetics don’t fully explain why clinical depression occurs.
Women are about twice as likely as men to become depressed. No one’s sure why. The hormonal changes that women go through at different times of their lives may play a role.
People who are elderly are at higher risk of depression. That can be compounded by other factors, such as living alone and having a lack of social support.
Chronic and disabling medical conditions that may have no cure can raise your risk of becoming depressed. __ Source
Stressful life situations of either a physical or emotional nature — particularly if intense and over a prolonged time period or at a vulnerable period of life — can leave lasting marks on a person’s brain which can be difficult to heal.
It should be pointed out when a society is constantly at war — or if the society is made to feel constantly on a war-like footing — anxiety and depression are more common. Politicians, journalists, priests, and professors are often guilty of perpetuating large-scale hysteria among the easily influenced.
Dealing With Depression and Anxiety
This is the conventional approach, which provides at least partial and temporary benefit for most people:
Depression is a complex disorder. Most clinicians practicing today believe it’s caused by a combination of biological (including genetics and bacterial), social, and psychological factors. A treatment approach that focuses exclusively on one of these factors is not likely to be as beneficial as a treatment approach that addresses both psychological and biological aspects (through, for example, psychotherapy and medication). In fact, the combination of psychotherapy and medication may provide the quickest, strongest results. __ https://psychcentral.com/depression/depression-treatment/
Of all antidepressants, the Selective Serotonin Reuptake Inhibitors (SSRIs) are the most popular. Of all psychotherapies for depression, cognitive behavioral therapy (CBT) is generally the best studied. CBT has proven effective, and can even be given online.
Psychotherapy and medication are the conventional approaches. And they often work. But often, they do not. What are some other approaches?
Electroconvulsive therapy is the best studied brain stimulation therapy and has the longest history of use. Other stimulation therapies discussed here are newer, and in some cases still experimental methods. These include:
- vagus nerve stimulation (VNS)
- repetitive transcranial magnetic stimulation (rTMS)
- magnetic seizure therapy (MST)
- deep brain stimulation (DBS)
Transcranial electric current treatments (usually DC, but sometimes AC) have also been used on an experimental basis.
We Live in an Age of Anxiety and Depression
Being at the constant beck and call of the self-interested rantings and pronouncements of unscrupulous journalists, politicians, professors, and other vested interests makes us more vulnerable to anxiety and depression.
1. Get in a routine. If you’re depressed, you need a routine, says Ian Cook, MD. He’s a psychiatrist and director of the Depression Research and Clinic Program at UCLA.
Depression can strip away the structure from your life. One day melts into the next. Setting a gentle daily schedule can help you get back on track.
2.Set goals. When you’re depressed, you may feel like you can’t accomplish anything. That makes you feel worse about yourself. To push back, set daily goals for yourself.
“Start very small,” Cook says. “Make your goal something that you can succeed at, like doing the dishes every other day.”
As you start to feel better, you can add more challenging daily goals.
3. Exercise. It temporarily boosts feel-good chemicals called endorphins. It may also have long-term benefits for people with depression. Regular exercise seems to encourage the brain to rewire itself in positive ways, Cook says.
How much exercise do you need? You don’t need to run marathons to get a benefit. Just walking a few times a week can help.
4. Eat healthy. There is no magic diet that fixes depression. It’s a good idea to watch what you eat, though. If depression tends to make you overeat, getting in control of your eating will help you feel better.
Although nothing is definitive, Cook says there’s evidence that foods with omega-3 fatty acids (such as salmon and tuna) and folic acid (such as spinach and avocado) could help ease depression.
5. Get enough sleep. Depression can make it hard to get enough shut-eye, and too little sleep can make depression worse.
What can you do? Start by making some changes to your lifestyle. Go to bed and get up at the same time every day. Try not to nap. Take all the distractions out of your bedroom — no computer and no TV. In time, you may find your sleep improves.
6. Take on responsibilities. When you’re depressed, you may want to pull back from life and give up your responsibilities at home and at work. Don’t. Staying involved and having daily responsibilities can help you maintain a lifestyle that can help counter depression. They ground you and give you a sense of accomplishment.
If you’re not up to full-time school or work, that’s fine. Think about part-time. If that seems like too much, consider volunteer work.
7. Challenge negative thoughts. In your fight against depression, a lot of the work is mental — changing how you think. When you’re depressed, you leap to the worst possible conclusions.
The next time you’re feeling terrible about yourself, use logic as a natural depression treatment. You might feel like no one likes you, but is there real evidence for that? You might feel like the most worthless person on the planet, but is that really likely? It takes practice, but in time you can beat back those negative thoughts before they get out of control.
8. Check with your doctor before using supplements. “There’s promising evidence for certain supplements for depression,” Cook says. Those include fish oil, folic acid, and SAMe. But more research needs to be done before we’ll know for sure. Always check with your doctor before starting any supplement, especially if you’re already taking medications.
9. Do something new. When you’re depressed, you’re in a rut. Push yourself to do something different. Go to a museum. Pick up a used book and read it on a park bench. Volunteer at a soup kitchen. Take a language class.
“When we challenge ourselves to do something different, there are chemical changes in the brain,” Cook says. “Trying something new alters the levels of [the brain chemical] dopamine, which is associated with pleasure, enjoyment, and learning.”
10. Try to have fun. If you’re depressed, make time for things you enjoy. What if nothing seems fun anymore? “That’s just a symptom of depression,” Cook says. You have to keep trying anyway.
There is such a thing as an “antidepressant lifestyle,” which provides a natural resistance to depressing and anxiety-provoking thoughts. It amounts to taking on enough good habits of thinking and behavior to overwhelm the many bad habits of thinking and behavior which keep trying to take over our lives.
Parents of young children should be careful not to assume that their children will thrive under the same conditions under which they themselves feel good — or under which they themselves grew up. Each child is a unique individual, with his or her own needs that can have little or nothing to do with what the parent thinks they need. Giving the child a broad range of good options to discover the things that makes them genuinely thrive, is the mark of a wise parent.
Better to help the child find his or her own way as early in life as possible, instilling solid habits of competence and achievement each step of the way.