Understanding depression: What you need to know about an afflicted loved one

Updated on:30 November 2019, 16:19pm IST
Depression is not just sadness and you can’t just snap out it. Here, we explain how depression actually affects the body and mind.
Dr Shyam Bhat
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depression symptoms
Depression is not a choice made by the sufferer. Image courtesy: Shutterstock

Despite the widespread prevalence of depression, there continues to be a lack of awareness about it globally. One of the most common misunderstandings is to equate clinical depression with sadness. People with depression are therefore advised to “cheer up” and “look at the bright side of it” or even to “stop feeling depressed because there is no reason to feel sad.”

Depression is not a choice made by the sufferer. Neither does it happen due to lack of will, weakness, or a bad attitude.

Understanding what depression does to your loved one…
The sadness experienced by those suffering from clinical depression is as biological as it is psychological–brain functioning is altered, and there is dysfunction of multiple organ systems including the endocrine system and immune system.

While self-help strategies can be helpful (such as exercise, yoga, meditation) especially for milder forms of depression–professional help is often required, since treatment may also require psychotherapy or medicines.

The challenge with recognizing clinical depression is that it can appear quite like commonplace stress.

Indeed, the first episode of clinical depression often arises in the context of a stressful life event.

However when the emotional anguish stays on far beyond the life event, then professional help is required. If someone is suffering from depression, they will feel worse when they are told: “just get over it” or “forget about what is bothering you,” or “just think positively”. This is similar to telling someone with a broken bone that they must just forget about the pain and run.

The emotional pain of depression cannot be changed by mere will. And telling someone suffering from depression to try harder, only worsens their sense of guilt, shame and loneliness.

It is important for people to understand that depression is curable and that treatment often involves a combination of different approaches.

For the milder forms of depression, lifestyle changes such as healthier eating, exercise, meditation, and talk therapy are highly effective. For moderate to severe cases, medicines are often also required to treat the condition.

This is how depression impacts the body
The brain is the seat of our emotions and research has shown several changes that occur in the brain in clinical depression. This includes decreased activity in areas of the brain that are responsible for motivation and energy, memory, and increased activity in centers of the brain that generate fear, and altered functioning in areas that regulate sleep, appetite and the hormones of the body.

depression affects the brain
The brain undergoes a lot of changes in cases of clinical depression

Furthermore, research shows that depression is associated with alterations in the immune system’s functioning, an increase in inflammatory hormones in the body, and widespread alteration of the nervous system. Depression can and does, affect all the parts of the body, and these changes are just as real as any physical illness.

Deep within the brain, depression causes atrophy of nerves in areas such as the hippocampus–the nerve cells begin to decrease in size and number. Fortunately, the brain like the rest of our body has the capacity to recover and heal, and successful antidepressant treatment has been shown to result in regeneration of nerve cells and a restoration of healthy functioning of the brain.

Many people fear medicines for mental health. Antidepressant medications commonly used are called SSRIs (selective serotonin reuptake inhibitors), and they do not have significant side effects.

They are not “happy pills” in that they do not boost the mood or mask the sadness.

Rather they restore normal brain functioning so that a person is free of the pathological state of depression and is able to return to normal functioning.

A specialist can help understand what course of treatment is required, however, the first step is to identify and acknowledge the issue and seek help. Family and friends must also be supportive and provide an enabling environment wherein the person can come out and talk openly about what is bothering them.

In conclusion
Depression and other mental disorders are the biggest health care challenge facing our society, indeed our world. It is predicted to be the number one cause of death and disability by the year 2030.

We cannot afford to ignore the issue any longer. We cannot be ashamed or uninformed. We must become aware and use this knowledge to empower ourselves and others.

The stigma must first be addressed at every level–individuals, families, care providers, policymakers, organizations, doctors.

Together, empowered with awareness and free of stigma, we can beat this epidemic, and live happier, healthier lives.

Dr Shyam Bhat Dr Shyam Bhat

Dr Shyam Bhat is a trustee of The Live Love Laugh Foundation, and a Psychiatrist, Integrative Medicine specialist and writer. Dr Bhat has a rare combination of postgraduate training and American Board certifications in two specialities – Psychiatry (American Board of Psychiatry and Neurology) and Internal Medicine (American Board of Internal Medicine)