What do you think about depression or depressive symptoms? Maybe you think people with depression can benefit from antidepressants and/or psychotherapy. You would be mostly correct since medication often targets the biological causes while therapy addresses the emotional aspects.
As a brief review, clinical depression can affect our daily functioning, including our emotions, thoughts, behaviors, and being able to care for our own basic needs, such as eating and sleeping. Multiple factors contribute to depression, ranging from stressful life events, life stressors, substance abuse, medical conditions, medications, and genetics. If you are interested in learning more about general depression, feel free to click here. In this blog, we will explore more of the biological underpinnings around depression.
Biological Causes of Depression
Current research suggests there are more causes to depression than just not having enough serotonin (Cowen & Browning, 2015). Serotonin has been linked to depression and mood for years now. There are recent studies showing at least three chemical/neurotransmitter pathways in our brain related to depressive symptoms, including serotonin, norepinephrine, and dopamine. Norepinephrine has a role in cognition, motivation, and intellect, which is also important in social relationships and can explain why some folks with depressive symptoms experience difficulty in maintaining/sustaining relationships (Moret & Briley, 2011). Dopamine plays a significant role in anhedonia, i.e., diminished/loss of interest/pleasure, within depression (Belujon & Grace, 2017).
In addition, hormones and stress play significant roles within depression. People with hormonal imbalances due to certain medical conditions, such as hypothyroidism, have a higher risk of experiencing depression (Dayan & Panicker, 2013). Depression has been shown to impact those who have menstrual cycles as well (Padda et al., 2021). Furthermore, chronic stress can negatively affect many areas, including depression (American Psychological Association, 2018).
Inflammation in the brain is a more recent theory behind depression (Felger, 2019). Researchers believe inflammation in the brain can affect the various circuits and neurotransmitters contributing to depressive symptoms as well as decreasing the effectiveness of antidepressants. All in all, there are multiple biological factors impacting depressive symptoms.
Ways to Deal With The Biological Part of Depression
There are many ways to deal with depression. The following are some starting points and not comprehensive.
Engaging in exercise
Exercise has been shown to have many physical and mental health benefits. It can help improve brain functioning, including norepinephrine and serotonin levels (American Psychological Association, 2020; Belvederi Murri et al., 2019; Valim et al., 2013)
Looking into your nutrition
Having a balanced nutritious diet has been shown to be helpful
Researchers found supplements, such as eicosapentaenoic acid (EPA), at certain dosages to be helpful for those with depressive symptoms (Martins, 2009; Sublette, Ellis, Geant, & Mann, 2011)
Consult with your physician or registered dietitian before adding any supplements to your diet
Getting enough sleep is tremendously important for our mental health
Using stress management skills
There are several ways to cope with stress. If you want to read more about or get some ideas on where to start, feel free to click here
Trying out appropriate psychiatric medication
Consult with your medical provider if you are struggling with depressive symptoms and want to try psychiatric medication to help
When it comes to mental health, including depression, there are no simple solutions since the causes/triggers are not simple themselves. We are still discovering new things about depression and why/how it works. If you struggle with depression, we highly recommend you seek professional mental health treatment. Prevention is easier to implement than treating something when it is already severe.
If you are interested in working on your mental health with us, feel free to contact us here for our mental health services.
Stay tuned. The next topic is "Numb is Also a Feeling."
References:
American Psychological Association. (2018, November 1). Stress effects on the body. American Psychological Association. https://www.apa.org/topics/stress/body
American Psychological Association. (2020, March 4). Working out boosts brain health. American Psychological Association. https://www.apa.org/topics/exercise-fitness/stress
Belujon, P., & Grace, A. A. (2017). Dopamine System Dysregulation in Major Depressive Disorders. The international journal of neuropsychopharmacology, 20(12), 1036–1046. https://doi.org/10.1093/ijnp/pyx056
Belvederi Murri, M., Ekkekakis, P., Magagnoli, M., Zampogna, D., Cattedra, S., Capobianco, L., Serafini, G., Calcagno, P., Zanetidou, S., & Amore, M. (2019). Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes. Frontiers in psychiatry, 9, 762. https://doi.org/10.3389/fpsyt.2018.00762
Cowen, P. J., & Browning, M. (2015). What has serotonin to do with depression?. World psychiatry : official journal of the World Psychiatric Association (WPA), 14(2), 158–160. https://doi.org/10.1002/wps.20229
Dayan, C. M., & Panicker, V. (2013). Hypothyroidism and depression. European thyroid journal, 2(3), 168–179. https://doi.org/10.1159/000353777
Felger J. C. (2019). Role of Inflammation in Depression and Treatment Implications. Handbook of experimental pharmacology, 250, 255–286. https://doi.org/10.1007/164_2018_166
Martins J. G. (2009). EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. Journal of the American College of Nutrition, 28(5), 525–542.
Moret, C., & Briley, M. (2011). The importance of norepinephrine in depression. Neuropsychiatric disease and treatment, 7(Suppl 1), 9–13. https://doi.org/10.2147/NDT.S19619
Padda, J., Khalid, K., Hitawala, G., Batra, N., Pokhriyal, S., Mohan, A., Zubair, U., Cooper, A. C., & Jean-Charles, G. (2021). Depression and Its Effect on the Menstrual Cycle. Cureus, 13(7), e16532. https://doi.org/10.7759/cureus.16532
Sublette, M. E., Ellis, S. P., Geant, A. L., & Mann, J. J. (2011). Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. The Journal of clinical psychiatry, 72(12), 1577–1584. https://doi.org/10.4088/JCP.10m06634
Valim, V., Natour, J., Xiao, Y., Pereira, A. F., Lopes, B. B., Pollak, D. F., Zandonade, E., & Russell, I. J. (2013). Effects of physical exercise on serum levels of serotonin and its metabolite in fibromyalgia: a randomized pilot study. Revista brasileira de reumatologia, 53(6), 538–541.
Written by Elena Duong, Psy.D.
Edited by Susanna La, Ph.D.