rebeccmeister | Some Lessons on Depression

I want to tell you a few things I've learned about depression over the years - most of this came from experiences as an undergraduate, in my psychology classes and from some personal experiences. So - big caveat - none of this is professional knowledge, treat it all as anecdotal information. It has just been on my mind recently.

A good friend of mine experienced severe depression during her freshman year of college, to the point where she needed professional help to address suicidal thoughts and the like. She was fortunate enough to get such help, and I will always admire her strength of character in terms of her frankness in talking about what she went through as she dealt with it. She described it as an absolutely overwhelming feeling of despair - even though she can now objectively reason that the despair was irrational, she said that at the time it felt insurmountable and neverending. When a person is in a hole that deep and dark and black, the person's "objective" experience of reality is that there is no way out. Looking back on that period, she can recognize the state that she was in, and recognize that she's in a completely different mental state now. A pretty amazing and fortunate transformation.

I never took a full clinical psychology course, but have generally been interested in learning about different methods that can be used to treat psychological disorders, as I have met many people who have suffered from different kinds of disorders. Let me give you the definition that I was given for what constitutes a psychological disorder, in general. In her introduction to her lectures on Abnormal Psychology, our Introductory Psych professor said that as we went over descriptions of psychological disorders, we psych students would probably all wind up self-diagnosing with at least one of the disorders we were learning about. [You know, bipolar disorder, schizophrenia, obsessive-compulsive disorder, you name it...] The critical points to remember, she said, were that (a) everyone is a little weird and different, and thus we all have our own individual tendencies towards different disorders, and (b) the thing that distinguishes this weirdness from an actual psychological disorder is that a person with a disorder is affected to the point where they are no longer able to function in their everyday life. [I am grateful to this professor for doing an excellent job of clearly laying out the situation, by the way.]

Anyway, to return to depression, and the subject of treating different psychological disorders. I got into the study of psychology because of an intellectual fascination with psychoactive substances - how is it that different chemicals can exert such powerful influences on the brain and human behavior? As with other types of illness, there's a tendency to want to treat psychological disorders with drugs. Big Pharma sure likes it. The weird thing is, in some cases, a particular drug "works" for treating a psychological disorder, but we don't have the foggiest idea as to why. The classic example of this is the use of lithium to treat bipolar disorder. Why it smooths out the highs and lows, we don't know. But it seems to work in many cases. In other cases, drugs don't exactly work, or they have pretty severe side effects, which can make the treatment of a disorder a very frustrating process. And meanwhile, sometimes completely drug-free intervention methods work as well as, or better than, drug-based intervention.

Clinical depression can sometimes be treated with prescription drugs, but it can also sometimes be treated with other things, such as cognitive behavioral therapy and exercise. [Oh, and sometimes (but not always) the body is resilient, and so there could be natural recovery cycles at play, too.] Cognitive behavioral therapy is a lot like it sounds - almost literally thinking oneself out of one's state of depression. I don't think it's very easy to do, though, which is why people usually require the help of a therapist, like the friend I've described, above. And therapists are much more expensive than drugs. So...most people get the drugs instead of therapy.

Here's one final anecdote: people interested in studying the physical underpinnings of depression use a variety of techniques to assess the conditions of a depressed person's brain. One such method is to examine and compare fMRI's of the brains of people who are "normal" (aka weird) to people who are depressed. One day, a neuropsychologist was testing out his fMRI equipment on a technician, getting some baseline measurements. At some point during the test, as he was chatting with the person in the fMRI, the topic of that person's very recent breakup with his/her significant other came up. Over the course of the test, that person's fMRI scan changed from the scan of a "normal" (weird) person to the scan of a depressed person. Now, ethical standards within the field of psychology dictate that one cannot engage in psychological research that has the potential to cause harm to participants. So, we can't really run around and make people depressed and then measure the resulting effects on their brains. Still, the evidence from this one case is pretty suggestive in some interesting ways. Anecdotes like this one are often as close as we can get to understanding some of these things without causing unnecessary harm.

Anyway, I often find myself thinking about these things as I go through my own life and deal with my own struggles in my own way.