SOME ATTEMPTS AT EXPLANATION
Biological
Some theories propose that clinical depression in caused by a biological problem. Sleep and eating (vegetative functions) problems are often used as evidence for the biological theories as is the fact that people who are depressed often respond to anti-depressant medication. Recent research made possible by non-invasive techniques (MRI, CAT) have shown that the brains of people experiencing depression show marked variations in the absorption of serotonin and norepinephrine. giving greater credibility to the biological bases for depression. Both the older and newer generations of anti-depressant medications deal directly with these neurotransmitter, often preventing their re-uptake making them more available at the synapses. If, ultimately, depression as we know it turns out to be a "biochemical disorder," the temptation may be to overlook the psychological components that are a part of this illness. Psychological reactions are a part of every illness and need to be addressed if the suffering individual is to be helped.
Psychological: Failure to live up to ideal
Psychological theories have traditionally explained depression as "Anger turned inward against the self." If you fail to live up to some internal standard of who or what you are supposed to be, some internal watchdog notes your failure and begins to let you know that you haven't been all that you could be--depression. People often talk about being angry with themselves because they have not accomplished or achieved or done what they think they should have. This explanation accounts for the diminished self esteem depressed people often report.
Psychological: Problems expressing anger
Often depressed people report having great difficulties expressing any kind of anger. Instead of becoming angry with someone who has provoked them, the anger is turned inward against some part of the self. They don't even kick the cat; they kick themselves. These people have a way of making everything their own fault so that no matter what happens, they can blame themselves. Others talk about anger as a useless emotion, i.e., "What good does getting angry do anyway?" Intellectually, they attempt to convince themselves and others that anger accomplishes nothing so why bother. What they don't realize is that this style drives anger beneath the surface and forces it to find a more indirect avenue for expression.
Psychological: Empathic failures
Depression also seems to be the reaction to empathic failures on the part of others. When important people fail to understand, recognize, acknowledge, appreciate, or respond in a way that we hoped they would, that can be a sufficient injury to produce a depression. It is as if their failure delivers the message that we are not good enough, worthwhile or important. It is a slight to our self esteem and it does not even have to be of major proportions. Some people are more sensitive to this kind of injury because of their personal history, so a small slight may well have the same psychological importance as a major rebuff
Psychological: Reactions to life events
Certain events that occur as a part of life carry depression as a component. Endings, separations. losses, and death elicit strong emotional reactions in those who are experiencing them; depression is often a part. More specifically, divorce, moving to a new place, graduations, the end of a romantic relationship, a good friend moving away, the completion of a major project, the death of a loved one are examples of normal events that can evoke strong, reactive depressions. These depressions are a part of a more global emotional state known as "mourning" when an individual withdraws his energies from other activities and seemingly reinvests them in himself. Loss is experienced as a wound and the individual needs time to heal, to restore his psychic equilibrium. The period following loss is a time of reassessment and revision. Loss requires a new adjustment, a learning to do without whatever has been lost. It is a slow process and often a confusing time as people try to work out how their life is going to be now. Periods of mourning and its attendant depression that stretch beyond three years, however, should be carefully assessed. This otherwise normal process may have taken on some pathological elements.
THE CLINICAL SPECTRUM
Depression runs the gamut from mild to severe and at the severe end of the continuum, it is a profoundly disabling disorder. The more common forms of depression are currently labeled Dysthymia (Depressive Neurosis). A more severe version is considered to be a Major Depression. At the severe end of the continuum are the Bipolar Disorders which are characterized by depression or mania or a combination of both mood states. Milder forms of this disorder are called cyclothymia. Depression may exist with or without psychotic features (markedly impaired reality testing, peculiar or highly idiosyncratic thinking). It may be chronic (of long standing) or episodic (intervening periods of normal moods).
Psychotic depressions are paralyzing, often characterized by complete withdrawal, the absence of speech and the absence of movement. It is as if the person returns to an exclusively vegetative state where only bare existence is maintained. Depressions that reach this level often require hospitalization and are treated with antidepressant medication or electro-convulsive therapy (ECT).
The manic side is quite a different picture. It is characterized by high states of agitation, driven behavior, stream of consciousness thinking, emotionality, a need to be doing something all the time, an exaggerated sense of well being, poor reality testing, poor judgement, and irritability. The person who is in a manic state gives the impression of being incredibly "high" on something. They are uncontainable, off in a million different directions simultaneously. Often, hospitalization and medication is required in order to treat the person. Lithium is often prescribed as the drug of choice since it tends to dampen the manic state and prevent future episodes when taken properly.
It is not uncommon for a person suffering from a bipolar or cyclothymic disorder to move back and forth between depressed and manic positions. Some theorists believe that the manic phase is really a defense against depression. The person is struggling mightily to keep from becoming depressed by maintaining this exaggerated mental and physical activity level. It is also possible for people to show only the depressed side or only the manic side.
In the more moderate range are the depressions that are not so profound but nevertheless painful and troubling to the people who experience them. Hospitalization is seldom required and usually psychotherapy will provide sufficient insight so that there will be relief from the symptoms of depression. It is not unusual to discover that people suffering a moderate depression are also being treated with antidepressant medication. What is important to remember is that talking is often a very important means for the depressed person to find out why he/she is depressed. What are the triggers in his/her life that sets the depression into motion.
. If it works then great if not i have not lost anything. Don't stress i won't come and say i took it and then go off about your crazy theory or anything. Willing to try different things. How long until i see the effect swa? Will it interfere with my current medication?
