Debunking Brain myths: Depression is not a physical illness. True or False?

Smart AgingDepression is both a physical and a mental illness. It has significant physical consequences.

It is a devastating illness that not only affects peoples’ ability to participate in everyday life but also robs them of the desire and the will to do so. “Depression causes people to develop a negative view of themselves, the world and the future,” notes Janet Murchison, occupational therapist in the Mood and Related Disorders Clinic at Baycrest. “It is doubly cruel in that it often goes unrecognized as a real illness and people are told to ‘snap out of it.’

No one would tell someone with a broken leg to run a marathon and yet the stigma of mental illness often results in people being expected to get on with their lives despite the fact that they are suffering.”

Although it has been known for a long time that there are biological links, the exact causes of depression are still not known. For example, scientists know that there are changes in brain chemicals in people with depression. There also appear to be genetic links as depression is more common in people who have a family member with the illness. Another theory is that depression is linked to hormonal changes.

New technologies used in research, such as functional magnetic resonance imaging (fMRI,) allow scientists to actually see the difference between the brain of someone who is depressed and someone who is not. In people who are depressed there is decreased activity in some areas of the brain and increased activity in others.

Depression, however, is not a normal part of aging. Clinical depression is not the same as feeling sad or blue. People who are depressed suffer from a combination of:

  • lack of energy;
  • decreased motivation;
  • poor concentration;
  • changes in sleep and appetite;
  • feelings of sadness, worthlessness, helplessness and hopelessness

These are real changes, not imaginary, says Murchison.

An interaction of many factors

Scientists believe that depression is probably an interaction of biology, genetics, environment and psychosocial factors, such as response to loss and lifestyle. These same factors affect disorders such as heart disease and diabetes. Although these are biological conditions, they are also affected by stress, environment and lifestyle, and are managed through lifestyle changes, psychotherapies as well as medication.

“The same with depression,” says Murchison. “There are several things that we can do to help influence a positive outcome for people with depression. Having a balanced routine, which includes staying active, eating nutritiously and getting good sleep are important for anyone under stress. For a depressed person, it is even more important because symptoms like lack of energy, decreased appetite, and poor motivation disrupt routines that can then make the illness worse.

Treatment for depression includes medications, which can help address the different aspects of brain chemistry as well as behavioural and psychological therapies which look at how behaviours, thoughts and feelings are contributing to the illness and affecting the person’s day to day life.”

Imaging technology makes it possible to take pictures of the brain while people are thinking or processing information. These images reveal that depressed people process information differently.

“This validates that what people are experiencing is not a character flaw and not something that someone can simply ‘snap out of’ but it has a real biological underpinning,” explains Murchison.

“It’s a matter of getting good treatment. There are many different components to what the treatment can look like.”

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