Depression

Depression is a mental health disorder that affects millions of people worldwide. Despite being quite common, depression is often misunderstood and mischaracterized, leading to negative attitudes towards those experiencing it. 


Depression is not just a fleeting feeling of sadness or disappointment; it's a persistent feeling of hopelessness and despair that affects one's ability to function in daily life. Depression affects our mood, thoughts, and behavior, and can manifest in various forms, including major depressive disorder, bipolar disorder, and seasonal affective disorder.
Depression is caused by a combination of biological, environmental, and psychological factors. One area of the brain that is particularly important in depression is the prefrontal cortex, which regulates our emotions, impulses, and self-control. Studies have shown that people with depression have a smaller prefrontal cortex than those who do not, leading to difficulties in regulating their emotions.


The amygdala is another brain area involved in depression, which is responsible for processing emotions such as fear, stress, and anxiety. In people with depression, the amygdala is often hyperactive, leading to a heightened response to negative stimuli and amplified emotional reactivity.


Moreover, the autonomic nervous system (ANS), a crucial controller of internal physiological processes, also plays a pivotal role in depression. Polyvagal Theory, proposed by Stephen Porges, provides a physiological explanation of how the ANS responds to stress and forms our social engagement behaviors. The theory delineates three evolutionary stages of the nervous system, each with its unique set of adaptive behaviors and physiological responses. This framework can help us understand the mechanisms underlying depression.
Firstly, the ventral vagal complex (VVC), a part of the parasympathetic nervous system, controls social engagement and emotion regulation. In depression, the VVC's function may be impaired, leading to difficulties in regulating emotions, as we see with a smaller prefrontal cortex.


Secondly, the sympathetic nervous system, which prepares us for 'fight or flight', might align with the hyperactivity seen in the amygdala of those with depression. This heightened state of alertness could exacerbate feelings of stress, fear, and anxiety.
Lastly, the dorsal vagal complex (DVC), which controls 'freeze' responses, may also play a part. The DVC induces feelings of hopelessness and despair, hallmarks of depression, when a person perceives threat and social engagement and 'fight or flight' mechanisms are unsuccessful. 


In this context, we can envisage how the interplay between these neural circuits could contribute to the physiological underpinnings of depression. It underscores the need for approaches that help regulate the ANS and improve emotional and physiological resilience.
In addition to brain chemistry, our life experiences play a significant role in why we get depressed. For instance, if someone experiences childhood trauma, they may develop depression as a result of it. The same goes for misattuned relationships, where a person feels neglected, unsupported or invalidated. Culture at large can also be a source of depression, with societal norms and social expectations often leading to feelings of inadequacy or worthlessness.


Depression is a complex disorder that can affect anyone, regardless of age, gender, or background. Understanding how the brain works in relation to depression and how our life experiences are part of why we are depressed is the first step towards symptom reduction and recovery. It's important to know that depression is not a sign of weakness or a choice, but a medical condition that can be effectively treated with a combination of medication and therapy. With the right support and resources, people with depression can lead fulfilling, happy lives.