Category Archives: Depression

The stress of depression

Stress is good for you. It keeps you alert, motivated and primed to respond to danger. As anyone who has faced a work deadline or competed in a sport knows, stress mobilizes the body to respond, improving performance. Yet too much stress or chronic stress may lead to major depression in susceptible people.

Depression is stressful and stress contributes to depression. Stress induced cortisol expression and depression are related events that lead to reduced serotonin levels, the major neurotransmitter involved in the development and progress of depression. High cortisol levels may not directly cause depression, but it may exacerbate a minor condition to a major syndrome. The brains of human suicide patients show extremely high levels of Corticotropin Releasing Factor (CRF), the precursor of cortisol and causes expansion of the adrenal glands.

The presence of cortisol in the blood undergoes diurnal variation, with levels peaking in the early morning and reaching its lowest level at about midnight or three to five hours after the onset of sleep. A changed pattern of serum cortisol levels has been found in people with major depressive disorders.

Once you’ve had stress sufficient to cause a protracted increase of your cortisol levels, your cortisol system is damaged and in the future, it will not readily turn off once it has been activated, as such, recurrent episodes of depression break free of situational triggers and leads to automatic triggers of episodes.

Beyond a certain point, depression becomes random and endogenous; dissociated from life events. At this point, an episode does not occur due to triggers by external stimuli, but altered biochemistry. This emphasizes the need for people with recurrent depression to stay on medication permanently.

Targeting cortisol as a treatment option is a viable idea but still under investigation due to its side effects and role in other biological events (fight-or-flight responses, adrenal energy, anti-inflammatory action, decision making and resolution, immune system activation among others).

Factors that reduce cortisol levels

Continue reading The stress of depression

The feeling of emptiness

“There’s no crispness to the morning. The smell of coffee serves only as a reminder that another long dreary day has begun. There’s no real feeling, no joy, not even much anger, only emptiness. It’s difficult to remember feeling any different and getting more difficult to go on feeling this way. Sitting in a dark corner with eyes closed imagining nothingness until there is nothing would be easier. Instead here’s the day to face, the responsibilities, the people, the emptiness, but the energy that once fortified the day is no more.

Concentration has become a bad joke. Even love is now only a faint echo of itself. A leaden haze obscures the day and folds into a dark tunnel with no hint of light at the end. Where is hope? There is none. Where is happiness? Gone as if it had never been, replaced by tears that must be hidden. Where is relief? Perhaps in death.”

Excerpt from the book “Understanding depression”- Patricia Ainsworth, M.D.

The stigma that kills

(Take a moment and think about this: what happens when you’re in a relationship and your partner dies? What do you do? In our part of the world where there are various misconceptions about relationships, how do you handle such a loss?).

It was the beginning of an academic year and her boyfriend had passed away, her world seemed empty, she was sad and devastated. Not a member of her boyfriend’s family knew about her or her relationship with the deceased. She joined the friends and classmates category just like everyone else and even in school where people knew of their relationship, it was no different than whispers and fingers being pointed at her as the girl who’d lost her boyfriend.
Martha was surrounded by people, yet she was lonely. She had so many thoughts and could hardly concentrate. Martha was depressed and needed help, but who would help? Her friends thought she probably just needed time and space to grieve her loss, but none of them took a step to talk to her about how she really felt, but instead they were waiting for the worst to happen then they could say, “I saw this coming”, “I knew it”. What if she committed suicide in the end? Continue reading The stigma that kills