Psychology Addict # 26 | Depression – Where to Draw the Line?

in #psychology7 years ago (edited)

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You might agree with me that Depression is an important topic nowadays. The reasons are quite clear; with the first and foremost one being its commonality. In spite of this, I feel (and I expect you’ll concur with me) that there is still great misconception and, therefore, stigma surrounding not only specifically this subject, but many other mental-health related issues. I believe this is due to lack of information, and this is precisely why we are going to further our discussion about mild depression and severe depression here today.

So, please read carefully, because there is a question waiting for you at the end of the post. 😊

Throughout this post let’s keep in mind that depression is an emotional disorder. It is an emotional state that we all experience at some point in life. And here is a question I am often asked whenever this discussion arises:

‘when is sadness or low mood officially considered a disorder?’

First, it is important to understand that there is a vast range of depressive experiences within a continuum; which go from feelings of ordinary sadness to attempts at suicide.

All of us experience sadness or even mild-depression following stressful events that involve loss - a break-up, loss of a job, for example. This is indeed an expected, healthy response to such situations. After a while most people embrace their new reality, overcome their grief and move on in life. These people show resilience.

Psychological Resilience

Resilience is the ability to recover quickly from adversities or stressful events and changes.

This is a notion that drew great interest from academics that conducted studies in emotionally adjusted adults who when children were maltreated and lived in extreme poverty. As children they were described as being loving, alert and with good personalities. All characteristics that helped them to obtain support from teachers, social-workers and other suitable adults. Despite everything, they were confident and had a positive outlook in life.

These were understood to be their coping strategies, which later in their adult years enabled them to have close friends as well as a long term partners.

Very much like in children adults exhibit resilience through different strategies. For example, some will just be pragmatic. They set a goal to get through the situation ‘no matter what!’ While other people just adopt what psychologists call repressive coping; basically, these are the people who ‘hide’ their sadness and difficult feelings, but ‘plough through the situation’.

Further still, it is also believed that certain individuals are genetically predisposed to show resilience. More evidence is needed to support this belief, though.

The most interesting thing I find about this topic, however, is that it has been found that resilience is an ability way more present in humans than previously believed. Now you may ask why this is important! Well, it is important because nowadays; particularly in Western cultures people are rather quick to resort to interventions to get rid of their difficult emotions.


My Friend’s Son
Take the case of a close friend of mine, for example. Luca is his 19-year-old son who is struggling with the choices he is facing about his future. He is unhappy at university and seems ‘uninterested’ and ‘disconnected’. His parents, in desperation, decided to take him to a psychologist who quickly referred him to a psychiatrist. Luca is now unwillingly under anti-depressant medication.


From a psychological perspective, I will tell you why this intervention may be an issue. Research has found that this may interfere with the person’s natural mechanisms of dealing with trauma. For example, not long ago, the immediate psychological treatment of victims found in violent and traumatic episodes was a largely adopted approach. However, it has now fallen out of favour because there is little evidence available in the literature to show that such interventions prevent PTSD. Sometimes it is better just to let people be for a while.

Fortunately, there are indeed several mechanisms that we turn to - consciously or not - to get through the set-backs life throws at us. Namely, taking some time alone, going to church, crying, playing an instrument etc. Then, we dust ourselves off and keep going.

Severe Depression

However, for some people, this is not possible. They remain in a state of mild depression for a long time. Instead of taking on board coping strategies, they struggle to find ways to make themselves feel better. In this sort of scenario what begins as mild-depression gradually develops to what clinicians call severe depression.

This is a good time to revisit that question I said I am often asked whenever this sort of conversation arises, and also the continuum. Do you remember the continuum?

‘when is sadness or low mood officially considered a disorder?’

Here a psychologist or a psychiatrist draws a line on that continuum based on a categorical diagnostic system - which I wrote about on my post The Diagnosis of Mental Illness – that helps them to decide if a client is afflicted by a particular disorder or not through the symptoms they exhibit.

For example, Luca (my friend’s son) presents primary symptoms: he has lost interest in his photography and playing with his little sister (this would be classified as his ‘usual activities’). Nonetheless, he has not exhibited: a different sleeping pattern, irritability or feelings of inappropriate guilt. All regarded secondary symptoms, among a few others.

Now, having a client presenting such symptoms would be a case where the prescription of anti-depressant medication is more suitable. In fact, according to NICE, individuals suffering from mild-depression are not recommended to undergo anti-depressant medication. For the very reasons we learnt during our discussion about resilience. So, what would be a good alternative for Luca instead of his medication?

Overcoming Mild Depression – exercising, making an effort to reengage in the activities he has been putting off. This is when a friend or family member could show their support and accompany him during an afternoon to take photos in the park, and bring his little sister with them. Brief psychological therapy sessions would be a good option to add to this list, but they would not be essential.

But, what about a more severe case?

Overcoming Severe Depression

Anti-depressants are recommended in such cases and you might be curious why. We could use Mr. B’s case (from my previous post) once again for purposes of illustration. By now you understand he presented what is categorized as secondary symptoms. Prior to his treatment, Mr. B thought he was a failure at everything. So, for several people in a similar situation, the SSRI drug fluoxetine (Prozac or Sarafem), for instance, has a beneficial psychological effect that enables them to see their situation from a more positive angle.

Biological psychology puts forward an assumption to explain this. I am fascinated by it, by the way. Although it lacks conclusive proof, there is a growing body of evidence to support its validity. It has been termed the Brain-Mind assumption and proposes the following:

Brain events and mind events are intimately related, so much so, that there is a corresponding brain event for each mental event.

Let’s discuss this further, Mr. B’s mental state prior to taking his medication was one of negative emotions, which according to the assumption described above, is related to a particular brain activity pattern. But then, the anti-depressant acts on Mr. B’s brain changing a certain pattern of activity – increasing levels of serotonin – correspondingly, improving his mood. But, wait a minute, this is not as straight-forward as it might sound! This is why there are a few very important points I would like to highlight about this particular class of drug (SSRIs). Therapeutic effects are only observed from three to five weeks after treatment begins, despite the immediate increase in neurotransmitters. Also, side-effects are immediately felt and they include: fatigue, gastric disorders and sexual dysfunction among others.

Additionally,

Research has found that part of the efficacy of mood-altering medication is a consequence of the expectation about their effects – an instance of the placebo effect

Alongside medication, therapy sessions are also recommended to help the individual overcome severe depression.

At this point you may, perhaps, be asking yourself:

Why some people struggle to defeat mild-depression and become severely depressed?

The types of depression that are associated with damaged hippocampus may offer a possible answer to this question.

You might have noticed now that depression often arises as a consequence of one isolated stressful event or a number of them. Luca has one particular thing stressing him out, while Mr. B had had several, and for quite a while. Drawing from the understanding that stress affects the structure of many parts of the brain developmental biologists proposed the Life-cycle model of stress, which suggests that stressful events affect the brain structure that are developing most rapidly at the time of the stressful experience.

Studies in rats that had been exposed to stressful situations when they were pups found that they presented damaged hippocampus; which caused effects that were difficult to reverse, and that played a role in their behaviour. In the human brain this is an area which actively develops both prenatally and during the first two years after birth. This finding is particularly relevant for mental-health professionals because the hippocampus is an area that also plays a part in controlling the HPA axis – a system that operates in stress responses.

This association damaged hippocampus – difficult stress response also exists in humans, as it is well-established that depressed people present a smaller hippocampus then those not suffering from depression. A study conducted in a group of depressed women who had suffered child-abuse and a group of depressed women who had not suffered child abuse demonstrated that the hippocampal size of the depressed woman who had not been abused as children was similar to that of women who were neither depressed nor had experienced child abuse, while the abused women’s hippocampus was much smaller.

This indicates that depressed adults whose hippocampus have been damaged by chronic stress during adult years present a scenario that can be more easily reversed.

Still, as you might expect this is only one out of a few different explanations for why depression sometimes is triggered and becomes difficult to be reversed in some people.

[Original Content by Abigail Dantes - 2018]


Reference List:

APA (2000), Diagnostic and Statistical Manual of Mental Disorders, 4th edn.

Bonanno, G.A (2004), ‘Loos, trauma and human resilience: have we underestimated the human capacity to thrive after extremely aversive envents?’, American Psychologist, vol. 59, vol. 59, no. 1, pp. 20-8.

Heim, C., Newport, J., Mletzko, T., Miller, A.H. and Nemeroff, C.B. (2008) ‘The link between childhood trauma and depression: insights from HPA axis in humans’, Psychoneuroendocrynology, vol. 33, pp. 693 – 710.

Heim, C., Newport, J., Heit S., Graham, Y.,Wilcox, M., Bonsall,R. et al. (2000) ‘Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood’, Journal of America Medical Association, vol. 284, pp. 592-7.

Marques, A.H. and Stenberg, E.M (2007) ‘The biology of positive emotions and health’, in Post, S. (ed.) Altruism and Health: Perspective from Empirical Research, New York, Oxford University Press, pp. 149-88.

Image source: 1, 2, 3, 4, 5.


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Dear Reader,

Now that you have made it here I have a very simple question for you: how has this post improved your understanding of depression? Take your time! The reason I am asking you this is because you are my partner on this journey to rid misconception about mental-health, and whatever your answer to my question is I know it will be the information you will pass on to your friend, neighbour and family member. 😊

Thank you so much for reading.

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Hi @abigail,

I found it important that you mentioned "Sometimes it is better just to let people be for a while."

When someone shows signs of a mild depression I would consider it normal for there are always events and episodes of disinterest, not engaging in family and friends life and to do what one may call to think about "the meaning of life". Thank you for pointing this out - at least I understood it that way.

From what I experience - I work a lot with young adults who partake a program in "Assisted living" they get no real time out. The program is there to stabilize and to give structure. To help with school issues, accompany the steps of leading an independent life and financial matters. What I see as problematic is that from what trauma or difficulties the young adults have gone trough they are then put into this program which sets the pace of development.

This is not wrong because it substitutes the parents home and what had to take place there, it takes place now in the institution.

BUT: nobody actually assures the young people that what they feel and gone through is not so much an illness or flaw. Some of them are in the program for about ten years and still under medication. Many are super trained in psychotherapy-speech. When a young adult sits in front of me, tells me that he is medicated for years and that he has "social phobia" and what else, I get frustrated sometimes. My systemic approach to coach them seems to be unknown to many therapists and neurologists.

I would say, the kids which I encounter are for the most part super clever. They know a lot about their weaknesses, can talk like psychologists with you and do have various remarkable skills. What they lack in my opinion is to realize, HOW smart they are, how young and full of energy.

What I want to say about medication: people don't like to take them. They take anti-depressants on and off. They interrupt the treatment or the therapy. The daily life doesn't follow a therapy plan (which is what science relies on) or a laboratory condition.

They take the medicine once it gets really acute. And when the acute state of existence calms down, the pills remain untouched.

So, why are they doing that? Wouldn't it help to follow the therapy plan?
It would, I think. But that is not what people want. Once under medication, integrated in a structure and daily tasks, fulfilling what is expected from them, they go back exactly to the point from where they missed something in the past: That someone cares. If a person gets the impression "If I only take the medicine, do my duty, engage in life, than what I need the most is not addressed!"

My conclusion from that is: What is most wanted is the perception that my sadness and my deep struggle with life is fully and 100% accepted from "society" - meaning: the people I am in touch with. If only I could sense and see that they really do care, than they would let me take my own pace. They would signal patience instead of worry.

The deeper meaning of "caring" is for people in a depression a living breathing being they can relate to and who shows patience and: is NOT AFRAID of the person with a depression.

Sorry for answering in this length, but you touched a point in me.

SO glad your answer has been this lengthy! You are basically my Guru. It is official :) I learn so much from you, and of course, what better person to evaluate the whole 'Luca' scenario than you?

I don't feel very comfortable with saying this, but this is what I believe Luca is going through, you know.

If only I could sense and see that they really do care, than they would let me take my own pace. They would signal patience instead of worry.

I don't mean to say his parents don't care; they love him so dearly, but they just want the kid to show happiness ALL the time! Because of that the kid feels suffocated, pressured and now undergoing a treatment he totally rejects. Guess what? His dad told us he stopped taking the medication (just like you said!). But then, now, he is in trouble with his parents ... it is a never ending cycle :/

Thank you for taking the time to offer us such great insight into this scenario.
Lots of love to you.

:-) HaHa, pleased to meet you, my name is Padme Garnesha.

It is so good, that you see that one cannot be always cheerful. Is there any chance for you to show him that you don't think humans have to be happy all the time? I find this insight really helpful - and/or what he is up to right now, what does he think of life/society?

I have no doubt Lucas parents do love him. Have you asked the parents if this is something they can put TRUST into their son? When they look back at their own lives with 19, what was the most annoying thing with parents and what were they wishing for back than in the same age?

What in general is truly annoying when one has a crisis in life?

I hope the family will shake distrust off and starts to accept "reality":-) I have a little graphic helper when I talk to people about life in general and daily events. When a day has 100 % of life, how many percent frustration tolerance one must build up in order to stay realistic about the fact that there will be for sure frustrating elements appearing?

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We know that depression is caused by a lack of social participation
But who is to blame?
Cold boring life because of the lack of values and ethics in society
And having a runaway "Social Media"

Hello @slimanepro. Thank you for stopping by again.

Yes, there indeed the kind of depression that has its roots in the pychosocial environment, and I thing that is precisely the kind of depression my little friend Luca is suffering from like you said: 'social pressures' and so forth. But there is also the kind of depression that is biological and it is do to with brain structure, hormonal functions etc.

All the best to you :)

Unlike most of the time, my morning actually started as planed! I had expected your post for the weekend, but when I came home late in the evening from exercising, I was so tired, that I knew it wouldn't make sense to read and try to understand it. But I left the browser window open, so it would be the first thing I'd see in the morning, together with two other blogs I really enjoy.

Since it was snowing, when I went to bed, I knew, I'd have to clean up in front of the café, so my wife could not ask me for that as one of those "ruining my plans surprises" I mentioned before.

All done, nice big cup of coffee and here I am :-)

The first thing I stumbled over was the emotionally adjusted adults, and I couldn't quite figure out what it means. In the context, it sounds to me, as if circumstances we would label as not particularly advantageous, like being

maltreated and lived in extreme poverty

actually lead to an "advantage", by being more resilient

Further down in your text however, you state that certain bad events in a child's life cause irreversible damage to the hippocampus. I'm most likely not getting it right, but so far it sounds like a contradiction to me...

Anyways, you asked a question, so I better get to the answer. I know you have a tight schedule ;-)

From the time I was married to a psychiatrist, I know enough about the subject to not just tell someone who is going through hard times to "get a grip" as the average German is quick to say. The view on mental illness has come a long way and I am particularly happy, when I see how the knowledge is shared with a larger audience, with publications like yours. Your post confirmed, what I already thought/knew, but also added some interesting new aspects, like the role the hippocampus plays. Inspires me to research the subject further.

Of course, as I was reading, I compared things to events in my own life and how I dealt with difficult situations. Guess I'm pretty resilient and the ups and downs of life don't throw me in a deep hole. As I can get very "attached" to another person, loss (of a loved one) and break-up would be my major issues and there was a phase of about year, when I lost all joy of living after a break-up. I usually busy myself in such a situation with simple, but hard physical work and back then I built a small office, complete with all built in furniture...

Now, here is a question I have. Its been with me for several years already and you mentioning Biological psychology brought it to mind again. Is it possible, that memories of traumatic events can be inherited? Trying to make sense of this in English... what I mean is this: All kinds of things are encoded in our genes. From what I understand, its generally accepted, that the, let me call it hardware, our physical appearance is largely determined by that. But what about the "software"? My brother walks like my grandfather, I have a lot of my dad's temper and creativity... our organs "know" how to function (also a kind of "software, that must come along). Could it be, that drastic events could leave a trace in the genetic information transferred from parent to child?

I'm asking, because, as a child I was haunted by "memories" that could not possibly have been my own. Consciously remember it from the age of 3, long before I even knew what a TV was (to exclude that option)..

My dearest @reinhard-schmid,

You know, in my head you are a character of a very good book: an artist who comes back home to his beautiful wife - in my head your wife's coffee bar is always full of delicious cakes (even at night when it is closed :D) - in a cold winter night!

I like your question very much, and the way you put it, yeah.. It does seem contradictory. But, let's see if I can address this in a satisfactory way:

-The first study mainly addressed poverty. When the author described the participants on his paper he focused on poverty aspects; and, even though he says the children were maltreated he doesn't explicitly state the kids were abused or treated with extreme violence. They were mainly neglected. In that study he was curious to find out how come some children who come from extreme poverty become fully-functional adults, while others enter a life of crime (unfortunately the majority). This is a social-psychology study. Further, from the way he describes the participants, I see -this may be a biased observation - even though those children were neglected and poor, they felt loved and protected by someone in their lives (by mothers, by teachers, social-workers etc..). While the abused women felt the opposite, none of them had someone to talk to about their fears. They spent a whole childhood in shame and feeling unsafe. For me, this is where the difference is. And, I base my conclusions on the findings of Harlow's attachment studies :)

As I said to the other readers, who like yourself, are kind enough to leave a comment and share their own experiences with low-mood and difficult feelings: Thank you for telling us about it. I find it particularly important because it is a real account of someone who overcame adversities and, therefore, gives real hope to those who are in the same situation now and reads it. The pattern seems quite clear to me: the recovery comes as a result of finding a new purpose in life.

Your question about memory is an intriguing one. This is one of the topics within my field that fascinates me the most and, hence, one of the topics I have studied more in-depth. Although, mainly repressed memories. But, to your question .... as you know * your memory is the product of your experience* and this is something that is not possible to be passed on through genetic materials. However, I don't want to limit you to my understanding only. There is a field Epigenetics that proposes this very notion, but for me there still lacks convincing explanation for how it happens, as well as experimental evidence (and this is the tricky part!). What drew my attention here, though, was the fact that you said you were 'haunted' by the memories, which makes me think they were bad memories. Epigenetics focus greatly in the inheritance of traumatic events. This might be something I should pay more attention to now, because of your account!

All the best to you my dear.
Have a wonderful weekend!

Phew.. time flies. Lots of unpleasant changes of plans this week. PC problems... hate those the most.

I wanted to come back here with nothing else on my mind, so I could give it all the attention, it deserves :-)

in my head you are a character of a very good book

sounds funny. Although part of it isn't all that far from reality. Only thing is, we have everything under one roof, so I only have to go down two stairs from my studio. And the café is usually only open on weekends. But my beautiful wife bakes sometimes during the week too.. or makes Austrian style pastries :-)

Thank you for making the issue with the children more understandable. I can relate to that, as we didn't have much in material goods, but I was fortunate to have good parents, particularly a very loving and warm hearted mother.

the recovery comes as a result of finding a new purpose in life.

For me it was always important to get myself going and stop the negative thoughts. Therefore I find some simple work good to get into a different frame of mind. Of course time is an issue. And I hope I also have learned what not to do to actively screw up my life. I also know, one is never safe from bad things happening from "outside", but at least I try not to contribute to that :-)

Thank you for pointing me to Epigenetics. It is something that really fascinates me and would answer a lot of questions, if there was any truth to it all.

I do make a difference between memories, which I consider my own. At the same age (3) I started having a reoccurring nightmare. When I put all the pieces together now, I believe its a memory of my own birth. The sounds of a heart beat, like you hear it through a stethoscope, and that of blood rushing through veins, pulsating and crushing movement, feeling trapped, a pulling movement with a high pitched sound and so on...

But the other "memories" are different. Bad, connected with war like environments and people being threatened and suffering. Vague pictures of undefined steel vehicles. Dirty water with dead plants... long ago and its all faded quite a bit by now and more of like felt rather that actually seen. I have just always wondered, where these things came from. My psychiatrist ex wife once said, that there is research on the issue, but she didn't know much about it.

But now, its smelling a lot like apple strudel...

Hello my dear @reinhard-schmid

This week has gone really quick indeed! Sorry to hear about your PC problems (truly annoying stuff!).

I have told you before about how fascinated I am about studies/research on memory (particularly repressed memories), and you are broadening my curiosity with your most intriguing accounts! They really got me thinking and making notes....

But now, its smelling a lot like apple strudel...

.... and there it goes my imagination running wild again.

" he had been sitting before his canvas for a while, his eyes twinkling at the sight of his finished painting. Now, out of his trance, he first heard his wife humming a song that she'd been repeatedly singing for the past few days. Then, he smelt the freshly made apple strudel. He went downstairs and there she was, humming away, the table was set for two ...

:D

Hm... I'm starting to wonder if you are more of a psychic or a poet.. ✨ 🤔

I think the key distinction to be made is the one about the difference between normal sadness and depression. As you said it is perfectly normal to be sad after tragic events and medication probably shouldn't be used in this case. However, it seems that this is becoming more common which is not a good sign. Not only does this minimize the suffering of those with severe depression but it places people who are experiencing a healthy response on medication they don't need. SSRI should not be taken lightly because they can be very difficult to get off of without side effects. Also, for many people they only have a mild help and in no way are a sufficient solution for treating the depression. I find the idea that mental and brain events can change each other quite compelling because I know it has helped in my personal case.

Hi @timspeer,

Thank you for taking the time to discuss this further. I mostly appreciate the observations you make about SSRI. Further, this is a very important point:

Not only does this minimize the suffering of those with severe depression but it places people who are experiencing a healthy response on medication they don't need.

As for the brain-mind assumption... yes! It is trully compelling.

All the best Tim :)

Hi @abigail-dantes

Thank you for your outstanding post. Since joining Steemit I have been looking for quality information that I can use to increase my own knowledge of various subjects. I have followed both you and SteemSTEM. Mental health is an area that is near and dear to my own heart.

I suffer from an anxiety disorder and associated depression, and I also have a niece that suffers from anxiety. I think your post raises some interesting questions about resilience and the use of medication amongst other things.

In the case of my niece (aged nine) the resilience comments are very pertinent. She was having significant difficulties at school and was diagnosed with an anxiety disorder about two years ago. What was most disappointing about this sequence of events was that upon presentation to a doctor, she was immediately prescribed antidepressants. I was somewhat shocked by this, as at this stage in her treatment she had not seen either a psychologist or a psychiatrist. My own experience is that medication should only be used in conjunction with regular therapy. On its own it is really just a Band-Aid solution that provides limited long-term benefits. Potentially this is oversimplifying some situations where medication is the only solution, however I think in her case some more formal assessment and specialist advice would have been warranted. Your comments on resilience rang a bell with me here. It makes me wonder how a child is to develop resilient behaviours when at the first sign of difficulty she is medicated. To put a silver lining on the situation, prior to this event occurring I had not disclosed my mental health issues to my immediate family. As a result of this situation I discussed my own background with my brother, and was able to provide some feedback and opinions. As of as a result of this he was able to take a more proactive role in his daughter’s treatment, which I think in the longer term has been beneficial.

The above notwithstanding, I feel that medication can play a very important role in treating some of these disorders. I know that in my case it has been a game changer and has significantly improved my quality of life. I think that the tendency to over prescribe medication that is identified in some of the comments to your article is a real problem. I think not only does the over prescription present a problem in its own right, but also leads to misinformation being spread in the broader community. Many people have a fear of psychoactive medication and this can interfere with them receiving quality care. The way it was described to me by my doctor was that the medication itself was not a solution to my problems, but was simply a tool to be used to allow me to manage my symptoms better. My anxiety manifested as frustration and anger, and my coping strategies were inappropriate. Going onto a medication enabled me to better manage my behaviour and in conjunction with a psychologist, work to develop more appropriate coping strategies when feeling stressed, frustrated or anxious. The medication was positioned as allowing me some breathing space to reassess my existing behaviours and to modify those without fear of being overwhelmed by pre-existing patterns of negative emotions. I haven’t fully conquered the beast, but medication has certainly played a key role in allowing me to maintain a healthy life.

Thank you again for your outstanding post. In addition to the thoughts that you prompted above, you have also motivated me to consider blogging on STEM related topics. I think I will start with ways of engaging young girls in STEM related to play. I have a wife who is an engineer and two young daughters, so this is pretty much mandatory in my house :-). My wife and I have put some significant thought into how to engage the girls in this fashion, and I may use this forum as an opportunity to provide some insights. Hopefully the SteemSTEM community find them useful.

Your comment is incredibly outstanding and informative! You raise so many valid points about the use of medication. This is the sort of comment that helps to debunk misinformation about not only the use of psychoactive medication, but also mental-health in general. I am truly grateful for you taking the time to read my writing and participate in this debate in a such meaningful manner!

As for your little niece's situation; unfortunately, this is a reality I come across more and more often. I disagree with it as I believe there are so many other healthier alternatives to address mental distress in children. As you point out! I truly don't know what goes through the mind of a doctor who puts a 9 year-old child under anti-depressant medication. :/

I am looking forward to seeing your STEM posts :)

All the best to you and your family always @aghunter.

My understanding of depression has improved so much after reading your post. For example, I did not know that the size of the hippocampus is closely related to depression.

Actually this comes at a time when I was in a bit of a depression myself until about 2 days ago. One of my relatives passed away suddenly. Death in the family or among friends gets me into a low mood which I guess is a sort of mild depression since it takes a few days to come out of.

Fortunately I have never needed medicines to recover from a depression. When I was younger I used to go for an hour-long run if I had a depression for more than a day and I would feel much better!

Now I know that it could have been classified as a mild depression after reading about overcoming such a depression in the post.

I am also glad that I have always taken steps to move out of mild depression phases so that I don't progress to a form of severe depression. In fact. this is where I will always keep your post in mind since I have a habit of going into a mild depression after setbacks, which are inevitable in life and can't be avoided. Thank you so much for what I would term as a gold nugget for myself that I got from your content!

Thank you for putting out such an informative article, of a high value as is always the case with your posts. I will have to come back again soon to read all the amazing comments that others have left, as I have been able to read only a few of them.

That is another great thing about your posts - they are so engaging that I have to always come back for more!

Dear @maxabit, I am so very sorry to hear about the situation your family is going through at the moment.

The loss of a loved one is indeed a tough reality to face (particularly when unexpected). I really appreciate a point you highlighted here, which I think it is very important for all of us to be aware of :

I guess is a sort of mild depression since it takes a few days to come out of.

I feel that nowadays, the line between sadness and mild depression is rather blurred, and one can easily morph into the other. This is precisely why bodies like NICE recommend caution when prescribing medication in cases deemed as mild-depression. In your situation, it is a most natural response! You are grieving, and you will go through different phases and overcome it at your own pace.

I am also glad that I have always taken steps to move out of mild depression phases so that I don't progress to a form of severe depression.

I am so pleased to hear this. Remember then brain-mind assumption! Brain-activity-patterns respond and change to mental events. So, there is a time (for some sooner and for some later) when we do need to move on. When we dwell for too long in that painful feeling our brain-activity patterns change in a way that leave us stuck there. So much so that we tend to forget the good things in life. This is a well-established notion in psychology, which has also to do with the hippocampus - an area of the brain that plays an important part on the functions of short-term and long term memory!

Exercise is indeed a great way to help you through this, among psychologists it is sometimes termed 'a natural anti-depressant'. Also, not long ago you posted a great, practical article about meditation. The hippocampus (and many other brain regions) also 'love' meditation :D

All the best to you my dear. I send my thoughts and love to your family.

Well, I had to read it twice because this post does not deserve a quick answer.

I always believed that treating mental health issues should not involve medication unless a patient's chemistry-anatomy demands it. And that is because when messing with the brain, a false diagnose might do irreversible damage. I also strongly believe that it's advisable to consult a second psychologist/psychiatrist before moving to more "advanced" methods of treatment.
Humans are a mixture of soul and body. The soul exhibits its natural cycles of coping with life, when the body malfunctions and affects the soul it is the time to intervene on the body. If not, then setting a protective net around the soul will help the individual overcome difficulties they would not be able to do so alone.

I think you just validated my beliefs with your thorough article @abigail-dantes.

I hope Luca will get over the hard times he's being through. I am sure he has all the strength inside him to do so! :)

because this post does not deserve a quick answer.

This means a lot coming from your @ruth-girl!

Let me just put your following statement in bold, so it won't be missed!

I also strongly believe that it's advisable to consult a second psychologist/psychiatrist before moving to more "advanced" methods of treatment.

I really like your discussion on soul & body, it reminds me of the Brain-mind assumption. It is as if you intuitively knew about the assumption!

Thank you for your nice words about Luca :)
I just wish they could let him be for a while. But, what can I do?

Lots of love!

@abigail-dantes, wow... tough one. I believe, in some cases, depression can last for years, not necessarily because it's clinical... rather because the perspective about one's future needs to be adjusted.

Years ago, I went through a phase where I picked up the bad habit of complaining. I was surrounded by complainers and joined the pity party. In reality, life was actually really good. I seriously don't know how anyone could stand being around me. Then the paradigm shift... I realized I had the power to choose my thoughts... and that my thoughts had the power to define my future.

Ironically, it was after "the dark days", that I truly went through several difficult situations... situations that would have crippled me emotionally in the past... with optimism... with the expectation of love, adventure, and a bright future.

Ha! The brain-mind assumption :)
I hope everyone here gets to read this comment. It is truly insightful.
Thank you for highlighting this points here through your personal experience!
Lots of love to you my dear.
:*

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