Every Molehill is an Everest
A Brief Primer on Depression and the Brain
It’s all in your head, my friend, because it couldn’t be anywhere else. By that I mean to say that your brain is the organ which generates your mind, who you are, and that organ is dependent on the same rules of biological homeostasis as the rest of you. Thus, if you suffer from a mental illness, there’s a good chance you have something wrong with your brain, whether it’s a short term bout of anxiety or a chronic depressive disorder. The pejorative phrase “It’s all in your head” exists in our lexicon thanks to a common, and very naive, assumption that anyone can think their way out of any mental health issue, that mind and body are somehow separate. Though there is a great degree of value in constructive thinking as a part of therapy, this assumption is a false one owing to the fact that research is starting to show just how out of control we are where it concerns the brain and mental illness.
As I’ve stated, the brain is every bit a part of your biological machine as your heart or your pancreas. The human body that is said machine is largely dependent on water for survival and without water, science tells us we will wither and die. Why is this important? It goes to a further point about naive assumptions and human brains where it concerns mental illness. There are a lot of people in society who are against medication as a treatment option. One of the arguments they use is that it can’t be proven that a chemical imbalance can exist in the brain. It’s a laughable assumption, really. Forgetting for a moment that our genetic code, what scientists call DNA, is a chemical substance and that there are known genetic defects which impair cognition, most any high school graduate who paid attention can tell you that water is a chemical compound. And since we know that dehydration can temporarily impair our ability to think clearly, it is therefore quite easy to demonstrate the possibility of a chemical imbalance in the brain.
Putting science lessons aside for the moment, If you’ve ever dealt with a severe depressive disorder, chances are good you’ve experienced a moment in time where a simple task laid before you felt in that moment like a Herculean quest, in that you just couldn’t muster the will to take on said challenge. Maybe you were doing laundry and the best effort you could put forward was to take the clothes out of the dryer and place them in the basket. Perhaps you had a term paper to write but you couldn’t hand it in when due because you could only half of the time draw up the requisite mental energy required to properly research the subject of the assignment. Perhaps you just had a child and your hormones were so out of balance that you didn’t have the energy to prepare a bottle for feeding time. If so, you are definitely not alone. These are all common examples of the effect depression can have on everyday life and it can strike anyone regardless of their status in the world. It wouldn’t matter if you’re a discharged war veteran suffering a bout of PTSD, a starving art student struggling with self-esteem or a television celebrity struggling with anxiety attacks and other mental maladies. Depression can strike anyone at any time.
If you’re a sci-fi nerd, as I am, you know who Carrie Fisher is, and you probably know enough about her to know that she struggled with mental illness for most of her life. If you’ve ever watched British television, perhaps you know who Stephen Fry is as well. If not, he is a British actor who has appeared in many high profile productions and was host of the groundbreaking panel quiz show Qi for sixteen seasons. What about popstar Robbie Williams, famed for numerous hits? These celebrities all have one thing in common in that they were brave enough to open up about their mental health struggles in a very public fashion, all in one documentary made for the BBC called The Secret Life of the Manic Depressive (2006). That documentary and its follow-up The Not-so Secret Life of the Manic Depressive (2016) are very valuable in that they allow average people the chance to hear others tell their stories, and relate their mental health triumphs and tragedies. More importantly, however, there are parts where in Stephen Fry attempts to tackle the underlying medical causes of mental illness by consulting with mental health professionals, so that a bit of scientific expertise can be juxtaposed with those same personal stories. It can’t be understated the value of this combination of fact and personal narrative to average people like you and I, in that we need a visible, common frame of reference to understand better the intricacies of mental illness, both on an individual level and a scientific one.
As it pertains to depression, the last example I gave above of bottles at feeding time comes directly from another documentary ‘The Truth About Depression’ (produced by BBC Northern Ireland in 2013, presenter Stephen Nolan) wherein a British actress, Denise Welch, relates her experiences with post-natal depression and its effect on her ability to function -
“I remember looking at the sterilizing bottles and my mom…she’d say ‘Go and get the bottles ready. It’s four hours. He’s ready for his feed.’ And it was like someone had said to me ‘There’s Everest. Go and climb it now.’ That’s how it felt to get off the settee and go and do the bottles.”
I’ll pause my train of thought for a moment and say that if you haven’t seen the documentary, I highly recommend finding it. The scientific facts are presented very well, in a manner that makes them easier to digest; more so than one might get reading a five hundred page text from the library. There’s certainly nothing wrong with books of that size, but the average person will probably have an easier time picking out relevant bits of information watching an hour-long TV special. For instance, a documentary shown on PBS in 2008, “Depression: Out of the Shadows”, provided me with a very valuable perspective that I might never have landed upon had I had to wade through a text-heavy tome on mental illness. In said presentation, the author Andrew Solomon stated “The opposite of depression isn’t happiness. It’s vitality.” Without that improved language, I might not be where I am today in terms of my understanding of mental health, owing to the fact that it changed my perception of just what depression is and how I was affected by it.
Returning to the science in “The Truth About Depression”, Stephen consults with an academic expert about four minutes in — one Professor Ian Anderson of the University of Manchester. In this early segment, Prof. Anderson talks about the Hippocampus, a region of the brain responsible for memory and emotion, and how the brain can be imaged now to show the structural differences in certain areas between people with depression and people without. In certain studies, it was shown that people with depression show structural atrophy in the Hippocampus, meaning it is smaller in depressed people. He muses a bit on the possibility that this happens to the brain from lack of use in much the same manner that muscles atrophy from lack of exercise. The important take-away from this segment, however, is that the research he’s conducted, along with others, shows that a marked improvement can be seen in the atrophied portions of the Hippocampus after a course of treatment (be it medication and/or talk therapy), ranging in length on the course of several weeks to several years. For myself, this leads to an obvious certainty, that the structural defects of a portion of the brain responsible for emotion can be attributable for a seemingly emotionless state like depression.
Later in the program, about 38 minutes in, Stephen talks with Catherine Harmer, a research scientist at the Oxford Center for Brain Research. The focus of this segment is on the Amygdala, a region of the brain which, according to Wikipedia, is ‘shown to perform a primary role in the processing of memory, decision-making and emotional responses (including fear, anxiety, and aggression)’. Akin to the computer hub of the brain, it is stated that the Amygdala, like the Hippocampus, behaves differently in depressed people in that, according to Ms. Harmer, depressed brains shown a greater tendency to exaggerate negative imagery. They effectively lose a degree of perspective and are more susceptible to negativity, however mild or ambiguous. Similar to the Hippocampus, the Amygdala responds positively to therapy. The program adds a couple of addenda to this segment, the first being a brief line from one Dr. Chris Kelly, a psychiatrist at Belfast City Hospital, where he talks about adrenal glands being larger in people with depression, hence an increase in stress hormones in the body and, by extension, the brain. This goes to validating a point that trauma effectively exists in the body and affects the brain, which is backed up by a second line from a Mary Corry, of the Everton Centre Belfast, who relates how observation of people affect by The Troubles (a violent sectarian conflict centered largely in Northern Ireland which lasted from the 1960s to the 1990s, also known as the Northern Ireland conflict) leads to the conclusion that the trauma these people experienced effectively roots them in their past and makes it difficult to move forward, due in part to the fact that they are conditioned by their experiences to expect tragedy around every corner.
Now, I’ve never experienced anything like the violence of sectarian conflict but I have been subject to a degree of emotional neglect and physical abuse, in that my family had a ‘fondness’ for that disgusting christian axiom ‘spare the rod, spoil the child.’ Over the years I have learned from various sources that children who have been subjected to corporal punishment miss critical phases in their emotional development and enter adulthood at something of a disadvantage. Based on what was stated in the documentary about the two regions of the brain, it is easy for me to infer a causal connection between the physical abuse I suffered and the fact that I can’t feel a good emotional connection to anything in my life, be it my art, my writing or even my sparse social connections. I must resort to a sort of cerebral rationale to infer and accept that these things are a positive and settle for a type of intellectual contentment in order to be able to live above the near-constant despair I feel at being disconnected from living a healthy mental life. Granted, there is a genetic component to my issues, in that it has been demonstrated somewhat that the traumas of a prior generation can be passed down due to malformed spermatozoa, which goes to the part about trauma in the body affecting the brain. That said, the bits about the Amygdala playing a role in exaggerating negative stimuli resonate with me, speaking as someone who has experienced firsthand just how badly even the slightest negative input can ruin even a neutral mood state.
There are certainly no guarantees in the depression game. According to various statistical sources, somewhere between a third and a half of people with a major depressive disorder suffer from what is known as treatment resistant depression. Many of those with TRD never recover and either live with the condition or take their own lives, some 10% according to the documentary. Despite the lack of certainty, in the end, it’s about having good information on the state of brain science so that we can move things like depression out of the realm of the moral and firmly into the realm of the rational, so that we as a society are no longer punishing those who suffer shame at having a mental illness for things which are probably out of their control. Just as every climber knows the proper tools that are needed to climb a mountain like Everest, understanding the variables at play in such an endeavor and the risks associated with said activity, I feel that every person suffering from mental illness should take a cue from this example. They should endeavor to reinforce their understanding of the same with accurate information that properly illustrates the paradigm of mental illness specific to their experience.
Mental health is not a one-size-fits-all proposition and not having accurate information can lead to serious setbacks in your quest to recover and lead a productive life. Warding off these setbacks means staying abreast of what science is saying about the brain and what implications that has for our everyday behavior. In the case of Denise Welch that meant recognizing a post-natal hormonal imbalance and treating said deficiency accordingly. In the case of severe anxiety, that means understanding what parts of the brain are responsible for the fear response and how structural defects in that region of the brain can exaggerate said response, so that it can be mitigated. Though success is not guaranteed, with this strategy of seeking out scientifically accurate information at hand, you have a significantly better chance of conquering the proverbial Mount Everests’ you encounter during bouts of depression and reverting them into the molehills they should be.
