What Do We Know (and Not Know) About Depression?

a little strange if you never did. But what about if those feelings persist, grow to be overwhelming, maybe affect your work or studies or relationships, or maybe make it feel difficult to get anything done. That might be depression. Just like any other health issue, depression can manifest differently in each of us, varying in severity and symptoms, and therefore solutions for it can vary too. Also, as with many things about our weird and wondrous human bodies, researchers

aren't entirely sure how depression works. Today, let's talk about what we do and don't know about this branch of mental health. First off, depression is a broad term. Health professionals can diagnose different flavors of depressive conditions based on a person's age, when and how and how frequently symptoms appear, and whether the person has any other mental or physical health issues going on. The definition common to all of these is a measure of sadness, emptiness, or irritability that

impedes your capacity to function. More specific symptoms can include loss of interest and usual activities, a withdrawal from family of friends, feelings of guilt, hopelessness, helplessness or worthlessness, changes in sleeping habits like being unable to sleep or sleeping too much, fatigue and lethargy or hyperactivity in restlessness, changes in eating habits leading to weight loss or weight gain, indecision,

difficulty concentrating or forgetfulness, persistent pains that don't respond to treatment, like headaches, stomach aches, or digestive problems, a worstening of other conditions like arthritis or diabetes, and or thoughts or actions towards self harm or death. That's a lot of symptoms and a bunch of contradictory ones, and no two people will have the same ones to the same levels of severity. But if someone experiences five or more of these symptoms for over two weeks that might be diagnosed

as major depressive disorder. If someone experiences just a couple of them, but for a couple years running, that might be what's called persistent depressive disorder. There are also specifications that can help diagnose forms of depression in someone going through prolonged grief, or someone who has particular trouble the week before their menstrual cycle or during certain seasons of the year, or someone with symptoms tied to another medical condition,

or a child or adolescent who's struggling. You can experience depression once in a lifetime, brought on by a single stressful event, or it can recur throughout your life. There is no single cause for depression, though research does suggest four factors from which it likely results, often in combination. Genetic, biochemical, psychological, and environmental. Scientists haven't found a gene for depression, but they have seen evidence based on family histories suggesting that

there may be a genetic link. Children of people with major depressive disorder are more likely to experience depression than the general population. Something in the way those children are raised could have an influence, but research has shown that social and family environmental factors are less important than genetic ones. However, because depression also occurs in individuals without family histories of

the condition, we continue to study additional factors. Other research with magnetic resonance imaging has revealed differences in the brains of people with depressive conditions. People with depression have abnormal levels of sub neurotransmitters, which are chemical messengers between cells and the brain, in between the nervous system and other

cells in the body. Having enough of these chemical messengers helps us process and regulate our mood and memory and behavior in complicated ways that we don't entirely understand yet. Researchers have honed in on three in particular, serotonin, neuropinephrine,

and dopamine. Psychological factors also come into play. People with certain characteristics such as pessimism and low self esteem have a tendency to develop depression, and stressful happenings such as relationship changes, illness, financial problems, or any major life event like a move or a job change can trigger a depressive event. Again, it's not straightforward or simple. The onset of depression frequently occurs from a combination of these causes.

Depression is highly treatable, but one of the complications of depression is that you don't always want to talk to anyone, or that you feel guilty about feeling sad. Wrapped up in all this, there's still some misplaced social stigma about mental health, which is why I'm doing this episode. It's just part of our health. There shouldn't be any shame in it. The first step toward getting help is to

talk to a health professional. If you have a primary doctor, a family doctor, or other medical caregiver who you trust, they're a great place to start. Though, if you don't, and there are lots of online services and local organizations that are designed to get you on a path to diagnosis and treatment. There's no easy test like a blood

panel or X ray. However, doctors may sometimes order lab tests for things like thyroid or heart or brain conditions to make sure that no more immediately serious physical disease is causing depression type symptoms that would require its own treatment. Generally, a health professional will ask you about your and your

family's medical history. Then they'll talk with you about your physical and social and psychological symptoms and your mood, determining what symptoms are present when they began, and your general state of mind. They might use a written or spoken diagnostic questionnaire. Researchers have come up with a bunch of different ones that can quickly, easily and accurate lea score how serious a person's symptoms are, since those symptoms can

be difficult to self report. Once you have a diagnosis, there are lots of different treatment options because mental health is highly individual, but what works for any given person can vary. It can take some time to determine what works for you, but over eighty percent of people who

are treated experience improvement. Effective and common treatments for major and chronic depression are antidepressant medications to relieve symptoms, and talk therapy to learn effective coping methods, or a combination of the two. Antidepressant medications help to normalize levels of those mood regulating neurotransmitter chemicals in the brain. The most common medications these days because they tend to be pretty effective and not have too many negative side effects, are

SSRIs that stands for selective serotonin reuptake inhibitors. Basically, they work by preventing your body from reabsorbing a molecule of serotonin after it's transmitted a message, so that serotonin molecule can keep on keeping on in your brain. There are other reuptake inhibitors for norbinephrin and dopamine and other antidepressants that work in yet other ways. Type of medication may work better than another from person to person, and sometimes it takes a few tries to find one or a

combination that works well. Talk therapy, also known as psychotherapy, can be used in conjunction with medication or solo. It involves talking through symptoms, behaviors, and situations with a mental health professional. There are two main types most common today.

Cognitive behavioral therapy or CBT is meant to teach you new ways of thinking and behaving, and interpersonal therapy or IPT is meant to help you understand and work on personal relationships and social behaviors that may be contributing to your depression. Just as with medication based treatments, can take a few tries to find a talk therapist or a course of therapy that works for you. For a science podcast, all of this is infuriatingly inspecific, just whibbly wobbly, brainywhiney.

Lots more research is being done into the complex soup of conditions that creates our mental health. Hopefully in the future we'll have more precise answers. In the meanwhile, if you're worried about yourself for a loved one, please remember that even with everything we don't know, depression is real and clinical and highly treatable. It can get better, and there is nothing wrong needing a little help. Today's episode is based on the article how Depression Works on how

stuffworks dot Com, written by Maria Tremarky. Brain Stuff is production by Heart Radio in partnership with how stuffworks dot Com and is produced by Tyler Klang. Four more podcasts from my heart Radio. Visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.