Hi friends,
One of the most commonly
asked questions about psychological problems is about the nature of the
condition that is called depression. The concept of depression as understood
(or misunderstood) by many, varies from person to person. For many, depression
represents a reaction to setbacks or tragedies in life, and therefore, cannot
be set right until the problem is solved. (Well that is right, isn’t it? Well,
not quite! We shall discuss this in a bit.) For others, these are to do with
‘chemical changes in the brain’. So what is depression really? How is it caused
and what can make it better?
We all know that
a wide range exists in people’s abilities to cope with a given situation. Thus
while one person is able to cope with a huge tragedy without much distress,
another person may breakdown under seemingly minor stress. So what is it that
makes this difference? To take this a little further, some people can breakdown
and go into depression with almost no stress at all! In other words, feeling
sad although there is nothing to worry about! So how do we make sense of all
this?
Well, let me put
it this way – Depression is a condition characterized by certain symptoms (such
as sustained low mood, lack of interest in pleasurable activities, pessimism,
poor confidence, tendency to self harm), the exact nature and duration of which
is defined by experts from time to time. Depression is best seen as a set of co-occurring
symptoms, and at a superficial level, seem to be very similar in different
people suffering from it. In reality though, depression varies from person to
person. In the case of a situation where a person is depressed with no obvious
source of stress in life, it is perhaps that an internal abnormality in the
chemicals in the brain has occurred spontaneously (due to inherent errors like
genetics). These chemical abnormalities ‘activate the parts of the brain that
trigger feelings of sadness’, making the sufferer feel sad! In such cases,
medicines are likely very effective, as they can reverse the chemical
abnormalities.
In other instances, depression emerges in the
wake of a major tragedy (or any stress) that may be seen as causing certain
changes in the brain. Thus, although medicines may be useful in this scenario,
additional strategies such as counseling, in order to reduce the psychological
impact of the tragedy and integrate it better, will be needed.
Let us take the help of an
analogy to understand this better. A person having really weak bones due to old
age suffers a fracture, without any trauma (what is called a pathological
fracture), as he was just walking on the road. Another person, a young man,
breaks a bone in an accident. In the former situation, merely resting and
plastering will not help much unless the problem of weak bones is rectified;
because otherwise, a re-fracture is likely – as the problem is within! In the
second case though, resting the affected part and plastering it to mitigate the
effects of the trauma will be the main intervention.
In both cases,
there is a fracture – in the former, it was a problem within, but in the latter,
it was due to external trauma!
Between these two extreme
descriptions, exist an entire spectrum of depressive conditions with causal
contributions from both internal abnormalities as well as external sources of
stress. Therefore, in the real world, a combination of medicines and counseling
usually works best – Medicines correcting the internal abnormality, and therapy
taking care of the handling and processing of external stressors.
SO
TO ANSWER THE QUESTION IN A SINGLE SENTENCE; DEPRESSION RESULTS FROM A
COMBINATION OF FACTORS, INCLUDING (BUT NOT RESTRICTED TO), INHERENT/ INTERNAL
VULNERABILITIES, EXTERNAL STRESSORS AND CHEMICAL CHANGES IN THE BRAIN, WITH THE
AMOUNT OF CONTRIBUTION OF EACH FACTOR VARYING FROM PERSON TO PERSON!
So that was the discussion for this week
friends. Hope you liked it!
Please let me know if you want me to
discuss any specific issue by typing in the comments section below.
So until next time, STAY HAPPY!
Dr. Sathya Prakash, MD, Dip. CBT
Consultant Psychiatrist, Psychotherapist
and Behavioural Sciences Expert
Sir I am eagerly awaiting for this article ....
ReplyDeleteExcellent explanation. ....
ReplyDeleteExcellent explanation. ....
ReplyDelete