A BRIEF HISTORY OF
DEPRESSION
Depression goes
way back to the times of the ancient Egyptians and Greeks. Back then,
depression was thought to be caused by the gods, at least until Hippocrates
came along. Hippocrates thought depression was due to an imbalance in
substances in the body. In the 1900s, Emil Kraeplin hypothesized mental illness
was related to the chemistry of the brain (much like Hippocrates) and Sigmund Freud
hypothesized it was due to childhood events and other relationships; both ideas
are correct.
In the 17th
century, a woman named Dorthea Dix took up the task of convincing states in
America to build asylums. Though some people were treated and discharged, the
majority were readmitted or never left. The asylums eventually fell into
neglect, and as such, the jobs for its upkeep and administration went to
unskilled persons. Though people still supported the idea that the mentally ill
be put away in hospitals, no one really lobbied for better facilities or admin.
Back then, most of the mentally ill were shipped off to these institutions
because living at home became difficult. However during the rise of medication
for these illnesses, living at home became easier for the mentally ill. Today, a combination of talk therapy (psychotherapy) and medication is usually used to
treat mental illness.
AN OVERVIEW
There are
actually many kinds of depression but the scope of this paper will only cover
major unipolar depression (as opposed to bipolar depression, in which there are
also episodes of mania colloquially known as “highs”). Though symptoms vary
from person to person, the following seem to be very common: difficulty in
concentrating and decision making, overeating or loss of appetite, hypersomnia
or insomnia, loss of interest in activities that were once interesting, and
persistent anxiety and sadness.
Depression is a
persistent illness, but it is hard to say whether the number of people
afflicted by depression is growing, or whether people are slowly becoming more
and more aware of the condition and how to treat it. Currently depression is
still misunderstood in some circles because most people experience at least a
mild depression once in their lives. The problem is that some people equate
that mild depression to the more major forms, which are not as easily treated
or overcome. Depression is not just pessimism or choosing to be unhappy. It is
the inability to make that choice.
THE ILLNESS
ITSELF
It has been observed in some depressives that they tend to go into a cycle of depression (recovery and relapse) which is governed the body’s biological clock. In the brains of depressives, there is decreased activity in the prefrontal cortex (responsible for decision making and strategizing) and the subgenual region. There is increased activity in the amygdala (involved in memory and emotional response) and the thalamus (controls motor function and sleeping). Other changes associated with depression include the imabalance in brain chemistry (notably the concentrations of serotonin, dopamine, and norepinephrine. Dopamine, serotonin, and norepinephrine were related to anhedonia, persistent grief, and psychomotor retardation respectively. It was also observed that drugs inhibiting Substance P (a neurotransmitter associated with physical pain) could relieve symptoms of depression; the brain uses the same neurotransmitter for physical and mental pain.
Major
depression can be characterized by (but is not limited to) anhedonia,
self-injury (including suicide attempts), psychomotor retardation. The last
characteristic is probably what makes depression so crippling—simple tasks
suddenly become complex and difficult to accomplish. Again, since people assume
depression is equal to a little sadness, they might not understand how
debilitating it can be. As a mental illness, it can also be discriminated upon
by just being “all in your head” when in reality is has very strong biological
basis.
“Some catastrophic moments invite clarity, explode in split moments: You smash your hand through a windowpane and then there is blood and shattered glass stained with red all over the place; you fall out a window and break some bones and scrape some skin. Stitches and casts and bandages and antiseptic solve and salve the wounds. But depression is not a sudden disaster. It is more like a cancer: At first its tumorous mass is not even noticeable to the careful eye, and then one day—wham!—there is a huge, deadly seven-pound lump lodged in your brain or your stomach or your shoulder blade, and this thing that your own body has produced is actually trying to kill you. Depression is a lot like that: Slowly, over the years, the data will accumulate in your heart and mind, a computer program for total negativity will build into your system, making life feel more and more unbearable. But you won't even notice it coming on, thinking that it is somehow normal, something about getting older, about turning eight or turning twelve or turning fifteen, and then one day you realize that your entire life is just awful, not worth living, a horror and a black blot on the white terrain of human existence. One morning you wake up afraid you are going to live. […]
That's the thing I want to make clear about depression: It's got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal—unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature's part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.”
—Prozac Nation
REFERENCES
1.
Muckenhoupt, Margaret, 2003. Dorothea Dix: Advocate for Mental Health Care.
United States of America: Oxford University Press.
2. Roy, Jennifer, 2005.
Depression. New York: Marshall Cavendish.
3.
Sapolsky, Robert. Stanford’s Sapolsky On Depression in U.S. (Full Lecture). http://www.youtube.com/watch?v=NOAgplgTxfc.
February 10, 2014.
4.
Wolpert, Lewis, 1999. Malignant Sadness: The Anatomy of Depression. New York:
The Free Press.
5.
Wurtzel, Elizabeth, 1999. Prozac Nation: Young and Depressed in America. United
States of America: Replica Books.
Cadiz, M.T.M.
STS THY
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