The Truth About MDD
Major Depressive Disorder and What You Should Know About It
Statistics say 1 in 4 adults suffer from a mental illness — so before you think this article does not relate to you, if it doesn't directly, someone in your life is suffering right now. In fact, 1 in 4 means several are suffering. Interestingly, that is the same statistic for abuse of women, 1 in 4. It is a pretty bleak statistic — it alone could cause depression! Depression is the mental illness I want to discuss, specifically Major Depressive Disorder (MDD).
So What Is MDD Anyways?
MDD, also known as Clinical Depression or Major Depression, is the more-severe form of depression. It can affect anyone at any age, including children, and while it can be improved with psychological counseling and antidepressant medications, it cannot always be “cured”. The average age of onset for MDD is 32. According to the Depression and Bipolar Support Alliance, approximately 14.8 million American adults, or 6.7 percent of the United States population over age 18, are affected by MDD every year. The disorder also occurs in about 1 in 33 children and 1 in 8 teens.
How Does MDD Affect the Brain?
There are three parts of the brain that are affected in a person suffering from MDD: the hippocampus, amygdala, and the prefrontal cortex.
The hippocampus is located near the center of the brain and it is responsible for producing a hormone called cortisol as well as storing memories. Cortisol is released during times of physical and mental stress as well as times of depression. However, excess amounts of cortisol can be sent to the brain that cause an imbalance in the chemical make-up of the brain. In a healthy brain, the dentate gyrus, a part in the hippocampus, produces brain cells, or neurons, consistently. However, the long-term exposure to heightened levels of cortisol in people with MDD causes a decrease in the production of these new neurons and cause existing ones to shrink. Generally, these cortisol levels decrease at night, however, they are not decreased in sufferers of MDD.
In conjunction, in people suffering from MDD, there is also a shrinkage in the prefrontal cortex. The prefrontal cortex is located in the front of the brain and is responsible for the regulation of emotions, making decisions and forming memories.
Finally, the amygdala is responsible for facilitating emotional responses. When the amygdala becomes enlarged and more active, due to the continuously high levels of cortisol, the person can suffer from disturbed activity and sleep patterns. Combined with the shrunken prefrontal cortex and hippocampus, the body can release irregular amounts of other hormones and chemicals that can cause further complications for the sufferer of MDD.
So How Do We Treat MDD?
There are a variety of different clinical drugs that can affect different parts of the brain, increasing some chemicals (norepinephrine-dopamine reuptake inhibitors: NDRIs), moderating serotonin levels (selective serotonin uptake inhibitors: SSRIs), improving brain cell communication (monoamine oxidase inhibitors: MAOIs), or blocking brain cell communication all together (atypical antidepressants). In addition, electroconvulsive therapy, transcranial magnetic stimulations, and psychotherapy can also be effective.
Do Treatments Work?
This question is up for debate. I’ve researched this question and some sources say that there is a “cure” for MDD, while others say that a person with MDD will always have MDD, although it may be “dormant”.
My personal struggle with MDD is more of the latter opinion. While I am not on any type of drug and I no longer undergo psychotherapy treatment, I still struggle with MDD. The symptoms aren’t the same for everyone and the levels of depression are not the same. For me, I struggle regularly with anxiety, hopelessness, guilt and insomnia. I also experience extreme emotions. I can be completely overjoyed today and tomorrow, extremely manic.
I do my best to self-reflect regularly and try and determine if I rightly feel the way I feel or if it is an emotion beyond my control (such as an overload of chemicals in my brain that are causing the issue). If the situation I find myself in warrants the extreme emotion, I let it wash through me and then release it. If the emotion is too extreme for the situation, I identify the main emotion I feel and I find something that can alleviate the feeling for me. For instance, If i feel overwhelmed, anxious and hopelessness, I have found that a trip to the beach at night to look at the ocean helps immensely. The feeling of being so much smaller and insignificant in the face of a force like the ocean can generally put me at rights. I also try and remind myself that my issues are first world issues, and therefore, not worth getting bent out of shape about.
While I could rely on drugs to regulate these ups and downs for me, I have opted to try and manage myself. However, that isn’t possible for every person experiencing MDD. In the beginning, it wasn’t a possibility for me. I spent a couple of years on a variety of different SSRI’s and MAOI’s but I didn’t like the affects on my emotions. While I rarely experienced extreme sadness, I also didn’t experience extreme happiness. I lived in a steady state of “fine” and I was not okay living like that. I wanted more out of life, so I made the decision to self-regulate. Perhaps this is possible because the drugs I did take did alter parts of my brain to lessen the effects of MDD. Perhaps if I was still on clinical drugs I could be “cured”. But I have to wonder if a cure only exists while you are still on clinical drugs. As soon as you come off of them, does the brain go haywire again?
There are still many discussions surrounding this topic. The fact is, we don’t know what causes depression in people. Researchers can isolate triggers (stress occurs around 80% of the time), but an actual cause is unknown. Abuse victims, stressed professionals and other trauma suffers can develop MDD, but they don’t always. I often wonder if having certain character traits, such as a pretense towards anxiety, hopelessness and worthlessness, can fast-track MDD. But ultimately, it is all a question until research makes breakthroughs and the understanding of the brain increases.
Sources:
