The National Institute of Mental Health defines depression as a common and serious mood disorder that affects more than 16 million adults in the United States. Depression may cause severe symptoms that affect how one thinks, feels, and handles daily activities such as sleeping, eating, or even working. In order to be diagnosed with depression, the symptoms must be present for at least two weeks. Those symptoms experienced and the circumstance that may have caused those symptoms are what determines what form of depression someone is diagnosed with.
The Different Forms of Depression
Persistent depression disorder is a depressed mood that lasts for at least two years. A person diagnosed with this type of depression may have episodes of major depression along with periods of less severe symptoms, but the symptoms last for two years or more.
Postpartum depression is often times confused with the “baby blues,” which is a relatively mild type of depression and anxiety that occurs within the first two weeks after giving birth. Postpartum depression is full-blown major depression during pregnancy or after delivery. These include extreme feelings of sadness, anxiety, and exhaustion which make it difficult for these new mothers to complete daily tasks to care for both themselves and baby.
Psychotic depression is when the person who already has severe depression now has some form of psychosis, such as having delusions, hearing or seeing upsetting things that others cannot hear or see (hallucinations). These psychotic symptoms usually have a depression “theme” to them, such as delusions of guilt, poverty, or illness.
Seasonal affective disorder is usually experienced during winter months when there is less natural sunlight. This form of depression generally goes away during spring and summer. The main symptoms a person experienced is social withdrawal, increased sleep, and weight gain.
Bipolar disorder is different from depression, but someone with bipolar disorder experiences episodes of extreme low moods that meet the criteria for major depression. This is known as “bipolar depression.” A person with bipolar disorder also experiences extreme high-euphoric or irritable moods called “mania” or less severe forms called “hypomania.”
What Causes Depression?
The cause of depression is not a simple one to understand as there are several factors that contribute to it. The National Institute of Mental Health explains that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Genetic factors can include personal or family history of depression. Biological factors can include certain physical illnesses and medications, and environmental factors can include major life changes, trauma or stress. It can also happen at any age but more often times beings in adulthood.
Depression can co-occur with other serious medical illnesses such as diabetes, cancer, heart disease, COPD, and Parkinson’s disease. These conditions are often worse when depression is also present. Unfortunately, sometimes the medications taken for these physical illnesses can cause side effects that contribute to depression.
How Does Depression Affect The Brain?
Depression mainly affects three major parts of the brain, the hippocampus, amygdala, and prefrontal cortex. The hippocampus is located near the center of the brain and is responsible for storing memories and regulating a hormone called cortisol. Cortisol is released during times when there is physical or mental stress, including times we experience depression. Excessive amounts of cortisol are not good for us. Long-term high levels of cortisol can slow the production of new neurons and cause neurons in the hippocampus to shrink which can lead to memory problems.
The prefrontal cortex is located in the front of the brain and is responsible for regulating emotions, decision making, and forming memories. When too much cortisol is released, the prefrontal cortex actually appears to shrink.
The amygdala is responsible for emotional responses. High levels of cortisol cause the amygdala to become enlarged and more active. This leads to disturbances in sleep and activity patterns. It can also cause an irregular release of hormones and other chemicals in the body which can lead to further complications.
The International Psychogeriatric Association published a study on cortisol levels and the relation to depression and dementia. The results showed that cortisol levels were highest among patients with dementia and depression. This proves that depression can actually change how the brain works as well as communicates with the body. This then creates the question of if long-term high levels of cortisol can actually be causing dementia.
Treatment for Depression
The simple answer on how to treat depression is how to essentially control the amount of cortisol and other chemicals in the brain. There are several medications on the market to do just this. With these medications sometimes come very serious side effects and risks.
Another problem is the risk of dependency on some medications and the time it takes for medications to take effect. These types of medications can take weeks to fully work due to the necessary build-up of them inside the brain.
- Selective serotonin uptake inhibitors (SSRIs) regulate the level of serotonin in the brain. Serotonin is responsible for mood and energy level. Prozac, Paxil, and Celexa are some of the more common forms of SSRIs.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants can also alter the amounts of serotonin and norepinephrine in the brain. The most common SNRIs are Tofranil, Pamelor, and Surmontil.
- Norepinephrine-dopamine reuptake inhibitors (NDRIs) aid in increasing the levels of norepinephrine and dopamine in the brain. Dopamine creates a pleasurable feeling. The most common NDRI is Wellbutrin.
- Monoamine oxidase inhibitors (MAOIs) increase the amount of norepinephrine, serotonin, and dopamine. They also help improve brain cell communication.
- Atypical antidepressants are a group of medications that include tranquilizers, mood stabilizers, and antipsychotics. They can block brain cell communication in order to cause a relaxed state.
There are also other options aside from medications to help treat the symptoms of depression or to boost brain health and help recover from the symptoms. These include electroconvulsive therapy (ECT), which involves passing electrical currents through the brain to booth communication between brain cells. Transcranial magnetic stimulation (TMS), which is done by sending electrical pulses into the brain cells that regulate mood. Aside from procedures, you can also booth brain health by eating healthful foods and staying active, sleeping well, and avoiding alcohol and illegal drugs.
Can Cannabinoids Treat Depression?
CBD has the ability to interact with the endocannabinoid system, which is responsible for our physiology and mood. CBD can trigger cannabinoid receptors throughout the brain and body. Knowing this poses the question, how can CBD help not only with the symptoms of depression, but with the changes that occur in the brain? Can CBD work just like the medications people are prescribed, but with fewer side-effects and risks?
One study published by Molecular Neurobiology was conducted to investigate the claim that CBD shows a large-spectrum of therapeutic potential benefits, specifically as an antidepressant. The study specifically looked at whether CBD could induce both rapid and sustained antidepressant-like effects after just a single administration, and if that effect would be related to changes in synaptic proteins and function in the brain. The results were astonishing-a single dose of CBD induced antidepressant-like effects. These results support CBD being a promising therapeutic antidepressant drug.
Another study published by the Progress in Neuro-Psychopharmacology and Biological Psychiatry in 2018 indicated CBD induces antidepressant-like effects. The work done in the study was aimed to investigate the participation of serotonin and noradrenaline in CBD-induced antidepressant-like effects. The results suggested that antidepressant-life effects induced by CBD were dependent on serotonin levels in the central nervous system (CNS). Cannabinoids respond differently for people depending upon how their endocannabinoid system is functioning.