Over 2018, the world has absorbed the shock and loss of multiple beloved individuals to depression, substance abuse and suicide. Fashion legend Kate Spade took her own life in June, as did writer-television host Anthony Bourdain. Pop star Demi Lovato suffered a very public breakdown and hospital stay following an opiate overdose. American musician and rapper Mac Miller lost a struggle with addiction in September. Global awareness of depression has skyrocketed as media coverage surrounding these losses has grown more sophisticated.
To approach an understanding of clinical depression, we must begin by recognizing that depression exists within a range of severities. Depression which surpasses the mild end of the spectrum is often referred to as clinical depression and is best treated by mental health professionals.
Two primary categories of depression exist: major depression and depressive phases stemming from bipolar disorder.
Major depression (frequently diagnoses as major depressive disorder or unipolar depression) is the most common conception of depression that people have. Feelings of sadness or emptiness, loss of satisfaction, appetite changes, sleep problems and suicidal ideation are all typical symptoms associated with unipolar depression.
Bipolar disorder is characterized by erratic, alternating periods of depression and intensely elevated mood known as “mania”. The depressive phase of bipolar disorder is accompanied by nearly identical symptoms to major depressive disorder.
Studies tend to show that several different factors contribute to an individual’s propensity toward depression. The cause may be linked to a hereditary condition wherein neurotransmitter malfunction in the brain. Environmental factors can also disrupt mental health by triggering symptomatic responses in those who are genetically vulnerable.
Despite seemingly frequent remainders in life to refrain from judging a proverbial book by its cover, Anthony Bourdain’s career and outward image deceptively point to a happy, content, rewarding life. Yet despite the late host’s many achievements, Anthony succumbed to his depression and decided to end his life.
During an episode of “Parts Unknown” centered around Argentina, Bourdain remarked upon the Central American country’s embrace of psychoanalysis and mental health treatment. In the episode, Bourdain spoke with his personal therapist and openly addressed his struggles with depression. By many accounts, Bourdain did not exhibit signs in his personal life, and certainly not publicly. Bourdain never shied away from admitting past substance abuse, but the Argentina trip was the first time he publicly acknowledged an ongoing battle with depression.
According to the National Bureau of Econo
mic Research, those suffering a mental illness at some stage in their life consume alcohol and other harmful substances at rates 70 to 80 per cent higher than the average person. Those suffering from both substance abuse and mental illness are said to have what is called a dual diagnosis.
Depression diagnoses often coincide with substance abuse. The interaction between depression and, say, alcohol is bi-directional, meaning that those afflicted with depression are statistically more likely to abuse alcohol, and those who drink heavily are more prone to experience depression.
The dangers of substance abuse originate from the momentary mood lifts that alcohol, opiates or amphetamines may bring. Though potent and addictive, many of these substances, primarily alcohol, serve as depressants to the user’s system. Substances not classified as depressants often induce a “crash” sensation following binge use; stimulants that deplete mood-positive hormones like serotonin leave users feelings empty and reeling from prolonged damage and the sudden absence of the substance’s fleeting joys and distractions.
These adverse health effects are compounded by the social stigma surrounding substance abuse. Prolonged abuse leave depressed individuals feeling even lower, which leads to repeated, continuous use, then finally addiction itself.
Clinical depression, by definition, limits an individual’s ability to function normally. Appetite is an early area of life that becomes altered by depression. Overeating becomes the abused substance for many, while a sparse appetite begins to encroach upon the health of others.
Fatigue and lack of satisfaction and pleasure are common symptoms of depression that many people address with food. Those doubting their self-worth will often find themselves turning to food as a means of solving their emotional hunger. Food alters the chemical balance in one’s brain, and in a healthy individual who keeps a balanced diet with appropriate portions, food regulates these chemicals in the brain. Simply put, a balanced diet regulates our mood. In depressive individuals prone to overeating, food can suddenly threaten hormonal stability, leading to chronic irregularities in mood.
Loss of satisfaction also frequently leads to a loss of appetite itself. Depression has an insidious propensity towards hampering healthy living and pleasure — two things that food comprises.
Depressive signals such as loss of appetite have a sort of dual-diagnosis effect: irregular and malnourished dieting leads to hormonal and metabolic abnormalities that exacerbate depression. By this measure, prolonged substance abuse has been shown to drastically restrict users’ appetites. Therefore, the combination of depression and substance abuse (already a negative feedback loop) frequently leads to severe malnutrition in afflicted persons.
A regular diet is one of the best things a depressed individual can employ to regulate their mood. While no diet has been proven to cure depression, certain diets have been shown to strengthen an individual’s mental and physical resolve in the struggle against depression. A diet rich in Omega-3 fatty acids (most often found in cold-water fish dishes) have been identified as crucial ingredients in healthy brain function. Many studies have pointed to beneficial side effects from Omega-3 fatty acids toward improving a person’s response to antidepressant medications.
The patience required to design and execute well-balanced, nutritious meal plans may prove too taxing for depressed people. Factoring in preparation time, easy-to-prepare meals can be key components in allowing depressed individuals to enjoy a balanced diet. For many, nutritional supplements may be required to mitigate weight loss and nutrient deficiency.
While consistent, wholesome dieting benefits one’s moods, such routines may still fall short of allowing depressed individuals to function happily in society. For extreme cases, antidepressant medication is available.
The antidepressants most often prescribed are known as selective serotonin reuptake inhibitors, or, SSRIs. Severe cases of depression are commonly treated with a combination of SSRIs and psychotherapy.
Outlier cases of depression may prevent the benefits of medications. Patients with treatment-resistant depression often seek out alternative treatments, such as Transcranial Magnetic Stimulation. This procedure involves the use of powerful electromagnets targeting areas of the brain most strongly linked to depressive disorders. The magnetic pulses delivered to the brain then safely stimulate nerves and depolarize superficial critical neurons. Though complex, TMS procedures are noninvasive and do not necessitate sedation. For depressed individuals who are resistant to medication, or if the side effects of different antidepressants prove too grueling, TMS Health Solutions offers an effective alternative with minimal side effects.
Depression lurks for any and everyone, but modern denizens of the world can live gratefully knowing that depression and mental illness are rapidly becoming more understood, and those who have devoted their lives to mental health are marching forward daily in combating this common monster.