Depression.

Depression is a silent and insidious enemy, sometimes hidden behind a smile, whose power over our emotions and mind is undeniable. Deeply rooted in the human experience, depression manifests not merely as fleeting sadness or stress; it is a complex mental disorder.

It is often characterized by mood disturbances such as prolonged dejection, sadness, hopelessness, and emotional pain. Depression is marked by a sense of emptiness and general malaise.

In addition, symptoms of depression can include feelings of irritability, frustration, and restlessness. We might experience insomnia or excessive sleeping. A common feeling is fatigue even after a night's rest, changes in appetite, feelings of guilt, worthlessness, and helplessness. We often lose interest in activities that once brought us joy or interest. Self-harm, and even thoughts of suicide, are possible.

Chemical Imbalance

For a diagnosis of depressive disorder, or unipolar depression, at least 5 of the symptoms listed below must be present for almost every day over a period of at least 2 weeks, with one of these 5 symptoms being either a depressed mood or loss of interest and pleasure (Davison and Neale, 1999):

• Sad, depressed mood
• Loss of interest or pleasure in usual activities
• Significant appetite loss and weight loss or significant appetite increase and weight gain
• Insomnia or hypersomnia
• Psychomotor retardation or agitation (significantly slowed or accelerated thought, speech, and movements)
• Lack of energy, feeling of fatigue
• Feelings of worthlessness and guilt
• Difficulty concentrating and remembering, indecisiveness
• Recurrent thoughts of death or suicide

From ancient times to today, efforts to clearly distinguish depression from normal sadness have evolved. Pioneers like Hippocrates, who emphasized the context in which symptoms appear, played an important role in differentiating adaptive reactions from mental disorders. It is crucial to separate depression as a disorder with clear criteria from the emotion of sadness (sadness is a common, normal, and necessary emotion for healthy and unimpeded individual development). Despite advances in biological theories of depression, which include neurotransmitters like serotonin and norepinephrine, research has highlighted the importance of the impact of stressful and traumatic childhood experiences on the development of depression.

Studies have shown that chronic stress and childhood trauma alter brain and body function at genetic, chemical, and structural levels. A chemical imbalance in the brain can be a cause of depression, but it is also important to emphasize the interaction between the environment and the organism. Pharmacotherapy and psychotherapy are effective approaches to treating depression, and the choice of therapy often depends on symptom severity and the patient's individual needs.

It is crucial to understand that depression is not merely a consequence of biological factors or the result of a chemical imbalance or conduction problems, but rather the result of a complex interplay of genetic, biological, psychological, and social factors. Therefore, a focus on prevention, psychological help, social changes, and changes in our companies (because we spend a good part of our lives in them) plays a key role in the fight against this serious illness.

When we talk about chemical imbalance, it's important to note that by the 1960s, science had advanced sufficiently for scientists to measure hormone and neurotransmitter levels in blood and brains. Neurotransmitters are chemical messengers that transmit information from one neuron to another, enabling us to function normally with the world around us. Research has shown that decreased concentrations of the neurotransmitter norepinephrine lead to depression, while increased concentrations lead to mania. Depression is also linked to another neurotransmitter, serotonin, which often modulates the activity of other neurotransmitter systems and allows for large fluctuations in their activities; thus, reduced concentration can lead to both mania and depression. Given these conclusions, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants began to be used for treating depression.

However, a problem arises if we use the explanation that depression is a chemical imbalance in the brain without being aware of the interaction between the environment and the organism, meaning the influence that personal stressful and traumatic experiences, and in the long term, the social (work) environment, have on our nervous, immune, and endocrine systems.

Finally, when we speak of a chemical imbalance in the brain in the context of depression, it usually refers to neurotransmitters and their role in regulating emotional states. Neurotransmitters are "chemicals" in the brain that transmit signals between nerve cells (neurons) and play a key role in regulating mood, emotions, and various brain functions. Two important "chemicals" often associated with depression are serotonin and norepinephrine. Their role, in addition to communication between neurons, is to regulate various body functions. Serotonin, for example, is often associated with feelings of happiness and well-being, while norepinephrine is involved in regulating stress, alertness, and concentration. Serotonin and norepinephrine are often incorrectly associated with hormones. Hormones are also chemical substances, but they differ from neurotransmitters in that they are secreted from our endocrine glands (thyroid, adrenal gland, pituitary gland, etc.) into the bloodstream and travel throughout our body to influence/regulate various organs and functions.

Hormones have long-term effects on the body, while neurotransmitters rapidly transmit signals between neurons to regulate short-term processes in the brain and nervous system.

The Roots of Depression

What do people with depression have in common, besides their struggle with this illness? Humans are environmental and experiential beings, and the answer is simple: their feelings, experiences, thoughts, and memories.

Feelings, experiences, thoughts, and memories – these are us. The human brain is simple; everything must be logical to it. Any unresolved "problem" in our four foundational elements can become the cause of our depression. Medications like antidepressants will only provide temporary relief but will not solve our fundamental problem: the problem with feelings, experiences, thoughts, and memories.

The true source of depression is not just a matter of chemical imbalance or genetics. Depression is a response-a complex response to stress, trauma, or suppressed emotions. It is a response to feelings that haunt us, experiences that define us, thoughts that obsess us, and memories that refuse to fade.

Depression can be like a malignant disease that slowly spreads through our lives, affecting every aspect of it. To find a lasting solution, we must return to the "roots," not by reliving the pain, suffering, or anger, but by transforming them.

The past is not our present, and it certainly does not define our future. And so our feelings, thoughts, experiences, and memories, sometimes hidden from our consciousness, hold the key to our freedom. To free ourselves from depression, we must confront these elements that keep us trapped in the past.

A Behaviorist's View of Depression

A behaviorist's view of depression offers one of the key approaches to understanding this mental disorder. Behavioral theory emphasizes that depression often develops as a result of unhealthy behavioral patterns and negative experiences.

Namely, behaviorists believe that depressive symptoms are the result of negative experiences and stressors in our lives. These events can lead to negative emotional reactions, such as sadness and helplessness. Also, the behavioral approach emphasizes observing our external behavior as an indicator of our internal state. For example, behaviorists will notice changes in sleep, eating, energy, and social withdrawal as signs of depression. According to behavioral theory, depression can create negative behavioral spirals. For example, a person who feels depressed might withdraw from social activities, which can lead to further isolation and worsening symptoms.

And no, I don't think behavioral therapy is the solution. Unfortunately, even behaviorists sometimes miss changes in behavioral patterns, and modern psychotherapy today (among other things) relies on a cognitive-behavioral approach to treating depression.

It combines elements of cognitive therapy (which focuses on thoughts and beliefs) and behavioral therapy (which focuses on behavior).

Giving Up on Oneself and Irrationality

Depression can lead to giving up on oneself and one's own life, a state that can be extremely challenging and emotionally exhausting. Our motivation for even daily tasks will be very low. Since depression is often accompanied by a deep sense of helplessness, we will feel like we are losing control over our lives and situations and that we can't change anything. Given that we are all, at heart, at least a little bit control freaks, this is probably the most terrifying feeling. Additionally, low self-esteem, coupled with a loss of control, will further reinforce the idea of ourselves as failures. The consequence of all this is hurting the already wounded, or emotional or physical self-punishment, i.e., self-aggression. And finally, a feeling of hopelessness, as a central part of depression, seems like a truly logical continuation.

And as if all this weren't enough, depression often leads to irrational thoughts, beliefs, and behaviors, which will further worsen an already not-so-good situation. There are also unwanted cognitive patterns like negative filtering, where we only see the bad, or catastrophic thinking, where we only envision the worst possible outcomes. Additionally, we will interpret all events in line with our pessimistic worldview (distortion of reality). We will further criticize ourselves, and there will be no "middle ground" in life; everything will be black or white. And that's why it's impossible to see "the light at the end of the tunnel."

Depression, Anxiety, and Aggression

Depression and anxiety are two common mental health conditions that often co-occur. This state is frequently referred to as "comorbidity" (a word we often heard during the COVID-19 era) because many people suffering from depression also experience symptoms of anxiety, and vice versa.

Depression and anxiety share some common symptoms, such as changes in sleep and appetite, fatigue, concentration problems, and irrational fears. These are the main reasons why someone's depression might be overlooked, as we might categorize it as anxiety. Also, depression and anxiety often potentiate each other. A person with depression may feel anxious due to their depressive thoughts and feelings of helplessness. Conversely, a person with anxiety may feel depressed due to constant stress and worry.

Although depression and aggression are two opposite emotional states, it can happen that depression leads to expressions of aggressive behavior or irritability. Aggression itself can be seen as a defense mechanism, given the helplessness, sadness, and frustration, but it can also be the result of lost emotional control.

In Conclusion

What we all must fight against is the stigmatization and trivialization of depression.

Stigmatization refers to negative prejudices, stereotypes, and discrimination against people with a certain health or social problem, in this case, against people with depression, which results in feelings of shame and guilt for individuals suffering from depression. Additionally, it can deter them from seeking help and support, as they fear negative reactions or judgment from their environment.

Stigmatization can also lead to misunderstanding and minimization of the seriousness of depression, making it difficult for those struggling with it to acknowledge their problems and seek help.

Trivialization occurs when the seriousness of depression is compared to other problems or emotional states, often with the aim of downplaying the importance of depression.

For example, some people might tell those with depression that "everyone goes through tough times" or "everyone feels sad sometimes," suggesting that depression is just a form of normal emotions.

Trivializing depression can be harmful because it diminishes the severity of depression as a mental disorder. Every person experiences their emotional difficulties in their own way, and what might be less stressful for one person can be an extremely difficult and painful experience for another.

And so, depression represents a challenging and complex mental disorder that affects many aspects of human life. It impacts not only individuals but also their families, friends, and work environment. It is crucial to understand that depression is not exclusively the result of a chemical imbalance in the brain, but rather the result of a complex interplay of genetic, biological, psychological, and social factors.

Society, family, and the work environment play a crucial role in preventing and supporting individuals struggling with depression. People have the ability to change their environment to create a safe and nurturing space for growth and development. Particularly in the context of workplaces, understanding and supporting employees facing depression can be key to their mental health.

Depression often arises from unresolved emotional problems, traumatic experiences, and negative emotional reactions to stressors in life, making it ultimately important what kind of legacy we leave behind in our relationships with the people around us.