Depression. It’s not “All in your head”.

Depression is excruciating, debilitating, isolating and very real. Suggesting it’s a just a sadness that you should snap-out-of, would be kind of entertaining if it wasn’t so insulting. It is a life-threatening health situation… that many strong, amazing people do not survive.

The women and girls I work with come to me ashamed and defeated, feeling like they are mentally-ill weaklings who can’t do life. The first thing I want them to know is that nothing could be further from the truth.

Depression doesn’t mean you are a mentally-ill weakling who can’t do life,

it means you are the sanest person in the room…

functioning exactly as designed.

QUICK STATS

• Depression is currently the 2^nd leading cause of disability in NA, and expected to become #1 over the next few years
• 2x as many women struggle with depression, compared to men
• 25% of women in their 40’s and 50’s are currently using a brain drug (1)

THE BIG Q is: WHY the heck are so many women going down?

MISSING CHEMICALS?

The predominant theory is that depression is a chemical imbalance and you need to take chemicals to fix it — just like a diabetic needs to take insulin to function properly.

But there are some staggering holes in this theory: (2, 3, 4)

• In 60 years of research, zero studies have been able to link serotonin or norepinephrine levels to depression. And goodness knows, they’ve tried!
• Across all of the research, antidepressants have an 18-30% effectiveness rate. The same effectiveness rate is seen in the placebos. (i.e. sugar pills)

We all know someone who has been helped by an anti-depressant — what we are currently learning is that this effect likely has little to do with correcting serotonin or dopamine; it may come with more brain baggage than you are willing to carry; and there are safer and more effective ways to get your life back.

SO, THEN IT MUST BE GENETICS?

This doesn’t appear to be the explanation either — a 2009 meta-analysis of 14 000 patients published in JAMA showed no link between genetic variations in neurotransmitter receptors and depression.

SO…WHAT”S GOING ON THEN?

DEPRESSION IS NOT A MENTAL ILLNESS

• Depression is not a disease, it’s a symptom — like a fever…it lets you know that something is not right. A symptom doesn’t tell you WHY — it just lets you know something needs your attention.

• Depression is not a mental illness, it’s a physical illness — Your brain is a totally legit tangible physical organ. Just like your heart. It also happens to be the most vulnerable organ — so the first to go down when your ship is in trouble.

• Depression is not “All in your head” — it is usually coming from physiological distress nowhere near your brain

• Depression is not a weakness, it is an intelligent, adaptive response — There are predictable changes that happen in depressed brains. The rock bottom definition of depression is decreased firing of brain cells in specific centers of the brain. The key is to know that your brain is being shut down on purpose.

THE INTELLIGENCE OF DEPRESSION

Depression isn’t pretty, but it is intelligent. It’s a symptom that your body is struggling to stay afloat under its current circumstances. Your answer lies in uncovering WHY your body is needing to create this response… why you are needing to shut your brain down.

Physiological distress anywhere in the body causes brain-based changes to help you survive in that moment. We’ve all heard of the distress responses “Fight” and “Flight”. There is also a third stress survival response called “Freeze”. It’s this mechanism that will cause you to freeze in your tracks — in other words…play dead — when finding yourself in a staring contest with a Grizzly bear. If the physiological distress is ongoing rather than momentary — you brain shuts down further and further until your whole life feels like a big game of playing dead. Sound familiar?

The serotonin/ neurotransmitter theory is starting to be replaced by the field of psychoneuroimmunology. Psychoneuroimmunology recognizes that the nervous system, digestive system and immune systems play closely with each other — and that chaos in one area, can take another area down.

Two of the key chemical players tying these systems together — and thus tying the brain to the rest of the body — are inflammation (eg. cytokines) and stress response (eg. cortisol).

• The level of inflammatory markers in the blood correlate directly with the risk and severity of depression. (5)
• Inflammatory messengers in the brain interfere with the conversion of tryptophan to serotonin by converting it into a brain-irritating chemical called quinolinic acid

THE BIG PICTURE

I have seen all of the following shut perfectly lovely brains down — creating chronic, serious depression that feels inescapable. It’s these situations that need to be fixed — not your brain.

Even in cases that medication didn’t help (especially in cases where medication didn’t help!), it can be as simple as correcting just one factor. Other cases might require the correction of several factors.

• Blood sugar roller-coaster — hypoglycemia, hyperglycemia, and insulin resistance promote inflammation and interfere with brain cell function (glucose is the #2 requirement for healthy brain cell function, #1 being oxygen)
• Gut inflammation — hidden inflammatory foods, leaky gut, infections, microbiome imbalance….all talk directly to the brain
• Nutrient deficiency — vitamin B3, B12, vitamin D and omega fats are among some of the deficiencies that can change brain function and mimic depression
• Thyroid imbalance — including undiagnosed or improperly treated thyroid dysfunction (hypothyroid, Hashimoto)
• Menstrual cycle irregularities — specifically understanding what’s normal and what’s not normal, and the brain consequences of using synthetic birth control pills
• Circadian rhythm disruption — lost sleep increases the circulating levels of inflammatory chemicals and increases the incidence of depression by 14x (14x!). A double whammy. In turn, inflammation and depression both interfere with restorative sleep…creating an evil vicious cycle.
• Unrelenting life stress — the stress response chemicals (eg. cortisol) shut down the frontal lobe and literally wear out brain cells and synapses

Depression is not “All in in your head”. At all.

The best way to heal your brain is to heal the body it’s living it.

1. Roni Caryn Rabin, “A Glut of Antidepressants,” New York Times, Aug 12, 2013
2. E. Castrén, “Is Mood Chemistry?” Nat Rev Neurosci 6, no.3 (March 2005): 241-46.
3. R. H. Belmaker and G. Agam, “Major Depressive Disoder.” N Engl J Med 358, no. 1 (Jan 2008): 55-68.
4. Irving Kirsch, “Challenging Received Wisdom: Antidepressants and the Placebo Effect,” McGill J Med 11, no.2 (Nov 2008): 219-22.
5. A.H. Miller et al., “Inflammation and Its Discontents: The Role of Cytokines in the Pathophysiology of Major Depression,” Biol Psychiatry 65, no. 9 (May 1, 2009): 732-41.

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