It does not feel right for quite some time
“You are not fit for the world”, you may feel this way if you are in depression.
You do not have the motivation to leave the bed. A new day on earth does not interest you. You fail to get things done. You see no purpose in your existence. Existing feels like fighting a battle to you. However, others may interpret your acts differently. Your withdrawal from everyday life may appear as self-pampering to people around you. In underdeveloped regions, where survival to this day is meant for the fittest, you might also be frowned upon as a pretentious lazy bum. But is that really so?
When I immigrated to Canada from Bangladesh, I carried a picture in my mind of what I am getting into. During my teaching career in a university in Bangladesh, my major hurdle was not communicating the course content. It was to deal with students in frustration, to see them sink into depression. I wanted to keep them motivated, to make them able to see a prospective future in a highly populated but resource-poor country. In a resourceful country like Canada, I expected a more peaceful crowd, more satisfied, and happier. My first workplace was partly affiliated with the University of Toronto and located near a campus. This was when I learned the truth about UofT students’ mental health.
UofT newsletters, their blogs relentlessly talk about depression. Deep sadness is reflected in their sleep-deprived coffee-driven unwilling lives. I started to dig in. In 2018-19, five of them have committed suicide! The countrywide statistics do not look any better. 1 in 5 people can experience a mental illness in any given year. Things are no better in the neighboring country. In the school year 2019-20 in the US, 1 in every 3 university or college students was screened positive for depression. It is the second major cause of disability in the USA after heart diseases. Worldwide, more than 350 million people have depression. So, the alarming and established truth of depression is that it is damn real.
Enough with the statistics, let’s see what are depressive disorders.
Depressive disorders (DD) are characterized by persistent feelings of sadness, fatigue, difficulties in focusing or making decisions, insomnia, restlessness, hopelessness, etc. These symptoms are the most frequent and the prominent ones. Many other symptoms can be associated with these. To understand clinical depression, let us see what not depression is.
You feel like a shit every now and then for various reasons. You got bad grades, lost your job, or your family did not show up for you. Unfortunate incidents throwing you off for a while is not depression. Every soul on earth experiences that. Depression is different from usual mood fluctuations and brief emotional responses to challenges in everyday life. It is depression when you are overwhelmed with these shitty feelings frequently and persistently; when these emotions disrupt your proper functioning in everyday life, your studies, career, your family life, and your future.
Why in the world you fell into depression, you wonder?
What could be the reasons that some homeless people are happy but some not?
Why would an educated, energetic, young person in her twenty with a fantastic career ahead not feel Joy in anything anymore?
Why does not having money or a loving family make any difference in the feelings of some people?
Why are some people more prone to depression?
Genes Come Into Play
Thanks to the advancement of medical science, insights about depression are not plain black-and-white anymore. Our early life experiences (childhood abuse, for example), daily life stress can trigger depression onset. But that is not all! The biggest trigger is ourselves!
Sorry for the extra drama! I only meant the DNA we inherit from our ancestors. Many thousands of genes that are lying on our DNA construct our genetic makeup. Genetic makeup is probably the greatest prophecy of our life on earth! Genes are responsible for our features, for example, eye color, height. The fact we need to learn at this point is that a gene can have many forms within and across populations. These are called gene variants. Say, gene ‘X’ (along with other genes) is responsible for skin color. Different people may have slightly different forms (variants) of gene ‘X’.
Similar to our physical features, our personalities originate from genes. These include the tendency to experience negative affect, motivation to engage with people, openness to experience, friendliness, organized behavior, etc. Personality and abnormal psychology are correlated. A whole network of genes and interactions between them contribute to personality features.
From an analysis of five hundred thousand Neuroticism patients, 136 associated gene variants were discovered. Many of these gene variants are involved in brain growth and signaling. Totally makes sense! Some of these gene variants can make us more at risk for particular disorders. Some people are at higher risk of diabetes, heart disease, breast cancer; likewise, some are of depression.
You may have heard of Dopamine and Serotonin a lot by now. They are essential for the sleep cycle, emotions, learning, alertness, etc. Activities like exercise, reminiscing happy memories, and sex stimulate these chemicals in our brain. A proper balance of these chemicals is necessary for controlling emotions. Depressive disorder patients may carry gene variants that can not function properly to command these levels! Thus, these variants can make us more at risk of a chemical imbalance in the brain leading to depression.
No wonder, genes are a player. But there are more!
So, is it just the genes?
We are a big fan of DNA in this century. Hail DNA! However, DNA is half the story in depression. One may mistakenly think DNA is static and stable since genes carry the most essential commands. In truth, DNA is plastic. DNA and some proteins around it (called histones) often go through slight chemical changes. It is called epigenetic changes when small molecules are added to or erased from DNA/histone. To make it clear, epigenetic changes do not change the DNA code itself or the information embedded into it. But the way this information is expressed can be changed.
To give an easy example here, let us talk about a gene named BRCA1. BRCA1 helps to protect us from breast tumors. But the addition of small methyl molecules to this BRCA1 gene makes it not suppress tumors anymore even though the gene remains intact.
So, when and why these changes happen?
Who gives the instructions for these epigenetic additions or deletions?
The answer is, some factors drive them. The environment of cells (this is where DNA lives) can trigger epigenetic changes. Thus, what we put our bodies through, such as our diet, air, exercise, lifestyle, stress, chemicals we frequently use, can push epigenetic changes.
You see that the factors mentioned above can change the DNA commands and mess up our physical features and personality! Now, if these changes occur in egg or sperm, they can be passed to the newborn! To summarize, we can receive genes from our parents, some of which are slightly changed. Theoretically, if these changes occur in depression-linked genes, that can directly affect emotions.
As a matter of fact, early life experiences (childhood abuse, for example) that trigger depression can cause these changes. Putting together all the evidence, scientists propose that epigenetic changes occur after unfortunate life events. These changes can make depression last longer.
No surprise, epigenetic changes were found in few genes of depression patients. These genes are often responsible for the growth and reorganization of the brain and psychiatric disorders. In fact, some depression patients contain genes that can drive epigenetic changes of other depression-linked genes. What a networking between them, huh?
Care for a recap?
Genetic risk factors, as well as epigenetic changes by exposure to risk factors, can target behaviorally relevant genes that are important in depression.
The final words
Depression has many faces. A highly functioning person can struggle with depression which could be invisible to others. The negativity depression can bring into life is boundless. Misfortune never comes alone, neither does mental illness. Other physical and psychological disorders may often co-exist or overlap with it, such as schizophrenia, bipolar disorders, Alzheimer’s, etc. Depressive disorder patients are also at increased risk for type 2 diabetes and metabolic syndrome, heart conditions, eating disorders, chronic pain, etc.
Your everyday struggle to concentrate on something, your relentless battle to hide your negative emotions, is not only yours. When a full of potential life stops functioning, it is a loss to society, to the world. At its worst, depression can lead to suicide. Suicide is the second leading cause of death among young people. Considering how depression changes a life, how challenging its diagnosis and treatment is, it is no less damaging than the other catastrophic diseases. Yet an expert psychotherapist is not affordable for most people even in the developed countries. This calls you to act fast, to contact a physician or social worker before it is too complicated.
If you feel you are in depression, the two top priorities are, first, not to blame yourself; second, to explore the treatment options. Do not compare your life with Ms. Perfect’s. Everyone is essentially victim to something and despite that everyone is capable of making a unique journey of life.