Depression

Depression is a mood disorder that deeply affects how we feel, think, and manage daily activities. It's like walking under a constantly gray sky, where the rain never seems to stop, obscuring the light and making it hard to see the beauty of the world around us. It’s not just about feeling sad or down for a few days; it’s something more intense and persistent, impacting the ability to function and enjoy life.

The causes of depression are complex and multifaceted, a combination of genetics, biochemistry, environmental, and psychological factors. Some people may be genetically predisposed, which means depression can “run” in families.

Changes in brain neurotransmitters, the chemicals that transmit signals in the brain, also play a significant role. Environmental factors such as stressful life events, loss, problematic relationships, or difficult living conditions can trigger depression, especially in those who are already predisposed. Furthermore, certain personality traits or negative thought patterns can increase vulnerability to depression.

Symptoms of depression vary greatly, but commonly include a persistent sense of sadness, emptiness, and hopelessness. People may lose interest and pleasure in activities they once loved.

Sleep problems are common; some people may sleep too much, while others struggle to sleep. Changes in appetite can lead to significant weight loss or gain.

Depression also affects how people feel about themselves, often leading to low self-esteem or feelings of worthlessness and excessive guilt. There can be a constant sense of fatigue, lack of energy, or a slowing down both physically and mentally. Concentration becomes difficult, making decisions feels like a challenge, and this can significantly affect work or school.

In some cases, depression escalates to thoughts of death or suicide, an alarming signal that requires immediate attention and support. Irritability and social withdrawal may become evident, pushing people away just when they need connection and support the most.

Imagine carrying a heavy backpack full of stones, day after day, without the ability to set it down. Even small daily tasks can feel overwhelming. Joy fades in a world that seems viewed through a gray lens. Hope becomes elusive, and the fatigue of carrying this weight can make it feel as if there’s no way out. Depression swallows the present and clouds the future, making it hard to imagine that things could get better.

Sadness, Low Mood, or Depression?

Sadness is a natural emotional response to difficult or painful life situations, such as losing a job, the end of a relationship, or other unfortunate events. It’s temporary, proportionate to the triggering event, and doesn’t prevent one from performing daily activities in the long term.

Low mood is also a feeling of dissatisfaction or irritability that can come and go, often influenced by stress, fatigue, or momentary frustrations.

Both are normal parts of the human experience that do not significantly impair one’s ability to function in daily life.

Depressive pathology, on the other hand, is something much more complex and debilitating.

It is characterized by a range of symptoms that include deep sadness, loss of interest or pleasure in activities, significant changes in weight or appetite, sleep disturbances, fatigue or loss of energy, feelings of worthlessness or excessive guilt, difficulty concentrating, and thoughts of death or suicide.

These symptoms are persistent, typically lasting most of the day, nearly every day, for at least two weeks.

Pathological depression significantly alters an individual’s ability to function at work, school, or in social and family relationships, leading to considerable distress or impairment in important areas of life.

"Imagine the difference between a cloudy day, which might bring a sense of melancholy but still holds the possibility that the sun may return, and a long, endless winter, where the cold seeps into your bones and the sun seems to have disappeared forever. Sadness and low mood are like that cloudy day: temporary, with the hope that things will get better. Pathological depression, however, is like that long winter: a condition that crushes all hope, making it hard to remember the warmth of the sun on your skin or even believe it will ever return."

While it is normal to experience sadness or low mood in response to life’s challenges, when these feelings become so intense or prolonged that they interfere with the ability to live fully, it may be time to seek support.

Pathological depression is not simply a condition that one can “snap out of” through sheer willpower (as is often suggested); it is a medical condition that requires understanding, treatment, and support.

In depression, neurobiological alterations are evident on multiple levels, including chemical imbalances, structural and functional changes in brain areas, as well as modifications in neuronal behavior.

These changes have a significant impact not only on brain function but also on various organs and bodily systems, due to the close interconnection between the brain and the rest of the body.

On a chemical level, depression is associated with dysfunctions in the neurotransmitter system, particularly involving serotonin, norepinephrine, and dopamine.

These imbalances directly affect mood, energy levels, the ability to experience pleasure, sleep, appetite, and concentration.

For example, a reduced availability of serotonin and norepinephrine has been linked to depressive symptoms, while changes in the dopaminergic system may contribute to anhedonia (the inability to experience pleasure) and reduced motivation.

Neuroimaging studies have documented structural changes in various brain areas in patients with depression. These include:

•  A reduction in hippocampal volume, related to the duration and severity of depression, can affect memory and emotional processing.

• Altered activity in the prefrontal cortex, involved in emotional regulation, decision-making, and executive function, is often observed with reduced activity in depressed patients.

• The amygdala, responsible for processing emotions, shows increased reactivity to negative emotional stimuli in depression.

Neurons may exhibit alterations in neuroplasticity—the brain's ability to shape and adapt neural connections in response to experience.

In depression, reduced neurogenesis (the formation of new neurons) in the hippocampus is observed, which may be partially responsible for the cognitive and emotional symptoms of the disorder.

Imbalances in neurotransmitters and changes in brain areas also have an impact beyond the brain itself. Depression has been linked to a higher risk of cardiovascular disease, diabetes, and a weakened immune system, highlighting how psychological distress can translate into physical vulnerability.

This is partly due to the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the stress response and may be over-activated in depression, leading to elevated cortisol levels, with negative effects on various bodily systems.

During depression, the body may release high levels of cortisol, the stress hormone, which has been associated with a range of negative effects, such as reduced neurogenesis and inflammation.

Want to laugh while being amazed? But did you know that sometimes we actually seek it out?

The complexity of human emotions sometimes leads us to find comfort in emotional states that might logically seem undesirable, like sadness or self-pity. This phenomenon, which may seem counterintuitive, has deep roots in our psyche and emotional biology, especially when we explore the context of depression.

In sadness, and particularly in depression, there can be a paradox of "pleasure in pain."

This doesn’t mean that people actively desire suffering or seek situations that reinforce their sadness (that’s a different story), but rather that there can be a component of comfort within the experience of sadness itself.

This may stem from various psychological and emotional factors.

Firstly, sadness and self-pity can serve as mechanisms of internal validation.

When we feel sad and immerse ourselves in those emotions, we are in some way granting ourselves permission to acknowledge and accept our pain.

This process can be unconsciously rewarding, as it validates our internal experience, making us feel understood, even if only by ourselves.

Moreover, there is a social dimension where expressing sadness or melancholy can lead to receiving support, attention, and care from others.

This positive reinforcement, though born from a negative state, can create a cycle where sadness becomes unconsciously desirable for the empathetic responses it evokes in others.

Depression, however, complicates this aspect as it can also lead to isolation and the feeling that others cannot truly understand or alleviate the inner pain.

Self-pity can also function as a defense mechanism, shielding us from external expectations. In a state of sadness or depression, the expectations placed on us—both those we perceive from others and those we impose on ourselves—may decrease.

This reduction in expectations can provide a sense of relief from pressure, even though it is only a temporary solution and does not resolve the underlying causes of our pain.

Reflection: the process of self-pity can spark a form of introspection that, though painful, also provides an opportunity for emotional self-exploration and growth.

I consider introspection to be necessary and legitimate, even when it occasionally results in melancholy. But be careful not to fall into the vortex.

Because we can become dependent on the satisfaction of personal growth through painful introspection, which may eventually no longer be as rewarding as it was at the beginning, becoming instead the author of depression and the vicious cycle of self-sabotage.

From a neurobiological standpoint, the "pleasure in pain" phenomenon can be partially explained by the overlap in brain circuits that process both pleasure and pain. Studies have shown that some areas of the brain, such as the nucleus accumbens and the amygdala, are involved in responses to both pleasure and pain. These brain regions are regulated by neurotransmitters like dopamine and serotonin, which play crucial roles in mood and motivation.

Dopamine: Though traditionally associated with pleasure and reward, dopamine is also implicated in the response to pain. The complexity of the dopaminergic system means it can be activated in response to both positive and negative stimuli, providing a sort of neurochemical “reward” even in contexts of pain or negative thinking. This could explain why some people may find an unusual satisfaction in activities or thoughts that are superficially painful or negative.

Serotonin: Serotonin levels, which are implicated in mood regulation, can also influence how we perceive pain and pleasure. While low serotonin levels are commonly associated with depression, its function is incredibly complex and not limited to promoting well-being. In certain contexts, the serotonergic system can help regulate how we emotionally respond to pain, affecting our experience of “pleasure in pain.”

Psychologically, the "pleasure in pain" can be interpreted as a coping mechanism that allows people to find a sense of control or meaning in otherwise unbearable situations. Pain or negative thoughts can become familiar, and this familiarity may offer a strange but real comfort.

So, be careful—you might even be seeking it out!

Solutions to all this? Do we have them?

Well, guaranteed, fixed solutions—no. But there are approaches. In this case, I’m definitely not replacing a professional, but I can share some mental patterns or questions to ask yourself, perhaps to gain awareness… because yes, in my view, awareness is the strongest weapon against everything: "awareness is freedom."

Let me preface this by saying I hate motivational speakers and cliché phrases (commonplaces included), but here I’ll have to cite a few, because they’re genuinely useful:

• Exercise: Whether you like it or not, it helps. Research has shown that regular physical activity can be as effective as antidepressants in some cases of mild to moderate depression. Exercise stimulates the release of endorphins, often called happiness hormones, which can boost mood and reduce stress (and also distract you and tire you out, improving sleep quality).

• Try to stay socially active, in person if possible, but if you absolutely can’t, even online, but seek relationships with humans.

• Maintain at least minimal daily contact with the outside world: The home can be a comfort zone, but it’s not good to stay indoors all day. Contact with nature and the outside environment stimulates our brain to release certain substances beneficial to our brain. If you notice, we have a different mindset when we’re in a comfortable environment like home compared to when we’re outside. Walks are very helpful; if necessary, put on headphones with music or an audiobook.

• Quoting Eckhart Tolle, "Ask yourself: 'What is the problem at this moment?' Not tomorrow, or in an hour, but right now. What exactly is missing now? What is wrong right now? You can always handle the present moment, but you can never deal with the future—nor do you need to. The right answer, the strength, the right action, or the resource will be available when you need it, not before or after."

  This quote highlights the importance of focusing on the present moment and setting aside worries about the future or regret for the past, suggesting that most of our worries are projected onto what might happen rather than what is actually happening now. Living in the "here and now" allows us to take life one moment at a time, reducing anxiety and stress.

• Pet therapy: Needless to say how much animals can make us happy and how much love they can give us.

• Stop focusing on problems (it doesn’t lead anywhere); focus on solutions.

• We’re all going to die anyway; it’s inevitable. Maybe it could even happen unexpectedly tomorrow. So, until your time comes naturally, try to enjoy what you have and what you can do in this ONE chance you’ve got. I repeat: we have nothing to lose, we have an expiration date, and we are already destined to die. Live from here; there’s no way out. So, enjoy it.

• Treat yourself as you would treat a friend in the same situation. I bet you wouldn’t be so pessimistic; you’d be more forgiving and optimistic, encouraging them that "everything passes eventually" and urging them to be brave, get back up, and start again without fear.