Depressive episodes plagued me during much of my younger life. There were periods of absenteeism in high school, and a blanked-out period in college that only made sense, in retrospect, as the result of an untreated mood disorder. And so, shortly after my 30th birthday, I resorted to a selective serotonin reuptake inhibitor (SSRI) to help manage my mental health, in the hopes that rebalancing my serotonin, a critical neurotransmitter, would alleviate my recurring suffering.
But nearly a decade later, my mind felt hazy and muted, and I wondered if the chemical was dampening my ability to fully experience my life. After reading studies that suggested the drug’s efficacy was little better than a placebo, I decided to stop taking it — abruptly, then and there.
I felt better than I had in years. For about two weeks, I was clear-headed, at times almost euphoric.
It didn’t last.
Like a farmer in a field watching the skies cloud over, I felt a storm of darkness descend. I spent hours sitting on the edge of my bed, unable to gather the threads of my thoughts. When I could connect with the essence of myself, the experience was repugnant. I observed thoughts of self-harm with cold detachment. I knew I had the will to survive this, but it was frightening.
The road to well-being turned out to be longer, and more complex, than I anticipated. I resumed the meds, but I also focused on diet and exercise. I entered talk therapy. I revived a long-dormant meditation practice. It was by no means a swift or linear process. But over the course of about five years, it has led me to a life of greater awareness and connected happiness — without SSRIs. It began when I learned to see my depression in an entirely new way.
Today, many health professionals are viewing mental suffering in the context of the whole person, rather than reducing it to an imbalance of brain chemicals. Along with this more complex understanding, nonpharmaceutical treatments have emerged that are changing lives and improving health from the ground up.
It starts with getting out of our heads.
Investigating the Causes of Depression
Depression is one of the most common, and most debilitating, mood disorders, yet researchers still haven’t determined theexact cause of this condition. There are several popular theories about the roots of depression, including the following:
The National Institute of Mental Health notes that the brains of some individuals with depressive disorder are structurally different from those who do not have depression. MRI imaging studies reveal that the areas of the brain that are responsible for mood, cognition, metabolic function, and sleeping have a unique appearance in people who have serious mood disorders.
Environment and childhood experience
A disorderly home environment or a history of physical, sexual, or emotional abuse in childhood can increase the chances of developing depression in adolescence or adulthood. Trauma therapy can be extremely useful for processing unresolved memories and healing the suppressed emotional wounds that can contribute to depression later in life.
The neurological differences that distinguish people with depression are at least partly hereditary. According to Stanford University, genetic research shows that people who have a close relative, such as a parent or sibling, with depression are 20-30 percent more likely to suffer from depression themselves. Unlike diseases that are linked to a specific, defective gene, such as cystic fibrosis, depression is more likely to be linked to several genes.
Although the losses that we all experience do not necessarily cause depression, a severe setback can trigger a depressive episode. For instance, the death of a loved one or a bitter divorce could send a person into a period of grief and bereavement, which may turn into depression if the emotions surrounding that loss are not adequately resolved. Unlike bereavement, depression is often accompanied by feelings of worthlessness, self-loathing, or the desire to die.
Neurologists and pharmacologists have long pursued the connection between brain chemistry and depression in an effort to offer solutions to this disabling condition. Depression has been linked to imbalances in the brain chemicals, or neurotransmitters, that regulate emotional states, moods, energy levels, and appetite, such as serotonin, norepinephrine, and dopamine.
As with other types of chronic mental illness, there are usually several factors involved in the development of depression.A family history of depression, for example, may be combined with a history of past trauma or the breakup of a marriage tomake an individual more vulnerable to depression.
Depression and Addiction
Research has revealed that many of the factors that contributeto depression also play a part in substance use disorders. Imbalances in brain chemistry, family history, and past trauma,for instance, are frequently involved in both depression and addiction. In addition, the physical and psychological effectsof addiction may mask the signs of depression or worsen the symptoms of this psychiatric illness.
Psychiatric Times notes that there is a strong connection between alcoholism and major depression. In a nationwide study of 43,093adults age 18 years and over, for those found suffering from a current alcohol addiction, the was evidence that over 20 percentof them also met the criteria for that of a comorbid major depressive disorder. Survey respondents in search of treatmentfor an alcohol use disorder were over 40 percent more likely than the general population to have at least one mood disorder.
There is a strong connection between alcoholism and major depression.
Alcohol is a central nervous system depressant that may initiallyfunction as a stimulant, but that quickly intensifies feelings of lethargy, drowsiness, and depression. Alcohol use, whichlowers inhibitions and impairs judgment, also increases the risk that a depressed individual will attempt suicide. Accordingto the American Association of Suicidology, at least half of individuals who attempt suicide have some form of depression, and peoplewith depression are 25 percent more likely than non-depressed individuals to display suicidal behavior. Alcohol and drugabuse can worsen the course of a depressive disorder by aggravating the symptoms of depression, increasing the likelihoodof hospitalization, and interfering with the course of treatment. Individuals who are being treated for depression whileusing drugs or alcohol are unlikely to see positive outcomes from therapy. Substance abuse impairs motivation and decreasesthe effectiveness of therapeutic interventions. In addition, alcohol or drugs can have dangerous interactions with the medicationsused to treat depression.
The most effective approach to treating depression is a program that integrates mental health and recovery services at the same facility, with a staff of professionals who are cross-trained in both fields.
One of the most important things you can do for your teen is to work on strengthening your relationship. Try to build empathy and understanding by putting yourself in his shoes. You might be frustrated that he seems down and irritable a lot of the time and doesn’t seem to be doing much of anything to help himself. But if there isn’t much in his life that is making him happy, or something intensely disappointing has happened to him, it’s understandable that he might avoid things he used to enjoy and retreat to his room. Depression makes even doing the smallest things more difficult.
Try to validate his emotions, not his unhealthy behavior. For example, you could say, “It seems as though you’ve been really down lately. Is that true?” Make it clear that you want to try to understand what’s troubling him without trying to problem solve.
Be compassionately curious with him. Ask him questions about his mood gently, without being emotional. Even parents with the best intentions often don’t realize that their concern can come across as critical rather than loving. Do not be judgmental or try to solve his problems, even if you disagree with his point of view. Listening to him talk about his problems might seem as though you’re highlighting the negative, but in fact, you’re letting him know that you hear him, you see him, and you’re trying to understand — not fix him. People don’t like to be fixed. Listening without judgment will actually make him more likely to view you as an ally and someone he can turn to when he’s ready to talk.
Try also to give him opportunities to do things without being critical of him. Instead of saying, “Honey, you should really get up and do something. How about calling an old friend?” you might say, “I’m going to the mall to do an errand. Let me know if you want to come with me, and maybe we can get lunch together.”
For some parents, this can feel passive, as though you’re not doing enough. But being there for him and communicating your acceptance of him is exactly what he needs from you right now. It’s actually a very active way to strengthen your relationship.