Throughout human history, people of all ages, races, and socioeconomic backgrounds have struggled with depression. At different points in time, we have conceptualized depression differently. In past centuries, depressed mood was seen as an affliction from God or as the manifestation of a weak will. More recently, however, we came to view depression as a mental illness. Imbalances of neurochemicals in the brain were thought to lead to rumination, sadness, and other symptoms of depression. Now, however, recent research suggests that depression is not just an illness or condition of the mind — it affects the entire body.
New Research Changes the Way We View Depression
Psychologists and psychiatrists diagnose depression using a core set of clinical criteria. These include a period of sadness or loss of interest in previously enjoyed activities that lasts at least two weeks, change in appetite, weight gain or loss, change in sleep, fatigue, feelings of guilt or worthlessness, and suicidal ideation. For years, scientists have conceptualized depression as an illness affecting the brain. Indeed, a large amount of research demonstrates that depression is associated with neurochemical imbalances in areas of the brain involved in reward processing.
Now, however, there is an increasing focus on the effects of depression on the rest of the body. Just looking at the clinical criteria for depression, it is clear that depression is not just in the mind. Chronic fatigue, weight changes, and sleep problems can all be caused by other systemic problems in the body.
In a recent study published in the Journal of Clinical Psychiatry, researchers analyzed data from 29 studies about oxidative stress and depression. Oxidative stress refers to physiological damage that occurs on a cellular level. When our body uses oxygen in chemical reactions, unstable “reactive oxygen species” sometimes result. Healthy molecules called antioxidants sweep these reactive oxygen species away. When antioxidants are unavailable or reactive oxygen species linger in the cell, however, they can destabilize DNA and cause cellular damage. Collectively, this damage is known as oxidative stress.
The findings from the study showed that patients with depression have significantly higher levels of oxidative stress and lower antioxidant levels than healthy controls. Antidepressant treatment, which typically increases levels of the neurotransmitter serotonin in the brain, also improved levels of oxidative stress. Taken together, these findings indicate that depression is not just a disease that affects the mind — cells throughout the entire body are being placed under stress that causes cellular damage.
Why Is the Distinction between Mental Illness and Systemic Illness So Important?
In the conclusions of the study, the authors highlight the importance of conceptualizing depression as a systemic illness, rather than solely a mental illness. So why is this distinction so important? One reason is that mental illness is unfairly stigmatized more than physical illness. People with depression are often reluctant to get help, because they view their condition as the product of a weak will or something that is “just in my head.” Refocusing the narrative to establish depression as an illness that impacts the entire physical being of the affected person may reduce this stigma. Just as no one feels stigmatized or guilty for seeking treatment for cancer, we must eliminate the stigma associated with seeking treatment for so-called “mental” illnesses.
Focusing on depression as a systemic illness or condition also allows us to better understand the medical consequences of depressed mood. Researchers have long known that depressed mood is associated with higher risk for conditions such as cardiovascular disease, stroke, and neurodegenerative conditions such as dementia. The mental anguish and emotional problems associated with depression also lead to thoughts of suicide and drug addiction. At the Waismann Institute, we often see patients who first began using drugs to numb the emotional distress caused by depression. Considering depression solely a “mental” illness ignores the person as a whole. This ignores the possibility that other physiological or situational factors could be the culprit causing the onset of depression.
This new research can serve as an important reminder to treatment providers who work with people suffering from emotional pain such as depression and to society as a whole. Rather than viewing depression as an illness of the brain or a flaw of the mind,it is essential to think about it as a physiological condition that could be caused by multiple factors or organs.Our body is an interconnected system, and only by examining the entire person can we effectively treat an emotional or physical condition.
Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes, Project Safety Net. Retrieved on 09/28/2016.
Oxidative Stress and Antioxidant Parameters in Patients With Major Depressive Disorder Compared to Healthy Controls Before and After Antidepressant Treatment: Results From a Meta-Analysis, Physicians Postgraduate Press, Inc.. Retrieved on 09/28/2016.