Main Finding Four: Depression damages the rest of the body.
The pathological losses or gains in tissue in specific sites set into motion pathologic changes outside of the brain:
- They’re responsible for the premature onset of coronary artery disease, stroke, diabetes and osteoporosis.
- Increased cortisol (growth hormone) secretion affects every cell in the body.
- Increased insulin resistance and cholesterol levels increases inflammation, produces bad lipids and increases clotting.
- Premenopausal women with major depression have much higher incidence of osteoporosis
- Depression is really the tip of the iceberg. The syndrome is serious and systemically widespread.
- Patients with untreated depressive illness lose approximately seven years of life, much as untreated hypertension predictably shortens a life.
Main Finding Five: The best treatment for depression at present is a mix of talking therapies and medication.
Depression is a serious disorder that impacts the whole body, it is progressive, and it needs to be treated.
Sixty percent of people with depression in the United States remain untreated.
The most effective way to treat depression at present is a combination of talking therapies and medication.
Data shows that people who successfully respond to talking therapies have positive physical changes in the three key areas of the brain that are affected in depression: the subgenual prefrontal cortex, the amygdala and the ventral striatum.
As for the future, there are trials ongoing of new medications (like ketamine) which are producing rapid remission of depression (within one to two hours).
There are also psychosurgery trials involving the implanting and stimulating of electrodes in the subgenual prefrontal cortex which are producing immediate and sometimes lasting response.
Magnetic resonance treatments (MRI) are also being used to treat areas of depressed patients brains in a non-invasive way.
Training in resilience is also proving helpful:
- The American Psychological Association defines resilience as the process of adapting well in the face of adversity, tragedy, trauma, threats and even significant sources of threat.
- Mild to moderate controllable stress early in life can have an inoculating effect. Such experience leads to increased neuroplasticity and neurogenesis, and increases the size of the subgenual prefrontal cortex.
- An enriched, nurturing environment in early life with exposure to manageable novelty increases resilience later in life.
- Positive emotion, optimism, loving caretakers, flexibility, the capacity to reframe adversity and strong social support also increase resiliency.
- Altruism, commitment to a valid cause, a capacity to extract meaning from adverse situations, and a tolerance for emotional pain and sadness promote resiliency as well.