When Depression Hurts the Body as Well as the Mind
When Depression Hurts the Body as Well as the Mind
By Hara Estroff Marano -- Publication Date: Jul/Aug 2002
Summary: Depression is a disorder of the body as much as of the mind. Consider that several of the core symptoms of the condition manifest in body systems: depression invariably expresses itself in a change of appetite, usually inhibiting the desire to eat, but occasionally reversing course, as in atypical depression, and increasing it.
epression is a disorder of the body as much as of the mind. Consider that several of the core symptoms of the condition manifest in body systems: depression invariably expresses itself in a change of appetite, usually inhibiting the desire to eat, but occasionally reversing course, as in atypical depression, and increasing it.
Similarly, the body's need for restorative sleep is profoundly disturbed, and nearly all depressed individuals experience sleep problems; 80% complain of insomnia, another 15% sleep excessively. Insomnia by itself appears to be a risk factor for depression. Most patients complain of body fatigue. In many, energy loss is so overwhelming that physical movement is arduous and grinds to a paralyzing halt.
Increasingly, there's evidence that depression involves various body systems. There seems to be a complex relationship between depression and the heart. Depression raises the risk of heart disease; it also magnifies the deadliness of existing cardiac problems. It's not clear why, although researchers have found that depression alters blood platelets, circulating elements that are responsible for clotting.
What's more, depression leaves footprints on the body's structure as well. For example, it accelerates changes in bone mass leading to osteoporosis.
But of all the signs that depression has a neck-down presence, none is more insistent than physical pain. For a substantial number of people, possibly up to half of depression sufferers, bodily pain is the way depression presents itself.
The pain is often vague and unexplained by injury. It may show up as headache, abdominal pain, or musculoskeletal pains in the lower back, joints and neck--alone or in any combination. The painful physical symptoms of depression typically take the form of multiple somatic complaints.
The trouble is, too often neither sufferer nor doctor is aware of the true source of the problem and the depression goes untreated as well as unrecognized. It's not that the pain is "all in the head." No, the pain is indeed real, but it likely drives many people to primary care physicians or orthopedists in the mistaken belief that that something has gone awry in their body. And there follows an unproductive search for an organic source.
"We're becoming more sensitized that major depressive disorder has physical as well as emotional symptoms," says Stephen M. Stahl, M.D., Ph.D., associate professor of psychiatry at the University of California San Diego. He believes that the many unrecognized cases of depression--some estimates put the figure as high as 50% of all cases--"may be the ones that do not complain of depressed mood."
Physical symptoms are as important in treating the condition as in recognizing it. "Even where people have emotional symptoms of depression--and many people have both emotional and somatic symptoms--they are not necessarily well when their emotional symptoms improve," says Dr. Stahl.
Failure to eliminate the pain symptoms reduces the chances of full recovery. Persistent pain typically keeps depressed people from regaining full function in the personal and professional lives, and it raises the danger of suicide.
Depression has long been associated with pain. But it was once thought that people with pain were somehow "denying" their emotional disorder and converting it into bodily pain. The new view is that somatic complaints are the way some people get depressed. There is actually something malfunctioning in their pain perception pathways.
In a recent study of over 25,000 patients at 15 primary care centers on five continents, Seattle researchers found that 50% of all depressed patients worldwide report multiple unexplained physical symptoms. It's wasn't that such patients were any less willing or able to express emotional distress. They readily acknowledged depressed mood when specifically asked about it.
Nor were there differences in the frequency of pain symptoms among Western and non-Western cultures. The researchers concluded that "somatic symptoms are a core component of the depressive syndrome."
Like the emotional symptoms, the painful physical symptoms of depression arise in specific nerve pathways presided over by the neurotransmitters serotonin and norepinephrine. From their base in the brainstem, such pathways travel up into the highest reaches of the brain, the frontal cortex, where they help regulate thinking and mood. They also travel up to the brain's hypothalamus, where they regulate eating, sleeping, and sex drive.
But serotonin and norepinephrine pathways also travel down into the spinal cord serving the rest of the body. And therein lies the problem.
As the body goes about its tasks, explains Dr. Stahl, there are constant sensations associated with the routine functioning of the body, such as digestion in the stomach and abdomen. The central nervous system is also fed routine inputs from the musculoskeletal system throughout the body. But normally those sensations are suppressed from consciousness and ignored. That's what allows you to pay attention to the world outside your body.
And that suppression is normally accomplished by serotonin- and norep-
ineprhine-dependent nerve fibers descending from the brain into the spinal cord. But they become dysfunctional in depression and fail to operate efficiently. As a result, routine sensory input "escapes" up into the brain, where it is interpreted as uncomfortable or even painful physical symptoms when in fact nothing is wrong.
"There are mechanisms for pain to be suppressed," explains Dr. Stahl. "If they're not working right even false discomfort can be perceived and magnified."
All effective antidepressants work on relieving somatic symptoms--to some degree, says Dr. Stahl. But some drugs work more robustly than others. "The emotional symptoms might be improved with agents that boost either dopamine, norepinephrine, or serotonin. But to get the optimal reduction of pain symptoms may actually require an approach that combines action on serotonin and norepinephrine." In other words, the use of dual-action agents. Currently, venlafaxine (Effexor, Wyeth) is the only agent that targets both neurotransmitters.
"When Depression Hurts the Body as Well as the Mind"
"Depression" sounds about as vague and systems unspecifying,
(Apart from that with my systems parts of the mind systems are in the body.
What I call the 5th emotion generator, for example, has to do with the adrenal glands.
The 7th is is to do with the thyroids.
In other words, hormone production sites, impacting also massively on emotional stages.)
"Depression is a disorder" orderly occuring on 5 continents in humans?
It are orders.
And therefore they also occur so orderly.
The lack of comprehending systems orders is not undone by calling orders disorders.
"usually inhibiting the desire to eat" Which might help with withdrawing from "the herd" as is often done by many when having serious mental problems.
And has important functions.
It can also be partially a signaling to others, who might get more concerned, and the concern might lead to more care about the person.
Excessive eating and fixing on that, can be a distractor from other problems.
It seems not uncommon when some have high emotional problems,
they fix on this or that.
What it is might be differing, eating a lot, anorexia, cutting with a knife into the skin, a religious craze, the water tap or whatever "talking" to them, "multiple personality", being the reincarnation of some famous person, ...
or I don't know what all people come up with to distract from emotional problems.
However a basic pattering behind a bunch might be, that emotional systems requirements have not been sufficiently getting what they need, or/and were partially highly disturbed by something happening.
Or also various not happening, or not enough. As getting positive recognition & inputs enough from from other persons (partner, friend(s), work collegues, neighbours ...),
and of some internal balances getting too highly disturbed by that.
If living a highly unnatural life, additional disturbances might come by that.
An ignoring of the individual source causes,
and hazing differing together under "depression",
might not lead to far better understandings.
Nor the declaration of orders as "disorders".
With sleep problems, it might also do to consider if sleep conditions are as naturally belongs. For example humans are herd animals, and sleeping alone might already cause some problems.
If feeling emotionally for this or that reason insecure, it might lead to disturbances of night sleep.
Alterations in sleep patterings might also lead to differing internal reactions.
Including emotional ones.
Too little sleep might in some for example lead to various emotions also running alike on lower energies. Or if "detonating", doing it faster, maybe also releasing out emotions.
Looong sleep might give more resting phases for systems. And have with the also beneficial effects.
"In many, energy loss is so overwhelming that physical movement is arduous and grinds to a paralyzing halt."
As mentioned, withdrawal can have important functions with many forms of mental problems. This might aid this.
Also a sort of withdrawing of the "rank-fighting system of the herd" might be parts of the programs. The just described might also support this.
The parts of the text I read seem to overlook the significance of emotional stress and withdrawing quite far.
In orderly working human systems, at high mental problems,
the programs for withdrawal might be initiated,
and along with high long lasting stress, cortisol being hammered out,
leading to a down-going of axonal interlinks in the brain.
If this procedure is disturbed too early by others, who do not recognize the orders behind this,
it might lead to that axonal interlinks are disturbed in the down-going and making place for a later better adapted "rewiring".
I have "admired" Westie science again and again, to call blatant orders observable on differing continents parallel, "disorders", and then proceeding to disturb important parts of these orders, without any considerations whatever about what is disturbed there by that.
This not meaning, it is never correct to interfere,
but at least some more heeding orders of systems could be occasionally done there.
"risk of heart disease; it also magnifies the deadliness of existing cardiac problems. It's not clear why, although researchers have found that depression alters blood platelets, circulating elements that are responsible for clotting."
Why? First guess is, cause someone busy with mental problems,
might partially withdraw into a room, and be circling around the problems or distractors of the problems.
Neither caring particularily or at all about doing sports,
nor often what is eaten.
And being maybe also so preoccupied in context with mental problems,
to not pay much attention to body signals.
Including a bunch of warning signals about more serious systems disturbances.
The combi of this might do the job for getting higher phsyical problems.
"headache" The self might keep being occupied with thoughts not leading to harmonious stages. Some systems might sort of be at hammering highly stuff, be it emotions or certain thoughts, depending on the systems.
Other sectors might segregate partially more off, as motor control systems.
The self being too busy with other stuff, to pay much attention.
With this the activity patterings within and between sectors
might seem, compared to someone having more calm and united harmonies there,
highly irregular and sectors stressing.
This might also cause headaches faster.
Additionally, the mentioned little sleep with various, might increase the potential for getting headaches.
"in the lower back, joints and neck--alone or in any combination."
While a person is preoccupied with high mental problems or something fixed upon trying to partially distract from them,
not much attention might be paid to the body position.
So a joint might be long in a position not good, also the neck, or segments of the spine in the lower back in context with the body position.
The I central might be too busy
to circle around this or that,
to pay particular attention to systems protests.
Or so preoccupied, to not notice many at all.
So while another might be with a friend taking a walk through nature, joints being in this and that position, moved and in training for natural movements,
with someone with high mental problems, might be this one is many hours in a room, often long in just one position not much changed,
with little to no attention being paid, if this is becoming for joints.
Something similar going for other problems.
"The trouble is, too often neither sufferer nor doctor is aware of the true source of the problem and the depression goes untreated as well as unrecognized."
As obviously here, no systems discerning being done between the self and differing emotional systems,
and instead doing vague hazing around with "depression"
while at "true source".
Also main causes having lead to the individual problems might be quite differing.
To make up some:
1: Caused a car accident killing parts of his family.
2: Was raped as a child or/and in adult age.
3: Has a drab job with stressing colleages, no partner and also hardly any friends.
4: Has turned blind around her 60ies and can't live as before anymore.
Not being well able anymore to live in her home, but fears living in a "home" elsewhere.
5: Was just left by someone loved,
who went off to live with another preferred.
6: Is in a "home" for old people, all brothers and sisters already dead.
Watching other old people in the "home" die,
and waiting for the own death to come.
Someone might just stuff these quite differing cases all together under "depression".
But this might not perceive individual partially highly differing causes well.
And declaring systems orders "disorders" might also not improve the approach.
In my systems what I call emotion generators 1, my self and eg.3 , and also rank status in the herd) are the most important for emotional balances.
(Eg.1 hatches mammal emotions. Also to do with herd binding programs as loneliness. And in humans (and I guess elephants, too), crying.
Eg.3 hatches aggression and rankfighting emotions. And can react disturbed if the position in the herd is not exactly the most aspirable.)
With some women reacting with high fear reactions to various, also eg.5 seems to be important.
Eg.5 is not just one sector(cluster) in one region, but consists of various systems.
It is to do with the adrenal glands releasing cortisol and adrenaline,
causing clusters of reactions in other systems.
(I mentioned also eg.7, to do with the thyroids.
Some forms alike hectic, with movements seeming hyper, might also have to do with it.)
With men, testosterone levels can also influence self confidence feelings.
Testosterone also alters something in the correlation between emotion generators,
dominance more than with females in average going to the third emotion generator.
(Hm, could write quite some more about the third emotion generator,
but then I might just get complaints about e-wallpapers.)
Anyway, outside my self, I regard the first and third emotion generator the most important.
Not sure, if together they got between several hundreds or a few thousand emotionional programs or so.
But simplified they are alike the giga-pillars of loads of emotoinal balances, where if these are disturbed, whole loads of other systems might get disturbed as well.
The first I think got in the amygdala, as a neighbour, the central part of the amygdala, and from there it goes off via other systems direction body.
The third (though in the past I accessed there often) I have no aware positional data about.
But if it were to interest me enough to search neuro data, first I might search among hypothalamus systems.
In the hypothalamus are also regulators towards pituary. Simplified a central hormones regulator.
My criticism of lacking source identification meant high undiscerning between differing internal systems of high importance for emotional status.
This "depression" vagueness-ing around, ain't discern one emotion generator from the next.
But jumbling them together undiscerned under "depression" might not help to understand far the high complexity of their programs and intercorrelations with other systems.
(And understandings are also not replaced by chemially attacking persons's receptor molecule numbers and partially also belly organs.)