Read an Excerpt
Chapter One
The Challenges of Treating Depression
Understanding the Brain and DepressionIn the blink of an eye, your brain interprets every experience you have and responds physically, intellectually, and emotionally, sending you a message that is at once infinitely complex and as simple as a single thought: "I feel good" or "happy" or "sad" or "safe" or "afraid" or "depressed." All your memories, abilities, talents, weaknesses, and potential as a human being lie within your brain. Everything you have ever experienced and learned —indeed, your very identity—is recorded in the tissues of a threepound sphere that is really neither very pretty nor very big.
When you think about all the jobs your brain performs—well, your brain can get tired just thinking about them. A short list doesn't come close to being representative, though it does provide a basis for our awe. The brain is the regulating center of the body, interpreting billions of bits of information received from the body and your environment and then offering a staggering array of biological, intellectual, and emotional reactions too numerous and complex to name. The brain is the seat of consciousness, that state of awareness that tells us who we are, where we are, and what is happening around us. The brain is the receiver and interpreter of the senses. Everything we see, hear, touch, taste, and smell—no matter whether these stimuli come from within the body or outside it—is recorded and understood by the brain. `The brain controls all the involuntary actions that are responsible for maintaining life within the body, suchas your heartbeat, nerve function, hormonal activity, immune function, assimilation of oxygen and nutrition, and elimination of waste. Every conscious and unconscious act that you perform is initiated by your brain. The brain is the seat of all intellectual activity. It also mediates all your emotional experiences and instinctive drives, such as hunger, rest, sleep, touch, sex, and companionship. And the brain is responsible for regulating your moods, including joy, hope, and depression.
The American Medical Association Encyclopedia of Medicine defines depression as "feelings of sadness, hopelessness, pessimism, and a general loss of interest in life, combined with a sense of reduced emotional well-being." Other authorities state that depression is associated with sleep disturbances, with loss of concentration, energy, appetite, and activity, and with withdrawal from social behavior. People who are depressed typically feel hopeless and suffer from low self-esteem. Many lose weight; others gain weight. Some describe depression as a feeling of "emptiness" or "being numb." Some say that they have no feelings at all. Depression can suppress the immune system and result in generalized fatigue and exhaustion. Those who suffer from severe depression—a condition known as "major depression"—can experience hallucinations, delusions, and recurrent deep-seated guilt.
It is easy to see that depression has a widespread effect on brain function. In fact, when we consider all the physical and psychological symptoms associated with depression and then review all the things that the brain does, we get a clear picture of how pervasive depression's effects can be on the brain and thus on your entire life. Depression, then, has its roots in this remarkable organ.
Obviously, the challenge in treating depression is understanding this complex brain and trying to put it in balance. That is precisely why it should be done naturally. Every time we alter one effect artificially, we create change in another area. The challenge then becomes changing the negative brain issues specifically for me, not a depressed society or group of people, but me—my specific brain and my specific issues. This is a challenge, but it is not insurmountable.
The connection between the dark cloud of depression and the physical brain lies in a set of neurotransmitters. These neurotransmitters are actually messenger chemicals that create feelings, stimulate thoughts, and trigger memories, just to name a few of the things they do. When you have an optimal amount of any single neurotransmitter in your brain, then you will experience the positive feelings associated with that neurotransmitter. A deficiency or excess of any single neurotransmitter usually results in the negative experiences associated with that brain chemical.
In this book, I'm going to discuss five of these neurotransmitters: serotonin, dopamine, norepinephrine, acetylcholine, and gammaaminobutyric acid (or GABA). Of these five, three are of particular importance in depression: serotonin, norepinephrine, and dopamine.
Your brain chemistry changes depending on your thoughts, expectations, and activities, the foods you eat, and the kinds of exercises you perform. In fact, every single physical act, thought, emotion, and image you call to mind triggers a corresponding change in your brain chemistry.
Yet despite the fact that brain chemistry can undergo such significant changes, all of us-no matter what our mood is at any given moment—tend to maintain an internal chemical balance within pretty specific limits. We do this by maintaining a certain consistency in the ways we think, eat, and behave each day. I call this consistent pattern your brain-chemistry baseline, or simply your baseline. In, fact, you maintain your sense of identity by maintaining your baseline.
Depression, as I've said, is the result of an imbalance in the chemical combination in your brain. This imbalance can become your baseline; in other words, some people's identities can become associated with depression. These people maintain their long-standing depression by sustaining the ways in which they think, eat, behave, and interact with others. Throughout this book, I will be talking about personality types that, taken to the extreme, support depression. You will have to look inside yourself to see whether these descriptions fit you and to determine which elements in your personality and behavior might be keeping you from achieving your optimal level of well-being.
