Triggers of a depressive breakdown

After a friend asked me how she could tell what exactly triggers a depressive episode and if an inferiority complex could contribute to depression. I remember telling her inferiority complex could contribute to the onset of an episode if, events capable of causing depression had accumulated in the course of life. I suggested; one way was to take stock of recent life events that may contribute to triggering an episode.
I recently came across a literature and would like to share what I learnt with my readers.

The onset of depression is a cumulative effect, having an uncharacteristic behaviour that is influenced by hidden variables. In the face of a major depression, one tends to look back for the roots of it; wondering whether it was always there or whether it came on suddenly as food poisoning. Having a breakdown when you have experienced trauma or when your life is a mess is clearly understandable. But having an episode when everything seems fine and you are finally in a good place is confusing. Depression does not always stem from recent life events. Factors leading to a breakdown gather over the years, usually a lifetime.

Severely threatening life events usually trigger initial breakdowns, the second episode, somewhat less; and for subsequent episodes, life events may play no part at all. It then becomes random and endogenous, dissociated from life events. (Look up The stress of depression on some factors that contribute to the dissociation of episode from event triggers).

Physical trauma is among the primary triggers for psychiatric trauma. We all encounter periods of physical and psychological trauma and chances are high, that people with a significant vulnerability will relapse in the face of a problem. So do not consider intolerance for extreme pain, whether physical or psychological as a weakness of character.

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The stress of depression

Stress is good for you. It keeps you alert, motivated and primed to respond to danger. As anyone who has faced a work deadline or competed in a sport knows, stress mobilizes the body to respond, improving performance. Yet too much stress or chronic stress may lead to major depression in susceptible people.

Depression is stressful and stress contributes to depression. Stress induced cortisol expression and depression are related events that lead to reduced serotonin levels, the major neurotransmitter involved in the development and progress of depression. High cortisol levels may not directly cause depression, but it may exacerbate a minor condition to a major syndrome. The brains of human suicide patients show extremely high levels of Corticotropin Releasing Factor (CRF), the precursor of cortisol and causes expansion of the adrenal glands.

The presence of cortisol in the blood undergoes diurnal variation, with levels peaking in the early morning and reaching its lowest level at about midnight or three to five hours after the onset of sleep. A changed pattern of serum cortisol levels has been found in people with major depressive disorders.

Once you’ve had stress sufficient to cause a protracted increase of your cortisol levels, your cortisol system is damaged and in the future, it will not readily turn off once it has been activated, as such, recurrent episodes of depression break free of situational triggers and leads to automatic triggers of episodes.

Beyond a certain point, depression becomes random and endogenous; dissociated from life events. At this point, an episode does not occur due to triggers by external stimuli, but altered biochemistry. This emphasizes the need for people with recurrent depression to stay on medication permanently.

Targeting cortisol as a treatment option is a viable idea but still under investigation due to its side effects and role in other biological events (fight-or-flight responses, adrenal energy, anti-inflammatory action, decision making and resolution, immune system activation among others).

Factors that reduce cortisol levels

Continue reading The stress of depression

The feeling of emptiness

“There’s no crispness to the morning. The smell of coffee serves only as a reminder that another long dreary day has begun. There’s no real feeling, no joy, not even much anger, only emptiness. It’s difficult to remember feeling any different and getting more difficult to go on feeling this way. Sitting in a dark corner with eyes closed imagining nothingness until there is nothing would be easier. Instead here’s the day to face, the responsibilities, the people, the emptiness, but the energy that once fortified the day is no more.

Concentration has become a bad joke. Even love is now only a faint echo of itself. A leaden haze obscures the day and folds into a dark tunnel with no hint of light at the end. Where is hope? There is none. Where is happiness? Gone as if it had never been, replaced by tears that must be hidden. Where is relief? Perhaps in death.”

Excerpt from the book “Understanding depression”- Patricia Ainsworth, M.D.

Are they attention seekers?

For someone who never had a personal encounter with someone battling depression, that was my first opinion when I met Frank. I hastily drew the conclusion that he didn’t get enough attention from his close relatives and therefore used depression to court attention from his friends. But after years of knowing him, I still find it hard to draw the link between this smart, intelligent guy who inspires me a lot and the guy battling depression.

Frank is a typical example of a smart person. He knows his stuff and you could never give him falsified information because he was always quick to challenge the authenticity of things you tell him. You need to be on top of your game to have a level-headed conversation with him. But on days, when he talks to me about his episodes, he is an entirely different person, it is like I never know who this person is.

For a smart person like him, his constant fear is what people think of him, and that, in my opinion, is the cause of his distress. He believes more in what others think of him than what he thinks of himself. Only if he believed in himself. I may never come to fully comprehend his condition, but I am glad he has a friend in me he could talk to.

‘I found my preconceptions of mentally ill patients were strongly challenged’

My name is Afrika and I’m a 23-year-old musician who was diagnosed with bipolar a little over two months ago.
Pre-diagnosis I kept up a busy life holding down three jobs as well as trying to climb the music industry ladder. My illness affected me by driving me to become over productive, filling my entire day with work, anxiety when not working, manic episodes and irritation. On the 4th of November 2013, I was admitted into hospital with hypermania, I stayed there for 2 months.
Whilst in hospital I found my preconceptions of mentally ill patients were strongly challenged. There weren’t padded cells, straight jackets or people being held down. But rather determined people working through their own issues by talking and coming up with a recovery plan with a specialist team of nurses, occupational therapists and psychiatrists.

‘There weren’t padded cells, straight jackets or people being held down. ‘

Outside the safety of the hospital I had fears about work that people would think I was faking my illness mainly because it’s not something you can see. I feared I would be treated differently in my music work, that parents would be concerned about me being left alone with their child whilst teaching them. I never told my employers about my diagnosis or why I was admitted into hospital, I just said I was recovering from stress. I believed that if they knew they wouldn’t take me back or would think I would be a danger to the students. My experience of informing people about my condition tends to be that I’m surrounded by friends who are walking on eggshells worrying about what could trigger a downwards spiral of my mental health.

I feared I would be treated differently in my music work

It’s too early to say whether I am getting better or what recovery looks like for me but I manage life by throwing myself back into my work
and trying to progress each day.What would make things easier is if I could be kinder to myself and if people could be kinder to each other and for friends to keep being understanding and supportive, but not oversensitive to my condition.
I believe people who have experienced mental health difficulties almost have a duty to break the stereotypes of mental health patients as being dangerous, irredeemably mad and useless. This could be done by re-engaging with friends, families and neighbours and talking about their conditions where appropriate and becoming just another member of the diverse communities that form our world.
‘..people who have experienced mental health difficulties almost have a duty to break the stereotypes of mental health patients as being dangerous, irredeemably mad and useless.’ 

 

Source: http://greatbritishcommunity.org/

The stigma that kills

(Take a moment and think about this: what happens when you’re in a relationship and your partner dies? What do you do? In our part of the world where there are various misconceptions about relationships, how do you handle such a loss?).

It was the beginning of an academic year and her boyfriend had passed away, her world seemed empty, she was sad and devastated. Not a member of her boyfriend’s family knew about her or her relationship with the deceased. She joined the friends and classmates category just like everyone else and even in school where people knew of their relationship, it was no different than whispers and fingers being pointed at her as the girl who’d lost her boyfriend.
Martha was surrounded by people, yet she was lonely. She had so many thoughts and could hardly concentrate. Martha was depressed and needed help, but who would help? Her friends thought she probably just needed time and space to grieve her loss, but none of them took a step to talk to her about how she really felt, but instead they were waiting for the worst to happen then they could say, “I saw this coming”, “I knew it”. What if she committed suicide in the end? Continue reading The stigma that kills

Am I ever allowed to talk about my depression?

Talking about depression makes me feel understood and makes me know that I am not alone. Don’t be quick to judge me. I had a life all figured out, before this battle to keep going began. I am going through an uphill mental battle and would need you to help and support me through it. I am irrational, not unintelligent. I had been trying to stay strong for too long and never considered myself weak. I wish I could get better and live my life to the full like everyone else, but I cannot simply snap out of it. I need your understanding and support, not your judgment, I have already done enough of that to myself.

Be supportive, do not be judgmental!!!!Depression is a real illness

The morning of my depression

The night before was no different from the previous nights in the last few weeks, feeling exhausted and weary from doing nothing. But then, I was hopeful, believing that I would wake up feeling better and with renewed energy, after all, I had listened to several messages telling me anything was possible with the right mindset and I just needed the willpower to overcome it, perhaps I could even work on my assignment.

But all I had the following morning, was a meaningless memory of the hopeful persona I was the night before and my only desire was to waste away in bed. I wished I could at least take a shower or get something to eat from my kitchen in the basement of my apartment (a deed which had become dreadful in that instance), but even these had become for me tedious everyday tasks I could no longer do. And there I was, cradled like a baby in the arms of depression and I couldn’t get free.

I was entangled, and in its grips and my branches would never sway freely in the wind. I had fallen prey to this vine of depression. In that moment, I knew I was never going to come out alive. I needed more than willpower to live, (not mine, but someone’s), I needed someone to hold me up and tell me they would stay with me through this, I needed a constant reminder that I was not a lost cause, that someday, somehow, I would find my roots and blossom again, and like a bird set free from its cage, I would fly and touch the skies.

I share my musings with you