What’s going on in the brain when people are depressed, and how can knowing that help us treat the condition more effectively?
When people experience depression, the frontal cortex – the home of logic, reasoning, and emotional regulation – tends to go offline, and the survival brain takes over. You see a reduction in dopamine and serotonin – the happy brain chemicals. So the way to respond to that is to do things like exercise, and maintain or increase communication – things that increase your dopamine and serotonin levels.
The three most important things your brain needs to be healthy are: relationship, relationship, and relationship! Being in relationship with others is absolutely vital.
With people being more isolated during the Covid-19 pandemic, are we seeing an increase in anxiety and depression?
Absolutely. Humans weren’t designed to be isolated; we’re a very interpersonal species. Studies show that elderly people who have a dog or another pet that they talk to have much better mental health than those who live on their own without pets. Talking and interacting releases those happy brain chemicals. Remember the movie Castaway? Tom Hanks’ character kept himself sane by constantly talking to his volleyball ‘friend’, Wilson.
So much of your brain is there for the purpose of interacting. You can see this on brain scans: if someone’s concentrating hard on a maths question and their mate walks into the room, you can see the brain really firing up when they begin to chat! All of a sudden their brain’s using the areas involving language – grammar, meaning, pitch, tone, hand- and facial-movements … and that really makes the brain spark up – far more than a tricky maths equation!
Anxiety and depression are connected … but they’re usually distinct from one another. How so?
I find that people tend to fall to one end of the spectrum or the other. When you’re stressed, you either tend to become anxious – which usually involves worrying about the future – or you have a predisposition to get depressed – which often involves focusing on the past. You can get both anxiety and depression, but usually people find themselves moving towards one end of the spectrum or the other – and actually, I don’t think anyone is entirely free of those things.
We’ve got shocking statistics on suicide here in NZ. Can anything be done to reduce these rates?
The number one way to reduce suicide rates in NZ would be to pay mothers to stay home for the first year of their baby’s life – because that child-caregiver connection builds a more resilient brain. It doesn’t guarantee you’re not going to get depression, but it builds up those neural networks that we associate with resilience.
Of course, other things can both help treat and ward off depression. Even a small amount of exercise (for instance) can make a big difference to your mood and brain health.
What are some of the signs of depression we should look out for in family and friends?
A general withdrawing from people … which can be tricky to spot in teenagers. So you have to differentiate between typical teen behaviour and problematic signs. If you’ve got a teen who’s monosyllabic, staying in his room and being sullen, that doesn’t mean he’s depressed; it depends if he’s like that all the time, or just around you! If he’s energetic and involved when he gets together with friends, then he’s probably fine … but if he’s withdrawing across the board (not just from his parents) and generally sliding backwards with self-care, then those are some things to watch out for.
And look out for regression – like if you’ve got a seven-year-old who’s suddenly acting like a four-year-old for a prolonged period of time …
So even a kid as young as that could be suffering from depression?
Absolutely. You can get depression at any age. In a child it’s more likely linked to PTSD, but parents should be aware that they might not even know that their child’s had a traumatic experience. There was a video that was going around on Facebook recently where someone commits suicide halfway through, with no warning … Your seven-year-old could see that, and that can cause PTSD, which could trigger similar symptoms to depression. But it’s easy for a parent to miss.
So it always comes down to having good communication with your children, because in a simple sense, psychological damage is caused by things staying inside the child’s head – and if they’re able to talk about it, that helps a lot because it gets it out there; it allows them to release it. Kids come up with some weird ideas sometimes. Seven year olds, for instance, can think it’s their own fault when their parents get divorced; they have a child’s perception of the world … but as long as we’re talking to them, those ideas can come out and we can address them.
How do parents help keep those lines of communication open?
I recommend parents create a family ritual of having a ‘mate date’ – a predictable window of time, even if it’s only 10 minutes once a week – in which all parenting rules go out the window. It can be really hard for children to open up about tricky subjects, because we have all these rules about what they can say and how they can say it … I even tell families that it’s okay for the kids to swear. They have to be allowed to say stuff that they’re not allowed to say; because that’s when you’ll find out about their deepest concerns, their worries, and their fears. People might worry about that, but there’s a clear boundary around it.
I did that less formally with my kids. For us, the garage was our ‘mate space’, and you were allowed to talk with Dad like a mate (unless someone else came into the garage, in which case you’d have to go back to speaking like you’re supposed to until they left again!). My kids are grown up now, and we’ve still got excellent communication with one another – and I think those special moments were a big part of that.
What help is available, and what’s most effective, in treating depression?
The doctor’s the first port of call; your GP can refer you to someone. And use those 0-800 numbers to find other resources. But I don’t want to create the false impression that it’s easy. If you’ve got a depressed teen, it’s going to be a struggle – and you’re going to have to be their determined advocate to get them the help they need. Make sure they have more contact with the people they do talk with, because communication is always going to help. And do things for them, too – with my daughter, I’d run her a bath and put the smellies in – just little things to make them feel loved and nurtured. A bath doesn’t solve the problem, but it’s soothing, and it helps.
And medication might be necessary, as well. People tend to have a very black-and-white view of treating depression with medication – you’re either for it or against it – but in truth, it’s a tool that needs to be considered in some cases. Sometimes medication is going to save kids’ lives, in which case they absolutely need it – but you can’t just medicate and do nothing else. Medication always needs to be used in conjunction with therapeutic methods, along with maintaining healthy relationships, and communication.
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