115. Let's talk about depression in our 20s

Depression is a complex, individualized experience that goes beyond just feeling sad. It is important to understand that depression can affect anyone, regardless of how they may appear on the outside. Stigma surrounding depression still exists due to a lack of accurate knowledge and understanding. This episode serves as an introductory guide to depression, providing scientific research and personal experiences to shed light on the topic. The origins of depression, various types, and the role of factors such as adrenaline, family environment, and positive experiences are explored. Additionally, emerging research on psychedelic and illicit substances as potential treatments for depression is discussed. This conversation highlights the need for ongoing research and challenges common misconceptions about depression, aiming to increase awareness and understanding of this condition.

It is crucial to have open and honest discussions about mental health and depression, particularly in our twenties. Jemma emphasizes the importance of seeking professional support if one finds themselves relating to the discussion or feeling distressed. She acknowledges that everyone's experiences with depression are unique and encourages listeners to educate themselves further using the resources provided. Jemma shares her own personal experience with clinical depression, highlighting the frustration of not being able to fully enjoy the best moments of her life despite external success. She aims to minimize the shame and embarrassment associated with discussing mental health by showcasing that it is possible to have a fulfilling life while managing depression. The conversation also sheds light on the rising rates of depression and unhappiness in this generation, especially among young people.

Depression is a real and consequential medical condition that has existed throughout history. The upward trend in people seeking a diagnosis can be attributed to reduced stigma in society and an increasing malaise with the state of the world. However, despite its prevalence, there is still a lack of necessary societal, community, and medical supports for those struggling with depression. It is important to acknowledge that depression is not simply sadness, but a complex medical condition that requires understanding, compassion, and proper treatment. The shame surrounding depression is societal and can be unlearned. Just like any other organ in our body, the brain can experience problems or chemical imbalances that contribute to depression, and it deserves the same care and attention as any other part of the body.

Depression is not a one-size-fits-all condition, and it can look very different from person to person. Society often perpetuates the misconception that depression is dramatic and requires your life to be falling apart. However, depression can manifest in various ways, and it doesn't necessarily align with external circumstances. It is essential to understand that depression is not just one diagnosis, but rather a range of experiences. The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides guidelines for diagnosing depression, but it is important to recognize that not everyone fits into the stereotypical image of major depressive disorder. Persistent depressive disorder, also known as high-functioning depression or dysthymia, is another form of depression that emphasizes the longevity and subtle presence of ongoing sadness and hopelessness. Ultimately, each individual's experience with depression is unique and influenced by numerous factors and experiences.

Depression is a complex condition influenced by genetic, biological, and environmental factors. It is not a personal flaw or weakness, and cannot be overcome solely through willpower or positive thinking. The symptoms of depression can manifest in various ways and may be comorbid with other conditions like anxiety or substance use. Situational depression, also known as adjustment disorder with depressed mood, can be triggered by specific events or situations that overwhelm our ability to cope. It is important to recognize the diversity of symptoms and adapt to the unique ways in which depression can appear. While there is no one-size-fits-all solution, understanding the 4 ps model (predisposing, precipitating, perpetuating, protective factors) can help identify vulnerabilities and develop strategies to mitigate symptoms.

Genetics play a significant role in the development of depression, with as many as 40% of individuals with depression having a genetic link. However, it is important to note that not everyone with a genetic mutation or family history will necessarily develop depression. The activation of genes by environmental factors is also crucial in determining an individual's risk for the condition. The specific gene mutation responsible for a majority of cases affects how the brain processes and releases serotonin, a neurotransmitter associated with happiness and mood regulation. This imbalance in serotonin availability results in the symptoms commonly associated with depression. While it may be challenging to directly target serotonin production in the brain, medications such as antidepressants, which prevent the reuptake of serotonin, have shown effectiveness in alleviating symptoms. The biological origin of depression is further supported by the involvement of hormonal imbalances, such as the overactive hypothalamic pituitary adrenal axis.

Depression can have various causes and influences, including genetic factors, neurotransmitter imbalances, hormonal influences, trauma, and environmental factors. It is important to recognize that none of these factors are within our control or our fault. Depression is not something we choose to have or want to deal with. However, there are treatment options available, such as SSRIs, that have been proven effective for many individuals. It is also worth exploring other potential avenues for treatment, such as psychedelics, ketamine, and nature-based therapies. Understanding the complexity of depression and its multiple contributing factors can help remove the shame often associated with the condition and encourage individuals to seek appropriate support and treatment.

Stressful or adverse life experiences can be major triggers for depressive episodes, but surprisingly, even positive events like marriage and the birth of a child can also induce emotional and deeper reactions. These events, when occurring in a short period of time, can lead to a cumulative effect of prolonged stress, impacting overall health. The body's response to intense and life-altering events, by releasing hormones like adrenaline and cortisol, can result in a crash and a depressive period or episode. While predispositions play a role in how these events affect individuals, it is important to consider protective factors as well. Society's focus on eliminating depression may overlook the benefits of perspective shifts and personal growth that can come from understanding and navigating mental health challenges. Ultimately, having a positive attitude towards one's experiences can help minimize distress and the severity of symptoms.

Various protective factors, such as personal attributes, social support networks, a sense of community, a strong sense of identity, and physical health and fitness, play a significant role in reducing the impact of depression. While exercise has shown to alleviate some symptoms of depression in certain individuals, it is not a one-size-fits-all solution and should not be considered the first line of treatment for everyone. It is important to approach the topic of exercise with skepticism and consider the broader context and interactions between exercise and other factors. Additionally, having a strong support network, a sense of purpose, and an optimistic mindset can help counteract negative thought patterns associated with depression. Active coping skills, such as journaling, can also be effective in managing and overcoming difficult times.

Depression should be managed through a series of treatments or interventions, similar to any other form of illness. Medication and therapy are the two main forms of treatment commonly used. Antidepressants, which work by correcting the imbalance of brain chemicals, can be effective in restoring a natural balance. However, medication alone may not be sufficient, and combining it with some form of talking therapy is believed to work best. Cognitive behavioral therapy (CBT) is widely practiced and focuses on identifying and challenging negative thought patterns to bring about positive changes. Interpersonal therapy, on the other hand, aims to improve personal relationships and address emotional issues within that context. There are also emerging experimental treatments involving substances like ketamine and LSD, which are being researched in clinical medical settings. However, it is important to note that no doctor would prescribe illicit substances for treating depression.

Ketamine and psychedelics like psilocybin have shown promising potential for treating depression and other mental health conditions. Ketamine has been found to trigger reactions in the cortex that enable brain connections to regrow, providing relief from depressive symptoms. Psilocybin, on the other hand, alters the brain's response to serotonin, leading to a hallucinogenic state that encourages the growth of new neural connections. However, it is important to note that these medications are highly regulated and should only be administered in a clinical setting. While the research is exciting, it is crucial to seek approved therapies recommended by licensed professionals for the treatment of mental health conditions. Nonetheless, the impact and influence of these drugs outside of a medical setting are intriguing and further research is required to fully understand their potential.

Managing depression is a continuous journey rather than a destination. It is important to accept and acknowledge the reality of the condition, understanding that it may not be curable but can be managed. Depression is not just about sadness, but a complex emotional state that affects various aspects of a person's life. It is vital to debunk misconceptions and avoid defining individuals solely by their depression. Building a sense of community and open communication can be powerful in combating the stigma surrounding mental health. For those supporting someone with depression, simply showing up, asking how they can help, and being there can make a significant difference. While depression remains an unknown and misunderstood condition, taking steps in the right direction, such as seeking further resources and support, can contribute to positive progress.