March 7 Notes, Explanatory Theories

“Depression, out of the shadows”

  • 20 million Americans have depressive disorders
  • it is a poverty of our language that we only have this one word  to describe…

Andrew the novelist: “it is so strange that I just don’t care” –

  • like that second when you slip and trip, right before you fall on the floor, it was like that 24 hours a day
  • A CURRENT AND OLD LOSS CAN TRIGGER A DEPRESSION – ask “Why Now” and “Has there been a recent loss”
  • quote that made me cry “all this time paradise was in this room”


  • between 15 and 34 – prime years to have depression onset
  • “Like the Dementors in Harry Potter
  • “like a meteorite smashed into our house”
  • started drinking and could not stop drinking
  • started smoking pot
  • felt suicidal and told her Dad
  • when to treatment and meds but ended up in in-patient hospitalizationon
  • tried 7 medications before finding one that worked

Hart Lipton

  • depression started in 6th grade
  • he requested to be hospitalized
  • he has bi-polar . .. 
  • BIPOLAR is more heritable than Uni-Polar depression
  • family concerned about adolescent suicide
  • has BiPloar 2 , comes with irritability and depressive episodes

Jed – college freshman

  • suicide is the 2nd leading cause of death in the population
  • 2x as common as homicide
  • most suicides are linked to Depression
  • his parents had no information about Depression at all

ANXIETY is often an early sign of depression

  • Most people with Depression has symptoms of Anxiety
  • The brain continues to grow and refne into adulthood – well into the 20’s
  • The Amygdala – MRIS’s shoe elevated activity that are activated longer than normal


BiPolar may initially present as depression because it is the first episode. Giving them a medication for depression may cause them to switch and become Manic.

creating a Mood tracking chart is helpful to make the diagnosis

women are diagnosed twice as often as men are

Postpartum Depression

Intrusive thoughts are common, acting on them is rare

1/3rd of the risk is genetic

the other 2/3rds include early life trauma, abuse, neglect and poverty


  • If you re young and alone, it induces depression
  • adolescents adopt their peer group as family
  • initiated at 11 years old
  • Violence = respect, love and Power
  • risky behavior is associated with Depression
  • Gangbang is another version of suicide



  • Dysthimia – mild long term depression
  • low grade and smoldering
  • last 2 years or more
  • over eating is common
  • went on meds and Talk Therapy
  • she was hapy to have a name for her diagnosis after living for 30 years with the symptoms
  • “Would rather say we have a family member in jail or on drugs before uttering Depression

Philip the CEO

  • low level depression eventually blew up until he checked into a psych hospital
  • he went public with his story and inspired other executives
  • 650,000 suicide attempts in America
  • encouraging  to find treatment helped him recover

50 years of Depression Medication  . . . currently 25 approved drugs

  • involves multiple neurotransmitters
  • meds can take 6 to 8 weeks for drugs to be effective

talk therapy is effective with 70 to 80% of patients

  • talking changes the brain
  • early interventions are key
  • think of Depressive Episodes like a series of heart attacks
  • can find cognitive errors


  • prefrontal cortex and hippo-campus is often smaller in depressed people. maybe Deoression is th process of the Neurons dying and shrinking
  • Excercise can stimulate the nerves there and help these regions grow

decrease in rx for depression drugs led to higher suicide rate


tryind a shorter period of time where people experience symptoms

IV KEtamine – targets Glutamate


old people relapse at a rate of 80%.

ETC : don’t let “One flew over the cocoo’s nest scare you off.

treatment resistant depression, refractory depression

Area 25 . . . lower functioning. seems to be at the core of all this

link between area 25 and frontal cortex…. like a teeter totter 

one goes up and the other goes down

50 billion dollars in productivity lost in the US due to Depression

**Talk Therapy ** best treatment for Depression people with a history of early childhood trauma

Beck’s New Cognitive Model of Depression: a theory

šGenetic vulnerability

šHigher activation of HPA

šReactive amygdala 

šReduced Pfc

šCognitive biases

šSelective attention to negative aspects of experience

šExaggeration of stressful events

šDepressive symptoms


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