Say, a loved one has passed away, which results in depression…does the chemical imbalance come after the fact, what triggers the imbalance, and why is it blamed for the depression, and not the passing away of the loved one?
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You’re conflating grief with depression. Depression isn’t grief. One can trigger the other but that’s not always the case. Grief and depression are different things.
Clinical depression and being sad for a long time due to a shock or tragedy are two very, very different things.
Generally, people who are sad because of externalities aren’t “depressed,” even though that’s the common term, nowadays.
Depression, stemming from a chemical imbalance, is a disorder that happens to people regardless or, sometimes, in spite of external stimulus. I suffer from MDD and I have bouts (even when medicated) of debilitating depression at points in my life where EVERYTHING is just rosy, perfect and couldn’t be better. That’s because he chemicals in my brain don’t work the way they should.
Conversely, when my best friend’s 9-year-old son died, who was a big part of my family’s life, I was sad for a good long while. Heck, I still get sad when I think about it.
The difference there is that just about ANYONE would be sad over a death in their circle of loved ones. Not everyone plots suicide when their life is going well, unless they are unwell.
There’s a difference between the subjective experience of feeling/being depressed and the clinical diagnostic criteria of various depression conditions.
A long time ago, there used to be two labels: exogenous depression (coming from external events) and endogenous (arising for no apparent external reason). 1) These labels are no longer used. 2) the so-called endogenous depression can be real and profound and apparently mystifying. 3) What if the stress of external events actually interferes with neurotransmitters and receptors – and therefore it becomes immaterial what one calls it? 4) The reality is that , if you are going to apply these labels, most are mixed in fact.
I am not advocating either this distinction, nor the chemical model, but just explaining that your observation is correct and leads to other queries about treatments (and indeed about the usefulness of labels)
The idea that depression is due to a chemical imbalance is just a hypothesis. It was made popular since it explained why SSRIs worked, but we now know that to be wrong.
The latest view is that depression isn’t due to serotonin imbalance.
>The main areas of serotonin research provide no consistent evidence of there being an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations.
>From <https://www.nature.com/articles/s41380-022-01661-0>
We don’t know that there is a such a thing as a “chemical imbalance” in the brain. We don’t really know very well how the brain works at all. We know that certain chemicals affect the brain and the behavior and experience of the person taking them, but that doesn’t imply the chemicals are treating an imbalance. A shy person will be more outgoing after drinking alcohol, but that doesn’t mean they suffer from an alcohol shortage in their brain.
It’s more like a cube than a square.
Chemical imbalance can cause depression symptoms on their own with no outside influence and this is treated with balancing of the neurotransmitters.
Or someone who has enough/correct balance of neurotransmitters(NT) gets hit by life maybe grief, or work problems or health issues and there are 2 (for simplicities sake) options. 1. They respond to the stressor and it does not impact their daily life or 2. The stressor causes sleep issues, eating issues, weight issues, motivation changes, libido changes etc
This is then [stressor] related depression. And is treated either by addressing symptoms maybe sleeplessness or by NT balance
When we treat the brain we are going in with a sledge hammer not a precision hammer so we try and see to figure out what helps. This is also why talking therapy is first line treatment in the NHS because it addresses the root cause and not just the symptoms
The chemical imbalance theory has actually been sort of disproven. At the very least, it’s not really the way we theorized it was. The general theory was that depression was caused by an imbalance of serotonin. This made sense, as meds that affect serotonin were effective at treating depression.
But, it’s more complicated than that. There’s no clear link between serotonin levels and depression.
>when it’s, for the most part, clearly external circumstances that lead to it?
This isn’t really true. You can do everything “right” to cure depression and may still have depression. You can deal with these external factors and still have depression. Treatment resistant depression is unfortunately a very real thing.
But, we don’t really know exactly what causes mental illness. It’s crazy how little we know in this regard.
Another thing I think is worth pointing out is how connected everything is. Your external life impacts your thoughts and actions, and that impacts your feelings and moods, and that impacts the actual physical parts of your brain (and vice versa).
That’s the idea behind CBT, working to change your behaviors and think differently to rewire your brain and feel better.
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