A global study involving 9,000 people has found that persistent and recurring depression can lead to a shrinking of one key area of the brain. This zone is known as the hippocampus (Greek for seahorse) and it does indeed look like one.
This is the area which helps us store long term memories and plays an essential role in connecting our emotions to memories, personality, and consciousness. It can also help us with spatial navigation. It is one of the first areas of the brain to be affected by Alzheimer’s and explains why recent memories are such a big problem for those affected.
The depression research project involved 15 institutes from all over the world. Researchers compared people possessing normal hippocampi with those who were suffering from persistent depression. This was the largest comparative study of brain volumes ever carried out. The results showed that people who had no treatment for depression (or had recurring episodes over long periods) ended up with a smaller hippocampus.
Researchers used brain magnetic resonance imaging (MRI) and this clearly showed that two thirds of the depressed patients who had recurrences over long periods of time were the ones who had a smaller hippocampus.
“The more episodes of depression a person had, the greater the reduction in hippocampus size.” – Prof. Ian Hickie, co-director of the research project
What are the implications for the treatment of depression?
First, the good news is that treatment with anti-depressants may help to preserve the size of the hippocampus. There are a wide variety of these drugs available, including Selective Serotonin Reuptake Inhibitors, or SSRIs, which help to balance serotonin and can improve mood. Other popular medications include tricyclic antidepressants.
Of course, it must be remembered that all anti-depressants are required by the FDA to carry a black box warning of possible suicidal thoughts. This usually occurs at the beginning of treatment in teens and young adults or if a drug or dosage is changed.
“There is a lot of nonsense said about antidepressants that constantly perpetuates the evils of them, but there is a good bit of evidence that they have a protective effect.”- Prof. Ian Hickie.
Experts are now convinced that medication in treating depression is just one of the many alternatives available.
Why talk therapy is a valid alternative
Talk therapy is another possible treatment for depression, with various types that can suit individual needs. The chance to talk about depression without being judged, misunderstood or even criticized cannot be overestimated. It is a great way to approach problems and possible ways of solving them. Most medications can never do that quite as effectively.
Additionally, there is a wide range of supplements and lifestyle changes which can help a patient to maintain balance and prevent relapses. These can range from exercise which helps the brain to rewire itself in positive ways to dietary and mindfulness routines.
Research presents no conclusive results regardging the use of supplements but it seems that fish oil, SAMe and folic acid hold out some promise.
“There’s promising evidence for certain supplements for depression. But more research needs to be done before we’ll know for sure.” – Dr. Ian Cook, Director of the Depression Research Program at UCLA.
The way forward
Depression is still not fully understood. We know that certain areas of the brain such as the hippocampus are involved, but experts are not sure how they all interlink and what mechanisms are at work.
“Despite intensive research aimed at identifying brain structures linked to depression in recent decades, our understanding of what causes depression is still rudimentary.”- Prof. Jim Lagapoulos, co-author of the research project, Brain and Mind Research Institute, University of Sydney.
One thing is certain. We have learned from the research on the hippocampus that lack of treatment or recurring depression are affecting the brain. Processing emotions and memories are at risk. That sends a very clear message — there may be other areas of the brain affected which may have more serious consequences. But this damage is in many cases also reversible.
This is why we can never ignore depression and always seek treatment when or if it should happen to us or our loved ones.
Featured photo credit: Sigh, Clouds, Rain, Sigh, Iceland via flickr.com