Disease Of The Thoughts
It arrived as the underbelly of a particularly sultry summer.
Hacking its way up my neck and mercilessly clouting me at the back of the head, over and over and over, until I’d want to throw up.
I’d never experienced this kind of pain before, and it surged anxiety through me like I’d received it intravenously. My world reduced, and I jettisoned my big hopes in exchange for small ones: to cry only in the shower, to manage to eat regularly, to feel something other than despondent and overwhelmed.
Someone once described depression as a disease of the thoughts. Disease is often the underlying cause of chronic pain.
But how can a mental illness produce physical pain?
Thoughts, memories and emotions are actually physical. They are particular patterns of activity in particular brain cells or neurons, and with the right sort of brain-scanning equipment, you can see them at work in the brain.
We know that physical pain is registered in the anterior cingulate cortex, which is a tiny bit of grey matter nestled in the groove that divides the left and right hemisphere of the brain. Laboratory research has shown that the anterior cingulate cortex also registers emotional pain. One study done at the University of California in Los Angeles deliberately provoked social humiliation in a group of participants, and compared their brain activity to another group of participants who had not been socially humiliated. What they found is that the anterior cingulate cortex was activated in the first group, but not in the second group. Neurologically speaking, emotional pain and physical pain appear to be generated in the same way.
It is suggested that ongoing emotional pain in the brain prompts it to become so familiar with depressed thoughts and feelings that it ceases to respond in any other way. The pain has become “learned”, and the brain is locked into this memory. As evidence for this, in people who are experiencing depression, the parts of the brain that register and respond to outside events tend to be underactive, whilst the parts that are responsible for monitoring a person’s internal feelings are on high alert.
In 2017, depression became and has remained the leading cause of ill health and disability worldwide. Globally, more than 300 million people of all ages suffer from depression. More women are affected by depression than men, and at its worst, depression can lead to suicide. However, depression continues to be significantly misunderstood. Can’t you just, you know, think positive? Make yourself happy?
As we move through life, we are required to navigate experiences that differ from what we’d hoped for. At times, the differences are significantly confronting and emotionally demanding. Sadness inside these experiences is normal, healthy, and necessary to accept and integrate what’s occurred into our lives.
Unlike sadness, depression isn’t triggered by a single, specific situation. The sadness felt in depression is pervasive, meaning that it is felt across all areas of life. Also, whilst sadness is temporary, and will eventually fade and resolve, sadness in depression is persistent and can be increasingly intense over time.
Also, the experience of depression includes strong feelings of hopelessness, worthlessness, and guilt. Accompanying ongoing physical changes are seen, such as disruption in sleep and appetite, feeling really lethargic, and having no energy or motivation. These changes significantly interfere with daily functioning. Sadness alone does not alter these physical states to the same degree or duration.
Finally, depression is a mood disorder, meaning that it is primarily characterised by a significant disturbance in mood. Mood is different to emotion. Emotions are reactions to something specific, but moods are more general, diffuse states of being that aren’t necessarily provoked by anything identifiable. Because of this, they are less intense but more persistent, and can last for hours, days, weeks, or longer.
We tend to refer to moods as either good or bad, but the mood disturbance in depression isn’t either of these. Those who have depression typically experience a continuously low or depressed mood. In fact, the term depression is taken from the Latin verb deprimere, meaning “to press down”.
Importantly, with the right intervention and support, depression can be overcome. Please consult your doctor if you are wondering whether you might be experiencing depression symptoms.