Depression as Injury Repair Gone Wrong?

I came across an interesting new research study regarding depression. The idea is that our minds react to stressful life events in the same way our bodies react to physical wounding, with an automatic attempt to heal ourselves. Some people do experience a period of depression that self-corrects. For others this process goes wrong.

Science Daily describes it this way:

Just as the body’s repair mechanisms for physical injury can sometimes result in chronic pain and inflammation, so too can the response to psychological trauma, resulting in chronic depression.

I am intrigued by the idea of stressful life events leading to microdamage in the brain! It fits with my understanding that we are greatly impacted by our environment and traumatic events. I look forward to learning more about this and the treatment implications. I am including the abstract below with links to the full articles.

Depression: A repair response to stress-induced neuronal microdamage that can grade into a chronic neuroinflammatory condition?

Abstract

Depression is a major contributor to the global burden of disease and disability, yet it is poorly understood. Here we review data supporting a novel theoretical model for the biology of depression. In this model, a stressful life event leads to microdamage in the brain. This damage triggers an injury repair response consisting of a neuroinflammatory phase to clear cellular debris and a spontaneous tissue regeneration phase involving neurotrophins and neurogenesis. During healing, released inflammatory mediators trigger sickness behavior and psychological pain via mechanisms similar to those that produce physical pain during wound healing. The depression remits if the neuronal injury repair process resolves successfully. Importantly, however, the acute psychological pain and neuroinflammation often transition to chronicity and develop into pathological depressive states. This hypothesis for depression explains substantially more data than alternative models, including why emerging data show that analgesic, anti-inflammatory, pro-neurogenic and pro-neurotrophic treatments have antidepressant effects. Thus, an acute depressive episode can be conceptualized as a normally self-limiting but highly error-prone process of recuperation from stress-triggered neuronal microdamage.

Research highlights

right triangle, filled Hypothesis: Depression is triggered by stress-induced brain injury.

right triangle, filled The injury repair response has neuroinflammatory and neuroregenerative phases.

right triangle, filled Released inflammatory mediators elicit sickness behavior and psychological pain.

right triangle, filled Neurotrophin- and neurogenesis- mediated regeneration normally resolves the injury.

right triangle, filled However, both neuroinflammation and psychological pain are prone to chronicity.

References:

Karen Wager-Smith, Athina Markou. Depression: A repair response to stress-induced neuronal microdamage that can grade into a chronic neuroinflammatory condition? Neuroscience & Biobehavioral Reviews, 2010; DOI: 10.1016/j.neubiorev.2010.09.010

University of California — San Diego (2010, October 20). New theory links depression to chronic brain inflammation. ScienceDaily. Retrieved November 10, 2010, from http://www.sciencedaily.com­ /releases/2010/10/101020091857.htm

Kathleen Young, Psy.D.

This entry was posted in Chronic Illness, Depression, Health, Mental Health, Psychologist, Trauma and tagged , , , , , , , , , , , , . Bookmark the permalink.

5 Responses to Depression as Injury Repair Gone Wrong?

  1. MFF says:

    I liken extreme pervasive trauma as repeated concussions. Depression for me is really exhaustion from trying to heal. Crashes are caused not by processing trauma rather not processing trauma. The not processing trauma can have a variety of reasons exasperated by most treatment methods.

    Most methods for healing from depression treat the symptoms which is similar to trying to get a person with a concision to not be concussed.

    A crisis is more like experiencing physical shock than an emotional crisis. Note: I would propose that a warm saline solution, oxygen and then rest would be a more effective treatment than most psychiatric hospitals in many cases.

    I would not phrase depression as healing gone wrong rather healing interrupted. It can be permanently interrupted if seen as going wrong, then the person may be in therapy or on meds for the rest of their lives.

    With a person who experienced life threatening trauma stating at birth there is no base line to find or return to there is not post traumatic stress it is traumatic stress a base line must be created.

    I have healed by rejecting what is known about how a traumatized body and brain is different than a body and brain that was not traumatized and gone with what is true for my body.

    As simply as I can put it I treated my body for shock, did meditation in motion, exercised my brain in a way that was good for my body and experienced complex psychotherapy and complex psychotherapy. Then and only then could I heal.

    Specifically I had to stay away from medication, DBT, any cognitive therapy, guided meditation , yoga and traditional exercise. Most importantly I did not cope I lived what was happening. I isolated as that was the intensity of experience that was required. When I focused on traditional therapy it was judged a success. The success was a very good masking of what was really going on which lasted for a while then resulted in exhaustion which was labeled depression.

    I consider any attempt to accept a life long experience of having the past grossly negatively impacting the present to be an attempt at failing and is often successful at failure.

    The concept of treating a person to become a productive member of society and then they will have a sense of self is flawed and only makes slight improvements for society. Expressing self and exploring self within the context of a self that has had trauma so severe that it effected their brain and body to the extent that it functions differently ultimately leads to a more productive member of society. This method requires more skill and effort by the treatment provider and can not be taught in a class room. It is a gift that the provider has for reasons unknown.

    To be clear my expertise is in healing from extreme life threatening trauma done by cults and psychologists in the MKULTA program which was not experiments rather a methodology being practiced starting at birth. Any correlation with my experience may be incidental, the measure is does treatment ever end.

    If symptoms are viewed as results than they can be seen as normal and the experiences can be seen as the abnormally.

    Dissociation is a normal process of organizing ones whole life which I expect happens during sleep in a person who has not experienced trauma and it is the experiencing in a wakeful state that is abnormal caused by trauma. My multiplicity is not related to dissociation and splitting off rather it is the result of a failure of coming together of my experiences due to constant trauma which prevented dissociation.

    Dissociation is the cure not the problem. I am using the term dissociation not a description of symptoms rather how the mind/brain process experiences.

    • MFF-

      You are giving me a lot to think about. Thank you!

      I like the point you are making about having no baseline to return to, about dissociation sometimes being about not coming together in the first place.

      I think you are also a good reminder that what matters is what works for the individual. Sounds like you have done an amazing job of figuring that out, even in the face of a mental health system that thinks it knows better.

      • MFF says:

        Thanks for reading.

        To be clear I did find a therapist how understands she does not understand.

        I am hesitant to equate healing from trauma once the memories start to come into consciousness to a brain hemorrhage stroke as I have never had one. It is the best fit that I can come up with.

        The changes to the brain that happen once the memories come into consciousness are extreme. It would be so helpful if the mental health field treated the changes and how hard it is to deal with with respect.

        It takes time for the brain to heal. It effects everything. Just has trauma is seen as events and not a way of life memories coming into consciousness is a way of life for a long time.

        Made harder and unprocessed trauma and processing trauma is 24/7 there is not real break possible only lulls.

  2. OneSurvivor says:

    My brain is not in a place to wrap itself around the post. Too technical for me to handle at the moment. Maybe another time.

    However, the first three paragraphs that MFF wrote really jumped out at me. I read that and just went “YES!”. The times when I was most depressed I desperately needed rest and freedom from commitments to anyone or anything other than myself. I needed time to strengthen and regroup so that I could deal with whatever was happening.

    She also mentioned isolation. It is extremely difficult…again…EXTREMELY diffficult…to work through things when I cannot isolate enough to permit myself to go through them and work on them.😦

    • MFF says:

      Hey OneSurvior,

      How apropos that you made this comment. I had just made the decision that if I can sleep I am going to sleep. I have gone with if I am tired I will sleep for a while. With PTSD in full swing it was nothing for me to stay up three days or go for long periods with 6 hours sleep a night. Now doing the work of trauma it is nothing for me to sleep 16 out of 24 hours.

      I do have some criteria for sleeping if I can to insure that it is not simple avoidance or treating my body so terribly it can not function. No just reading all day or staying up all night and then needing sleep.

      I consider the work of therapy work.

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