PSYCHOLOGICAL CAUSES OF HEADACHES: WHY DOES DEPRESSION OCCUR?

In the brain messages are passed electrically along the nerve cells, but on reaching a junction between two nerve cells this electrical impulse is converted into physical form. Chemicals called transmitter substances are released by the first cell and travel across the synapse, to land on special receptor sites on the second cell. Here they either excite the cell or inhibit it, depending on their function. Each nerve cell may have hundreds of synapses on it, and will only fire off its own impulse if it receives enough incoming signals at the same time. In other words, nerves in the brain act not just as passive carriers of information, they also filter the information before passing it on.

The transmitter chemicals are stored in tiny bags inside the ends of the nerve cells. However, sometimes these transmitter substances don’t seem to work as well as they should. Perhaps the nerve cell isn’t producing as much transmitter chemical as it should; or else The receiving nerve isn’t as sensitive as it could be; or alternatively, the first nerve cell has been stimulated so much that it has partially run out of transmitter chemicals and can no longer pass on the messages.

In depression it seems that there isn’t enough transmitter substance to go round, so messages can’t pass freely round the brain as they once did; as a result, thinking becomes an effort, and the emotions are dulled. This neatly explains how and why we may get depressed.

Some types of depression (particularly manic depression in which episodes of depression alternate with periods of excessive activity) undoubtedly occur for genetic (hereditary) reasons, and there has been some interesting work among the Amish community in America to show how this genetic predisposition to depression is passed on. But there is a second group of people who get depressed; and at first sight this appears to have nothing to do with transmitter chemicals.

People in this category become depressed for psychological reasons: they worry about things, perhaps becoming obsessed with a problem that they can’t solve, and have ideas, thoughts and anxieties racing round their head. You might think that depression which was entirely related to an outside event – such as bereavement -would have little or no effect on the transmitter chemicals. Not so! This is a good example of how transmitter chemicals can be used up by excess brain activity. In fact, the brain isn’t inactive – it’s simply having all its energy short-circuited in an attempt to deal with an insoluble problem. It’s exactly the situation that happens in your house when someone switches on the washing machine: for a moment all the lights may dim, because most of the energy in the electricity supply is being diverted to making that huge motor start up, so there’s much less left for the lights.

Exactly the same thing happens within the brain: so much mental energy is being used up trying to solve this unsolvable problem that there isn’t much left for anything else. AH this excess internal activity in the nerves is merely going round and round in circles, depleting the transmitter chemicals and making them unavailable for use in other situations.

There are therefore two main ways we can help people with depression. The first is to put back some of these transmitter chemicals (or else make the existing transmitter chemicals work more effectively); the second is, where appropriate, by counselling or psychotherapy to try to solve some of the problems that are rocketing around the subconscious. If successful, it will leave the brain cells free once again to pass messages on in the normal way.

Many anti-depressive drugs improve the brain’s supply of 5-HT (one of the transmitter chemicals). This fits in neatly with the idea that the increased sensitivity to headaches in depression is due to a lack of 5-HT, making you both more depressed, and more sensitive to pain. Medicines to help restore some of the transmitter chemicals improve depression of both origins – biochemical, and related to external events. There are many non-brain causes of anxiety/depression, too. General physical problems such as lack of thyroid hormone (causing depression) or excess (causing agitation); kidney or liver disease; alcoholism; drug dependency; pre-menstrual syndrome (PMS); food allergies; lack of natural light during the winter in certain susceptible people, also called SAD – Seasonal Affective Disorder; and peculiar reactions to medicines, chemicals and food additives can all cause anxiety/depression. The treatment here is to remove or treat the cause wherever possible.

In many ways, depression is not a disease of the logic as much as disease of the emotions; it is often the inability to express those intense emotions that cause problems in the first place. Paradoxically, it is not the inability to experience joy that’s the problem, but anger; and a fear of sadness.

Whatever the exact trigger, there is often a fear of the intensity of the emotions it engenders. For example, maybe you’ve just been bereaved – but you don’t cry, perhaps through fear of making a scene, or because you are scared of the intensity all your emotions. When you do this, you put a clamp on your emotions, so your emotions are unable to change or move; the result is that although you’re protected against the intensity of the sadness or anger that you feel, this emotional 11,imp also prevents you from becoming happy. Letting out these emotions, taking the clamp off so that you can first go down emotionally – by crying or expressing means that ultimately you’ll be able to come up again.

There are two ways to face your problems. Firstly, if you know what they are |and can verbalise them, then concentrate on them and think them through. But be warned, facing your problems in this way is frightening: don’t try it on your own, unsupported, especially if your depression seems severe.

Often these fears and emotions are too deep-seated to verbalise, and all that you ,due aware of is the emotion you feel, emotion that can’t be put into words or reduced to logic. This is where things like art therapy can come in: by using music, .lit and dance, skilled therapists can help you express those inner feelings and let suit those hidden emotions that have troubled you for so long.

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