Depression and the "I-Function"

         As we continue to explore the brain as a material entity, composed of boxes within boxes, I kept thinking about the “I-function” as it relates to depression. When I was seventeen years old, my father passed away from a sudden heart attack. Needless to say, this event devastated my family and me. It is hard to describe the various emotions I felt at the time, but I remember feeling shocked, confused and depressed. These general feelings manifested themselves in my behavior; I had trouble sleeping and performing my usual activities, and I was more irritable and forlorn. Although I was not alone in these feelings, it was evident this experience impacted the individual members of my family in different ways. In reflecting on my father’s death and thinking about depression, it became clear that different people react differently to depression.

This leads me to the “I-function,” a distinct region in the brain that enables us to experience and take

ownership over our behavior. The “I-function” is involved in conscious thought and by coordinating these

thoughts, it allows one to interpret an experience. In the aftermath of my father’s passing, I was definitely

conscious of my emotions but it was impossible for me to control these feelings (as hard as I tried). This led

me to consider what role, if any, does the “I-function” have in controlling one’s emotions? Before jumping to

any conclusions about this relationship, I first wanted to explore depression and the varying ways in which

this condition arises.

Although there are several types of depression, I will focus on Major Depression Disorder (MDD), which is characterized by a pervasive low mood, low self-esteem, and loss of interest or pleasure or pleasure in normally enjoyable activities. Since I demonstrated some of these symptoms and “the diagnosis of MDD is based on the patient’s self-reported experiences,” I believe this type of disorder is worth exploring (1). In addition to the aforementioned symptoms, those who suffer from MDD also display “significant changes in weight or appetite, difficulty getting enough sleep or sleeping too much, slow talking, delayed responses to others, feeling guilty and worthless, difficulty concentrating, planning and making decisions, and thoughts about suicide” (2, pg. 6). In order to diagnosis a patient with this disorder, at least five of these symptoms must be present for at least two weeks.

Major Depression Disorder is common and treated in a variety of different ways. In fact, “large surveys indicate that about 5% of adults in the United States and Canada are experiencing this form of depression at a given point in time” (2, pg. 8). Essentially, there are three main theories about the cause, or causes, of depression, and each theory expounds a certain course of treatment to mitigate the effects of the disorder.

         The first theory, called the Cognitive-behavioral approach, uses therapy to gage a patients’ pattern of depressive thought, challenge their beliefs, and thereby establish new ways of thinking and behaving. Cognitive therapy is based on the premise “that our emotions and behavior are determined by the attitudes and assumptions that we use to structure reality” (3, pg. 198). In MDD, one’s thinking becomes distorted, and this distortion gives rise to attitudes and assumptions that do not predict reality correctly. This cycle of distorted thought leads to adverse consequences, and it is this distortion that is seen as causing depression. Therefore, the goal of cognitive therapy is to “identify, test, and correct cognitive distortions and the dysfunctional beliefs that underlie these distortions” (3, 198).

           Psychodynamics presents another approach to classifying and treating depression. This course of treatment, however, focuses more on the interrelationship of the mind and the mental, emotional, or motivational forces within the mind that shape a personality (4). In this model, depressive symptoms arise when the unconscious and conscious parts of the mind conflict with one another, producing what Freud called repression (a state where you are unaware of having troubling motives, wishes or desires but they influence you negatively just the same) (4). Psychodynamics, unlike cognitive therapy, seeks to resolve early developmental conflicts (e.g. gaining trust, affection, interpersonal relationships, etc) in order to overcome repression and achieve mental health. In practice, psychodynamics employs therapy to study developmental conflicts, and psychoanalysis, to diminish this conflict and treat the depressed individual.

            Next, The biochemical theory proffers the idea that depression arises from chemical imbalances in the brain. The preeminent belief is that depression results from “low serotonin levels [promoting] low levels of norepinephrine.” (1). Both serotonin and norepinephrine are monoamine neurotransmitters, which are believed to regulate the activities of other neurotransmitters. A deficiency of these monoamine neurotransmitters creates erratic and unusual activity amongst other neurotransmitters, which is responsible for depression. In this model, treatment is based on pharmacology and administering the proper medications to correct this imbalance.

           This cursory overview reveals that there are multiple ways to view and treat depression. Returning to the “I-function,” it is evident that each of the above theories supports the idea that depression is not a conscious decision. Simply stating, one cannot feel better by thinking happy thoughts. This leads me to conclude that the “I-function” can influence one’s mood, but depression cannot be overcome by exerting the “I-function.” There are a variety of factors, both external and internal, that influences one’s mood. From my own experience, it seems that depression is not a stagnate condition. It can vary from hour-to- hour, day-to-day and week-to-week depending on the different stresses and external factors one encounters. So, my initial depression after my father’s death could have been amplified by the stresses of school and life in general. I have no way to ascertain whether or not the physical composition of my brain changed, but I do know I had different thoughts running through my mind after this traumatic event. Consciously I wanted to feel better, however, my subconscious needed to deal with the emotions that arise when one deals with the loss of a devoted parent. At the outset of this paper, I wanted to find out why I was depressed. As it turns out, there is no simple answer to this question and, it is obvious depression is a complex issue that cannot be relegated to one arena of thought. 

This is why depression remains a nebulous topic, and, it is obvious that psychologists, biologists, and neurobiologists do not have a unified view of this disorder. There are many areas of disagreement, and so, “different schools of thought…have developed their own theories as to why someone becomes depressed” (4).

              Inherently, depression depends on the chemical, physical and emotional state of the individual. Due to this complex, dynamic interrelationship, a wide range of theories exists that spans multiple scientific disciplines. This also explains why some people benefit from certain courses of treatment and others do not. There is no “silver bullet” to treat depression, since the condition manifests itself in both the unconscious and conscious parts of the brain. Therefore, it should be the goal of modern psychology and neurobiology to synthesize and refine the various opinions about depression in order to better treat this disorder. Given the complexity of the brain, in terms of its organization between the conscious and unconscious state, the integration and processing of external stresses and other environmental factors, it seems that depression must be approached from a holistic, yet individualist, sense. And clearly, we have a lot left to learn about depression.

References:

(1) http://en.wikipedia.org/wiki/Clinical_depression

(2) Richards, Steven and Michael G. Perri. Depression: A Primer for Practitioners. California: Sage publications, 2002

(3) O’Connor, Richard. Active Treatment of Depression. New York: W.W. Norton & Company, 2001.

(4) http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=13003&cn=5

(5) /exchange/node/2175