Multifactorial Depression

This from Ken Pope: Neurogenesis in the adult brain: The association with stress and depression Presented at the 21st Congress of the European College of Neuropsychopharmacology 2008, Barcelona, Spain.

The statement includes several interesting points about possible causes and remedies of depression. In the clinical implications section:

Experiments show that stress and depression inhibit the growth of new nerve cells as well as glial support cells, and that this inhibitory effect can be counteracted by antidepressive therapy.

Within the last two decades, the understanding of the mature brain has changed: Neuronal and glial cell networks in the brain are far from being fixed and immutable – a multitude of factors such as environmental stimulation, learning, growth factors, glucocorticoids, sexual hormones,
stress, aging, and several neurotransmitters regulate the generation of new neurons. Antidepressants stimulate the growth of neurons and glial cells again so the brain changes that occur as a consequence of stress and depression are generally reversible.

The idea that antidepressants stimulate the growth of neurons is news to me. The idea that depression is generally reversible is not news, but it is heartening. Also included are some of the statistics regarding the prevalence and cost of depression, not necessarily widely known. Here’s a compact summary of depression:

Depression is a chronic, recurring, multifactorial, and life-threatening disorder, which represents a collection of psychological, neuroendocrine, physiological and behavioural symptoms. Chronicity and frequency of these symptoms constitute the clinical condition.
Depressive disorders affect up to 20% of people at some time in their life. In primary care, an estimated 20% of patients suffer from depression, but often are not diagnosed correctly (Wittchen, 2000).

Depressive disorders are among the most prevalent illnesses worldwide, producing significant public health and socioeconomic problems (WHO, 2001). The immense costs of depression account for approximately 1% of the gross domestic product in Europe (approximately 100 billion Euro). Depression is affecting more than 120 million people globally, and is set to rise to become one of the leading causes of disability, second only to cardiovascular disease, by the year 2015.

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