It’s not just in your head

"Oh you're depressed? Don't be".

We have come to a point where such statements are only found mostly in sarcastic memes floating on social media platforms. However, there is little denying that mental health still remains one of the most neglected health issues in our country today. 

A 2014 literature review published in BMC Psychiatry, showed that around 6.5 to 31 percent of adults in the country suffer from some form of mental health issue, while the window for children was between 13.4 and 22.9 percent. 

However, as alarming as these numbers are, the rise in incidence of mental disorders does not coincide with the social awareness and resources dedicated to combating them. 

Whether it is a job holder in a corporate industry or a student facing midterm exams, chances are that if these individuals come down with debilitating symptoms caused by the mental condition, such as depression or anxiety, neither the office nor the educational institution would grant them the leave that any other physical condition would have warranted. Despite relentless efforts of various groups and aware citizens on creating awareness regarding mental health issues, we still struggle to see such conditions as a legitimate biological health concern.

And this is where most people are so poorly mistaken. Depression and mental disorders are about as biological and as physical as it can be. Here, a part of the body responsible for maintaining every other organ and function, i.e. the brain, is the site of the pathology. 

Before getting into the heart of the matter, it is helpful to go over the biological basis of mental health problems. Different areas of our brain are responsible for controlling separate body processes. For example, the Medulla Oblongata is responsible for controlling breathing and heartrate, the Cerebellum controls voluntary movements such as talking, and the Cerebrum is responsible for complex functions such as thought and reasoning. A sub-compartment called the Limbic System controls our mood and motivation. Throughout the limbic system and indeed in other parts of the brain, chemicals known as neurotransmitters are responsible for activating and deactivating the brain cells or neurones. As such, these neurotransmitters also help control and regulate the brain functions. 

The neurotransmitters serotonin and dopamine, working inside the Limbic System, control our feelings of happiness, reward etc. There is a delicate balance in the amounts of these two chemicals active in the Limbic System. A number of mental disorders result from this balance becoming distorted.

It is vital to remember that our thoughts are not some kind of spiritual essence that we conjure from nothing. At a molecular level, thoughts are the result of the connections formed inside our brain over the course of our lives. These connections depend on the kind of environment and experiences we have been exposed to. When the chemical imbalance occurs in the brain, it impedes the brain's ability to produce the positive thoughts compared to a healthy person.

Since the brain is the part of the body that controls and regulates everything else, issues with the chemical balance of one part of the brain, can have a trickledown effect on the entire body. Many parts of the brain share strong connections at the cellular level. A dysfunction in one part such as the Limbic System, can impact others too. 

This is especially true for the Hypothalamus, the brain part responsible for maintaining body temperature and the other essential functions. The Hypothalamus is in fact part of the Limbic System, making it ever more prone. The mechanisms are complicated and in many cases not properly elucidated, but it is very much established that any brain dysfunction brought about serotonin/dopamine imbalances, is almost certain to translate into symptoms of physical sickness. Coincidentally enough that is exactly what people suffering from depression often report.

Lastly, because mental health ailments such as depression are a biological condition, many times they are completely unaffected by how well a person may be doing in life. Hence, one should never presume that just because their friend or relative is financially well-off, or a class topper, that they will be immune to depression. 

You would never go up a diabetic person and ask, "hey, you have all these sweet delicacies, why don't you just eat them?" You would never go up to a heart patient and say, "hey, you have all this delicious fat rich food, why don't you just eat it?" Because you know very well they can't as a result of their physical condition. 

Similarly, a person with depression cannot feel happy even if they have all the success in the world, as a result of the physical condition inside their brain. Mental health is a real biological concern, please treat it as such, please be there for your loved ones.     

The author is a computational biologist at the NSU Genome Research Institute with research interests in the genetic basis of Depression.