I've always thought that the name "depression" is unscientific. "Depression" is a description of the state of mind, which is a psychological term. Many people think that depression is a mental illness. Including some patients, they would rather accept this judgment and not go to the doctor, fantasizing about changing the environment and adjusting it, and the disease will be cured.

Lucky to be there? Yes. Depression is a self-limiting illness that progresses to a certain level and sometimes stops the course of the disease on its own. According to empirical statistics, about one-third of patients will gradually recover after a year and a half without treatment. However, it is very dangerous to do so. Because of the difficult life in the past year and a half, the quality of life is low, and the risk of suicide is high; And the so-called "good" just doesn't have a seizure. It hangs above his head like a sword of Damocles, and he doesn't know when it will fall.

Today, modern science has proven that depression is not just a mental illness, but a functional disease.

In the early days of mankind, the ancient Greeks believed that depression was caused by an imbalance of four body fluids in the human body: blood, mucus, yellow bile, and black bile. This claim is certainly unscientific, but it is a genius guess to link depression to physiological factors.

In the 3rd century B.C., there was a breakthrough in the study of the brain, which found that the brain was in charge of thinking, and the cerebellum was in charge of muscle movement, and the theory of the nervous system was established. Later, further research concluded that "mental disorders are brain diseases", and if there is a disturbance in the brain, mental disorders may arise from them.

The middle of the 20th century was an era of scientific progress in human history. The study of depression has been revolutionary: researchers have collected and dissected brain specimens from people who have committed suicide with depression, and microscopes have seen lower levels of three neurotransmitters in the brain (serotonin, norepinephrine, and dopamine) than usual. This led to a research direction: to find a correspondence between depression and the concentrations of these three neurotransmitters.

Let's start with what neurotransmitters are. We know that there are hundreds of millions of brain cells in the human brain, called neurons. Between two brain cells, there is a gap. When the human brain transmits information, the nerve endings of the previous brain cells release a chemical whose mission is to carry the information, cross the gap, and pass the information on like a postman. This chemical is called a neurotransmitter.

There are many neurotransmitters in the brain, the most important of which are the three mentioned above: serotonin, norepinephrine, and dopamine.

These three neurotransmitters do not function identifiously. For example, serotonin governs emotions, desires, and will; Dopamine transmits pleasure; Norepinephrine provides life power. If these three neurotransmitters are out of balance, and the signals received by neurons are weakened or changed, the human body will experience symptoms such as insomnia, anxiety, obsessive-compulsive, depression, fear, etc., manifested as depression, bipolar disorder, schizophrenia, and other brain diseases.

Antidepressants are developed against these three neurotransmitters under the guidance of the above theory. For example, the most common series of SSRIs, the full name of "selective 5-HT reuptake inhibitors", has a function that specifically inhibits the brain's recovery of serotonin, thereby maintaining the balance of serotonin concentrations in the blood.

The discovery of the earliest antidepressant drug isoniazid was purely accidental. At that time, isoniazid was an anti-tuberculosis drug, and when doing drug experiments, it was accidentally found that tuberculosis patients would feel euphoric after taking isoniazid. Following this path, the first generation of antidepressant drugs was developed. Today, antidepressants have evolved into the third and fourth generations. The effectiveness of these antidepressants is evidence of a definite correspondence between depression and these three neurotransmitters.

In recent years, there has been occasional progress in the study of the pathology of depression in China. Dr. Gong Qiyong and Dr. Jia Zhiyun, directors of the Department of Radiology and West China Magnetic Resonance Research Center of West China Hospital, Sichuan University, and Professor Guo Weihong of the Mental Health Center, used advanced imaging technology to find that the characteristic abnormalities and damage of neural pathways in brain regions such as the prefrontal and limbic systems of the brain may be related to depression and suicidal behavior.

The experts also recruited 16 suicide attempts and 36 depressed patients who did not engage in suicidal behavior to study the volume of gray and white matter and the integrity of white matter fibers in their brains using a new functional magnetic resonance imaging technique. Through the comparison of brain images, it was found that the anisotropy values of the forelimb part of the left internal capsule in the brain of these suicide attempters were significantly reduced, suggesting that the destruction of white matter in this area led to damage to the frontal striatal pathway.

However, this is still only a description of the phenomenon. Correlation does exist, but why is it? The mechanism is unknown. The pathogenesis of depression is complex, and there are only a few hypotheses, which are supported by some research results, but these hypotheses sometimes contradict each other or even deny each other.

There is now a tendency to think that depression is a heterogeneous group of disorders with different etiologies and pathogenesis, rather than a single disease. Each of them has its own causes and mechanisms, and cannot be explained by one etiology and mechanism.

At this point, the conclusion is clear: depression is not just a simple psychological pathology, but also a group of functional pathologies. Initially, it is not possible to observe whether the brain is damaged, but if the disease is too long and the hippocampus of the brain shrinks, the functional lesion can become irreversible and organic. At this time, it is too late to treat.

Like many people, I have thought, without thinking, that depression is caused by a lack of mental strength. Now I know that people who have never been ill may never be able to appreciate the frustration, loneliness and desolation in the hearts of patients. As a result of a functional or organic lesion of the brain, he suffers from mental disorders and pain that his will cannot control. It is unscientific and unfair for outsiders to stand on the moral high ground and sympathize, enlighten or accuse them condescendingly or even with a hint of superiority.

Compared to other physical illnesses, depression is not easily self-conscious. If you have a disease, such as a cold, due to the invasion of foreign pathogens, the body will produce an immune response and will cause fever and runny nose; If you have a traumatic injury, the wound will become inflamed and swollen, which can be a warning sign. Brain lesions are silent, and patients don't feel that something is wrong until they are severely depressed and their cognition is biased. At this time, I often think that it is just a psychological problem.

At this point, you may be able to understand why I think the name "depression" is unscientific. Perhaps it should be called "brain dysfunction". However, since it has been agreed, the name should not be changed. But we must not be misled by the name and simply equate depression with a psychological problem, thus missing the best time for pharmacological intervention.

Those who "cross" from this shore and the other shore. For people with depression, "getting over" is not only a religious feeling, but also has a real saving meaning - returning from hell to the world.