Psychology Course Discussion: Depression Pathophysiology and Symptoms

This discussion post explores the pathophysiology of major depression, a serious illness with significant social and clinical complications. The post examines the neurobiological hypotheses, including stress hormones, neurotransmitters (serotonin, norepinephrine, dopamine, glutamate, and GABA), neurocircuitry, and rhythm. It delves into the impact of depression on appetite, with discussions on both increased and decreased appetite, and the related neural responses. Additionally, the post analyzes two additional clinical findings: increased fatigue and sleep problems, and uncontrolled emotions, providing the pathophysiologic basis for these symptoms. The post references several studies to support the discussion, highlighting the complexities and the need for personalized treatment approaches for individuals with depression.

Discussion Prompt
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Discussion Prompt
Initial Post: Describe the Pathophysiology of Depression
Major depression is a serious illness with significant social and clinical complications.
The discovery of antidepressants in the 1950's led to the first biological theory of depression,
which suggested that paralysis of the central monoaminergic function was a major cause of the
disease. Basic research in all fields of neuroscience (including genetics) and the discovery of
new anti-depressant drugs is changing our understanding of the mechanisms underlying stress
and drug use. (Leonard, 2018). There is no doubt that the monoaminergic system is one of the
cornerstones of these processes, but more interactions with other brain systems and the control of
the nervous system should also be considered despite all the progress achieved so far, be aware
that there are many open questions to be resolved in the future. Due to the clinical heterogeneity
and etiology of major depressive disorder, it has been difficult to determine its pathophysiology
(Abdallah, Chadi G., et al, 2018). Current neurobiological hypotheses with an active basis and
high clinical significance are reviewed in relation to their strengths and weaknesses.
The ideas selected are based on research investigating stress and stress hormones,
neurotransmitters such as serotonin, norepinephrine, dopamine, glutamate and gamma-
aminobutyric acid (GABA), neurocircuitry, neurotrophic features, and rhythm. . Because all
depressive symptoms apply only to certain types of depressed patients but not others, and
because depressive pathophysiology can vary greatly during illness, current data contradict the
notion of depression. For this reason, antidepressant therapies, including psychiatric and physical
therapies, should be developed for each patient with the disorder (Dmitrzak-Weglarz & Reszka,
2017). Each assumption based on neurobiological information is discussed through their
observations on a daily basis by clinical investigators developing new therapies.

Depression is a life-threatening disease that affects hundreds of millions of people
worldwide. It can happen at any time from childhood to the end of time and is a huge cost to
society as these disorders cause great stress and health problems and, if left untreated, can be
fatal. The psychopathological condition includes a minimum of symptoms of hyperactivity or
depression, anhedonia, and low energy or fatigue (Dean & Keshavan, 2017). Other symptoms,
such as sleep and psychomotor disorders, feelings of guilt, low self-esteem, suicidal tendencies,
and autism spectrum disorders, are also common. Depression is not a coincidence, but it is a
complex, multi-particle and perhaps more than one etiology. It includes the prioritization of
episodic and often progressive emotional disorders, differences in the appearance of symptoms
ranging from mild to severe or without psychological symptoms, as well as exposure to other
mental and psychiatric disorders.
Depression is a life-threatening disease that affects hundreds of millions of people
worldwide. It can happen at any time from childhood to the end of time and is a huge cost to
society as these disorders cause great stress and health problems and, if left untreated, can be
fatal. The psychopathological condition includes a minimum of symptoms of hyperactivity or
depression, anhedonia, and low energy or fatigue (Abdallah, Chadi G., et al, 2018). Other
symptoms, such as sleep and psychomotor disorders, feelings of guilt, low self-esteem, suicidal
tendencies, and autism spectrum disorders, are also common. Depression is not a coincidence,
but it is a complex, multi-particle and perhaps more than one etiology (Leonard, 2018). It
includes the prioritization of episodic and often progressive emotional disorders, differences in
the appearance of symptoms ranging from mild to severe or without psychological symptoms, as
well as exposure to other mental and psychiatric disorders.

References
Abdallah, C. G., Sanacora, G., Duman, R. S., & Krystal, J. H. (2018). The neurobiology of
depression, ketamine and rapid-acting antidepressants: Is it glutamate inhibition or
activation?. Pharmacology & therapeutics, 190, 148-158.
Dean, J., & Keshavan, M. (2017). The neurobiology of depression: An integrated view. Asian
journal of psychiatry, 27, 101-111.
Dmitrzak-Weglarz, M., & Reszka, E. (2017). Pathophysiology of depression: Molecular
regulation of melatonin homeostasis–current status. Neuropsychobiology, 76, 117-129.
Leonard, B. E. (2018). Inflammation and depression: a causal or coincidental link to the
pathophysiology?. Acta neuropsychiatrica, 30(1), 1-16.

1st Response: Discuss the phenomenon of depression effects on appetite
Dietary and weight changes are common but with the changing symptoms of major depressive
disorder: some depressed people show an increase in appetite, while others lose their appetite.
Many areas of the brain involved in the digestive response are also affected by stress.
Surprisingly, there is no published study comparing neural responses with food allergies in
depressed patients with decreased appetite. Loss of appetite may be the first sign of depression or
a warning to return. (Rahim & Rashid, 2017). On the other hand, some people are unable to stop
eating when they are depressed. Sudden weight loss, whether gaining or losing weight, can be a
warning sign of depression, especially for someone with other symptoms of depression or a
history of depression. "While anorexia is a common symptom of depression, feelings of sadness
or unhappiness can cause some people to overeat." Depression can also cause emotional distress,
a common occurrence when the need for food is not related to physical starvation.
Some people show histopathological and functional differences in patients with major depressive
disorders thought to cause depression. Surprisingly, although elevated and decreased appetite are
ways to prevent the diagnosis of major depressive disorder, and the main regions involved in the
pathophysiology of depression are affected by diet, there are no studies comparing neural
responses to the diet of depressed patients whose appetite appears to increase (Nemeroff, 2020).
The internal insula showed a pattern where the depressed group with more desire showed greater
activity in food images than the reduced diet group, while the hemodynamic response of the
healthy group was between the two depressed groups. This pattern is clearly thought to reflect
the role of internal inclusion as a center for consolidation of functions within reward and non-
compliant distribution. (Lee & Rhee, 2017). This account appears to be linked to the insulin's

internal functionality across multiple internal networks in the brain, including award regions and
managed organizations.

References
Lee, S., & Rhee, D. K. (2017). Effects of ginseng on stress-related depression, anxiety, and the
hypothalamic–pituitary–adrenal axis. Journal of ginseng research, 41(4), 589-594.
Nemeroff, C. B. (2020). The state of our understanding of the pathophysiology and optimal
treatment of depression: Glass half full or half empty?. American Journal of
Psychiatry, 177(8), 671-685.
Rahim, T., & Rashid, R. (2017). Comparison of depression symptoms between primary
depression and secondary-to-schizophrenia depression. International journal of
psychiatry in clinical practice, 21(4), 314-317.

2nd Response: Expand on your own post. Discuss two additional clinical findings of
depression and present the pathophysiologic basis of these symptoms
Due to clinical heterogeneity and the etiology of major depressive disorder, it has been difficult
to determine its pathophysiology. Current neurobiological theories with a more practical basis
and higher clinical significance are reviewed in relation to their strengths and weaknesses. The
ideas selected are based on research investigating stress and stress hormones, neurotransmitters
such as serotonin, norepinephrine, dopamine, glutamate and gamma-aminobutyric acid (GABA),
neurocircuitry, neurotrophic features, and rhythm (Stewart & Vigod, 2019). Because all
depressive symptoms apply only to certain types of depressed patients but not others, and
because depressive pathophysiology can vary greatly during illness, current data contradict the
notion of depression. For this reason, antidepressant therapies, including psychiatric and physical
therapies, should be tailored to each patient and to the patient (Quigley, 2020). Individual
reasoning based on neurobiological knowledge is discussed in terms of their interest in both daily
practitioners and clinical investigators developing new therapies.
Increased fatigue and sleep problems: Part of the reason you stop doing the things you enjoy is
because you feel so tired. Depression often comes with a lack of energy and a disturbing feeling
of tiredness, which can be among the debilitating symptoms of depression. This can lead to
excessive sleepiness (Czéh & Nagy, 2018). Depression is associated with insomnia, as it can lead
to other similarities. And they can do even worse. Lack of quality, not getting enough sleep can
also lead to anxiety.
Uncontrolled emotions: One minute is a burst of anger. Next he cries uncontrollably. Nothing
but you made a change, but your emotions are in and out with a moment's notice. Depression can
cause mood swings.

References
Czéh, B., & Nagy, S. A. (2018). Clinical findings documenting cellular and molecular
abnormalities of glia in depressive disorders. Frontiers in molecular neuroscience, 11,
56.
Quigley, E. M. M. (2020). Epidemiology and pathophysiology of gastrointestinal manifestations
in Parkinson's disease. In Neurogastroenterology (pp. 167-178).
Stewart, D. E., & Vigod, S. N. (2019). Postpartum depression: pathophysiology, treatment, and
emerging therapeutics. Annual review of medicine, 70, 183-196.