On some black days everything seems gloomy and our heart dissolves into the darkness of fear, anxiety, sadness, or even a vague desire for death. We feel alone, afflicted, useless, hopeless, tired, even without doing anything, apathetic, unwilling to do anything. Yet, such a day is not enough to define ourselves as depressed. Depression is a true illness, which is widespread and debilitating. The “black evil” is considered to be the plague of our century. It affects over 15 percent of the population, especially adults between 25 and 44 years of age and later, as we grow older, it strikes women in particular. It affects almost 72 million Europeans. Not even children are exempt from it. It involves mood and sleep disorders, panic attacks, obsessive-compulsive behaviors, irritability, loss of libido, attention impairment and damage to a person’s social skills for a long period of time. In severe cases, it can even lead to suicide.
Depression is often associated with other organic diseases, such as diabetes or hypertension. In many cases it is accompanied by traumatic events such as mourning, relationship breakdown, accidents, fights, job loss or difficulty in finding one. In some people, however, it seems to have no reason: it comes out of the blue and wrecks our entire existence.
Scientific literature identifies two main causes of depression: the biological factor and the sociopsychological one. Some people are thought to be genetically predisposed to it and the trigger seems to be in brain activity, whereas in other people, it is reactive, that is, the legacy of one or more painful experiences or an unbalanced life environment.
Peter Kinderman, Professor of Clinical Psychology at University of Liverpool, has criticized the decision of the Medical Research Council to spend hundreds of millions on research concerning genetic and neurological factors. According to the professor, the nature of the trigger is always experiential. Life events and our existential environment are crucial to the outbreak of mental disorders, according to Kinderman. If research funds are limited – the British clinical psychologist argues – it would be preferable to invest these scarce resources in this direction. “Obviously, every single action, every emotion involves the brain,” – he has told the BBC – “but scientific research that will tell us which part of the brain is involved, will not help us to obtain significant results in understanding mental disorders. On the contrary, it is important to keep in mind the fact that when unemployment rates rise in a locality – to give an example – there is a proportional growth of the number of suicides.”
“Biology may be crucial to understanding mental illness,” psychiatrist Jeff Barrett from Welcome Trust Sanger Institute said instead. There is still an open debate.
We talked about it with child psychiatrist Angela Magazù, senior physician at the local hospital company of Matera.
Do you think there are organic and genetic causes for depression?
“There is always a neurobiological substrate. Research in this field aims at preventing the most inclined family strains. There are people who suffer from mood deflection which eventually leads to depression even when they do not have a negative or painful social background. Total recovery is extremely challenging for these people. There are family strains that are more liable to an altered genetic code. And depression is a multi-gene manifestation, it depends on several genes, not on a single one.”
Childhood depression seems to confirm this thesis. Cases of children who at seven or eight years of age have gone through such tragic experiences as to cause them a true psychological disorder are rare, at least we hope so…
“Yes, although childhood depression is rare – it affects about 2 percent of preschool children and about 10 percent of adolescents -, it is no less serious, and its symptoms differ from those of the adults. Depressed children are aggressive, they have frequent and sudden mood swings, switching from excitement and euphoria to sadness and apathy. More often than not, they have a depressed mother. We do not know whether its origins are hereditary or environmental. We do not know whether they would have had the same disorder with a different, healthy mother. Usually, it it is reactive, environmental, and psychological. We are talking about children whose mothers are depressed or seriously ill, children who live in unbalanced family situations, who are neglected by parents and are being raised exclusively by their grandparents or babysitters, or children who live in degraded environments and contexts of social exclusion. The percentage of such cases is low in any case.”
How can you tell a depressed child from a very lively one?
“From his ability to learn, in the broad sense of the word, not only in terms of academic success. There are children who are extremely dynamic, even turbulent, but they show active and proper cognitive abilities. Depressed children often lack appetite, for food, but especially from a cognitive point of view: they lack curiosity, desire for exploration, and interest in the world”.
And how can we tell depression from autism?
“Autism is a neurological disorder, which pervades development and affects ability to connect with other people and behavior. People with autism have no normal relations, no empathy; they behave atypically. They fail to keep eye contact, for example. They also show emotional indifference to stimuli and have an atypical interest in certain details, such as parts of the objects. Usually, it is referred to autism spectrum disorder rather than autism.”
What kind of treatment is used in cases of childhood depression?
“There are age categories. We use specific drugs with children from the age of eight and provide psychological counseling, which involves both the child and his/her parents. The environment where these children live has to be appropriate, stimulating and welcoming, appropriately restrictive and reassuring, and instructive”.