What to Do If You Are Depressed: Taking Care of Your Biology

A blog series guiding folks who are depressed.

Posted Jul 11, 2019

Welcome to Part XI in our “What to Do If You Are Depressed” blog series. Today’s entry is about understanding the relationship between biology and depression, and what it means for fostering an adaptive lifestyle. It is a natural extension of the previous entry (see here), which focused on “anti-depressant lifestyles” and recommended a book that guided folks toward healthier ways of eating, sleeping, developing exercise routines and the like. (For the first in the series, see here).

Let’s divide your “lifeworld” into three domains. The first domain is the personal domain, which is the self-conscious part of you. This is part of you that is reading this blog and deciding what it means.

The second domain is the mental domain. The mental domain consists of your sensory inputs, motor outputs, and feelings and drives and other subconscious processes. These are "sub-personal" in that they connect to the personal domain, but they are not as directly controllable as the personal domain. For example, you can personally decide to stop reading this blog, but you cannot decide to “not see” the visual input that comes to you when you open your eyes.

Finally, there is the impersonal biological part of you. Your heart is pumping, your blood is flowing, your brain’s neurons are making new connections. This is the domain of biology. These things “just happen” and you have no direct knowledge of them, nor do you have direct control over them (although see below). That is what makes them "impersonal."

I have introduced these three categories of personal, mental and biological to help clarify the potentially confusing relationships between “biology,” “disease,” and “depression.” When folks think about depression as a kind of disease, they have in mind the idea that the cause of the behavioral shutdown stems from something that has broken or malfunctioned in that domain. Consider, for example, the “chemical imbalance” hypothesis for explaining depression. This is the idea that depression is caused by problems with neurotransmitters, the special chemicals that foster communication between neurons in the brain.

Many people think about depression as a kind disease. Is this wise? This blog series encourages you to think about depression as “biological” (as well as mental and personal) but to be cautious about thinking about it as a “disease.” To understand why we should be cautious, we need to understand the research-based reasons and the psychological reasons.

The research-based reasons are simple: for many, many years, Western medicine has looked for disease-type mechanisms and faulty genes that try to explain the underlying cause of depression in terms of broken biology. The result of all this effort can be summarized as a complicated mishmash of findings and no clear result. The “chemical imbalance” hypothesis, for example, is almost certainly wrong. In addition, the thousands of studies looking for specific genes for depression have basically "struck out" and failed to find anything definitive. More recent neuroscience research is examining the “inflammation” hypothesis. Perhaps that will yield something of use, but as of now, unless you want to become an expert in neuroscience or psychiatry, then there is not much information on "depression as biological disease" that is helpful.

The psychological reason to be cautious about the “depression as disease” idea is because of what the idea justifies. The key thing here is that it offers an “impersonal justification” for one’s depression, which has some potential benefits but also a number of costs.

Consider that if depression is caused by faulty serotonin production, then it follows that the person (or the family or life circumstances) are surely not at all responsible for the sad state of affairs. We can see this when we move to more traditional disease states. For example, when I got a rare cyst in my spine, no one asked me about my self-esteem or my relationship with my mother—the cyst was obviously caused by an impersonal, biological malfunction. Likewise, if depression is caused by impersonal biological breakdowns, then it follows that folks are relieved from all personal responsibility.

Because of this consequence, the justification can feel good and may even be helpful in some cases. It is the case that many people who are depressed are prone to excessive self-blame and so relieving some personal responsibility can be helpful. (Note that research has looked at the impact of thinking of depression this way, and the results are mixed).

But it is also the case that this justification can work in highly problematic ways. Most notably, it can function as a psychological defense against looking at one’s life, one’s relationships, one’s coping styles, one’s emotions, and one’s personal narrative for living. This can be a real problem.

At a broad societal level, the idea that depression is primarily a disease is almost certainly problematic. The unified theory of psychology approach that I developed states we should consider depression a state of behavioral shutdown. This means that the appropriate “placement” of depression is to consider it as a mental phenomenon. Because the mental domain lines up with the domain of behavioral activity, it means that the primary intervention of behavioral activation (described here, in the ninth installment) deals with depression at the right dimension of analysis.

Even if we locate it primarily in the mental sphere, depression clearly involves both the personal and the biological domains. This is not surprising because these three domains are all interconnected. Consider that you are engaging with these posts at the personal level. That is, you are choosing to read about them, think about them, and following the advice they offer (or not). If they help you, it is because they have altered your self-conscious understanding of depression and that has impacted what you have done and felt.

To see how the domains are constantly interacting, let’s take a moment to engage in a brief exercise:

First, breath gently through your nose for a period of 10 seconds.

Second, engage in a relaxed “soft gaze.” This is where you allow your vision to stare at some ill-defined figure, like the corner of a table, and you gently attend to the periphery of your gaze. Do that for 10 seconds.

Finally, breathe such that you inhale through your nose and then engage in an extended exhale, for 10 or so seconds, pausing for two seconds prior to inhaling again. Do that for 10 breaths.

If you have taken the time to do this, you almost certainly altered your biology. The reason is that engaging in this activity alters the behavior of your vagus nerve, which is a highway that connects the brain to many parts of the body. This kind of breathing also changes the ratio of activation in your sympathetic and parasympathetic nervous system, moving you into a more relaxed, parasympathetic state.

The idea here is something that you already know intuitively, which is that how you personally direct yourself impacts your mental states and your biological states. Thus, although you don’t have direct control over the impersonal biological domain, you clearly have indirect control over much of it.

A key aspect of depression is taking care of your biological domain. This involves learning how to harmonize your personal, mental, and biological dimensions of being. The breathing exercise provided you a glimpse into how you might systematically create “flow” and “harmony” between your personal, mental and biological domains. This is a window into the world of meditation, which I think depressed folks should seriously consider. (For more on how to achieve this kind of flow state, see here.) 

A previous blog post on healthy lifestyles provided information on key habits, like eating, sleeping, and exercise. The adaptive principle of living in this post is the idea that the body is the “temple” in which your mental and personal domains reside. To help with depression, it is crucial to listen to what your temple is telling you and to try to take care of it accordingly.

For some resources that might help guide you in taking care of your body and its chemistry, consider the book Depression Free, Naturally, which outlines a seven-week “emotional healing” program that emphasizes diet, nutrition and body chemistry. Another potentially useful book is The Chemistry of Joy (and accompanying workbook). This book guides you toward understanding your depression and provides a specific lifestyle plan to address it, as well as nutritional supplements and mindfulness exercises that the author’s claim can restore your body’s natural balance and energy. 

This concludes our 11th entry in the series. Next time we dive fully into the domain of emotions, where we will explore how to relate to emotional reactions and hold them in the “adaptive sweet spot” of the mind, where one is able to be aware and attuned to them on one hand and able to adaptively regulate them on the other.