Major Depression: Causes, Symptoms and Natural Treatments

Major depression affects 5% of the world's population, becoming the fourth leading cause of disability globally. If you're in a group of 100 people, statistically five of them have experienced or will experience major depression at some point in their lives. Understanding this condition is fundamental to recognizing its symptoms, understanding its causes, and exploring effective treatment options.

What is Major Depression?

Definition and Prevalence

Major depression is distinguished from other types of depression, such as bipolar depression, by its specific characteristics:

Significant impact: Causes work and school absenteeism
Decreased performance: Affects productivity before fully manifesting
Prolonged duration: Episodes can last weeks or months
Functional interference: Limits basic daily activities

Difference from Other Types of Depression

It's important to distinguish major depression from:

Bipolar depression: Includes alternating manic episodes
Seasonal depression: Related to light changes
Dysthymia: Chronic but less severe form
Reactive depression: Response to specific events

Main Symptoms of Major Depression

Emotional and Cognitive Symptoms

Anhedonia

Anhedonia is one of the most characteristic symptoms:

Loss of pleasure: Inability to enjoy previously pleasurable activities
Flat affect: Reduced emotional expression
Generalized disinterest: Lack of motivation for any activity
Social isolation: Avoidance of social interactions

Anti-Self Delusional Thinking

A unique phenomenon of major depression is "anti-self confabulation":

Reality distortion: Negative interpretation of neutral events
Destructive self-evaluation: Erroneous perception of own progress
Pessimistic narratives: Creation of stories that reinforce negativity
Disconnection from reality: Perceptions don't match objective facts

Vegetative Symptoms

Vegetative symptoms occur without conscious control:

Sleep Alterations

Early awakening: Between 3:00-5:00 AM unable to return to sleep
Altered sleep architecture: Disruption of normal REM/non-REM pattern
Non-restorative sleep: Awakening without feeling rested
Maintenance insomnia: Difficulty maintaining sleep

Other Vegetative Symptoms

Constant fatigue: Exhaustion that doesn't improve with rest
Loss of appetite: Significant decrease in interest in food
Weight changes: Involuntary loss or gain
Hormonal alterations: Imbalances in cortisol and other hormones

Biological Bases of Depression

Neurotransmitter Systems

Norepinephrine System

Norepinephrine regulates:

Energy and alertness: Low levels cause lethargy
Motivation: Drive to initiate activities
Physical activation: Capacity for movement and action
Stress response: Adaptation to challenges

Dopamine System

Dopamine controls:

Reward circuits: Nucleus accumbens and ventral tegmental area
Pleasure experience: Ability to enjoy activities
Motivation: Active pursuit of goals
Anticipation: Expectation of positive experiences

Serotonin System

Serotonin influences:

Emotional regulation: Processing of emotions
Mood: Emotional stability
Guilt and grief: Processing of losses
Cognition: Mental clarity and decision-making

Hormonal Dysregulation

Cortisol and Stress

Cortisol in depression presents:

Altered pattern: Peak at 9:00 PM instead of morning
Elevated levels: Sustained chronic stress
Disrupted circadian cycle: Alteration of natural rhythm
Cascade effects: Impact on other hormonal systems

Thyroid Hormone

20% of people with major depression have:

Hypothyroidism: Reduced thyroid function
Slow metabolism: Decreased energy
Altered brain function: Affected cognition
Increased susceptibility: Higher risk during hormonal changes

Risk Factors and Predisposition

Genetic Component

Twin studies reveal:

Identical twins: 50% probability of developing depression if one has it
Fraternal twins: Lower probability than identical
Siblings: 25% shared probability
Half-siblings: 10% probability

Environmental Factors

Cumulative Stress

Risk increases with:

Stressful episodes: 4-5 traumatic events significantly increase risk
Chronic stress: Prolonged exposure to difficult situations
Early traumas: Adverse childhood experiences
Significant losses: Unprocessed grief

Hormonal Changes

Moments of greater vulnerability:

Postpartum: Hormonal changes after childbirth
Menstrual cycle: Specific hormonal fluctuations
Menopause: Significant hormonal transition
Adolescence: Intense hormonal development

Pharmacological Treatments

Tricyclic Antidepressants and MAO Inhibitors

The first treatments developed:

Mechanism: Primarily increase norepinephrine
Effectiveness: Good results in many cases
Side effects: Cardiovascular and other problems
Current use: Limited by adverse effects

Selective Serotonin Reuptake Inhibitors (SSRIs)

The most commonly used currently:

Mechanism: Increase serotonin availability
Effectiveness: 2/3 of patients experience improvement
Response time: 2-4 weeks to see effects
Side effects: Varied according to individual

Limitations of Pharmacological Treatments

Variable response: Not all patients respond equally
Side effects: Can be significant
Latency time: Delay in showing effects
Dependence: Difficulty discontinuing

Natural and Complementary Treatments

Exercise as Medicine

Neurochemical Benefits

Regular exercise:

Increases norepinephrine: Improves energy and alertness
Releases dopamine: Increases sense of well-being
Stimulates serotonin: Improves mood
Reduces inflammation: Combats inflammatory processes

Recommended Types of Exercise

Aerobic exercise: Running, swimming, cycling
Resistance training: Weights, strength exercises
Rhythmic activities: Dancing, team sports
Outdoor exercise: Additional benefits from sunlight

Cold Therapy

Mechanism of Action

Cold exposure:

Releases norepinephrine: Increases alertness and energy
Activates sympathetic nervous system: Improves stress response
Strengthens resilience: Develops stress tolerance
Improves mood: Documented antidepressant effects

Recommended Protocol

Cold showers: 2-3 minutes of cold water
Gradual progression: Start with 30 seconds
Consistency: Regular practice to obtain benefits
Safety: Consult doctor if there are cardiac conditions

Omega-3 Supplementation

EPA Fatty Acids

EPA (eicosapentaenoic acids) are especially important:

Dosage: Minimum 1000mg of EPA daily
Mechanism: Reduce systemic inflammation
Synergistic effects: Improve antidepressant efficacy
Sources: Fatty fish, krill oil, supplements

Anti-inflammatory Pathway

Omega-3s work by:

Reducing cytokines: IL-6, TNF-alpha, C-reactive protein
Protecting tryptophan: Prevent conversion to neurotoxins
Improving serotonin synthesis: More tryptophan available
Reducing kynurenine: Fewer neurotoxic products

Creatine for Mental Health

Brain Phosphocreatine System

Creatine in the brain:

Neuronal energy: Improves mitochondrial function
Cellular communication: Optimizes neuron-glia dialogue
Mood regulation: Affects reward circuits
Neuroplasticity: Facilitates adaptive changes

Scientific Evidence

Studies show that creatine:

Improves SSRI response: Especially in women
Reduces necessary dose: Enhances antidepressant effects
Works independently: Benefits without other drugs
Dosage: 3-5 grams daily

Innovative Therapies

Ketamine

Mechanism of Action

Ketamine works by:

Creating dissociation: Separation from intense emotions
Inducing neuroplasticity: Changes in neural circuits
Providing perspective: Distance from negative thoughts
Rapid action: Effects in hours, not weeks

Clinical Application

Supervised use: Only in specialized clinics
Specific candidates: Treatment-resistant depression
Temporary effects: Requires repeated sessions
Active research: Ongoing studies on efficacy

Psilocybin

Mechanism and Effects

Psilocybin:

Activates 5-HT2A receptors: Increases serotonergic transmission
Induces neuroplasticity: Circuit reorganization
Modifies narratives: Changes perspective on experiences
Lasting effects: Benefits that persist weeks/months

Research Results

Recent studies show:

50-70% improvement: In patients with major depression
Independent effects: Benefits regardless of subjective experience
Neural rewiring: Changes in brain connectivity
Renewed hope: Optimism about the future

Nutritional Approaches

Ketogenic Diet

Mechanism of Action

Ketosis:

Changes brain metabolism: Use of ketones as fuel
Modulates GABA: Increases inhibitory neurotransmission
Balances glutamate: Improves excitatory/inhibitory balance
Reduces inflammation: Anti-inflammatory effects

Clinical Application

Especially useful for:

Refractory depression: Cases that don't respond to standard treatments
Euthymia maintenance: Emotional stability in bipolars
Specific symptoms: Improvement in energy and cognition
Medical supervision: Requires professional monitoring

Dietary Considerations

Pro-inflammatory Foods to Avoid

Refined sugars: Cause systemic inflammation
Trans fats: Increase inflammatory markers
Processed foods: Contain harmful additives
Excess omega-6: Imbalances omega-3/omega-6 ratio

Anti-inflammatory Foods

Fatty fish: Salmon, sardines, mackerel
Leafy greens: Spinach, kale, chard
Nuts: Walnuts, almonds (in moderation)
Berries: Blueberries, blackberries, raspberries

Prevention Strategies

Stress Management

To prevent depressive episodes:

Relaxation techniques: Meditation, deep breathing
Regular exercise: Consistent physical activity
Adequate sleep: 7-9 hours of quality
Social support: Maintain meaningful connections

Early Detection

Warning signs:

Sleep changes: Alterations in normal pattern
Loss of interest: Incipient anhedonia
Persistent fatigue: Tiredness without apparent cause
Negative thoughts: Excessive self-criticism

Conclusion: Comprehensive Approach

Major depression is a complex condition that requires a multifaceted approach:

Evidence-Based Treatments

Pharmacotherapy: When necessary, under medical supervision
Regular exercise: Natural medicine with proven effects
Supplementation: Omega-3, creatine with adequate dosing
Psychological therapy: Professional support for cognitive changes
Dietary modifications: Reduce inflammation, optimize nutrition

Importance of Professional Treatment

It's crucial to remember that:

Major depression is a serious medical condition that requires professional attention
Natural treatments complement, not replace, medical care
Medical supervision is essential for any medication changes
Recovery is possible with the right approach and support

Understanding the biological mechanisms of depression allows us to address it more effectively, combining traditional treatments with natural approaches based on solid scientific evidence.