Depression is Not a Moral Weakness.

It Has a Biological Basis. 

Here Are the Pictures to Prove It.

12 Brief Chapters on the Brain Chemistry of Depression
(In plain English, 2-3 pages each) 

"From Stress to Genes, from Mind to Molecules" 

What causes depression?  Is this a personal weakness, flaw, or failure?  Is it something you should be able to fix on your own, "pulling yourself up by your bootstraps"?  Certainly a lot of people think so, right?  In many cases, there is probably some truth to their point of view.  But there is now very good evidence, as you will see here in some stunning pictures, that many people's depression is strongly associated with factors beyond their control.  

Mind you now, an explanation is not an excuse.  Allow me to say that again, as this is one of the places people get stuck: an explanation is not an excuse. You can still take responsibility for what you've got, even if you're not the basis of how it got that way. Indeed, you have to take responsibility for all that you are -- there is no one else who can, for one thing. And our laws, and our ways of relating to one another, are based on the expectation that whatever's going on inside your skin is not an excuse for what your body ends up doing.    

However, knowing how you may have come to be the way you are, at least in part, can often be helpful in coping with how you are.  My patients say this often.  So, this is the story of how researchers are working to understand depression, starting from social stresses like poverty and loss of loved ones, then working all the way through the brain systems involved to the level of cells and molecules and even some genes which appear to be related.  If you want a short but thorough professional article to show skeptics who won't come here (Tom Cruise?), here's a good one; same stuff you'll see here, but mine's in plain English. 

Part One: From Genes to Experience

Chapter 1:  Why are some people so affected by stress? 
    A big part of what causes depression is in a single gene.  

Chapter 2:  Short genes are involved in more than depression?
    Yes, fear responses are also influenced by the same gene. 

Chapter 3:  Short genes affect alcohol use?  
    It may depend on childhood experience! 

Chapter 4: Why are there "shorts and longs"? 
    What does this genetic difference do?

Chapter 5:  Hey, where do I get my genes tested?
    If you could, would you want to? 

This is a very active, very exciting area of research.   Because I'm a not a researcher myself, but a clinician -- a doctor who sees patients all day, most days -- this essay will present a clinician's understanding of this research.  Although you can find some of this story elsewhere in more detailed terms, here you'll find the new findings "translated" into what I hope is pretty plain English, with a focus on their practical implications.  

However, we're going in deep here.  You probably need about a good high school education's worth of knowledge to appreciate the whole thing, if I've done my work correctly. We're going to be looking at parts of the brain and then directly at brain cells and the molecules they use to function.  I hope you'll find most of it entirely understandable.  At times you may want to just skim over some of the more technical stuff and get the big picture.  At the start of each section, you'll find a summary and a link to skip ahead.  


Part Two: Stress Mechanisms, From Molecules to Brains

Chapter 6:  What happens to people's brains when they're depressed?
    How brains reshape during mood disorders

Chapter 7:  Why does this re-shaping happen?
    Cell shrinkage, and fewer new cells

Chapter 8
    The role of stress hormones -- and the short gene story again

Chapter 9:  Some good news:  anti-shrink factors
    (no, we're not talking about psychiatrists)

Chapter 10:  All the Players on One Stage
    This diagram is overwhelming; let's build it one step at a time.

Chapter 11:  Can the shrinkage be reversed? Does treatment help?
    Yes -- at least somewhat -- in depression, PTSD, and bipolar disorder

Chapter 12: The Big Picture:  Putting all these chapters together


Warning: Slow Loading?
Unlike other pages on this website, this section is going to include a lot of images, so it may load much more slowly on your computer.  This is a story told mostly in pictures, as you'll see.  Some of them are really amazing, though.  Worth waiting for, I hope.