Unseen Triggers: Surprising Factors Fueling Depression That You Might Not Know

By Indrani Lewthwaite

Are you or someone you know struggling with depression, with medication as a traveling companion? You might be surprised to learn that the path to mental wellness is as nuanced and complex as the human mind itself. In this exploration, we delve into the surprising factors that could be fuelling your depression beyond the medication aisle.

Unlike physical illnesses that can be confirmed through blood tests or scans, mental health disorders are assessed through the lens of client behaviour, actions, emotions, and their capacity for self-disclosure during evaluations. Think of it as piecing together a complex puzzle—each piece representing a different facet of one's life experience and internal dialogue.

The Metaphor of the Mind

Consider mental health diagnosis like tuning a complex musical instrument. The quality of the sound—or in this case, the accuracy of the diagnosis—depends on the instrument’s intricate design and the player's skill in expressing their internal melodies. If a client struggles to articulate or reflect on their experiences, the resulting "tune" may not accurately reflect their true mental state.

Beyond Chemical Imbalances

When depression receives a clinical diagnosis, the default response often leans towards medication as the primary line of defense. While diagnosis can provide clarity and reassurance for those struggling, there is an inherent risk in neglecting the broader spectrum of contributing factors. My experience as a therapist, working intimately with countless individuals who have bravely shared their most harrowing secrets and unseen struggles, reveals a crucial insight: medication alone isn't always the answer. For some, pharmaceuticals don’t yield the expected relief, and true healing emerges only when we dive deep into their emotional and psychological landscapes.

Addressing only the symptoms without exploring the underlying causes can lead to incomplete recovery and prolonged suffering. Diagnoses have undoubtedly risen, yet paradoxically, the rates of people experiencing depression have not declined accordingly. This suggests that increasing numbers of diagnoses have not translated into healing. In fact, it often seems that the prevalence of depression has statistically increased. To achieve genuine and lasting recovery, we must expand our focus beyond the diagnosis and take a holistic approach to mental health.

The Biopsychosocial Approach

The biopsychosocial model presents a holistic framework for understanding mental health. This model considers biological, psychological, and social factors, allowing for a comprehensive approach to treatment. By exploring a person’s history, trauma, relationships, and experiences, we can begin to unravel the complex narrative of their mental health.If we fail to address these layers, we risk bypassing the true causes of these complex mental health conditions, leaving individuals adrift without the anchor they need to move towards healing and improved quality of life. By understanding and treating the whole person, not just the diagnosis, we open up avenues for healthier, more sustainable healing.

Medication: Benefits, Limitations, and Risks

While medication can provide short-term symptom relief, it often does not address the root cause of mental health disorders. My experience over seven years with various clients has shown that unresolved emotional issues, broken relationships, and past traumas are frequently the foundational elements of anxiety and depression. Though some individuals may benefit from medication, others encounter significant side effects.

I decided to write this blog after one of my clients, who was responding well to psychotherapy, suddenly experienced a severe episode of suicidal thoughts. He had just returned from a great holiday with his kids and was planning for a positive future. It was frightening to think of what might have happened if he wasn’t receiving therapy at the time or if I hadn’t asked him the right questions about why his symptoms escalated without known reason. I discovered he had been prescribed Pregabalin (Lyrica) for neck pain—an alarming revelation as Lyrica is known to potentially increase depression or suicidal thoughts, particularly in those with a history of depression. This insight underscores the importance of being vigilant about medication side effects.I am grateful for my ongoing study and research on mental health ( causes and treatment) and i am proud of my cinet for reaching out to me that day. He was able to see his GP and change the pain medication and get on with his life.

Certain medications can cause or worsen depression. Here's a more detailed explanation:

Direct Effects: Some medications directly alter neurotransmitter levels, potentially leading to depression.

Indirect Effects: Other medications cause fatigue, appetite changes, or sleep disruptions, which can contribute to depression.

Examples of Medications: These include acid reflux medications (e.g., omeprazole), allergy medications (e.g., montelukast), anxiety medications (e.g., alprazolam), birth control pills, blood pressure medications (e.g., atenolol), pain medications (e.g., ibuprofen), and seizure medications (e.g., topiramate).

Determining if a medication influences depression can be challenging, especially with pre-existing mental health conditions. Monitoring is vital to detect any worsening symptoms or unusual behaviours, particularly with new medications or dosage changes.

Integrating Therapy and Medication

Choosing medication without pursuing psychotherapy is akin to taking Panadol for a headache without investigating the underlying cause. Medication should complement, not replace, therapy. Cognitive-behavioural therapy (CBT) and counselling can effect structural brain changes, fostering lasting mood improvements and emotional stability.

Encouraging Holistic Healing

The path to mental wellness is paved with self-exploration and relational healing. Healthy living, stress management, Psychotherapy and cultivating healthy relationships are proven methods for achieving sustainable recovery. While medications have their place, their long-term effectiveness is debatable without accompanying psychological support.

Conclusion

Understanding the intricate dance between emotions, biology, and social factors empowers us to approach mental health with a more nuanced perspective. Let’s prioritise therapies that address the deep-seated roots of mental disorders, and reserve medication as a supporting tool rather than a first resort. By doing so, we honour the complexity of the human mind and promote paths to healing that are as diverse as the individuals themselves. After all both science and ancient wisdom shows we are born with built in power to heal.

References:

Celano CM, Freudenreich O, Fernandez-Robles C, Stern TA, Caro MA, Huffman JC. Depressogenic effects of medications: a review. Dialogues Clin Neurosci. 2011;13(1):109-25. doi: 10.31887/DCNS.2011.13.1/ccelano. PMID: 21485751; PMCID: PMC3181967.

National Research Council (US) and Institute of Medicine (US) Committee on Depression, Parenting Practices, and the Healthy Development of Children; England MJ, Sim LJ, editors. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington (DC): National Academies Press (US); 2009. 3, The Etiology of Depression. Available from: https://www.ncbi.nlm.nih.gov/books/NBK215119/