Depression results when a person experiences more frustration and anger than he or she can handle. Each person is capable of handling a different amount of frustration or anger. The result is an abnormal receptor-neurotransmitter relationship at the synapse mainly in the limbic system in the brain.
The presynaptic receptors deal primarily with the storage, release and uptake of the neurotransmitter. The primary neurotransmitters, both monoamines, are serotonin and norepinephrine. The available antidepressants, according to the latest theory, may increase the sensitivity of the post-synaptic receptor sites and decrease the presynaptic receptor sites. It is thought by some that the antidepressants may work by blocking the uptake of the neurotransmitters, thereby upgrading the synapse by having more available.
Bipolar - mood disorders in which both manic and depressive episodes occur
Unipolar - mood disorders in which only depressive episodes occur.
Causes of depression include: Impaired synthesis of the neurotransmitters; Increased breakdown or metabolism of the neurotransmitters; Increased pump uptake of the neurotransmitters. When a person experiences anger or frustration these chemicals are released at the synapse. The action potential is passed on from neuron to neuron. Following this the neurotransmitter is (1) reabsorbed into the neuron where it is either destroyed by an enzyme or actively removed by a reuptake pump and stored until needed or (2) destroyed by monoamine oxidase (MAO) located in the mitochondria.; Lack of these neurotransmitters causes certain types of depression, e.g., decreased norepinephrine causes dullness and lethargy, while decreased serotonin causes irritability, hostility and suicide ideation
Risk factors for depression include: Females more likely to develop depressive illness than males; Strong family history (depression, suicide, alcoholism, other substance abuse); Presence of chronic disease, especially multiple diseases; Migraine headaches; Back pain; Chronic pain; Recent myocardial infarction; Peptic ulcer disease; Insomnia; Stressful situations; Adolescence; Advancing age; Retirement; Children with behavioral disorders, especially hyperactivity
Methoxyhydroxyphenylglycol (MHPG), the metabolite of norepinephrine, can be measured in urine and in some laboratories in the CSF. Similarly the major CNS metabolite of serotonin, 5-hydroxyindoleacetic acid (5-HIAA), can be measured in the urine and CSF. These tests are not a good reflection of the levels in the central nervous system, but rather in the peripheral nervous system.
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