The other day I found myself in tears. Maybe I am only missing my big family back in Italy. Surely this has something to do with the famous song from the old Italian singer Mario Merola called “Neapolitan’s tears”, which I was listening to (the YouTube link is below if you are curious!). The song is about a homesick man emigrated to US that wish he was spending Christmas with his family in Napoli, the city where I am from. So, I felt particularly touched as I will be spending Christmas here in Australia, which is very far away from my family too.
Christmas means time for gifts shopping, family lunches, gatherings with friends and colleagues and holidays as well. Time to celebrate the birth of Jesus Christ for the religious people or just reflect on the year that has passed, with projection to the New Year and formulation of often almost unreliable good purposes. However for many people, Christmas is that time of the year when some form of melancholy comes to fill up the body and the mind. People feel under pressure for practical reasons including spending (too much) money in buying presents and maybe cooking for (too many) guests. One can be victim of stressful interactions in case of dysfunctional families and sadness in case they have to spend the festivities in a foreign country away from the beloved ones.
The Christmas melancholy is like a form of depression that is called Seasonal Affective Disorder (SAD). In the Northern hemisphere SAD is usually linked to the mild depression that occurs during the winter time, when cold and absence of light have a huge impact on people’s mood leading to depressive feelings of hopelessness, worthlessness and loss of interest in activities and withdrawn from social interactions. SAD can also happen in a certain time of the year that reminds of a traumatic experience. Someone who has experienced the loss of a beloved one, let’s say in June, then every June could experience a mild depression. Usually people that go through SAD feel better after the specific time has passed. They struggle for a while but come at the other end.
However, other people might not be able to cope with it and the persisting symptoms may lead to a major depression. Depression is considered one of the main causes of disability worldwide and it is associated with increasing mortality. The causes of depression are really variable. Studies conducted in twins and adopted children demonstrate that the influence of genetic factors is about 30-40%. The remaining 60-70% of risk factors are non-genetic and often environment related and individual-specific, therefore explaining the high heterogeneity of this disease. Trauma or abuse in childhood and prolonged stress are highly correlated with depressive states.
Depression has some form of gender specificity as well. While the manifestations of depression are the same between males and females (altered sleep, appetite, sex drive and pleasure in general) they vary in their response upon stressors. A man is more likely to experience depression after divorce or loss of the job, while women are more susceptible to rejection in social relationships, illness and death. Overall, women are more likely to experience depression due to the lower levels of testosterone. It is also known that women might fall into depression in two specific life events: after giving birth or around the menopause.
Stress hormones like cortisol play a big role as well. Studies conducted in post mortem brains show that there is an increased number of neurons secreting cortisol in limbic brain regions in depression (limbic system is the core region for emotions, see post number 2).
Imbalance in the amount of other chemicals that function as neurotransmitters (molecules released from the upstream neurons in order to communicate with the downstream one) is implicated in depression too and these molecules include serotonin (the neurotransmitter of pleasure), noradrenaline (the neurotransmitter of mind and body action) and dopamine (the neurotransmitter of reward-motivated behaviour). Some of the antidepressants on the market work in re-establishing a balance of the neurotransmitters in the brain.
Depression can be cured with drug therapies but can also be tackled, if not prevented, with talking strategies. If you want to know more, visit the blog and website from the psychologist Giovanni Felice Pace:
Stanford lecture on depression:
“Neapolitan’s tears” song with english lyrics: https://www.youtube.com/watch?v=–uYLkyVTcs
Review from Gregor Hasler, Professor of Psychiatry at the University of Bern: Pathophysiology of depression: do we have any solid evidence of interest to clinicians? World Psychiatry 2010;9:155-161.