The Depressed Brain: A Medical Reflection

Suicide is a permanent solution to a crisis point that will pass. If you need to speak with someone urgently, click the button for some resources that will help keep you alive.

Get Help

Depression is one of the most prevalent mental illnesses in the world. Contrary to stigmas, past and present, depression is not representative of one’s character, nor is it a sign of weakness.

Depression results from biological alterations in the brain; functional, structural, and molecular components all become affected. In addition to biological factors, there are also psychological, environmental, and genetic factors that contribute to its etiology. The neurobiological basis of this illness, however, is the hallmark of depression and is strongly indicative of the severity of this illness.

Depression is far more complex than solely a feeling of ‘sadness.’ When an individual suffers from depression, it manifests as persistent and chronic feelings of sadness, emptiness, hopelessness, fatigue, and worthlessness that can often compromise their daily functioning. With a better understanding of the neuro-abnormalities underlying the illness, we can promote greater awareness of not only the severity of depression but also the reality underlying this illness. Furthermore, with a greater understanding of depression, we can offer more compassion to those in a constant battle with this debilitating illness, and encourage those suffering to also be kinder to themselves.

The brain structure and functioning of an individual with depression are vastly different from an individual not affected by this illness, making the reality of this illness even more apparent. Those who have depression have a deficiency in vital chemical messengers, called neurotransmitters. The role of these neurotransmitters is to facilitate communication amongst nerve cells, or neurons in the brain. The brain is comprised of billions of these tiny, but vital components.

In the ‘healthy’ functioning brain (one not affected by depression), these messages are efficiently carried from one nerve cell to the next, allowing for sufficient communication to take place. Whenever we feel, think, or react, our nerve cells transmit messages from one nerve cell to another, throughout various structures in the brain.

Research indicates that individuals affected by depression have various brain structures that are compromised in size, and in numbers (of existing neurotransmitters). Thus, the symptoms of depression result from chemical imbalances and abnormalities in brain structures, which, in turn, affect how the brain operates.

Depression seems to influence many brain regions simultaneously, including the prefrontal cortex, the limbic system (comprising of the amygdala and hippocampus), the hypothalamus, and the anterior cingulate. The illness results in molecular abnormalities in the neurons of these affected brain regions.

The primary neurotransmitters affected in those with depression are serotonin, norepinephrine, and dopamine – all of which help to maintain a healthy balance in mood. Hence, the primary treatment typically prescribed for depression is the restoration of the altered physiology at the root of the illness.

Additionally, psychosocial factors, also contribute to the etiology of depression. When the body is stressed, the hormone cortisol is released into the bloodstream. Although certain amounts of cortisol are healthy and serve as survival mechanisms for the body, excessive production of this hormone, over time, reduces the size of the hippocampus (which, as previously noted, is also thought to be a contributor to depression).

Finally, research also suggests that genetics play a significant role in depression, by predisposing an individual to this illness. If an individual’s parents suffer from depression, it increases the likelihood of them also suffering from this illness (as the hallmark of depression is altered brain chemistry and function). The good news is researchers and experts in the field are working on identifying the genes that make those most susceptible to the illness, so we can continue to move forward with implementing effective treatments for those affected.

Thanks to advances in research, we are gaining a better understanding of the biological factors underlying this prevalent and serious illness. We now know that compromised neural networks in the brain, brain chemistry, and chronic external stressors are all contributing factors in the etiology of depression. Overall, these findings amplify how unique the illness is to each affected individual. Treatments that work for one person may not work as well or at all for someone else who suffers.

Depression isn’t a choice – it isn’t someone being lazy or weak. Depression is a brain chemistry imbalance, rooted in science, and not the afflicted individual’s fault.

Depression isn’t a choice – it isn’t someone being lazy or weak. Depression is a brain chemistry imbalance, rooted in science, and not the afflicted individual’s fault. Also, as previously indicated – as debilitating as depression can be, there is ongoing research aimed at finding the most effective treatments to combat this illness. So, there is plenty of hope ahead as we make continuous strides and advancements in our knowledge of its etiology.

By gaining a better understanding and awareness of the strong biological contributions to depression (and other mental health illnesses), we can continue to make progress in ending the stigma associated with this illness. A stigma which is, in fact, because of misinformation, inaccurate preconceived notions, and ignorance. In actuality, those suffering from depression are the opposite of weak – they are warriors who are fighting this terrible illness, every day, with undeniable strength and resilience.

To those with loved ones affected by this illness – know that your support and compassion truly matters. To those affected by depression – keep fighting!

The Depressed Brain


Davidson, R. J., Pizzagalli, D., Nitschke, J. B., & Putnam, K. (2002). Depression: Perspectives from Affective Neuroscience. Annual Review of Psychology, 53(1), 545-574. doi:10.1146/annurev.psych.53.100901.135148

Deacon, B. J., & Baird, G. L. (2009). The Chemical Imbalance Explanation of Depression: Reducing Blame at What Cost? Journal of Social and Clinical Psychology, 28(4), 415-435. doi:10.1521/jscp.2009.28.4.415

Maletic, V., Robinson, M., Oakes, T., Iyengar, S., Ball, S. G., & Russell, J. (2007). Selective reuptake inhibitors result in such an increase, often relieving symptoms of depression.

Pandya, M., Altinay, M., Malone, D. A., & Anand, A. (2012). Where in the Brain Is Depression? Current Psychiatry Reports, 14(6), 634-642. doi:10.1007/s11920-012-0322-7

Sathyanarayana Rao, T., Asha, M., Ramesh, B., &Jagannatha Rao, K. (2008). Understanding nutrition, depression and mental illnesses. Indian Journal of Psychiatry, 50(2), 77. doi:10.4103/0019-5545.42391

Lauren Ann
Lauren Ann

Lauren Ann is well-versed with depression. A clinical researcher and someone with personal experience, Lauren is passionate about promoting awareness of the illness. Through her work at Sad Runner, this coffee and dog lover hopes to erase the stigma associated with depression and encourage others fighting it.