You can feel all of those depressed feelings , but still show up for work and your family and your friends with a smile on our face. That's what's known as "smiling depression," which, tbh, sounds counterintuitive, but according to Heidi McKenzie, PsyD, a clinical psychologist practicing in Pittsburgh, Pennsylvania, depression and smiling are not mutually exclusive.
Here's what you need to know about "smiling depression," including what to do if you think you have it, and how to get help. McKenzie says that smiling depression is essentially another name for high-functioning depression or persistent depressive disorder PDD , a chronic level of sadness that can include sleep or appetite changes, feelings of hopelessness or fatigue, panic attacks, and loss of interest in favorite activities.
If you're looking for "smiling depression" in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition DSM-5 , you won't find it, but experts are fairly comfortable using the term as a stand-in for mild to moderate categories of depression, especially if it prompts someone to seek help for their symptoms when they might not otherwise realize they have a problem. McKenzie agrees, explaining that the idea of "smiling depression" can go a long way toward busting the myth of the depressed person as someone who only stays in bed all day with the blinds drawn.
While some people with depression become bedridden it can happen with major depressive disorder , many others are able to do their jobs, take care of their families, and even smile, laugh, or maintain their sense of humor, says McKenzie. There were other hints as well: autopsies of suicide victims revealed they had less serotonin in their brains compared to people who died by other means.
Injecting rats and rabbits with the mood-elevating tuberculosis drug iproniazid doubled the amount of serotonin in their brains within a few hours. Prozac changed depression treatment after its release in By , more than 6 million Americans had been prescribed Prozac.
And, in , Lilly scientists reported on fluoxetine, a compound that blocks the removal of serotonin — and only serotonin — from synapses. After more than a decade of clinical trials, the FDA approved fluoxetine for the treatment of depression in Marketing began in under the brand name Prozac. Fluoxetine was the first of a class of antidepressants called selective serotonin reuptake inhibitors SSRIs. Prozac was nothing short of a breakthrough. Its success was mainly due to its safety — by selectively targeting serotonin and little else, it produced fewer side effects than drugs like imipramine, and patients tolerated it better.
But, it was no more effective than these earlier drugs at alleviating the symptoms of depression. Prozac was the first of a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. These drugs work by blocking the molecular sponges, or reuptake channels, that sop up serotonin from synapses, increasing the amount of the neurotransmitter transmitted to receiving neurons.
By selectively targeting the serotonin system, SSRIs produce fewer side effects than earlier generations of antidepressants. SSRIs transformed depression treatment. Still, evidence poking holes in the serotonin deficiency theory of depression began trickling in. If boosting serotonin signaling is the key, then patients should feel better right away. In the last 20 years, other pieces of the story have fallen into place.
Brain imaging studies show depressed people possess smaller hippocampi, the seahorse-shaped swaths of brain tissue that are the center of learning and memory. Neurons in the hippocampus shrink, and the connections between them wither. SSRIs reverse these losses — they boost proteins that help neurons grow and survive, prod neurons to form new connections, and encourage the growth of new cells. The anesthetic and club drug ketamine appears to do just that.
Ketamine can improve mood and stimulate the growth of new synapses within hours, and the effects persist up to a week. Krystal is also a co-inventor of a patent licensed to Janssen Pharmaceuticals, the developers of the nasal spray. Alexis Wnuk Alexis is the science writer and editor for BrainFacts. She graduated from the University of Pittsburgh in with degrees in neuroscience and English.
Benkelfat, C. Archives of General Psychiatry , 51 9 , — Berman, R. Antidepressant effects of ketamine in depressed patients. Biological Psychiatry , 47 4 , — Cole, C. Archives of General Psychiatry , 1 5 , — Canadian Medical Association Journal , 78 2 , — In a controversial new book, Professor Jane Plant, a chief scientific adviser to the government, proposes a raft of unorthodox treatments for the millions of Britons who suffer from anxiety, stress and depression.
Instead of just popping 'happy pills' such as Prozac to beat the blues, Plant and her co-author, Janet Stephenson, advise sufferers to take steps such as avoiding dairy products, sending fewer text messages, eating porridge at night and playing card games.
They say all their tips are based on hard scientific evidence gathered from studies around the world. In Beating Stress, Anxiety and Depression , Plant and Stephenson urge a radical overhaul of the way the NHS treats the soaring number of people with some form of mood disorder.
They advise sufferers to increase their intake of mood-boosting chemicals by eating kippers or poached haddock for breakfast because they contain omega-3 fatty acids, and to be less materialistic, as those who achieve success may do so at the expense of personal relationships, which are a better guarantee of happiness. The authors are serious figures. Plant, a professor of environmental geochemistry at Imperial College in London, is the government's chief adviser on toxic chemicals and a trustee of Prince Charles's Foundation for Integrated Medicine, while Stephenson is an NHS psychologist.
The holistic approach, which may involve medication, nutrition therapy and emotional and social support, is usually best. Unfortunately, people in this country don't have access to a broad range of therapies. Psychologist Karen Belshaw, stress consultant with VHI Healthcare, says that there are often ways to tackle stress and anxiety without popping pills.
This means stopping thoughts that exacerbate stress from building up in your head. So each time you find yourself worrying about something, give yourself a positive command such as 'Stop: I'm doing the best I can'.
Belshaw's general rule regarding stress is to acknowledge that it is always going to be there, and so learn to manage it. Why smiles can be better than Prozac. Close Keep smiling: kippers and haddock are 'happy' foods. Pictures posed.
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