Pathophysiology of Depression
1) Describe the pathophysiology of depression.
2) Discuss the phenomenon of depression effects on appetite. Describe from a pathophysiologic basis why some people with depression experience a lack of appetite resulting in weight loss while others will experience increased food intake and have weight gain.
3) Discuss two additional clinical findings of depression and present the pathophysiologic basis of these symptoms.
Nsg5003 Advanced Pathophysiology
Currently, there is no clear definition of the underlying pathophysiology of depression. However, there is a link between the availability of neurotransmitters and receptor sensitivity and regulation, and the underlying effective symptoms. Several studies have indicated that disturbances in the central nervous system serotonin (5HT) activity is one of the most important factors that cause depression (Hasler, 2018). Disturbances in other neurotransmitters such as dopamine brain-derived neurotrophic factor norepinephrine and glutamate can also cause depression. Disturbances in the central nervous system serotonin play a significant role in the onset of depression because of its importance in enhancing selective serotonin reuptake (Hasler, 2018).
Among patients with depression, pathophysiologic processes can contribute to the onset of anxiety that can trigger gastrointestinal symptoms such as diarrhea, nausea, and abdominal pains, among others that can contribute significantly to a loss of appetite. According to Simmons et al. (2016), depression patients that exhibit appetite loss will show hypoactivation in the mid insular region that might be implicated in interoception. On the other hand, depression can also trigger pathophysiological processes that can contribute to emotional eating, which emerges from a need to eat that is not associated with physical hunger. According to Simmons et al. (2016), depressed patients with an increased appetite show greater hemodynamic activity to food stimuli compared to healthy individuals.
Two of the main clinical findings associated with depression include inflammation and chronic pain. According to Simmons et al. (2016), depression can trigger stress hormones that are linked to inflammation and may cause significant changes to the immune systems causing inflammatory conditions or autoimmune disorders such as arthritis and irritable bowel syndrome. Depressed individuals can also experience unexplained pain or aches in their muscles, joints, headaches, breast tenderness, and muscle pain (Simmons et al., 2016).
Hasler, G. (2018). Pathophysiology Of Depression: Do We Have Any Solid Evidence Of Interest To Clinicians? World Psychiatry, 9(3), 155–161. https://doi.org/10.1002/j.2051-5545.2010.tb00298.x
Simmons, W. K., Burrows, K., Avery, J. A., Kerr, K. L., Bodurka, J., Savage, C. R., & Drevets, W. C. (2016). Depression-Related Increases and Decreases in Appetite: Dissociable Patterns of Aberrant Activity in Reward and Interoceptive Neurocircuitry. American Journal of Psychiatry, 173(4), 418–428. https://doi.org/10.1176/appi.ajp.2015.15020162