We human beings are not jaguars, roaming life alone. We’re lions in our prides or elephants in our herds or ducks in our flocks. We become not normal when we’re left to be by ourselves, especially in times of crisis such as injury or acute ill health. Disability becomes less tolerable when endured alone without deep, stable relationships to carry us along when we can’t carry ourselves. Even hermits need one connection. I know a doctor who is the one and only friend of a man and sees him regularly but not too frequently. That man is mentally ill, afraid of people, yet even he needs a friend.
Social Context
North Americans view Africans who’d rather contract Ebola than not hug and touch their dead loved ones as strange. Why would Africans want to risk contracting Ebola just for a hug or touch? But they are the normal ones, doing what even elephants understand is necessary to recover fully and well from the grief of losing an integral part of ourselves: our relationships. We are the abnormal ones who so fear our social biology that we have memorials not funerals; that we don’t want to “interfere” then wonder why people suicide; that we fear to be near suffering and so are blind to the quiet joys of being with another as they walk a difficult path through suffering and into a new life.
On top of the effect of being shunned and isolated, brain injury can also affect the emotional centres of the brain. It can rob you of affect, create leaky eyes and face-reddening sobbing, damage your ability to feel bonded to another — even while you crave human connection.
Neurophysiological Damage
Neurophysiological injury leads to microglia attacking neurons and eating synapses in a way that researchers are beginning to realize creates “sickness behaviour,” an evolutionarily adaptive response to infection, as well as manifesting what psychiatrists diagnose as major depression. In addition, this injury also steals your ability to relate and communicate, and it takes away your skills and talents. You lose relationships, jobs, finances, and yourselves. Any one stressor arising out of brain injury is at the top of the stress list. People with brain injury suffer from several top stressors: ill health, marriage breakdown, moving, to name a few. Unlike those without brain injury going through a major life stressor, people with brain injury also lose their usual stress management techniques. For me, reading was my top stress management technique, and brain injury vanished it.
After injury, you experience both major stress, the kind that can kill, and loss of your prime management techniques. Add on fatigue, loss of motivation, initiation deficit, and confusion as you grapple with the rapid deterioration of your lives, and the superficial presentation mimics depression.
It’s not depression.
Medication won’t fix it. At best, it masks the spiritual, psychological, and neurophysiological damage that remains unhealed.
It’s why it persists for the rest of one’s life.
Causes
Multiple causes create it; multiple modalities can heal it.
- Activated microglia, the immune cells of the brain, which damages neurons and their synapses
- Damage to the neural networks involved in mood and affect
- Damage to processing speed and cognitions, resulting in confusion and an inability to keep up with social situations and work
- Damage to language centres so that communication becomes confusing
- Fatigue
- Lack of objective diagnosis and effective treatments
- Loss of identity
- Loss of income support
- Loss of talents and skills
- Loss of social support
- PTSD onset from abandonment and betrayal.
Solutions
The key to resolving depression is listening to what the person with brain injury wants: healing and support during the exhausting work of regaining brain function. And then finding a way to provide it. Hope lives in real and rapid healing.
- Neurostimulation to heal the affected neural networks
- Regaining lost talents and skills
- Social support
- Talk therapy
- Trauma therapy
- Discovering your new identity after receiving appropriate, complete objective diagnostics and solutions that heal brain injury.
Evidence?
What is the evidence for the above?
On 29 April 2013, Thomas Insel, then the Director of the National Institute of Mental Health in the USA, declared that the NIMH will be reorienting away from the traditional Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The NIMH essentially declared the categories of symptoms for brain issues no longer useful nor wanted. As Insel wrote, “symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.”
The current standard medical “evidence-based” view contends that medication works; the standard practice of diagnosing depression using the subjective DSM-V and prescribing evidence-based medications, is evidence. I suggest that researching medications is not evidence that they are appropriate for this state when the studies don’t include a control group of treating brain injury. I suggest that research into medications is not full evidence when we don’t understand precisely the neurochemistry and electrophysiology. I suggest that submissiveness, compliance, and/or surface acceptance are not evidence of an effective solution. I suggest that blunted affect, increased suicidal ideation from medication reflect a failure of medicine and a failure to use objective tests and the art of medicine to investigate the root cause of what looks like depression.
I ask those who disbelieve what I wrote about causes and solutions and who come down firmly on the side of depression in a person with brain injury is a mood disorder that requires medication: What would happen if you used objective diagnostic tests and treated the brain injury so that the person regained their talents and skills, their physical health, and ability to converse and socialize in the way they used to with (re)new relationships — or to a significant, life-improving extent?
When this happens, depression lifts and people thrive.
That is the evidence that diagnosing the state as the mood disorder “depression” is, in fact, a misdiagnosis. That is why I created this website — the misdiagnoses and abandonment of people to diminished states must stop.