Recently, physicians and researchers alike have become more aware of the benefits of CBD for depression. Depression usually refers to a general feeling of sadness or lack of motivation, and this differs from clinical depression, or major depression, in that that latter two are diagnosable conditions of the central nervous system.
Depression is much more common in the developed world than anywhere else, and it seems to have a combination of causes including environmental, psychological, neurological, and genetic factors.
Thus, depression experienced following a funeral or negative life event is a natural and healthy reaction to such stimuli, and is altogether different from clinical depression, which is a disorder and can be medically treated. The following discusses clinical depression.
What is depression?
Depression, or major depressive disorder, is a condition characterized by a persistent feeling of sadness and general loss of interest. It doesn’t just affect how you feel; it affects you physically as well. Depression affects 1 in 6 adults over the course of their life. Every year approximately 16 million U.S. adults are newly affected by this disorder.
Patients with depression experience problems in their day-to-day routines, such as school, work, and social interaction with friends and family. An imbalance of neurotransmitters, the chemicals that our neurons use to communicate, can lead to an imbalance of emotion and cognition, which is experienced as depression.
Causes of depression
According to the Center for Disease Control, clinical depression has no single obvious cause, but a complex relationship between genes, environment, and attitude moving forward can lead to depression. The basic symptoms are: feelings of worthlessness, anxiety, reduced appetite, weight loss, lack of energy, and a loss of interest or pleasure in normal activities or activities which used to bring pleasure.
Hormonal alterations and drug abuse can both contribute to depression by changing underlying brain chemistry. Serotonin, a neurotransmitter with hundreds of different roles, is implicated in most cases of depression. One of serotonin’s primary roles is in maintaining mood and circadian rhythms. It is responsible for inhibiting the anxiety and fear center of the brain, which is active by default. Without constant inhibition by serotonin, anxiety and depression can occur. The production of serotonin for this purpose is controlled by a myriad of factors, including other neurotransmission, blood glucose levels, stress from daily life, and drug use.
Moreover, sometimes major depressive disorder is triggered completely by life events coupled with strongly-held beliefs instilled during one’s childhood, which affect outlook and therefore neurotransmission. While billions have been spent researching the phenomenon of clinical depression, it seems that one new answer creates ten new questions.
Diagnosis and characteristics of depression
A physician may determine a patient to have depression after conducting a couple of evaluations. By default, a physical exam would be included in addition to a complete blood test and thyroid gland function test. Most importantly, a psychoanalysis assessing your symptoms, thoughts, feelings, and behavior patterns is the most definitive evaluation.
Sadness, while commonly associated with depression, is not a defining characteristic. Rather, overall suppression of thoughts, mood, motivation, and behavior is more closely-aligned with major depressive disorder.
There are 5 subtypes of major depression
This is characterized by loss of pleasure or reactivity to normally-pleasurable stimuli. Increased feelings of guilt are common as well. Symptoms generally worsen in the morning hours, and reduced motor activity along with excessive weight loss are key signifiers of melancholic depression.
This is characterized by mood reactivity (mood is highly dependent on immediate environment), significant weight gain (generally from comfort eating), excessive sleepiness, a sensation that the limbs are too heavy to move, and significant social impairment, as a consequence of reactivity to negative social cues and perceived rejection.
This is a severe form of major depression involving dysfunctional motor behavior. Patients with catatonic depression are mute, primarily immobile, and exhibit sporadic and/or purposeless movements. It is rare, and completely prohibits normal functions.
This refers to the intense mental and behavioral impairments, which are sustained and sometimes disabling, experienced by women in the months after giving birth. Postpartum depression occurs in 10–15% of new mothers. The DSM-IV defines postpartum depression as occurring within one month of delivery, and lasting as long as three months. It has been said that consuming the placenta over the months following birth can reduce the likelihood of postpartum depression by replenishing nutrients and compounds which may pull the hormonal “rug” out from under the mother’s feet immediately following pregnancy.
Seasonal affective disorder (SAD)
This form of depression comes on in the fall or winter, and resolves in spring as the length of day increases. Diagnosis is dependent on the occurrence of at least two episodes in colder months, with no episodes over a two-year period. Because our circadian rhythms are centered around the hours in which we perceive daylight, they can become disrupted in the winter months when there are less than 7 hours of daylight per 24 hour period.
Current treatment options and best practices for depression
Various types of antidepressant medications, along with psychotherapy for depression are effective for some individuals. PRescriptions can be expensive, and the US spends more than any other nation treating the various kinds of depression.
At first, physicians will usually prescribe an SSRI, or selective-serotonin reuptake inhibitor. This class of drugs prevents the recycling of serotonin, meaning that it will remain in the brain for longer, thus having a greater effect. SSRIs are the most commonly prescribed medications for depression, but they work in less than 50% of cases, which demonstrates our lack of understanding about this disease.
Other types of antidepressants have some nasty side effects. For example, MAOIs, or monoamine oxidase inhibitors, are so potent that using them requires a strict diet. There can be deadly side effects if these drugs are taken and foods such as pickles, cheese, and wine are ingested.
Often, lifestyle modifications such as more time spent outdoors or exercising is an effective way to mitigate depression, if only temporarily. In addition, cannabis is gaining more popularity as an addition to existing treatment plans for those with depression. CBD, thanks to its lack of psychoactive effects, is highly popular among those who want maintain a stable and healthy mental state.
Is endocannabinoid deficiency involved in depression?
The endocannabinoid system is the regulator of thousands of processes in our system. In the brain, it directs memory, mood, and several other systems in terms of their baseline neurotransmission. The endocannabinoid system, or ECS, is comprised of a series of inhibitory receptors which, when activated by endocannabinoids, act to decrease the activity of the cell in which they are found.
For example, in the memory area of the brain, neurons will release endocannabinoids after they have received a signal, and the endocannabinoids will activate cannabinoid receptors on the neuron which sent the initial signal, and prevent that neuron sending any further signals. This is how our brain decides what’s worth retaining and what shouldn’t take up our consciousness.
This is over-simplified, but in general, the ECS maintains the balance of neurotransmission in order to keep us in a healthy mood and mindset.
In cases of depression, the endocannabinoid system is commonly expressed in abnormal or reduced patterns. Moreover, the endocannabinoid system and the immune system both rely heavily on an omega-6 fatty acid known as arachidonic acid. Arachidonic acid is present in the cell membrane of nearly all cells. It is readily processed both by immune enzymes to form prostaglandin, and by endocannabinoid enzymes to form the various endocannabinoids, which all include arachidonic acid and some other common cellular messenger, including ethanolamine, dopamine, glycerol, and ethylene glycol (in the form of a glyceryl ether group in 2-arachidonyl glyceryl ether (2-AGE)).
It is postulated, because of the shared common essential precursor of the immune and endocannabinoid systems, arachidonic acid, that an imbalance in the metabolization of arachidonic acid could be an explanation of the common comorbidity of chronic inflammation and depression, as inflammation is the primary function of the prostaglandins.
Does CBD improve cases of depression?
CBD for depression has worked for thousands. This could due to the recallibratory effect of CBD on endocannabinoid system function, and also due to CBD’s activity as a direct partial agonist of serotonin 5-HT1a receptors.
In addition, Zanelati et al experimented with CBD’s antidepressant effects on mice in 2010, and the results were surprising. Zanelati and company found that mice which were given CBD exhibited results identical to those given antidepressants, following series of standard behavioral tests. This follows the trend that one of the benefits of CBD is a balancing effect on neurotransmission as a whole, along with the ability to correct many disorders and dysfunctions which arise from faulty endocannabinoid activity.
For this reason, cannabidiol derived products are already being manufactured for the treatment of depression. CBD could represent an effective option for the future treatment of depression. As usual, more research is warranted.