This is number five in my series of articles on depression — my depression. They are written from a very personal perspective; they are my views of how I see things working and what it feels like on the inside. Your views and experiences may be vastly different. My views and experiences are not necessarily backed by scientific evidence or current medical opinion. These articles are not medical advice or treatment pathways. If you think you have a problem then you should talk to your primary care physician.

Questions & Answer
In the course of writing these posts I’ve collected a small number of articles which throw some interesting lights on various aspects of depression. I’ve already mentioned some, but this post is to try to gather some of the others together.
The first is a quote from The Body Keeps the Score: Brain, mind, and body in the healing of trauma by Bessel van der Kolk

If your parents’ faces never lit up when they looked at you, it’s hard to know what it feels like to be loved and cherished.

Now that’s a fairly telling statement and if, like me, it fits your childhood then any wonder we get depressed.
This next is a link to a cartoon, about just how badly we treat the mentally ill (not just the depressed but I guess it happens to us more as our illness isn’t always so apparent). So what would it be like if physical illness were treated as we treat depression.
And now a short animated video which explains a little of the science behind depression but also highlights, perhaps, how little we really know.
Unfortunately research into depression struggles to attract funding in a way which would not be tolerated for, say, cancer. This Scientific American article demonstrates how important it is to change this especially now that useful technologies are becoming available. For those who don’t want to read the whole article here are a few key comments.

If the extent of human suffering were used to decide which diseases deserve the most medical attention, then depression would be near the top of the list.
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[A]lthough depression is common, it is often ignored. Three-quarters of people with depression in the United Kingdom go undiagnosed or untreated — and even if the disorder is diagnosed, today’s medications will work well for only about half of those who seek help.
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Research into depression … seems to have floundered.
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Although … extra money would have solved some challenges earlier, the technology needed to crack others — by probing the brain and analysing its circuits, for example — is only now emerging.
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[A]nother major factor is the long-standing stigma associated with depression. Many people still do not acknowledge that it is a legitimate condition … A large proportion of people believe depression is just something that we all feel … They think you should pull your socks up and get back to work.

One thing which seems to be common to most depressives is sleep disruption in some form, whether that is a disrupted or inappropriate sleep pattern or just plain old insomnia. But there may be some distant hope as scientists seem to be homing in on disrupted circadian rhythms being the underlying cause.

Disrupted sleep is so commonly a symptom of depression that some of the first things doctors look for in diagnosing depression are insomnia and excessive sleeping … scientists have observed for the first time a dysfunctional body clock in the brains of people with depression.
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People with major depression … show disrupted circadian rhythms across brain regions.
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[G]ene activity in the brains of depressed people failed to follow healthy 24-hour cycles. They seem to have the sleep cycle both shifted and disrupted.

The article goes on to explain how looking at the brains of dead but non-depressed people the scientists could pinpoint the time of death from how various genes were switched on or off. This was impossible with depressed subjects whose clocks were both shifted and disrupted. It isn’t simple as there are many genes involved, but variations in the gene expression could potentially cause all sorts of different sleep pattern disruptions.
Here are two more articles on sleep and depression. This first Sleep and Depression is a fairly simple explanation of the sleep disruption you may encounter and some pointers to what you can do to try to alleviate it. The second by David Nutt & Louise Paterson is an academic review from 2008 of what was then known; needless to say it contains lots of data.
Finally in this short round-up we must return to the question of body clocks, because another aspect is Season Affective Disorder (SAD) which affects many people during the darker winter months probably because we don’t get enough light to reset our clocks every morning. A very recent article by Katherine Hobson on Nautilus summarises some of what is known about high intensity light therapy to treat not just SAD but potentially other disorders too.

Light therapy has become standard for treating seasonal depression … light has a benevolent influence on mood during the dark days of winter instinctively makes sense: As hazardous as sunbathing is, it certainly feels good … research into the circadian underpinnings of chronic depression, bipolar disorder, Alzheimer’s disease, and fatigue suggests that light could help these patients readjust too.
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Exactly how light works isn’t known, but many researchers suspect that bright lights help SAD sufferers by regulating their sluggish circadian clocks.
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[C]ircadian rhythms appear to be disturbed in non-seasonal maladies too, which means there is a potential for light therapy beyond SAD.
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In general, bright light therapy is a low-risk and low-cost option for treatment … it may speed up patients’ responses to antidepressants.
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[T]he elderly might be particularly susceptible to the benefits of light therapy because their light perception declines with age, which might be throwing their internal clocks out of sync.

While SAD is one of the factors in my depression — and I know I feel much better on bright sunny days — it is far from the only one and is not the most crippling. I have tried light therapy two or three times over the years and never had much success with it. But it doesn’t work on everyone: while it doesn’t work for me it might work for you.