On this topic-- sure but in those cases isn't significant stress involved?
What I don't understand is why aren't doctors seperating the biological depression/anxiety cases from the psychological depression/anxiety cases and tailoring treatments to each of those.
Theres people all over the world suffering from medication or drug induced depressive disorders. How are "thoughts" (as in CBT) causing the feelings here? I don't even understand some of the reasoning in some of these psychotherapies.
I'm not trying to be fatalistic but is counseling/CBT/mindfulness less effective in biological induced depression vs. psychological stress-induced depression?
A lot of mental illnesses are thought to be "bio-psychosocial" in the sense that there is a interaction between the genes and environment that can't necessarily be separated. Some diseases have stronger genetic components than others, for example schizophrenia.
If you have a relative with schizophrenia this increases your risk of developing the disease by almost 10x, and if you have an identical twin with schizophrenia, you have a 50% chance of developing the disease.
But there probably isn't one gene that causes schizophrenia - there are probably many different genes (polygenic), and some people may not have ended up developing schizophrenia had there not been in-utero stress, while some people had so many genes that they were very likely to develop the disease.
Depression is pretty heritable, but people with no family history of depression can certainly develop it randomly without an apparent cause (or the causes are subtle - decades of internal monologue in a linguistic and imperfect society mixed with a few bad genes and intermittent stresses, then an inciting event like taking E).
That doesn't necessarily mean that we should tunnel vision on the E however, because there can be multiple ways of developing the same symptoms and condition, and the treatments will ultimately reflect that commonality in the disease's pathophysiology.
What actual depression is about is essentially there isn't anything wrong with somebody's life yet they are still depressed. So there is a lot of talk about depression among psychologists who see people all day long who have had horrible lives, but a lot of the times the interesting depression that psychiatrists/neuros really talk about is when there is no clear environmental reason for it. Psychologists are probably used to sorting out people whose lives are a mess, which is sort of a reactive depression (their depression would lift if their lives didn't suck).
That doesn't necessarily mean that methods like reducing the activity of the internal monologue or reducing stress aren't important, along with cardio and medications, but I can understand how it would be difficult to causally link something like decades of internal monologue to depression.
"How are "thoughts" (as in CBT) causing the feelings here?"
So for example, if internal monologue circuitry (default mode network) is strong and hypertrophied and activates a particular depression related region like the subgenual cingulate, this can result in neurophysiology that is conducive to depression.
Consciousness is probably integrated network activity amongst the neurons. Depending upon the patterns of activity, consciousness will be different. So thoughts change neurophysiology because they really are neurophysiology (I hope this makes some sense).
One may attempt to alter said circuitry with mindfulness but it certainly won't happen overnight, and different people's circuitry could be better or worse at reverting. Maybe someone has great neuroplasticity and their mind is still malleable, maybe another person needs SSRIs and cardio to boost their neuroplasticity for that circuitry to rewire faster.
"Synaptic remodeling" certainly doesn't happen overnight but is still the major feature of antidepressant therapies and very likely mindfulness. Some brains may be more or less resistant to the remodeling, and some brains may need different kinds of remodeling. Maybe the original E use remodeled the brain in the wrong direction.
