Nov. 19, 2007 — -- Laura, whose name was changed for confidentiality, said she knew she needed help when she started thinking that death would be preferable to living with the kind of misery and pain she felt, even though she had two young sons whom she loved dearly.
So she went to see a psychiatrist, and he diagnosed major depression and prescribed an antidepressant medication, along with weekly psychotherapy. She took the prescription, and returned the following week, reporting that she had filled it, but could not bring herself to take the pills. She felt that needing to rely on pills reflected a kind of weakness, and she wanted to be strong enough to fight this on her own.
Laura is not alone. Only 25 percent to 50 percent of patients take antidepressants consistently for the length of time recommended by their doctors.
While this is an important issue for short-term health, it may also be important for the longer term, because there is some evidence that depression shrinks the brain — no, it is not the psychiatrists who are the "head shrinkers!" — and that antidepressants might put the brakes on this process.
While much remains to be sorted out, one of the key players in this story might be "neurogenesis," or growth of new brain cells.
Just two weeks ago researchers reported in the journal Science that they had devised a method, based on an imaging technique called magnetic resonance spectroscopy, that could detect new cell growth in the brains of living people. This raises the possibility of being able to monitor effects of antidepressant treatment on neurogenesis in patients.
The hippocampus is a seahorse-shaped region of the brain found on both the left and right sides, buried a few inches in from the ears. It has a critical role in memory and is part of the connected circuit of brain regions called the limbic system that generate and regulate our emotional lives.
The results of more than 20 studies now strongly suggest that the hippocampus is smaller in patients with major depression than in people without illness. The average difference is about 10 percent.