Depression is not a single, uniform condition but a multifactorial disorder influenced by biological, psychological, environmental, and social factors. While diagnostic criteria help identify symptoms, the underlying causes can vary greatly from one individual to another, requiring a personalised and systems-based approach to understanding and treatment.
Found this valuable? Share it forward.
Depression is a complex disease with multiple contributing factors. The diagnostic criteria for depression include:
Depressed or irritable mood
Decreased interest in pleasurable activities and ability to experience pleasure
Significant weight gain or loss (>5% change in a month)
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Diminished ability to think or concentrate
Recurrent thoughts of death or suicide (Berton O, et al. Nat Rev Neurosci. 2006)
Chances are that you have felt several of the above criteria but yet you may not have associated it with depression.
This is because depression is a broad term that may affect one person differently to the next, along with having a diverse range of possible causations.
Below is a list of some of the factors that can lead to depression and apathy:
Trauma
PTSD
Abuse
Post-natal depression
Adverse childhood exposure
Lack of safety
Economic struggles
Autoimmunity
Social isolation
Heartbreak
Social media
Lack of purpose
S.A.D – Seasonal Affective Disorder (Vitamin D deficiency)
Mold exposure
Anaemia
Sex hormone imbalances (Low/high oestrogen, low testosterone)
Hypo/hyper thyroidism
Stress
Pain
Chronic illness
Genetic traits
Methylation issues
Heavy metal toxicity
Parasites
Nutrient deficiencies (B6, etc)
Nutrient excess
Artificial light exposure
Poor sleep
Mitochondrial dysfunctions
Poor gut health
Gut/brain axis inflammation
Cytokine model of depression
Medication
Loss of a loved one
Divorce
Substance abuse
Neurotransmitter imbalances
Lyme
Toxic and ambivalent relationships
Each reason, being so unique, may require a completely different approach for therapy from the next.
This reverberates a quote of William Osler, stating ‘It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has’. Unfortunately, society generally neglects the beauty of individuality whilst overlooking the crucial interplay and synergy from the multifactorial systems essential for optimal function within our body.
Next news
Are you currently exposed to phthalates on a regular basis? Were you exposed during early developmental stages—for example, through maternal exposure such as a mother working in a hair salon while pregnant? Have you noticed symptom improvement after reducing phthalate exposure?
Higher phthalate levels have been associated with a two-fold increase in the rate of endometriosis. Phthalates are present in almost anything fragranced and are widely used in soft plastics, vinyl, cleaning products, nail polish, and perfumes. As early as 2002, environmental groups reported that over 70% of personal care products contained phthalates. Today, according to the Environmental Protection Agency, more than 470 million pounds of phthalates are produced each year.
Phthalates are now officially recognised as reproductive toxins throughout both the European Union and the United States. Animal studies show that rats given high doses of certain phthalates stopped ovulating altogether. Phthalates reduce oestrogen production by ovarian follicles—oestrogen being one of the primary drivers of follicle growth and egg development in both animals and humans. Suppression of oestrogen by follicle cells would be expected to impair follicle growth, helping explain why women with endometriosis often exhibit significantly higher phthalate levels than those without the condition.
Potential sources of exposure are extensive. Plastics can leach into food, particularly when food is packaged while hot or stored in plastic for long periods. Personal care products are a major contributor, including cosmetics, hair products, lotions, infant care products, medications, medical devices, nail polish, and perfumes.
Vinyl products are another source, such as shower curtains, flooring, wallpapers, blinds, diaper mats, rain gear, inflatable mattresses, school supplies, car interiors, and yoga mats. Additional exposures may come from air fresheners, electronics, plastic jewellery, sex toys, and children’s toys.
Given their prevalence and biological impact, understanding and minimising phthalate exposure is an important consideration in hormone and reproductive health.
The lymphatic system is becoming increasingly more talked about but is still, in my opinion, one of the least appreciated and under-utilised systems in the restoration of movement dysfunctions and chronic health complaints.
Everybody, including health practitioners and those in the fitness industry, could benefit from understanding and implementing lymphatic techniques. You can consider that a homeostatic balance of the internal environment can be a true measure of health.
Lymphatic techniques can, therefore, aid the body in moving towards more of an internal state of homeostasis.
How does the lymphatic system function?
The lymphatic system is, in essence, the sewage system of the body.
It has the incredible ability to trap nearly all soluble antigens, roughly 99%, with its role in waste removal. This is significantly important for the other body systems to not become overwhelmed and develop issues as well.
The lymphatic system contains the thymus, an endocrine organ which is responsible for the development of T-lymphocytes, immune cells that are involved in fighting infection through the process of cell-mediated immunity.
The spleen plays a key role in the lymphatic system as the largest lymphatic organ, having a vital role in a host of detox processes, such as:
Filtering blood
Removing old dead red blood cells
The maturation of lymphocytes and macrophages to aid in fighting infection
The splenic communication of the tenth cranial nerve, the Vagus nerve, is crucial in reducing inflammatory cytokine production.
The tonsils also form part of the structure of the lymphatic system. With the tonsils formed of lymphatic tissue, housing lymphocytes and macrophages, they protect the digestive system and lungs from pathogens entering through the nose or mouth.
There is also a deep association with the gastrointestinal system through gut associated lymphoid tissues (GALT) known as Peyers Patches, with the role of the gastrointestinal system intrinsically linked to the immune system. Estimates suggest that roughly 70-80% of immune function is beholden to gastrointestinal health.
This amazing system also comprises millions of lymphatic vessels which, if placed end to end in a continuous line, would circle the earth four times! Alongside these vessels there are over seven hundred lymph nodes within the body, with the most populated areas being the neck, skin and the intestines.
This mass of lymphatic vessels works in uniform direction towards the heart, with valves interspersed to prevent any backflow from occurring. This one-way system is aided by the structure of the vessels which allow fluids to flow in the direction of clearance, but with numerous valves preventing backflow. Allowing the system to be cleared, very much how a filtration device on a fish tank would work.
The ability to regulate fluid homeostasis is a key aspect of the lymphatic system. The body contains fifteen litres of lymphatic fluid, predominantly of water, and roughly 10% of proteins, hormones and waste products. Comparing this to the five litres of circulating blood that we have, the body wouldn’t contain three times more lymphatic fluid than blood if it wasn’t a critical component of our survival!
From the five litres of circulating blood, over the course of a day, three litres of plasma leaks out into the interstitial space.
If not appropriately removed through the lymphatic system this can lead to swelling outside of the cellular space due to the increased fluid concentration and alterations in pressure.
Without effective drainage this can create stagnation in the fluids; Let’s go back to the fish tank analogy above, we know that stagnation of fluids is detrimental to the ecosystem, the same being the case for our health.
In a system with appropriately functioning lymphatics, this plasma is removed from the interstitial space into the lymphatics system and circulated upwards towards the subclavian vein. This is where it flows into the venous system, before returning to the liver, detoxifying and purifying the blood.
Taking a deeper look into the pathway of the lymphatic vessels will give an understanding into the application of treating the lymphatic system.
As a one way system drains into the venous system at the bilateral sites of the subclavian veins, all lymphatic vessels are required to flow in this direction. The right upper quadrant of the body drains through the right lymphatic duct and into the right subclavian vein, whilst the remainder of the body drains through the thoracic duct into the left subclavian vein.
The thoracic duct is responsible for the majority of lymphatic flow and also houses the largest lymph node, the cisterna chyli, which is a major site of drainage for the liver. It’s crucial to keep this node functioning well as between 25-50% of the returning lymphatic fluid through the thoracic duct is returned from the liver.
There is an important bidirectional relationship between the cisterna chyli and the liver, with an overburdened liver that can’t move or function optimally placing more load on the cisterna chyli. Having a lymphatic system that can’t drain well, especially at the cisterna chyli, increases the potential to create stagnation around the liver. A lymphatic vessel that is unable to drain will not be able to receive fresh supply creating this backlog.
A fairly recent discovery reveals that the lymphatic system also continues up into the central nervous system through the glymphatics, more commonly known as the glymphatic system.
The glymphatic system has the same role as the lymphatic system, however it is only situated in the brain. This helps to reduce inflammation and drive the removal of waste products which is essential for overall brain health. Additionally, the protective benefits of this system helps to distribute fuel sources and various other vital components around the brain.
If you are unfortunate and have had your palatine tonsils removed or have reoccurring infections with your tonsils, this may just help …
The group of tonsils provide:
Protection against pathogens and toxins
Lymphatic detox
Excretion organ
One of the greatest immune modulators
Supporting the brain's glymphatic system
This last point is massively overlooked, here’s why …
The glymphatic system is essential in mitigating risk against neuro-developmental disorders and degeneration, this ranges from Autism, Alzheimer’s through to some categories of depression.
This system clears the brain during sleep (mostly delta-wave sleep) of harmful proteins (such as amyloid-beta) and waste products by pumping the cerebral spinal fluid through the brain’s tissues. This flushes the waste into the body’s circulatory system in which it eventually reaches the liver where it can be eliminated.
This process is roughly 10 times more active during sleep as opposed to when awake. The brain also shrinks by around 60% of its original size to increase the efficiency of waste removal.
The removal of tonsils will also reduce the efficiency of the immune system, resulting in an increased chance for the development of food intolerances and possibly acting as a contributing factor towards autoimmune diseases (the severity of this risk is not currently quantifiable). If you have had your tonsils removed, there are several options you can do.
In my opinion, here are two of the most important:
Massage the intracranial lymph (around the jaw and neck) to improve glymphatic circulation and possibly decrease neuroinflammation
Ensure you have a good duration and quality of sleep (promoting delta wave sleep through binaural beats, gratitude logs or specific devices may help)
* The group of tonsils provide direct lymphatic drainage through the cribriform plate to Waldeyer’s Ring – this is a formation of lymphatic tissue situated in and around the:
Pharyngeal tonsils (adenoids)
Two tubal tonsils (posterior to Eustachian tu)
Two palatine tonsils (this is what the tonsils is most commonly referred to)
Lingual tonsil (base of tongue)
Laryngeal tonsil (near the vocal cords in the larynx)
