On a slightly less silly note than usual (what, Me?): I thought you might be interested in something I heard on BBC Radio 4 'Start the Week' this morning.
John Humphrys (I think) hosted a discussion with a few experts on the thorny and complex topic of Depression, and the possible causes. Before you say it: yes, the Big D affects 1 in 4 of the population at some time in our lives. And of course it can have its roots in any or all of Genetics, Major Life Change, Illness, Physical Injury, Viruses and Infections, Emotional Trauma, Environmental factors, Lifestyle, the pressures of Modern Society, and even the Weather / Time of Year (as if we don't know that already - ha!). And not forgetting Brexit - but best not go there or there'll be a massive punch-up
But.. the main contributor to the discussion was Edward Bullmore (Professor of Psychiatry, University of Cambridge) whose recently published book 'The Inflamed Mind - a radical new approach to Depression' advances the idea that, in some cases at least, Clinical Depression is caused by... wait for it... (sic) 'Inflammatory activity in the Brain (as well as the rest of the Body) due to an over-active Immune System'. Sound familiar in our context..?
The Gist of Ed's input / theme of his book is that higher-than-normal inflammatory stuff in the Brain can affect Mood quite significantly (something to do with Serotonin inhibition?) - and that recent breakthroughs in medical science are suggesting a clearer Causation between some (I stress, some) Mental Health issues and an over-active (for whatever reason?) Immune System, amongst other things.
Ed's book sounds like an interesting read for any of Us Lot who are unduly and / or dis-proportionately affected by Depression in tandem with PMR / GCA. It's available via Amazon, in Kindle or Audio, or on the BBC Sounds App (if you're geared up for that?).
I'm not endorsing Ed's book and hypothesis as such (haven't read it yet) - just mentioning it as being potentially relevant to some of Us Lot here.
That's it, must go: I'm off out to look for an elusive glimpse of Bl**dy Sunshine in between the gloomy Winter clouds and rain... Vitamin D and all that..?
Best wishes and try to keep smiling in the meantime. That can help in coping with Depression at least
'Uncle' MB
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Plenty of sunshine this side of the Alps - perhaps a bit too much for comfort in a ski resort. Different matter the other side - up to 2m of snow in the last few days. But snow is at least bright
Hi uncle MB, could this be a hen and a chicken discussion ( what was first, the egg or a hen ? If I compare my own situation , first was the distress, after that the pmr. Might be possible the feelings cause a change in our hormones and leukocytes
.But before reading the book I speak before it is my turn. Thanks for bringing this to our attention and maybe pampering ourselves is a good medicine.
Greetings Aletta I'm sure you are correct that emotional stress / distress causes hormonal changes in the Brain (as well as the rest of the body). There seems to be an increasing body of evidence to support that theory. But, as you say, it's difficult to prove Cause and Effect when there are so many other factors which could contribute to Depression. But I agree - 'pampering' must be a good thing for a weary or stressed Mind..
Jane, one of them might have been prompted by a Post by me after hearing about 'Brain on Fire' (also by Ed Bullmore I think, and on a similar theme) on BBC R4s 'All in the Mind'.
I agree - it makes a lot of sense.
Haven't heard it yet Mark but lets hope it's a positive way forward for those of us who have had or are having serious clinical depression at some time in their lives!
Looking at the history of the shrinks & ologists fashionable theories over the past century or so! Watson,Skinner,Pavlov et al . Freud,Jung,Adler et al. There's certainly a brain mystery world there!.. Always remember the John Cleese tv series "Families & How To Survive Them"!!! MMmm!
I studied Counselling and Relationship Psychology for my Masters at Uni about 20 (or was it 200 - so long ago I can't remember!) years ago, when Freud, Jung, Maslow etc were the flavour of the month with many Psychotherapists etc.
Things have moved on since then, and Integrative approaches to understanding the Mind seem to be more favoured by some Counselling Professionals nowadays. But there's still an awful lot of Pseudo Psychology and Self-Help Quackery out there. For what it's worth: my money's on Carl Rogers.... ;-).
Did you hear the one about a bunch of Psychologists going to a café in Birmingham for a healthy meal to start the working day? Apparently they all ordered a Freud Breakfast....
There's more where that came from. This isn't intended as a plug, but there are a couple of chapters of them in That Silly Book Wot I Wrote.. (see the PMRGCAuk website / 'books about..')
I am a Carl Rogers, Person Centred Therapist , trained at Temenos in Sheffield ( Validated by Leeds University). Not practising since this implosion. How interesting. Roy ha ha ha!
I am also a qualified Nursery Hurse and Homeopath and a former middle management Civil Servant and HR Practitioner. We have many lifetimes really. Sorry for the self indulgence, I now lie on the sofa and read books after short bursts of activity. It was your mentioning the teachings of Carl Rogers that woke me up.
Many lives indeed. It seems hard to believe my previous lives. This morning I did the ironing, sitting down, which totally wiped me out and have slept all afternoon
Ironing is oddly tiring, perhaps that is why I rarely do it now. OH does his own non iron ( lies they do need a bit) shirts and I wear fabrics that un- wrinkle on my body, like jersey and hang everything up.
😅😂🤣 I only discovered it when my parents moved in with me!! My mother even ironed underpants and vests!! Now she’s gone It’s down to me, but only his essentials!!! I’ve got very good at folding!
My mum irons everything snd i mean EVERYTHING. OH and myself were visiting my parents a few years ago and my mum took our dirty clothes and washed and ironed them for us which was great but my poor husband totally lost it when he got his underwear back with a nicely ironed crease in his boxers!! She still irons everything but I make sure she doesn't get anything that she might be able to put a crease in where it isn't wanted when we visit. When i lived at home she quite rightly expected me and my sister to do our share of the ironing. As a teenager I obviously had other more important things to do so when she said "iron everything in the basket please" so i did exactly that and ironed her tights, not just one pair but every pair in the basket!! My poor dad had to try very hard not to laugh as he tried cleaning the burnt nylon off the iron!! Needless to say my mother was not impressed. YB
🤣🤣excellent. I was also expected to do my share. But I did it so badly that my mother refused to let me do it anymore!! I even failed the Brownies’ ironing badge! (I wonder if Cubs had the same badge?!)Same with my husband, he did all the ironing!! Result!!
I think my plan was getting my mothet to never ask me to iron again but unfortunately my mother knew what i was up too and i still got my share. Luckily my husband is quite useful with an iron and would happily iron my clothes for court as well as his own fire brigade dress uniform. Now i only wear things that can folded amd put in a drawer. Result for me as well!!
Interesting thought. As you see Selena Gomez struggling from mood issues in the news, it would not be surprising. It is a systematic disease they really do not know a lot about. I know my anxiety has been higher. Always nice to keep aware of new research.
No, Humphreys goes home at 9 o'clock to get well rested before his next bout of bullying. Mind you, I tend to think the present batch of politicians deserve the treatment he gives them ...
Thanks Bee. However, Confession time: I nicked that gag from BBC's hilariously funny and silly 'I'm Sorry I Haven't a Clue' with Jack Dee, Barry Cryer and a few other witty wordsmiths. It really should be on Prescription.....
One of my favourite shows , and that had to come from the great Barry Cryer , the man must live forever in my opinion , or at least wait to pop his clogs until I have fallen off my mortal twig .
( Which could be next week the way I am feeling at the moment so perhaps I shouldn't curse Bazza!)
Yes , I know , but why must it pass like an elephant sized kidney stone through the nostril instead of the gentle breeze from a dancers tutu?
I am blaming you , you clearly did something really bad in a previous life and got me to be an accomplice , I reckon we must have sank a ship or something. 😂😂😋
Very topical for me at the moment as my sister (a retired nurse with MS) and I have had many recent discussions about depression (cause and effect) and the impact of a lack of serotonin. Extremely complex but definitely food for thought. As you say, should be an interesting read.
Despite all the advances in medical research, the intricate workings of the Human Mind are still one of the world's greatest mysteries. Well, the workings of mine at least...
Just when many of us were having trouble dealing with the gloom Radio 4 seems to have added some of the antidote.
Thanks so much for letting us know , I listened to it on iPlayer earlier and it was an interesting discussion .
Not that any of us need telling that inflammation of the body disturbs the working of the mind , we have been trying to explain that to the white coated devils for years!
We are not ill because we are anxious or depressed, we are anxious or depressed because we are ill and have not fully controlled the cause.
In my current inflamed state I have also noticed that I am constantly having to go back and rewrite words on replies today because I keep writing them totally the wrong way around, weird , haven't done that since I had issues as a child. Inflammation , you are a git!!
Plus , you only have to read some of the posts we put up to see the link between inflammation and mild insanity , but there great humour lies , or is that Tedski in a lump by the door , put more water in it fella!!
Thanks Bee - mine's a Chicken Karma with Poppadoms, Lime Pickle and six pints of Lager
I tend to agree with you - is it any wonder that the likes of Us Lot get at least a bit fed-up, or even quite seriously depressed with the ravages of a chronic AI illness like PMR or GCA - and not forgetting the potential cognitive and other side-effects of the Preds (even though they are intended to manage the main / more dangerous symptoms)?
That said: for some, sadly, Depression is a Life-long curse. Another invisible illness that's often still stigmatised ('All in the Mind..' - how ironic?) not just by those who haven't experienced it (or are in denial - I know one or two - but, dare I say it, some Medics too.
As for the idea of Insanity? To be honest, I'm not sure if it really exists other than in the minds of those who don't really understand the Human Condition. As I've wrote in previous Posts: historically, some of the world's greatest Creative and Intellectual Minds would be classified as 'Insane' by the latest Methodological Apparatus for assessing Mental Health (e.g. the controversial but widely marketed DSM 5). Mmmm...
For me, at least, if Insanity / Eccentricity / Bonkers-ness (call it whatever) are harmless and productive to the Self or others, that's ok. Dunno about Tedski though... x
apart from on the curry choice , mines a Lamb Tikka Chana Ceylon , with pilau rice and a Peshawar Naan , and a good hot side of pickles .
I actually feel that the Medical Profession are the most judgemental when it comes to mental health , and they often make many mistakes on the road to diagnosis to comp!ex and multi system illnesses because of their prejudice and lack of real social or psychological training.
If someone in a white coat would only accept that many of our mental health issues , including stress are caused by our physical health and not always the other way around , there would be leaps and bounds in the progress of treatment of illness the world over.
And as a fellow Loon ( let's face it in Georgian Times , we two would have probably only been let out of our padded cells on visitors day for the Threepenny amusement of Aristocrats)
I know there is no such think as Insanity , except for in the minds of Pseudo Socio Psychological Pattern Makers who need to make the world all neat and tidy and wrap Mankind up in little boxes with little bows, just so.
The rest of us know there is plenty of variety in the broken biscuit box , and just because you are broken doesn't mean you are beyond hope.
Yep: the Medical Lot (GPs, Rheumies etc) seem to be a very mixed bag in terms of Bedside Manner and / or understanding and relating to the Psychological Journey that their Patients endure at the same time as the Clinical one. There's often much chat about it here...
It reminds me: did you know that until the late 1950's (I think), things like Epilepsy were deemed to be mental illnesses - with innocent (but perfectly Sane) sufferers banged-up in psychiatric hospitals - and with often tragic outcomes? Thank goodness for the advances in medical science since those days.
Like you: I'm in the Broken Biscuit category - and proud of it x
As late as the 1970's you still had to go to the local Asylum to get the tests done like EEG for Epilepsy , how do I know this?
That was my juvenile condition. Pubescent Petitmal and infrequent Grand Mal Epilepsy.
So , to have my tests each six months for many years we had to go to what my Nana called ,' Deva' , which was a Mental Asylum near Chester , I think?
At such a young age it was terrifying , only 8 , we had to walk through the halls with the orderly shouting at us not to look at the windows and telling people off for banging on them as we were scuttled in , then they locked us in a side room until I could be tested.
The test rooms were opposite what must have been one of those water therapy rooms , everything looked terrifying , except the patients who just looked terrified.
Got any better now ?
No , not in my opinion , they have just named more conditions not addressed the way Doctors or Society deal with them.
And rather than locking away the severely mentally ill in institution we prefer to do the caring thing and shove them out on the street to live under a bush.
Oh , and have we stopped using the Mentally ill for public entertainment , no , we just put it on TV , haven't you seen Jeremy Kyle , or Big Brother , or I'm a Celebrity...
And let's not even think about the House of Commons or US Senate!!!
Nah - we are actually suffering from a lack of snow!!! I drove south into the mountains on Sunday with our cousins who are there to ski - and it was all brown and snow-less! Just stripes of piste...
The weather is coming from the north, gets to the northern Alps and gets slowed down. Then it reaches the next lot of mountains on the border between Tirol and us - and gets totally stuck. About 40km away they have had over 3m of snow in the last week - we've had none, just a few flakes.
Austria and southern Germany has had massive amounts of snow and it is very wet so trees and roofs are suffering. The avalanche risk is also very high. Lots of ski resorts are near enough closed as a result, lots of roads are closed - and somewhere used tanks to take food supplies in today - only thing that was safe enough because of trees falling down!
Yes, that was what I was wondering about , I knew you were in the vicinity so just wanted to check on your snow issue. I was picturing you as a BRAINS Snowwoman!!
It is crazy how that happens near the mountains , we are in a micro climate on Anglesey because of Snowdonia on one side and the Irish Sea the other.
That year virtually every part of UK was Snowed In Anglesey was the only green blob.
The snow got stuck on the mountains and only literally dusted the South end of the island . The snow from Ireland hits Holyhead Mountain and that's it. Unfortunately , the weather systems clash and we end up being stuck in a wind tunnel , that why if you visit Anglesey you can tell the difference between locals and tourists , gets up to 20 mph and tourists are talking gale , we call anything under 30mph an Anglesey Breeze , it's not classed as wind until it's 50+ round here .
Hope your slopes can steal a flurry soon but not a deluge like the rest.
Wow, Bee, sorry to hear your story. There still seems to be so much progress to be made in how Society and some Medics perceive and manage what are (maybe wrongly?) called Mental Health issues in the 21st century? And, as for the Meejah? Food for thought...
All I can say is that it's good that at least some high profile Public figures like HRH William and Harry, and a few others seem to be on the case in promoting greater awareness.
Now that Brexit business..... No, wouldn't even dare, it's enough to give us all a nasty PMR flare and you are doing so well Uncle.
Yes , the politicians could take a few lessons from the New Royals , and the Old ones!
Never let them get rid of the Lord's , the only insane political unit to temper the actions of the kids next door . And that's coming from a life long Socialist!!
Now off to build up my collection of plastic bottles as I have recently seen some really cool photos of the recycled bottle boat races held in the UK , you have to love that British Eccentricity , and I am sure I could find a spot for you and Tedski in my PMR/ GCA team , have you got a bucket ?
Some fhings have improved re mental health but some things never change, they are just given a new name and supposedly new treatments. When I had my tests for my epilepsy when I was 12 the tests were carried out at pinderfields in sheffield and were not that scary and that was in about 1975 so I was probably very luck about where I lived.ybcc
Me too. I developed epilepsy at the age of 12 but had been suffering petit mal for a few years before. Grew out of it at about 17 but had one more aged 27 after a three week migraine!! Nothing since thank God.YBxxx
It is scary but interesting just how many parts of our medical history link.
I am convinced that rather than epilepsy the seizures and episodes I had as a young person were all part of the mix , many people with multi system disorders found in adulthood were diagnosed with epilepsy in their youth , then other disorders until someone finally starts to join the dots.
There are quite a few medics who work in mental health who have no real idea what depression is like. Becoming a specialist in a medical subject doesn't mean they have any experience of it. They spout off about what you should be feeling and how the drugs should make you feel. How the hell would they know exactly how your body should feel when tipping a mixture of serious drugs drugs down your throat?!! Sorry about rant buy some doctors really shouldn't practice medicine. YB
I agree Ybb, and don't worry about the rant. The term 'Try to Walk in my Shoes?' comes to mind - especially with some Medics and even Mental Health Professionals / Psychologists / Therapists who are immersed in Theory and haven't experienced the sometimes Real and Catastrophic impact of these things on an otherwise sane, rational and intelligent person. Ok, I'll get off the soap box now.
On the positive side: there are a few who surprise us with their Humanity, Insight and Emotional Empathy. All I can say is: stick by, and look after them too
There are some bloody fantastic specialists and they deserve their weight in gold but you don't hear as much about them. My big thing about the doctors is that they are really blase about giving certain drugs but dont stop to consoder what the side effects will do to their patients. I was told by a really good psychiatrist that thw side effects of some anti psychotic drugs are worse than the illness itself. How on earth can that possibly be helping these people.YB
I agree - although with the caveat that, sometimes, some Medics struggle to manage contingencies / observe Professional Protocols in terms of a Patient's Physical Health when administering certain drugs. In a small way, I have some empathy with their Dilemma. I.e. is it better to effectively treat the Condition Clinically or to keep the Patient happy by not doing so...
I just don't know - best to ask some Medics maybe?
I wouldn't want to be the specialist deciding what to do but I also think these people need to seriously weigh up the issue that eventually their patients stop taking the drugs, end up suffering with the withdrawal symptoms and their illness which makes them even more unstable.
I have a more recent issue with the police and their treatment of people with mental health issues. My eldest developed post natal depression after a very traumatic birth and got into an argument with her sister. Somehow the police were called prob by a neighbour and two 20 year old police men turned up. They wouldn't listen to me about how she was ill and insisted on arresting her. They dragged her away from her son and shoved her in a police car. They wouldn't take her medication with them and said if I got in their way again I would be arrested myself! She was released the next morning with no charges and no blemish on her record thanks to a colleague who turned up at the police station at 7.30am to get her out. When the police were questioned about their actions they put it down to inexperience and wouldnt accept they did any wrong.YB
Has anyone else volunteered for that university research project, Cambridge I think, 3 monthly questionnaire? All the questions seem skewed towards depression and it’s manifestations, being the correct answer. They are looking at PMR I thought. Bit annoying.
I agree , I hate reading questionnaires that show clear bias in their wording to create the results the researchers want to find.
What happened to the true nature of scientific discovery.
It is meant to be about Negative Hypothesis Theory, you make an assertion and then test it vigorously to see if it can be proven wrong, not the other way around.
Plus , I am getting a bit fed up of all the labels , not all emotional responses , especially temporary states of mind created by environmental or physical illnesses are full scale mental illness.
You can be depressed but not have Depression , you can have anxiety but not an Anxiety Disorder and you can suffer from Stress because you are ill , not just suffer from illness because you have stress.
The Medical Fraternity seem to have completely forgotten that being human in never a simple black and white process.
It's you and Mark and this great debate that inspired me to write it down.
Perhaps we should send the people in Cambridge a copy of our conversation and this post if they really want to know what the complex nature of chronic illness and mental health changes are really like for the people who are actually affected by it.
If it's any help: I read / heard somewhere recently that the Medical / Scientific community are increasingly interested in peoples Experiences and Narratives (true stories and accounts) around their Health Journey as opposed to data-crunching around such - with possibly false / skewed conclusions. We live in Hope...
Ooh, after twelve years of experiences and counting I could give them a thorough account, might help me , but I don't know wether they would feel helped!
We're overloaded with vit D..Down under summer Storms and heat waves. Barometric pressure exasperate the PMR...we're all subject to weather conditions! And an interesting concept regarding inflammatory disease of the brain. Definitely agree. And depression follows soon after a flare up of hashimoto's thyroiditis and now discovering during my initiation period of PMR...
Can you please send some Natural Vit D to Us Lot in the UK? I agree - although we, too swelter in the occasional blisteringly Hot weather and high BP here (once in every 20 years - ha ha!), it's known that people in Northern European countries tend to suffer from a relatively higher Vit D deficiency than in others around the world. (Dunno about the Arctic regions though..).
As you say: Management is Key - by whatever means.
Read it in a vit D treatise somewhere... Not saying it is true - but there is a grain of truth in it in that if you avoid sun altogether you will become vit D deficient. It is a problem in children in the south of England and rickets is making a comeback.
It's TRUE. The skin clinics employ people without sun damage. When visiting they resemble ghosts! A down side of living on the largest island continent in the middle of oceans at the bottom of the world...skin cancers. Melanoma our worst nightmare. Both my husband and eldest son, melanoma. Its the stupidest thing...northern hemisphere origin heritage, living in a sunburned landscape...
Only my guess.. but maybe a pre-disposition (or not) to these types of skin cancers has a genetic component as much as anything else?
My late mother, Lil, RIP (of Welsh / Celtic origin as far as I know - died age 84 from pancreatic cancer) had dark hair and blue eyes. She was constitutionally as strong as an Ox and could soak-up the Sun until brown as a berry with never any hint of skin problems. I seem to have the same genes (although fair haired - ok, now grey - ha!) and the same characteristics.
Maybe there's something in my Family / Genetic blueprint that I don't know about...?!
I've had a DNA test. Interestingly and not unexpected..my heritage anglo/Indian. Paternal grandfather punjabi Indian, paternal grandmother Anglo ancestors. Maternal grandparents all Anglo/Celtic ....my skin fine.
My husband...all Europe/Anglo/Celtic....melanoma x twice...our son nodule melanoma this past year. Australian treatment world class...best. immunolo therapy..he's doing well.
Genetic research shows that Celtic ancestors are mostly to blame.
On the other hand..PMR is supposed to be a viking desease...I guess I've enough from my mothers ancestors to lay blame on the Vikings...! My dad had PMR...half Indian heritage anglo/India!
Mind you, no right minded Aussie exposes unprotected skin to the sun, so it is prevalent there too. When I think of being proud of my black stomach in the old bikini days cringe!
Thanks Mark,Ed,’s book sounds very interesting,l am usually listening to Radio 4 but had to go out today so missed that ! No sign of any sun today,really gloomy and it made Luton even more depressing,l keep vowing never to go there again and go to Bedford or MK instead. There is no M&S in Dunstable ,in fact there is not much there at all !! I will try to keep smiling though,there are worse places to be and l must count my blessings. The news regarding Brexit gets worse,but best to not say too much about that .Best wishes ,Patricia.
It's the same here in WSM today - VERY cloudy, dull and Wintry. But the forecast is better for this week - we live in Hope.
I spent a lot of time in MK some years ago whilst visiting / working with Mercedes Benz UK at their Head Office delivering 'Winning Hearts and Minds' Sales Training courses (and do they need it!). After the usually enjoyable, lively classroom sessions, I used to wander around The MK Centre in the evenings searching-out obscure Latin Jazz CDs in the (then) blossoming HMV Music stores, and loitering around the various other stores looking for bargains before turning-in at my hotel. Happy Days, but how things have changed...!
Yep: The Brexit Drama..? You couldn't make it up - or could you?! (Disclaimer: no political opinion implied either way or there'll be an almighty FIGGGHHT here about Politics)
Keep Smiling. As you say, things could always be worse
Well, teesher: that's the implied message from the BBC broadcast.
Unfortunately, it's probably not so simple as that. As I always say here, the supposed PMR / Pred / Depression Causality Link needs to be considered in context. In my (non-professional) opinion, and as said previously, there can be any number of other contributory factors in the experience of Depression. So, we have to try to join-up-the dots in terms of whether Clinical (as opposed to Reactive) Depression is 'in-the blood' or due to the many other external factors that might bring it on. For many of Us Lot, it's work in Progress whilst dealing with PMR and GCA.
We should have serious discussion after some of us have read it.
And maybe put this man forward as a speaker at PMRGCAuK AGM.
Valerie
Thanks for that Mark, just read your post.
Having suffered from depression on and off for most of my adult life, I come to the conclusion some time ago that each episode followed a periods of severe anxiety.
I won't go into the causation's of those periods only to say that some of us can deal with situation better than others. Unfortunately I thought that I could handle stress as well as any other person could, but unfortunately we now know that this isn't true.
I haven't read the book yet and I am not sure that I will, but I will add it to the many I have already read on the subject.
Interesting what you say about (major / clinical?) Depression being associated with periods of severe (Stress related?) Anxiety. In my books, the 'SAD' - Stress / Anxiety / Depression - link (as opposed to Seasonally Affected Disorder) is quite a natural human experience. I can relate...
Of course, Depression is a very personal and subjective experience in an individual's context. And, as you say, in relation to our emotional resources to manage / cope with it. It's known in Occupational Psychology circles that High Achievers (very 'Driven' / Type 'A' Personality Types) tend to suffer more from Stress related Burn-out syndrome / Depression than other Types: i.e. where Stress actually becomes habituated or even addictive ('living on Adrenalin'?) but the emotional and physiological consequences are blanked-out in the Mind. Also, in some Professions (e.g. the Care / Medical / Emergency Services) where people are dealing with very stressful events in difficult circumstances, and Performance-Managed at the same time.
Reminds me of the old saying: 'it's often the tallest oak trees that snap in a hurricane'...
Again, and as you say, it can help to recognise and make some sense of the root causes of major Depression (whether due to Stress, Neurochemical imbalance, Circumstances, Environment, Lifestyle, Genetic pre-disposition, or a combination of all?) in the coping process.
A bit like joining-up the Neuropsychological dots..?
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