Reader’s Question

When I was a kid I went through a lot of trauma. I was diagnosed with depression until I was about 18 or so. I was on Effexor for the longest time and I seemed to be doing well on it. Then I took myself off it because I was tired of taking pills. I had problems for awhile, but now I’m fine. There’s no way I would say I’m depressed, but I still have times where I go through depressed behavior. Sometimes it lasts a few hours, sometimes a day or two but rarely longer than that.

Before when I was depressed I would focus on the past, focus on what I’d done and what’d been done to me. But I don’t think about that anymore. When I go through it now it’s always in a present tense. If someone doesn’t talk to me I think it’s because they don’t like me (even though I know that’s not true), etc. I also have these “attacks”: they are very similar to panic attacks, except from everything I’ve read about them they aren’t. The only thing they have in common is the suddenness. In these attacks I can’t do anything but lay and sob, and they always play out the same way, ending with the, “maybe I should just pack my bags and never come back” attitude. They last maybe 20 to 30 minutes and always leave me exhausted. But candy makes it better (which I read raises Serotonin levels for a short time). From everything I’ve been reading, it has everything to do with my Serotonin levels.

But my question is this: is it possible for Serotonin levels to change that rapidly and that intensely, or do they basically just stay at one level until they’re treated? And is it possible for the depressive attitude to switch focus once you come to terms with that thing in your life that caused it in the first place (the past)? I also have Fibromyalgia and Polycystic Ovarian Syndrome (PCOS).

Our Clinical Psychologist’s Reply

Great question! Many people who have a history of depression experience brief episodes of depressed mood and/or anxiety as you describe. While these mood appear suddenly, the individual doesn’t have the other symptoms associated with a Serotonin depression such as preoccupation with the past, sleep/appetite problems, fatigue, etc. The question is always…what’s going on?

When we’ve been depressed for several years or experienced several years of emotional trauma, we’ve recorded many memories during those difficult times. Due to the emotional distress at that time, those are “emotional memories” rather than regular memories such as our birthdate, type of first automobile, etc. Emotional Memory contains not only the details of an experience, but also the mood that was present at the time. In other words, if you start thinking about the death of a loved one, even when it happened several years ago, you slowly feel emotional grief again.

During our daily routine, many common activities and experiences trigger these old emotional memories and they are followed by, as you describe, the mood we experienced at that time. When this happens, our mood may become very depressed or anxious and we feel as though we’ve been suddenly hit in the face. Also as you describe, that mood tends to fade away after a few hours as long as we try to return our focus to our daily activities.

In answer to your question, Serotonin typically has a “level” that operates on a daily basis. Sustained low levels of Serotonin are associated with a variety of mental health issues (depression, OCD, eating disorders, etc.). Emotional memories can increase or decrease multiple neurotransmitters as the memory duplicates the mood in that memory. These changes in neurotransmitter levels are temporary, as when we are emotionally distressed following a traumatic experience such as an automobile accident, often requiring several hours to calm down from the experience as neurotransmitter levels return to the stable range.

Depression can change focus. Other events and experiences can cause our depression to reappear and when that happens, we must often return to our previous treatment approach. If this is true in your case, I would recommend reviewing the use of Cymbalta as an antidepressant as it has shown a positive response in physical issues such as Fibromyalgia, muscular and skeletal difficulties, and pain syndromes.