Mood and the Brain

Colette Dowling, LMSW

When it comes to mood disorders such as depression, the schism between psychology and psychiatry is basically this: therapists influenced by Freud’s psychology see depression as a product of the mind and talk about it in terms of drives, defenses, regressions, and problems of identification and self-esteem. Those influenced by biological psychiatry see mood disorders as caused by shifts in the levels of hormones and neurotransmitters in the brain.

Shephard Kantor, a psychiatrist on the faculty of the Columbia University College of Physicians and Surgeons, looks for ways of bringing the two approaches to mood disorders--biological nd psychological--together. Kantor believes the mental "productions" of depressed patients--negative thoughts and, in the case of psychotics, hallucinations--come from chemical changes in the central nervous system and that they are not psychologically caused. Dr. Kantor no longer believes that the crazy thinking that accompanies mood disorders is triggered by external events or is the residue--for example--of childhood interactions with parents. He believes the crazy thinking that accompanies mood disorders is caused by a state of chemical imbalance in the brain.

But hey, what about the effects of trauma? we may ask. Surely disturbing, traumatic events of childhood can’t be totally unrelated to mood problems later on in adulthood. Kantor has suggested that the mental changes produced by depression may be due to certain sensations and memory traces that go back to "the calamities of childhood". Such calamities, he theorizes, produce changes in neurotransmitter levels or receptor sites. And it isn’t just childhood trauma that creates such effects. Emotional wounds at any point along the way might produce similar chemical alterations in the brain.

Studies with primates show that circuitry linking structures in the central nervous system is responsible for perception, memory, and emotion. With this in mind, Kantor says, it isn’t such a big jump to imagine how the tiniest of biochemical disturbances at any of these sites might evoke memories and moods whose origins lie in childhood.

Kantor has another idea. One of the breakthroughs of modern neurology was Wilder Penfield’s discovery that stimulating certain areas of the brain with electrical impulses produces visual and auditory images and memories. Kantor asks this provocative question: Isn’t it possible that the signals generated by neurotransmitters might function as "the internal equivalents" of Penfield’s externally applied stimulating electrodes? If so, he says, it "would cause patients to report feelings, recollections and ideas generated not by conflict, fantasy, or drive derivatives, but by chemical stimuli."

Kantor stands firm in his conviction that psychiatrists should learn to understand--and accept--the chemical nature of mood disorders.Kantor’s ideas may need to be substantiated by further research but he is widely regarded as an important scientist.

Clearly, childhood events produce inner experience--feelings and attitudes that stay with us, affecting our lives immensely. The question psychiatry wrestles with is how these powerfully resonant events interact with neurotransmitter deficits to produce shifts in mood state that are sometimes volatile, sometimes subtle. There are differences, after all, among all of us--differences in the amount of trauma or stress we experience and in the degree of chemical vulnerability we inherit. No one exists in a perfect state of chemical balance. Where, then, should the line be drawn with respect to neurotransmitter deficits? Do they exist in all who become mood disordered or only in those suffering from severe forms of these illnesses?

Colette Dowling, LMSW, is a writer and psychotherapist with a private practice in Manhattan. Books she's written are "You Mean I Don't Have to Feel this Way?": New Help for Depression, Anxiety and Addiction, The Cinderella Complex: Women's Hidden Fear of Independence, Red Hot Mamas: Coming Into Our Own at Fifty, and the Frailty Myth: Redefining the Physical Potential of Women and Girls. Ms. Dowling can be reached for consultation at dowlingcolette@earthlink.net, or by calling 718-594-0201, For information on her psychotherapy practice see her profile at Psychology Today.