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Causes of depression, anxiety: Brain circuits vs chemical imbalance

Northeast Mississippi Daily Journal - 9/15/2017

Sept. 15--Most people have probably heard that chemical imbalances create anxiety and depression. Although medications have helped a number of people, that does not prove psychological problems are the result of an imbalance of neurotransmitters, such as serotonin. The imbalance theory has been predominant for many years, but psychotherapy has been shown to be effective in treating both depression and anxiety even when medications are not given. This leads to the question of how could psychological treatment work if a chemical imbalance is the cause? I believe the answer lies in brain circuits.

The outermost part of the brain is the cerebral cortex, (i.e., cortical), with a number of structures underneath. Similar to an orange with a thin outer and inner skin with the bulk being underneath, the thin cortex, 1.5 to 4.5 millimeters in thickness, surrounds the "subcortical" structures. Our ability to think and reason is controlled by the cortex, and that is the location where detailed memories are stored. As with computers that use "bits" of information, it has been proposed that the cortex has its own bits, called cortical columns, that are organized into circuits. There are many different circuits involved in each of our cognitive abilities, such as using language and doing mechanical tasks.

There appear to be two different minds that exist, the left cortex and the right cortex. The left side is a detailed processor that allows us to understand and speak our native language, which is English for most of us. Our memories of how to read and speak are located on the left side. When we silently talk to ourselves, usually called "consciousness," it involves the left cortex. The right cortex is our other mind, being a faster but less detailed processor. It controls our ability to enjoy music and do mechanical tasks. The right side also controls our ability to process emotions shown by others, such as voice loudness and facial expressions. Our memories of emotions tied to our past and current relationships are housed in the right cortex. This leads to the emotions we experience in our relationships and our personality. The presence of two different minds leads to the common problem we all face at times; we can verbally and logically think one way, yet feel differently, about the same thing. In that case, our thinking and feeling are in conflict, preventing us from feeling any sense of peace.

Based on how the circuits in our brains are designed, experiencing anxiety and depression can result from three different sources: ongoing situations, such as pain or an argument; loss issues, such as being unable to do normal activities or losing a desired relationship; and reactivation of negative emotional memories, such as a trauma or negative relationship, like a verbally abusive parent, spouse or supervisor. The greater the number of past negative emotional memories, the greater the likelihood of having depression and anxiety. In this case, the cortical circuits are connected to the subcortical structures that control the physical symptoms of negative emotions. Medications can impact the subcortical areas, but not the cortex. Psychotherapy is the way the cortical circuits can be impacted.

For more articles on the brain and how different psychological approaches, search or for the profile page of Robert Moss.

Clinical psychologist Dr. Robert A. Moss works with North Mississippi Regional Pain Consultants.


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