What You Didn’t Know About Depression
- Integramed
- Sep 15
- 2 min read
By Dr. Georgia Brunner, Psychiatrist & Psychotherapist
Depression is more than just sadness. Millions of people worldwide live with it, yet the myths and misunderstandings around depression are still strong. In this article, I’ll share insights as a psychiatrist and psychotherapist into what you may not know about depression — based on science, therapy, and lived clinical experience.
1. Depression Is Not Just Sadness
Depression symptoms can show up as irritability, emptiness, or even physical pain. Many patients don’t cry all day — instead, they move through life with fatigue, lack of motivation, and a sense of emotional numbness. Others hide it behind overworking or people-pleasing until their energy finally collapses.
2. Beyond the “Serotonin Imbalance”
You’ve probably heard the idea that depression is caused by low serotonin. Research shows the reality is more complex:
Stress and trauma change how brain circuits regulate emotions.
Inflammation in the body interferes with neurotransmitter function (serotonin, dopamine).
Hormonal changes (thyroid, cortisol, estrogen, testosterone) directly affect mood.
👉 Depression is not a single “low chemical.” It’s about dysregulated networks between brain, body, and environment.
3. Physical Conditions That Mimic Depression
Before diagnosing depression, physicians must rule out other causes of fatigue and low mood:
Hypothyroidism, anemia, vitamin B12 deficiency
Sleep apnea
Chronic inflammatory or autoimmune diseases
4. Hidden Psychological Patterns
In psychotherapy, we often see patterns like:
People-pleasing and weak boundaries → exhaustion
Suppressed anger → turned inward as self-criticism
Perfectionism → constant sense of failure
These unconscious strategies often set the stage for depression.
5. Lifestyle Factors That Matter
Lifestyle is not just “extra.” It is central to mental health.
Sleep deprivation disrupts mood regulation.
Poor nutrition (low omega-3, B-vitamins, magnesium) impairs brain function.
Lack of movement reduces resilience and neuroplasticity.
Isolation worsens hopelessness.
Even small steps — regular wake-up times, balanced meals, gentle exercise — can shift the system.
6. First Steps Toward Understanding Depression Differently
There is no one-size-fits-all cure. But first steps include:
A thorough medical check-up
Naming the experience without shame
Creating small daily rhythms
Exploring patterns in therapy
Reaching out instead of isolating
Depression is not a weakness. It is a multi-layered condition that arises from biology, psychology, and life history together. The key is to move beyond clichés like “chemical imbalance” and understand the real roots and patterns.
👉 For more insights, watch my YouTube video:
