Depression is a chronic disease with mental and physical symptoms, and there is evidence that there is a neurodegenerative component to depression that would make treatment urgent. With repeated episodes of depression, the episodes come more often, become more persistent and recovery becomes less complete. As depression becomes more chronic, structural changes develop in the brain.
Serotonin (5-HT) and norepinephrine (NE) neurotranmitters both play role in depression and are important in the treatment of depression. Treatments that alter both 5-HT and NE systems are effective in treating depression and the pain symptoms, which often are seen with depression. The pain symptoms include body aches, headaches, intestinal disturbances, fatigue, and loss of energy. The same treatments also promote neurogenesis (production of gray matter by the brain.)
CONCLUSION: Treatments for depression that alter both norepinephrine and serotonin systems seem to be best at altering the course of depression. They promote neurogenesis and treat the pain symptoms that occur with depression. Aggressive treatment is encouraged by the author to prevent the loss of brain tissue seen with chronic depression.
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