The Cause(s) of (My) Depression

This is Part 3 in a series of posts about my experiences with depression. (Part 1: And Then It Got Bad; Part 2: And Then It Got Better.)

When I was hit with major depression late in 2014, it came unexpectedly. It wasn’t there, and then it was there. Over the next two years, I spent time and energy turning my skills as a researcher towards being a kind of brain detective, figuring out just what had gone wrong. After your brain experiences the short-circuiting of depression, there’s many things about the way your brain works that you can no longer control. The circuits have been fried.

What I could control was my role as an observer. I would watch my mood go up and down, and take mental notes. I observed my patterns. I observed my interactions with people. I observed my emotional and physical reactions to the rhythms of the week or the day.

I thought I would just informally share my findings over the last two years, as documentation for myself, but also in case what I discovered might be of use to anyone else.

Here’s what I consider the significant contributors to my episode of major depression:

Lack of Sleep

I never would have understood the importance of sleep until I just didn’t have it anymore. Like most new parents, having a child was devastating to my sleep. I was already a light sleeper, and after my son was born in September of 2012, I basically stopped sleeping.

The kind of tired you get as a new parent is unlike any kind of sleeplessness at any other time in life. Some people seem to be able to survive it somehow. I didn’t. I would fight to stay awake during the day. If we visited family, I would sometimes nod off immediately if I found myself alone in a room.

At a certain point, your body somewhat accepts that this is the new normal, and that’s when weariness adds to sleeplessness. Eventually, even if I had the time to sleep, my body refused. I would wake up every 2 hours regardless. I developed what’s called maintenance insomnia. I could fall asleep initially, but occasionally I would wake up in the middle of the night, and think it was near morning because I felt completely awake. Then, I would be dismayed to find that it was still the middle of the night.

A year passed. My wife started to ween our son off of breast-feeding in the middle of the night. But to get him to stop crying for it, I became the one to put him back to bed by offering him water instead. It took a while for that to work, but no matter if it did or didn’t, I still had to be the one to get up for practical reasons.

So, I slept even less. I craved sleep. I longed for sleep. But it was never really there. It probably wasn’t until 6 months after I was living on my own this year that my body began to be able to sleep again, and that was still more than a two full years after depression had hit. I had to carefully re-train my body to expect to sleep at a certain time at night, and then stay asleep until a sufficient time the next morning. (I still haven’t been able to consistently keep myself asleep the whole night, but I’m getting there.)

Stress

Stress is a common contributor to depression. I was working on a stressful, thankless job at work, and in my off-hours, I was attempting to build a start-up with some friends of mine. As the side-project went on, my friends got less reliable at doing the things they said they would. I started to take on more tasks myself. I spent weekends and vacations working, attempting to complete a Minimum Viable Product, because start-up culture had taught me the importance of driving that entrepreneurial spirit forward, to forego the pleasures of the moment in order to achieve a momentous result.

After skipping multiple outings with friends and family to work on my project, the only result was the loss of my sanity, and a disconnection from other people. My stress only built and built, and it started to manifest as a constant anxiety.

Relationship

Whether or not you have a supportive and committed partner can make a big impact on your health and recovery from illness. The thing is, whether or not you have that partner is not something you really know until something happens.

For some partners, major illness is a deal-breaker. Heck, some husbands leave because of their wife getting pregnant, when they see the hormonal and physical changes that brings, and what it does to their attraction for their partner and for their sex life. Newt Gingerich is often chided for leaving his wife while she had cancer, which was somewhat damaging to his political brand and his run for the presidency.

And some wives leave their depressed husbands. To be fair, living with someone with depression may actually be harder than living with someone with, say, cancer, as crazy as that may sound. The quality of life is often lower with depression. That’s not to say it’s a worse disease, as they aren’t really comparable, but by definition, you’re likely going to feel (emotionally) much worse with depression. That’s what it is. It’s feeling chronically terrible, regardless of any physical pain happening. With other diseases, no matter the physical challenges, you have the ability to feel hope. With depression, by definition, you can’t. When someone feels despairing while having another disease, it’s likely they are also suffering from depression. So it’s still the depression that’s the culprit.

So for partners, that is probably hard to be around. One thing a person with depression could remind their partner is that often a person has one severe episode in their lifetime and that’s it. So, if the worry is that it’s going to be a reflection of the future relationship, that’s really not what the data shows. When my relationship ended, I would estimate that I was probably about 60–75% of the way through recovery. That’s still a recovery measured in years, but if you’re aiming for a 40+ year committed relationship, that’s a small slice. If you’ve got a good working relationship in terms of mutual respect and compatibility, and are also committed to raising children together, then the chance of all of that working again are quite high. So that may give a sense of hope for the person who is depressed and for their partner. All long-term relationships have these lows, and this just happens to be one of them.

But, you can say all that, and they can still leave. At that point, you may have to accept that their leaving probably has little, if not nothing, to do with the depression.

Abuse and the brain

One of the most important areas of research into mental illness has been the growing set of data that links abuse history to depression and other disorders.

When major depression hit me, we were staying in a friend’s home. For some reason, the environment, the decoration, whatever it was reminded me of an abusive situation I had been in. I suddenly felt like I was in terrible danger. What’s worse is that the rest of my family was leaving to go camping while I was going to stay there and work remotely until they came back. So, not only was my body screaming at me that I was in danger, but it was also telling me that I was about to be abandoned there.

I’d been feeling the same about my son. I’d had a growing sense of anxiety that something terrible was going to happen to him by a certain age. This anxiety was starting to manifest as full-blown panic attacks, triggered in any moment of overwhelm.

In that moment, all of the stress and anxiety of that, added to the lack of sleep and other physical stressors, resulted in my brain finally snapping. In a matter of 24 hours, my ability to regulate my mood collapsed. I started losing grip of reality. It started a routine that would continue for months, of sobbing on a nearly daily basis. Through no reason that I could really pinpoint.

Through therapy, a lot of that full-body reaction was addressed, in pulling apart just where all of that might have originated, and then starting a healing process from there. For most, this healing process never really stops. You just continue to work on it.

The compounding nature of depression

Know what depression does? It starts to negatively affect your sleep. Know what else it does? Your body loses the ability to regulate stress. Hey, guess what less sleep and more stress cause?

The seemingly endless cycle of depression takes a long time to interrupt and redirect. After a lot of effort, work, medication, and support, I began to re-orient my brain into a zone of near-normal stable functioning. By 2016, I was feeling quite successful at managing stress, but had a lot of severe dips that I still didn’t enjoy. As I said, I would say I was about 60–75% through recovery. So I began to tackle the last 25–40%. What was it that was still throwing me off-balance?

An enflamed brain

I thought the problem was still sleep, and beginning to get sleep this year did help a lot, but after tackling stress and sleep (and throughout, tackling any emotional contributors), I started to see the contributors that were originally less obvious.

Over the last two years I’d begun to have knee problems. Basically, any kind of stress on my knee and I had enflamed tendons, and would be in pain for weeks or months.

Doing my research on that, I found that one thing that could help my joints and tendons was through nutrition. Certain foods are inflammatory, and the same foods that can cause you to feel bloated or gassy in your digestive system can have a similar irritating and enflaming effect on other tissues on your body.

So I began to cut out wheat, dairy, and nightshades like peppers and potatoes. While my knees didn’t immediately begin to recover, I had a more immediate and startling discovery:

My brain began to feel better.

The biggest impact seemed to be just plain ol’ bread. There’s a lot of pushback in the science community now about just how “real” gluten-sensitivity is, but the good thing about learning your own body is that you don’t need the consensus of the entire scientific community in order to feel better. I stopped eating wheat, and my head stopped feeling like it was full of cotton in the morning.

It may seem obvious, but if a food causes an inflammatory (basically an immune response) effect on your gut and your tendons, the same thing is happening throughout your body, including your brain.

I was excited about this discovery, so I began to ask: “What else? What else could be causing this effect that I could cut out?”

Probably the most important food discovery I made, and maybe the most important personal discovery in my research into the depression I experienced, was that of one particular culprit: caffeine.

The Coffee Problem

Here’s what I pieced together:

After I became a parent and I started to lose sleep, I started to increase my intake of coffee.

Increasing my coffee started to negatively affect my sleep. But…I didn’t quite recognize it yet, because either way, I was going to be tired.

When my workplace started buying some good brewed coffee, I switched to that from buying lattes since it was cheaper. What I didn’t realize is how much different the caffeine content is between “specialty” coffees (espresso) and drip coffee. It depends on the brand of coffee, but if, for example, you had a grande latte from Starbucks, you’d have about 150mg of caffeine. If you filled the same coffee cup with one of their brewed coffees, you’d have about 330mg.

During my son’s second year, I took a year off to be a stay-at-home dad. I had my own coffee maker at home, so I brewed my own. I like the taste of coffee so I’d make myself a lot.

My normal routine was to have coffees twice a day, so I went from two lattes a day, to two pots of coffee.

From 300mg while working in an office to probably something like 1,000 to 1,500mg of caffeine while at home as a stay-at-home dad. Per day.

Health experts will tell you that a safe amount of caffeine is around 400mg per day.

Oops.

Besides the problem of the effect on sleep, caffeine can also lead to dehydration. The science is mixed on just how much (or if at all), but I know that dehydration was an issue for me. My water cravings seemed almost constant, and my skin on my cheeks was sometimes dry to the point of being painful. And Vancouver is a rainy climate, so the issue wasn’t air humidity.

Hey, fun fact — guess what dehydration can cause: DING DING Depression! Correct! In fact, it turns out that chronic dehydration actually shrinks your brain.

So I decided to try cutting out coffee. I knew that I should try it just for its inflammatory effects alone. I really was still just thinking mostly about my knees at that point. To trick my body, I decide to keep the taste of coffee and just switch my coffee to decaf.

During that first week, I was quite groggy. But unexpectedly, after about two weeks, I began to wake up feeling more refreshed than I had in years. I was astonished at how relatively quick this change was. I felt awake. Like I could actually see the world around me. Like I was in the world, and not just some faraway outside observer of it.

Now, that effect hasn’t been a complete constant, since stress and anxiety are still things I experience, and still can disrupt my sleep quite a bit. But the restfulness I’ve felt, in general, since making that change, has fully convinced me to make this change permanent. I also was surprised to see in the mirror one day that my skin looked healthier, more rosy. And, well, my knee pain has lessened.

It’s hard to say which thing: physical therapy, nutrition, caffeine reduction made the biggest impact on my knee, but the improvements for my brain were incredible.

Aiming towards a healthy weight

One thing I should mention: by changing what I was eating, I started to drop pounds.

Guess what being overweight contributes to? Yep, lack of sleep and depression. So losing weight (when one is overweight), can improve both of those things.

So, now, I find myself in a different self-regenerating cycle. Previously, the cumulative effects and conditions I was experiencing just continued to make things worse.

Now, every positive shift seems to be building on everything else, moving me slowly up the road, progressing in what seems like an inevitable full recovery.

There isn’t anything to do but continue doing what I’m doing, which is a good feeling. And I expect to discover more things along the way, healthier turns that continue to raise my quality of life. Unlike two years ago, I feel hope.

I’m sad, yes, about the time and relationships lost along the way, but nothing is guaranteed in life. And that’s what ultimately is important: I’m alive, and I intend to stay that way.