Regulation of Emotions: Sadness and Depression

Aim: To introduce issues in the regulation of emotion through depression and sadness.
Background on mental health and depression
Biology of normal mood: emotions vs feelings
Animal models of depression
Depression as a biologically adaptive process in normality

National health survey: 2017-2018 financial year Australia (from ABS)
- 20% or 4.8 million Australians had a mental or behavioural condition, an increase from 18% in 2014-15.
- 13% or 3.2 million Australians had an anxiety-related condition, an increase from 11% in 2014-15.
- 10% had depression or feelings of depression, an increase from 9% in 2014- 15.
DALY (Disability Adjusted Life Year): a measure of overall disease burden, expressed as the cumulative number of years lost due to ill-health, disability or early death
YLD (Years Lived with Disability)
YLL (Years of Life Lost)

All mental disorders rank high in terms of YLDs (Years Lived with Disability), indicating a significant impact on quality of life.
Table 3: Rank among Level 2 causes for global deaths, YLLs, YLDs, and DALYS in 1990, 2010, and 2019, for both sexes combined

Triggering Factors
- Stressful life events (usually some experience of loss; or feeling emotionally trapped in a situation; or a sense of humiliation or shame)
  - separation from a loved one
  - threat of separation
  - infidelity
  - relationship problems commencing or increasing
  - illness, injury, accident
- Stressful life events (cont.)
  - bereavement (worse if child or spouse)
  - loss of job, unemployment
  - discrimination – LGBTIQ, Indigenous
  - acute financial difficulties
  - increased responsibility
  - injury to pride/reputation
Predisposing Factors
- Our genetic make-up can make us more vulnerable to becoming depressed on exposure to stressful life events
- Genes alone don’t cause depression
- In elderly, depression more likely with brain small blood vessel disease
Model of Depression Risk Factors:
- Genetic Risk + Childhood adversity + Life events and chronic difficulties + Low self-esteem + Chronic anxiety and subclinical depression - Social support = Depression

Are emotions just feelings? No.
Continuum comprising:
- Emotions: collections of chemical and neural responses (role is to assist organism in maintaining life)
  - Biologically determined
  - Automatic, not conscious
  - Use the body as their theatre (internal milieu, visceral, vestibular and musculoskletal systems)
  - Affect brain circuits -> neural patterns which become ‘feelings’
- Emotions are external (body), feelings are internal
Levels of Life Regulation (Table 2.1):
- High Reason: Complex, flexible, and customized plans of response are formulated in conscious images and may be executed as behavior; involves consciousness.
- Feelings: Sensory patterns signaling pain, pleasure, and emotions become images; feelings involve consciousness.
- Emotions: Complex, stereotyped patterns of response, which include secondary emotions, primary emotions, and background emotions.
- Basic Life Regulation: Relatively simple, stereotyped patterns of response, which include metabolic regulation, reflexes, the biological machinery behind what will become pain and pleasure, drives and motivations.

Emotions are complicated collections of chemical and neural responses
All emotions have some kind of regulatory role to play
They lead to the creation of circumstances advantageous to the organism, i.e. they assist the organism in maintaining life
Emotions are biologically determined processes, depending on innately set brain devices, laid down across a long evolutionary history
Learning and culture can alter the expression of emotions and give them new meanings
The neural devices which produce emotions occupy a restricted sample of mostly subcortical regions, beginning at the level of the brain stem and moving up to the higher brain
All the neural devices can be engaged automatically, without conscious deliberation
The emotions are fundamentally stereotyped, automatic and regulatory in purpose – any variations are shaped by individual variation and culture
All emotions use the body as their theatre:
- humoral/bloodstream (internal milieu),
- neural: visceral, vestibular and musculoskeletal systems
Emotions affect the mode of operation of numerous brain circuits; these changes lead to the experience of “feelings”
Emotions alter activity in other brain regions via monoamines/peptides and trigger behaviours e.g. playing, bonding, crying
Principal emotion induction sites:
- amygdala
- ventromedial prefrontal
- brain-stem nuclei
- hypothalamus and basal forebrain

Feelings are brain representations of emotions (derived from changes in body and brain)
We have a feeling when we know that the emotion is happening in our us i.e. feeling is the result of a relationship between the organism and the emotion

These form background emotions and the latter might be observable to others e.g. body posture, speed of movements, tone of voice etc
Examples include fatigue, energy, excitement, wellness, sickness, tension, relaxation, harmony, discord
The relationship between background feelings and moods is close. Moods are made up of modulated and sustained feelings of primary emotions – sadness in the case of depression.

We are social beings – perhaps sadness is a means of temporary withdrawal to cope with loss of relations;
Other more conceptual losses (health, status, etc) may be elaborations of this with our more complex brains
Depression is presumably a pathological distortion of normal sadness
Communicating a need for help, yielding in a hierarchy conflict, fostering disengagement from commitments in unreachable goals
Low mood may increase an organism's ability to cope with the adaptive challenges characteristic of effort to pursue a major goal will likely result in danger, loss, bodily damage, or wasted effort.
In such situations, sadness/depression may give a fitness advantage by inhibiting certain actions, especially futile or dangerous challenges to dominant figures, efforts that would damage the body etc

Emotions
Feelings
Depression a pathological distortion of sadness (next lecture Treatment Choices in Depression)