Depression: More Than a Feeling

March 28, 2023

In his book Turtles All the Way Down, John Green wrote, “We don’t really get to pick the painting of our lives; we do to some extent get to pick the frame.”

The character in that story is implying this truth: unexpected things impact our lives. We get into car accidents, spouses are abandoned, people witness violent acts, cancer occurs in the human body, and chronic mental illness develops. Unfortunately, this list could be endless. No one asks for these things to happen, and yet they do happen. While all of creation was perfectly created, because of sin, our world and our bodies are far from perfect. Disease and illness are some of the many ways we see how damaged our world is.

Depressive disorders are not merely mental disorders, they are complex biological disorders. Scientists study how certain genes present themselves in different ways. This helps us understand things like why identical twins can exhibit different skill sets or develop different chronic illnesses. While there is no single cause of depression, multiple genes, and environmental causes have been found to play a role in the development of major depressive disorder.

Mental health issues can even affect different structures of the brain. The use of medical imaging, which focuses on the brain, has allowed researchers in the field of psychiatry to gain a better understanding of the results of depression. Findings included: increased activity in certain specific parts of the brain (e.g. the amygdala), and other structures of the brain revealed a decrease in brain volume when compared to non-depressed individuals (Peluso et al., 2009; Bhatia et al., 2018).

Brain cells produce chemicals that allow different parts of our brain to communicate with each other. A protein (brain-derived neurotropic factor) in our brain permits it to change and adapt. Low levels of this protein can cause reduced communication in the brain and a reduced amount of chemicals released. These chemicals allow us to feel happiness, pleasure, and the ability to concentrate. In fact, antidepressants promote the release of this protein (BDNF) and may be part of the reason for their effectiveness in treating depression (Yang et al., 2020).

Our God understands our struggles and even understands the most complex disease processes. The prophet Isaiah describes Jesus as, “a man of sorrows, and acquainted with deepest grief” (Isaiah 53:3). Psalms 145:9 states, “The Lord is good to everyone. He showers compassion on all his creation.” Our God not only sympathizes with our emotions, He also gives undeserved blessings to all people. This can be exemplified by a supportive friendship, therapy, and/or medical treatment. So, maybe the painting of our lives is not what we would have chosen, but we do get the opportunity to frame our experiences.


Bhatia, K. D., Henderson, L. A., Hsu, E., & Yim, M. (2018). Reduced integrity of the uncinate fasciculus and cingulum in depression: A stem-by-stem analysis. Journal of Affective Disorders, 235, 220-228.

Green, J. (2018). Turtles all the way down. Penguin Books.

Hamilton, J. P., Siemer, M., & Gotlib, I. H. (2008). Amygdala volume in major depressive disorder: A meta-analysis of magnetic resonance imaging studies. Molecular Psychiatry, 13(11), 993-1000.

Peluso, M. A. M., Glahn, D. C., Matsuo, K., Monkul, E. S., Najt, P., Zamarripa, F., Li, J., Lancaster, J. L., Fox, P. T., Gao, J., & Soares, J. C. (2009). Amygdala hyperactivation in untreated depressed individuals. Psychiatry Research. Neuroimaging, 173(2), 158-161.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.

Yang, T., Nie, Z., Shu, H., Kuang, Y., Chen, X., Cheng, J., Yu, S., & Liu, H. (2020). The role of BDNF on neural plasticity in depression. Frontiers in Cellular Neuroscience, 14, 82-82.

Susan is a Psychiatric and Mental Health Nurse Practitioner who specializes in adult, adolescent and child psychiatry in the Richardson, TX clinic. She is dedicated to providing compassionate, patient-focused care. She is concerned about the happiness of those whom she works with and prioritizes listening to her patient’s needs, experiences, and goals. She has a Bachelor of Science in Public Health from Baylor University, 2009; Bachelor of Science in Nursing from Texas Women’s University, 2013; and a Master of Science in Nursing from University of Texas at Arlington.

Located in our Richardson office


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