Metabolic-Based Depression?

A sad story about a man's brother and electroconvulsive therapy reminded me of why I've always struggled to respond to queries framed as; "Would you be slim if you could?" The short answer is that weight can't be separated from the state of your metabolic function and your body's use of energy.

Consider Stephen Mayers-the writer's brother. The article tells the story of how he developed a deep and intractable form of depression ten years before the end of his life. In the end his cause of death was a heart attack. Certain things leapt out, 

A life that had been little more than an extended stupor, enlivened only by the gobbling of stodge...

Insatiable appetite for carbohydrates-ready energy.

The article itself is defending the revival of ECT-electroconvulsive therapy, where electrodes deliver electric shocks to the brain to induce seizures. This supposedly can relieve the deepest of depressions, presumably by destroying certain functions of the brain,

The addiction to discomfort eating, which brought only self-hatred, was ousted by a renewed passion for cycling.

Something was wrong with his body's use of energy and a signal of this prompted feelings of self loathing, well done 'obesity' crusade.

As the writer and professor of clinical psychology Andrew Solomon has sagely noted, the opposite of depression is not happiness, but vitality.

For "vitality" we can read, flow as well as presence of energy. Once ECT broke through depression, the brother felt a restored urge to really stimulate his flow of energy via activity.

It's possible that heart trouble was the cause of what was perceived solely as his state of mind. It could also have been something else that eventually caused his heart to succumb, perhaps something about the workings of his digestive system.

How ECT works is not fully understood. The damage from these induced seizures seem to have the effect of separating certain functions in the brain associated with depressions' circular thinking, this undermines depression.

Our results show that ECT has lasting effects on the functional architecture of the brain. A comparison of pre- and posttreatment functional connectivity data in a group of nine patients revealed a significant cluster of voxels in and around the left dorsolateral prefrontal cortical region (Brodmann areas 44, 45, and 46), where the average global functional connectivity was considerably decreased after ECT treatment (P < 0.05, family-wise error-corrected). This decrease in functional connectivity was accompanied by a significant improvement (P < 0.001) in depressive symptoms;

[My emphasis] It's possible that it affects functioning in the gut, sort of reversing the effect of gastric mutilation.

One thing that has revealed to more people is the intimate connection between that area, the brain and the heart/circulatory system.