The MAD Theory provides a unique biological and logical framework to understand why depression occurs, emphasizing that it is not a primary illness but a functional shutdown of specific neurons.
Here is a detailed explanation in English regarding the mechanism of onset and why modern brain labor has significantly increased the incidence of depression.
1. The MAD Neuronal Framework
The theory is based on how individual neurons respond to repeated stimulation:
- M-cells (Manic): These cells amplify their response over time (sensitization). They are the basis for enthusiasm, elation, and the feeling of “getting into a roll”.
- A-cells (Anankastic): These cells provide a stable, constant response. They represent meticulousness, responsibility, and perseverance.
- D-cells (Depressive): These cells respond briefly and then quickly “give up” or attenuate. They act as a protective device to prevent total organism exhaustion. Crucially, the vast majority of neurons in the human brain are D-cells, making this “quiet” state the biological default.
2. The Pathogenesis: The “Primacy of Mania” Hypothesis
According to the sources, depression never exists in isolation; it is always preceded by a state of neuronal hyperactivity.
- Step 1: M-cell Hyperactivity: Under sustained stress or effort, M-cells first amplify their response. This creates a (hypo)manic state where the person feels “fired up” or that work is going exceptionally well.
- Step 2: Functional Arrest of M-cells: Neuronal energy is finite. Eventually, the M-cells reach their limit, run out of fuel, and accumulate waste products, leading to a sudden cessation of activity.
- Step 3: A-cell Compensation and Collapse: When M-cells fail, the individual relies on A-cells (meticulousness/responsibility) to “get through somehow”. However, A-cells also have limits and eventually shut down under continuous load.
- Step 4: Completion of the Depressive State: Once the “striving” cells (M and A) have burned out, only the D-cells remain manifest. The resulting state—characterized by weakness (asthenia) and negative mood—is the essence of depression.
3. Why Modern “Brain Labor” Increases Depression
The theory explains that the shift from physical labor to mental labor has removed natural biological “stoppers”.
- The Physical Stopper (Past): In the era of physical labor, the body would reach its limit first. Muscle fatigue, tears, or an Achilles tendon rupture would force the individual to rest. The flesh acted as a safety valve, protecting the neurons from burning out.
- The Lack of a Stopper (Modern): Modern brain labor (working on computers and documents) does not cause such clear physical damage. At most, one feels eye strain or stiff shoulders, which are not strong enough to force a total stop.
- The Result: Because there is no physical “forced interruption,” neurons are overworked to their absolute biological limits until they hit functional arrest. This makes the modern increase in depression inevitable.
4. Recovery and Treatment
The MAD Theory offers clear guidance for recovery:
- The Importance of Waiting: The essence of treatment is “resting over time” until the arrested M and A cells recover their function, which typically takes approximately three months.
- Distributing Exertion: Prevention involves transforming a personality that “pushes to the limit” into one that distributes effort.
- Medication Logic: Mood stabilizers act by setting a “ceiling” on excitement, preventing M-cells from over-striving until they burn out. SSRIs are seen as supplementing the serotonin that has decreased as a result of neuronal functional arrest.
