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The honest short answer is more nuanced than either extreme you may read online
It's a catastrophic failure at the molecular level
(PDF) Harnett, N.G., Finegold, K.E., Lebois, L.A.M., van Rooij, S.J.H., Ely, T.D., Murty, V.P., Jovanovic, T., Bruce, S.E., House, S.L., Beaudoin, F.L., An, X., Zeng, D., Neylan, T.C., Clifford, G.D., Linnstaedt, S.D., Germine, L.T., Bollen, K.E., Rauch, S.L., Haran, J.P., Storrow, A.B., Lewandowski, C., Musey, P.I., Hendry, P.L., Sheikh, S., Jones, C.W., Punches, B.E., Kurz, M.C., Swor, R.A., Hudak, L.A., Pascual, J.L., Seamon, M.J., Harris, E., Chang, A.M., Pearson, C., Peak, D.A., Domeier, R.M., Rathlev, N.K., ONeil, B.J., Sergot, P., Sanchez, L.D., Miller, M.W., Pietrzak, R.H., Joormann, J., Barch, D.M., Pizzagalli, D.A., Sheridan
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