The disease model of depression – and anti-depressant use – has been aggressively promoted by the pharmaceutical industry, and embraced by many mental health professionals. This is alarming given that there is no proof that shortages of neurotransmitters – such as serotonin or dopamine – cause depression. It may actually be the reverse, that depression lowers neurotransmitter levels. We only know how depressed people respond to anti-depressants – their levels of neurotransmitters rise, just like they would in response to any mood altering substance. This results in an artificial ‘high’. It does not amount to resolving the problem. Over the past few years, reviews in the New England Journal of Medicine, the Journal of the American Medical Association and PLOS Medicine question the efficacy of anti-depressants, except in extremely severe cases, highlight the placebo effect, reveal an absence of integrity in the pharmaceutical industry, and pinpoint adverse physical and psychological side effects, including increased suicidal thinking. 1
From my many years of personal and professional observation, and review of research, it seems to me that depression is primarily a socially mediated or interpersonal psychological problem, stemming from loss, shame, lack of love, options, support, as well as abuse, neglect, loneliness, poverty, health problems, trauma, double binds, etc. There may be some biological vulnerabilities in individuals who suffer from depression, but the most important triggering factors appear to be adverse social, interpersonal or familial events. Of note, people who were abused or neglected as children seem to be particularly susceptible to depression. Repressed emotions, such as anger and hatred – often directed towards the self – can also play an important role in predisposing people to depression.
Unfortunately depression tends to feed on itself, and can be learned or reinforced in families where depression exists but is not acknowledged or dealt with in a healthy manner. Depression causes distorted thinking where people can get trapped believing they are worthless and/or unlovable, and then feel hopeless and helpless to do anything about it. This creates low moods and bleak perspectives that sadly push away the very people the depressed person needs contact with, in order to regain their psychological well being. Depressed people sometimes gravitate towards unhealthy coping strategies, such as substance abuse, which only serve to make the problem worse through the disturbance of brain chemistry. They may neglect their diet and appearance due to low energy and/or having given up on themselves.
Psychotherapy helps depressed folks learn the skills of overcoming and preventing depression. By uncovering and working through repressed emotions, and learning to stand up to the psychological ‘habits’ of depression, including negative belief systems and ruminative thinking, depression starts to be replaced by hope and strength. Coming to believe in oneself increases optimism, emotional resiliency and improves relationships. Such positive changes profoundly impact our ways of thinking, living, and relating in ways that can turn depression around and keep it away.
Photo Credit: lanier67 via photopin
1. Impugning the integrity of medical science: The adverse effects of industry influence, Catherine DeAngelis, Journal of the American Medical Association, 2008.
Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration, Kirsch, I., Deacon, B., Huedo-Medina, T., et al, PLoS Medicine, 2008.
Selective publication of antidepressant trials and its influence on apparent efficacy, The New England Journal of Medicine, Turner, E., Matthews, A., Linardatos, E.,et al, 2008.
2. Anxiety and Depression Are Symptoms, Not Diseases, Gregg Henriques PhD, Psychology Today, 2016
3. Keys To Unlocking Depression, Michael Yapko PhD, 2016
Glynis Sherwood – MEd, Canadian Certified Counselor, Registered Clinical Counselor, specializes in recovery from Depression, Low Self Esteem, Anxiety, Scapegoating/Bullying, Grief and Addictive Behaviors.
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