Bucking conventional wisdom, as I am known to do, I do not believe that depression is a biologically based illness. Many in the medical and psychiatric profession believe and promote that depression is caused by a “chemical imbalance in the brain,” a theory that no one has actually ever bothered to scientifically prove. It just sounds good.
I think this conventional wisdom and the chemical imbalance theory is a bunch of bullshit, crafted in part by the pharmaceutical companies as a marketing campaign to sell more anti-depressant medications.
But there’s more to this theory than it just being a way to sell medication (though it does an excellent job at that, unfortunately). I think the reason why the “chemical imbalance” theory of depression is so popular is because it is a passive way of dealing with a serious issue. It is easy to explain away a mood by saying, “I have a chemical imbalance”.
Calling your depression a chemical imbalance is really just a big cop-out, with you basically removing the notion that you actually have to take action beyond popping a pill in order to change the way you feel. When you are depressed, you likely aren’t motivated to do much, so it’s cozy and comforting to think you have a problem that is out of your control to correct, which only serves in keeping you depressed.
This does not mean that depression isn’t real. It’s not “all in your head” as many people say dismissively. Depression is very real. I think it is your body’s way of letting you know you are not living life the way we are supposed to be living. I see depression as a symptom, a red flag, a warning sign, not an isolated illness that is unrelated to other things going on in your life and body. Depression is very hard on your body as well.
Depression is often triggered by a jarring event such as: getting a serious illness or injury, the death of someone close, a job loss or learning that something you believed isn’t quite true, for example. However, sometimes the start of depression comes more quietly and slowly, creeping in over time, in a way that leaves you truly not knowing the cause, saying “I don’t know why I feel this way”.
Just like how weight often creeps on over many years of eating too much and exercising too little, without you realizing it until your clothes don’t fit, depression can creep on through months and years of engaging in little bad habits and negative beliefs. Some of the little bad habits, what I like to call “energy leaks”, that can add up to getting depressed over time include:
- not being able to say no to people
- being sedentary
- feeling resentful, especially resentment towards past events
- working for too long a time without adequate breaks/rest/food
- doing the wrong type of work
- giving up the things you really enjoy doing, especially if you stop doing them because you think you “should” no longer do those things, for whatever reason
- being in depressive environments that suck your energy
- becoming cynical and negative towards people, places and things
- not being truthful with yourself
This is just a short list of things we do every day without thinking about the impact they have on our life and health.
When someone comes to see me and says that they are depressed, (after we’ve established that they have no underlying medical problems that may be affecting their mood) I have them take a look at their routines and habits, so we can see where the energy leaks are. I find there are always energy leaks, 100 percent of the time.
But this is good news. Finding these energy leaks means you can take lots of action to pull yourself out of your depression. Notice I didn’t say “snap out” of your depression. You can’t “snap out” of depression just like you can’t “snap out” of the flu. Just as it takes time and taking certain actions, such as rest, to recover from the flu, it takes some time, and a lot of action to stop the energy leaks.
Stay tuned for Part 2.
Interestingly, I wrote a blog post on depression last month http://insuremekevin.com/2011/08/16/confession-of-depression/
I echo many of your comments in my post.
However, there is more going on in the brain than we know. How is it that a person can be so damn happy, supportive and positive to friends and family, yet at the same time be walking a fine line between keeping it together and loosing it in the head?
I appreciate the fact that this post strives to look deeper into the issues at hand.
I have to say that I thoroughly disagree on your point about chemicals. As someone very close to those with depressive episodes and who has had patient side experience in the psychology field, I can’t believe that chemicals do not play a part. I actually don’t believe that it is even helpful to suggest that they don’t. There are a lot of factors involved, including important chemicals like serotonin.
That said, I really like your bullet list of beliefs and negative, self-talk that can build up over time. Love the comparison to “snapping” out of a flu. Too often treatment of any mental illness (I said it!) stops merely at a chemical level. Which is a bit like refilling a leaking radiator with coolant; sure there’s coolant now, but it didn’t stop the greater problem of continual coolant loss. That’s not to say that anything mental is that simple.
Consciousness cannot be limited to a single definition. If someone were to tell me that a person is nothing but a combination of electrical signals being sent back and forth between primitive and relatively new evolutions of a mass of meat called the brain, I would say that’s probably pretty narrow. I also don’t think it makes sense to ignore the fact that for all our complexity, we exist within a world of preloaded systems; and our brain, and the chemicals therein, are a system to which we are bound and somewhat obedient.
If we rule out chemicals, we ignore the problem of someone who is having a great day, and is suddenly, uncontrollably thrust into a new mindset. We can’t will our way through everything. If I decide to never eat again, my mental decision does not change how much energy my body needs.
I truly believe a combined approach is needed.
Thank You Stuart,
I wouldn’t go as far to say that chemicals are not involved at all. I just don’t buy the generic “chemical imbalance” theory that gets thrown around but has never been empirically tested or proven. There is so much we do not know about the brain and neural networks. And time is showing us that messing around with serotonin can and does cause a whole host of problems for many people.
I think we’ve become conditioned to look for passive solutions to problems, and viewing depression from a disease perspective, puts people in a passive position, which I think only keeps you more stuck.
Thank you Jackie for sharing your positions on depression. I also agree with you that most of us do have negative thoughts and behaviors that can suck energy and contribute to depression or make it worse, and making positive changes are possible. I also agree that just like medications for ADD, anti-depressants can be prescribed too easily as a generic solution and should not be the first, only, or even a solution for everyone.
However, I agree with Stuart that you can’t discount the chemicals involved in depression, nor can you address each case of depression with a one-sided approach. I strongly believe that combinations individualized for every patient is required. When I read your response to Stuart, you you seem to offer a more balanced argument focusing on active, rather than passive solutions (like just popping a pill) to depression. I can wholeheartedly agree with that. And there you acknowledge brain chemistry is likely involved at least to some extent, but there can be negative consequences, too. Yet, your original post does not offer anything that might be considered a middle ground. By arguing in your post that depression should never be considered a mental illness, that chemicals in the brain have little or nothing to do with depression, or that medication is a cop-out seems excessively one sided and harshly judgmental against everyone who has found the use anti-depressants helpful.
What if depression doesn’t come from a sudden event or appear slowly over time (the only options you pose)? While I run the risk of appearing to personalize this too much, I think my experience offers a counter example that might contribute to the discussion. I have life-long memories of feeling sadder, reacting more emotionally in inappropriate situations, and going through periods struggling with motivation than any of my peers (of course mixed in with memories of happiness, activity, and great success at school, too). Varied approaches of therapy from teen to mid-twenties did not provide sufficient solutions. Adding medication (aiming for the lowest dosage) to therapy was the only way I could regularly manage life without frequent emotional outbursts, self-created crises, or losing significant motivation for lengths of time. Attempts to go off the medications under supervision, were not successful. I have found a combination of meditation, yoga, exercise, therapy, and medication works best for me. Even when facing a real crisis, I can more easily work through theraputic methods to avoid losing my mind with a combined approach. I can’t believe I am a unique case. Nor do I suffer from very severe, incapacitating depression.
I have not enough medical journals to effectively challenge your claim with evidence that “chemical imbalance” is an just unproven theory thrown about. On the other hand, is there medical research that conclusively proves that medication is never needed for depression? If medication is at least sometimes needed how is not a form of an illness? If the medication targets brain chemicals, then how can there be no form of a chemical imbalance?
While you argue against a generic medication solution for everyone, it appears that you are instead arguing for a generic anti-medication solution that similarly discounts the varied experiences of depression and the multiple solutions. I realize I personalized my response, yet I hope this is taken in a manner meant to deepen the discussion and challenge ideas.
Thank you. My goal is always to get a dialogue going and deepen the discussion.
I like that you take a multi-faceted approach to your recovery. When you think about it, most problems in life, medical or not, do best with a multi-faceted approach. We all know people who look for quick and easy solutions to complex issues. I cannot tell you how many people I met during my years as a crisis clinician who, while taking anti-depressants, were also taking illegal drugs, large quantities of alcohol and living in dangerous situations for example, and wondering why (to use their words) “my meds aren’t working”. (It’s obvious from your post that is not what you do).
Chemicals affect all body processes. When I speak of the “chemical imbalance” theory, I attack that because it is a buzzword and an unproven theory that the pharmaceutical companies run with. Fortunately a lot of doctors are moving away from calling it this because they know it has absolutely no scientific basis. Yes, chemicals affect your mood (and all body processes when you think about it), but is it an “imbalance” that causes problems?
I’ve chosen to draw my line in the sand because I see how the pharmaceutical companies are using it to their advantage to sell more drugs. I’ve also seen the studies that show that SSRIs are no more helpful than a placebo in actual scientific studies that were not funded by the drug companies. I’ve also seen how side effects of SSRIs can made otherwise placid people suicidal and violent. So that’s why I am choosing to speak out and get the conversation started.
I’m just thankful there are those out there in the mental health “industry” who don’t fully subscribe to the “chemical imbalance” theory. Suffering with depression myself for let’s say…all my life Jackie’s article is one of these few reads that ever made sense to me. While depression may have a genetic component as to why it is more prevalent in some while not n others her “energy leaks” seems to make plausible sense. Depression is just as much as a physical stranglehold as it is is mental yet you never hear of a intestinal, heart or spleen imbalance do you? And this is why medications fail. To go about treat an illness with no known etiology with more chemicals is like trying to hammer a nail blindfolded using a screwdriver – you may have some success if you regard success in such a warped way.
Depression is too multifaceted with again, genetic, environmental, biological physical and even educational factors. Jackie seems to know this but is still so sad to know the majority of the mental health industry does not. Part of this is the insanity if the profit of big-pharma, the ignorance of therapist who are more like drones in the system knowing full well in the back of their minds that there is no cure for such a debilitating illness. Until the “industry” changes how goes about treating depression I’m afraid even with “energy leaks” it is here to stay.
Thanks for your $.02 Kristy!
I recently read a medical professional describe anti-depressant medication as being akin to “carpet bombing”. We don’t know what causes things like depression so we just bomb the brain with medication and hope we hit the right target knowing there will be “collateral damage” in the form of adverse side effects.
I believe that every single human suffers from depression at one point or several points in their lives. If it affects everyone why do we or should we call that a disease. I think it’s the body’s reaction that life is sometimes hard and painful and we don’t always life it authentically.
“carpet bombing” is a great analogy
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