depression - person sitting alone

Let’s expand our view of depression

In Community and Relationship, Health and Healing, Health and Nutrition by Michael YapkoLeave a Comment

Depression is more a social problem than a medical one, and no purely biological cure will be found for it any more than biology alone will cure other social ills such as poverty or child abuse.

The costs of depression on a variety of levels are huge. Marriages and families splinter and individuals suffer. Societies suffer the consequences of the often destructive behaviours of people coping badly or not at all with their depression. Businesses suffer the negative effects of employees too disabled to function properly. The economic costs of greater health care expenses are greater for depressed patients. There is the also the tragedy of suicide – lives lost to despair and apathy.

Depression is a terribly disabling disorder, and despite significant advances in treatment, the problem continues to grow.

Depression is a multi-dimensional disorder

It has biological components based in genetics, neurochemistry and physical health.  It has psychological components that involve many individual factors such as cognitive style, coping style, and qualities of personal behaviour. And, it has social components, factors that are mediated by the quality of one’s relationships, including such variables as the family and the culture one is socialised into, and one’s range of social skills. The best, most accurate answer to the basic question, “What causes depression?”, is, “Many things”.

Currently, the medical model of depression receives the greatest attention for a variety of reasons

The pharmaceutical industry in particular has invested literally billions of dollars to promote the view of depression as a disease caused by a neurochemical imbalance that requires medication to manage. The lion’s share of research money goes to drug research, further elevating drugs to the status of being the principal source of hope for everyone who suffers depression. As a result, antidepressants are among the most widely prescribed medications and are considered a first-line treatment approach, de-emphasising the value of psychotherapy despite its equal rate of success  in treatment, and even greater success in the area of prevention.

It may sound extreme to some who think only in biological terms, but I stand by this statement:

Depression is more a social problem than a medical one, and no purely biological cure will be found for it any more than biology alone will cure other social ills such as poverty or child abuse.

This is not to say that antidepressant medications shouldn’t be a part of treatment

Especially in those specific instances where there are clear benefits medication can provide over psychotherapy. Rather, medications should be used much more selectively and with an associated recommendation for a well-considered skill-building psychotherapy.

The social side of depression is especially important

Yet this factor is terribly under-considered in most people’s consideration. We know, for example, that depression runs in families. The child of a depressed parent is anywhere from three to six times more likely to become depressed than the child of a non-depressed parent. The genetics research makes it quite clear that it isn’t entirely – or even mostly – faulty genes responsible, especially since there is no known ‘depression gene’. It has more to do with the patterns of thinking, coping, behaving, and relating that parents (and other significant role models in our society) model day-in and day-out than it does one’s genetic makeup.

When you have the largest demographic group of depression sufferers – those aged 25-44 – now raising children, it should surprise no one that their children are the fastest growing group of depression sufferers.

After all, parents can’t teach their children what they don’t know

Furthermore, the more distressed one’s marriage, the more likely one is to either already be or to become depressed. The quality of one’s marriage is a very large risk factor. Yet many people never consider how powerful a good marriage can be in helping insulate its members against depression.

These points provide excellent reasons to want to strengthen parents and marriages, something no antidepressant medication alone can accomplish. To think of depression as only an individual’s biochemical disorder does not serve. He or she is a product of powerful social forces that operate in families, organisations, and cultures. To reduce depression even further to a purely biochemical phenomenon, is so terribly reductionistic. It disempowers the very people who need help changing their lives, not just their brain chemistry.

It’s true: You are more than your biochemistry.

About the author
Michael Yapko

Michael Yapko

Michael D. Yapko, Ph.D., is  a clinical psychologist widely considered an expert on treating depression. He is the author of a dozen books, including Depression is Contagious: How the Most Common Mood Disorder is Spreading Around the World and How to Stop It, Breaking the Patterns of Depression, and Hand-Me-Down Blues: How to Stop Depression From Spreading in Families. www.yapko.com

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