Allan Macdougall

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Is depression a dysfunctional reaction to something considered 'normal', or a normal reaction to something dysfunctional?

I find it improbable that there happens to be in these modern times, a pandemic of neurochemical deficit in westernised populations giving rise to depression.

What I would like to know is:

Why is depression less prevalent in more traditional societies?

Is a neurochemical deficit (ie serotonin, dopamine etc) a symptom of depression rather than a cause? If it is, then are we mistakenly treating it as a cause? Are we treating the wrong thing by prescribing more chemicals (antidepressants)?

Is depression really an illness, or is it an indicator of something more fundamentally wrong, external to ourselves (illness in society maybe?)

  • Aug 12 2011: I believe depression is a symptom of various problems, and the neorochemical imbalances are the physical indicators of the symptom not the cause of the disease. However, because of the pharaceutical companies' need for profit and no real incentive to actually cure anything, the disease has been misdiagnosed and mistreated.

    Depression is the result of a person not being able to cope with a situation or occurence, usually because of self imposed or external unrealistic expectations. A lot of this occurs in the subconscious and discovering the source of the problemn is usually an emotionally painfull process which most of us try to avoid. Counselling or therapy can help find the root cause, and quite often the finding is the cure. All the medications do is mask the symptom.

    Our society frowns on displays of emotion or signs of weakness, when in reality, these are natural and healthy functions in the processing of our human experiences.
  • Aug 12 2011: Very interesting question concerning directionality and I believe the answer is- both. There are examples where one comes before the other. I think that it is often the case that we are merely reacting to our environments. I'll give you an example: Today we have become masters of multitasking as a result of the over stimulization and the fast-paced world around us. As a result, we have what I refer to as "self-induced AD(H)D". We have actually had to react to the world in a manner that makes us appear to have a disorder when we are actually just adapting to our surroundings. This is a very interesting topic....
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      Aug 14 2011: Over stimulation of the consciousness is dangerous - I agree. Switching that part of the mind off is very difficult, but I think it can be done - and needs to be done in order to allow the subconscious to get some 'airtime' for a change. This, I believe, is what happens in meditative practices.
      • Aug 15 2011: I agree that a balance between work and play is very important and healthy. Today we are 'busy' and 'connected' 24/7/365. Even though we may think that this is a good thing- it isn't.
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    Aug 15 2011: I remember i asked a psychiatrist a similar question that whether the chemical deficit is a symptom or a cause and he answered the symptom and cause are actually interactive with each other,hard to say which one comes first.

    I think cognitive treatment of depression is more based on the rationale that depression is a dysfuctional reaction to something normal thats where people would say why different individuals react differently to the same thing.I dont know any therapies that helps dealling with the external things in society but i know therapies that tends to look one family system as a whole and that depression is seen as a symptom of a dysfuctional family or relationships.

    I am curious how you draw that conclusion that depression is less prevalent in more traditional societies?
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      Aug 15 2011: Hi Amily. Just to try and clarify that conclusion: My brother in law is Melanesian. He is one of the most charming, grounded, wise men I know. He says that depression was unknown in his society, but is now becoming more prevalent the more westernised his society is becoming. I had the privelege of being able to visit his village and meet his extended family a while back. What really struck me was how well-behaved the children were, and how the simple the adult pleasures were of 'storying', fishing for your own food, making shelter out of rainforest materials etc.

      I'm fairly sure that other traditional societies are similar, although I don't have much in the way of empirical data to prove this.

      It's interesting what you say about dysfunctional family relationships. I think a close, 'functional' family is almost definitely a grounding influence, which can effectively prevent depression from getting a foothold. Close families effectively have a 'built-in counselling service'. But with families becoming more fragmented, we now have to pay for our counselling.
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        Aug 16 2011: Hi Allan , i wish i could visit his village like you did!(especially when you mentioned "fishing for own food"part ;-D)

        so when you say traditional societies you mean those that are less westernised?
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          Aug 16 2011: I guess so. 'Traditional Society' works for me as a description.

          Some might say 'primitive' but I'm reluctant to use the word because of it's implied negativity. They are only primitive in the material sense. In very many other respects, they are way ahead of us.
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    Aug 15 2011: Depression is a stage in the process of coping with great pain and grief like the loss of a close relative or a friend. It's the step that leads you to finally accepting the problem so I guess it's just a way to adapt as is any other neural condition. The external environment isn't as friendly as we want it to be so we have to make it such.
    Of course, levels of hormones are important but it's just as essential to realize you're in this state and deal with it with minimal outcome damage. So it's not a matter of drugs or stress level - it's how you cope with it.
    The healthier way we find - the better for us! Some people use this word very lightly saying that they are simply unhappy but it's actually much more than that!l
    I really like your point there that it can be an illness in the society itself. This is the case I believe for most of my fellow countrymen and women. We are often concerned about money and our financial income so we often talk about it - it's in fact quite regular here but in the end we have a strong network of friends that helps us get out of the black hole and this is something I don't notice in western societies.
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    Aug 15 2011: A really excellent book to read and remember is Your Brain at Work by David Rock. Chapter Seven discusses the newest findings in functional brain imaging.

    Farb "discovered that people have two distinct ways of interacting with the world, using two different sets of maps. One set of maps involves the region mentioned earlier in the scene on distractions and insight. It’s the “default network”".... One way of interacting with the world activates the "default or narrative" circuit, usually when thinking about yourself, other persons, your memories, your mistakes, your plans, your fantasies - anything concerning YOU - but it is verbal, sequential, realistic, and connotes action or judgment. It frequently becomes repetitive, self critical, and can become almost obsessively ruminative in depressed states ("Why am I so stupid?""Why did I say that?""What am I gonna do to fix this?""I am failure!").
    The other circuit or network in the brain is called the "sensory" or "direct experience" circuit. It becomes active when your mind is focused on sensory impressions coming into the brain. When you learn to attend toyour breath or count your breaths, when you do yoga (correctly) or tai chi, when you concentrate on the feeling of your legs and feet and back while walking, you are activating the "direct experience" network. This happens in Mindfulness-meditation, prayer, yoga, sports (the zone), moments of intense peacefulness, and the like.

    "A series of other studies has found that these two circuits, narrative and direct-experience, are inversely correlated.".... and MOST IMPORTANTLY when one circuit is activated (whether deliberately or unkowningly) the other circuit is 'turned off . Attentional-focus-shifting techniques can be learned easily and when practiced frequently, may restructure a brain with overused default circuitry.

    "...studies by Mark Williams (Oxford) found that the recurrence of depression could be decreased by 75 percent with mindfulness training."
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      Aug 15 2011: That sounds like an important book I should read Renzo, thanks for that.

      The two distinct ways of interacting with the world is also analysed in another book I am currently reading: 'The Master and His Emissary (The Divided Brain and the Making of the Western World)' by Iain McGilchrist. This ascribes the two different ways of interacting with the world, to the two separate brain hemispheres; the left being devoted to the sequential, verbal, logical thought processes, while the right is more concerned with the sensory, spiritual, wide-ranging thought patterns.

      McGilchrist doesn't necessary allude to this, but I am fairly convinced that there seems to be a correlation of depression sufferers who have a propensity to thinking too deeply about things, which if allowed to become too introspective, can lead to depression. On the other hand, deep ruminative thought, if external and positive, can be incredibly stimulating - almost addictive. I wonder if this, if true, has any relationship towards bipolar type depression?
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        Aug 15 2011: I believe the "thinking too deeply about things" that you cite is called rumination, and is a common symptom in depression (not saying whether it causes or is a result of 'depression'). Then we butt up against the same old question of changing the causes of disease or the results of disease (???). I don't know which it is but the correlation is quite high. Many modern mental health theorists believe that changing 'the thinking' changes 'the depression' (relieves it): thus cognitive behavioral therapy, mindfulness techniques, emotive behavioral therapy (neurolinguistic programming), rational emotive behavioral therapy and many other recent permutations.
        I suspect that connections to emotive centers that experience pleasure (since the opposite is clearly in scope here) is also part of the wiring of the brain, at least for some of us. Those of us so gifted experience deep thinking as stimulating and 'good' in, and of, itself. (that's me too).
        Whether these connections are formed by the time of birth (or determined ahead of time genetically and epigenetically) OR purely environmental (teach your baby to be happy smart and productive), is completely or nearly unknown.
        Thanks for the other book recommendation. I am researching it.
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    Aug 15 2011: I 'believe' that depression is caused by our not (any longer) having to work so constantly and hard to stay alive. Now our physical labor is minimal compared to the hundreds of thousands of years of years (or millions) we spent as hunter gatherers before we got to this point. Altered neurochemical balance is probably a symptom of depression, much as fever is a symptom of malaria: but we treat the fever because IT causes damage beyond the malaria organisms themselves. Marcia Angell, MD (former editor of the New England Journal of Medicine) wrote a recent two part review of three books in the New York Review wherein she discussed this very issue, pointing out (by way of quoting from one of the books reviewed) that most of the clinical trials of antidepressants are woefully inadequate at proving that they lessen depression. They rarely do better than a few percentage points better than the PLACEBO in the trials at alleviating depression. In fact the FDA has guidelines now that any new antidepressants MUST show 5% MORE more improvement in patients than the placebo to get licensed for use in the US. Not twenty percent or fifty percent ---- just 5% more than NOTHING. If penicillin performed that badly in meningitis we would not have started using it. She wonders aloud in the review if we have made a very enormous mistake in going down this road of treating neurochemical abnormalities without KNOWING for sure that normalizing them will cure depression.
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    Aug 14 2011: Modern life is restrictive and dull. If people cut loose more often and acknowledged and accepted their more primitive drives in an appropriate context, there would be less of it.

    "Depression is rage spread thin" George Santayana.

    Bring back the Saturnalia..
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    Aug 13 2011: Thank you for your insightful comments. Please keep them coming - I'm really interested in hearing your views about this debilitating condition.
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    Aug 13 2011: Having experienced depression myself, I have to say both physical and emotional.
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      Aug 14 2011: What have been your strategies for overcoming depression Helen? I hope you don't mind me asking - are they strategies applied through direct conscious effort, or was it more to do with something more subliminal (ie maybe putting yourself into a favourable position where depression is likely to be overcome)?

      I guess this is the difference between directing the course of depression by using stimuli external to self, and/or the encouragement of something innately held in our subconscious.

      My own strategies include both. When I feel myself going downhill fast, I gravitate towards the somewhat perverse strategy of listening to 'dark' music, reading dark novels, appreciating dark works of art etc. It seems to match my mood at the time, plus there is the comfortable assurance that someone else has been there before too.