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The Real
Causes of Depression
How many times have you heard it said, ‘Depression
is caused by a chemical imbalance in the brain’? If you’ve been depressed and
consulted a doctor it’s very likely you’ve been told this in tones of absolute
certainty. If you’ve been prescribed one of the SSRI antidepressants like
Prozac or Sexoxat you were probably told that this drug would replace the
serotonin that was missing from your brain. The SSRI drugs certainly do put
serotonin in the brain, but there wasn’t any missing in the first place. There
never has been any evidence that any brain chemical was depleted when a person
was depressed. However, psychiatrists kept hoping that one day their hypothesis
that depression was caused by a chemical imbalance would be proved to be right.
Now, thirty years after the hypothesis was first produced, the Royal College of
Psychiatrists and the Institute of Psychiatry have accepted that depression
isn’t caused by a chemical imbalance. But you’ll find this out only if you
visit their websites. They haven’t issued a press release saying, ‘We were
wrong.’
On the Institute of Psychiatry’s website there is a
lengthy notice about an important conference on depression which will be held
in April 2007. The preamble to this notice reads, ‘Depression cannot be
described any longer as a simple disorder of the brain, but rather as a series
of behavioural and biological changes that span mind, brain, genes, body – and
indeed affects both psychological and physical health.’
The website of the Royal College of Psychiatrists
has dropped all references to chemical imbalance causing depression. If you
look at the very detailed and informative pamphlet on depression made available
on the website, under the heading, ‘Why does it [depression] happen?’, there is
a statement which says that sometimes there’s an obvious reason for becoming
depressed and sometimes there isn’t. It’s different for different people. Then
there’s a list of the things that can lead you to be depressed. These are: things
that happen in our lives, such as a bereavement, a divorce or losing a job;
circumstances, such as having no friends, being stressed or physically
run down; physical illness, such as having a life threatening illness
like cancer or a chronic disease like arthritis or bronchitis; personality
which ‘may be because of our genes, because of experiences in our early life,
or both’; alcohol ‘It often isn’t clear which came first – the drinking
or the depression’; gender ‘Women seem to get depressed more than men
do. It may be that men are less likely to admit their feelings and bottle them
up, or express them in aggression or through drinking heavily. Women are likely
to have the double stress of having to work and look after children’; and genes
- depression can run in families.
All of these causes have to do with how we see
ourselves and our world and how we live our lives. This includes the possibility
that genes are involved. For many years geneticists have been saying that a
single gene cannot be the cause of complex behaviour, but only recently have
psychiatrists stopped talking about ‘a depression gene’ or ‘a schizophrenic
gene’. Genes and the multitude of proteins which genes express interact in very
complex ways. Specialists in physical illness whose genetic basis has been
identified know only too well that the outcome of the disease in each
individual depends on how the individual interprets his situation. If cystic
fibrosis, an inherited disease which shortens life significantly, is identified
in the first four years of a child’s life AND the parents meticulously follow a
daily programme of helping the child to clear his lungs, AND if the child as he
grows doesn’t fail to carry out this daily programme, then he can look forward
to a life of normal span. We all know that nicotine and alcohol can kill us,
but many people continue to smoke and drink to excess. It’s not what happens to
us that determines our behaviour, but how we interpret what happens to us.
Moreover, developmental psychologists studying
newborn babies have shown that babies born to depressed mothers become
distressed and then apathetic when their mother fails to respond to the baby’s
attempts to engage his mother in those little conversations which undepressed
mothers have with their babies all the time. Also, when parents try to
inculcate a sense of guilt in their children in order to teach them to be
socially responsible, the lessons can be learnt far too well and the child
becomes an expert in feeling guilty. Many depressed people have told me that as
children they had felt responsible for their father deserting the family or
their mother dying, and that their guilt for their failure remained as keen as
ever. Depression does run in families, but it’s not through the genes
Many people will continue to believe that their
depression has a physical cause. The one great advantage to this belief, is
that you don’t have to feel responsible for your depression. However, there is
one great disadvantage. There’s no physical cure. Psychiatrists don’t talk of
curing depression but of managing it in a way similar to the way doctors manage
a chronic illness like diabetes or epilepsy. If you see your depression as
being the outcome of how you see yourself and your world and how you live your
life then you are saying that, while you didn’t set out to make yourself
depressed, this is the outcome of what you have actually done. We often get
results we didn’t plan for. Having to take responsibility for yourself can seem
like a tremendous disadvantage, but there is a great advantage. If you don’t
understand how you created your depression, then by learning more about
yourself you can uncreate it. In the same way many people diagnosed
schizophrenic have recovered by coming to understand themselves.
The different experiences which psychiatrists call
mental illness or mental disorder begin with an overwhelming fear and a feeling
that your very self is shattering, even disappearing. This happens when you
discover that there is a serious discrepancy between what you thought you life
was and what it actually is. Mental illnesses are not illnesses but defences to
hold the person together when he feels that he is falling apart. These
desperate defences are terrible to endure but, if we are willing to learn, they
can teach us that we need to change the way we live our life. It isn’t always
easy to change how we see ourselves and our world but, as the testimonies of
many people show, it is in our power to do so.
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