Depression

I get many unsolicited emails from a variety of sources on depression, most of them promoting one kind of drug or the other.


I find myself dismayed by this - not just because I am getting spam from drug companies—and who needs more spam?__but because of the misinformation contained in the messages.

One piece of misinformation is that depression is the result of a chemical imbalance in people's brains, when in the vast majority of situations, there is no evidence whatsoever to prove this assertion.

But the drug companies have been relentless in pushing this convoluted idea. And regrettably, with the help of some fancy scientific jargon, gadgetry, imaging technology and so on, they have been very successful in distorting what is a very significant psychological problem worldwide. With the help of these misinformation campaigns, pharmaceutical companies have built entire empires selling psychoactive, mind-altering drugs - drugs that often have side-effects that are extremely harmful to people. As recent studies have shown, some antidepressants actually increase suicidal thoughts in teenagers.

Drugs therefore are no panacea for depression. Considerable research evidence is now starting to prove this. It is, for example, the conclusion of the most recent meta analysis from the University of Hull in England, evaluating the findings of 46 drug studies that examined the effectiveness of so-called 'antidepressant' drugs. If drugs did control depression, it would not be on the rise worldwide despite the mass medicating of millions.

So what is depression, if not a chemical imbalance in the brain?

Depression is a very painful psychological state that is generally defined by the following cluster of symptoms, symptoms that vary somewhat from person to person, but last for several weeks at a stretch:


•Overwhelming sadness most of the day, nearly every day, as indicated by either subjective report (e.g., feeling low or empty) or observation made by others (e.g., appears tearful). In children and adolescents, this may manifest as an extended period of irritability.


•Markedly diminished interest or pleasure in most activities most of the day, for many successive days


•Significant weight loss when not dieting, or marked weight gain--e.g., a change of more than 5% of body weight in a month. A decrease or increase in appetite persisting nearly every day


•Insomnia or hypersomnia (excessive sleeping) nearly every day


•Psychomotor agitation or retardation nearly every day (i.e. restlessness and anxiety)


•Fatigue or loss of energy nearly every day


•Feelings of worthlessness or excessive or inappropriate guilt nearly every day


•Diminished ability to think or concentrate, or perpetual indecisiveness, nearly every day


•Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Why depression happens

People get depressed for a reason. Some are depressed because they are no longer able to cope with the high degree of stress in their lives, while others are depressed because they cannot seem to get themselves out of debt, no matter how hard they try. Some people are depressed because they are lonely and despite trying, cannot find someone with whom to share their lives. There are people who are depressed because they find their lives to be empty and meaningless, while others miss their kids who have moved away. Sometimes depression has to do with living with chronic illness or pain. At other times depression is about being in a dead-end job where a person has no power and is treated with disrespect and contempt.


Depression, in other words, has everything to do with the circumstances of our lives now—and only in the rare case does it have anything to do with chemical imbalances in our brain.

How can depression be cured?
We can start on the road to curing depression by first admitting what is not true, and that is, that depression is some kind of brain chemistry gone wrong. People who are depressed are not abnormal mutants and there is nothing wrong with their neurotransmitters. These people need a little help getting out of their individual situations. At times that help is simply having someone to talk to. At other times, people need more. Some may even need to discover why they are depressed because they may not even be able to articulate their emotions. After that, people need education in the management of depressive thoughts and emotions. They need training, support and skill building in real techniques they can apply to control and eradicate their depression. The plan will of necessity be different for each person because each person has his/her own reasons for being depressed. Some people may want help to redefine their lives because they are not happy with where they are. Others yet may need to find their faith, spirituality or meaning to fulfill lives they perceive as meaningless and empty. Each person requires care tailored to her individual need.

Dealing with depression takes time, patience, courage, and an honest investigation into the things that hurt and trouble us. To suppose that some pill is going to miraculously heal us of all our mental afflictions is to rely on a dangerous shortcut that does nothing to address the underlying causes of why we’re depressed in the first place.


Having said all that, let me also add that there are appropriate and necessary uses for drug therapies. As much as I oppose the rash and reckless dissemination of psychoactive drugs, mine is not a crusade against drugs in general. Along with depression I also specialize in pain management and there are many drugs that work wonders for pain. I encourage people to use these drugs to help them deal with their pain. I am not therefore opposed to the use of drugs for treatment of health ailments. What I am opposed to, however, is deception.

What Do We Really Know?

The theory of relativity showed us that time and space are intertwined. To which our smarty-pants body might well reply: Tell me something I didn’t already know, Einstein.


Researchers at the University of Aberdeen found that when people were asked to engage in a bit of mental time travel, and to recall past events or imagine future ones, participants’ bodies subliminally acted out the metaphors embedded in how we commonly conceptualized the flow of time.


As they thought about years gone by, participants leaned slightly backward, while in fantasizing about the future, they listed to the fore. The deviations were not exactly Tower of Pisa leanings, amounting to some two or three millimeters’ shift one way or the other. Nevertheless, the directionality was clear and consistent.


The new study, published in January in the journal Psychological Science, is part of the immensely popular field called embodied cognition, the idea that the brain is not the only part of us with a mind of its own.


Research in embodied cognition has revealed that the body takes language to heart and can be awfully literal-minded.


You say a person is warm and likable, as opposed to cold and standoffish? In one recent study at Yale, researchers divided 41 college students into two groups and casually asked the members of Group A to hold a cup of hot coffee, those in Group B to hold iced coffee. The students were then ushered into a testing room and asked to evaluate the personality of an imaginary individual based on a packet of information.


Students who had recently been cradling the warm beverage were far likelier to judge the fictitious character as warm and friendly than were those who had held the iced coffee.


Or maybe you are feeling the chill wind of social opprobrium. When researchers at the University of Toronto instructed a group of 65 students to remember a time when they had felt either socially accepted or socially snubbed, those who conjured up memories of a rejection judged the temperature of the room to be an average of five degrees colder than those who had been wrapped in warm and fuzzy thoughts of peer approval.


The body embodies abstractions the best way it knows how: physically. What is moral turpitude, an ethical lapse, but a soiling of one’s character? Time for the Lady Macbeth Handi Wipes. One study showed that participants who were asked to dwell on a personal moral transgression like adultery or cheating on a test were more likely to request an antiseptic cloth afterward than were those who had been instructed to recall a good deed they had done.


When confronted with a double entendre, a verbal fork in the road, the body heeds Yogi Berra’s advice, and takes it. In a report published last August in Psychological Science, Dr. Jostmann and his colleagues Daniel Lakens and Thomas W. Schubert explored the degree to which the body conflates weight and importance. They learned, for example, that when students were told that a particular book was vital to the curriculum, they judged the book to be physically heavier than those told the book was ancillary to their studies.


The researchers wanted to know whether the sensation of weightiness might influence people’s judgments more broadly.


In a series of experiments, study participants were asked to answer questionnaires that were attached to a metal clipboard with a compartment on the back capable of holding papers. In some cases the compartments were left empty, and so the clipboard weighed only 1.45 pounds. In other cases the compartments were filled, for a total clipboard package of 2.29 pounds.


Participants stood with either a light or heavy clipboard cradled in their arm, filling out surveys. In one, they were asked to estimate the value of six unfamiliar foreign currencies. In another, students indicated how important they thought it was that a university committee take their opinions into account when deciding on the size of foreign study grants. For a third experiment, participants were asked how satisfied they were with (a) the city of Amsterdam and (b) the mayor of Amsterdam.


In every study, the results suggested, the clipboard weight had its roundabout say. Students holding the heavier clipboard judged the currencies to be more valuable than did those with the lightweight boards. Participants with weightier clipboards insisted that students be allowed to weigh in on the university’s financial affairs. Those holding the more formidable board even adopted a more rigorous mind-set, and proved more likely to consider the connection between the livability of Amsterdam and the effectiveness of its leader.



As Dr. Jostmann sees it, the readiness of the body to factor physical cues into its deliberations over seemingly unrelated and highly abstract concerns often makes sense. Our specific clipboard savvy notwithstanding, “the issue of how humans view gravity is evolutionarily useful,” he said.


“Something heavy is something you should take care of,” he continued. “Heavy things are not easily pushed around, but they can easily push us around.” They are weighty affairs in every tine of the word.


The cogitating body prefers a hands-on approach, and gesturing has been shown to help children master math.


Among students who have difficulty with equations like 4 + 5 + 3 = __ + 3, for example, performance improves markedly if they are taught the right gestures: grouping together the unique left-side numbers with a two-fingered V, and then pointing the index finger at the blank space on the right.


To learn how to rotate an object mentally, first try a pantomime. “If you encourage kids to do the rotation movement with their hands, that helps them subsequently do it in their heads,” said Susan Goldin-Meadow of the University of Chicago, “whereas watching others do it isn’t enough.”

What does all this mean? It means we are guided by more than conscious thought and in fact much of how we relate to the world around us - the people, the relationships we have, how we feel about ourselves and others -  is driven by social learning, subconscious and unconscious processes and the subtle and not so subtle interactions of our bodies to the environment. 

Reading this article I think about all those times people have come into my office convinced of their grasp on reality believing they are right and the other person is wrong.

* The article was taken from the NY Times and was written by Natalie Angier.