The Mechanics of Depression ― Towards a consensus viewpoint? Or just another Icarus moment?

R3 Files Podcast ― The Success of Failure

In this installment I initially consolidate the previous sections on the nature of depression, its origins, causal factors and the relevance and theory behind anti-depressants into five main summarizing points.

The first point of summary relates to the Chemical Imbalance Theory or (CIT). Despite volumes of research already devoted to the study of depression; and the billions of dollars being prescribed each year on antidepressants, the subject matter of depression still remains a complete mystery to a range of experts. That’s because, as is the case with many other neuro-psychiatric diseases, including Alzheimer’s, precise causes of major mood disorders are still unknown.

The second point of summary concerns the communication role offered by doctors in diagnosing depression. In particular, there appears to be a clear dichotomy, whereby General Health Practitioners (GPs) are expected to communicate knowledge and understanding on mental illness, yet the etiology of depression remains largely unknown.

The third point of summary is the dichotomy of conveying hope, while also destroying confidence. That’s because, the CIT was designed as an all embracing communication tool, to inform patients that their condition is understood and that treatments are available. However, if the CIT then leads to patient pessimism in the post prognosis stage then the overall narrative of conveying hope may actually destroy the patient’s confidence, and therefore undermine long term recovery.

The fourth point of summary concerns the romantic appeal of the depressive sufferer. Uniquely, the CIT narrative comprises a compelling romantic appeal by evoking a mournful image of suffering among those experiencing depression. The idea being that biological explanations are believed to reduce the stigma and self-blame associated with depression, by appealing to powerful emotions such as suffering, guilt and shame

The fifth point of summary relates to a ‘post-CIT’ scenario and possibly finding new ways forward. Many psychiatrists have now moved past the CIT as a consensus viewpoint when contemplating the causes of depression. This is largely due to its unknown etiology and range of potential causes, as evidenced by the BPS argument which leads observers to ask; Is there potential for a renewed consensus viewpoint?

However, to arrive at a renewed consensus we are immediately reminded of the history of depression. In other words, the way we view depression in the modern context is not how it was viewed in the past. Furthermore, if it’s etymology cannot be defined neither can its true meaning. Therefore modern diagnoses are indeed subjective matters and as we know, subjectivity can be interpreted in many different ways. Instead, finding a consensus requires transforming one’s mindset and adopting practices that will allow the individual to mitigate the negative effects of depression, while harnessing some of its more positive attributes. And in the next installment I will discuss a more measured approach while sharing several areas of guidance to navigate the endless cycles of highs and lows, within the state of depression.