The British Psychological Society continues to lead the way in our understanding of human suffering. In its October 2020 report, readers are given an up-to-date primer on what is meant by the term ‘depression’.
Here are some highlights.
The Most Important Message
The most important message of this report is that depression is not a disease but a human experience: a complex, understandable set of psychological responses to the events and circumstances of our lives. It is understandable in both evolutionary and psychological terms and has a function: it often tells us that things need to change in some way. When we are depressed, we don’t necessarily need ‘treatment’. However, we may well need practical support, and perhaps help to make changes – both small, short-term ones to help get ‘unstuck’, and sometimes larger ones too.1 (emphasis added)
Debunking the Myth of Chemical Imbalance (For the Nth Time)
Neurotransmitters are chemical messengers in our brain and central nervous system. Many people assume that depression is caused by an imbalance of these chemicals. For obvious reasons, it is in pharmaceutical companies’ interests to promote this idea. One company’s website states that ‘Clinical depression… is a serious medical condition… believed to be caused by an imbalance of chemicals, called neurotransmitters.’ Although often reported uncritically by the media, this view is not currently supported by the evidence.… Our brain chemistry is different when we are happy, or in love, bored, irritated or sad, or when we are looking at a face or a tree. The undoubted existence of biological aspects to all human experiences, including low mood and despair, does not itself tell us anything about what causes them, or justify categorising them as brain disorders.2 (emphasis added)
‘Antidepressant’ is a Misleading Term
Psychiatrist Joanna Moncrieff has suggested that the term ‘antidepressant’ is misleading, pointing out from her detailed examination of research literature that there is no evidence that the medication corrects any biological abnormality. She has argued that taking these prescribed drugs actually creates, rather than corrects, an abnormal brain state. This, she argues, may help people to cope with some of their difficulties, in the same way that alcohol or sedatives may temporarily lessen social anxiety, but it does not solve the underlying problem. Moncrieff accepts that medication can sometimes be helpful for people who are in distress, but points out that it does not ‘cure’ depression in the way that some physical illnesses can be cured – and that it doesn’t help us to understand or address the reasons that a person became depressed in the first place, or what is keeping the depression going.3 (emphasis added)
Consequences of Psychiatric Drugs
Worryingly, research has found that a significant number of people have difficulty stopping the drugs because of withdrawal effects, which can be severe and long-lasting. Being prescribed medication may also reinforce the idea that people are ‘ill’, and that it is medication that makes things better. This can give the misleading message that there is little that people can do to help themselves and each other.4
What Can Help?
The report highlights physical health, social support, practical problem solving, meaning and purpose, and psychotherapy, as paths towards improved well-being.
Looking after your physical health is an important first step: exercising, eating well and cultivating good sleep habits.
Our friends, family, colleagues and communities are often the most important sources of support and help.
If there are practical problems to be solved, for example at work or school, or if people have experienced abuse or financial difficulties, these should usually be addressed first. It is important for professionals to help with practical as well as emotional issues.
Issues of meaning are often central to depression. For some, this is expressed through their questions around spirituality.
Psychological therapies are helpful for many people and so it is a good idea to try them if they are made available.5
If you are considering counseling but aren’t sure where to start, see my article Choosing a Counselor.
Footnotes
- Division of Clinical Psychology. (2020). Understanding Depression: Why adults experience depression and what can help. Leicester: British Psychological Society, p. 51.
- Division of Clinical Psychology, 2020, p. 37.
- Division of Clinical Psychology, 2020, p. 43.
- Division of Clinical Psychology, 2020, p. 44.
- Division of Clinical Psychology, 2020, p. 50.
