Is Depression a Disease of the Body or Mind?

Clinical depression is a serious, often fatal illness that is so common that it's hard to see. Researchers estimate that more or less 20 percent of the population meets the criteria for some form of depression at any given time. And that doesn't mean people who are momentarily feeling the blues and will be better next week, but people who are having sincere difficulty functioning in life.

Depression is extraordinarily under-diagnosed. Sundry people don't recognize they have it. Often times, people report they have disturbences sleeping and have other physical symptoms, feel nervous and overcome, have lost determination and hope, feel alone and alienated, are tormented by guilt or obsessive thoughts, may have thoughts of suicide etc., but don't say they're depressed. They just feel that life is miserable and there's nothing they can do about it. They go to their doctors for aches and pains, sleeplessness, lack of energy and they get a ineffective prescription or medical procedure or get dismissed as hypochondriacs. They may medicate themselves with alcohol and drugs. Their families don't know how to comfort; neither sympathy nor moralizing seems to have any impression. The depressed person is stuck in in a wild circle from which there appears to be no escape.

While there are numerous things that can't be helped within mental health, depression happens to be one thing that can typically be treated effectively and efficiently. Estimates are that when people are treated straightaway, 90 percent of them will recover. New medications are rather helpful, with hardly any side effects. Psychotherapy and medication together have been reliably determined to be more helpful than either alone.

Depression can be a confusing condition. There is a great deal of value in thinking of it as a ordinary physical disease. For one thing, it responds very well to medication. Seventy percent of patients who take medication for depression state they begin feeling better. Further supporting the disease model is the finding that the brain chemistry of depressed people is different from that of other people; and it is possible to discover the same biochemical differences in the brains of animals who seem depressed. On a human level, helping people who are depressed understand that they have a disease can free them from much of the guilt and self-blame that accompanies depression. They can learn diverse ways of reacting to stress and learn to get involved more quickly with medication so that the threat of future episodes is greatly reduced.

But if it's a disease, the question is, how do we catch it? The onset of depression is almost permanently connected with a particular incident in a person's life, and not necessarily physical contact with another depressed person. It is consistently associated with old and upsetting memories, a history of abuse, and a failure in relationships.

Depression looks to be a disease both of the mind and of the body, the present and the past. In psychiatry, there are two sides of thought - those who want to treat the brain and those who want to treat the mind. Both sides have impressive motives for pushing their own theories, but unfortunately the patient is caught in the middle. The family doctor, supported by the pharmaceutical industry, is likely to say, "Take this pill", but when it doesn't work; the patient just has another in a long line of failures to add to his baggage. The mental health professional is expected to say, "Let's talk about it", and the patient is likely to feel patronized, misunderstood, because, how can purely talking cure such terrible pain?

It's not an either-or question. Both ways of thinking are true. Both points of view have much to contribute to helping the depressed person and their family. Both also have a lot to teach people who simply want to raise emotionally resilient children in a challenging world.

There is a biochemical process in depression, but the individual has been made susceptible to depression through life experiences. The current episode may be precipitated by an external event, but the event has set in motion a change in the way the brain functions.

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Depression Treatment