The term "depression" is descriptive and vague. I believe the whole concept of depression is flawed and needs to be revised. "Depression” does not point to one discrete disorder but to a variety of unpleasant experiences common to all humans. When the term “depression” is used without qualification, it is usually misleading. Since antidepressant drugs have become a big business, the promotion of "depression" as an illness, treatable with drugs has become a scandalous enterprise with little or no merit.
Although the term “depression” was an invention of psychiatry the use of the term is pervasive in medicine, the media and in folk psychology. Writers, TV journalist and MD’s alike have been talking about “clinical depression” as if the word “clinical” increased the credibility of this dubious term. The best use of the term “depression’ is to point to someone who is unusually sad, critical and angry; a person who does not enjoy life and withdraws from work, play and close relationships with other humans.
Suppression and Oppression
All humans are involved in competition and negotiation with other humans. If you are losing a competitive struggle, you feel, sad and angry, sometimes with a terrible sense of loss; you want to withdraw, hide, cry and sometimes you want to die. If you habitually lose competitions or have an effective oppressor close by, you feel dysphoric often or always. We call this social inhibition, oppression or suppression rather than depression.
The symptoms are features of a withdrawal-inhibition-supplication response that occurs normally in social mammals to reduce the consequences of power struggles for dominance in a social hierarchy. Subordinate individuals in any primate group are more or less “depressed.” They have to withdraw when challenged by superior animals, supplicate and inhibit their self-serving, aggressive inclinations. All humans experience episodes of withdrawal with inhibition and supplication if someone threatens or is mean or if privileges, property or prestige are lost. Whole groups of humans experience collective depression when the group is threatened or diminished in some way. Suicide is equated with depression, but self-inflicted death is a deep and troubling human behavior that cannot be explained away as an illness. Self-inflicted death may follow loss of prestige and property and is associated either with giving up hope of desired rewards, or anger at the inequities and injustices of the “system”.
A reasonable person will acknowledge that life is difficult and suffering is inevitable. Everything we value is impermanent. Every feature of each of us is in flux and we change continuously. We age. We become ill. We suffer injury and loss. No human knows what comes next so that uncertainty is a constant companion. Modern life in cities is not normal for humans who emerged from living in small groups in natural environments and whose basic tendencies want to continue in that style of living, but cannot.
Psychiatrist, Clements observes that normal feelings and the inevitable sadness of life are often denied and turned into a disease that can be treated with expensive chemicals. She stated: “Sorrow is not recognized as part of the human condition and reactive sadness is viewed as a medical illness, a pathology rather than a normal and very human response… I confess I cry for humanity, and another person's tears tend to generate tears in my eyes too. If sorrow can be avoided, well and good. But the reality is sorrow is an integral part of the complicated system of the cosmos, and of human existence.
Depression, a vague label, what is the correct diagnosis ?
Depression as a medical diagnosis is equated with “mood disorder’ and as a problem located inside one individual. Much of the content that is included under the term “depression” has little or nothing to do with mood and involves changes in body function, cognitive dysfunction and changes in specific behaviors. The main textbook features of “depression” are withdrawal from and loss the loss of interest in job, family, social activities and personal hobbies. "Depressed thinking" is said to be pessimistic, critical of others and oneself and tends toward guilty ruminations and suicidal thoughts.
Research into the neurobiology of “depression’ has produced a bewildering display of abnormalities, not because depression is a real illness with a lot of abnormal findings, but because people gathered together under this diagnosis are a heterogeneous group with many contributing disorders. Some are just sad, lonely people with poor diets, poor living conditions, family conflict, no fun and no exercise.
It should be obvious that some people are happier than others and some people live under a cloud of doom. The reader needs to recall our basic understanding of genetics. The idea is that all human characteristics are distributed and, no matter what human feature you are considering, you will find some individuals with more and some with less. When you accumulate sufficient data and do the appropriate statistics, you will have an idea about the distribution of the feature and an indirect understanding of the genetic and environmental determinants of that feature. When researchers reported that variations in a gene they were studying more or less correlated with the tendency to become depressed, the media ran cover page stories linking the gene to “stress” to depression and promising new tests and treatments.
Helen Person in her review of the study stated: “The gene, which encodes a protein called 5-HTT, reveals its influence when people experience divorce, debt, unemployment or other occasions of "threat, loss, humiliation or defeat. People carrying two short forms of the 5-HTT gene had a 43% chance of becoming clinically depressed after four or more stressful events experienced between the ages of 21 and 26. This compares with 17% of those with two long ones… The new results also raise the prospect of genetic tests to predict those who are vulnerable to depression. But this remains unlikely, partly because there is no clear preventative therapy for those at risk. Such a test would also be unreliable. Of the two-thirds of the general population with one or two short stress-sensitive genes, only a fraction becomes depressed. Many other genes and experiences, such as physical illness, are involved. These must be identified before an accurate risk assessment can be made.”
Many of the symptoms included under the title of “depression” are typical of common food-related diseases including diabetes, atherosclerosis, malnutrition, hormonal dysfunction and delayed pattern food allergy. All these problems require diet revision. We suggest that a prudent person suffering depression and body symptoms would be wise to pursue vigorous, thorough diet revision at the earliest opportunity. Because some brain dysfunction compromises judgment learning and motivation, family members, friends and professional advisors often have to provide the right direction and support.
From the Human Brain by Stephen Gislason MD