An Epidemic of Depression
Our society is in the throes of a virtual epidemic of depression. The numbers are quite staggering. More than twenty percent of the American population will experience at least one episode of what we refer to as clinical depression. We need to look deeper into this phenomenon to understand it and overcome it. My contention is, firstly, that our cultural values and memes induce us to live in ways that are, indeed, depressing. Secondly, much of what we refer to as clinical depression is inaccurate. Most depression is situational. The symptoms of depression are often due to depressing circumstances, not disease. In other words, under certain circumstances, it makes sense to be depressed.
Have We Lost Our Way?
Many of us live dulled lives, somewhat robotic in nature and devoid of deeper meaning and purpose. Our lives, often become visionless and passionless. We live in an intensely competitive culture that rewards achievement and success. Our identity and esteem become reflections of these external markers of achievement. Our pursuit of happiness and well-being become terribly misdirected. The demands of our intensely and neurotically driven culture strain our emotional and psychological balance well beyond its comfortable balance. The cultural paradigm in which we live leaves us disconnected, disenchanted and isolated. When this occurs, we tend to honor and seek material acquisitions at the cost of devoting ourselves to intimate and loving relationships – with others and ourselves.
People that thrive in loving relationships don’t typically feel depressed. Depression is symptomatic of feeling isolated and cut off. In our drive to live the good life, we typically isolate ourselves from relationships that might nourish us. Intimate and loving relations have become somewhat marginalized and have lost value in our very hurried lives. Our frenetic pace of life sees one day blur into another, until life begins to lose its meaning. We don’t have time to nurture our loved ones or ourselves, and we lose our vision of a well-spent life. In fact, the problem is that we don’t know how to live well.
Are People Dysfunctional?
Our therapeutic community attaches labels such as dysfunctional to people and families. People are not dysfunctional; social systems are. People suffer and experience pain. We are human beings, not machines that dysfunction. Such terminology expresses contempt for the human spirit. A society that produces such staggering rates of depression is dysfunctional. Our culture has created this epidemic.
Part of the problem is that we become corralled into a consensus of belief that does not serve our higher purpose. The desire to fit in and conform induces us to lose our inner voice. We are products of a cultural belief system that ignores or devalues matters of the heart and then turns and points its accusatory finger at those who suffer. When we do so, we victimize the victim. If we began to look at the depression as symptomatic of living depressing lives, we’d begin to understand that the cure lies in addressing what our souls are longing for. When we suppress the voice of our soul, depression arises. Depression surfaces for a reason. The symptoms of depression are crying out for our attention. The epidemic of depression is simply indicative of lives lived errantly, without joy or purpose.
People who feel passion for their work and friends and love their families and partners don’t become depressed as often as the population at large. People who are in touch with their spirit and enjoy a sense of community don’t incline toward depression. People who maintain a sense of wonder and awe don’t become depressed. Depression isn’t the enemy. It’s simply a warning sign that we’re not on the right path. Our disconnection and folly pursuits of happiness may have much to do with this.
Before the advent of modern psychotherapy, and well before the pathologizing of the word “depression,” we would refer to such symptoms as melancholia. Life would bring certain periods and events in which one might feel some melancholy. Sadness is appropriate at times. When people experienced such sadness, friends and family may have supported them through the difficult times. But they weren’t told that there was something wrong with them. Loving support is the most powerful agent in the treatment of depression. When we lose our compassion and relegate depressed people to their diagnosis, we tend to dehumanize them.
Is Our Society Manufacturing Depressed People?
A dominant theme in our society is that you should be happy, and if you’re not, there’s something wrong with you. Life can be difficult at times. It is in the labeling of people as depressed that the greatest injustice is done. I’m not suggesting that there aren’t people who are indeed clinically depressed, but simply that the indiscriminate manner in which diagnoses are meted out to people without proper discrimination is grossly absurd. When clinical diagnosis of depression is made in the astronomical numbers we witness in American culture, it speaks to something much larger: A society that has lost its way.
If we see depression as a signal that something is off, we might use the depression to catalyze positive change. Very often depression makes perfect sense. In my practice, I often treat individuals who are being abused, living in loveless relationships or suffering from loss. Depression in such instances seems quite appropriate. Rather than treat the depression, I prefer to assist these people in coming to terms with their life challenges. It is essential to treat the person, not the depression. We must come to understand how the depressed person struggles contextually in their lives and to appreciate their particular struggles and challenges. We must, at all costs, refrain from reducing them to a clinical compilation of symptoms.
Situational Depression
In some instances, depression is situational. Loss of a loved one, illness or job loss creates circumstances that are painful. Working through the loss is more healing than medicating the pain. It is essential to address the underlying causes and not simply suppress the symptoms. The difficulty is that in our quick fix mentality, we believe that if we can suppress the symptoms then all is well. When we come to see depression not as the enemy but as an expression of struggle, the epidemic will likely subside as we come to honor the integrity of our human spirit. We do not ordinarily grow without engaging struggle. So the irony is that by medicating our symptoms with psychotropic medication, we ensure continued stagnation, for the struggle is never resolved toward a breakthrough; it is merely placated.
Gary Greenberg, in Manufacturing Depression, suggests that depression as a clinical disease may indeed be manufactured. He references best selling psychiatrist Peter Kramer’s assertion in Against Depression that “depression magically skyrocketed after the drug industry introduced SSRIs and that diagnostic criteria can’t distinguish between depression and grief.”
My thesis is, therefore, twofold: Much of what we call depression is a typical life struggle around loss, fear and grave situational issues that have become clinicalized for profit. Yet, there also lies a deeper despair that accompanies living an incoherent life, as a stranger in a strange land. What I am strongly asserting is that depression, and anxiety for that matter, are the most likely outcomes of living in and with the unmerciful and misguided constraints of a tired and destructive worldview. Our constructed reality is for many people depressive and anxiety inducing. Feeling as such ironically suggests that many depressed people are merely mirroring the affects of a somewhat incongruous, if not insane way of living, fostered by the society itself. In effect, the way that we are living is producing tragic results.
Mel, one thing I have observed living in a country like New Zealand where rugby, racing and beer are the sense dullers, I notice that many people get depressed when life fails to work out as expected. I know in my brief bout of depression, it was because everything I tried seemed to get screwed up. It was a tough year when many things I believed were challenged on ALL levels. And for many people I see around me suffering anxiety and depression, it seems to result from expectations and plans going awry despite all their best endeavors.
Roberta,
And to add to your thoughts I find many people become depressed from a total lack of any expectations or vision. Not reaching your expectations should be disappointing and at worst temporarily depressing. Might that warrant a reconsideration of the expectations at times and at other times understanding why we let ourselves down?
I have been in the field of Psychophysiology for 38 years, and am surrounded by brilliant Clinicians. Here are their opinions, about treatment – “Don’t have it ‘Done to You’ – ‘Discover Yourself’!
Neurofeedback Software Provides a Fast and Simple Assessment Method for ADHD in Adults and Children as Young as 5-Years Old
The BFE has just released a new ADHD Assessment software suite for use with the ProComp Infiniti system. The suite was designed by a team of clinicians led by Dr. Vincent Monastra and Dr. Joel Lubar and is based on the hallmark study published by Monastra, Lubar et al. 1999.
ADHD, neurofeedback
“The software consists of age-appropriate assessment scripts, during which the client performs a reading, listening, drawing and/or working-memory task.”
François Dupont, Ph.D., senior software developer and key member of the ADHD Suite design team noted, “The software consists of age-appropriate assessment scripts, during which the client performs a reading, listening, drawing and/or working-memory task. Statistics are monitored throughout the assessment from a single EEG-Z sensor and the results are arranged in an excel report. The excel report includes notes and norm values for easy comparison and interpretation.”
Neurofeedback and ADHD
Asked about the use of neurofeedback for ADHD, Northeast Regional Biofeedback Society president Cindy Perlin replied, “Recently a 7 year old boy was referred to me. He had been prescribed Concerta six months before for hyperactivity and explosive behavior. After starting Concerta, he began to express violent and suicidal ideation and behavior that are known side effects of stimulants. The response of the psychiatrist was to keep him on Concerta and also put him on Zoloft. Neurofeedback is a much safer, more effective and more permanent solution to treating ADHD than stimulant drugs, and should be much more widely used than it is now.”
According to BFE President Dr. Erik Peper, “The evidence is overwhelming in meta analysis that the medication for ADHD has zero long term efficacy and inhibits growth. A superb description of the dangers and harms of medication is in the book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker.
Supporting Research and Education in Neurofeedback
Dr. François Dupont is a registered psychologist with competence in general, health, and rehabilitation psychology. In his private practice in Ottawa, Canada, he often combines bio/neurofeedback with techniques borrowed from cognitive-behavioural, dynamic-humanistic and experiential approaches. Involved with the BFE for more than a decade, he has developed a variety of neurofeedback software suites.
When asked about different approaches to neurofeedback assessment and training for ADHD, Dr. Dupont commented “There are many different approaches supported by the BFE. At the core of the BFE-LFB program are a number of very dedicated and talented leaders in the field who have shared their expertise.” In addition to Dr. Monastra and Dr. Lubar’s ADHD Assessment, the BFE has published software on other methods including Setting Up for Clinical Success and Specialized Application Scripts by Drs. Michael and Lynda Thompson, Dr. Paul G. Swingle’s ClinicalQ and BrainDryvr, Peter Van Deusen`s The Learning Curve (TLC) and Dr. Dupont`s own Integrated Neurofeedback.
“An important question to ask is what kind of research supports a specific approach and how do you select the most qualified neurofeedback provider in your area? The BFE offers members of biofeedback and neurofeedback societies opportunities to affiliate with the BFE ADHD team to learn how to apply the proven methods developed by the best practitioners in the field.”
Mel – This is, as always, such a well-written posting. I have to say, however, that it seems uncharacteristically off-the-mark with regard to the core philosophies that I am used to reading from you (your and my perspectives tend to align fairly consistently, in my brief experience contemplating yours).
I cannot and will not go so far as to say you’re wrong (on the contrary, I’m trying not to be judgmental here); however, I believe you are passing up the opportunity to highlight some truly relevant points that should be brought out in this topic. Let me elaborate.
One of your commentors (Donna) mentioned the symptom of hopelessness. I am not a qualified psychologist, but it seems to me that this sense of hopelessness must be a very common attribute of clinically depressed individuals. Perhaps you could comment on whether there are data to support this. But from my perspective, this is a vital point that should be addressed, and that you seem to have omitted in this article.
Consider the opposite(s) of hopelessness: a hopeful, confident, positive, optimistic sense of can-do, independence, enthusiasm, and so on. From my experience, folks who exhibit these complementary qualities are those who are strongly oriented in a sense of self-efficacy. They feel empowered to solve their own problems (not to mention pro-actively and responsibly avoid getting into many problems in the first place), rather than sitting around passively letting the world “happen to them” and live their lives in reactive mode.
At some point in one’s life, we all need to assimilate a sense of personal responsibility and resilience. If individuals are more purpose-driven, and less situation-driven, they tend to be masters of their own fate. I don’t mean to undervalue what you’re saying about society here, but aren’t you somewhat allowing people to “blame” their depressed circumstances on “society”…and simply assume the role of “victim” in their lives?
I’d be intrigued to hear more of your elaboration on this, and forgive me if I missed a point that you may have made in this regard. That said, I always do, and will, look forward to reading your perspectives in these excellent postings of ideas.
Charlie,
Good questions indeed. The last thing that I’d intend is to leave people feeling helpless. The intention of this post is to firstly illuminate why many people are in fact, not clinically depressed but more situational. Yet, many people who are clinically depressed are indeed that way because they are victims of an incoherent worldview in which their role in life is dis-empowered, without vision, meaning or purpose. The path for such people is to reclaim their identity and find meaning and vision. How does one do that?
I find it most helpful to see reality operating differently. This is a mindshift in which we see our identity as evolving, not fixed. Furthermore, the emerging sciences depict a universe which is perpetually flowing and emerging, in which all is potential ready to be actualized.Why not jump into that worldview? To enable that shift, we must look at our beliefs that restrain us and our thoughts that keep us stuck in a groove..All achievable once we set the intention.
Agreed, Mel. Those are very achievable, with the caveat, as you suggest, that the intention is set and the mindset can be shifted. This conjures up the research of Carol Dweck around growth (vs. fixed) mindset orientations. These seem to coincide with the construct you’ve described here. I also see this related to “innovativeness,” to the extent that an individual can obtain, and retain, a worldview that they can create new value (in their own lives, in virtually any context) at will…as opposed to those who have no consciousness of this ability, and thus do not see their ability and power to choose to do so as an available option.
I’m wondering if you have had similar thoughts about the depression continuum being somewhat analogous to the innovation continuum. The dynamics of this, I see, exist within a common framework, one that I refer to as Value-Driven Thinking. If you have 15 minutes, you can view my description of this, accessible via my LinkedIn profile. Otherwise, I do agree with your current Rx.
EXCELLENT.
Mel
Great article! Just last week I had a “medical necessity” review which left me angry and frustrated having to deal with a medical model that has little room for anything but symptoms. It’s great to hear their are others out there who are giving an alternative perspective because changing people’s minds both individually and culturally is in the hands of behavioral health professionals.
Thanks
Jeff
I couldn’t agree more Jeff