What is depression? Is it simply a chemical imbalance in the brain? An imbalance of neurotransmitters resulting in low mood, sluggish lethargy and general disinterest in life’s activites? An imbalance that can be chemically corrected by medication? Or is it our mental, emotional and psychological reactions and perceptions to events and patterns in our lives that triggers this potentially dangerous unhappiness? Reactions and perceptions that can be “unlearned” and re-taught in a more healthy, realistic manner?
This is the old drugs vs. behavioral therapy debate regarding depression. Advocates of both camps believe it can be treated successfully using only one (their) treatment path. What I have always struggled with is why must it be viewed as an either/or choice? Why not see depression as a hybrid of both schools of thought? It is indeed a chemical imbalance of neurotransmitters BROUGHT ABOUT by events/happenings and/or patterns in one’s life that are perceived to be bad/sad/negative-in-some-way. Now one might immediately argue, “if they weren’t ALREADY depressed, they wouldn’t perceive those events in a negative way to begin with.” So which comes first, the chemical imbalance LEADING to the negative perception of an event, or the negative perception of an event leading to the chemical imbalance?
I know it sounds kind of confusing, so I’ll give an example. Say a man loses his job and falls into a terrible depression. Was this man already suffering from a chemical imbalance of serotonin in his brain that caused him to perceive the loss of his job as a “life-ending”, totallly devastating blow to his life, whereas a proper chemical balance would enable him to interpret this event on a more normal, even keel? OR, was the loss of this man’s job such a devastating blow to this his life that the perception of the experience caused the man’s chemical levels of serotonin (which up to that point had been normal) to become imbalanced, resulting in his depression?
I think both types of depression are out there. Those that suffer a pre-existing chemical imbalance and are prone to perceiving and interpreting the events in their lives’ as excessively negative in some way. And those who go through events or occurences which change a previously “normal” balance of neurotransmitters in the brain. However, if these depressions are never addressed or treated, they ultimately becomes one and the same. Because both types of depression have the bottom line of having an imbalance of chemicals in the brain. And even the person who once had normal levels, after going through whatever they did to make the levels alter, if nothing is done to treat or alleviate this imbalance (this depression) it will remain and they will be prone to perceiving events in their life as excessively negative. Just like the other type.
And you can’t treat the chemical imbalance without treating the person as well. This is where the hybrid aspect comes in. If a pill is just given in order to restore proper neurotransmitter levels, what happens the next time an unexpected tragedy occurs and those levels get unbalanced again? That would happen to the man who became depressed originally as a result of an outside occurrence. This man needs to also have the skills and knowledge to positively and effectively cope and deal with the realities he is facing. He needs medicine AND behavioral/talk therapy. Perhaps medicine-only treatments work for depressed patients who had a pre-existing imbalance, irrespective of any occurrence or event in their lives, but how do you really differentiate those when you get down to it?