Scientists: Depression is not caused by a chemical imbalance. Treat the cause!



Here is a recent article [click here for article] reporting on the fact that there is no scientific evidence for (and good evidence against) the popular idea that depression is caused by a chemical imbalance. According to the "chemical imbalance" idea, depression occurs when the brain has low levels of the neurotransmitter serotonin. This idea has been used in many ads for prescription medication. But, as the article explains, it's not based in reality, and goes against the evidence. While medications such as Prozac and Zoloft are often very helpful, the article highlights how people who have been led to believe that depression just happens when chemicals are out-of-whack, feel a sense of helplessness and loss of control, which makes depression worse.


Depression demonstrably occurs due to events and the way they are processed, and before TV ads for drugs, this was the common perception based on everyone's experience. In my entire career, I have never encountered someone "born with depression." Some people have a higher natural level of emotional instability (trait neuroticism in the "Big 5" theory). But this is not something that cannot be overcome, and it's certainly not the cause of depression. Furthermore, it is cruel to suggest that someone's personality type is somehow inferior or means that you have less of a call to personal responsibility in your own healing and growth.


What causes depression? A sense of meaninglessness, either about one's own person, or the world in which one lives. How can this happen? One common reason is trauma.


Trauma creates parts of the self--part(s) doing everyday life, part(s) stuck in the trauma--that fracture along the lines of mental defenses (such as fight/flight) when these defenses are thwarted. A common defense system is "shutdown," in which natural opioids are released in the brain to prepare for death. When someone is totally helpless in a terrifying situation, but lives, the fractured part that has entered shutdown is still there, separate and seemingly out of control--sometimes present, sometimes not. The trauma victim who feels depressed is feeling the meaninglessness of trauma, as this part is constantly preparing for death. The trauma victim has often been told by an abuser that they were not good enough, or "had it coming." Children, desperate for attachment, cling to the abusive parent in the only way possible--by accepting this lie. As a result, this traumatized part of self can feel worthy of suffering, or even deserving of death. This condition is worst when the abuse or neglect is chronic and in childhood. These actions are not conscious, and are unlikely to be changed much by traditional therapy. This needs attachment-focused trauma therapy.


Depression is often the result of a death, and this can be related to trauma, and the "stuck" emotions and beliefs that need to be released. A soldier may feel responsible for a friend's death in combat for many reasons, and may feel the need to suffer either as punishment, or from a fear that if he recovers the friend will be forgotten. This might not be PTSD, but it can be much worse. Grief gets more complex when the stuck emotions are related to the death of an abuser--in this case, grief can feel like a crime. One client said, "If I heal, I'll stop hating him, and he needs to be hated." A recent development in EMDR is a formal way of using it in grief therapy. But all trauma treatment is grief therapy--having parts of the self stuck in "trauma time" and still experiencing traumatic emotions, is unfinished business that needs to be grieved and placed in the past.


Take a look at the posts on the blog related to EMDR. To live in the present, it's necessary to revisit the past--to place it where it belongs and makes sense, especially if what happened was horrible.