Dr. Matthew Edlund tells us:

Too Many Are Depressed

Depression is one version of hell on earth, and Americans have a lot of it. A recent international study run by Evelyn Bromet of 18 countries found America near the top, with 19.2 percent of the population having experienced depression -- only France, at 21 percent, ranked higher. With our tottering health care system and vigorous arguments that antidepressants are useless, what are people to do?

Lots. Recognize that a stalled body and a stalled economy have much in common. They can degenerate or reinvent and regenerate themselves to survive and thrive. Depression is a systemic, whole body illness -- its causes are multiple, its manifestions endless and its treatment multi-faceted. As Jonathan Himmelhoch and others have argued, depression represents an overall failure of the human body to adapt.

It's time to adapt a new way of looking at the human body -- one that aids us to heal ourselves.

Systemic Causes

When you're depressed you can't think, and you can't sleep. Your IQ drops, you're tired in your bones and you become convinced this horror will never leave -- and nothing will make it better. No wonder depressives were burned as witches in 17th century England and New England; the transformation of the person is so total only devils could have done the work.

And the causes? More than you can name.

People with pancreatic cancer can become severely depressed months or years before the tumor is found. Hypothyroidism can lead to depression, as can adrenal insufficiency, strokes, heart attacks, rheumatoid arthritis, child abuse, job loss, loss of a loved one, a football player who breaks his leg. The medical causes can fill a textbook, and the social ones can and do break your heart.

Systemic Effects

It's no wonder the World Health Organization labels depression as the No. 2 cause of worldwide disability by 2020. But the medical problems alone are legion, as a recent study of depression and strokes demonstrates. From a medical cost standpoint alone, costs are a doubling of mortality and illness in a younger group right in the prime of life. Beyond the increased rates of coronary artery disease, diabetes and osteoporosis, there are changes in systemic inflammation, overall immune response, increased visceral fat, ineffective fibrinolysis (http://ajp.psychiatryonline.org/cgi/...ll/159/11/1826.) The lack of adaptation inherent in depression causes more than the loss of jobs and the frequent end of marriages; it makes people physically sick just as they lose their hope to get well. http://www.psychologytoday.com/blog/...s-treat-it-way

He concludes:

Depression represents a global failure of adaptation. The body does not regenerate the way healthy bodies do. But there are many ways to treat this scourge, and to prevent it. And many of these treatments -- whether they're bright light boxes, physical activity or cognitive-behavioral techniques that allow the world to be seen in terms of solutions rather than problems -- also promote systemic regeneration.

So when you're depressed, remember this: almost everybody gets better. And there are many ways -- more than we imagine today -- to get better. Some involve drugs and therapists, but many engage friends, family, nature, the community, sunlight and walking. And by regenerating people out from the abyss, we can also regenerate their work, their creativity, their homes, families and communities.

There's a lot more to treating depression than arguing whether drugs or psychotherapy are superior. A systemic illness affecting at least a fifth of the population requires systemic treatments - now.

In between, Dr. Edlund discusses a number of ways to treat depression systemically, none of them particularly new. For me the article affirms that the depressed must do to get better.

http://ajp.psychiatryonline.org/cgi/reprint/159/11/1826

[Perna]

Yes, I'm always amazed by people who decide there is a "single" cause/way of treating depression like it was only one- or two-dimensional.