How many “cures” are there for depression?

Before going into class on Wednesday, although many people had expressed how much they had enjoyed the paper from Nestler and Carlezon, I had not really enjoyed it that much. I think this is because of how uneasy it made me feel about how much we don’t know about depression. I feel like we’ve been pretending that we know a lot about this disorder, and even though we do know a significant amount about it, we also don’t know a significant amount about it. There are so many other areas of the brain and neurotransmitters and neural pathways that are linked to this disorder, and I guess I just found it all frustrating before we discussed things in class. However, I now appreciate the article giving light to this issue, as hopefully it will help us to better determine the causes for depression, and to develop better cures/antidepressants that have less side effects and lead us to new therapeutic ideas.

So far, we’ve learnt that serotonin, the hippocampus, dopamine, the nucleus acumbens, the ventral tegmental area, neurons, glial cells, and multiple proteins effect depression… will there ever be a day that we will be able to regulate all of these to alleviate depression? I was interested in whether or not therapy or psychotherapy would be a better cure for depression than pharmacology, but it appears that’s not the case according to Cuijepers et al. (2010). However, I feel like everybody experiences depression in varying degrees and cases, and so perhaps for some people, psychotherapy could work just as well, even though it may take longer (18 treatment sessions (Cuijepers et al, 2010)).

So I decided to look and see what the web had about “cures” for depression, and I found this website pretty interesting: http://www.anxiety-and-depression-solutions.com/wellness_concerns/community_depression/011905_depression_real_cure.php

This woman believes that depression can rise from dysfunctional relationships in your CHILDHOOD! Sound a little Freudian? Will understanding how to deal with relationships really cure depression? This sounds a little crazy to me, considering all the neurobiological evidence that has been found with the imbalance of chemicals in one’s brain and the neuroanotomical changes in the brain due to depression… but could depression be a social issue?

References: Cuijpers, P., van Straten, A., Schuurmans, J., van Oppen, P., Hollon, S.D., & Andersson, G. (2010). Psychotherapy for chronic major depression and dysthymia: A meta-analysis. Clinical Psychology Review, 30(1), 51-62.

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8 thoughts on “How many “cures” are there for depression?

  1. What an interesting website. It is not supported by empirical evidence and seems more like an opinion website. I agree, there are so many facets in the brain that can be attributed to the cause of depression but I think there is a lack of evidence supporting childhood abuse resulting in depression, especially only childhood abuse. I think depression is a combination of social and biological issues, comparable to the nature/nurture debate.

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  2. I liked your perspective on this entry, Natasha. I think we have to consider the consequences of becoming overconfident in what we think we know but I also think that we do know a lot. Hopefully we can recapture that feeling a bit more in tomorrow’s class. 🙂

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  3. After taking a sociology class on mental health and illness last semester I’ve begun to question our system for classifying mental illness and the way that that system contributes to misconceptions about disorders. For instance I think that it’s entirely possible that destructive relationships contribute or even cause the majority of depressive symptoms that people routinely experience, but that does not mean that they have depression. If a person seeks help from a mental health care professional or takes a survey (as is more often the case in research that deliver statistics on general mental health) and they exhibit enough signs of depression, then they are classified with the disorder. I do believe that there is a biological form of clinical depression that affects many people throughout their entire lives, regardless of life circumstances yet how can we begin to understand the cause of it, if we can not even define it using a less arbitrary system than a list of “a certain number of the following systems” over a period of “such and such a time”. It seems to me that in many ways our research is backwards. Instead using experimentation to understand what depression is, we arbitrarily defined it then used experimentation with the parameters of that definition. As you said “So far, we’ve learnt that serotonin, the hippocampus, dopamine, the nucleus acumbens, the ventral tegmental area, neurons, glial cells, and multiple proteins effect depression…” Isn’t it possible that some underlying cause of depression in fact effects all of these areas instead of the other way around? Also you ask the very compelling question, “will there ever be a day that we will be able to regulate all of these to alleviate depression?” It’s hard to imagine this happening considering that our current psychiatric practice of medicine seems little more than a crapshoot. You display enough symptoms for a long enough period of time so you are prescribed medication, if the medication doesn’t work, you take more, if it makes you affectless you take less, or you get put on a different medication, then you are put on more medication perhaps while you are still on the first kind. In order to alleviate the side effects you receive a different type of medication and it goes on and on you are taking several pills a day.

    I hope I don’t offend anyone with this post, a lot of it stems from my personal experiences and frustration and the disappointment that my studies in neuroscience have left me with more doubts than assurances

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  4. I agree with you Natasha–I know I often catch myself being surprised at how little we know about MANY (if not ALL) disorders. It scares me to think that we can build a computer that can do essentially anything, that we can see the tiniest organisms with powerful microscopes, and that we can send people to a different PLANET (though, I’m not gonna lie, I still kinda think the moon thing was very hollywood..) but we can’t figure out what’s going on in our own freakin’ heads!!! It always amazes me–I feel like we should have a more secure grasp on what makes us humans-our brains-but for some reason, we still have a long way to go.

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  5. I too was surprised that the woman suggested childhood trauma as the cause of depression. While it seems possible, we do know (or at least we think we know) so much about the brain and neurotransmitters and their relation to depression. I agree with Stephanie, in that, what if it is the other way around? What if depression is the cause of imbalance of chemicals? If so, then perhaps building “supportive and trusty-worthy relationships,” like the women proposed, is a cure for depression and the imbalance could be prevented. The women also mentioned that antidepressants are effective on less than 50% of depressed individuals, which is about as effective as a sugar pill. Could the combination of antidepressants and relationship building be 100% effective in treating depression? I’m definitely curious about the short-term and long-term effects of such a solution. Knowing that this disorder effects so many people on so many different levels, a solution could change so many lives. Like Jenn said, we’re not there yet. There’s a bunch more to discover.

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  6. The idea that depression could arise from childhood experiences and family dynamic does not surprise me at all. Although this may not apply to every family, but our parents and the type of family we grew up in, can helpe predict many things in our future. For example, people with parents that went to college will more likely obtain that same level of education or even beyond. Similarly, people with divorced parents will most likely suffer from relationship and trust issues. People who grow up in big families with strong relationships will strive to mantain or build similar, close connections with the people they meet in the future. Although these patterns may not necessarily involve specific neurotransmitters or imbalanced chemicals, what is important is that they show a trend. This means that children who experience a depressing sort of childhood may be more susceptible than others to develop depression in adulthood. So, with that said, I think I am taking a Freudian stand in this discussion to argue that childhood can effect depression.

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  7. So CBT has an 80% relapse rate… but I’d guess the relapse rate for people who stop taking anti-depressants is pretty up there, too. (I’m assuming that the author meant for people who completely stop CBT). I would have liked to see her directly citing some of the things she said, because they opposed a lot of things I’ve learned. Perhaps she was referring to more mild forms of depression, when she suggested taking a walk in the park with a friend as an effective step towards recovery… because if Solomon couldn’t take a shower, I doubt he was going to go for a stroll!

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  8. so, the recipe for depression is a combination of predisposition, neurological imbalance, and developmental social experiences…would it be safer to just live in a box or a bubble? Maybe the predisposition and neurological imbalance would not be in our control but our experiences “could” be.

    I think this conversation here feeds into our conversation in class on whether or not we should give medicine to people “just in case” because they have experienced a traumatizing experience that “could lead to” depression. We all experience some time of experience growing up and as we all know children have varying degrees of imagination. Some child hood experiences are more traumatic in the eyes of some children then others.

    There might be a trend for kids with traumatic experiences to develop depression but trends the existence of trends and associations should not be taken as cause or even near a cause. I think people looking into trends and diagnosing trends is subjective.

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