A deep dive into a man’s search for the cause of his depression…all in this week’s Reading List.
The Real Causes Of Depression Have Been Discovered, And They’re Not What You Think
By Johann Hari
Read the Full Article
For this week’s Reading List I’m taking a deep dive into a fascinating opinion article I ran across in the Huffington Post. While it’s an opinion piece, I do believe it helps us apply analytical thought about the concept of the “broken brain” mentality in psychiatry.
For this Reading List, all indented word’s are Johann’s. My comments are in between to highlight what I took from his passage to apply it to my work. Johann’s article is much longer and more in depth so please make sure to read it in it’s entirety.
Here goes:
”Across the Western world today, if you are depressed or anxious and you go to your doctor because you just can’t take it any more, you will likely be told a story. It happened to me when I was a teenager in the 1990s. You feel this way, my doctor said, because your brain isn’t working right. It isn’t producing the necessary chemicals. You need to take drugs, and they will fix your broken brain.”
It’s not uncommon for me to hear this during therapy sessions; that someone’s brain is “broken”. But with all we know about neuroplasticity we should be well over the assumption that we are “locked in” to our brain. We need to reject the idea of “once a depressed brain, always a depressed brain.”
“I longed for relief. The drugs would give me a brief boost whenever I jacked up my dose, but then, soon after, the pain would always start to bleed back through. In the end, I was taking the maximum dose for more than a decade. I thought there was something wrong with me because I was taking these drugs but still feeling deep pain.”
Ask any psychotherapist, this is a constant refrain from clients taking antidepressants.
“Many leading scientists believe the whole idea that depression is caused by a “chemically imbalanced” brain is wrong.“
Read that again and let it sink in. What if we find out we’ve been wrong all this time?
“Depression is often measured by scientists using something called the Hamilton Scale. It runs from 0 (where you are dancing in ecstasy) to 59 (where you are suicidal). Improving your sleep patterns gives you a movement on the Hamilton Scale of around 6 points. Chemical antidepressants give you an improvement, on average, of 1.8 points, according to research by professor Irving Kirsch of Harvard University. It’s a real effect – but it’s modest.”
Based on this study, getting better sleep improves your score 4.2 more points than antidepressants. That is quite the bump. And there are no negative side effects, withdrawals or dependencies to getting better sleep.
”I learned that there are in fact nine major causes of depression and anxiety that are unfolding all around us. Two are biological, and seven are out here in the world, rather than sealed away inside our skulls in the way my doctor told me.”
”I was even more startled to discover this isn’t some fringe position – the World Health Organization has been warning for years that we need to start dealing with the deeper causes of depression in this way.“
”I was finally taught about it in San Diego, California, when I met a remarkable scientist named Dr. Vincent Felitti. I have to tell you right at the start though – I found it really painful to investigate this cause.”
Dr. Felitti! We must be related right?
“Once the numbers were added up, they seemed unbelievable. Childhood trauma caused the risk of adult depression to explode. If you had seven categories of traumatic event as a child, you were 3,100 percent more likely to attempt to commit suicide as an adult, and more than 4,000 percent more likely to be an injecting drug user.”
3,100%.
That is not and typo.
A quick warning before you continue reading. The following passages explore a bit of Johann’s trauma and may cause distress.
“After I had one of my long, probing conversations with Dr. Felitti about this, I walked to the beach in San Diego shaking, and spat into the ocean. He was forcing me to think about a dimension of my depression I did not want to confront. When I was a kid, my mother was ill and my dad was in another country, and in this chaos, I experienced some extreme acts of violence from an adult: I was strangled with an electrical cord, among other acts. I had tried to seal these memories away, to shutter them in my mind. I had refused to contemplate that they were playing out in my adult life.”
“Why do so many people who experience violence in childhood feel the same way? Why does it lead many of them to self-destructive behavior, like obesity, or hard-core addiction, or suicide? I have spent a lot of time thinking about this. I have a theory – though I want to stress that this next part is going beyond the scientific evidence discovered by Felitti and the CDC, and I can’t say for sure that it’s true.”
”If it’s your fault, it’s — at some strange level — under your control.”
This is the most important concept for anyone who has neglect or trauma in their life to understand.
“When you’re a child, you have very little power to change your environment. You can’t move away, or force somebody to stop hurting you. So, you have two choices. You can admit to yourself that you are powerless ― that at any moment, you could be badly hurt, and there’s simply nothing you can do about it. Or you can tell yourself it’s your fault. If you do that, you actually gain some power ― at least in your own mind. If it’s your fault, then there’s something you can do that might make it different. You aren’t a pinball being smacked around a pinball machine. You’re the person controlling the machine. You have your hands on the dangerous levers. In this way, just like obesity protected those women from the men they feared would rape them, blaming yourself for your childhood traumas protects you from seeing how vulnerable you were and are. You can become the powerful one. If it’s your fault, it’s ― at some strange level ― under your control.”
“But that comes at a cost. If you were responsible for being hurt, then at some level, you have to think you deserved it. A person who thinks they deserved to be injured as a child isn’t going to think they deserve much as an adult, either. This is no way to live. But it’s a misfiring of the thing that made it possible for you to survive at an earlier point in your life.”
This is the crux of the work in therapy. Identifying and disrupting the irrational and unhealthy thoughts which become automatic and slip into core belief of self.
“As I listened back over the tapes of my long conversations with Felitti, it struck me that if he had just told people what my doctor told me – that their brains were broken, this was why they were so distressed, and the only solution was to be drugged – they may never have been able to understand the deeper causes of their problem, and they would never have been released from them.”
This is why deep reflection and exploration is crucial. Masking the trauma or neglect with medication won’t challenge and rebuild irrational thought patterns. When the effects of the medication wear off the same irrational and unhealthy core beliefs are still present.
While medication may be necessary to relieve the most acute and oppressive symptoms, it’s imperative to challenge this irrational core belief to get to the root of the distress.
Prescribing medication without therapy and telling someone there’s nothing they can do about it (“your brain is broken”) is both misleading and damaging to one’s core belief of self.
“When people are behaving in apparently self-destructive ways, “it’s time to stop asking what’s wrong with them,” he said, “and time to start asking what happened to them.”
“…and time to start asking what happened to them.”
Truer words can’t be said.
Why a Reading List? I do a good amount of reading and I‘m constantly finding articles which are informative, entertaining and applicable to my private practice. Instead of hoarding this information to myself, I’ve decided to begin sharing the articles and pull quotes on a semi-regular basis.
Photo by Nina Luong on Unsplash