Maybe We Can Cure Depression All By Ourselves

The Medical Model and Why We Should Question It
Antidepressants. They're prescribed all over the place. They can even be prescribed by your local General Practitioner (i.e. someone not trained in psychiatry or psychology). They're basically what this generation is hailing as the "solution" to this rising epidemic. And this conclusion rides on the Medical Model of Depression: the premise that depression is the result of a chemical imbalance in the brain (a serotonin deficiency).

Most of us out there are just kind of assuming this to be correct. As I've mentioned, I take a Zoloft every morning myself. But recently a dangerous question has been posed: what if chemicals aren't really the culprit?

It's the question that plagued me in the throes of my depression: can I chalk this up to something that's out of my control, or... could it be my own fault? As you may predict, the notion that I was to blame for my disorder was frightening, demoralizing, and exhausting. For a long time, I clung to the belief that it was a chemical problem, suggesting an easy fix. "Magic pill = feel better".

New research is actually indicating that the Medical Model of Depression-- which we have thrown ourselves into headfirst-- is not as well substantiated as previously supposed. It turns out that these magic pills aren't significantly more effective than placebos. You've heard of the placebo effect: it's the notion that if we believe that something will work, it will work. It looks like that might be what's happening here: these pills designed to increase the serotonin in our brain-- thereby supposedly reducing the depressive symptoms-- are not working much better than sugar pills.

(Please visit this article for more information on this particular placebo effect, and this book review to sum up some of the arguments against the Medical Model.)

Could it be that simply believing we have the power to pull ourselves out of our sadness could be all we need?

As I described in my previous blog post on the subject of depression, part of the biggest problem is that we feel weak and helpless to make any changes. But it's a case of the chicken or the egg-- we are assuming that we feel powerless because we are depressed. But isn't it just as plausible that we are depressed because we feel powerless?

I have pondered this and come up with my own take on what exactly this process looks like. Much in the style of Aaron Beck (all around important guy in depression research), I have crafted my take on this in the form of a triad, which I am calling the Efficacy Triad.

Here's how I define efficacy: our ability to accomplish what we set out to do. It is regulated by our relationship with ourselves.



What we require to possess efficacy is 1.) Self Discipline, or the ability to prioritize our needs and our wants in a healthy way, and then direct our behavior accordingly, 2.) Self Esteem, a true love and appreciation for ourselves, as well as a healthy understanding of our strengths (weaknesses too, but that is really a given in depressed people), and 3.) Self Confidence, or the belief that we can accomplish what we set out to do. It's the perception that we are strong, capable agents in our own lives. These three areas all affect one another, and so lacking one will often lead to a lack the others as well. When these deficits become severe enough, they may result in depression.

Basically, we become depressed when we have this poor relationship with ourselves, leading to a lack in efficacy, meaning we are no longer effective individuals in our lives. And isn't this, in a nutshell, what depression is? The inevitable despondence that comes with a poor self-image, resulting in no longer being able to function well, leading to further lowering of our self image.

That's my theory. So why does it happen? I have a few answers.

I think-- particularly in America-- there exists a sense of entitlement. Written into the core of the "American Dream" is the notion that we can accomplish anything, and, moreover, that we deserve to accomplish everything. If we are thoroughly enough imbued with this philosophy, imagine the existential crisis we face when we fail. Not only will we feel profoundly disempowered, but worthless on top of that, because obviously if we can't have the exact kind of life we want, we must not be deserving of it. There's a host of philosophical implications in this progression that I won't get into now, but it's well worth some pondering.

Another way of conceptualizing it is actually rather Freudian: consider the expectations we have regarding what we "should" be like. Now picture what we tend to actually be like. When an individual is forced to internalize both of these concepts, they may be faced with a terrible psychological conflict. We have to struggle to reconcile the disparity, because it creates a dissonance that is psychologically uncomfortable. When we fail to reconcile it, however, we may be faced with depression.

So, how on earth can we treat this?

I believe that, since the depression was caused by a lack of efficacy, it can be reduced by bolstering the efficacy one possesses. Makes sense, right? So what does this look like? Well, predictably enough, each of the three parts of the triad need to be addressed to ensure a strong sense of efficacy.

Self Discipline has been often conceptualized as a muscle-- it can be trained. In practicing control over our negative thoughts and impulses, we can build up the power to have control in other areas of our life.

We can increase our Self Esteem by making a daily emphasis in our minds of our strengths, rather than our weaknesses. We can spend time developing our existing skills. We can interact with loved ones who will love and support us, and help remind us of what's good about ourselves.

Finally, we can increase our Self Confidence by putting all of these things into practice and starting to see change wrought in our lives. As we watch ourselves progress and move beyond our disorder, we will most likely begin to feel as though we have power over our lives, and the ability to change our own emotional fate.


This is why I believe embracing a model of depression which emphasizes our own responsibility for our difficulties is actually the perfect way of addressing the problem. While it acknowledges how our failings can cause trouble, it also highlights and power to bring about real, tangible improvements for ourselves, which is exactly what we need to get better. We need faith in ourselves as people and as free agents, not slaves to our imperfect minds and bodies.

So I never got to some of the things I wanted to address-- notably, depression as addiction. But honestly, I think the little dissertation I've composed here is more than enough for one blog post. If you have the patience to conquer this monster of a post, please tell me what you think! My experience is rather limited, and I am curious to know whether anybody else sees truth in these theories. What do you think?

Thoughts for a Monday Morning

Here’s my question on this Monday morning: why do so many of us hate our jobs? Is it an element of discontentment inherent to humanity? Or is it that the jobs are truly miserable—in which case, why aren’t we more inclined to pursue a career we really want?

Which is it: are humans disposed towards misery, or disposed towards willful slavery? So many people drag themselves out of bed every morning to go sit behind a desk, or cater to rude customers, or in some other way undermine their own dignity.

We seem to be choosing jobs on the basis of necessity and obligation. But could it be possible to rewire the way we approach our day-jobs, so that rather than a miserable chore we had to complete every day, it was an honorable responsibility through which we find inherent satisfaction? What kind of world would it be where people wanted to be tax lawyers? Or wanted to be custodians? Or wanted to be waitresses? I’m not sure whether a world like that would look socialist, Buddhist, or like a Borg collective. Or none of the above. But the point is, what if each of us really loved our careers—and, by some miracle, the world still turned?

“Don’t confuse your career with your life”.

I read that quote earlier this week. Although it’s an important mantra in a world where we are struggling to retain a sense of dignity in undignified jobs, I wish it weren’t necessary. If we could feel as though we had, fully conscious and purposefully, entered our line of work, and we did it because we wanted to—would we feel fulfilled by the same careers that are now making us miserable?

Just some random thoughts. This is a prelude to my (hopefully) upcoming blog posts on the subjects of depression and efficacy… could we escape chronic sadness and discontentment if we felt more powerful in our lives? I say yes.

In the meantime, if you have any insight to share, I'd be interested to get some of these questions answered!

The Insidious Face of Depression

One of my main interests in psychology is, at the moment, depression. This wasn't the case until recently, when I was finally told that I had it. All of a sudden, this "common cold" of mental disorders that I had been learning about for years, which never really interested me before, turned into the issue I devoted all my energy into understanding.

Depression is deceptive in its simplicity. At first blush, it is someone being unhappy for a long time. The predictable consequences of this are lethargy and lack of motivation, meaning the person is doing less in their lives that might make them happy. Therefore, they continue being unhappy. Bam-- you have a case of depression!

But when you delve deeper, you begin to see how treating it can look like beating your head against a brick wall, with, understandably, few results other than "Now my head hurts". In other words, one of the aspects of depression that makes it particularly dangerous is its self-perpetuation, even when we are trying to address it. In many ways, working towards "fixing" depression can actually worsen the depressive symptoms.

The core of depression is, I would argue, in the rumination: the tendency to chase negative thoughts round and round in your head, until they seem worse and worse, and impervious to solution. All of the time you spend telling yourself "I am intelligent and I don't have to be beaten by my depression" serves only to feed into the misery you feel when you are, in fact, beaten by your depression.

To put a real face on this issue, let me describe what happened with myself: I spent months and months making mental lists of all the reasons I was miserable. It was isolation at work, it was family drama, it was relationship drama, it was my social failures, it was my lack of academic motivation, it was my lack of self esteem, it was my lack of life direction... the list literally seemed to never end. I attempted to address each of these, but found myself unable to bring about any major changes, until eventually I could add "inability to make progress" to my list. No amount of thinking about these issues could do any good, because my depression was serving as a barrier between myself and personal improvement.

Have you ever had a depressed friend? Based on the statistics, we all probably have at one point, whether we knew it or not (research is showing that close to 40% of the population will experience significant depression at some point in their lives, even if they are never diagnosed). I can absolutely sympathize with the frustration that I'm sure many people feel when faced with someone going through depression. I believe there is a formulaic process that a bystander of depression tends to undergo: first, compassion and sympathy, feeling genuinely sorry for them that they are going through such a tough time. Next, attempts to help, and improve their situation, reminding them of things to be happy about, trying to please them however possible. Next, the inevitable irritation when none of the efforts are successful. You start thinking that the person is doing it to themselves, and just refusing to be happy. Finally, you start to resent them for being so dramatic and stubborn, and find yourself less able to feel that initial compassion/sympathy for them in any subsequent episodes they may go through.

Does this sound familiar? I know I've gone through this, myself. It wasn't until I, myself, became depressed that I started to understand how little sense this makes. No amount of telling someone to "snap out of it" will do any good, no matter how much we think it should work. When I was in a deep depression, feeling unable to be truly happy, and unresponsive to any logical reasons to cheer up, I finally got it. It's not something you can wish away, and it feels impossible to pull yourself out of-- particularly given depression's tendency rob us of energy and motivation, leaving us feeling utterly disabled by inertia! For this reason, it's a double whammy, which is why depression has some mysterious element of stability that makes it so resistant to change.

My own story with depression, at this point, has a happy ending, for which I am incredibly grateful. It was a painstaking process, however: when attempts to reason my way out of it failed, I turned to therapy. When therapy failed (I call seeing five different therapists with no improvement failure), I finally turned to medication. And, either because I really did have a serotonin deficiency or because the placebo effect is awesome, I felt substantially better after two weeks. I felt like myself again. I went to my therapist one more time after that, found that re-starting the process of examining my misery was only making me miserable again, and told her goodbye and thank you. I am still on my meds, and I suppose will eventually have to see what life is like without them. But I have a lot more faith in my ability to cope now that I have been pulled out of the pit.

However, I know that my story is actually rather uncommon. Many people continue to struggle with their depression, finding no help in therapy or medication. Which is why, in a forthcoming post, I would like to discuss some of the more philosophical aspects of depression: what is it, really? Why does it happen? Why are depression rates rising beyond anything we've ever seen before? Is depression unique to humans, and why? In addition, I will explain my new theory of depression as a form of addiction. Stay tuned!

Until then, please share with me your experiences, either as a victim or bystander of depression, or just someone who is interested in the topic. What do you all think about this issue?

If you're more interested in this topic, this blogger lays out the issues of depression much more clearly than I do. And be sure to check out this blog in particular if you're interested in the pitfalls of trying to think yourself out of depression.

Sanity's Madness: An Introduction

I am a firm believer in natural selection. Through this logical mechanism, a species can grow and improve, as they develop only those traits and behaviors which help them to a.) not die, and b.) have babies. Thereby, a species can thrive as its weaker links are weeded out. It is for this reason (among others) that I am so utterly mystified by human beings.

Humans do not obey the laws of natural selection—they are able to defy their survival instinct at will. Consider the thrill seekers, jumping off of mountains, out of planes, deliberately putting their lives in jeopardy despite the obvious risk. And for what? An adrenaline rush. Consider those who put dangerous substances into their body for a short term pleasure, numbness, or euphoria. Who, usually well aware of the danger, begin using, no matter the long-term consequences. Consider those who fall into one unhealthy relationship after another, seeking those who may bring them temporary satisfaction or psychological security, at the cost of their safety, freedom, or happiness. Consider those who deliberately end their lives, doing the ultimate in ignoring their inborn survival instinct.

Despite all our purported superiority, we humans seem to fall short on that evolutionary necessity. We are able to flout natural selection and allow our dysfunction to persist in the species, thereby allowing humanity to become increasingly diluted with its own irrationality. So my question is, how on earth are we getting by? How are we surviving our own self-destruction?

Maybe, as a college student, I’ve been exposed to a nonrepresentative sample, but in my experience, people are generally pretty messed up. I believe the individual who is genuinely psychologically healthy is a rare specimen indeed. We all enter the real world laden with years and years of baggage, carrying with us every remotely traumatic experience we ever had to live through. It’s little wonder therapists make bank doing what they do! But the thing to keep in mind is that our issues are what make us interesting. They make us fascinating, freakish creatures of mystery. It is this very freakishness that makes for the best sorts of dialectical exploration. Those late-night conversations in which you may arrive at some personal epiphany about how the world works, or, better, how you work— those can be truly mind-blowing.

Four years into studying psychology has, disappointingly, yielded little of this discussion; it’s usually less a matter of theorizing and more a matter of studying what has already been theorized. For this reason, I’d like this blog to be something of a social experiment: I would like to introduce a topic, give a lengthy spiel on my take on it, and open it up for discussion. I want to be disagreed with. I want to be challenged. I want to engender a deeper understanding in all of us as to what really makes humanity tick. So let’s have a conversation. And maybe we’ll have some fun epiphanies along the way.