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?