As a psychologist, I cringe every time I hear someone say, “Depression is just a chemical imbalance in your brain… There’s nothing wrong with you, it’s just how your brain works.” Each time I cringe, I question whether my reaction is a result of how grossly incorrect that statement is or perhaps how unwilling we are to validate the complexities of the human condition and life experience. Before I go on, there is one thing in that statement that I must validate as true: there is nothing “wrong” with you.
Ever since the evolution of anti-depressant medications from drug companies, SSRI’s have essentially become the new aspirin of our time. If you have a headache, take an aspirin. If you are feeling depressed, take an anti-depressant. While I understand the need and desire for a “quick fix,” I cannot help asking the real question: “does medication fix?” The role of medication itself can be it’s own blog post (or perhaps it’s own book and debate), but that is not what I am wanting to focus on here today. What I want to challenge is the reductionist approach that we, as a society are taking as an approach to “dealing with” human struggle.
I acknowledge the research studies that show that there is a chemical component to depression and I validate their many attempts and theories about increasing a certain chemical to help alleviate depressive symptoms. But truly, if clinical depression were “just chemical,” then why is it that there are so many individuals who do not respond to anti-depressant medication, who then take tertiary off-label medications, or a “medication cocktail” to only show modest results? Why is it that we are still needing to explore alternative interventions including still using ECT and now magnets in Transcranial Magnetic Stimulation? These expensive and profitable interventions fail to acknowledge a very basic fact that every university undergraduate learns about the brain: the concept of neuroplasticity. The most basic way to describe this is that the brain (neural pathways) change and evolve in response to changes in behavior, environment, neural processes, thinking, and emotions.
If the brain is so complex that it structurally changes every time we learn (even learning how to do a math problem or navigate a new route in our cars), why is it that we find the need to pick a single neurotransmitter to blame for someone’s emotional struggles? Instead of saying that “it’s just chemical,” how about we take a moment and ask ourselves, “I wonder what their life has been – and what it is like for them right now, in this moment.” What if we, not just psychologists and therapists, but all of us actually take interest and validate the pain and emotional struggle that perhaps have contributed to someone’s experience of depression? How about we have a “real conversation” about what is “really” going on. Let’s take a moment and validate and be curious about that person’s story, their life, their experiences, and all of the culminating and multitude of factors that make this person uniquely who they are.
In order to have a real conversation though, it unfortunately will take a lot of change within each of us. We too must acknowledge our own emotions and emotional state, and not just the positive experiences and how awesome our lives are. We have to validate and contact our own experience of pain and sadness, get uncomfortable, and open ourselves to the possibility of connecting with another person’s experience. We have to unravel and give ourselves permission to do what was so easy to do as children yet seems so complicated to do as an adult: express accurate empathy – to feel what another person feels in that moment; not feel sad for them or pity, but rather, make contact with their emotional struggle. Maybe, just maybe, we can start to have a conversation about what it’s like to be human rather than a conversation about what pill works to help you not feel this way.
As a Clinical Psychologist, I acknowledge and validate the role of medication for the “treatment” of mood and anxiety struggles. I see medication as adjunct to the psychotherapy process. I do not see medication as “curative” – as in, removing depression. Rather, I see medication as a way of assisting an individual to help access curative experiences and hopefully experience “something different.”