Depression: To Medicate, or Not to Medicate?

Depression seems to have become a go to diagnosis for all our ills within modern society. We see it as some kind of anomaly, a monolithic entity that needs to be gotten rid of and as such requires treatment in returning us to a place of unalloyed happiness.

However, depression can be seen as having several different facets; these being “reactive or environmental”; “inherited” and “historical”. We might experience one, or all of them simultaneously. They are however, often undifferentiated, though have different root causes, as well as asking differing questions of us.

- Reactive or Environmental Depression:

A reactive depression is a normal response to a loss or disappointment. It is understandable to feel a period of depression, following a bereavement or ending of a marriage. The extent to which we are emotionally invested in the world we live in; will determine the pain we experience. With the right support reactive depression will resolve itself. It only becomes a longer-term difficulty if it begins to profoundly affect the normal day to day functioning of the individual.

- Inherited Depression:

Inherited depression derives from biological causes. This kind of depression can be carried genetically through the family. Individuals experiencing this, find a real difficulty in performing the day to day tasks that many of us take for granted. As though they are constantly walking up a steep hill, carrying a heavy weight. This kind of depression can respond particularly well to medication, as this helps to re-balance the chemical make-up of the brain.

- Historical Depression:

Depression can sometimes feel like a well with no bottom. However, from a therapeutic perspective, historical depression is a well with a bottom; even if we may need to dive deeply to find it! We might see this form of depression as a kind of collusion against ourselves. Where we have suffered an early trauma in our lives, such as an emotional abandonment by a care giver. We come to see ourselves as not being worthy of love and care from others in later life. Therapeutically, the task here is to attempt to become conscious of the difference between what happened to us in the past and who we are in the present.

(Hollis, J., 1996. Swamplands of the Soul. Toronto: Inner City Books)

Depression in mid-life often carries with it a crisis that embodies the conflict between what we have created through this false self of our early conditioning; (the belief we are unworthy of love) and the spontaneity and energy of our true selves. We could say at these times that depression is the individual experience of the discrepancy felt between our false selves and the call of our true self.

Unfortunately, at these times, what can become de-pressed is the space that allows us to reflect on “what is the meaning of this depression”. We might say that the therapeutic process is one whereby we are offered the means, at these times to take a breath and allow ourselves to sit with what is being asked of us.

As such, I am not implying that medication doesn’t have a place in treating some forms of depression; especially if there has been a chemical imbalance in the functioning of the brain. However, depression might also be asking us to reconcile who we think we are, with who we actually are. At these times; in using medication as a one size fits all “cure”, we may be missing an opportunity in coming to know the real self within us.