Is Depression Always a Disease?


OLYMPUS DIGITAL CAMERALike most mental health writers, I have compared depression to other illnesses like diabetes in the past, and stressed the biochemical aspect of mood disorders in my efforts at reducing stigma. Somehow talking about the gene G72/G30 located on chromosome 13q (that may predispose individuals to depression and bipolar disorder) makes it more legitimate, as if the gene proves we aren’t making it up. However, the more I read about how abuse, trauma, and chronic stress—unresolved issues of all kinds–can cause and aggravate depression, the less I want to compare it to diabetes.

Taking insulin really isn’t the same thing as taking an antidepressant.

It’s not that simple.

As I wrote about in my recent blog about SSRIs, the theory that depressed people suffer from a lack of serotonin and other neurotransmitters, which are replenished by antidepressants, sounds good, but isn’t totally accurate. SSRIs aren’t like insulin in that they fill in a deficiency. In fact, we still don’t really know how they work, but they certainly do for many people.

In his chapter “A Heroic Passage” in the book “Darkness Before Dawn,” psychiatrist James Gordon writes, “Depression is not a disease, the end point of a pathological process. It is a sign that our lives are out of balance, that we’re stuck. It’s a wakeup call and the start of a journey that can help us become whole and happy, a hero’s journey that can change and transform our lives.”

Part of me cringes when I read that.

Forever stuck in my brain is renowned psychiatrist Peter Kramer’s quote: “Depression is not a perspective. It is a disease. To see the worst things a person can see is one experience; to suffer mood disorder is another.”

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Therese Borchard
I am a writer and chaplain trying to live a simple life in Annapolis, Maryland.

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6 Responses
  1. mrs clarke

    I have been going through a situation for the longest while but by reading this article i chose to write for help i have been hearing voices towards god, my children my self an it frightens me no matter how i try to think positive i can’t i am always in a trance of fright with my heart racing have only negative thoughts even if i try to be positive. The strange thing is when i sleep i sleep peacefully but as soon as i wake up it like a CD playing music. Need help.

  2. Lizzie

    This article made me cry Therese.The in depth explanation of a complex condition which when you just think you have found answer and you are feeling well it sneaks up on you and bites.
    I once told by my GP that I was lucky I didn’t have diabetes and I only had depression. And I know some people with diabetes have mood swings if not properly controlled and other health problems but living with” the death wish” and trying to dodge it i itself becomes so tiring.
    It is to me a disease. Whatever it’s cause it impacts on our physical health and our daily wellbeing and quality of life.
    If there was a ” magic pill” I could tolerate I would take it and go skipping in a field of buttercups. But sadly I haven’t found one.
    I can understand the people who give up the struggle. Lizzie

  3. Margaret

    I am grateful there is no one answer. It would make it easier if there were, I suppose, as in just take a pill for it, like you would an antibiotic for an infection. But we are dealing with people’s minds, hearts, souls, what make us unique, authentic. I know I am stuck in some ways that if dealt with might free me up to experience life in new ways. Why am I too afraid or lazy to risk getting unstuck? Knowing me, it is just that, too lazy, comfortable, to go out of my comfort zone. Where do we draw the line and just accept that we won’t make changes until we are forced to make changes. I was forced to make changes when my husband left me without warning. It was awful but I lived through it because of my Catholic faith and the words from scripture. I remember saying to myself at times: “The joy of the Lord is my strength” and “I can do all things through Christ who strengthens me.” Just putting one foot in front of the other until I reached a better place. The emotional pain was awful then and in some ways is still with me but I have become stronger through it.

  4. Elise

    If depression is a disease then they will have to stop blaming us. I believe the title Behavioral health leads people to believe people can control their illness.