03/18/2010 05:12 am ET | Updated Nov 17, 2011

You're More Than Your Biochemistry: A Social Perspective On Depression

Welcome to my new blog for the Huffington Post. I'm excited about this new venue for sharing information and perspectives about the work I've been involved in for more than three decades. I'm a clinical psychologist, author and regularly conduct clinical trainings for mental health professionals around the world, particularly in the areas of short term psychotherapies and the treatment of depression. I was invited to contribute as a blogger as a direct result of my newly released book, Depression is Contagious: How the Most Common Mood disorder is Spreading Around the World and How to Stop It (The Free Press). You can watch a short video describing the book by clicking here.

Depression gets a huge amount of attention yet, in my opinion, not nearly enough of the right kind of attention. We are routinely bombarded with ads for drugs that inform us depression is a "medical illness" caused by a neurochemical imbalance in the brain. I will present a broader view of depression in my blogs, drawing your attention to the growing evidence that depression is much more a social than medical problem. The spread of depression across age and demographic groups in this country, and around the world, is a direct consequence of social forces that deserve recognition and careful consideration. The purpose of my blog is to shine the spotlight on the social forces that give rise to depression that all but guarantee this problem will not and cannot be solved through biology alone. We can't medicate everyone, realistically, and even if we could, the reality is that medication has too many limitations associated with it that unintentionally actually further exacerbate the problem. In future blogs, I'll say more about that. Suffice it to say for this first entry that depression is too serious and complex a problem to be dealt with only one-dimensionally.

Depression is a multi-dimensional disorder. It has biological components based in genetics, neurochemistry and physical health. It has psychological components that involve many individual factors such as cognitive style, coping style, and qualities of personal behavior. And, it has social components, factors that are mediated by the quality of one's relationships, including such variables as the family and the culture one is socialized into, and one's range of social skills. The best, most accurate answer to the basic question, "What causes depression?" is, "Many things." Likewise, the way out of depression has many different paths, and each person's will uniquely be his or her own.

The costs of depression on a variety of levels are huge: Marriages, relationships and families splinter, individuals suffer, societies suffer the consequences of the often destructive behaviors of people coping badly or not at all with their depression; businesses suffer the negative effects of employees too disabled to function properly; the economic costs of greater health care expenses are greater for depressed patients; and, there is the tragedy of suicide - lives lost to despair and apathy. Depression is a terribly disabling disorder, and despite significant advances in treatment, the problem continues to grow.

The social side of depression is especially important, yet is terribly under-considered in most people's awareness. We know, for example, that depression runs in families: The child of a depressed parent is anywhere from three to six times more likely to become depressed than the child of a non-depressed parent. The genetics research makes it quite clear that it isn't entirely - or even mostly - faulty genes responsible, especially since there is no "depression gene." It has more to do with the patterns of thinking, coping, behaving, and relating that parents (and other significant role models in our society) model day in and day out than it does one's genetic makeup

When you have the largest demographic group of depression sufferers now raising children, it should surprise no one that their children are the fastest growing group of depression sufferers. After all, parents can't teach their children what they don't know. In saying that, I am not blaming parents since it is entirely an unconscious process when you're not even aware that you're passing on those patterns that increase your child's vulnerability. But, I am suggesting that by becoming more aware of their influence, parents are in a powerful position to not only change their own depression, but to take steps to prevent their children from developing the disorder. In future blogs, I'll describe some of the "how-to's."

There are many studies that address the impact of the quality of one's relationships on depression and vice versa. Whether it is a marriage, some other form of committed relationship, a business partnership, or a good friendship, the quality of your relationships influences how you see things and how you feel. Good relationships help insulate people against depression, but poor ones increase the risk greatly. Developing the skills for building good relationships is essential, and it will be a regular topic in my future blogs.

These points provide excellent reasons to want to strengthen parents and relationships, something no antidepressant medication alone can accomplish. To think of depression as only an individual's biochemical disorder, as if he or she isn't a product of powerful social forces that operate in families, organizations, and cultures, or to reduce it even further to a purely biochemical phenomenon, is so terribly reductionistic as to disempower the very people who need help changing their lives, not just their brain chemistry. It's true: You are more than your biochemistry, and a pill a day won't keep the depression away.

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