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JAMA-.will never be a drug that 'cures' depression

Posted by violette on November 28, 2010, at 20:57:52

If Depression Isnt in Your Genes, Then Where the Heck Is It?

By Michael D. Yapko, Ph.D.

A highly publicized study published in the Journal of the American Medical Association last year (June 17th issue) challenged earlier research suggesting that depression is caused by a depression gene.

The new study reaffirmed other research associated with the Human Genome Project which also clearly indicated the lack of a single depression gene as the cause of depression. In fact, the search for a depression gene has made it clear that not only has no such depression gene been found, but no single gene will be found.

What has been found, however, is that there is a heritability, a genetic predisposition. But it is a relatively weak one that is highly modifiable by environmental factors. This is the new field called epigenetics, the study of how environmental conditions including social interaction affects gene expression.
For the people who continue to hold out hope for a purely biological cure, this is an inconvenient truth. As I have said in previous blogs, depression is much more of a social condition than a biological one, and just as there will never be a drug that cures poverty or racism, there will never be a drug that cures depression.

For the people who blame their genes for their depression, they have lost scientific support for their belief that theres nothing they can do because of their presumed genetic destiny.

Lets face it directly: Depression is mostly a socialized phenomenon. We learn ways of thinking, coping, relating, being, that increase our vulnerability and put us at a higher level of risk. Depression has many causes, some of which are biological to be sure, but most of which are psychological and social. Consider these facts:

Depression is striking people at younger and younger ages.
As societies westernize, the rates of depression go up.
As relationships decline in quantity and quality, depression increases.
As people learn prevention skills, they show remarkable ability to prevent episodes from developing in the first place.
As they go through psychotherapy to learn better coping skills as well as other mood management skills, they have fewer and less severe episodes and their brains change in measurable ways.

Just how much convincing does someone need to understand that focusing on the biology of depression alone isnt nearly enough?

So, if depression isnt in your genes, then where is it? It isnt anywhere and, paradoxically, its everywhere. Its in your thought processes, its in your relationships, its in your lifestyle, its in your diet, its in your level of physical wellness, its in your style of decision-making shall I go on? Yet, what people write to me about is almost always biology. They ask medication questions, they ask biochemistry questions, and they blog about herbal remedies and dietary supplements. Is this an unrealistic search for the magic cure? I think so.

With the evidence so strong that depression is largely a social phenomenon, and when the research highlights you dont have a depression gene to blame, it means people can no longer be passive, taking a drug and sitting around waiting for it to work.

The evidence is unambiguous that the more passive you are, i.e., the less you do to take active steps to help yourself out of depression, the worse youre likely to feel. Its why Im a huge advocate of active, skill-building approaches based on sound therapeutic principles affirmed by good science that shows these methods work. Ill be describing some of these in future blogs.

 

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