The Chemical Balance Myth

I recently read the August 7, 2017 Time cover story "The Anti Antidepressant." It talks of possible "new" innovations in psychopharmacology. It's hardly new Ketamine, MDMA, and other medications have been researched in the past. Often street (ab)use, led to discontinuing the research in medications like this.
This latest article does a fine job of describing the (Western) understanding of depression. It also does a poor job of updating the understanding that's come in the last 40 years. The brain in "chemical imbalance" model of understanding and treating depression was outdated by the time it was used to help portray to clients the usefulness of SSRI in treatment. It's not that it's totally incorrect -- it's incomplete. The latest Time article does at least note that the latest understanding acknowledges the likelihood that depression is perhaps a dozen plus conditions. It still, however, perpetuates the perspective that depression lives solely in the brain.

Depression may be demonstrated through low serotonin, dopamine, or other neurotransmitters. Recent researchers, though, see a multidimensional, physiological syndromes that explain the depressive experience. There is a shift in how the anatomical areas of the brain metabolize and send impulses (a neurological and circuit based disease.) Not only do certain genes show links to depression, but whether those genes have been turned on or off in a person's lifetime (a genetic and epigenetic disease.) The genes con
trol how hormones are replicated and how sensitive our body is to these hormones (an endocrine disease.) These hormonal interactions inflame our tissues - a disease of inflammation. These are all parts of depression - it is not only seen in the brain, not only felt in the brain.
Depression impacts our sleep, appetite and metabolism, our sense of energy, our ability to concentrate. It impacts relationships in the family and in the community - a person's participation in the call and response of human connection.
I hope that clinicians find one more effective treatment of depression. I regularly tell my clients and colleagues (with a touch of facetiousness) "No business is good business." My sense of this comes with the belief that counseling is only one vehicle to address depression. Often, it's the job of therapist to connect people to more meaningful interventions, more resolute solutions to managing mood: Healthy relationships, healthy lifestyles, communities, friends, exercise, greater sense of connection to the world and to people, a sense of meaning, a remembrance of one's fortitude and internal resources. Because depression does not simply live in the brain. Treatment can start in the brain, in relationships, and in physiology. It does not end there.