There is a new explanation for depression that takes a striking departure from the current view that depression is caused by a chemical imbalance in the brain.* In the new explanation, it is the creation of new neural pathways (the freshly minted connections between brain cells) that is what ultimately frees people from the grips of depression.
The interesting thing about the new, "neuro-genesis" explanation is that this model also explains why depression is so intractable for those who have it and can't seem to shake it off. Old patterns of behavior (i.e., pre-existing neural pathways) get reinforced in depressed patients in quite the same way that new patterns of behavior get formed: with repetition. Depressed patients, who find themselves stuck in a rut, continually ruminating over the same negative thoughts for hours on end, aren't likely to form any new neural pathways. New behaviors create new neural pathways, and repetition of the old behaviors, reinforce old pathways.
So depressed people, who tend to repeat old patterns of behavior and thus reinforce old pathways, find it almost impossible to escape from the grip of their melancholy: Sitting on the couch, thinking negative thoughts and afraid to try anything new. That means a period of depression brought on by one isolated traumatic event is likely to get reinforced by the patients' pessimistic world view that things will never get any better.
In order to benefit from our brain's ability to change, i.e., neuro-plasticity, the depressed patient must force him or herself to do new things and participate in new activities (every day) that stimulate neuronal growth and create new neural pathways (which of course is next to impossible with depressed patients who find it hard to get out of bed in the morning). One way to do this is to encourage depressed patients, who often get little or no exercise, to get out and move. This is really one of the most effective prescriptions a therapist can offer under this new explanation for depression.**
If you want to learn more about this fascinating subject, check out the book, The Brain that Changes Itself, by Norman Doidge. We'll continue to explore this topic in our next blog.
* The neuro transmitter (the current) explanation for depression relies on antidepressants as the primary form of treatment. But this approach to treating depression which has for over twenty years been considered the gold-standard, is now under fire from the likes of the Journal of the American Medical Association. This highly respected journal, considered the voice of mainstream western medicine, recently reported that "anti-depressants were no more effective in treating mild to moderate depression than a placebo."
**Keep in mind, this new explanation for depression has not been proven and is not the mainstream, "medically accepted" explanation. If you are on anti-depressants talk to your doctor before even considering a change. Chances are, he or she won't know about this new theory. My doctor, who is a professor at The Yale School of Medicine, had never heard of it. So, please let this article be a starting off point for your own education and any discussions you may have with your doctor. This theory is just that: a theory.