iology or Psychology? - 'Depressive Pressure'

> It doesn't adress the root cause. Worse even, it can allow the root cause to become worse. The root cause is family dysfunction.

In 2002 wrote something else that was a kind of model to understand depression and antidepressants. I called it "Depressive Pressure".

"
I dont know if this helps, but this is how I currently approach things. I like to use
the word spectrum.

1. Clinical depression is a diagnosis of an observable syndrome.
It is not an assignment of cause or etiology.

2. The etiologies of what is characterized as depression are numerous. For
example, the word depression is used to describe a symptom of
hypothyroidism. In this case, depression can disappear immediately upon the
ingestion of pills containing T3 or T4 hormone. Is not the cause of this
depression completely biological?

3. The word depression is used by people to describe quite a variety of
subjective experiences. Any two people whom describe themselves as being
depressed might be experiencing completely different things. In such a case,
person #1 might have a tendency to deem their depression as being equivalent to
that of person #2. It makes sense to person #1 that person #2 came to be
depressed in the same way, and that the same treatment will prove successful.

4. There is a spectrum of varying ratios of nature versus nurture as contributions
to the evolution of depression in the individual. At one end, there is a
depression that is completely psychological, and at the other a depression that is
completely biological. (I think it is worth repeating that the one word
depression might be describing two completely different experiential
phenomena). In between lies a dynamic interaction between biological
vulnerability and psychosocial stress.

I like to use the term depressive pressure to describe the psychological
experiences that act to stress the biological system. Sometimes these are acute
events like the death of a spouse or child. Sometimes they are chronic patterns of
depressive thought-styles. For those individuals whom possess a biological
vulnerability, there is a threshold of depressive pressure beyond which causes
the biological system to collapse beneath this pressure and function abnormally.

1. Some people experience depression, even though no collapse of the
biological system has occurred. Psychotherapy alone can be sufficient.

2. Some people who have experienced a collapse of the biological system can
recover, as the system will repair itself once the depressive pressure is
removed. Psychotherapy alone can be sufficient. However, the continued
depressed mood produced by the alterations in biology can hinder ones ability
to respond to psychotherapy, as it is more difficult to process through thought the
psychological issues producing the depressive pressure. This can end up being a
self-reinforcing loop that perpetuates the dynamics causing the depression.
Additional treatment with antidepressants might alter the system in such a way as
to produce a more functional milieu within which psychotherapy can work.

3. For some people, the biological collapse can produce long-lasting
deformities in supportive structures, leaving these people more vulnerable to
depression with each successive collapse. Removal of the majority of
depressive pressure through psychotherapy might not be sufficient to prevent
periodic collapses, especially when the system is challenged by subsequent
psychosocial stresses. Longer-term antidepressant therapy might be indicated.
Perhaps this extended use of antidepressants creates a temporary structure to
support the weight of the depressive pressure while the system rebuilds itself.
However, managing psychosocial depressive pressure with continuing
psychotherapy can be important or necessary. Of course, sometimes the system
cannot rebuild itself sufficiently to remain standing when the scaffolding created
by antidepressants are removed. Indefinite treatment with antidepressants might
be necessary.

4. For some people, the biological system can begin to function abnormally in
the absence of concurrent depressive pressure. A variety of genetic and
environmental factors can play a role in the evolution of system dysfunction.
Bipolar depression is probably a good example of this, although I think many
cases of unipolar are just as biological. Studies of heritability probably
demonstrate this for both, and the genes responsible eventually will be
identified. Treatment with antidepressants alone are necessary and often
sufficient. However, psychotherapy might be helpful to manage the perturbations
in psychosocial function produced within the milieu of the biologically altered
state of affect and cognition. Indefinite treatment with antidepressants is often
necessary, especially if recurrent episodes have occurred. Each successive
collapse of the system produces an increasing deformity of the structure of the
biological system, such that it becomes less amenable to repair and treatment-
resistant.
"

Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

iology or Psychology? - 'Depressive Pressure'

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