Jerome A. Price, MA, LMFT, LMSW
Depression is a word used generically to describe a mood problem characterized by sadness, withdrawal and a variety of negative symptoms. You may have seen commercials or heard from doctors that it's caused by a chemical imbalance in the brain. This isn't entirely accurate. Much like listening to political campaigns, this definition has been one that some factions prefer, but is in fact a misunderstanding of the facts. They refer to the belief that the change in level of Serotonin in the brain is the cause of the depression.
It's true that when a person is depressed they show a reduction in the level of Serotonin in the brain. However it's unclear whether this chemical change is a cause, an effect or a co-existing symptom with depression. We also know that medications that increase the level of Serotonin in the brain can help reduce symptoms. Unlike in the television commercials, people using these medications rarely experience a transformation into the happy, joyful people you see on television. Antidepressant medications can be very helpful, though, in reducing symptoms so that depressed people can begin to do the daily activities and participate in therapies that can truly help resolve the depression.
About half of depressions, statistically, resolve within six months even if untreated. How do we go about increasing the chances that a particular depressed person will be one of those who improves in a reasonable length of time and gets on with his or her life? Family Therapy theory and treatment methods differ from the mainstream approach regarding depression.
Traditional wisdom, whether with youth or adults, is to reduce the pressure on the person so that they don't get worse because they're suffering from a disorder. In Family Therapy we're more likely to think of depression as the onset of inertia while a person is working something out for themselves. The Law of Inertia in general states that an object in motion will tend to stay in motion and an object at rest will tend to stay at rest - unless it's acted upon by an outside force.
The more withdrawn, inactive and emotionally paralyzed a depressed person becomes, the more an outside force will be needed in order to get him or her back in motion. Therefore, we are proponents of steady healthy pressure on the person to keep her or him maintaining normal functions. This pressure also pushes the person toward known remedies to depression such as aerobic exercise, meditation, yoga, tai chi, changes in eating habits and exposure to humor and positive distractions from one's own thoughts.
The further a person is allowed to withdraw from normal life the longer the journey will be back toward normality. Rather than a mantra of DON'T PUT PRESSURE ON HIM we encourage a mantra of EXPECT NORMALITY. We find that the person's journey back toward feeling normal will be much shorter with this approach.
As a final thought, the Depression Project at the University of Michigan carried out a three year study of responses to treatment for depression. Among their findings was data that showed that depressed adults improved more rapidly in marital therapy than they did in individual therapy. Perhaps that improvement was because the presence of another family member in therapy allows the therapist to choreograph interactions at home that activate the depressed person. The therapist can utilize that other person as the "outside force" to combat the inertia we discussed earlier.