The Truth About Depression
by Charles Whitfield, M.D.

Editor’s Note: Dr. Charles Whitfield is a renowned author, lecturer and therapist.  His book, The Truth About Depression: Choices for Healing, takes the position that the principal cause of clinical depression is childhood trauma and not a biochemical imbalance.

The truth about depression is that it is not as advertised.  It is not what some special interest groups tell us.  It is not the single, simple disorder that drug companies and some mental health groups may claim.  It is not simply a genetically transmitted disorder of brain chemistry.  It does not reliably respond to antidepressant drugs.  And these drugs are not the only available recovery aids.  These special interest groups may have misled us.

Their special interest is in large part about money, power and influence in the diagnosis and treatment of common mental health problems.  Much of what they tell us about depression and other mental illnesses is actually in their own best interest.  It is not always in the interest of the people who experience the pain.

At the top of the list of these groups is the drug industry.  While drug companies have produced some effective pharmaceutical agents, such as antibiotics, insulin and others, they fall short when it comes to mental illness.  But to help market and sell their drugs, they have often resorted to making up a limited theory about the cause of mental illness.  The theory is that depression and other common mental disorders are caused by genetic and other biological defects that are somehow inherent in our makeup.  In other words, they claim that we are born with faulty genes and brains—which their chemical will fix.  A problem is that after a century of looking for a cause, and since 1960 looking for a “magic bullet” drug, we still do not know what causes depression and other mental illnesses, and our drug treatments for them do not work very well.

Influenced and often financially supported by the drug industry, and probably for other reasons, health insurance companies (including those who call themselves “managed care”), some academics, professional organizations, some mental health advocacy groups and government agencies have bought this unproven theory.  These groups, which some call a major part of the “mental health industry,” have used this limited theory as a basic principle in diagnosing and treating people hurting with what they call “mental illness.”  On the surface, they may espouse the more accurate and balanced aspects of these disorders (thus a bio-bio-bio theory) and commonly ignore or even neglect the physical, psychological and social traumas in the person’s past and current history.

The DSM (Diagnostic and Statistical Manual of Mental Disorders) has traditionally  avoided addressing the causes of the mental disorders that it classifies.  Combined with the long tendency of psychology and psychiatry to discount childhood trauma as an important causal factor for mental illness, such a tradition is unlikely to be broken.

The Evidence

Over the past century, numerous observers have looked at trauma and how it affects us.  But since 1980, there has been an outpouring of over 327 clinical scientific studies that have shown a strong link between repeated childhood trauma and the development of mental illness (including depression)—often decades later.  In most of these investigations, the authors have controlled for other potential causes or associations with mental symptoms and disorders (called “modulating” or “confounding” variables in the research trade), and they have usually found them to play a less important role than did the trauma itself.  These findings have major implications for the prevention and treatment for the prevention and treatment of depression, which I address in The Truth About Depression and The Truth About Mental Illness.

For depression—now over 327 studies showing the trauma link—and alcoholism and other drug dependence (153 studies), the link with trauma is powerful.  For others, such as anxiety disorders, PTSD, eating disorders, psychoses and some personality disorders, the evidence is very strong.  Nearly every one of the 327 studies that have examined a potential relationship between trauma and depression has found it to occur to a statistically significant degree.  These investigations have also found a similar trauma-disorder link for most of the other common or major mental illnesses.

A Problem

A problem is that most clinicians – including psychiatrists, other physicians, psychologists and social workers still drink the “kool aid” that depression is a biogenetic disorder that needs drugs to get well. But the drugs not only don’t work well, but they are toxic, causing bothersome weight gain, anorgasmia, over-stimulation or sedation and have distressing withdrawl effects that make the person appear crazier. They often leave the person more distressed then they were originally.

The truth about depression is that the published clinical scientific evidence overwhelmingly shows the link between having a history of childhood trauma and the development of subsequent depression.  The truth is that antidepressant drugs are not as effective as we would like them to be in ameliorating the symptoms of depression.

The truth is that the very diagnosis of “depression” may be inaccurate and at times even totally invalid for many people so labeled.  And the most important truth is that people with depression have several more choices that they can use to heal their pain than using drugs alone.  I describe these choices to heal in my book and at my website www.cbwhit.com.