Chemical Imbalance or Difficult Times?

Those suffering from depression in the 21st century are lucky--today we know that depression is a disease process and not just a personality quirk--and once a mental illness is classified, treatment becomes possible, giving hope where before there was none. Still, there is much light to be shed on the differentiations between the various manifestations of the disease. The medical profession seems hard-pressed to define the borders that separate one type of depression from another.

In general, physicians make a distinction between clinical and situational depression. Clinical depression is believed to be caused by a chemical imbalance and is most often treated with medication. Situational depression is caused by painful life experiences and it is therefore believed that the best treatment involves therapy to address the underlying cause. The borders get blurred because a short-term course of medication can be helpful in situational depression and because situational depression can turn into clinical depression when left untreated or when unresponsive to initial treatment.

There's No Lab Test

Controversy enters the picture when one learns that there is no simple lab test to determine the type of depression that is presenting in a given patient. The nature of the depression is determined by empirical data, such as the length of time symptoms are experienced. A trend of thought exists that since all depression has its origins in the mind and body, it's all chemical.

Proponents of the "all chemical" viewpoint believe that the distinction between these two types of depression is based on the belief that clinical depression can only be helped by popping pills and that situational depression requires psychotherapy. Those who see little distinction between the two schools of thought would like to see more leniencies in how short-term and long-term depressions are treated. For instance, psychotherapy may be helpful in treating long-term depression as an adjunct to medication, and medication should not be ruled out as a viable treatment for more short-term episodes of depression--medication can sometimes help people get back on their feet faster than psychotherapy.

Overwhelming Feelings

The feelings that come with situational depression can be overwhelming, but as time elapses, one may better be able to cope with and work out the emotions that come with a crisis, even without benefit of psychotherapy. Medication can help get one past the first stage of distress to a better place where one can deal with the situation that caused the initial symptoms. An open-minded physician is a good place to discuss your concerns about depression.