Is Depression All in Your Mind?
Every day, another genetic anomaly underlying a mental illness makes the headlines. Evidence of serotonin (a neurotransmitter) disorders has led to the widespread use of prescription medications such as Prozac and other SSRIs (selective serotonin reuptake inhibitors). Many people aren’t comfortable with this trend and similar ones, like prescribing Ritalin to children for attention deficit hyperactivity disorder (ADHD). Are we prisoners of our brains? If our brains are imbalanced, do we require pharmacological adjustment (in other words, drugs)? Is there no free will or responsibility for our actions that is derived from free will?
Virtually all spiritual traditions teach the virtues of self-control and responsibility. Our laws, legal system, and entire civilization are founded on the idea that people can make good or bad choices, and are to be held responsible for the results of those choices. If our choices are due to neurotransmitter imbalances, who is responsible for anything?
Societies typically take the middle ground of differentiating what is normal, a state in which the person is responsible for his actions, from abnormal, in which, to some extent, the person may not be responsible. What is the basis for a middle ground? Consider depression and the behavior that results from it. In the past, people with depression were often told, It’s all in your head or Just snap out of it. Today, they’re often given pills. Can information from neurobiology help us understand this dilemma, which is so fundamental to our role as citizens in society?
One of the most important ideas in neuroscience in recent decades has been that cognitive processes affect the brain, and the brain affects cognitive processes in a feedback loop that can spiral out of control. Depressed thoughts, such as those caused by negative events, like losing a loved one or ending a relationship, can cause the pharmacology of the brain to change so that we remember the bad aspects of things more than the good ones. Future experiences that may otherwise have been perceived as neutral get processed negatively, leading to further negative effects. Sometimes the cycle can be disrupted, and sometimes medications work, but in the long run often only when the depressed person is successful in deciding to take responsibility for correcting his life. Depression is all in the mind, but the mind is a product of the brain, and the ability of the mind to beat depression can be aided by pharmacology, or spiritual awakening, or even exercising.