There are two dominant approaches to depression in Western societies; medications and talk therapy. Medication can work for some people but it has dangers and possible side effects, and it does not work for many. Talk therapy, and the related cognitive behavioral therapy, as we will see, are better for causing depression than for curing it. Both of these treatment modes fail to examine the real causes of the epidemic of depression. Let us begin by examining the root of depression then.
Humans evolved, although most of the Social Sciences will deny this. The mind is just as subject to evolutionary selection as any other physical feature is. So unless we want to deny the Theory of Evolution we have to say that emotions, which all normal humans have, are an evolved feature.
If emotions evolved then they are not just there for fun, they exist because they increase our fitness. So saying that depression is "caused" by an imbalance in chemicals in your brain is a denial of the Theory of Evolution, and that is pretty backwards thinking for a scientist. If emotions evolved then in most cases we should experience those emotions because of some trigger from the environment. Depression is not a random event.
What might be triggering depression on such a massive scale? Approximately 18 million American adults suffer from depression in a given year. Millions of children are also affected. Even four percent of preschoolers, according to some, suffer from depression. The common thinking blames various traumatic events; divorce, neglect, abuse, yelling, conflict, violence, even watching violence on TV according to some. Strangely, anthropologists document most of these same problems in tribal cultures, but there are few reports of depression in the literature. And certainly even in Western societies not everyone who has a difficult childhood or who watches violence on TV suffers from depression. Even more telling is the incredible rise in the rates of depression in America, from 3.3% to over 7% just from 1991 to 2001. There is no chance that the rate of traumatic events doubled during this period. What then makes the difference?
Let us briefly examine what makes us happy, something Psychology has only just begun to do. (How do you cure depression if you do not know what makes people happy?) Love, friendships, being praised and having our work recognized, helping others, feeling a part of a community, accomplishing things; all of these make us happy, and keep us happy. All of these things increase our fitness, evolution gave us an emotional reward for things that increased our fitness.
Evolution also designed our emotions to make us depressed when we lacked the above, especially when we lack social support. Humans did not evolve to be very fit on their own in the world. We evolved as a group social species that had to depend on each other to survive and thrive. If we find ourselves without the social support that evolution expected us to have except for in extreme circumstances, it makes us depressed.
Modern society is one where many of us do not have any kind of stable social groups, we spend most of our time alone or with relative strangers at work. Children often see their parents infrequently. Our evolved mind interprets this as our having been rejected by the tribe, and is likely to trigger depression to spur us to change. Many who achieve "success" are still depressed, lacking social support. Actors get fame and money but live in a world where trust and real friendship is close to non-existent. They self-medicate with drugs and alcohol.
Enter the Psychiatrists, working hard to cause depression. Studies show that the people who are happy and recover quickly from hardships are the ones who dwell on the past the least. They just forget about it and move on. Talk therapy is there to make you dwell on the past more, much more. Cognitive behavioral therapy aims to strip us of our illusions about ourselves, to force us to see who we really are. This is a strange objective since one of the main ways to diagnose depression is that the sufferer becomes far more objective about who they are than someone who is happy is. How about a little salt for that wound? Happy people have positive self-deceptions about themselves that help them try to impress others and keep them feeling good about themselves.
Then Psychiatry frequently punishes the patient mentally for the failures of the field, telling people that they have to "learn to love themselves before they can expect others to love them." Never mind that this is not how evolution designed us, being social creatures, and is therefore a completely impossible task. If no one likes you, you are not supposed to love yourself. This message can make depressed people feel like the failure is their own and many, giving up hope of ever achieving the impossible task which they are told is the only way to become happy, kill themselves.
Enter the medications. These anti-depressants help between 30 and 45 percent, depending what study you believe. Some studies show them to be only slightly more effective than sugar pills, and they do have some serious side effects. Some evidence suggests that they can cause suicides. Only a few years ago we learned that these medications affect the brain in a way completely different from how we had thought, so to say they are poorly understood is a huge understatement.
Society needs to recognize that depression is most often a symptom of how society itself is currently structured, and not an individual issue at all. From 1991 to 2001 we had marked increases in the number of single Americans, the number of parents where both were working full time, the amount of time we spend on computers (which correlates with social isolation and depression), and in the number of Psychiatrists.
We need to connect with each other more, and that starts with ending the huge fear campaigns that teach us to be wary of each other. It continues with making our cities and public spaces conducive to people walking and getting together, making new friends. It means turning off your TV and computer and going and meeting your neighbors. It means trusting each other and acting that way.
In the neighborhood in Tucson I lived in until recently I helped to make a new park, designing it so that people could easily sit together and kids could play in unstructured ways, ways that mean they socialize with each other more than with swing sets and slides. We put in a large sand play area with some large rocks and a climbing rock and my mom bought some sand toys and just left them there. In over a year only one has disappeared, and other people have brought more toys and left them for the kids. Now kids just walk themselves to the park, run into each other and play together. The neighborhood has Fiestas there and everyone knows each other. People in the neighborhood are happy, have a sense of community, help each other out.
A new park is far better for our mental health than Prozac or hours of being blamed or dwelling on bad events in the past. Better still, most in the neighborhood helped design the park or make it happen in some way; we all feel a great sense of having helped our community. Which makes you happy. I was always thrilled to ride past and see kids happily playing, and I married my wife on the stage that I had designed.
If you are depressed, think about how you can help others. Think about how you can change your neighborhood to make it more of a neighborhood. Do something that requires you to trust someone.
Finally, a recent study showed that there is a bacteria in soil that has the same effect as Prozac on our brains, without side effects. Exposure to this is easily gotten by doing gardening, going for a hike, playing outside. Things we do less and less but which are very good for us physically as well. Spending time outside helps us connect with each other and breath in this bacterium, both of which help us be happier.