I have a bone to pick with “Depression.” There are too many things that I do not understand about it.
Interestingly, the questions aren’t so much about how to treat or work with depression. We know, for example, that three approaches working simultaneously and in coordination with each other are remarkably effective in dealing with depression. They are:
✓ Therapy (helps some)
✓ Medication (helps some)
✓ A lot of Community and Connection (helps a ton)
The research is clear that 70% or more of people dealing with depression achieve real, long-lasting improvement when these three elements are working in tandem. Each one by itself is much less effective. The treatment of depression is essentially a good news story.
Instead, my questions for “Depression” have to do with how widespread it has become. In these musings I will simply pose questions, because I do not have answers for them. The questions seem to stubbornly resist answers. That is why I’m not impressed with “Depression.” I want answers to these questions, and they are not forthcoming—at least to me.
Bill Wilkerson is a colleague of Shalem. He is the Director of Mental Health International. Bill is working especially in Europe to develop partnerships between business, researchers and practitioners to find a cure for depression. He has taken this on as his life’s work, and he is a tireless and effective advocate.
Here are three facts that Bill highlighted in a recent speech, called The Early Light of a Long Sunrise:
✓ If depression were a country, it would be among the top ten most populous in the world today.
✓ According to the World Health Organization, by 2020, depression will be the leading cause of disability in the world.
✓ A study by the European Commission has calculated the costs of depression to the European Union. They break down as follows:
✓ €270B/year through employee lost work time.
✓ €240B/year through reduced output.
✓ Healthcare and social welfare of €100B/year.
✓ 84% of the total EU depression cost burden is thus borne by business, while 16% is borne by government-funded healthcare and social welfare.
Here are my questions:
1) Why is depression so widespread, and why does it appear to be spreading like wildfire?
2) Depression is a “Western” condition. It does not exist in cultures that have not been touched heavily by modernization. What is going on there?
3) We also know that there can be a genetic component to depression. If that’s true, then why does depression only appear in Westernized countries? How is it possible that a genetic condition only appears in countries that have embraced or been affected by modernization?
4) One can describe depression as a “prosperity” disease. What is it about prosperity that seems to correlate with depression? Of course, in the West, depression affects people from all walks of life. People who live in poverty, who deal with anxiety about where their child’s next meal will come from, are understandably especially susceptible to depression. Nevertheless, at a macro level, depression appears only in countries that have embraced Western forms of achieving monetary prosperity.
I have no answers to these questions. Perhaps they are the wrong questions. But so far “Depression” is not good at delivering answers. I really want to find them, because in the meantime, depression is exacting a heavier and heavier toll around the world—on people, on families, on economies, on businesses, on governments, and on societies.
People who deal with depression have my utmost respect and appreciation. The journey of healing can be long and challenging. But the good news is that have learned a lot about treatment, and it is often effective.
Mark Vander Vennen, MA, M.Ed, R.S.W., is Executive Director of the Shalem Mental Health Network