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"Depression's Upside" is the title of a New York Times article I just read, which explores the possibility that depression can have a positive effect on mental health.

Andy Thomson and Paul Andrews, the authors of the paper cited, argue that an area of the brain closely associated with depressed people (the left ventrolateral prefrontal cortex, or VLPFC) is also important for our ability to intensely focus our attention on a particular problem or situation. Thus, when depressed people are using their VLPFC, they are also training themselves for more difficult mental tasks.

Thomson, a psychiatrist, seems to value this training above the current medical climate, which seems to favor medicating depression. "As a society, we’ve come to see depression as something that must always be avoided or medicated away," he says in the article.

"We’ve been so eager to remove the stigma from depression that we’ve ended up stigmatizing sadness.”

The article highlights a lot of objections to this argument, including that Thomson and Andrews homogenize depression, which in fact has many different causes and effects; that depression can lead to suicide, which certainly does not help the brain; and that when it is particularly severe, depression can be completely crippling, making any possible benefits seem somewhat remote.

But Thomson responds with a story from his clinical practice about how he treated a depressed woman with medication, only to find that while she was no longer "depressed," per se, the situation in her life that contributed to her depression had not gone away. "The point is the woman was depressed for a reason; her pain was about something," the article states.

I found Thomson's and Andrew's argument compelling, on a personal level at the very least. I've never been severely depressed—I can only speak to my own mild, occasional depression (which, after all, maybe doesn't even count as "depression")—but I've found that lifestyle changes are extremely effective at changing my mood. Often, I'm depressed—or perhaps just "sad" is more accurate—because I've been sitting around and not doing anything. When I get up, get things done, feel accomplished, I feel better. Moreover, when I've had longer periods of (admittedly) non-severe depression, I've come out of them with new insights about my life.

To me, this makes more sense than the immediate move to pathologize all depression and treat it with medication. While, in the end, everything may just come down to chemicals in the brain, there's no denying that life circumstances affect those chemicals. Or, in the language of our class, some aspects of depression may be purely brain-related: outputs with no inputs; others, however, have an identifiable external source.

As Thomsons asks, why do we assume that all sadness is inherently bad? Using medication to maintain some kind of artificial level-ness in mental state seems unhealthy—people get sad, people cheer up. Sometimes, it takes a long time, and in rare cases, it takes more than just time to clear it up, but overall, the fluctuation seems like a natural part of human existence—something to think about, evaluate, and discuss, but not something to medicate out of existence.

I'd appreciate any attempts to more closely tie this issue to the specific terms and ideas we've been discussing.

http://nytimes.com/2010/02/28/magazine/28depression-t.html