Melancholia, as it was known in Ancient Greece, was thought to be due to an imbalance of the four basic bodily fluids, or humors. This condition, now afflicting roughly twenty percent of adults and the leading cause of disability, is better known today as Depression.

A dizzying array of hypotheses, whether based in science, medicine, neuroplasticity, psychology, physiology, or even philosophy, have now overtaken that ancient theory such that the layperson might be tempted to default back to the humors explanation. Nevertheless we shall identify a couple of the more modern approaches in hopes of deriving something worth discussing.

Even the basic science behind Depression remains provisional with the current research now citing the lack of any clear evidence behind the once-established belief that Depression is caused by a "chemical imbalance," a lack of the neurotransmitter serotonin, in the brain. The focus article cites two books that offer alternative explanations i.e. the "stress response run awry" theory leading to this "total-body" illness felt in the mind or, the second book, the result of a malfunctioning immune system (Breaking Through Depression).

Both books thus suggest antidepressant drugs would be better directed at altering the fundamental cognitive bias behind one’s perception of the world i.e. seeing this “doom-laden” thinking more in terms of a neurodegenerative disease. Reframe the brain. Gee, the layperson might think, this sounds like a restatement of existing cognitive behavior therapy. Maybe, but there’s more.

Enter the introduction of psilocybin as a tool we had discussed before in a different context ( in MM 7/24/17 Psilocybins and Fear of Death) as we contemplate its power to open the doors of perception by reconnecting different brain regions in order to rewire an existing neurological distortion. Science alert: it does this by docking into the same receptors as brain-derived neurotrophic factors, a protein that promotes the growth and rewiring of neurons – a chemical reboot.

This subject would seem to be of great interest whether or not you or an acquaintance have personally experienced this “cancer of the self.” The chances are higher in the West than you might think. A study in one such country, Scotland, revealed close to a quarter of its adult population is now being prescribed antidepressants (the U.S. close to 15%), along with a host of other drugs to address anxiety, insomnia, along with so-called z-drugs and opioid-based pain medication.

The reason given for the marked escalation is intriguing – it really comes from the greater awareness of depression’s treatability, so that the reality is the one-quarter affliction rate has probably been the steady-state all along. Even that rate might be skewed artificially low as the study (allegedly) excluded those deemed to be suffering severe depression, comorbid anxiety and suicidal thoughts, those in the class who would seem the most relevant. The article cites studies that support the skepticism in the first article about the efficacy of the serotonin inhibitors.

We can take the above for what it’s worth as we judge for ourselves the observations in this other piece, A New "Brave New World" piece, including its case that depression is part and parcel of this growing medicalization of society, when we see illness as simply an issue to be solved by technical intervention. The problem (as asserted) is that it masks the more fundamental problem which is the mismatch between our nature as human beings, stretching back 200,000 years, and the very different social (industrial) world we now inhabit.

Member Monday is the perfect place to rebalance the humors.