Abstract
This article develops the idea that clinical depression can be seen as a typical human response, largely rooted in human culture, to events of loss or times of adversity. Various biological, psychological, and social factors may cause some individuals to have a depressive reaction that is ineffectually limited in time and/or severity. Recovery occurs mainly based on natural resilience mechanisms, which come into play spontaneously, but which are sometimes inhibited or blocked by specific pathological biopsychosocial mechanisms. One of the mechanisms for this could be the influence of the circuits that regulate pleasure and happiness, along the dorsal diencephalic connection (DDC) pathway from the forebrain to the midbrain via the habenula. Therapy works by undermining the biopsychosocial factors that prevent the natural recovery mechanism from working. Treatment should, therefore, be seen as facilitating rather than causing natural recovery. This approach is in line with the high recovery rate after placebo treatments and the positive influence of pharmacological treatments with completely different sites of action. Acceptance of this model means that when studying new treatments for depression, a new paradigm must be applied in which the relative value of antidepressant treatment is specifically weighted in terms of enabling the natural resilience process.
Highlights
Since the pioneering ideas of Emil Kraepelin [1], neuroscientific psychiatry has been dominated by the paradigm that psychopathologies, such as schizophrenia and bipolar disorder, can be considered as ‘nosological entities’: well-defined disease units, which can be mutually distinguished [2,3,4,5]
We argue that the explanation for the low effectiveness of drugs in treating major depressive disorder in pharma-trials is mainly related to dominant social and cultural factors, which accompany the clinical picture in the generally accepted traditional notion
We suggest that the lack of a delayed specific antidepressant effect in our study is more related to the current types of depression covered by major depressive disorder in comparison to former ‘endogenous’ depression than to the effects of antidepressants, therewith following the idea of Stassen et al [11] about the nature of the antidepressant mechanism of action
Summary
M. Loonen 1, * , Taichi Ochi 1 , Lisanne M. Touw 2,7 , Bob Wilffert 1,2,† , Alexander N. Division for Control and Diagnostics, School of Non-Destructive Testing and Security, National Research. L.M.; Simutkin, G.G.; Bokhan, N.A.; Touw, D.J.; Wilffert, B.; Kornetov, A.N.; Ivanova, S.A. A New. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil-
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