Depression: Does No-Fault Equate to No-Hope?

John McManamy Health Guide
  • A few weeks ago, I posted Ten Depression Myths Busted. (The post appears to have vanished, so here is my repost.) Two commenters took issue with a key point in my piece, which begs this response:


    One of the myths I attacked was the one about depression being all your fault. Wrong, dead wrong, I said. There is a clear biological basis to depression. I deliberately refrained from comparing depression to diabetes (which so many people do), but I could have said that no one ever tells us to snap out of our diabetes.


    So far, so good. Then I directly contradicted myself by challenging the notion that depression is NOT your fault. This time, I did mention diabetes, namely:

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    If you have a chronic physical illness such as diabetes, you don’t push your luck by indulging in sweets. Knowing that we have a predisposition to depression challenges us to lead more disciplined lives. We may not always prevent a depression from occurring, but we can learn to get smart about reducing our risks.


    Toward the end of the piece, I also mentioned that “over time, with effort, we can lay down new neural roadwork.” Not only that, “we can also change our environment. And - very mind-boggling - by changing our environment we may change our genes.”


    So, obviously, those who don’t put in the effort, those who don’t lead disciplined lives, they get what they deserve, right? Of course not. But maybe I didn’t emphasize the “of course not” enough. 


    Jim Phelps, author of “Why am I Still Depressed?”, on his Psycheducation site, frames the issue this way:


    "Just because we know a part of the cause of depression is beyond your control does not mean that the solution is beyond your control." (My emphasis.)


    Dr Phelps was referring to a study that I frequently cite here at HealthCentral (see eg Facing Past Trauma, Part IV). In the study in question, researchers found an association between being exposed to stressful events and depression. The real eye-opener was that those with a variation to a particular gene (the short allele to SLC6A4, if you want to get technical), were way more likely to suffer from stress-related depression than those without this variation.


    The journal Science lauded this particular study, together with related studies, as the second-most significant scientific breakthrough of the year 2003, and it’s easy to see why. There, in a nutshell, we have a credible synthesis to all those genes/environment, nature/nurture dichotomies. To vastly oversimplify: 


    Our genes may render us vulnerable to stressors in the environment, past trauma, and so on. One result is we may get depressed. Other people may have genes that protect them against these very same stresses. Lucky people. 


    We’re stuck with our genes, but we can, to a certain extent, change our current stressful environment to one less stressful. Here’s where it gets interesting: By changing our environment, we have some say over whether our vulnerable genes get switched on in a bad way or not. In effect, we can use our environment to control our genes. 


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    In other words, we are not necessarily doomed by our biology. This is what Dr Phelps is driving at when he says the solution is not beyond our control. Granted, we can’t just snap out of our depressions, nor is it easy to change our behaviors. Likewise, there are no guarantees. But we do have the promise of a better life by acting as though we have some say in the matter. Are you with me? 

Published On: December 28, 2012