Depression Is Contagious: How the Most Common Mood Disorder Is Spreading Around the World and How to Stop It

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9781416590743: Depression Is Contagious: How the Most Common Mood Disorder Is Spreading Around the World and How to Stop It


Depression is more of a social problem than a medical illness, reveals expert psychologist Dr. Michael Yapko, whose revolutionary new approach—based on the latest research—treats depression with positive social relationships, not drugs.

Depression is now the world’s most common mood disorder, and is spreading like a viral contagion. You can’t catch depression in the same way you catch a cold, but the latest research in neuroscience, social psychology, epidemiology, and genetics provides overwhelming support that moods spread through social conditions. Our social lives directly shape our brain chemistry and powerfully affect the way we think and feel; our brains change with positive life experiences and can change as much with social circumstances as with medication. Drugs may address some of depression’s symptoms, but they cannot change the social factors that cause and perpetuate it. Indeed, Dr. Yapko argues convincingly, by treating a social condition as though it’s a disease, the problems will spread rather than diminish.

In Depression Is Contagious, Dr. Yapko identifies the patterns often seen in modern relationships that lead to depression and provides practical exercises that will help readers develop the skills and insights they need to forge stronger, healthier social connections. This practical, definitive book provides an empowering prescription for hope and healing through people, not pills.

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About the Author:


Michael D. Yapko, Ph.D.
, is a clinical psychologist and internationally recognized expert who lectures widely on depression, psychotherapy, and clinical hypnosis. He is the author of ten books, including Breaking the Patterns of Depression, Hand-Me-Down Blues, and Suggestions of Abuse. He lives with his wife, Diane, in Fallbrook, California.

Excerpt. Reprinted by permission. All rights reserved.:

Introduction

The rate of depression is rising. According to the World Health Organization, the international watchdog of health issues around the world, depression is currently the fourth greatest cause of human suffering and disability around the world. That observation alone tells us how serious and pervasive the problem of depression already is. Even worse, however, is the World Health Organization prediction that by the year 2020, depression will have risen to become the second greatest cause of human suffering and disability. This unprecedented rapid growth rate is strong evidence that biology is less a factor in its spread and social forces the greater factor.

Is depression really on the rise, or are people just more tuned into depression as a general topic of interest? The best evidence we have suggests strongly that depression is increasing in prevalence not only in the United States but around the world. This is not simply because more people are seeking help for depression or because wary clinicians are diagnosing it more frequently. Rather, the increase appears to be the product of more and more people manifesting the signs and symptoms of depression.

People Can Spread Depression

What we do to each other can too easily become the source of great hurt in our lives and can result in an enduring way of thinking, feeling, and relating to others. But, we are relearning something of vital importance that has been too often overlooked in recent years: Just as people can be a source of pain, they can also be a source of comfort and happiness and a way out of pain. In light of new research, being the strong, self-sufficient “go it alone” type no longer seems the most effective route to personal fulfillment. Instead, science is confirming what we have probably always known in our hearts: We are built to be in positive, meaningful relationships with others in order to feel good. Yet, today, our relationships are damaged and suffering in unprecedented ways.

As relationships face more challenges, whether in love, family, business, or friendship, depression is on the rise. Depression spreads in part through troubled relationships and, in this sense, is socially contagious. You can’t catch depression in the same way you catch a cold, but the latest research in neuroscience, social psychology, epidemiology, and genetics provides overwhelming support that moods spread through social conditions. Our social lives directly shape our brain chemistry and powerfully affect the way we think and feel. With modern scanning technologies, we now have evidence that our brains change with positive life experiences. In fact, brains can change as much with social circumstances as with medication. Drugs may address some of depression’s symptoms, but they cannot change the social factors that cause and perpetuate it.

The Skills for Living Well

What makes for healthy, strong, happy people? Why do some people face stressful and challenging events in life and seem to rise above them, while other people implode in the face of what seem like routine stressors? These questions provide the foundation for much of what I will talk about in this book. The vast majority of research into depression has focused on the pathologies within people that presumably give rise to the disorder, such as character defects, anger-turned-inward, and chemical imbalances in the brain. Only recently has there emerged a different paradigm for thinking about human experience. Known as positive psychology, its focus is on what is right with people rather than on what is wrong. Instead of studying people who suffer, positive psychologists study people who have overcome adversity and thrived, who are happy, competent, and fulfilled. By striving to identify people’s strengths, psychologists hope to help those who are suffering.

One of the first tasks positive psychologists attempted was to develop a new manual that would catalogue and define many of the best aspects of human experience. Unlike the well-known psychiatric manual listing various forms of psychopathology (the Diagnostic and Statistical Manual, now in its revised fourth edition, DSM-IV-R) used by mental health professionals to diagnose patients, a new manual called Character Strengthsand Virtues was developed by psychologists Chris Peterson and Martin Seligman to identify and describe some of the best human attributes. These include the courage to speak the truth, kindness, love, fairness, leadership, teamwork, forgiveness, modesty, gratitude, and many other such positive characteristics. If you reread that list of attributes, you cannot help but notice that they are wonderful human potentials that can only be expressed in the context of human relationships. Simply put, how people develop their best selves is largely, though not entirely, achieved in the context of positive relationships with other people.

At a time when we are learning how vitally important it is to have positive and healthy relationships, we are seeing such relationships on the general decline. Even a cursory review of recent U.S. Census data shows us the warning signs: More people are living alone than ever before, people wait longer to marry, on average, yet the national divorce rate remains slightly over 50 percent for first marriages, and even higher (about 70 percent) for second marriages. The number of births outside of marriage has risen sharply, and single parents who must work and are thereby too often unavailable to their kids experience and transmit stresses that are widely cited as a reason why children are often struggling emotionally. Millions of children are currently on antidepressant medication, as well as other psychoactive medications for their social and behavioral problems.

As families struggle and marriages wobble, large studies of the prevalence of various disorders in the general population show rates of depression nearly four times higher than a generation ago and nearly ten times as high as two generations ago. Social skills have declined and relationships have become less rewarding and effective. As a result, the vulnerability to depression has increased.

For over half a century, researchers have known that good relationships serve as a buffer against illnesses of all sorts. The evidence is clear, for example, that when you are happy in your primary relationships, you suffer less depression. Furthermore, people who enjoy close friendships and the support of others are happier and more productive. They also suffer fewer illnesses and, on average, live longer. We will explore the health and mood benefits of good relationships with others in the first chapter. What most of this book will be about, then, is how to develop the kinds of relationships that can help you overcome depression, and perhaps even prevent it.

Depression Rises as Relationships Fall

Mental health experts have generally treated depression by giving their patients drugs and shock treatments and other newer brain stimulation treatments, or by talking with them about their childhoods. Yet the social conditions that give rise to depression continue unabated, allowing the rate of depression to continue to rise at an alarming rate. New research makes it clear that depression is not just about the suffering of one individual, as if he or she lived in total isolation. Rather, depression occurs in a social context; it occurs within people, and also arises from the hurts that take place in relationships between people.

The pains of rejection, humiliation, the loss of a loved one through a breakup or death, the betrayal of trust, the trauma of violence and abuse, and the many other ways people can wound each other are all reliable pathways into depression. Simply put, depression can be and often is a direct consequence of relationships that are, well, depressing.

Depression doesn’t just affect individuals, although it’s easy to focus on the person with the symptoms. For every depressed person who gets treatment, at least four more don’t. For every depressed person who doesn’t get treatment, his or her depression affects the lives of at least three others. For every depressed parent who goes without treatment, his or her child is at least three times more likely to become depressed than the child of a nondepressed parent. Relationships can spread depression as surely as germs can spread illness. Depression is contagious.

More and better drugs will not solve the problem. People who suffer depression, and the people who love them who suffer right alongside them, must also avoid overthinking the symbolic meaning of the depressive experience. Depressed people are usually already quite good at isolating themselves and thinking too deeply about themselves. Instead of examining them even more closely under the microscope, analyzing ever smaller pieces of their psyche, as if depression is just their individual problem, the solution lies in a broader view. We need a macroscope. We need to see depression in its larger social context, see it for what it is when the world gets more dangerously crowded while people are literally dying of loneliness.

Depression Gets a Lot of Attention ... but Not Nearly Enough

Few mental health problems have received as much attention as the problem of depression. There are many reasons: (1) Depression has a huge financial impact on our society because of the exorbitant economic costs associated with it; these are measured in terms of lowered productivity, more employee sick days, and diminished job performance. Current estimates indicate depression is costing the U.S. economy at least $70 billion per year. (2) Depression’s cost in terms of health care expenses is huge since it is so closely associated with cardiovascular disease, diabetes, smoking, drug addiction, and many other costly health related problems. (3) Depression exacts a heavy toll on individual lives, causing high levels of suffering, anguish, unhappiness, and even the ultimate loss of life when people in despair kill themselves. (4) Depression is terribly destructive on the social level. Depressed people are often unable to establish and maintain healthy family environments and constructive working relationships with others, or to build loving and positive relationships with others. Some depressed people even destroy and sabotage important social bonds and harm society through antisocial acts.

The power of depression to damage and destroy lives cannot be overstated. We in the mental health professions have worked especially hard to better understand and treat depression and, over the last two decades, our understanding of depression has increased dramatically. In fact, depression has gone from being one of the least understood to one of the best understood disorders that clinicians treat.

A Multidimensional View of Depression: Multiple Paths into Harm’s Way

Many things cause depression. Some factors are biological, some are psychological, and some are social. Hence, a biopsychosocial model of depression dominates the field.

The biology of depression is an extraordinarily complex arena of research. A young field called affective neuroscience is striving to understand the brain mechanisms underlying moods and mood-related disorders like depression. Geneticists are investigating the role of genetics in vulnerability to depression. Psychopharmacologists are striving to understand the role of neurochemistry in mood states in order to better understand how drugs might more effectively be employed in treatment. Some optimistically envision a day when “designer drugs” can be tailored to an individual’s unique biochemistry.

The psychology of depression is also an extraordinarily complex area of study. Psychologists have always been interested in how people’s quality of thought affects their mood states and how one’s behavior increases or decreases vulnerability to depression. The study of factors such as personal history and styles for coping with stress and adversity has generated important insights about who gets depressed and under what conditions. Many previously unrecognized factors that influence depression’s onset and course have now been identified. Great strides have been made in developing effective psychotherapies for treating depression which are based on sound scientific research.

Biology and psychology—singly and in combination—play a large role in the development of depression, but considering only these domains in treatment has proven less helpful than psychotherapists had hoped. Drugs have become the most common form of treatment, even in the face of the accumulating volume of objective evidence that clearly demonstrates antidepressants—alone or even in combination with other approaches—have numerous problems associated with them. Likewise, the psychotherapy of depression has shown itself to be less effective when it treats depression only as an individual phenomenon. Talking about your depressed feelings or exploring your childhood can too easily miss the fact that an individual’s depression occurs in a social context and is even socially defined. Your mood and outlook are powerfully influenced by your relationships with others.

No One Is a Biochemical Island

It may seem obvious that our relationships with other people affect our moods, behavior, and quality of life, yet most people focus almost exclusively on the biology of depression when seeking solutions. This is primarily because the drug industry has aggressively marketed the self-serving but unfounded perspective that “depression is caused by a chemical imbalance in the brain.” We in the United States are bombarded by television, radio, and print advertising that asserts that depression is a “brain disease” requiring drug treatment. This may be true for a relatively small percentage of depressed individuals, but there is no objective test for depression in existence yet that could prove it. To the contrary, there is growing evidence available to disprove it.

As a direct consequence of these relentless, pervasive advertising campaigns, the average person has heard this message that depression is a biochemical problem so many times that he has come to believe it. By continually shining the spotlight on the biochemistry of depression, sales campaigns have left in the shadows other contributing factors. After all, you can’t package and sell relationships. Thus, the social domain of depression has largely been ignored. This has been a very costly oversight on the part of the mental health profession. Instead of making sure the value of drugs isn’t overstated and seeing that the merits of building healthy relationships are recognized, the drug sales campaigns have rolled right over us, misdirecting our attention from other more important considerations. The damaging message has been all too clear: You don’t need to change your life in any m...

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