So much has been said, written, and thought about nearly every aspect of depression. Every day, we know more about the factors that contribute to it, the factors that maintain it, and we've even made progress towards identifying effective treatments for depression. The NIH spent about 400 million on depression research last year. Each month, our journals are full of worthy articles about the cognitive, social, biological, genetic, and developmental aspects of depression. Recently, legislation was passed to establish a National Network of Depression Centers to improve research, diagnosis, treatment and care for the 1 in 5 Americans that will suffer from depression. I could go and on with exciting developments. But sometimes I fear we may be mistaking motion for progress.
There remain three great mysteries about depression that are in my opinion completely unsolved.
(1) Why is there a depression epidemic in affluent western societies?
(2) Why haven't massive investments in research enabled us to reliably identify the putative defects (biological or otherwise) that define depression?
(3) Why is depression so recalcitrant to existing treatments?
It feels like the more we understand the details of depression, the more out of touch we become about the big picture. For other disorders, like simple phobias, research has produced breakthroughs that have yielded true cures, such as rapid exposure treatments that can wipe out a phobia in a single session. For depression research, I cannot identify a single finding that truly justifies the word breakthrough, and it is obvious that there are no cures now, or on the immediate horizon (see my previous post on this issue).
This gap between our energic and well-intentioned aspirations and our results to date feels like the elephant in the room that no one wishes to discuss. I cannot ignore it any longer. I have a Sabbatical year coming up and I have decided to devote it to writing a book about the "big picture" of depression aimed at a general audience (not just other academics). I hope to use my perspective as an emotion researcher to sort out why progress in understanding depression has been so elusive (and possibly even illusive). I hope I will find answers to these mysteries that readers will find satisfactory. When I say satisfactory, I mean the answers will resonate both to what scientists know from research studies and to what depressed people have learned from their often hard personal experience. A steep climb, for sure. Please wish me luck. I will post periodic updates on the Charting the Depths blog. For now, I welcome your thoughts and comments on any of these mysteries.