The physical world we have created and within which the incidence of depression is most rapidly rising is the densely populated Western city. It is made of concrete, steel, glass and asphalt. Most of us breathe hydrocarbon polluted air, eat nutritionally harmful or vacuous food (see your local fast food menu or supermarket tomato or strawberry for details), and drink plasticized bottled water. The National Institute of Health is studying over 900 new-to-nature chemicals, thought of as hormone interrupters, to see what effect they have on us.
If we are fortunate, we may have an ocean retreat from the man-made. If we are less affluent we may make special trips to connect to nature, be it at the zoo, or the botanical gardens. But for most of us in most of Western civilization, nature is absent from our daily life. We and nature are strangers, distant relatives, and therefore we have become estranged from an important and deep aspect of our own natures. We do not, in a personal sense, understand nature as Thoreau came to, when he was at Walden Pond. I experienced this for several years as an avid mountain biker. Year after year I would bike the same trails. I was foolishly surprised when, after a winter away, the forest had changed. Year after year, bit by bit, storm by storm. I began to notice the death and new growth, the re-working of the bike trails around natures events.
Most of us do not know, in our bones, the slowly changing rhythms of the forest, through the seasons, and year after year. We can only see time passing in the faces of our loved ones, or the mirror, but we do not experience the naturalness of the passage of time via a changing, slowly morphing landscape around us. We have lost the mirroring experience which the natural world provides us around the experience of time, the naturalness of it, as we might experience, if we lived connected to nature. And so we are left with an experiential void which is filled by a tremendous existential aloneness and anxiety about the strangeness of death, which seems quite disconnected from our lives, and therefore fails to inform our lives with meaning and value. We are no longer chaperoned through the stages of our lives by nature. And so we cling to youth, attempting to freeze time.
In the purely physical universe, where there is no inherent meaning, and no dialogue with nature, we seek solace in the physical. We buy what we don't need, because it is supposed to make us feel good. We work harder to buy more, because it may make us feel better. Safer. In the process, we become alienated from our families (too much time at the office, too much pressure on performance which translates into money and purchasing power and ultimately, safety from financial anxiety), our coworkers (who are generally viewed as competition).
Furthermore, as a culture, western society seems to have lost its center, and seems disoriented, and without a higher purpose. The capitalistic ethos seems to have replaced a constitutional, higher purpose or imperative.
And finally, we, as a society remain largely unconscious of the issues I have raised above, about our effect on other cultures, and on our planet. In the last 90 years, two world wars, multiple holocausts, threatened nuclear annihilation, and now a massive global imbalance are in the consciousness of each person on the planet. It is all very real, yet we, as individuals, as political parties, as families, communities and as a culture, are quite willing to be unconscious of the clear evidence that our current approach to human existence is failing. What is often said to alcoholics-the definition of insanity is doing the same thing over and over again and expecting a different result-can certainly be applied to Western civilization. Perhaps, with the current economic crisis, we have ‘hit bottom'.
And so, to circle around to the point at hand-if one is living in a fundamentally imbalanced and insane culture, is it surprising that greater and greater numbers of individuals are presenting with depression? Should we be so myopically focused on the individual? Is that individual focus not part of the reductionsitic thinking that has limited the effectiveness of the current treatment approach? Can and should the individual carry the full burden for recovery from depression?
It seems that on a collective level, higher numbers of depressed non-functioning individuals are already causing a braking, or a negative feedback loop to the growth of the culture, via excessive health care costs, comorbid conditions such as diabetes and heart disease, and reduced viability of the individual, the family unit and therefore the community-all known sequelae of depression.
If we can learn about and understand the links between the brain and the immune system, and between diet and mood, must we not wonder about the links between the culture and individual behavior, between the stresses of Western psychology and the craving for something to satisfy the inner emptiness? Is there not then a link between this craving, and the purchase of material goods (and the attendant stresses of paying for them), just as there is between the intake of sweets and the subsequent inflammatory response?
Ultimately, reduction of the incidence and prevalence of depression on the public health scale will not come from anti-depressants, individual psychotherapy, or from fish oil. It will come from a re-connection of the individual with the larger whole of the family, the community, a purposeful culture, and a dialogue with nature and meaning. This will require a rebalancing of the male-dominated, individualistic, domination oriented culture (in which reason and logic are the only way of knowing) with the feminine, wholistic, interactive and participatory approach to life. We, as human beings need a balance of both to thrive. Socioeconomic and political efforts to incorporate such an integrated view of ourselves, the world and our futures are the therapy which this culture requires, if we are to stem the rising tide of depression.
In the many older cultures (e.g., Jewish, Indian), the collective community is responsible for the well-being and good behavior of the individual. So too, must the larger Western society and culture be held accountable for its role in the mental health and wellbeing of individuals.