What is Depression?

Kelly Brogan, MD reveals the truth about depression, that it is a symptom and not a disease.

  • Depressed Woman
    Kelly Brogan has witnessed her patients change from perpetually drained, unsettled, mentally foggy and unable to enjoy life to vibrant and emotionally balanced individuals — without medication.
    Photo by Fotolia/Focus Pocus LTD
  • A Mind of Your Own
    "A Mind of Your Own" by Kelly Brogan, MD and Kristin Loberg gives women the tools they need to tackle depression naturally.
    Cover courtesy Harper Wave

  • Depressed Woman
  • A Mind of Your Own

A Mind of Your Own (Harper Wave, 2016) by Kelly Brogan, MD with Kristin Loberg explains that depression and anxiety are not  diseases, but rather symptoms. Brogan is revealing this information to rescue the more than 23 million women considering or taking antidepressants. Brogan outlines a 30-day plan that will enable anyone struggling with depression to finally take control of their mental and physical health. This excerpt comes from chapter 1, "Decoding Depression."

Psychiatry, unlike other fields of medicine, is based on a highly subjective diagnostic system. Essentially you sit in the office with a physician and you are labeled based on the doctor’s opinion of the symptoms you describe. There are no tests. You can’t pee in a cup or give a drop of blood to be analyzed for a substance that definitely indicates “you have depression” much in the way a blood test can tell you that you have diabetes or are anemic.

Psychiatry is infamous for saying “oops!” It has a long history of abusing patients with pseudoscience-driven treatments and has been sullied by its shameful lack of diagnostic rigor. Consider, for example, the 1949 Nobel Prize winner Egas Moniz, a Portuguese neurologist who introduced invasive surgical techniques to treat people with schizophrenia by cutting connections between their prefrontal region and other parts of the brain (i.e., the prefrontal lobotomy). And then we had the Rosenhan experiment in the 1970s, which exposed how difficult it is for a doctor to distinguish between an “insane patient” and a sane patient acting insane. Today’s prescription pads for psychotropic drugs are, in my belief, just as harmful and absurd as physically destroying critical brain tissue or labeling people as “psychiatric” when really they are anything but.

My fellowship training was in consultation-liaison psychiatry, or “psychosomatic medicine.” I was drawn to this specialization because it seemed to be the only one that acknowledged physical processes and pathologies that could manifest behaviorally. I noticed that psychiatrists in this field appreciated the role of biological actions such as inflammation and the stress response. When I watched fellow psychiatrists consult on surgical patients in the hospital, they talked about these processes much differently from when they saw patients in their Park Avenue offices. They talked about delirium brought on by electrolyte imbalance, symptoms of dementia caused by B12 deficiency, and the onset of psychosis in someone who was recently prescribed antinausea medication. These root causes of mental challenges are far from the “it’s all in your head” banter that typically swirls around conversations about mental illness.

The word psychosomatic is a loaded and stigmatized term that implies “it’s all in your head.” Psychiatry remains the wastebasket for the shortcomings of conventional medicine in terms of diagnosing and treating. If doctors can’t explain your symptoms, or if the treatment doesn’t fix the problem and further testing doesn’t identify a concrete diagnosis, you’ll probably be referred to a psychiatrist or, more likely, be handed a prescription for an antidepressant by your family doctor. If you are very persistent that you still need real help, your doctor might throw an antipsychotic at you as well. Most prescriptions for antidepressants are doled out by family doctors — not psychiatrists, with 7 percent of all visits to a primary-care doctor ending with an antidepressant prescription. And almost three-quarters of the prescriptions are written without a specific diagnosis. What’s more, when the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health did its own examination into the prevalence of mental disorders, it found that “Many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders. Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.”

I’ll never forget a case I consulted on several years ago that involved “psychosomatic” facial burning in a woman. Her story is insightful. She complained of an intense burning sensation in her face, though there was no explanation for it other than it being “all in her head.” Her symptoms were so disabling that she was barely able to function. I was still prescribing psychotropics at the time, but a voice inside of me knew there was something real going on, and it wasn’t at all in her head. But unfortunately the Western medical model had already labeled her as being a psychosomatic case, which called for psychiatric medication and couldn’t appreciate or even begin to understand the complexity of her condition. Antidepressants and benzodiazepines (tranquilizers including Valium or Xanax) didn’t help her. What ultimately did was dietary change, supplementation, and rebalancing of her bodily flora. Was this all a placebo effect? Clearly she wanted to feel better with such intensity that she would have done anything. But traditional medication didn’t cure her. At the heart of her pain and distress was an immune and inflammatory process that could not be remedied via antidepressants and antianxiety drugs. It was fixed through strategies that got to the core of her problem—that yanked the nail out of her foot and let the injury heal.

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