Depression Is Not An Illness: It is an Adaptive Mechanism

Post edited and updated March 9, 2013, to reflect additional thoughts as a result of interactions with the many people who left comments. I thank them for their input.


Contrary to the APA’s assertion, depression is not an illness. In fact, depression is an adaptive mechanism which has served humanity well for millions of years. When things are going well in our lives, we feel good. This good feeling is nature’s way of telling us to keep doing what we’re doing. When our lives are not going well, we feel down or depressed. This is nature’s way of telling us to make some changes.

This is very similar to pain. Pain is a signal that tissue is being damaged and that urgent action is needed. For instance, if you touch a hot stove, the pain induces an immediate reaction to pull your hand away. Usually this is accomplished with minimal damage to the skin. Without pain, we would not respond as quickly to these kinds of situations, and we would incur a great deal more tissue damage than is actually the case.

Depression or despondency is not as acute a sensation as pain.  It is more generalized and it signals  – not imminent tissue damage – but problems of a more general nature.  In order to feel good, the following eight factors must be present in our lives.

– good nutrition
– fresh air
– sunshine (in moderation)
– physical activity
– purposeful activity with regular experiences of success
– good relationships
– adequate and regular sleep
– ability to avoid destructive social entanglements, while remaining receptive to positive encounters *


When any of these factors are missing, or are present to only a slight degree, we begin to feel despondent or depressed.  When many of these factors are missing to a large degree, we become very depressed.  Over the years, I have worked with hundreds of people who were depressed.  To all of these people – without exception – I could say, “If I were in your shoes, living the life you are living, I would be depressed too.”

Many of these individuals lived on a diet which was generally poor.  Others drank enormous quantities of alcohol.  Few ate fruits or vegetables regularly.  Many stayed indoors a good deal of the time.  Physical activity was low.  Purposeful activity – i.e. activity directed towards some kind of goal – was seldom present, and good honest, open relationships often non-existent.

The point here is not to disparage or castigate people who are depressed, but rather to point out that depression is essentially and fundamentally a function of what we are doing – how we are living our lives.  It is not an illness.  It is the body’s natural feedback system.  It is nature’s way of trying to induce in us some motivation to make changes in our lifestyle – to eat better; to abstain from toxic substances; to get out in the fresh air and sunshine; to identify goals and pursue them; and to talk to friends and family honestly and openly about the things that trouble us.  If we do these things consistently and regularly – if we integrate these things into our daily routines, then we will start to feel good.  If we don’t do these things, we will feel depressed.  Or as Peter Breggin, MD, puts it in Antidepressants Cause Suicide and Violence in Soldiers:  “The principles for overcoming depression are exactly the same principles required for living a good and happy life.”

Everybody experiences an occasional down day.  But we also know what to do about it – get out for a walk; start a project; talk to a friend or loved one, etc.  Chronically depressed people, however, are individuals who have been neglecting these areas for years.  They spend most of their lives indoors.  They are often over-weight, have no goals other than the next TV show, and although they may have many acquaintances, they tend not to share their concerns and worries in an open and honest manner.

Of course, not all depressed people are deficient in all these areas.  Some depressed people eat well, but never share their worries or concerns with anybody.  Others share their worries, but have no purposeful activities.  Others have purposeful and rewarding jobs, but never get outdoors and never engage in physical activity, and so on.

To feel consistently good, we need to have all of these factors present in our lives to a substantial and significant degree.  Nor is this such a daunting proposition.  A person who eats moderately from the five main food groups; who controls his intake of sugar and alcohol; who doesn’t smoke; who has a job or hobby that provides challenges and a sense of fulfillment; who gets outdoors most days for exercise or even for a brisk walk; and who has at least one other person with whom he is open and honest, will feel generally positive.  A person whose life is lacking in one or more of these areas will feel generally negative.  This latter is not an illness – it is not an instance of something going wrong in our bodies.  Rather it is an instance of something going right.  Depression is a message from the organism calling for change.  Induction of negative feelings is the only language the organism has to express the need to make changes.


Severe losses can, of course, precipitate depression even in otherwise very orderly and functional lives.  Even when all eight factors are present to a substantial degree, the loss of a loved one will usually result in profound feelings of depression.  Similarly, the loss of one’s career, health, home, etc., will generate some measure of depression regardless of previous lifestyle.  People who have been living functional and productive lifestyles, as described above, however, will normally come to terms with the loss in a reasonable time frame.  They will talk about the loss to the people in whom they confide; they will continue to eat well and to exercise, and will continue with the various purposeful activities they have always pursued.  Gradually the sense of loss will recede and the ability to enjoy life will return.  When it seems as if life is coming apart at the seams, it is our routines that save us – provided we have established good functional routines which incorporate the eight factors mentioned above.

However, for people whose lifestyles are deficient, or only marginal, in terms of the eight factors mentioned earlier, a major loss can put them “over the edge,” and they sink into a state of chronic long-term despondency.  In this regard it is worth noting that all human lives are, sooner or later, touched by major tragic losses.  What matters is: how equipped are we, in habits and lifestyle, to handle these losses.  When a person goes to a mental health center and asks for help with depression, the first priority should be a detailed assessment of the person’s lifestyle, habits, relationships, history, etc., to determine the source of the depressive feelings.  From this assessment, a remedial program should be developed and active support and assistance provided to the client in the implementation of this program.

In practice this almost never happens.  The client who mentions depression is routinely shuffled off to the psychiatrist.  He gets a prescription for an antidepressant and is told (falsely) that his depression is an illness “like diabetes,” and that he must take his pills in the same way that a diabetic must take insulin.  If supportive or adjunctive therapy is provided at all, it usually takes the form of patronizing pats on the back or reminders to take the “medication.”


Despite decades of highly motivated research on the part of pharmaceutical companies and university departments funded by pharmaceutical companies, no evidence has ever been presented that depression is caused by a physical problem in the brain.  Yet this assertion is routinely presented to clients and their families as justification for the drug prescription.  Elliot Valenstein, Professor Emeritus of Psychology and Neuroscience at the University of Michigan, having reviewed the various biological theories of depression, summarizes the results as follows in his book Blaming the Brain:

“Although the often-repeated statement that antidepressants work by correcting the biochemical deficiency that is the cause of depression may be an effective promotional tack, it cannot be justified by the evidence.” (p. 110)

The fact is that antidepressants are mood-altering drugs (essentially in the same general category as alcohol, cocaine, amphetamines, etc.).  All of these drugs have in common that they alter people’s moods.  They make people feel better.  That’s why people take them!  But it doesn’t mean they are a good idea.  There are two ways to get drugs in the United States.  You can go to the street corner and buy them illegally; or you can go to a physician and tell him you are depressed, or anxious, or both.  Either way, you’ll get something that will give you a temporary “fix” for whatever negative feelings are troubling you.  But you will not get any real help with your problem.  In this regard it is worth noting that anti-depressants are only about as effective as placebos (sugar pills).  Whatever lift people get from these products actually comes from within themselves, not from any pharmaceutical correction of brain chemistry.


In recent years many hospitals and clinics have been offering free depression screenings.  If you go in for one of these screenings, it’s obvious that you have been experiencing some depression, and the interviewer will quickly establish (through insultingly simplistic questionnaires) that, yes, you are indeed depressed, and that you would benefit from one of the many wonderful antidepressants currently available, and wouldn’t you like an appointment to see our psychiatrist.  These “free” screenings are almost invariably paid for by a pharmaceutical company.  They are a form of marketing and have been a major factor in the promotion of psychotropic drugs.  The hospital staff who participate in these charades are well-intentioned, but in fact are mere cogs in an enormous drug-marketing scheme.

The purpose of the DSM is to promote the false notion that depression is really an illness, and to legitimize the prescription of mood-altering drugs.  The manual lists several different kinds of depression.  Acute, severe depression is called Major Depressive Disorder.  Persistent though less severe depression is called Dysthymia.  Depression that comes and goes and is interspersed with periods of mild mania is called Cyclothymic Disorder.  And so on.  And, of course, if a client doesn’t meet the criteria for any of these – there’s always Depressive Disorder Not Otherwise Specified: a residual category to broaden the scope of the diagnostic net.  In fairness to the APA, all of the several diagnoses require a fairly significant level of severity.  In practice, however, the precise criteria are routinely ignored.  In fact, most of the staff working in the mental health system have only a vague notion of the criteria.  A client who says he’s depressed is assigned a diagnosis and is given antidepressant drugs.

There are, of course, small numbers of mental health staff who although constrained by regulatory agencies to work within the DSM context, nevertheless ignore the implications of the sickness model and provide real help to their clients.  These staff members are a very small minority and, the vast majority of mental health workers embrace the DSM taxonomy wholeheartedly and believe unquestioningly in the ontological validity of the diagnostic categories.


It is sometimes argued that depression can’t be an adaptive mechanism, encouraging us to make changes, because many depressed people, in fact, sink into inactive, lethargic despair.  What’s being missed here, however is that in almost all cases, feelings of boredom, blues, depression etc., do in fact serve as a spur to action.  A person sitting around sluggishly on a rainy Saturday afternoon, for instance, starts to feel down and shakes it off by getting up and doing something, or calling his mother, or putting on a raincoat and taking a walk, etc., etc…  But all the messages we receive from our bodies can be eclipsed by counter-productive training.  We are all born with a strong drive to preserve our own lives.  But soldiers, through training and various pressures, can overcome this drive and continue fighting even though the message from within is to run.  Similarly, when our stomachs are full, we get a message from our bodies to stop eating.  It’s clear that this message often gets eclipsed.

Whether the depression message gets eclipsed or not depends largely on our childhood experiences.  If we grow up in a family where depressive feelings are dealt with by getting up and getting going, then that’s probably how we will respond to these feelings as adults.  But if we grow up in a situation where the depressive nudge is routinely ignored, then there’s every chance that we’ll continue to ignore these nudges in later life.

When a person’s life is characterized by strong functional routines, episodes of depression are rare, but when they occur, they are responded to in a positive manner.  But when functional routines are largely absent, and where the depression message is generally ignored, then people sink deeper into despondency.

A good analogy here is our response to cold weather.  If I’m outdoors working in the yard, and it starts to get cold, my body encourages me to take some action.  So let’s say I go get a jacket and continue with the job.  If it now gets a good deal colder, perhaps I’ll go in and get a heavy coat, then continue work.  If the temperature continues to fall, I may simply give up and come inside.  What I’m doing here is responding appropriately to messages from my body, and it is clear that the precise nature of my responses were shaped by my earlier training and experience.  If I ignore the messages from my body, however, and stay outside as the temperatures falls, I become hypothermic and perhaps die.  But nobody would conclude from this that the sensation of cold is an illness!  The sensation of cold is an adaptive mechanism that encourages us to take appropriate action in response to falling temperatures.  Similarly, the sense of depression is an adaptive mechanism that encourages us towards greater functionality in our daily routines.  It is not an illness.

* added on August 27, 2013 at the suggestion of Nadia, a reader of the blog


  • Rob Bishop

    Nobody questions you and millions of us suffer with depression. The question is, is this suffering a biological defect, such as abnormal neuro-chemical levels. We all suffer in many ways. I suffered with depression for many years and at one point lived in my car. There’s a large community of scientists who argue that challenges such as depression and anxiety are not symptoms of a defective brain. Are you willing to consider the possibility nothing is wrong with your brain, even though you are suffering?

  • Phil_Hickey


    Thanks for coming in. The critical point is not to belittle anyone, but simply to point out that there is no evidence to support the notion that depression, in and of itself, is an illness. If you believe otherwise, and would like to send me references to support this position, I would be happy to discuss.

    Best wishes.

  • Phil_Hickey


    Thanks for coming in. I very much appreciate the compelling logic of you comments, and your gracious manner.

    Best wishes.

  • Izera Stephen

    Great post, im sure many are going to disagree with it.
    I have never yet met someone who trully has a proven chemical imbalance that results in real clinical depression. Never.
    I have only ever met people who claim they suffer “depression”.
    They are, without fail, always victims and sympathy addicts who do not want to own their choices or values.
    Depression is not a thing you suffer, its a result.
    I would say that most are suffering from a severe case of “consequence of choice”.
    Like the article says, if you dont feel good, its natures way of letting you know you are not running your shit correctly.
    You cannot hold on to selfish or lousy or flawed values and expect to feel good.
    You cannot live a lie and expect pleasant results.

    For what its worth, consider it a blessing that you are unable to continue living the way you have been and start to:
    Own your mistakes, past and future.
    Own your choices even if you cant do no better.
    Question your own values behind your thoughts.
    Question your own motives behind all of your decisions.
    Learn to be honest with yourself and take ownership for your life direction and stop being a victim.

    Life aint easy for some of us, and no one fights harder than the person who fights them self.
    So do what you can as best you can.

  • Phil_Hickey


    Thanks for coming in and for your support. As you say, many disagree with me, but I think the idea of depression being a message to make changes is just common sense.

    Best wishes.

  • Rob Bishop

    A common response to this opinion is that you’re “blaming” people for the challenges they call “mental illness”. People often react furiously because they interpret this perspective as someone saying their mental challenges are their “fault”… henceforth the anti-stigma movement. The “blaming” rhetoric is congruent with today’s PC attitudes. Mental health is each of our responsibility. We can ignore our mental health, just like we can ignore maintaining a healthy diet and lifestyle.

  • Carly Gregory

    You didn’t answer my question.

    Anyway, Yes it is an illness.

  • Carly Gregory

    There is something wrong with the brain. It’s an organ like any other organ in the body, and sometimes it can go wrong. And yes Depression can be a symptom of this malfunction.

  • Rob Bishop

    There’s no scientific evidence depression is due to biological malfunctioning or chemical imbalances. The suffering of depression is very real. The belief that depression is a symptom of a defect or illness is rooted, in part, in self-hatred. Self-hatred and chronic negativity fuel depression, but they are not abnormal. Self-hatred is uncomfortable and disturbing, but it’s not an illness. I’ve been so depressed I lived in my car at one point and could not hold a job. Like most people, misery is familiar territory for me.

  • Rob Bishop

    What leads you to think something is wrong with your brain? When we don’t like how we feel it doesn’t mean something is wrong with

  • Phil_Hickey


    Thanks for coming back. Like just about every human being who’s ever lived, I have experienced a good measure of misfortune in my life, and during the down times have been markedly despondent. But I’ve never had an illness called depression, because there is no such illness.

    To repeat my earlier statement, if you will send me evidence to the contrary, I would be happy to discuss.

    Best wishes.

  • RuthieSue

    I found this post very insightful.
    On the first day of grade 11, my daughter had a panic attack. She was referred to a youth mental health clinic by the school counsellor. She received talk therapy and a consultation with a psychiatrist. Quickly she was put on prozac. How can telling a young woman that they have an illness (anxiety and depression) so serious that they require medication help? If the common sense approach offered by Phil had been taken, my daughter may still be a functioning individual. SSRI’s are gateway drugs.
    One month after she was started on Prozac, I found her in a coma after a very serious overdose (one full bottle of gravol). She was comatose for 3 days. Once psychiatry gets a hold of our children and begins drugging them, there is little parents can do to release them from their clutches. I know because I have been trying for 7 years. Although my daughter has never been diagnosed with schizophrenia, she has been involuntarily committed to psychiatric wards and forcibly drugged with neuroleptics. She is forced to receive a monthly injection of Abilify or be dragged kicking and screaming back to the psych ward.
    The indication for this drugging is that it is “protecting her brain from developing psychosis”. Abilify, like other neuroleptics act like a chemical lobotomy. Cognitive decline is rapid, emotional blunting occurs and the person is so sedated, they cannot function. My daughter sleeps 16 hours a day, awake she is only semi-consious. She loses all her belongings due to memory loss. She can’t remember the details of her childhood, high school days or the conversation she had yesterday.
    I understand that some people find comfort in hearing that their depression is an illness.
    Others, like my daughter however, obviously do not. When you are growing up, you want to be normal, to fit in. If she was told that she was experiencing stress, given a cup of tea and an opportunity to tell the counsellor what was bothering her without being “diagnosed and drugged” perhaps some common sense approaches could have been found to help her manage her stress. Psychiatry has spread like a disease into every mental health program in our city. With their ideas and their drugs. I wonder where all the people disabled by neuroleptics will go. Never have psychiatrists been allowed to hand out these toxic tranquilizers on a similar scale. Who will care for the mentally disabled ? And where will they live? My daughter was a perfectly healthy high school student, good at school and sports and very social. She was beautiful. Now she is on permanent disability and 6 psychotropic drugs. Extended leave and the forced drugging of our youth is a human rights violation of the worst kind. When will psychiatry ever make it out of the dark ages or cut their evil ties with the drug companies? How does the public see them as a credible department of medicine? I pray for the day that psychiatry is eradicated from society for their crimes against humanity, past and present.

  • Athena Koop

    RuthieSue, I am so sorry to hear what has happened to your daughter. You are not alone. I, too, hope for the abolition of psychiatry, and so do many other family members of those whose lives have been infected by psychiatry’s poisonous “treatments” and disempowering “diagnostic” labels. Your story brought to mind this one shared by Tabita Green on Mad in America.

    Also this one by Suzanne Beachy who refused to let psychiatry kill her late son’s cousin.

    As long as your daughter is alive, there is hope for her!

  • Phil_Hickey


    Thanks for coming in. I’m sorry to learn of your daughter’s “treatment”, and I hope that things can and will get better.

    I also hope for the day when psychiatry and its rampant destructiveness is a thing of the past.

    Best wishes.

  • RuthieSue

    Thank you Phil. That means a lot to me.

    I will never stop fighting for my daughter’s release. She was able to postpone her injection for several weeks this time!

    In Vancouver, there is one progressive program that came out of Providence (with aspects of “Open Dialogue” in Finland). I then found out that there is a house psychiatrist there that has put all the youth on Abilify Maintena (only format still under patent). When I visited, I knew they were all on it as they had that same look in their eyes as my daughter, the same shuffle to their step. All the mental health workers were amazing…except for the psychiatrist.

    Oh and Phil, thanks for all the good writing that you do. You bring the sham that is psychiatry out from behind closed doors and into the light of the public eye.

    God bless you,

  • RuthieSue

    Thank you Athena for your kind words.
    In fact my daughter also developed an ED but later when she was 19. So I found Tabita’s story very helpful. My daughter’s best friend was also a long time anorexic. My mistake was not getting her out of Vancouver before she became too sick to move. It was impossible to secure treatment for her in the ED programs available here but they didn’t hesitate to put her on the strongest psychiatric medications. At one point when she weighed 80 lbs, she was put on dexedrine and mood stabilizers.
    That’s what landed her in the psych ward for the 1st time, amphetamines and mood “de”stabilizers.
    Also, because she had just turned 19, they no longer agreed to include us in her care despite her signing consent forms to release information and later a representation agreement with myself. In the agreement, she explicitly wrote that she wished to be treated without anti-psychotics in the event that a psychiatrist would want to prescribe them to her. This request was completely ignored.
    After release from the psych ward but on many many medications, she lost her housing and made another very determined suicide attempt for which she had to be hospitalized for 10 days for complications related to the overdose.
    But slowly, she regained weight, really by sheer will power and the condition finally resolved on its own.
    If only now they would allow her off all the medications, especially the anti-psychotics. They have only made her so much worse. It’s been 6 months on Abilify now and nothing I say or do will change the mind of her psychiatrist.
    I pray for her. She does what she can and she practices what she’s going say at her next Abilify maintena appointment…

    Let’s all pray for my daughter Lucie. And all the other youth that have lost their rights to self-determination and the right to a healthy mind and body.

    Yes of course there’s hope. We must never lose sight of that..

    God bless you Athena.

  • Athena Koop

    Of course I will pray for Lucie. I only wish I could do more.

  • Mellmac

    Well, I don’t doubt that doctors are pushing pills, though I’m sure there’s no conspiracy between them and the drug companies. It’s just very convenient, since in cases like mine, they work. And while I’m also sure that his 8 practices might do the trick in many, if not most cases, I doubt whether those things would work in some cases. After having been raised in a dysfunctional home where my mom was a pill popping drunk, my dad was extremely distant and us kids had to fend for ourselves, one develops an “I don’t deserve to be happy” attitude. I was bullied in junior high and high school after my parents divorced, and my mom OD’d on tranquilizers and whiskey. My dad had just left my puddle of a mother for a woman he worked with. Mom survived because I (age 13) found her comatose in her bed and called the ambulance and they pumped her stomach. Had I not found her, she would have died that day. This episode was preceded a few years earlier after mom was hospitalized several times for major depression, which included several courses of shock therapy treatments. By 17 years of age, I too, was an alcoholic and a pot head. I had dropped out of school in the 11th grade to escape the humiliation and shame of the bullying I was enduring. By this time, though I didn’t realize what it was, I was severely depressed, and my only escape, short of taking my own life (which was often considered), was getting drunk and stoned. I doubt regular walks in the fresh air would have done the trick. Plus, when you are that depressed, you are also so full of self-loathing and worthlessness, that you don’t think you have a right to be happy. Even if you find some measure of relief, and the painful memories fade so that you can function and find some small amount of happiness, you are so broken up beyond repair inside, and just plain feel permanently damaged. You try to process the ugly events in your past, do the positive self talk, and desperately attempt to feel better with sheer will-power. But all the fixes and help you get and practice, are like painting over a loud and annoying wallpaper pattern. It just bleeds through no matter how layers of paint you apply. You feel damaged at your core, and that feeling just never seems to go away. You have moments of happiness, but the depression lingers at the door. The point of all this is to say that depression sets in and takes root in some people and becomes so ingrained as we develop into adults, that the only way to get rid of it, is to rewind the tape and start over with a healthy, happy upbringing, with a well developed sense of self. But of course that’s impossible. I’d be more surprised that anyone with a similar story emerges without chronic depression, or ever gets permanent relief. All the anti-depressants do for some of us is help us to cope and function. They don’t put me “in a good mood” either. They just help me to feel not overwhelmed by sadness. I don’t mind getting out of bed. There is a danger in making some of us feel like taking these is not the answer, especially without offering relief. I hate that I’m on them, but I hate life without them much more.

  • Anonymous

    Please name the Vancouver program where the house psychiatrist is doing this.

    And “She is forced to receive a monthly injection of Abilify or be dragged kicking and screaming back to the psych ward. Cognitive decline is rapid, emotional blunting occurs and the person is so sedated, they cannot function. My daughter sleeps 16 hours a day, awake she is only semi-consious. She loses all her belongings due to memory loss. She can’t remember the details of her
    childhood, high school days or the conversation she had yesterday.”

    If that’s not oppression enough to go on the run and move provinces and change her name and cut off all contact with the ‘services’ I don’t know what is. There are allies in Canada who will help you hide from this violence. Often when we are in the middle of forced drugging brain rape we cannot see what is the best thing to do to get out of it. As a community forced drugging survivor, my position now is, if they ever pulled this shit on me again, I would go underground, it is intolerable to submit your body for trashing to these fanatics. Bodily ownership is more important than anything else in life, I would be out of there faster than you can say ‘postpone’, out of the country, out of the state/province, anywhere, but under the radar of these sickos.

  • Phil_Hickey


    Thanks for coming in. You make lots of good points.

    I agree that the psychiatry-pharma marriage was initially one of convenience. Pharma had mood-altering drugs to sell, and psychiatry was desperately looking for ways to establish itself as a legitimate medical specialty. But this did morph into a conspiracy. When a pharmaceutical company writes an article for a learned journal, and pays an eminent psychiatrist to sign it – that’s conspiracy. When an eminent psychiatrist like Joseph Biederman, MD, the inventor of “childhood bipolar disorder” tells Janssen Pharmaceuticals, a division of Johnson & Johnson, in an email that his research will produce a positive result for their drug if they will pony up $700,000 for a research lab at Harvard, that’s a conspiracy.

    You write:

    “I’d be more surprised that anyone with a similar story emerges without chronic depression, or ever gets permanent relief.”

    It’s impossible to compare one person’s painful memories with another’s, but during my career, I worked with hundreds of people who had come through horrendous childhood experiences and yet managed to find some sense of contentment in adulthood without drugs.

    I’m not trying to dissuade you from taking drugs. Obviously that’s your business and your choice, but there is a great deal of evidence linking long-term use of antidepressants to chronic despondency. The condition is called tardive dysphoria. You can read about it here.

    Again, thanks for coming in, and best wishes.

  • Laura Jaksen

    The fact that this condition is called “depression” causes great confusion. There is a huge difference between being depressed, and suffering from clinical depression. You can be depressed because someone died, or you have health problems, or you lost your job… But when you suffer from clinical depression, there is not necessarily a reason (there can be “triggers”, but not a “cause”). You can be living the same healthy lifestyle as your neighbor, be in healthy relationships like your neighbor, etc., but something goes wrong and your life becomes gray and miserable.
    Is it caused by a “chemical imbalance”? Of course it is; every emotion and feeling we have is caused by chemicals. Our brain is full of chemical interactions. The question is; should we use pills to put the chemicals back into a happier pattern?
    Doctors can be very quick to pull out the prescription pad. Many people, even doctors, see medication as the first resort, not the last resort. However, if nothing else works, medication is crucial. Many people’s lives have been saved by anti-depressants. While rarely a “cure”, anti-depressants can make some people’s lives more bearable. A “bearable” life is not the goal for most people, but it is far better than “unbearable”!
    The danger in this post is that some people will read it and think that pills are a coward’s way out, and that it is their lifestyle to blame for their condition. While a healthy lifestyle and a brave heart are certainly important in life, please don’t think for a moment that they will always be able to cure clinical depression.

  • Rob Bishop

    Anger, a common emotion, is a good example. Let’s assume anger is chemical in nature, like other emotions, and someone has road rage and kills another driver. Although the violent behavior is rooted in biochemistry, that does not mean the road rage violence was inevitable or a result of biological malfunctioning. Most disturbing emotions (depression, anxiety, anger) are propagated by certain types of thinking habits… how we choose to think and what we choose to think about has a huge effect on our emotional experience.

  • Phil_Hickey


    Thanks for coming in.

    “There is a huge difference between being depressed, and suffering from clinical depression”

    The term “clinical depression” has no formal meaning in psychiatry’s diagnostic manual. I assume that you mean what psychiatrists call “major depressive disorder”. Can you cite me any evidence for your assertion that there is some fundamental distinction between depression and “major depressive disorder”?

    Also, there is no evidence whatever that the people whom psychiatry “diagnose” as having “major depressive disorder” have any kind of chemical imbalance in their brains. The chemical imbalance theory is a hoax. I have written extensively on this – search the site for the phrase “chemical imbalance”.

    “The question is; should we use pills to put the chemicals back into a happier pattern?”

    Antidepressants don’t put brain chemicals back into a “happier pattern”. In fact, they disrupt normal brain functioning (as do all psychiatric drugs). Were you aware the cocaine is an SRI?

    Again, thanks for writing. Please feel free to come back. Incidentally, all the issues you raise I have addressed multiple times, and at great length, on the site. If you are interested in these areas – and the scientific facts – as opposed to psychiatric hype – please browse around.

    Best wishes.

  • Circa

    I think “being depressed” versus “having major depressive disorder” is simply a matter of degree. The latter is just another way of saying “really, really depressed.”

  • Laura Jaksen

    Not in my experience. In fact, “being depressed” is not necessarily the main symptom of MDD.

  • Laura Jaksen

    The main point of my post was that there is a danger in telling people that anti-depressants are always a bad idea. I am well aware that anti-depressants are over-prescribed, and that some people just like to pop pills.
    But anti-depressants (ideally along with therapy) are sometimes very important. They can and do get people back on track, and sometimes even prevent people from killing themselves.

  • Circa

    What other symptoms rate a MDD diagnosis? Anxiety?

  • Circa

    They can also cause people to kill themselves. That’s the reason for the black box warning from the FDA.

  • Laura Jaksen

    Anxiety, hopelessness, apathy, lack of sex drive, despair, emptiness, not enjoying anything, feeling of being surrounded by a gray cloud…

  • Laura Jaksen

    I agree; they can be very dangerous, and their use must be appropriate and well-monitored.

  • Circa

    But you are just using different words to describe the same phenomenon. Hopelessness, emptiness, lack of enjoyment, etc. — these are the hallmarks of depression. I have struggled terribly with depression at periods of my life. I just have yet to see any indication whatsoever that the problem is neurological.

  • Circa

    But they are so often not! How many AD-induced cases of mania go misdiagnosed as Bipolar I?

  • Laura Jaksen

    Have you tried anti-depressants? I struggled for years, refusing to take any kind of medication. Now I wish I had tried medication sooner – it would have saved me a lot of grief.
    It is, of course, an individual decision. All medications (psych or otherwise) come with their own set of risks, and whether to take them or not is a very personal thing.

  • Rob Bishop

    Everyone experiences depression and anxiety, so that’s a good point. Most people have a strong tendency for negative thinking, which fuels depression and anxiety. Depression is often rooted in a form of anger and self-hatred, and noticing the substance of our cognitive chatter helps reveal the part of our psyche that makes us miserable.

  • Circa

    I like the term “cognitive chatter.”

  • Circa

    You’re telling him to get a fucking education and then “right” [???] an article? That’s comedy gold.

  • Efraim Kristal

    Phil, thank you for this relatively rare and important, though controversial, article. I have been making a similar argument for years inside the biomedical and cognitive sciences communities, but have found the perspective of depression as a fundamentally organic disease so deeply entrenched professionally and popularly that no matter how rational and evidence-based the counterargument, it is summarily dismissed, with no small measure of vitriol–as evidenced by some of the comments here. I have often sat stupefied as colleagues in medicine and the sciences–bright minds well versed in empiricism–tout the physical-to-mood-disease model that fails to satisfy any of the criteria of medical causation central to all other medical disease states.

    Just as disturbing, it is also easier culturally–again, for both many professionals and the lay–to assign the burden of rehabilitation to the individual exhibiting depressed mood than for us collectively to address ways our culture contributes to substantially increased stresses on subpopulations that incite depressed mood. Reading many responses to depression among reports of bullied teens, or the chronically unemployed (many who despite investing great resources in attaining skills and credentials, and diligently following job-seeking advice find themselves on the cusp of homelessness), or the abandoned and isolated elderly poor, or other marginalized groups, one quickly understands that our culture on the one hand recognizes these as grave problems, yet on the other hand hoists the responsibility for dealing with them on the ephemeral political and local services machinery, and on those who’re barely able to hang on by themselves. The whole imbroglio is disillusioning.

    But slowly, over the past few years, I’ve noticed more and more clinicians and scientists globally speaking out on this issue, and so I happily came across your article, already old in Internet time. Please continue spreading this message. Our country–the world–is more receptive to it than ever.

  • Phil_Hickey


    Thanks for your supportive words.

  • Franziska Fischer

    You speak of your physical illness with such understanding but blame MDD on doctors and pharmaceuticals? I was 7 years old the first time I tried to end my agony. I was SICK. I experienced non stop pain and one night I climbed to the roof and jumped off. I thought I would die. I didn’t. Don’t you DARE tell me it is not an illness or blame psychiatric drugs. I am not on any because none of them work for me. Not only is that true, but I won’t even let them try any new ones on me because the treatments are so inexact. My illness is real and fatal.

  • Franziska Fischer

    Oh and Phil? You are an ignorant, clueless dick. Couch potatoes? Nothing could be further from the truth. I actually HAVE no appetite and have to force myself to eat. What an idiotic, misinformed piece of dreck this article is!

  • Rob Bishop

    Chronic negativity is not a disease.

  • Jarvis210

    Anyone who wants to see the reason for the lies should look up “the marketing of madness” documentary on youtube and the picture becomes so much clearer

  • Jarvis210
  • Jarvis210
  • Jarvis210
  • Rob Bishop

    There are no medical tests to diagnose “mental illness”.

  • Jarvis210

    exactly..and the drugs don’t’s all about the money and the pharmaceutical industry.

  • all too easy

    Here is the medical proof: millions suffer from the same persistent disabling symptoms.

  • all too easy

    Indeed. The money depressed people make from this grand conspiracy is phenomenal. They all fake their supposed “illness” because they secretly invest in big-pharma and make 10s of millions off every placebo that’s sold to fool morons into thinking they are getting real medicine. What geniuses.
    Thanks for alerting us to their scheme, boys and girls. You have opened our eyes! We love and appreciate you all so very much. I’m getting misty-eyed just thinking about what precious souls you are. You are always so polite and welcoming, especially to those filthy creeps who dare to question you.

  • Hello Phil. Way late on this post, but I must ask… have you personally experienced clinical depression?

    I was always an upbeat, positive, curious person who enjoyed many creative and athletic outlets… but after several years of chronic stress due to a perfect storm of challenging circumstances, I succumbed to a nervous breakdown and experienced, first-hand, most of the key symptoms of major clinical depression. I lost all interest in the things I once enjoyed, and there was nothing I could do to get myself out of the constant feelings of sadness and despair. It was extremely difficult to summon any measure of motivation or concentration. Early on, no one told me that prolonged exposure to the stress hormones cortisol and adrenaline can impair the neural pathways responsible for a healthy mood spectrum. Clinical depression IS the brain being literally stuck on the “sadness channel”, with no way to move the dial to a better mood. I now understand why some choose to end their lives… there is no escape from the unrelenting feelings of despair. I’ve spent the last 5 years slowly recovering, and the process has been a roller coaster of ups and downs… good days followed by days of mental fatigue and extended sleep. If my care givers had told me initially that my brain was injured due to prolonged stress hormone exposure, resulting in limited mood response, my strategies for coping and recovery would have been very different. In a way, I view a healthy brain as a fully inflated tire – resilient and able to bounce over bumps or potholes. The brain of someone suffering from clinical depression is like a deflated tire – without enough PSI, there is no bounce or resilience, making every bump or pothole worse. Though not ideal, antidepressants are required slowly help to correct pathway damage and elevate mode. It’s a shame that they are too quickly dispensed without much explanation for the root problem.

    The “regular” depression that you describe sounds more like prolonged feelings of disappointment and discouragement, which can be alleviated with various positive changes in environment, habits and activity. This is NOT to confused with clinical depression, which IS AN INJURY/ILLNESS that impairs the frontal lobe center responsible for healthy mood. For someone suffering from major clinical depression, they need a) an understanding of the physical reasons for their depressed mood, and b) the full support of loved ones to provide and maintain a minimal-stress environment and as much time as is required to allow recovery. This is not easy for anyone, and in many ways can be viewed much like a preemie baby being nurtured in an incubator. Without patience and understanding, families and friendships can be torn apart.

  • Rob Bishop

    Chronic feelings of despair are rooted in thinking habits such as cognitive distortions, self-loathing, and a lack of emotional intelligence (something we don’t teach our kids, unfortunately). When we read suicide notes, such as Jim Carrey’s girlfriend wrote before she died, we see examples of cognitive distortions and a lack of emotional intelligence. I’ve been homeless struggling with depression during my life, and have been diagnosed and prescribed meds three times after brief conversations with a so called specialist. It takes specific skills to change our cognitive habits and reduce our self-hatred. There is no scientific evidence chronically depressed people have a malfunctioning brain, or else the diagnosis would include a test. Did your diagnosis include a blood test for cortisol and adrenaline levels?

  • Rob, what you describe are the preconditions that make a person
    particularly vulnerable/susceptible to being overwhelmed by high
    cortisol exposure, leading to injury. Many sufferers of depression will
    confirm that even in the best of circumstances they can’t shake the
    feelings of despair/hopelessness, etc. SINCE THERE ARE NO PAIN

    (to circumvent the neural pathway damage) are only one part of the
    recovery process. Cognitive therapy and the improvement of emotional
    intelligence are also key components.

    Sadly, like you, I was not
    given any specific tests, but was quickly dispensed with a medication
    that slowly worked for me. However, I was left with too little information
    about what actually happened physiologically to my brain. I know now
    that a PET brain scan should be the FIRST step, but where I live, it’s
    apparently easier to dole out medication than line patients up for
    expensive scans.

    I encourage you to view the following links:

    And another talk on the importance of brain scans:;search%3Abrain%20scans

    A link on brain inflammation and depression:

  • Phil_Hickey


    Thanks for coming in.

    Your opening question presupposes that there is an entity called “clinical depression” which people can have or not have, analogous to, say pneumonia, diphtheria, diabetes, etc.

    The central theme of this website is that no such entity exists. So for me, your question is logically equivalent to asking me if I have ever been under the spell of a witch, or ridden on the back of a unicorn. There are no witches or unicorns, so such questions are meaningless.

    The chemical imbalance theory that you outline is a hoax, and has been debunked by a great many writers. If you have any doubts on this, please read Terry Lynch’s book Depression Delusion. You should also know that most psychiatric scholars have admitted that the theory has no substance. See, for instance, Ronald Pies’ article Nuances, Narratives, and the ‘Chemical Imbalance’ Debate in Psychiatry. Ronald Pies is one of the most ardent supports of psychiatry in the US today.

    But having said all that, if you can provide me evidence to support your theory, I would be happy to have a look.

    What’s particularly interesting in all this is that your story, as you briefly recount it, actually supports my position on depression. My position is that depression is the organism’s normal and natural response to adverse events or an unfulfilling lifestyle. Depression is essentially our body saying to us: this isn’t good; make some changes. But if we don’t make the changes, for whatever reason, then the depression deepens.

    By your own account, you had “several years of chronic stress due to a perfect storm of challenging circumstances…” You apparently didn’t make appropriate changes when this sequence of events began (and I say this merely as an observation, not censure), and so the depression deepened and deepened.

    Anyway, thanks for coming in. As I said earlier, if you can cite any evidence to support your chemical imbalance theory, I’d be glad to see it.

    Best wishes.

  • Since initially posting, I see now that this site is all about dismissing clinical depression (or depressive disorder). You are basically insisting that my illness (and my experience) did not actually exist. You might as well ask for hard medical evidence when someone complains of a simple headache or a muscle strain, or has feelings of love for a particular individual, or goes into shock after a violently traumatic event.

    Did I make any corrections to my situation to knowingly avoid the end result? Ask the same of someone who have been blindsided in a car accident, or has taken a bullet simply by being in the wrong place during a shooting, or was abruptly thrown out of a small boat during a horrific sea storm.

    I made choices based on what I knew at the time, trying to be “resilient”. I used to dismiss depression as a choice. I now know how dangerous stress can be to one’s brain.

    Can you share what it is that makes you so adamantly opposed to believing that stress-induced neural injuries could actually exist?

    I too believe that gross profits are made by pharmaceutical interests. Chemotherapy is big business. It’s easy (and lucrative) to prescribe medication for any number of legitimate ailments. Conversely, many people can hide their issues behind medication. Doesn’t mean that cancer, pain and mental illness do not exist.

  • Rob Bishop

    Nobody denies the reality of depression and anxiety. What we discuss is the lack of evidence these experiences are due to biological defects. Or “damage”. There’s no scientific evidence that supports this hypotheses. The brain scan of a person being chased looks very different than a person siting quietly on the beach, but that doesn’t prove disease or damage. BTW, how do you feel about the idea we cause our own stress? (Of course I don’t ever speak for Phil, just adding my own thoughts here.)

  • Rob Bishop

    That some people can’t reduce their depression and anxiety isn’t evidence they are biologically defective or damaged. Just like addiction, fear of public speaking, wanting to commit suicide, etc. just because people are unable to change does not mean they can’t change. If someone tries 30 times to ride a bike, and fails every time, the conclusion they’re unable to ride a bike is illogical and it creates a sense of powerlessness and victim-hood, crippling them. Mental health is a skill set.

  • Phil_Hickey


    Thanks for coming back.

    You wrote: “Since initially posting, I see now that this site is all about dismissing clinical depression (or depressive disorder). You are basically insisting that my illness (and my experience) did not actually exist. You might as well ask for hard medical evidence when someone complains of a simple headache or a muscle strain, or has feelings of love for a particular individual, or goes into shock after a violently traumatic event.”

    This site is not all about dismissing “clinical depression (or depressive disorder).” Rather, this site’s focus is that psychiatry’s insistence that all significant problems of thinking, feeling, and/or behaving are illnesses is a hoax. Depression is one of the problems on which I focus, not the only one. And I don’t dismiss depression. Rather, I point out, with copious evidence and references, that psychiatry’s claims in this matter are unfounded in terms of evidence, and spurious in terms of logic. If you wish to acquaint yourself with these matters, feel free to browse around.

    I did not say that any illness that you might or might not have does not exist. I know little or nothing about you. In my reply to your comment, I simply repeated the information that you had divulged about yourself, and pointed out that it lent itself readily to a different interpretation than the one you embrace. I also pointed out that there is no evidence to support the theory that you so ardently promote. But I’m not insisting on anything. You’re free to investigate these matters yourself, or go on believing the psychiatric fiction. Remember, it was you who wrote to me. I certainly never said that your experience did not exist.

    With regards to my asking for “hard medical evidence” for headaches, muscle strain, feelings of love or post-trauma shock, I have to confess that I don’t have the slightest idea how this relates to the topic in hand.

    You wrote: “Did I make any corrections to my situation to knowingly avoid the end result? Ask the same of someone who have been blindsided in a car accident, or has taken a bullet simply by being in the wrong place during a shooting, or was abruptly thrown out of a small boat during a horrific sea storm.

    I made choices based on what I knew at the time, trying to be ‘resilient’. I used to dismiss depression as a choice. I now know how dangerous stress can be to one’s brain.”

    You seem to be under the impression that I criticized you when I made the point that you apparently hadn’t taken corrective action with regards to the adverse events that precipitated the initial depression. Nothing could be further from the truth. In fact, I stated clearly in my reply that it was an observation, not a censure. There are lots of very understandable reasons why a person might not take steps to ameliorate the situation that precipitated his initial depression, but the result will almost always be that the depression deepens.

    You wrote: “Can you share what it is that makes you so adamantly opposed to believing that stress-induced neural injuries could actually exist?”

    Between articles and replies to comments, I’ve written over a million words on this site. But I have never stated anything even remotely like this. I am opposed to the psychiatric hoax that all significant problems of thinking, feeling, and/or behaving (including depression) are brain illnesses. And I’m opposed to this because fifty years of highly-motivated and lavishly-funded research has failed to produce one shred of supporting evidence. Nevertheless, psychiatry has been promoting this hoax vigorously for decades. If you’re interested in this matter, please see my post Psychiatry DID Promote the Chemical Imbalance Theory,

    I am also opposed to this hoax on logical grounds. Consider the hypothetical conversation:

    Wife: Why is my husband so depressed? Why does he just sit around? Why has he gone off his food? Etc.

    Psychiatrist: Because he has an illness called major depressive disorder.

    Wife: How do you know he has this illness?

    Psychiatrist: Because he is depressed, sits around, and has gone off his food, etc.

    The only “evidence” – and I stress only – for this putative illness is the very behavior and feelings that it purports to explain. The statement: “Because he has an illness called major depressive disorder” explains nothing. It has no explanatory value, but is constantly and mendaciously promoted by psychiatry as if it did. It is nothing more than a stigmatizing and disempowering label, particularly when, as is often the case, it is used to justify prescribing psychiatric drugs for life!

    And I am adamantly opposed to the psychiatric-pharma hoax because I am opposed to all hoaxes that bilk people of their money, rob them of their sense of efficacy, and subject them to a wide array of adverse effects. In addition, the pills aren’t very effective, a fact that has been clearly and repeatedly established in bona fide research studies. In reality, there is no essential difference between a psychiatrist prescribing a pharma drug and a street corner dealer making a sale.

    You wrote: “I too believe that gross profits are made by pharmaceutical interests. Chemotherapy is big business. It’s easy (and lucrative) to prescribe medication for any number of legitimate ailments. Conversely, many people can hide their issues behind medication. Doesn’t mean that cancer, pain and mental illness do not exist.”

    Pharma does, of course, make enormous profits in this area. In my view, this is an integral part of the hoax. But not one of these pills could have been sold without psychiatry’s spurious illnesses.

    But that is not why psychiatry is a hoax, and I have never proffered that as an argument in this regard. So your attribution of this argument to me is, I suggest, not honest. If you want to understand my position of these matters, browse around. Feel free to disagree, but please do not accuse me of facile nonsense.

    And, having said all this, I notice that you did not take me up on my invitation to send me evidence to support your chemical imbalance theory. That invitation still stands. Send me a reference from a bona fide peer-reviewed research journal that demonstrates a clear causal link between a specific neural pathology and depression. I would be happy to take a look.

    Best wishes.

  • Rob Bishop

    Phil, what do you think about Karen Horney’s ideas about the nature of neurosis?

  • Runner

    What made me more depressed was hearing my psychologist say I WAS depressed due to a problem in the brain, and he just ignored my real problems in life. That’s what makes a depressed person become even more… (you know)

  • Runner

    I believe there are two kinds of depression; mental ilness kind and the kind that is a manifestation of multiple problems, In my case medication did not help at all, But don’t you hate it when people call it an ilness? I mean, I rather have them call it a state of mind.

  • Runner

    It is not an ilness, problems in life cause people to feel bad, sad,… calling it an ilness is saying their problems are nothing.

  • Phil_Hickey


    It has been many years (decades?) since I studied or even thought about the work of Karen Horney.

    To the best of my recollection, she identified several specific “neuroses”; e.g. excessive need for affection; excessive need to control others; excessive need to be admired; excessive need for perfection; etc.

    And, again to the best of my recollection, she stressed the role of the parent-child relation in the development of these characteristics.

    So, about all I can say is: it’s a better approach than brain disease!

  • I had typed in a lengthy response but then my browser bombed. I’ll just say that to dismiss the reality of clinical depression because there is no scientific evidence would be the same as dismissing feelings of love because there is no scientific evidence to show that they exist. My experience of being trapped in a paralyzing state of depression was very real, one that I was not able to “think” my way out of without medication. (I have since come to know others who wrestle with the same struggle… wonderful, smart people in blessed situations, but now stuck in an injured brain state that they simply cannot will their way out of.)

    To refer to your own analogy about cold and hypothermia, stress is the cold, and clinical depression is the hypothermia. At best one can ward off the effects of cold, but sometimes unusual circumstances prevent one from being able to take measures, so one succumbs and is left injured. I could point to a number of links to support my view, but it’s evident that you would remain unmoved in your position. I’ll leave this thread and wish you well, along with the hope that you will never have to experience what I went through. Peace.

  • Phil_Hickey


    Yes, the irony is profound. They help people deal with depression by telling them the falsehood that they have an incurable brain disease!

  • barney_el_mas_bonito

    to much naturalist fallacy on this post, cant take it serious

  • Runner

    I’m glad you understand 😉

  • Darius Thurman

    What should I do? I hate myself for past regrets (romantic rejection, crashing my mom’s car in high school, wasting 2500 on an MLM pyramid scheme, constant procrastination from 10th grade to my MBA). I stew over regrets and wallow in misery. Yes I’ve been to counseling, in the short run it felt good but sometimes feels useless as I keep going and stewing over the past. I feel like a loser. I’m in a cycle, bitter, self pity, rock bottom then I get mad at myself (think about my blessings, family, God, my hopes for the future) and I feel free and clear again, only to drag myself in the muck with more self sabotage. Soon I turn 23, yet I feel like a weak helpless boy, all the things I could be doing yet I’m scared I’ll just wreck it. I hate my life, I hate who I’ve become, I’ve made the lists and burned them, I’ve tried to let things go only to still have them at heart. I hate being a burden on my family when I should be providing for them. What do I do to stop it.

  • Rob

    What you describe is common. I can totally relate. Realize that suffering and misery can be seductive and addictive, and if you truly want to improve your mental health and emotional stability, you must ignore the beliefs this is just how you are, and you are powerless to change. Here are 3 well known books I recommend. They can give you the clarity, perspective and tools to change. Theodore Isaac Rubin’s classic book on self-hate. Mark Coleman’s book on the inner-critic. And Kristin Neff’s book on self-compassion. These books deal with exactly what you’re talking about.

  • all too easy

    Make amends. Seek forgiveness. Forgive yourself. Have some fun. Consider an antidepressant. Prozac is excellent at diffusing anger.

  • Phil_Hickey


    Thanks for coming in. Because I don’t know you personally, I can’t give you specific advice, but here are some general thoughts that you may find helpful.

    1. Everybody has regrets; some are major; some are minor. Just about everyone feels guilty for something. Regrets and feelings of guilt are the price we pay for being socialized. So essentially, the issue here is one of degree.

    2. Changing habits of thinking is basically similar to changing habits of overt behavior. Getting our feelings of regret/guilt into proportion is a skill. We don’t ordinarily think of it that way, but it is accurate. So the task becomes: how do I acquire this skill?

    3. It can sometimes be helpful to identify someone in one’s circle of acquaintances who appears to have mastered this skill, and to ask that person for help, ideas, even coaching, if the relationship is close enough to warrant this.

    4. There are helpful counselors and there are unhelpful counselors. Perhaps it’s time to try someone else?

    5. A vicious circle can readily develop in these kinds of situations: One feels too bad about oneself to do anything constructive; but doing something constructive is the best way to start feeling good about oneself. Here again, involving another person can be useful. If you know that an acquaintance/friend is doing a yard job next Saturday, say, offer to help – commit to being there, show up, and help.

    6. Finally, it should be noted that people who are raised very strictly often have these kinds of feelings of guilt and regret. It’s hard to shed the imposed injunctions of childhood, but sometimes that is what has to be done.

    7. Its very important not to look for solace in alcohol or other drugs. People in the predicament you describe are very vulnerable in this regard.

    8. Harper West’s blog Self-Acceptance Psychology has some very useful insights in this general area.

    I hope some of this is helpful.

    Best wishes.

  • love is an illness, didn’t you know?