I find this whole line of research interesting, and I look forward to seeing replication studies. I would quibble with the use of NAMI mothers as sources of information in Torrey et al (2000) on two grounds. Firstly, I don’t believe they are representative of the population in question; i.e. mothers of individuals who have been assigned a diagnosis of schizophrenia. Secondly, NAMI is an avid supporter of the bio-psychiatric position (and indeed derives a large share of its funding from pharmaceutical companies). I consider it extremely likely that the 264 mothers who were questioned were familiar with the “schizophrenia germ” hypothesis and would have been highly motivated to provide the “correct” answers. I’m not suggesting, of course, that they were deliberately lying, but simply stating the well-known fact that motivated respondents are not always reliable.

I also have a quibble with Torrey and Yolken (2003). This is a meta-analysis of 19 studies conducted in various countries between 1953 and 2003 and purports to show an increased incidence of antibodies in “schizophrenics” compared with controls. Setting aside definitional difficulties, I was struck by the fact that the controls in the US study (Boronow et al 2002) had only a 7% incidence of antibodies. The McConkey press release (2009) quotes a prevalence in the US of 22%. Even though the Boronow controls were matched to the “schizophrenic” sample, this discrepancy seems very large. One would expect the controls’ incidence to be close to the general population.

The implications of this body of research are more complicated. I have said elsewhere in my posts that neurological damage/malfunction can have an obvious effect on people’s behavior, and that when such a neurological issue is identified and described, it needs to be given a name and treated (if treatment is possible ) by neurologists. This, in my view, has nothing to do with the so-called “mental disorders.”

An additional consideration is the causal connection between physiology and behavior. If, for instance, you see a man starting to eat, you might conclude that he was hungry, and that the hunger mechanism (physiology) was the proximate cause of the eating (behavior). Life, however, is more complex than this. One man on becoming hungry might sit at this table and shout: “How about some lunch, woman?” Another goes to his kitchen and starts cooking. A third goes to his orchard and plucks some fruit. A fourth goes to a store and steals a cooked chicken. A fifth goes to McDonalds, etc., etc., etc.. And whilst the physiological hunger mechanism explains the eating, we must look to behavioral science to explain (or at least try to explain) the enormous variation in the way this drive is expressed.

The analogy to “schizophrenia” is that infection with toxoplasma gondii may impair neurological functioning in some general way, but it is quite a reach to suggest that cysts in the brain cause a person to say that she is the queen and deserves to be afforded special honor and privilege.

In my view, the brain, like any organ, is subject to a variety of assaults. Some of these impact the individual’s overall coping ability and render more likely the experience of failure. From profound feelings of failure in early adulthood to paranoid and grandiose speech is an understandable step, and I believe that this is the most fruitful way to conceptualize these issues. Of course failure can occur without neurological damage of any kind – hence the neurological heterogeneity of the “schizophrenia” population.

The fundamental principle underlying the DSM system is that unusual/disturbing behaviors are caused by mental disorders/illnesses. In my view this proposition is analogous to the notion that crop failures are caused by witchcraft. The issue is not whether Mrs. Jones is or is not a witch. The issue is that there are no witches. It is not possible to cause crops to fail by chanting curses or whatever. And there are no mental disorders. “Mental disorder” and “mental illness” are anachronistic pre-scientific terms similar to phlogiston. A century of behavioral science has demonstrated clearly that disturbing/unusual behavior is the product of the individual’s reinforcement history and the stimulus properties of the present situation (as is “normal” behavior). As long as “schizophrenia” is defined behaviorally, we should focus on behavioral explanations rather than vague pre-scientific pseudo-explanations.

Overriding this notion, of course, is the obvious fact that an organism can only perform actions of which it is physically capable. A person who has lost his eyes can’t be taught visual discrimination skills. Similarly, brain damage/malfunctions represent limits for general learning, though it is my experience that individuals in this latter category are often capable of acquiring far more skills than is often imagined.

The sad fact is that relatively little attention has been afforded to teaching the individuals concerned the skills they need to begin to find some sense of success and mastery. Indeed, the bio-psychiatric position for the past forty years has been that their position is intrinsically hopeless; that the best they can do is eat the pills, and the most they can look forward to is tardive dyskinesia. Big pharma is raking in the money and the psychiatrists, psychologists, and mental health centers are walking in perfect step to the corporate drumbeat.

The tragedy of the Webster et all (2006) study is that for all its elegance and achievement, it will be used by the bio-psychiatric/big pharma lobby to promote their dehumanizing agenda, which includes legally enforced drugging and leaves people in the same state of wretchedness and failure.

So – as always – a single question takes us in many directions. I greatly appreciate your interest and your taking the time to write. Best wishes.

You express the view that mild depression is not an illness, but severe depression is. You also state that: “Many types of depression are quite clearly a biological malfunction.” My position is that there is insufficient evidence for either position. Of course depressive feelings are always accompanied by neural events. If I punch someone in the jaw, my action can be described from various perspectives. From a psychological point of view, it could be pointed out that the individual had insulted my favorite baseball team (say) and I retaliated physically. A sociologist might note that there were on average five physical altercations in the particular establishment each month, and that the combatants always came from different ethnic groups. An anatomist might describe how the human arm was uniquely suited to the purpose of striking blows to other objects. A physiologist might study the movement and interplay of muscles, tendons, etc. And a neurophysiologist might focus on specific mechanisms that link neural and hormonal correlates of anger with large muscle neurons, etc.. Now all of these perspectives are valid ways of examining the event in question. But no one would suggest that the act of throwing a punch should be regarded as an illness just because it has some neural correlates. Similarly, feeling good or feeling down can only occur if certain neural events happen in the brain. This does not establish the principle that depression is an illness. At the risk of stating the obvious, it is clear that a brain malfunction could cause depression. But the biopsychiatric adherents, despite their claims, have never established that this actually occurs. For a very detailed examination of the evidence in this matter, I recommend Elliot Valenstein’s book Blaming the Brain (1998).

Even if brain malfunctions were identified and were shown to cause depression, it seems unlikely that it would account for more than a tiny proportion of the depression we see in our society. The notion that human brains are “breaking” with such frequency is difficult to accept, especially when more parsimonious behavioral explanations are available.

You ask that I not categorize all depressed people into the same group. And in this, we are in full agreement. One of my major criticisms of DSM is that it does just that. It purports to collapse the enormous complexity of human life into the so-called diagnostic categories. My position is firstly, that every case of depression is different, and secondly, every depressed person is understandable if we are willing to take the time and trouble to listen and encourage communication. Within the DSM context, this almost never happens. The “diagnosis” is assigned and the pills are administered, and the “just like insulin” fiction is perpetrated.

With regards to pills, I don’t encourage people not to take them. In my experience some people take pills, others don’t. If you find them helpful, who am I to argue? My only position is that depression is not an illness, and anti-depressant drugs are not medication.

Anyway, despite our disagreements, I’m extremely grateful for your comments. I believe that dialog is the only way to move forward, and your thoughtful and detailed comment is greatly appreciated.

Even though this could be thought of as a normal evolutionary response, psychological pain like this, as with physical pain, can become dysregulated. Depression is “not an illness” if you are talking about the mild stuff. If it’s something that’s prolonged, intense, frequent and exists even in the absence of triggers, then it’s something that needs to be addressed with psychological and medical interventions. Many types of depression are quite clearly a biochemical malfunction. For example: in certain diseases, the immune system develops auto-immune pathologies, and makes antibodies to serotonin, which can then lead to depression. And in chronic infections, depression can also arise from raised interferon-alpha levels, which are known to affect the serotonin system.

All I ask of you is not to categorize all depressed people into the same group. As you can judge by some of the responses, every case is different and some quite prolonged and severe. As much as we’d like to simplify the treatment into six factors, for some, this approach would be insulting and discouraging. There are clearly some people who need the pharmacotherapy along with the psychotherapy; perhaps as an adjuvant or a catalyst for change. We speak of ‘quick fixes’ as bad things but we know that treatment for psychological illnesses tends to take a long time and anything that would speed up the process has the potential to save lives. The only thing lacking is competent practitioners who know when and how to appropriately use medication.

You also make the point that there is often a wide discrepancy between what people actually eat and what they say they eat. This is certainly true. People whose diet is less than ideal often feel very guilty about these matters, and will present a picture of their dietary intake that is rosier than the reality. In many cases this is as much self-deception as a desire to deceive others. Many years ago I was talking to a client and he mentioned that he always ate a good breakfast before going out in the morning. I asked him what he actually ate, and he replied “two pop tarts and two cups of coffee.”

The central theme of my depression post was that depression is not an illness, but is rather a warning signal from our bodies, to the effect that something is wrong – something needs to be changed. Tragically the bio-psychiatric school has persuaded large numbers of people that depression is an illness (“just like diabetes”) and needs to be “treated” by taking drugs.

Once again, thanks for your comment.

Actually, here in Germany a Big Mac (or fast food in general) is not the least expensive food available. Not by a long shot. It’s more like bulk buying bread, apples and cheese, and choosing your produce wisely that will make your budget last, but that doesn’t make it any less imbalanced and lacking in variety. As I said: Not anywhere is the USA, so please don’t assume everyone is living the same lifestyle – not even those with depression or other mental health problems, no.

All I meant to say was that being in financial dire straits and having no perspective for the future will impact your resilience/ability to bounce back. It seems long-term unemployment and – what is that nice term economists use nowadays? – “elevated levels of food insecurity” are major stressors. Does that really surprise us?

What I am trying to say: A lot of the things suggested above may be fine for low/medium levels of depression and a middle-class background. Pack financial instability or a lack of education and social networks on top: Not so much. I’ve seen in my fellow patients how hard it was for poor, single mothers to cope and how little all the good advice did for them. Seems we’re all mighty privileged.

Thank you for your take. However, I would be very pleased if you refrained from judging my lifestyle without knowing me and also if you stopped assuming that everyone is US-American. Thank you.

Also, I sense a certain amount of condescension toward those people who apparently are too stupid to ‘do the right thing’ according to your theory. Context matters, honey: Not all everyone lives under climatic and/or socio-economic conditions in which your advocated measures are as easily accomplished as they seem to be for you. If you want to convince people to “keep an open mind” and try out your approach, this might be something you may want to reconsider. Just saying.

For my part, therapy has helped (and still does help) a lot; I am getting better by the day, even though it’s winter (How did that happen?), even though there is no sunshine let alone the possibility of exposing your body to it, even though my diet is less healthy than it used to be (Thank fructose intolerance, lack of finances and my thesis).

So, does that make me a miracle, or might it be that the ‘traditional’ approaches of learning how to cope actually work? For my part, I don’t care what it is, it works and I am glad. Actually no, I am happy. Happy that for the first time in years I am able to concentrate, work, relate to my friends, go out, get organised, do all the stuff normal people do…

And I resent the fact that this talk about toxins and food being the be-all end-all of the issue may result in some people not receiving the understanding and help they need in order to get out of this and start making changes in to their lives. Basically, the ‘eat right, live right, do as I say’ approach is a sorry excuse for the old ‘Pull yourself up by the bootstraps’ advice. It is insensitive and it prejudges people. I, for one, much as I believe in taking care of my mind and body, am not convinced.