‘What if it [depression] was a physical illness that just happens to make people feel pretty lousy? Would that make it less of a big deal to admit to? Could it even put a final nail in the coffin of the idea that depression is all in the mind’?
Such is the question posed by Caroline Williams writing in the UK’s ‘The Guardian’. Her piece, ‘Is depression a kind of allergic reaction’? is accompanied by the strap-line, ‘A growing number of scientists are suggesting that depression is a result of inflammation caused by the body’s immune system’.
And Williams is of course right – there has been a growing body of scientific literature that links inflammation, and the chemical cascade that precipitates it and continues to fuel the fire, with depression and other mental health conditions.
Theoretically, and in practice, it makes sense to view the body as an holistic system; the duality of body and mind is anachronistic and does not adequately reflect the complicated dynamics of what is actually happening.
Indeed, Williams goes on to quote a clinical psychologist who has much experience of studying depression. She writes:
‘George Slavich, a clinical psychologist at the University of California in Los Angeles, has spent years studying depression, and has come to the conclusion that it has as much to do with the body as the mind. “I don’t even talk about it as a psychiatric condition anymore,” he says. “It does involve psychology, but it also involves equal parts of biology and physical health.”’
But despite the empirical and clinical evidence that is pointing in the direction suggested by Williams, there may very well be a warning from history that may cause us to pause for thought.
Quite incidentally, I’ve begun to read the excellent book ‘Madhouse: A Tragic Tale of Megalomania and Modern Medicine’ by the historian Andrew Scull. In the book, Scull provides an in-depth study of the life and work of Dr. Henry Cotton, an American psychiatrist and the medical director of New Jersey State Hospital at Trenton between 1907 and 1930. Cotton was a leading proponent of what was termed ‘scientific medicine’, and included a belief that mental illness was the result of untreated infections in the body. Thus in order to properly treat such illnesses, Cotton believed that ‘surgical bacteriology; was required; this often meant that patients had teeth removed, sections of colon excised, hysterectomy and other major surgical procedures to effect a ‘cure’.
For a while, Cotton’s work was viewed as ground-breaking by a sizeable section of the psychiatric community. That it was later discredited as a result of poor statistical analysis and other major failings, meant that this avenue of research was effectively closed down, and rightly so.
Now, I am not suggesting that the current scientific data is a re-run of the Cotton debacle. Statistical methodology today is far more robust and reliable that it was in Cotton’s day. So we might pause for thought, but not for too long. Today’s data, and shifting scientific knowledge, may very well lead to better, more integrated and targeted treatments for devastating illnesses, including bipolar disorder.
Whether all of this will come together to effectively reduce the stigma of ‘mental’ illness is a moot point. It is true that conditions with a clearly demonstrable ‘physical’ basis are treated more equitably than bipolar disorder, schizophrenia or major depression for example. But such stigma is deeply ingrained in society and will take time and effort to address.
You can read more about the issues raised by reading Caroline Williams’ article here in its entirety.