What causes depression and can it be cured?

If you have depression, you may have been told by your doctor or even a therapist that your condition is a result of low levels of serotonin or a chemical imbalance in your brain. Conveniently, this theory of depression comes with a quick-fix solution: taking a pill. 

In my experience over the past decade, after treating hundreds of clients with depression, I have yet to see a single one cured by a pill. (I am not writing this article to make you more depressed!) 

There are effective treatments for depression, even curative ones. You just can’t swallow them with water. 

Depression is not just a result of a chemical imbalance. It’s a lot more complicated. You need to go to the root of those negative thoughts, beliefs, and attitudes and transform the causes of your depression. Only then will your symptoms go away.

The therapeutic modality I use, EMDR (Eye Movement Desensitization and Reprocessing), does exactly that. EMDR can help significantly with depression and even eliminate it. 

Here’s why a pill won’t cure you and how EMDR can.

Why medications don’t cure depression 

The medicalization of our emotional problems is a cause-and-effect model that simplifies things for us. We put our complex emotional problems in the microwave, push the button, and what comes out is a pill that will solve all our suffering. 

That’s what we are told, anyway. It’s actually a very smart marketing strategy, designed to sell pills. And it does.

Depression is skyrocketing

Yet the number of people in the United States being treated for depression has tripled over the last two decades. Today it is estimated that one in ten Americans now takes antidepressants. Another report suggests that the number may be as high as one in six Americans taking a psychiatric drug. Sales of psychiatric medications recently surpassed $76 billion per year! 

If Americans now take ten times as many psychiatric medications as they did in the 1950s, why aren’t we less depressed?

Why are we in the middle of a depression epidemic? 

Why are 45,000 Americans taking their own lives every year? 

Sales of psych meds exploded in the late 1980s

When antidepressants first came out around 1987, they were welcomed as a new and promising solution. For those under treatment for depression, antidepressant use doubled over the next 10 years, from 37% to 75%. The market expanded as well, under the influence of factors such as direct-to-consumer advertising and managed care insurers requiring treatment first by a doctor. An explosion of prescriptions followed, with over 130 million antidepressants prescribed each year in the U.S. alone by 1998.

Let’s be realistic. Selling medicine is fundamentally a business. Businesses are designed to make money. Pharmaceutical companies spend billions of dollars on marketing psychiatric medications, to both doctors and patients, directly. They spend way more money on marketing than on research and development and have undue influence in the doctor’s office. 

As treatment of depression by prescription became the norm, depression was explained away as a brain chemical problem. One that you could (and allegedly should) throw other chemicals at. 

But then we began to learn more about these drugs. We learned they sometimes work well in the short term and that once you stop taking them – you relapse right back into depression. We learned of serious side-effects that were more common than first thought. We learned that they work best side-by-side with therapy (yet with big pharma heavily funding research, you might not be surprised to find out that little research has looked at the most effective forms of psychotherapy).

Depression is not caused by a chemical imbalance

Today, we seem to equate getting a prescription with being treated effectively. The tragic side of the expanding drug business is that so many sufferers now believe that only a pill will cure depression. If this one doesn’t work, another will. If none of them work – take more than one and all your problems will be gone. It’s just not true.

The downside of today’s view is that patients are left feeling helpless, with a vacuum of options, only because doctors don’t do therapy. 

Our belief in the power of drugs should not change our understanding of depression. 

If you’ve been taking an antidepressant medication for a while, you know that it doesn’t really solve the problem. The best-case scenario is a reduction of symptoms, usually in the short term. 

There is a better way.

What really causes depression 

In my clinical experience, what really triggers depression are negative, traumatic events that happened in childhood. Memories that were not processed at the time and which still impede on everyday life. And not necessarily horrific cases of outright incest, beatings or other violence. Far more common with depression is simple emotional neglect or abuse by a parent or caregiver. 

In other words: a lack of unconditional love and responsible nurturing in childhood. 

What might qualify as emotional neglect or abuse? A parent (or parents) who: criticizes the child frequently or harshly, undermines regularly, ridicules or name-calls, or yells harshly for no understandable (to the child at the time) reason. Selfish parents who direct negativity toward a child who “inconveniences” them with a need or request (even genuine or urgent needs). Or a parent who withdraws their affection, care or attention when they feel displeased by a child. 

No child deserves this kind of treatment from those who are supposed to protect, care for and guide us to become our best selves.

Wounds and emotional trauma suffered in childhood usually go unprocessed. A child can’t understand the parent, has no perspective to make sense of their words and actions. So the child stores these memories differently than normal memories. 

These unprocessed, painful memories are held separately in the brain and can have significant effects on our everyday life later as adults. They can lead to depression.

How to eliminate the roots or cause of depression

Cognitive Behavioral Therapy (CBT) is one of the most common forms of therapy in the treatment of depression. CBT teaches you to examine your thoughts, feelings, and behaviors. After recognizing the nature of your thoughts (they’re automatic!), you have a better insight into how your thoughts affect your feelings and behaviors. 

In CBT, your negative thoughts are seen as the source of the problem, so you learn to reframe or change your thoughts to feel better. 

In EMDR we look at negative thoughts as a symptom—not the problem. These thoughts didn’t start up randomly one day or because you have a chemical imbalance in your brain. They started because of something that happened earlier in your life that led you to accept these negative thoughts as your reality. 

If, say, your dad was too busy and didn’t pay enough attention to you, you may have learned or internalized the thought, “I am not important enough.” If you were constantly criticized by your mom, you possibly concluded that you’re never good enough. If you were physically abused, you may believe the world is not safe. 

Over the years, these beliefs became automatic. With the force of repetition, you perceive them as objective truth. And depression sets in.

In EMDR’s view, the problem is not that you’re truly not important enough, not good enough or not safe. The problem is how the events that happened in your past have led you to hold those beliefs. 

EMDR goes beneath these thoughts and eliminates what is causing them to arise in the first place: improperly stored and unprocessed memories.

Logic doesn’t work on negative thoughts and beliefs

A CBT therapist will try to convince your logical mind to disbelieve your automatic thoughts. She will challenge you to find evidence that discredits these thoughts, and, with such evidence, you will come to the realization that these thoughts are false. You will also learn to catch yourself having the negative, automatic thoughts. And CBT works… sometimes. 

CBT can run into roadblocks because irrational beliefs are stored in a separate compartment in the brain from where logic lives. You are trying to apply logic to something that can’t be accessed by logic. It’s like explaining the theory of relativity to a 3-year-old: he will nod his head and try to convince you that he’s got it. But he can’t. 

When you live with a sense of worthlessness for so many years, trying to convince yourself that your thoughts are not accurate is not very effective. Maybe your best friend has told you many, many times how awesome you are. Did it work? 

I myself have explained to many of my depressed clients how worthy they are—explained that their worthlessness is only a result of conditioning or the experiences through which they learned to think that they are worthless. 

I usually get that “thanks for trying” look.

EMDR transforms the cause of negative thoughts

In EMDR, your therapist will help you to reprocess the events that you were not able to process in real time – when you were a child. The events that have led you to develop negative beliefs and thoughts about yourself. 

This reprocessing and desensitization of the event that started the negative thoughts will not help you cope better, like in CBT and other forms of therapy. EMDR treatment will eliminate the thought patterns that led to your depression. 

Simply put, processing as an adult the events that started your depression will lead to the end of your depression. Once an event has been processed, the thoughts will stop popping into your head. 

When you go to the root of the problem, you can cure depression. The results—elimination of symptoms and immediate feelings of relief are reported—speak for themselves. 

That makes more sense to me than drugs. I’ve seen the results again and again, and can only recommend that anyone with depression seriously consider working with an EMDR therapist.

Rotem Brayer is a certified EMDR therapist and an EMDR consultant in training practicing in Denver, Colorado. He divides his time between helping refugees to improve their mental health and maintaining a private practice.

Resources and further reading

1. Knaus, William J and Ellis, Albert. The Cognitive Behavioral Workbook for Depression: A Step-by-Step Program. New Harbinger Publications, 2012.

2. O’Connor, Richard. Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You. Little, Brown and Company, 2010.

3. Schapiro, Francine. Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy. Rodale Books, 2013.

4. Weill, Andrew. Mind Over Meds: Know When Drugs Are Necessary, When Alternatives Are Better—and When to Let Your Body Heal on Its Own. Little, Brown and Company, 2017.

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