On this episode of The Shrink & The Pundit, Jeff and Dr. Keith talk about one of the oldest and most dreaded of human afflictions. They consider not just the suffering, but also the wisdom and growth potential that depression offers. They look at the qualities of modernity that magnify the condition, the mixed blessing of pharmaceuticals and neuroscience, and how depression is experienced and best treated at different stages in the developmental journey.

It seems that humanity is paying a heavy price for the “spectacularly tangible” achievements of modernity. The current generation has four times more depression than the last one, and ten times more than the one before that. Part of that story is increased self-awareness and over-diagnosis, but only part of it.

Antidepressants are the most widely prescribed drugs in America. There is so much of these drugs in our waste that we’re actually poisoning the fish. What’s going on here?

Generally, if you’re sufficiently bummed so that you can’t live the life you want to live, you could be depressed. But that includes a huge spectrum, says Dr. Keith. “When therapists talk about depression it’s like Eskimos talking about snow. There is a panoply of experiences that fall within the zone of depression.”

All mammals have the capacity for it, but humans are particularly vulnerable because of genetic mutations that gave us an awareness of ourselves in the stream of time. The tradeoff for remembering a past and imagining a future is an increased capacity for depression and anxiety.

Trusting your feelings only works when you are centered and connected with your higher self. ‘Trust your feelings’ does not work when you’re anxious, depressed or frightened.
~Dr. Keith Witt

In the upper right quadrant of the AQAL maps (the physical body) there are many things that can contribute to depression—low testosterone, hyperthyroid, hypoglycemia and other endocrine imbalances, as well as chronic lack of sleep. The integral view is that there are causes of depression in each quadrant. It’s a bio-psycho-social condition, with genes, culture and individual choices all in play.

Put any mammal into a situation of learned helplessness and they’ll get depressed, so groups of people with low socio-economic opportunity and a sense of oppression become very susceptible. Another way to depress people is to gradually give them more and more stuff to do so they never feel they have enough time to do what has to be done.

Excerpt | Mammals have a natural capacity for depression, humans especially

But the number one cause of depression is a sense of isolation. It’s an oft-remarked irony of the modern age that as connected as we are, we also experience more loneliness.  With increasing numbers of the population living in urban centers, uprooted from family and culture, there is a more pronounced sense of social isolation.

So what to do? One in ten people are diagnosed with major depression at some point. Only about half of them get treatment and the most common treatment is drugs. In the podcast Dr. Keith tells Jeff how the drug companies hijacked the neuroscience back in the seventies to sell us the idea that depression is a biochemical imbalance, which is a partial truth. It was an easy sell, of course, because who wouldn’t want to believe that taking a pill could make everything better? Yet, they work barely better than placebos.

“In 2007 the drug companies spent 23 billion dollars promoting antidepressants and 16 billion of that were free samples that they spread to doctors around the country,” he tells Jeff. And once you’re on them, it’s not so easy to get off.

Of course, occasionally they do work. And when they work, they work really well. “If you’re at a ten on a 1-10 depression scale and they can take you down to an eight so you’re functional, that’s how they should be used—only for severely depressed people,” says Dr. Keith.

An integrally informed psychotherapy is becoming the standard of the 21st century. It includes the possibility of pharmaceuticals but it will look at the issue from all four quadrants, with a developmental perspective, and the realization that different types of people are coming from different states of consciousness.

People at different stages of development deal with different flavors of depression and anxiety. The source and the remedy depend upon your worldview.

In addition to bio-psycho-social treatments, an integral approach can reframe the issue to include a larger embrace of all the aspects of being human, of being alive in a wonderful and difficult time.

“At every stage in development there is a dark night,” says Jeff, “this is well mapped in the mystical traditions … and you’re supposed to be depressed, you’re supposed to be unhappy. It’s part of the path. In some ways we need to be friendlier to that.”

In this way an integral perspective not only includes more, it can completely reframe the issue.

Dr. Keith says there are many different kinds of depression, but in general, “if we see depression as a sign that the current worldview is breaking down, and that we need to push through to a new worldview, then that completely reorganizes our thinking around the experience. It’s not a sign of disease under that circumstance, it’s actually a reflection of development.”

If your center of gravity is at an integral altitude, and you’re depressed, either you’re in the process of resolving that depression or you’re recognizing that you’re neglecting a major personal responsibility. ~Dr. Keith Witt

In more developed stages we resolve to turn toward these emotions with more consciousness and more love, while staying connected to others. This is crucial. “People who try to get happy just to get happy are rarely successful,” says Dr. Keith, “people who do their best to engage in meaningful relationships, they get happier.”

Find past episodes of The Shrink & The Pundit here, and more about Dr. Keith Witt here.