One may ask what this title has to do with depression which I’m about to discuss here, or mental health in general. Well, it concerns most psychology and its subfields these days.

We all hear these topics in many discussions about mental health and especially depression in different places:

• Depression is a form of inflammation
• Depression is not simply a serotonin imbalance, and it is also related to BDNF 3
• Probiotics are promising for depression treatment because they reduce inflammation in the gut
• Depression has a lot to do with the HPA axis

We all hear these arguments almost regularly nowadays, and I won’t fully dismantle them. It may be ironic that I’m the one arguing in this way because my first published work and future ones will be directly related to this neurobiological view of depression.

However, I believe there is much more to depression than imbalances in the brain.

Considering depression in a mere neurological or neurobiological manner is a strict form of reductionism which many researchers have dismantled. Yes, depression is related to serotonin and dopamine.

Still, by simply searching “monoamine hypothesis of depression criticism”, one can find almost endless articles arguing that first, this hypothesis was accepted, but after a while, the long time that antidepressants take to work. Their side effects and inefficiency in treating depression caused scholars to learn about BDNF (a
neural factor) and inflammation and…

I believe this approach is ironic. Why? Because many birds indeed fly and have specific facial features and anatomical characteristics, they have unique social and sexual behaviour and many other factors that categorise them as birds, not simply the ability to fly.

This goes for depression: Depression has cognitive features and social aspects in how one acts in society and the way society considers the individual; it also has unique physical characteristics and, without a doubt, neural aspects.

This doesn’t mean that these aspects of depression work separately and, at the end of the day, make the affected person depressed. Yet, they work altogether and concurrently even affect one another.

When serotonin and dopamine are imbalanced, one may feel hopeless and sad and lose his/her ability to function at the workplace, so the people there view him/her as lazy and change their behaviour. Again, this worsens the depression. Finally, that person comes home and fights with a friend and gets insomnia for it, and
depression is further worsened…

All the features that a depressed individual is experiencing should be viewed equally when any scholar or researcher is studying the causes of depression, as they only work together and affect people.

Sole consideration of a simple aspect of any disease or disorder or even an animal for labelling and categorising it is not only reductionism but also completely false and incorrect in many situations.

 Kian Zehtabian is a psychology graduate mental health advocate.