Depression is a multifaceted problem, noted author and lecturer Michael Yapko PhD told a session at the 2002 Depression and Bipolar Support Alliance conference held in Orlando. Unfortunately, he observed, not all facets get equal attention, which may explain why depression is on course to be the world's second-most disabling illness by 2020. We have more medications to treat depression, he pointed out, yet the rates of depression keep going up.

No, Dr Yapko is not against drugs, though he does draw the line at puppies on Prozac (yes, it's true). Depression is on the rise in every age group, he states, yet no amount of meds is going to change one's style of coping and build stronger families. The illness may have a biological and genetic
component, but the strongest predictor of major depression is life experience.

And where do we get much of our life experience? The average American is exposed to 30 to 40 hours of TV a week. "What TV does in many ways is it beams into our brain a constant state of dissatisfaction," Dr Yapko observed, such as the disturbing knowledge that most of us don't have washboard abs. Depression, he went on to say, is contagious in a social sense, with people rapidly adopting a viewpoint that works against them to devastating effect.

Meanwhile adolescents comprise the fastest-growing depressed population. A recent Time cover story, "The Quest for a Superkid," spoke of childhoods turning into apprentice adulthoods and of programs more concerned with building resumes than building character. "I have a niece who is 11 going on 57," Dr Yapko revealed. Fully one-quarter of kids in her class need chiropractors from having to drag their book-laden backpacks around.

In some cultures, Dr Yapko, points out, depression is virtually nonexistent. These cultures are primitive by our standards, but they place community at the heart of things. Our culture, by contrast, focuses on the self and social isolation. The global village is merely an illusion, he said, as no one from the global village is going to pick up your kid from soccer practice. In 1990, USA Today ran a survey that found people saw each other socially six times a month. In 2000, that figure was one and a half.

If modern living helps create depressed people, the converse also applies. Depressed people have fewer social skills and social contacts. A child of a parent who is depressed is six times more likely to be depressed, and of those seeking help for marital relationships there is a fifty percent chance
one has depression. People do better, he said, when they feel they are connected to something greater than themselves, be it God, their art, or a support group.

Surprisingly, for a psychotherapist, Dr Yapko sees psychotherapy as "mop-up" to address a situation that has already happened. Instead, he is more interested in identifying those at risk for depression and intervening before they become depressed. He cited Martin Seligman PhD of the University of Pennsylvania, who has used cognitive therapy and social problem techniques to teach children to recognize negative thoughts and substitute them with positive ones. Follow-up studies five years later found these kids with less than half the depression rates as other kids.

The foundation of prevention, Dr Yapko concluded, lies in the ability to think ahead. Unfortunately, we tend to want it all now, without giving a second thought to the consequences. "Why do people sleep with each other," he asked, "before they find out what they like on a pizza?"

Clearly the answer to that doesn't come in pill form.

Coda

"Our scientific power has outrun our spiritual power. We have guided missiles and misguided men."

Martin Luther King Jr, quoted by Michael Yapko PhD at the DBSA conference. You can check out his website here

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Discussions

Fred (Aug 1, 2003): I believe that the notion that social isolation contributes heavily to the growth in depression numbers. As well I have long thought that the tele-media gives people a far more harmful self perspective than is generally appreciated. When communities worked together to care for each other and watch out for the welfare of the community, people experienced a source of energization from the knowledge that the community was there for them, even if it were not so stated by intrinsic. Tele-media and urbanization has drawn people away from the notion of community and into isolationism. One of best therapies I've heard of for depression is to force oneself to do something for someone else to help them. Understanding that it isn't easy to do that when one is in the pit of despair, when we lived as a community we were usually doing something to help someone else so frequently that depression didn't have the opportunity to find a footing. And if one were manic, there were always laborious jobs that could be tackled, building a barn, chopping fire wood, pulling the neighbor's plow when the mule was lame...in a way we may doing this to ourselves, at least partially.

Matt (Sept 9, 2003): Stating that depression is the result of social isolation may be true in some instances but it is by no means a broad diagnosis - how do you explain people like my aunt (and many millions like her) who was "highly social" her whole life and "contracted" depression anyway. It's like saying cirrhosis of the liver is brought on by drinking unfiltered water - it may contribute to it but it's not usually the cause.

McMan (Sept 9): Hi, Matt. Earlier this year I did a poll of my Newsletter readers, where I was shocked to discover 83 percent of us were introverts. There are many causes to depression, and the brain is a very complex organ. But we are discovering that social isolation can play a major role in depression for many people, and impede recovery. For more on social isolation and the Newsletter poll results, click here.

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John McManamy

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Michael Yapko: People do better when they're connected to something greater."