Depression and anxiety are the most common mental health issues of our times, and are one of the most common reasons that people come to counselling. For many first-time sufferers of depression, the symptoms begin to stack up unnoticed – or rather, they are noticed, but not linked to being ill. So people can feel lacking in energy, become irritable more quickly, have trouble sleeping, or wake up early in the morning with the mind racing, or simply find that all the pleasure seeps out of life. Eventually, all this gets in the way of carrying out our normal lives, at which point, wisely, people will seek help, usually from their GP, who will most likely prescribe anti-depressant and/or anti-anxiety medications, and also, often, a course of talking therapy.
Many people wonder about this. If depression can be traced to a chemical imbalance, to the point where adding additional molecules to the body (ie the meds) will restore that balance, then why is there also this emphasis on talking? Surely the chemicals will do the real work?
This is a huge question, and takes us to the heart of how the mind and body work together, and to the reason why talking therapies exist in the first place. The reality is that it is not only drugs that influence our brain chemistry. So do our experiences, thoughts, and emotions. And beyond that, the activity of our minds (including feeling stressed, anxious and depressed) can have a physical effect on our bodies. This is not new, nor is it any kind of rocket science. Just think of the ‘butterflies in your stomach’ experience when you’re nervous, or the way in which certain experiences can bring you out in goose bumps, or leave you suddenly with a dry mouth or clammy hands. What goes on in our minds has instant (and often longer term) physical effects.
Historically, there has been quite a bit of resistance to the idea. When a physical illness is described as ‘psychosomatic’ it feels like a put-down, as if the sufferer is somehow faking it. But when we consider the scientifically proven links between our mental states and the biological consequences of these, then identifying a link between our experiences and our body’s reactions becomes impossible to deny. A psychosomatic response is not a judgement: it is just a statement of fact about how the body (and mind) work together.
So, going back to the question about why people on anti-depressants will also be recommended a course of talking therapy: the answer is that working on our mental states is as much a part of the recovery process as taking the medication. The two work in tandem.
The NHS has a good selection of resources on depression and anxiety, including some audio guides.
Also from the US, the Anxiety and Depression Association of America – with information on symptoms, types of disorders, and treatment options.
I don't want to go overboard on US sites, but the Depression Alliance is notable for its blog articles on recent developments and research.
Thoughtful man seated on bus at night