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The best summary of depression research by the world's experts was just published in the @WPA_Psychiatry journal. https://onlinelibrary.wiley.com/doi/10.1002/wps.20771 Read it. Then join me in a thread about whether this line of research has gone about as far as it can go...and how to move on.
The article by Maj, Stein, Parker @blackdoginst and other experts organizes an enormous body of knowledge about depression symptoms, course of illness, vulnerability factors, and precipitating events. It is superb.
It aims to provide a guide for personalized assessment and treatment, and does. But most research has used a disease model that focuses on what is wrong with the person, with less attention to situations because they are so hard to measure. People talk about #complexsystems...
But the reality of pathways to depression frustrates our wish for simplicity. People become vulnerable in many ways for many reasons. Situations are created by people interacting with environments to create idiosyncratic recursive tangles of causes nearly impossible to describe.
This is all awful! Science is supposed to simplify! But the reality is even worse. #Depression is not one thing and people come to different symptoms via idiosyncratic routes. For instance, this person has a relatively uncomplicated genetic diathesis.
But this person's problematic personality is a product of many factors. It causes major disruptions that feed back and further influence the person and the situations.
This person is, for complex reasons, addicted to alcohol, which has wrecked his marriage, jobs, health, and friendships, creating more vulnerability and more situations.
But many cases are yet more difficult to describe, and to live. The person depicted below began life with #abuse and the genes of the abusing parents, and proceeded to tangles of events, vulnerabilities and situations that nearly defy description.
But description is possible. One can draw red lines on the diagram to depict how an individual's vulnerabilities arise and how they interact with specific situations. And we can analyze what resources an individual has and is trying to get and how things are going.
A Life Situation Analysis summarizes what an individual has, wants and is trying to get and avoid losing in six S.O.C.I.A.L. domains:
-Social status and allies
-Occupation
-Children and family
-Income
-Abilities, appearance, health and personal resources
-Love and sex
-Social status and allies
-Occupation
-Children and family
-Income
-Abilities, appearance, health and personal resources
-Love and sex
This doesn't reduce the complexity, but it organizes the description of situations so we can find out if depression really does often result, as I have argued, from continued pursuit of unreachable goals. And so we can understand individuals as individuals http://goodreasons.info
