The common thinking of the cause of Depression in the last 15-20 years has been that it is due to a chemical imbalance. Recently, it is found to be more complicated than that.
It is true that many people’s symptoms are improved with the use of antidepressants. Whether it be by a selective serotonin reuptake inhibitor (SSRI), or selective norepinephirine reuptake inhibitor (SNRI, tricyclic antidepressant or another class, they all are helpful for many people. But it is also believed that close to 50% of people do not benefit from antidepressants. Personally, I question that number when I think about my own practice and how many people have improved. In my own experience, I see 70-80% improving with antidepressants. The prior low numbers may be due to a person getting their meds from a general practitioner than from a specialist who is more adequately prepared to choose the correct type of medication. It could also be that in my practice, I follow my patients much closer than the typical GP who gives psychiatric meds to their patients. Additionally, most of my patients also receive from me some type of counseling or therapy and other health counseling so that should surely be a factor in my better outcomes.
Other factors that appear to be related to depression are genetic predisposition, other illnesses like Diabetes, heart disease, Parkinsons and Cancer, lifestyle factors such as substance abuse, exercise and nutrition. In the last few years there has also been much research directed toward inflammation and its influence on depression which is also showing a lot of promise.
Considering the complexity of issues related to Depression, in my practice I have a multidimensional holistic approach to target Depression. I use a combination of psychotherapy, lifestyle counseling, nutritional counseling, spirituality, and medication prescribing if appropriate and the patient is interested. I have helped many many people overcome the terrible delibitating disease of Depression.