Depression expert focuses on social effects

Although most experts focus on the biological nature of depression, the disorder’s social effects deserve more attention, said depression expert Michael Yapko in a seminar last week.

A clinical psychologist and noted author, Yapko discussed depression’s three different aspects—biological, psychological and social. Most professionals neglect the social aspect, despite its importance.

The emphasis on the biological side, whether hormonal imbalances causing the disorder or prescription therapies to remedy symptoms, has created a dependency on drugs to treat depression, Yapko noted.

“People are taking anti-depressants, hoping against hope that it will work,” he said. “This is a wave of deception we’ve all paid the price for.”

Duke Integrative Medicine, a medical center dedicated to treating patients holistically through both Western and evidence-based, non-Western techniques, hosted the talk in Griffith Film Theater Wednesday. About 650 people registered for the event, making it the largest public event sponsored by Duke Integrative Medicine to date, Isabel Geffner, director of communications at DIM, wrote in an email Friday.

Yapko, who specializes in depression treatment, strategic short-term psychotherapy and clinical applications of hypnosis, acknowledged the growing incidences of depression at universities. He said in an interview that applicants unable to handle the pressures of college without significant medication or other help should not have been admitted in the first place. Colleges should have a screening process, and students should be assessed before admission.

“We live in a time when good relationships fail, and all you need is your iPad,” Yapko said. “This is a generation raised on appliances.”

Generations play a significant role in the rising level of depression in society. Most people who are depressed range from 25 to 40 years old—people in their prime childbearing years. The children of depressed parents are more likely to be depressed than children of parents who are not depressed.

Yapko said people need to develop better skills for coping with depression, such as actively combating their depression, having realistic expectations and avoiding too much rumination.

“Rumination is one of the most debilitating aspects of depression,” Yapko said. “Socrates once said that the unexamined life is not worth living—well, neither is the over-examined life.”

Geffner said that the high proportion of women in the audience Wednesday may reflect a proportional willingness to seek help in dealing with depression.

“Women are change agents—a known sociological phenomenon—and they are typically more willing to be ‘seen’ in states of vulnerability,” she said.

Dr. Amy Leung, a resident in the psychiatry program at Duke Medicine, volunteered as an usher for the event.

“The medical model is limited,” said Leung, who has also worked for Counseling and Psychological Services. “The idea that medicine can fix everything is ridiculous. Dr. Yapko challenges the current frame.”

In his remarks, Yapko noted that schools of thought regarding the disorder are the drivers of treatment for patients, as well as patients’ attitudes.

“What you believe about depression influences what you do about depression,” Yapko said.

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