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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

The modern idea of depression appears similar to the much older concept of melancholia. The name melancholia derives from "black bile", one of the "four humours" postulated by Galen.

Clinical depression was originally considered to be a chemical imbalance in transmitters in the brain, a theory based on observations made in the 1950s of the effects of reserpine and isoniazid in altering monoamine neurotransmitter levels and affecting depressive symptoms.[1] Since these suggestions, many other causes for clinical depression have been proposed.[2]

Some medical professionals and anthropologists have formed several theories as to how depression may have evolutionary advantages, i.e., how it might have increased genetic fitness in ancestral populations. For example, psychic pain may have evolved in an analogous way to physical pain so that organisms avoid behaviour which hinders reproduction. This insight may be helpful in counselling therapy.[3][4] Proponents of the psychic pain theory tend to view clinical depression as a dysfunctional extreme of low mood or mild depression.

Archaic Methods of Treatment

Insulin shock therapy is an old and largely abandoned treatment for severe depression, psychosis, catatonia, and other mental disorders. It consists of induction of hypoglycemic coma by intravenous infusion of insulin. Atropinic shock therapy, also known as atropinic coma therapy, is an old and rarely used method. It consists of induction of atropinic coma by rapid intravenous infusion of atropine.

Atropinic shock treatment is considered safe, but it entails prolonged coma (between four and five hours), with careful monitoring and preparation, and it has many unpleasant side effects, such as blurred vision.

References

  1. Schildkraut, J.J. (1965). "The catecholamine hypothesis of affective disorders: a review of supporting evidence". Am J Psychiatry. 122 (5): 509–22.
  2. Castren, E. (2005). Is Mood Chemistry? Nat Rev Neurosci, : p6(3):241-6 PMID 15738959.
  3. Tony J. Carey (September 2005), "Evolution, depression and counselling", Counselling Psychology Quarterly, Volume 18, Number 3: 215–222
  4. Tom Geoghegan (Thursday, 28 February 2008), Is depression good for you? Check date values in: |date= (help)