Creating Optimism

New research shows that most treatments for depression, including cognitive behavioral therapy, diet and antidepressants aren't enough. The only lasting solution is the oldest of all: a supportive "band" of relationships.

One of the things we find most affecting in our program for people with depression is how incredibly relieved people are to have a non-judgmental forum in which to discuss the ongoing pain of this devastating illness. They feel there’s something wrong with them for not being able to get out of bed easily--and sometimes not at all--in the morning, or for bursting into tears at work. Most believe that somehow it’s their failure that none of the prescribed treatments have worked; that they haven’t “gotten over it”. They are often afraid to “burden” friends and family with their anguish. They scarcely dare hope that there really is an answer for them.

Yet the truth is they are not alone. Also that the illness has even deeper causes than we once thought. They are not “weak” or “lazy” or “hopeless”. They are merely misinformed and isolated. Depression is not a life sentence. There is a way out.

Nearly every researcher agrees that early childhood traumas (i.e. those that happen before the age of six) lie at the root of most long-term depression and anxiety, and many emotional and psychological illnesses. Severe traumas can even alter the very chemistry and physiology of the brain itself! Among mental health professionals, and even some childhood development specialists, there is sometimes a lack of understanding over exactly what constitutes childhood trauma.

A seminal 1992 American Academy of Pediatrics (AAP) report defines childhood abuse as "a repeated pattern of damaging interactions between parent(s) [or, presumably, other significant adults] and child that becomes typical of the relationship."

In addition to physical, sexual and verbal abuse, this can include anything that causes the child to feel worthless, unlovable, insecure, and even endangered, or as if his only value lies in meeting someone else's needs. Examples cited in the report include "belittling, degrading or ridiculing a child; making him or her feel unsafe [including threat of abandonment]; failing to express affection, caring and love; neglecting mental health, medical or educational needs."

The AAP also includes parental divorce in the list of potentially harmful events which can traumatize a child.

Many things on the AAP's list of factors leading to childhood trauma benefit from further definition. For example, what do "belittling" or "degrading" mean in terms of a child's development? What actions--or inactions--on the part of parents or child carers would lead little Tommy to feel degraded? Under this category I would include criticism, and even failure to praise him (for accomplishment, for effort as well as just for being a "great kid"), listen to his opinions, and take an interest in his activities or friends. Praise and encouragement are essential to a child's sense of competence and emotional security, and absence of positive feedback can be extremely damaging to a child's self-esteem.