Why Depression Needs a New Definition

The Atlantic: 

In his Aphorisms, Hippocrates defined melancholia, an early understanding of depression, as a state of “fears and despondencies, if they last a long time.” It was caused, he believed, by an excess of bile in the body (the word “melancholia” is ancient Greek for “black bile”).

Ever since then, doctors have struggled to create a more precise and accurate definition of the illness that still isn’t well understood. In the 1920s, the German psychiatrist Kurt Schneider argued that depression could be divided into two separate conditions, each requiring a different form of treatment: depression that resulted from changes in mood, which he called “endogenous depression,” and depression resulting from reactions to outside events, or “reactive depression.” His theory was challenged in 1926, when the British psychologist Edward Mapother argued in the British Medical Journal that there was no evidence for two distinct types of depression, and that the apparent differences between depression patients were just differences in the severity of the condition.

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Part of the problem, said Scott Monroe, a professor of psychology at the University of Notre Dame, is that in medical parlance, depression is considered a syndrome rather than a disease. (While a disease is a specific condition characterized by a common underlying cause and consistent physical traits, a syndrome is a collection of signs and symptoms known to frequently appear together, but without a single known cause.) In a paper published in June in the journal Current Directions in Psychological Science, Monroe called for scientists to begin defining depression with more precision. “It is in this vague and imprecise realm that problems can arise,” he wrote, “and vague insights based on imperfect similarities and differences eventually may prove to be clear oversights.”

Read the whole story: The Atlantic