Depression: Why Drugs and Electricity Are Not the Answer

The dominant ideology within mental health services and research, sometimes simplistically described as ‘the medical model’, tends to argue that feeling depressed is a kind of medical illness caused by various forms of biological deficits which are somehow corrected by psychiatric interventions such as drugs and electroconvulsive therapy. This article discusses the evidence for these claims and concludes that it is, at best, very weak. We argue that this flawed understanding of the causes of human distress and misery has led to equally flawed, and sometimes dangerous, interventions. An alternative understanding recognises depression as an emotional response to unwanted circumstances that requires human support and understanding, rather than technical, physical manipulations. It also demands that we address the social conditions that make depression likely. Such alternative approaches, increasingly endorsed around the world, including by the United Nations, the World Health Organisation and service users, are briefly described.

This article has been published in a revised form in Psychological Medicine https://doi.org/10.1017/S0033291721005031. This version is published under a Creative Commons CC-BY-NC-ND. No commercial re-distribution or re-use allowed. Derivative works cannot be distributed.