Interaction of social and neurobiological factors in depression

A multifaceted approach to treating depression may be optimal. Use of antidepressant medication in the United States is very high. While medication has saved lives, in some instances it paradoxically extends depression, if it leads patients to avoid changing life situations and personality patterns that are destructive. involvement of the community in treating depression may be helpful, too, as in the rituals of the Ndup and of "sitting Shiv'a." The link between depression and a lack of social connectedness may have a specific neurological underpinning, as demonstrated dramatically by Mayberg. Changes in neurobiology can significantly alter experience, but changes in experience can also significantly alter neurobiology.