Part 3: Depression and Trauma
In Part 1, I described my own history of depression, how pervasive it has become, and my Moonshot Mission for Healing Mankind. In Part 2, I discussed the evolution of a new approach for treating and preventing depression. Here I will describe why our present way of treating depression is limited and the things we need to understand to develop a more comprehensive and effective approach for treating depression.
Our modern approach to understanding and treating depression assumes that our civilized lifestyle is better than anything that came before. It assumes that depression is a brain disease that is present in a small portion of the population and can be treated with medications or some sort of psychotherapy.
But it is becoming increasingly obvious that this approach has not been working and depression and other health problems are getting worse, not better. A 2003 study by Dr. Ronald C. Kessler and colleagues, “The Epidemiology of Major Depressive Disorder” examined the lifetime prevalence of depression in four age groups, those who were 60+, 45-59, 30-44, and 18-29. The findings are startling:
For the oldest age group by the time they were in their 80s, 10% had experienced major depression. The prevalence of depression increased in each successive generation. For the youngest, 25% had experienced major depression by the time they were 20 years old.
The problem is continued to get worse. A 2019 study by Dr. Jean M. Twenge and others, showed that 60% of teenagers 14-17 years of age had experienced depression and Covid and related stresses have made the problems even worse. When the CDC surveyed almost 8,000 high school students in the first six months of 2021, researchers found that depression, anxiety, and other disorders permeated the lives of adolescents during the pandemic.
Why I Focus on Depressed Men and Have Initiated a Moonshot Mission for Mankind and Humanity
As I noted previously, a 2021 report by The World Health Organization says,
“Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease.”
If we can solve the mystery of why more and more people are getting depressed and find a solution, we will help improve the health of humanity.
Depression is not an isolated problem. Depression is connected to many other problems including anxiety, obesity, diabetes, heart disease, certain cancers, alcohol and drug abuse, violence, divorce, despair, hopelessness, etc. Solve the problem of depression and we solve a lot of other problems facing humanity.
Numerous studies, including my own research demonstrated that depressed men are underdiagnosed and under treated and as a result the suicide rate for males is 3 to 17.5 times higher than it is for females and increases as we age. Solving the problem of depression in men can save the lives of millions of fathers, sons, husbands, brothers, and other men and improve the lives of women and children.
The Moonshot Mission for Mankind and Humanity has a simple, yet profound, goal: To improve the health and well-being of men so that males can live as long and healthy lives as females. As my colleagues Randoph Nesse, M.D. and Daniel Kruger, PhD say,
“If you could make male mortality rates the same as female rates, you would do more good than curing cancer.”
Clearly, there is a connection between depression and cancer as well as heart disease and many other problems. Solving the problem of male depression can help us solve many other problems.
The ACE Studies Show That Physical and Mental Problems Have a Common Underlying Cause
I’ve always known I had a challenging childhood growing up with an absent father and a mother who was terrified of death, hers and my own. But I just assumed life is hard for everyone and we just need to forget the past and do what we had to do to make the future what we wanted it to be. Without really thinking about I came to believe that I could take care of myself and I didn’t really need any support from others.
I had serious asthma growing up and throughout my life, had kidney problems and a number of other serious medical issues, felt isolated and alone as a kid, depressed as an adult, and went through two marriages and divorces before I began to examine what might be wrong. Yet, it didn’t occur to me to wonder whether any of these problems might be related to my childhood.
That all changed when I learned that I had four ACEs. Let me explain. ACEs, stands for “adverse childhood experiences” and the studies began in 1998 as a collaboration between Kaiser Permanente hospital in San Diego and the Center for Disease Control (CDC). It has become the largest public health study on the impact of childhood trauma in the world. The original study began with a 10-question survey that examined adverse experiences in childhood. Answering “yes” to each question gave you an ACE score.
The four questions I answered “yes” to were: (1) Were your parents ever separated or divorced? (2) Was a household member depressed or mentally ill, or did a household member attempt suicide? (3) Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other? (4) Did a household member go to prison? (In 1949 being committed to a mental hospital, was like being locked up in prison).
What surprised me the most was how ACEs impacted our adult lives. The more ACEs a person has, the higher the risk of facing physical, mental and social problems when we grow up. For instance, people with four ACEs are:
- 1.5 times as likely to have a stroke.
- 1.7 times as likely to have kidney disease.
- 2 times as likely to have asthma.
- 3 times more likely to smoke, binge drink and engage in risky sexual behavior.
- 4 times more likely to develop dementia or Alzheimer’s.
- 5 times more likely to be depressed.
- 12 times more likely to be the victim of sexual violence after the age of 18.
- 30 times more likely to attempt suicide.
Of course, just because we experienced adverse childhood experiences doesn’t doom us to adult problems later in life, but it does increase our risk if we don’t do something to heal. Healing often begins with recognizing the positive experiences we had as well as the adverse ones. For me, even though my father was absent and my mother had to be away from the home a lot, I felt she loved and supported me. I also had teachers in school and coaches in after school sports programs that gave me support.
Second, we can build on our positive experiences throughout our lives so that we don’t let the negative experience from the past cause us to suffer physical, emotional, and relationship breakdowns.
Third, once we know that we may have certain vulnerabilities, we can work to strengthen ourselves. Once I realized my susceptibility for certain medical problems, I took steps to build myself up. I exercised more to increase my lung capacity to minimize the impact of asthma. I sought out counseling to address my life-long issues with depression.
Forth, we can recognize that our childhood wounds have not taken us down. We’ve survived and gotten stronger as a result. Knowing what we’ve gone through and how we’ve managed to adapt and triumph can help us feel more powerful and able to address other challenges in our lives.
Fifth, we can recognize the truth that ACEs are not just individual problems, but are part living in a country that has trauma built into our lifestyle. In her book, Sacred Medicine: A Doctor’s Quest to Unravel the Mysteries of Healing, Lissa Rankin describes the trauma of the American Dream and our views of rugged individualism.
“I think one of the greatest traumas of modern culture is the social isolation,”
says Dr. Rankin.
“In the U.S., there is a value of rugged individualism, the I can’t rely on anybody and have to solve every problem myself mentality.”
She goes on to say,
“My country has historically been an inspiration to oppressed people worldwide who come here in search of their own American dream. My county is also historically one of the world’s most powerful abusive oppressors, colonizers, genocidal, enslaving, bullying forces in the world. And because of that, the odds of winning the American dream are stacked to uplift those with the most privileges–the white, heterosexual, cis-gender, able-bodied, wealthy, property-owning, American born, educated, neurotypical, and beautiful (by American standards, which generally means model thin, light skinned, blonde, busty, and wrinkle free if you’re a biological female and over 6 feet tall, muscular, and medium weight with a full head of hair if you’re a biological male.)”
“Sadly,” Dr. Rankin concludes,
“part of the American dream myth is the John Wayne story of rugged individualism that stands out in stark contrast to the way people live in protected Indigenous tribes and other cultures that are based on true partnership, connection to place, and deep family and community ties. These are cultures where depression is rare and people live long and healthy lives.”
The ACE studies have expanded over the years and we continue to increase our understanding about how our early life experiences impact our adult health and wellbeing. You can learn more about ACEs and get your own scores by visiting ACEStooHigh.
In the fourth part of this series, I will continue to deepen our understanding of depression and other illnesses, how to better treat them, cure them, and prevent them. I write an article each week that I hope will help you to live more fully, love more deeply, and make a positive difference in the world. If you’d like to receive our weekly updates on programs and read my latest article, you can subscribe for free here. If you’d like to learn more about our Moonshot for Mankind project to save lives, you can get information here.