Friday, April 07, 2006

Scholar's Paper Example: Nancy Godfrey


By Nancy Godfrey

Final Draft

Depression is one of the most frequently diagnosed conditions in the United States today. According to the National Institute of Mental Health, approximately 18.8 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year have a depressive disorder.[1] Those staggering statistics should cause us to question what is behind this pervasive condition. Though the cause of depression is unknown, many theories suggest possible causes. There is some thought among the scientific community that depression may have a genetic basis. So far studies have only hinted that bipolar disorder, which does have a depressive component, can be linked to a different genetic makeup. Other causes are thought to be low self-esteem or hormonal disorders. It is not entirely clear whether these factors are causes or simply an early stage of the illness. What is clear is that those who suffer from depression often have altered structures within the brain.

Physical changes are also sometimes associated with depression, though it should be noted that depression associated with illness is difficult to determine cause and effect. The one cause of depression that all scientists and researchers seem to agree upon is stress. That stress can take many forms such as illness, traumatic experience, financial hardship, or relationship difficulty. Even desirable stress is thought to trigger depression in some cases. The combination of biological and environmental factors is thought to be involved in the onset of depression. This is one area where the principles of Pleneurethics may have profound impact on the magnitude and prevention of depression.[2]

Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill. However, the reverse is not true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.

In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function. People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Whether this represents a psychological predisposition or an early form of the illness is not clear.

In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Only mild stresses, or none typically precipitates later episodes of depressive illness at all.[3]

Treatment choice will depend on the outcome of evaluation. There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders. Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression are typically treated with medication. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression. Depending on the patient's diagnosis and severity of symptoms, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression. These treatments are the standard for most forms of depression.

In the past few years, much interest has risen in the use of herbs in the treatment of both depression and anxiety. St. John’s Wort (Hypericum perforatum), an herb used extensively in the treatment of mild to moderate depression in Europe, has recently aroused interest in the United States. St. John's Wort, an attractive bushy, low-growing plant covered with yellow flowers in summer, has been used for centuries in many folk and herbal remedies. Today in Germany, Hypericum is used in the treatment of depression more than any other antidepressant. However, the scientific studies that have been conducted on its use have been short-term and have used several different doses.

Because of the widespread interest in St. John's Wort, the National Institutes of Health (NIH) conducted a 3-year study, sponsored by three NIH components-the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, and the Office of Dietary Supplements. The study was designed to include 336 patients with major depression of moderate severity, randomly assigned to an 8-week trial with one-third of patients receiving a uniform dose of St. John's Wort, another third sertraline, a selective seratonin reuptake inhibitor (SSRI) commonly prescribed for depression, and the final third a placebo (a pill that looks exactly like the SSRI and the St. John's Wort, but has no active ingredients). At the end of the first phase of the study, participants were measured on two scales, one for depression and one for overall functioning. There was no significant difference in rate of response for depression, but the scale for overall functioning was better for the antidepressant than for either St. John's Wort or placebo. While this study did not support the use of St. John's Wort in the treatment of major depression, ongoing NIH-supported research is examining a possible role for St. John's Wort in the treatment of milder forms of depression.[4]

The Food and Drug Administration issued a Public Health Advisory on February 10, 2000. It stated that St. John's Wort appears to affect an important metabolic pathway that is used by many drugs prescribed to treat conditions such as AIDS, heart disease, depression, seizures, certain cancers, and rejection of transplants.[5] Some other herbal supplements frequently used that have not been evaluated in large-scale clinical trials are ephedra, gingko biloba, Echinacea, and ginseng. It is possible that these have not been tested because they are not controlled by the FDA, nor are they owned by a specific pharmaceutical company, therefore the interest in their study is limited.[6]

Many forms of psychotherapy, including some short-term (10-20 week) therapies, can help depressed individuals. "Talking" therapies help patients gain insight into and resolve their problems through verbal exchange with the therapist, sometimes combined with "homework" assignments between sessions. "Behavioral" therapists help patients learn how to obtain more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to or result from their depression.

Two short-term psychotherapies that research has shown helpful for some forms of depression are: interpersonal and cognitive/behavioral therapies. Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate (or increase) the depression. Cognitive/behavioral therapists help patients to change the negative styles of thinking and behaving often associated with depression. These treatments begin to take into account the individual’s power to influence their condition and recognize the value of right-mindedness and right living, two principles of Pleneurethics.[7]

Psychodynamic therapies, which are sometimes used to treat depressed persons, focus on resolving the patient's conflicted feelings. These therapies are often reserved until the depressive symptoms are significantly improved. In general, severe depressive illnesses, particularly those that are recurrent, will require medication (or ECT under special conditions) along with, or preceding, psychotherapy for the best outcome. These recommended treatments are followed by a brief list of self-help means of getting over depression, but individual ownership of healing is almost an afterthought to the medical therapies.

In light of the many possible causes of depression, it is surprising that treatment options are so limited. The primary treatment of choice in the United States is medication. Antidepressants represent one of the most widely prescribed classes of drugs on the market. Psychotherapy is thought to be an important adjunct to drug therapy, but often it is not utilized by primary care providers who most often treat mild to moderate depression among patients. Sadly, it is our culture to seek instant satisfaction and quick fixes to problems. The unfortunate result is that the cause and prevention of depression often goes unaddressed. Even the NIMH pays nominal attention to measures the individual can take to deal with a depressive episode.

In the search for effective treatment of this potentially debilitating condition, science has overlooked one of the most powerful tools available to us: the human brain. Though the primary focus in the medical community is on the chemical imbalance thought to cause depression, almost no attention is given to the idea that depression may be caused by a life imbalance.

The principles of Pleneurethics stress that it is imperative to strengthen and preserve the neural system. This principle may be applied to depression through its prevention. One of the preventative measures that is always mentioned, but seldom emphasized is stress reduction. Ian Wickramasekera, Ph.D., clinical professor of psychiatry at Stanford University Medical School states, “Many people who have stress-related pain aren’t even aware of what they’re fearful or angry about.”[8] He claims, “Half of the patients doctors see for various common body aches are actually expressing psychological distress.” He attributes most of that pain to stress. According to Richard Laliberte in the same article, “The source of stress-related pain lies in the brain…”[9] It is logical that if stress causes physical pain and physical pain can cause psychological distress, stress relief should in turn ease any psychological distress. Because Pleneurethics is considered “any corrective force applied to body or mind to restore neurological sufficiency”, stress reduction is an integral part of incorporating Pleneurethics into everyday life.[10]

One cultural phenomenon that seems to contribute to stress is increased reliance on prepackaged foods and decreased exercise. Prepackaged foods and fast foods tend to contain higher fat, higher calorie items, which are now thought to be one of the primary culprits in the rising rate of obesity. As our nation becomes more obese, we also become more sedentary. The effect could be an increase in rates of depression due to changes in hormone levels, decreased blood flow, decreased levels of the amino-acid L-5 Hydroxytryptophan (a neurotransmitter which increases seratonin levels) and reduced amounts of endorphins that are produced during exercise. Recent studies have shown the rate of obesity and sedentism among U.S. citizens to be growing at an exponential rate.[11] The effects of obesity are well known on the body, but we may tend to overlook the underlying stress, low self-esteem, lack of healthy human interaction and dependence on medical solutions for depression that obesity may cause. Pleneurethics relies on the integration of physical, mental and spiritual balance.[12]

The reduction of stress is one concrete way that the physical and spiritual forces can greatly affect mental status. The imbalance that we suffer from ignoring our spiritual needs for peace, the physical needs for exercise and rest manifests itself in depression in some cases. Exercise and proper nutrition are ways of promoting chemical pathways to the brain, encouraging healing Delta sleep patterns and increasing blood flow to organs. These processes support brain activity and are embedded in the Pleneurethics principle of protecting the brain and enhancing its supporting mechanisms. There is an underlying fear among much of the public that depression is a biological condition that must be treated using medication. Pharmaceutical companies play on this fear by using advertisements and generalized symptoms for diagnosis to promote the use of their product.

The very nature of depression causes uncertainty, questioning one’s own judgment and a desire to know that a solution may be readily at hand. Some sufferers of depression have described wanting a cure so desperately that they are willing to submit themselves to trials of medications they do not understand. In an interview with a current antidepressant user she admitted, “I was hesitant to start medication. I waited for years before surrendering to it. I always felt that I was smart enough that I should not have to take it (medication) to get better. One day I finally broke into tears and couldn’t stop. That is when I realized I couldn’t figure out how to fix it myself. My doctor suggested I take antidepressants and I have been on them since. Sometimes I feel like I am not myself anymore, but I am too afraid of getting that bad again to stop. Depression is like a hole that keeps caving in on you. Just when you think you have reached the top, the walls fall in and you give up and look for someone or something to lift you out.” Name withheld.

That sense of desperation often leads independent, intelligent people to rely on a solution that does not involve them. By using medication as a quick fix, people remove themselves from the process of healing and thereby may negate any responsibility they owe to their own well-being. That is a dangerous prospect when you consider that most depression sufferers will experience at least two relapses during their lifetime. The use of medication does not give people the tools they need to battle the condition, prepare for its return or remain healthy.

A recent article on WebMD asks a question that one studying Pleneurethics might. “Is it possible for psychiatry and religious/spiritual beliefs to coexist, or even to be entwined?”[13] There may appear to be an obvious answer, most of the medical community treats the mind, body and spirit as separate entities. In some cases, medical professionals find themselves at a loss to explain phenomenon that appears to point directly to this connection. In an attempt to remember that we are connected to our spirit by mind and body the article some scientific research has been done to examine this concept. Not surprisingly, studies have shown that “spiritual practices may indeed exert a positive influence on a person's health and well being, including those experiencing mental health problems.”[14] Though this may seem a positive step, there are those in the clergy as well as psychiatry who question the intertwining of the two. Some in the psychotherapy field believe that religion may be the cause of some mental illness. In spite of this disagreement, groups are forming around the country that utilizes prayer or meditation as a tool to treat and prevent further episodes of depression. This recognition of us as spiritual beings is one step along the Pleneurethics path.

Another Pleneurethics principle that has close ties to spirituality is ethics. It is not surprising that in a nation as cynical as ours tends to be, we give short shrift to ethical issues. We see CEO’s, sports icons, heads of state and even religious leaders embroiled in ethical controversy. As individuals trying to live in a society that places value on power, position and possessions, it is difficult to find our own ethical boundaries. Events take place daily that may call into use our ethics. Things as simple as taking a day of sick leave to play golf or cutting off another driver to get a parking space may become ethical roadblocks. Though these things may seem trivial, they can add up, much in the way plaques build up in an artery. Eventually the pressure of each unresolved ethical issue can cause a moral attack. The weight of living unethically is often unseen. It exists subversively in our subconscious, depleting our energy to contribute to others. Once we stop giving to the world beyond ourselves, we cease to have a purpose. That leaves a space that the universe must fill. Often, it is filled with self-loathing, guilt and eventually depression. To avoid oversimplification, living unethically may not lead to any of these things. The point is that by living ethically, we free that portion of our mind that would tend to build up stress over such issues. Ethics is an individual issue, as well as a global one. Living within the boundaries of your personal belief system may alleviate some of the potential pitfalls of allowing yourself to yield to outside pressures. Richard Bach wrote, “Your only obligation in any lifetime is to be true to yourself.”[15] By maintaining a strong sense of self, spirituality and ethics, depression brought on by regrettable decisions can be mitigated. Knowing that you always act in a way that you believe is ethical allows self-respect and dignity that can fade in times of impending depression. [16]

Depression can be a problem of chemical imbalance or life imbalance. It is a state in which your impression of the world and your place in it is distorted. Though this distortion may be real or perceived, the effect is very real on the lives of depression sufferers. Depression can cause doubt about every decision, inflate every emotion and call into question one’s own worth. Because of the very nature of the condition, utilizing Pleneurethics principles may promote a state of awareness that reduces the consuming doubt and potential for self-loathing that accompanies many depressions. This concept is gradually gaining support among the scientific community.

The Massachusetts Institute of Technology recently held a conference between top scientists and the Dalai Lama to study Buddhism and its relation to the way the brain functions. The conference, sponsored by the Mind and Life Institute explored the tendency to equate objects with happiness and self worth. The Mind and Life Institute also examines the link between Buddhist practices and the ability to intentionally manipulate basic physiological processes, and to catalyze psychological and biological healing effects.[17]

Author of the book Destructive Emotions, Daniel Goleman, PhD said in a recent interview, “The dogma in neuroscience was that the brain…was unchanged by life experiences.”[18] Recently science has begun to challenge that long-held belief. David Lykken, PhD, professor emeritus of psychology at the University of Minnesota is author of the book Happiness: The Surprising Ways We Can Make the Most of What Nature Gives Us. In a recent interview he addressed the issue of our ability to create happiness and actually change the brain. He said, “Happiness is genetically influenced but not genetically fixed…the brain’s structure can be modified through practice.”[19] This concept is slowly gaining strength. It gives credibility to the principle of Pleneurethics that thoughts can change the actual structure of the brain. This gives way to the simple conclusion that practicing right-mindedness and ethical thought and action provide neural sufficiency and can actually change the internal structures of the brain.[20]

The utilization of Pleneurethics principles could help prevent episodes of depression and heal those already suffering with depression. By understanding the need for support of the brain and its systems, we can conclude that Pleneurethics principles may offer solutions to those who seek to prevent depression in their lives. Caring for our bodies, hearts and minds could be the most powerful tool for healing and prevention of this debilitating condition.

[1] National Institute of Mental Health. Publication No. 01-4584. Updated: January 01, 2001.

[2] Richard Bangs Collier. Pleneurethics: A New Concept of Healing. Vol. II, Second Ed. p. 86

[3] National Institute of Mental Health. Publication No. 02-3561. Printed 2000, Reprinted September 2002. - ptdep4

[4] National Institute of Health. Study Shows St. John's Wort Ineffective for Major Depression of Moderate Severity Embargoed for release: Tuesday, April 9, 2002. 4 p.m.

[5] National Institute of Mental Health. Updated: January 12, 2001

[6] National Institute of Mental Health. Updated: January 12, 2001

[7] Richard Bangs Collier. Pleneurethics: A New Concept of Healing. Vol II. Second Ed. (p. 159-180)

[8] Shape Magazine. “Is stress making you ache?” Richard Laliberte. (p. 152)

[9] Ibid. (p. 152).

[10] Pleneurethics Journal. (Vol. II, Chapter 1, p5).

[12] Richard Bangs Collier. Pleneurethics. Vol. V. (p. 91-93).

[13] WebMD. “Mental Health and Spiritual Wealth”. Roxanne Nelson. WebMD Medical News Archive. 28, 2000.

[14] Ibid. p. 4.

[15] Richard Bach. Illusions: The Adventures of a Reluctant Messiah. 1977.

[16] Richard Bangs Collier. Essential Pleneurethic. Second Ed. (p. 118-130)

[18] O Magazine. “Looking for Happiness in All the Right Places”. Mark Matousek. (March, 2004. p192-195).

[19] Ibid. p. 195.

[20] Richard Bangs Collier. Essential Pleneurethic. Second Ed. (p. 86).


Richard Bach. Illusions: The Adventures of a Reluctant Messiah. Delacorte Press.New York, 1977.

Richard Bangs Collier. Pleneurethics: A New Concept of Healing. Vol. II, Second Ed. Ed. John Terrey.


Richard Bangs Collier. Essential Pleneurethic. Second Ed. Ed. Donald C. Emmons, PhD, Ralph D.

Shoub, PhD.

Richard Bangs Collier. Pleneurethic. Volume V.

Mind and Life Institute. (December 1, 2004)

National Institute of Health. “Study Shows St. John's Wort Ineffective for Major Depression of Moderate Severity” (June 6, 2003).

National Institute of Mental Health. Publication No. 01-4584. Updated: January 01, 2001. (March 15, 2003)

National Institute of Mental Health. Publication No. 02-3561. Printed 2000, Reprinted September 2002. (March 18, 2003)

National Institute of Mental Health. Updated: January

12, 2001(July 24, 2003).

O Magazine. “Looking for Happiness in All the Right Places”. Mark Matousek. (March, 2004. p192-195).

Pleneurethics Journal. (Vol. II, Chapter 1, p5).

Shape Magazine. “Is Stress Making You Ache?” Richard Laliberte. (p. 152)

WebMD. “Mental Health and Spiritual Wealth”. Roxanne Nelson. WebMD Medical News Archive. Aug. 28, 2000



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