Is depression a disease?

Question

I got this question after reading this: http://worldradio.ch/wrs/news/wrsnews/basel-study-shows-positive-side-of-depression.shtml?24427

When a person is depressed, is it because the brain is malfunctioning, or is it just a natural reaction for sadness?

Today you say to a doctor that you are sad, and he prescribes you an antidepressant without asking further questions. Instead, shouldn't depression be considered a natural reaction from the brain and be treated only for special cases where it is a syntom instead of the main disease(bipolar disorder, pacient getting suicidal, ...)?

By a natural condition I point out the Basel study saying that people get more analytic during a depression. It is the way that the brain found to protect the person from getting another sadness.

Answer 1

I think your defenition of depression as "sad" is a missunderstanding on your part. Depression is clearly defined in DSM-IV.

Depression that meets the DSM-IV criteria for a depressive disorder. The term is usually used to denote depression that is not a normal, temporary mood caused by life events or grieving

DSM describes symptoms and does not discuss the causes of the disorders. DSM-IV designates the 4th edition. Issued in 1993, DSM-IV is currently the latest edition (as of 2001).

A better defenition would be:

Chronic Depressive Disorder (Dysthymia)

A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.

B. Presence, while depressed, of two (or more) of the following:

1. Poor appetite or overeating

2. Insomnia or hypersomnia

3. Low energy or fatigue

4. Low self-esteem

5. Poor concentration or difficulty making decisions

6. Feelings of hopelessness

C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time.

D. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder.

G. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Once you clear that definition up, there are of course unethical doctors who may not perform a full diagnosis and just prescribe medicine that has been show to work on the surface symptoms.

So in answer to your question, yes, it is a disease. (Although, keep in mind that a layman may think of a disease being caused by pathogens as opposed to a chemical imbalance. This is a limitation in layman understanding).

Answer 2

Yes. Depression is a disease.

Disease, a harmful deviation from the normal structural or functional state of an organism.

Your statements and questions...

When a person is depressed, is it because the brain is malfunctioning, or is it just a natural reaction for sadness ?

There is a big difference between feeling depressed (or sad) for a few days and having a depressive disorder. ^{_{See below.}}

Today you say to a doctor that you are sad, and he prescribes you an antidepressant without asking further questions.

Wildly unethical behavior by doctors has no effect on the status of depression as a disease.

By a natural condition I point out the Basel study saying that people get more analytic during a depression. It is the way that the brain found to protect the person from getting another sadness.

There are many hypotheses on the exact cause of depression.

From your link....

The results of the study give weight to one American theory on depression, which sees the mood disorder as an adaptation to solving complex problems.

^{_{NOTE: The authors understanding of what constitutes a "theory" is incorrect.}}

This is, most likely, a reference to the idea of analytical rumination (one of the evolutionary approaches to depression).

The analytical rumination (AR) hypothesis proposes that depression is an adaptation that evolved as a response to complex problems and whose function is to minimize disruption of rumination and sustain analysis of complex problems.

...evidence suggests that much of what is currently classified as depressive disorder represents normal psychological functioning (Horwitz & Wakefield, 2007). One likely factor contributing to overdiagnosis is that clinically significant impairment is not conclusive evidence of disorder (Spitzer & Wakefield, 1999). Impairment can be caused by biological dysfunction, but it can also be caused by properly functioning stress response mechanisms.

The AR hypothesis suggests that psychotherapies are productive when they help depressed people identify and solve important problems in their lives. It also suggests that depressive rumination is useful and that antidepressants may interfere with the ability to ruminate. For these reasons, the AR hypothesis would place greater emphasis on psychotherapy and less on medications.

^{_{Depression as an adaptation for analyzing complex problems.}}

However...

Terminology is inconsistent in this area. Those who see depression as intrinsically pathological tend to reserve the word for severe states that are mostly unrelated to ordinary mood variation, while those who see it as a defense use the same word to cover a wide range of normal and abnormal states.
^{_{Is Depression an Adaptation ?}}

In other words: Semantics might cause confusion.

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Depression

Taken from my answer to Do antidepressants work ? See also: Is there any scientific basis for Seasonal Affected Disorder (SAD)?.

When a person has a depressive disorder, it interferes with daily life, normal functioning, and causes pain for both the person with the disorder and those who care about him or her. ^{_{(Emphasis mine.)}} **

General forms of depressive disorder...

• Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally.
• Dysthymic disorder, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well.
• Psychotic depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.

^{_{Source: National Institute of Mental Health}}

Brightblades answer also has some excellent information on depression.

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The Bottom Line...

Some manifestations of disease arise directly from a defect in the body’s machinery while others are defenses or dysregulations of defenses...defenses such as pain or diarrhea are adaptations shaped by natural selection. Dysregulated or extreme defenses cause many diseases, such as chronic pain or dehydration from diarrhea.

^{_{Source: Is Depression an Adaptation ?}}

If "depression" is an evolutionary adaptation...

The disease caused by its dysregulation, currently known as depression, will need a new name.

Answer 3

There is no denying that those who suffer from severe depression are ill. Depression can be debilitating and, in some cases, deadly. Physical symptoms such as nausea, vomiting, fatigue, chronic pain, diarrhea, insomnia etc. are common concomitants to major depression. https://www.psychologytoday.com/blog/evil-deeds/200809/is-depression-disease