Explanation of depression as an adaptation to surroundings better accepted by patients than depression as a disease

Clinical Question

Does framing depression as an adaptation to one's environment, rather than as a disease, result in better patient outcomes?

Bottom line

Explaining to patients that their depressive symptoms are an adaptation to their current circumstances, rather than as a "disease like any other," may produce less stigma and greater patient acceptance and self-efficacy. It may be time we all start thinking of depression as a signal that something in a patient's life needs more attention and not as something endogenous; this approach opens up the toolbox. The "chemical imbalance" explanation of depression, if true at all, may be the effect and not the cause. 1b-

Study design: Randomized controlled trial (nonblinded)

Funding: Foundation

Setting: Outpatient (any)


Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA

Discuss this POEM



Depression often environmentally triggered

This approach will help patients better accept treatment and will dig deeper into root causes of depression; environmental triggers


Impact assessment