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Change or homeostasis? A systems theory approach to depression
1Department of Psychiatry, Milton Keynes Hospital.
Abstract:
Looking at the onset of depressive states in linear terms, there is often a problem of distinguishing cause and effect: did the adverse life-events cause the depression, or did the depression cause the adverse life-events? If we abandon linear thinking and look at depression in systemic terms, the problem of cause and effect disappears, but it is replaced by another problem: is the patient/environment system characterized by homeostasis or change? Some depressed patients seem to be spiralling down towards disaster. Others seem to be stuck in a rut. In systems terms, can depression be at the same time an agent of change and an agent of stasis (or even homeostasis)? The paradox can be resolved if we postulate that the function of depression is to reconcile the individual to an involuntarily subordinate social role; depression which reconciles to a pre-existing subordinate position has static properties; depression which mediates a switch to a subordinate position from a previously dominant position has properties of systemic change.
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