[NOTE: The following selection comes from "Shades of Sadness" (subsequently
published as "Case Studies in Depression") by David McMillin. Copyright
© 1991 by David McMillin. Used with permission. All rights
reserved. "Case Studies in Depression" is currently available from
A.R.E. Press in Virginia Beach, Virginia.]
The Neurobiology of Depression
Depression is a morbid sadness. It may manifest
in degrees of severity ranging from mild impairment to total debilitation.
Depression is distinguished from grief, which is realistic and proportionate
to personal loss.
In recent decades, considerable advances have been
made in understanding the causes of depression. Researchers have
implicated a variety of psychological, interpersonal and biological factors
while clinicians have authored an abundance of innovative therapeutic interventions.
Thus, a considerable literature has accumulated resulting in a greater
appreciation of the breadth and complexity of depression. In this
and subsequent chapters, we will examine this literature and compare it
to the psychic readings of Edgar Cayce. However before we engage
in comparative studies, it may be helpful to define exactly what depression
signifies in common terms.
The word "depression" is commonly used to describe
mood states ranging from mildly negative feelings of sadness to the most
severe and debilitating psychiatric illnesses. Traditionally, the term
melancholia has been used to designate depression. Even today, psychiatry
utilizes this expression when distinguishing certain forms of depression.
Regardless of the label, feelings of hopelessness
and worthlessness are typically prominent. Excessive or inappropriate
guilt is sometimes associated with depression. Depressed persons have difficulty
experiencing pleasure and frequently report a loss of interest in the normal
activities of life.
The mental symptoms of depression include difficulty
in concentrating, slowed thinking, and indecisiveness. Thoughts tend
to center on self-reproach and negative self-evaluation. Memory may be
impaired and the person may be easily distracted. Thoughts of death
and suicide may be prevalent.
Physical symptoms are also common in depression.
Disturbed appetite and sleep patterns, coupled with numerous "somatic"
complaints of various aches and pains give the impression of poor general
health. "Somatic" is an important word in the psychiatric literature.
It is derived from the Latin soma, meaning body. Thus, depression
has a strong physical dimension which we will examine more closely when
we discuss the medical model of mental illness. In fact, we will
focus heavily on the somatic aspects depression in the first four chapters
of this book.
A depressed person may experience anxiety, tearfulness,
irritability and excessive concern about their physical health. Depressed
thoughts and feeling may be translated into behaviors such as "psychomotor
agitation" or"psychomotor retardation." In other words, the person
may either experience a restless, nervous energy leading to excessive movement.
Or, little or no energy may be available resulting in an inappropriate
lack of movement.
In its most severe forms, depression may be mixed
with psychosis. Psychosis refers to a loss of touch with reality.
This form of depression is sometimes called psychotic depression or depression
with psychotic features. For example, a person may experience sensory
hallucinations such as "hearing voices." Or an individual may become
delusional and believe that they are being persecuted because of some misdeed
or personal inadequacy. As we shall see in Chapter Nine, bipolar
disorder (manic-depressive illness) is a particular type of mood disorder
in which mania can sometimes manifest as psychosis.
While there have been an abundance of theories of
depression put forth to explain the causes of all of the symptoms just
mentioned, one approach is rapidly becoming predominant in western culture.
This theory is based upon the biochemistry of the body's cells, specifically
the cells in our nervous system. Going even further, this approach
focuses on the molecules within and between nerve cells as the source of
depressive symptoms. This fixation on the neurobiology of mental
and emotional symptoms has been called the medical model of mental illness.
The Medical Model of Mental Illness
Psychiatry is the branch of medicine dealing with
mental disorders. It has been undergoing a revolution during the
last four decades. The tremendous growth in our understanding of
the medical aspects of mental illness goes back to the mid-1950's.
It was at that time that French physicians discovered the antipsychotic
properties of a particular class of drugs called the phenothiazines. Specifically,
it was a phenothiazine marketed under the trade name Thorazine which initiated
the biological revolution in modern psychiatry.
The story of this important discovery is fascinating
and may help us to understand the process of medical research. Here
are some of the facts.
The French physician Henri Laborit was looking for
a drug to prevent a drop in blood pressure during surgery. Although
the drug he used failed in that respect, it did have noticeable sedative
effects. The astute physician wondered if the drug could be useful
in the treatment of mental and emotional disorders. Labori's curiosity
paid off. Subsequent research by French psychiatrists was by trial and
error - they gave the drug to persons suffering a wide range of disorders
to see if it had any effect. The medication had powerful calming
effects on agitated psychotic patients and thus: "The first powerful drug
available to treat serious mental illness was discovered in much the same
way as was penicillin: by accident. The discovery was the happy consequence
of a chance finding being observed by a person with a fertile mind who
could recognize its larger implications." The preceding observation
was noted by Nancy Andreasen, M.D., Ph.D., a leading researcher in the
field of mental illness.
Just as the first antipsychotic medication was discovered
by accident, one of our most useful mood altering drugs was likewise a
gift of serendipity. Lithium carbonate, a naturally occurring salt
widely used in the treatment of mood disorders such as bipolar disorder,
was discovered by an Australian researcher seeking a neutral solution to
serve as a control substance in experiments with rats. Fortunately,
he was astute enough to notice that the substance intended to have no effect,
actually affected the rats' behavior in specific ways. Like Laborit,
he wondered if the calming effect of the substance could be helpful in
the treatment of mental and emotional disorders. He had a difficult
time convincing his colleagues to give lithium a try - it had been used
in previous experiments with humans and its propensity for toxicity resulted
in several deaths. Eventually, its therapeutic value was acknowledged
and is now widely used by the medical profession in treating emotional
disorders such as depression and mania.
Finally, the use of "monoamine-oxidase inhibitors"
(or MAOIs, a class of drugs used to treat depression) can also be traced
to a lucky side-effect. One of the MAOIs is an antibiotic used to
treat tuberculosis. Clinicians noted that the drug helped to relieve
the depression which also plagued the patients. Subsequent trial and error
experiments further refined the applications of this family of anti-depressant
With the accidental discovery of these "wonder drugs"
came a surge of research and development to expand their therapeutic efficacy
and to understand how they worked. The ensuing research not only
produced a multitude of new drugs for treating mental and emotional problems,
but also helped to extend our comprehension of the biological dimension
of mental illness.
Specifically, this research focused on the way nerve
impulses are transmitted from one cell to another, hence the term neurotransmission.
To understand what neurotransmission is, let's look for a moment at how
the nervous system works.
The body's nervous systems have often been compared
to electrical wiring. However there is one major difference. The
various "circuits" in these systems make connections at junctures between
individual nerve cells. These junctures are called synapses.
Synapses are spaces between the cells in which special chemicals produced
in the nerve cells act as messengers between the cells. The chemicals
are known as neurotransmitters.
I will point out an important anatomical detail
which will become relevant later on when we discuss Edgar Cayce's view
of neurobiology. While there are various types of nerve cells, most
of these cells are composed of two main parts: the cell body which is called
the gray matter in nerve tissue; and the axon or nerve fiber that extends
out from the cell body to make contact with other nerve cells or muscle
tissue. The axon or nerve fiber is generally surrounded by white
fatty tissue called myelin sheathing. This fatty coating is sometimes
described as a form of insulation, such as found surrounding an electrical
wire. Although the myelin sheathing may serve multiple purposes,
one of its most important contributions to the nervous system is facilitation
of the nerve impulse along the axon. In other words, it helps the
nerve impulse to travel faster, up to twenty time faster, than would otherwise
be possible. Because of this fatty coating around
the axon, this part of the nerve cell is called the white matter.
If you were to look at brain sections in which the gray matter and white
matter were differentiated, you would notice that the white matter seems
to predominate. So if you should ever feel like calling someone a
"fathead," you would at least be accurate strictly on anatomical grounds.
Getting back to neurotransmission in mental illness,
researchers have compiled substantial evidence in support of faulty neurotransmission
in mental disorders. Many illnesses, including schizophrenia, depression,
and anxiety disorders are thought to result from abnormal neurotransmission
within the synapses of certain circuits of the brain. Specifically,
the neurotransmitter dopamine is widely recognized to be involved in the
symptoms of schizophrenia. Hence, drugs used to treat schizophrenia
directly affect the activity of dopamine in the synapses between nerve
cells in certain areas of the brain.
Likewise, the various antidepressant medications
are thought to affect certain key neurotransmitters within the brain. You
may think of it this way. Depression may result from a deficiency
of impulse between nerve cells. Perhaps there is a decrease in neurotransmission
within certain circuits of the brain. Hence nerve activity is literally
depressed or inhibited. Interestingly, Edgar Cayce sometimes spoke
of a "lapse of nerve impulse" in cases of depression. Research appears
to indicate that medications somehow change the chemistry within the synapses
or within the nerve cells themselves to enhance neurotransmission.
Two neurotransmitters have been strongly linked
to depression: noradrenaline and serotonin. Antidepressant medications
are thought to increase the activity in nerves which utilize these neurotransmitters.
You may have heard of the drug Prozac. This widely used (and controversial)
antidepressant is thought to therapeutically effect serotonin neurotransmission.
There are two important points that I would make
regarding this discussion of the neurobiology of mental illness. First,
most of the major breakthroughs in this field resulted from accidental
discoveries. Compared to these serendipities, the list of major therapeutic
breakthroughs resulting from a concentrated study of a mental illness and
thorough understanding of the problem is meager. The fact is, we
still don't know for sure what causes these disorders or exactly how the
drugs suppress the undesirable symptoms. So the image of successful research
(i.e., a team of knowledgable researchers who produce an effective treatment
based on a thorough understanding of the condition and millions of dollars
in government funding) is not necessarily accurate or comforting.
Consequently, the truth of the matter is, the cause or causes of mental
illness (of any type) remains unknown. This includes depression.
Secondly, all mental illnesses are presently incurable.
The drugs (and other therapeutic interventions) only provide symptomatic
relief. In many cases (particularly the more severe forms of psychopathology),
the drugs must be taken regularly for long periods, or even a lifetime.
When the medications are stopped, the symptoms usually return.
I want to be clear about this. I am not saying
that drugs are wrong or that they don't work. To the contrary, I
think drugs can be very helpful in certain cases; particularly when they
are integrated into a more comprehensive treatment approach. I am
especially appreciative of the wonderful research that has been done into
the neurobiology of mental illness. Without doubt, most mental symptoms
involve significant pathology at the level of nerve cells. However,
as we shall see in this and subsequent chapters, neurobiology is only part
of the story of mental illnesses such as depression.
Edgar Cayce's Holistic Approach
To gain an understanding of Cayce's approach to
depression, including the neurobiological aspects which relate to the medical
model, we must first consider the concept of holism. Within the context
of the Cayce readings, holism refers to the inherent inner-connectedness
of the triune aspects of the self. In other words, it signifies the
intimate relationship between the physical, mental and spiritual dimensions
of our being. This viewpoint is not particularly unique. Throughout
the ages, various religious and philosophical systems have been created
which recognize the multiple aspects of selfhood. For example, Plato
used a triune model to explain human experience. He acknowledged
that each human being represented a combination of three aspects: a divine
(rational) aspect; a mortal, animal aspect and an intermediate, interactive
The uniqueness of the Cayce readings, in this respect,
is the depth and specificity with which the readings elaborate the interface
of the triune aspects of selfhood. The physical body is associated
with the organs of the body - literally, flesh and blood and the organs
which sustain these vital substances.
Not surprisingly, the mental aspect is correlated
with the nervous systems. This is consonant with modern biology and
other disciplines in the fields of medicine and psychology.
However, Cayce's viewpoint on the spiritual connection
within the body is a bit more unique. He cites the glands as primary
spiritual "centers" within our anatomy. Here is an excerpt from a
reading given for a thirty-year old woman suffering from severe mental
symptoms (anxiety in the form of panic attacks and phobias). Reading
2114-1 clearly defines the triune aspects of self in anatomical terms while
emphasizing the importance of viewing the whole person:
... it is well to consider the entity as a whole ... the entity
finds itself made up, as it were, of body, mind and soul ... There are
centers in the physical body through which all phases of the entity's being
coordinate with one another; as in the physical functioning there are the
pulsations, the heart beat, the lungs, the liver, and all the organs of
the body. They each have a function to perform. They each are
dependent upon the other, yet they function according to those directions
of the mental self - or the nervous systems.
Yet, while the brain and the cords through which
the nerves function are the channels, these are not the mental consciousness;
though it is through the nerve plasm that the nervous systems carry impulses
to the various forces of the system.
There are the spiritual attributes, - desire,
hope, will, - that function through the organs of reproduction, as well
as becoming the import or motivative force in expression even in a material
manner through the senses of the body ...
In this instance we find that the glands
of the body form the greater portion of such associations or activities.
Note that Cayce states that there is more to mind
than the brain and nerve fibers. While these structures serve as
the channel for mind to manifest in a physical body, mind is eternal.
Mind both predates and survives individual human existence. Yet "it
is through the nerve plasm that the nervous systems carry impulses to the
various forces of the system." This reading was given on February
24, 1940. This was over a decade ahead of the pioneering medical
research which linked faulty neurobiology to mental symptoms. Incidentally,
Cayce went on to diagnose Ms. 2114's problem as a thyroid deficiency (a
condition now acknowledged by medical practitioners as one of the sources
of panic attacks).
Cayce stated that proper glandular functioning was
essential for a healthy nervous system. For instance, in reading
566-7 he described how, "All portions of the nervous system ... are affected
by those activities of secretions through glandular forces of the body."
Hence, the intimate relationship of mental and spiritual processes as manifested
in a physical body through the nerves and glands of the body. We
will look more closely at the importance of the glandular connection in
depression in Chapter Two.
At this point, I merely want to emphasize that Edgar
Cayce was well out front in recognizing the neurobiological dimension of
mental symptoms. As we shall soon see, years before medical research
explored these connections, the readings described the cellular processes
involved in depression and other mental disorders.
Reading 241-1 contains one of the many explicit
references to faulty neurobiology in cases of depression:
Impulse in brain forces, or its reaction, are
of two natures - the white and gray matter, as is ordinarily called. One
an impulse, the other the active force that carries same. In the body,
when the impulses come from the pressure as has been created in the forces
seen to the brain itself, we have that of the activity without the impulse
to carry same forward. Hence we have what is commonly known or called
melancholia, or depression, or the inability to carry out the impulses
of the body.
Note the similarity to contemporary views of neurobiology
in depression (i.e., the "medical model"). Cayce is describing a
breakdown in the way the nerves transmit impulses. Keep in mind that
this reading was given to a lay audience years before the discovery of
neurotransmitters and the development of modern models of neuropathology.
Reading 4519-1 provides another example of Cayce's ability to address depressive
symptoms at the level of neurobiology:
The melancholia [depression] has now become remorse.
Still, we have the supplying nerve forces in their rebuilding protoplastic
cells gives an action to the gray matter carrying in nerve tissue, that
does not act with the white nerve forces and tissue, and as it is made
up gives two separate actions. One is acted on by the expression
of one of the senses of the body. Expression reaches the nerve center
through one of the senses. As the action comes to the brain through
the gray matter, the action of the brain to the body comes through the
white. In this we have a lack of expression through the gray forces.
Again, the emphasis was on a breakdown in nerve
impulse within the brain. Frequently, the readings referred to this
condition as simply a "lapse of nerve impulse," as we shall observe in
the case study which follows.
"I am no good"
According to his mother, Mr. 3207 had a perfectly
normal childhood. He was born in Paris, France in 1905 to a French
father and American mother. Both parents were musically gifted and
their son attempted to follow in their footsteps. As his mother's letter
of June 1, 1943 reports, he was to encounter extreme disappointment in
this and other areas of this life:
... his one bent was music - singing and violin - but he did not
succeed in either as a professional. He worked two years in a music
store, lost his job, married and after five years his wife left him for
another man which resulted in his trying to take his life by monoxide gas.
He had a complete nervous breakdown ... was in a sanitarium one year; was
another year recovering and remained well for five years. In 1941
he showed signs of another nervous attack, but a trip south on a small
boat seemed to benefit him until he went all to pieces and into a sanitarium
for another year. I have him with me now. He eats and sleeps
well, meets people and SEEMS normal but has obsessions, first one and then
another and keeps saying, 'I am no good, Mother.' ... He is six feet [tall],
well formed and of dark complexion, a very charming young man, but really
AFRAID to meet the world. Doctors do not seem to understand his case.
He is religious and told me quite frankly that the only thing that 'saved'
him this time was prayer ...
Three weeks later, the mother again wrote to Edgar
Cayce describing the events leading up her son's severe depression:
Up to five years ago he was a normal, fine, happy
young man. His wife deserting him caused him to attempt suicide, but after
a year he was alright again and for five years, until he was rejected from
the Army. He is very depressed, talks of suicide, as an accident,
so as not to cause me trouble, asks my permission to allow this to free
him from this troubled mind. He eats and sleeps well and meets people
as you and I would, but drops back into his tragic state and often drops
his head as though there was something wrong. He has been with me
two months, after a year in a sanitarium, and much prefers death to a return
there. You will have to decide which reading fits his case.
I am doing all in my power to give him help. I hope the reading can
be soon, as I live in constant dread that he may take his life ...
The third letter sent prior to 3207's reading reiterated
the mother's concern for her depressed and suicidal son:
He seems so well until he talks and then it is
always, 'Mother, I can't live with myself any longer. I'm no good
- perhaps the next world will give me a chance.' He says this over and
over, often to himself in an undertone; he mumbles all the time.
There must be some hidden reason for this that they have not discovered.
He has a way of shaking his head that leads me to believe the trouble is
mental. 'I am no good' he will always say when questioned.
His one concern is my welfare and peace of mind, and he thinks by doing
away with himself he will free me from all worry. I cannot erase
this idea from his mind. I am holding the thought that he will not
try again to do away with his life - and I accept the September 11th appointment
The final letter before the psychic reading stated
that 3207 wished "I could only bore a hole in my head and shake out something."
According to his reading, this man's sense that something was wrong in
his head - something so physical, so biological that it could be surgically
removed, bore some degree of truth. A single reading was given for
this thirty-eight year old man on September 11, 1943. The seriousness
of this man's disorder was immediately addressed:
Yes, we have the body, . As
we find, unless there can be the persuasion through suggestion in or from
the spiritual approach, little may be done to arouse this body from the
lethargy into which it has purposely driven itself.
To be sure there are pathological disturbances,
but these arise more from the psychological or psychopathic conditions
than from the purely physical condition. To be sure there are incoordinations
between the cerebrospinal and the sympathetic [nerve] systems. These
are nerve lapses. And these may be aided. But the real basis
of the aid must come from spiritual suggestion ...
Suggestions should be made from purely the spiritual
angle, in conjunction with purely mechanical applications. These,
if practiced in this particular case would bring relief.
The reading went on to provide specific therapeutic
recommendations which we will discuss later. However, first I would
point out the holistic emphasis of this excerpt. There is a recognition
of the physical level of pathology as mentioned in the "nerves lapses"
producing incoordinations between the nervous systems.
The mental or "psychopathic" dimension of the problem
is also acknowledged. His mental reaction to the disappointments
in his life was cited as the source of the breakdown within the nervous
systems. We will further explore the destructive power of the mind
in Chapter Five. For now, I will simply indicate the readings' consistent
and even pervasive recognition of the "mind-body" connection. The
relationship was seen as interactive. Mind affects body; body affects
mind. In this particular case, the self-condemning contents of his
mental processes actually programed the nervous systems to deteriorate
in their functioning.
The third aspect in this case, the spiritual dimension,
was addressed in the treatment plan. Mr. 3207 was to be provided
with a companion or attendant who would employ a technique called suggestive
therapeutics. Specifically, the readings recommended a "Christian
Science Reader" as an ideal companion. This was a common recommendation
in cases of major mental illness where the person was dangerous to themselves
or were incapable of functioning at a level necessary for implementing
the treatment plan. Cases of severe depression (including bipolar
disorder) and schizophrenia frequently called for companion therapy.
The spirituality of the companion was emphasized in such cases.
In this particular case, the companion was to give
positive suggestions to Mr. 3207 at various times of the day. This
application of suggestive therapeutics is essentially a form of natural
hypnosis. Because most persons are unfamiliar with the techniques
for inducing a hypnotic trance, the readings advised that suggestions be
provided during the physical treatments while the person was in a relaxed,
receptive state of mind. Thus during the physical therapies such
as electrotherapy and massage the caregiver was directed to talk to the
patient in a calm, firm voice; giving positive suggestions for physical,
mental and spiritual healing. The suggestions could also be directed
towards undesirable behaviors or lack of cooperation.
The readings also frequently advised that bedtime
be utilized as a time for suggestive therapeutics. During the first
few minutes of sleep, a slumbering individual is in a hypnogogic state
and is very open to suggestion. This form of suggestive therapeutics
is sometimes referred to as presleep suggestions. As with all forms
of suggestive therapeutics, presleep suggestions are made to the person's
unconscious mind and should be positive and constructive in tone and content.
In a sense, you can think of suggestive therapeutics
as a form of mental programming similar to computer programming. Only in
cases of chronic mental illness where there is actually nerve tissue pathology,
the process is more complicated. It was as if both the "hardware"
and the "software" of the system has to be corrected. The physical
therapies focus on healing the "hardware" (the neurobiology of nerve tissue)
while suggestive therapeutics serve as the "software" or program.
In other words, the readings stated that as the nervous system was being
healed, it was important to give it constructive information for its new
In the case of 3207, the mental programming would
undoubtedly have addressed his self-condemnation, replacing with positive,
affirming statements to his unconscious mind. However, the suggestions
were also to focus on "awakening to possibilities in the outdoors, in nature,
in things of Creative activity."
In addition to companion therapy and suggestive
therapeutics, Cayce recommended treatment with an electrical appliance
called the Wet Cell Battery. This low form of electrical energy was
occasionally mentioned in cases of mental illness such as depression.
This form of electrotherapy was prescribed to address the "incoordinations"
in the nervous systems. The electrical power from the battery is
minute. In other words, its use is not comparable to electroconvulsive
therapy (or ECT) which is sometimes used in the treatment of severe depression.
A "gentle massage along the spine" was also advised
in this case. Cayce stated that such a rub would help to relax the
body and improve nerve functioning.
Reading 3207-1 concluded on a positive note, indicating
that if the treatment plan was faithfully followed this man's perilous
decline could be turned around:
And we will find we may supply the breaking up
of the nerve forces in this body. This will prevent the deterioration
or the regular conditions that ordinarily arise when such melancholy becomes
a part of the experience.
DO that - if we would make the better conditions.
We are through with this reading.
About two weeks after the reading, the mother responded
to the content of the reading by writing "I received your reading of my
son and feel that perhaps there is little hope of recovery." She
was willing to hire a Christian Science healer to help her son but stated
that "[I] do not feel that I can use, personally, the mechanical applications
and that no one else here would be willing to."
Thus the treatment plan was not implemented.
We do not know what the eventual outcome was in this case.
Some Key Points to Remember
In this chapter we have looked at the neurobiological
dimension of depression. The medical model of depression was presented
and the importance of nerve impulse transmission between the cells of the
brain (neurotransmission) was discussed.
Cayce's holistic approach also acknowledged the
importance of the neurobiological dimension in depression. Years
before medical research focused on this aspect of mental symptoms, the
readings explicitly described biological pathology in depression.
However, the readings went beyond the physical dimension to describe the
significance of the mental and spiritual aspects.
In the case study presented in this chapter, mental
factors figured heavily into the cause and treatment of depression. Self-condemnation
was cited as the source of a breakdown within the nervous systems ("nerve
lapses"). Thus in this particular case, Cayce's perspective of depression
is consistent with the medical model - only it goes beyond this view.
From the standpoint of the readings, the medical model is not necessarily
"wrong," it is simply incomplete. It is part of the answer to understanding
As with many of the case studies which we will examine
in the chapters which follow, the recommendations in the readings were
not followed. Perhaps it was too much to expect that persons in the
early decades of this century would appreciate the strong physical dimension
of depression. With our current understanding of the neurobiological
aspects of depression, perhaps we can better appreciate Cayce's integration
of biology into his holistic approach to depression. The importance
of physical causation and physical treatment will be strongly emphasized
in the next three chapters which address this facet of depression.