I'd disagree - the cause should be hugely important in deciding the treatment. If I'm depressed due to psychosocial factors, then it makes the most sense to remedy those factors. If I'm depressed due to neurotransmitter imbalance, then taking a drug to address that imbalance is likely to be more effective than talking about my feelings. If I'm depressed because my psychologist is an asshole, then the best solution is probably to avoid that psychologist. If I'm depressed because life is hard and I don't know how to cope with it, then it makes sense to get a therapy involving practical advice.
I'm not going to take a pill because my psychologist is an asshole, or because some doctors treat me like crap. All the advice in the world won't solve a severe neurotransmitter problem or brain damage. Hence the cause of the depression is of great importance, in my opinion. Unfortunately there often isn't a perfect pill or psychological treatment or piece of advice to solve a case of depression, but at least it gives guidance on where to start and what sort of improvements to expect.
I do like the cut of your jib, Val
However.... we are all human. We go to the doctor and sit in front of him, and he (or we) try and determine from our expressed symptoms (or visible symptoms and - let's face it - behaviours), what might be the problem. This involves much
interpretation on the part of patient and doctor, and on anyone else's specialty part if we are referred.
So. How to determine if someone who is - for arguments sake - presenting with symptoms of depression, has a 'psychosocial' cause or a biological one? Indeed, I would argue that even a psychosocial 'cause' involves a stressor that antagonises a biological response by way of a defense mechanism perhaps.
For some (many?) antidepressants can help relieve some of the symptoms - but unless the cause is identified and treated successfully the problem will remain - as will any susceptibility. Antidepressants (stupid name) are also prescribed to relieve similar symptoms for conditions or symptoms unrelated to depression - biological causes as well as - if you chose to delineate - psychosocial ones.
Who is to say if there is not something 'deeper' behind any presenting symptoms? Only by a 'suck it and see' approach can even modern medicine hope to get to the root cause. Of course for many patients this isn't enough. They would rather face a battery of tests, and even if those tests are
interpreted as meaning very little, they will seek even more. Sometimes - hopefully - a test or several will determine a cause. And that cause can be treated. And the symptoms will resolve.
But for many people with e.g. depression, there does seem to be this susceptibility. Does that come from a genetic component, an inability to cope as well as others, or something else? Is it 'really depression'? Or is depression really something else?
Replace depression with any condition you choose, including ME. It is I think the
interpretation that causes the problems and seeing many doctors or specialists doesn't always lead to a determining cause or successful treatment and a resolution of the symptoms, disability and return to full function.
You know, I watched Lipkin's Oxford presentation recently, and he was talking about something I have mentioned in jest with Bob before now. This Star Trek gadget that they use on the show to scan and diagnose a patient. Lipkin was saying how something similar will likely be seen in hospitals enabling quicker diagnosis from the bedside. But the gadget still requires programming by humans and using human knowledge and...
interpretation.