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WRITER and comedian Ben Pobjie wrote eloquently about depression on recently as part of our onehour|onelife campaign with Lifeline.
He urged us to stop tip-toeing around the subject of depression.
He said hopefully soon, a friend will be able to talk about their depression at the pub like they might talk about an injured knee ... because both are medical issues.
I couldn't agree and disagree more.

No doubt one of the most important things we can do to battle depression is encourage open discussion. But open discussion shouldn't mean we adopt one single, homogenised way of looking at what has become a critical public, health and social issue.
I agree we need to be able to talk with friends and family about depression. We need to hear and understand people's stories and symptoms of depression. We need to allow them to discuss what is happening to them without fear of judgment.
But I don't agree - and nor do many psychiatrists and mental health experts - that depression is just a medical problem.

For some people, viewing depression as a medical illness is helpful. It can be a blessed relief to those suffering depression to have an explanation for what is going so wrong. Being told it is a medical problem can also help lift the burden of guilt many people feel about being depressed.
But for others, the medical view of depression becomes a trap. For every person I know who has been helped by antidepressants, another feels a medical diagnosis of their condition got in the way of their recovery. The more they were told their depression was about a chemical imbalance, the less artistry and control they felt they had over their recovery.

This is not to suggest that people can just sit up and "get well". Depression isn't something people choose, and unhelpful and unsympathetic people who say friends with depression should just "harden up" or stop wallowing, simply don't understand how serious depression can be.
People who are depressed can't just snap out of it. They are, at times, extremely unwell and unable to function. They struggle to get through the most mundane tasks. Getting to the kitchen to make a cup of tea can seem insurmountable.
But when you look beyond the medical model of depression you also allow that there are other answers to depression. It enables us to look beyond antidepressants, which are helpful for some people but far less helpful for others.
Antidepressants have become the front line defense against this serious issue. This represents a significant problem for the large proportion of people who are adversely affected by their use. This is particularly true of children and adolescents.
Suggesting antidepressants are not the only answer isn't popular. People who use them feel they are being judged. So let's clear that up now. If they work for you, then bulls-eye. We couldn't hope for a better result. Be happy and proud of your choices and what has helped you out of a terrible period. If they help you manage on and off over a lifetime then that is also a great blessing.

But let's also feel free to talk about the fact that even London's Royal College of Psychiatrists admits antidepressants don't necessarily treat the cause of depression or take it away completely. They also say that without any treatment most depression will get better after about eight months.
The Australian College of Specialist Psychologists also believes the term ''mental illness'' can put people off seeking treatment. They suggest, in a paper sent to Mental Health Minister Mark Butler that depression and anxiety should be described as 'psychological disorders to prevent people being propelled into a medical model of treatment and given drugs they don't need.

The issue is not hectoring people off drugs or even onto them. It's understanding we are facing a problem of Tsunami-like proportions for our society. It is estimated that about one million Australians live with depression and as many as 100,000 young people.
We can no longer afford to look to one solution to this problem, especially when that solution has failed to deliver a long-term cure. We also need to see that when we write down depression as a purely medical problem, we can often marginalise sufferers and minimise their experience.
When we fail to ask questions about the stresses or grief in a person's life, the life events they have gone through, their early attachment and even their health and diet; when we simply say the depression has "just happened" because of a chemical imbalance, we are not assisting their recovery.
Fortunately doctors such as Melbourne psychiatrist Dr George Halasz see times changing. He points to a shift within psychiatrist circles, led by experts such as researcher Allan Schore, who are trying to merge biological and psychological models of mental illness with emotional and social development across a lifetime.

"The chemical imbalance hypothesis has run its course. The idea was originally that if you resolved the imbalance there would be less depression. But of course prescription rates are soaring and at the same time so are the rates of depression," says Dr Halasz.
"If you open up the discussion beyond the very narrow medical model, then it takes us to a new understanding of treatments and ultimately to a new paradigm."
Let's keep talking about depression, just like Ben suggested. People who are depressed need understanding and support. But let's make sure we really talk, and don't simply follow one solitary line of thinking about the causes and treatment for this terrible condition.
Kate de Brito is a journalist and Ask Bossy blogger.
If you or someone you know may be at risk of suicide contact Lifeline 13 11 14, beyondblue 1300 22 46 36, or Salvo Care Line 1300 36 36 22.

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