From Chaos to Consilience: Using the New Mind-Body Science to Improve the Diagnosis and Treatment of Major Depression

Lecturing around the country has left us with the powerful impression that both psychiatrists and primary care physicians are hungry for new ways to think about and manage depression and the myriad symptoms and syndromes with which it is associated-including attention deficit disorder, insomnia, chronic pain conditions, substance abuse, and various states of disabling anxiety.

Chaos – definition [from wordnet.princeton.edu]: a state of extreme disorder or confusion

Consilience – definition [from Wikipedia]: literally a jumping together of knowledge by the linking of facts and fact-based theory across disciplines to create a common groundwork for explanation

Lecturing around the country has left us with the powerful impression that both psychiatrists and primary care physicians are hungry for new ways to think about and manage depression and the myriad symptoms and syndromes with which it is associated-including attention deficit disorder, insomnia, chronic pain conditions, substance abuse, and various states of disabling anxiety. Primary care physicians also seem especially excited to learn that depression is not just a psychiatric illness but a behavioral manifestation of underlying pathophysiological processes that promote most of the other conditions they struggle to treat-including cardiovascular disease, diabetes, cancer, and dementia.1,2

In hopes of simultaneously quelling and stimulating this hunger and excitement, we have developed a 3-part series that sets forth a new view of major depression that synthesizes multiple converging lines of scientific evidence from an array of fields relevant to mind-body neurobiology.

While this new science is fascinating in its own right, our emphasis in this series is to clearly enunciate the promise these new findings hold for improving our ability to diagnose and treat depression and its many comorby Charles L. Raison, MD, Rakesh Jain, MD, MPH, Vladimir Maletic, MD, and Jon W. Draud, MD, MS bidities. We also hope to show that an integrated mind-body view of depression helps explain many aspects of mood disorders that have long been enigmatic. We believe this view can help enhance our ability to provide our patients with an honest prognosis for their long-term functioning and survival.

You will find the first article in our series online at www.psychiatrictimes. com. We begin the series with a general discussion of how a mind-body neurobiological approach to depression is an improvement over our current diagnostic understanding of mood and related disorders.

In part 2, we will detail the primary elements of a mind-body view of depression. In part 3, we will describe treatment implications that arise from the new science. Throughout, we will highlight ways in which neurobiological understandings of mood disorders can help us move toward a personalized approach to the treatment of depression and its multiple comorbidities, both psychiatric and medical.