Welcome to Back from the Abyss. I'm Dr. Craig Hecock.

I wanted to start with an email I got a few days ago from a therapist named Rachel.

Hi Craig, Dr. H. Love your podcast.

As a psychodynamic slash psychoanalytically inclined therapist, I appreciate the way it broadens my perspective of mental health and of psychiatry.

I love the most recent episode on good psychiatry, and it touched on so many issues that contribute to the split in my own mind and in the mental health field between psychiatry and psychotherapy.

So much of what you and your guest said about, quote unquote, depression fit my own view that so much of what we call depression is dissociation, that trauma is the great imitator,

that little T trauma in our early relationships can look like depression, that undigested

grief looks like depression, that there are root causes beyond anything we were taught or

can imagine. And in my own practice, I'm not even sure what else depression is outside of those

things above and like them. While destigmatizing, I find that my patient's belief in the medical

model that quote unquote depression is a disease that exists in its own right, like diabetes,

is typically unhelpful for them to explore or to process and potentially heal from whatever

is underlying their depressive symptoms. Outside of bipolar depression, my personal bias largely

rejects a disease model of depression. I'm not sure you would go so far. So my question is,

since you shared all of these things that are not depression, what is true depression from your

vantage point? And from my vantage point, how might I recognize quote unquote true depression or

differentiate it from all these other things? Not sure how much email you receive or your

capacity to engage here, but I thought about emailing you many times. So glad to finally reach out

warmly, Rachel. Oh, thank you for writing. I do get a lot of

emails, but I really love to hear from all of you. So, yeah, this letter brings up some really

good issues. I see depression is really existing in sort of two buckets in Will Vandervir,

and I also talked about this, that I do think

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