Jonathan Rottenberg

Correct.

So one of the main neurotransmitters that's implicated in this disease model or defect model is serotonin.

There's no way to assay serotonin and give your reading where you are with respect to serotonin right now in your brain like you can with cholesterol or you can with insulin.

So depression involves biology.

But it's not a disease in the same way that diabetes is a disease or Huntington's disease is a disease.

But in that case, we know what genes are responsible and we understand what those genes are doing and how it relates to the symptoms of this neurological disorder.

Depression, the understanding is much more diffuse.

Like maybe it has something to do with serotonin.

Maybe it has something to do with dopamine.

That's a very different level of understanding.

Well, I think that all of these are valid therapies.

So if you're struggling with depression, medications are an option and cognitive behavioral therapy is an option.

And that's a good thing to have multiple options.

But again, that's very different from saying that the reason that people become depressed is

in the first place is because there is something fundamentally deficient in their cognition in the way that they're thinking.

It could be instead that these changes in cognition are part of what's maintaining the depression, which is why the therapy can be useful.

So I do believe that cognitive behavioral therapies can be really helpful, not only in helping people resolve a depression episode, but the skills that are learned in cognitive behavioral therapy can be useful in keeping people well.

So I do believe that cognition is a contributing factor to depression.

But that, again, is different than saying that people who are depressed all are somehow defective or deficient in how they think about the world.

There's no question that nature built us with the capacity for low mood.