Question: What is the latest research on depression?

Dr. Mayberg: Well, one of the things that is sort of new trends is that brain imaging has allowed us not to make diagnoses of depression. I mean, general practitioner, gynecologist, I mean, every doctor, you don't need to be a psychiatrist to diagnose depression. Every doctor recognizes signs and symptom, and the treatments are fairly well established, but what we are coming to learn is that one has to think about just not replacing chemistry or doing therapy, but trying to understand what is not working properly in the brain.

And so what brain scanning has allowed us to do is to try to study the brain in people who are ill, use the treatments we have to actually understand what's wrong and what corrects, to start to get a handle on just what is driving these very complex set of symptoms. We are taking the approach to depression just like a neurologist takes an approach to Parkinson's disease or someone who has a stroke to understand where in the brain is responsible for the behaviors that we see.

And so just like when someone presents and says, you know, I am having trouble moving my arm and I can't talk right, and I seem to be having trouble with my vision, and it just started up, you know, yesterday very suddenly. Say that to a neurologist; say that to an emergency room doctor, they know immediately how to approach a patient and say; I know where in the brain those symptoms are coming from.

And what's happening new in psychiatry, and it's not that new, it started, you know, 20 years ago with advanced imaging techniques, is we can--not just think about this laundry list of symptoms, it's very good to make the diagnosis--but we can use that to say, Where in the brain do those symptoms come from? And things like PET scanning allow us to map the brain and see how it's working and actually see that certain areas of brain, they are not absent in functioning, but they are not working 100%.

And to understand how different treatments correct brain function and we can study how medication works, we can study how therapy works, and that's put a very different face on this illness. It's not just psychological, it was never psychological, but it makes it concrete, just like when you have chest pain; it isn't just, Oh, I shouldn't have eaten so much. It's that no, chest pain is indicative that you may have a blocked artery, and that that set of symptoms has a biology that's resulting in the symptoms.

Same thing with depression; taking this elaborate and complex constellation of symptoms and actually looking to see what in the brain isn't working as it should.