Scars in depression: is a conceptual shift necessary to solve the puzzle?

Abstract

Although clinical findings suggest that in the aftermath of depression a process of ‘scarring’ may ensue, research examining the issue of ‘scars’ (including biological, psychological and cognitive changes) has remained largely inconclusive. This paper proposes a new approach to the concept of ‘scars’ that is (i) based on a dimensional view of depression, (ii) uses methods that take into account the dynamic interplay between the person and his context, (iii) differentiates between scars following depression and scars following the factor that actually caused the depression such as stress and (iv) introduces a dynamic view of the concept of ‘scars’ in that it hypothesizes that scars can wax and wane. This approach may stimulate the discovery of new entries in the puzzle underlying the ontogenesis of vulnerability and resilience. Furthermore, it may provide insights that help to develop new therapies for depression.