Saturday, May 23, 2009


Depression is such a controversial condition. First of all, is that even the proper term for it: “condition”? Is it an illness? A disease? A disorder? Either way, it means that something is wrong with you, and only lately has anyone decided to claim that the defect is medical.

Forty years ago, if someone said, “I’m depressed,” the reaction they received was usually along the lines of, “Oh suck it up,” “Get over it,” or, if the listener was feeling particularly compassionate, “Don’t worry, things will get better.” Now, the moment anyone hears the word “depressed,” their reaction is, “For how long?” “Can you eat?” “Can you sleep?” “Do you ever think about killing yourself?”

Back in 490 BC, Empedocles tried to measure different amounts of the “humors” in the body (blood, phlegm, yellow bile, and black bile) to determine whether someone had depression (see Pre-Twentieth Century Theories Of The Aetiology Of Depression). Today’s measurements, while significantly more respected, are equally as elusive. Who doesn’t contemplate suicide at some point in their lives? Psychological diagnoses are tough to make because no one can physically see what is wrong with another person; you can only see the behavioral manifestations. Neurologists would beg to differ—“Look at the synapses! That serotonin is being absorbed too quickly to do its job!”—but we don’t test every patient’s brain who arrives at the doctor's office and says, “Doctor, I think I’m clinically depressed.” No—this person is asked a series of questions, the doctor makes his/her best guess, and then something is (or is not) prescribed.

This, then, leads to another source of controversy: overprescription. I agree that antidepressants are overprescribed. If someone has a bad day or has had trouble sleeping over the past week, the immediate response should not be to label them “depressed” and to toss them a bottle of Zoloft. Overprescription is a serious problem, because it is the mark of the lazy doctor and ultimately doesn’t solve anything. If the person truly has issues that have manifested themselves as depression--anatomical or not--these outer manifestations will merely multiply into other problems, which will then require another medication, and the next thing you know, some poor hapless patient is wobbling out of the pharmacy with two shopping bags full of pills.

However. This is not to say that antidepressents are merely ineffective sugar pills or, worse, suicide-instigators that should be abolished. In spite of all the research that has been done, the predominant attitude toward depression is still, “Get over it.” Only people who have suffered traumatic events in their lives “deserve” to be depressed. And then, once these people have taken enough medication and gone to enough counseling, they should finish their prescriptions, say goodbye to their counselor, and rejoin the world of “normal people.” God forbid someone who seems "together" admits to being depressed. “Everyone feels sad,” will be the scoffing reaction. “What do you have to feel sad about?”

Unfortunately, "feeling sad" is not all there is to depression, and antidepressants do not make you feel “happy.” If they did, everyone would want to be on them! Instead, no one wants to be on them—including the people who need to most. It’s my opinion that whether or not the treatment is prescribed, all depressed people will find an antidepressant of some sort to alleviate their disorder. Is it any surprise that the darkest and craziest artists and thinkers were the worst drunks and drug addicts? Think of Edgar Allen Poe! Beethoven! Freud…! If the world of medicine can’t or won’t provide the help they need, people will find ways to self-medicate. And wouldn’t we rather have a team of doctors trying to return functioning members to society rather than slews of people merely trying to avoid pain?


Mike S. said...

I'm going to have to disagree with you on this post Allison. I *wish* more people had the "get over it" attitude. That mindset on depression is slowly fading away. I think the word "depression" is thrown around way too much. In my lifetime, I've seen so many people who claim they are depressed but in reality just feel sorry for themselves. This especially occurs with people who are our age who feel "depressed" once they realize it's time to grow up. Oh well. You're spot on with the over-prescribing culture though!

Neen said...

The most important lesson I've learned regarding depression is that it is something that requires a multi-faceted approach to treatment.

I was on many of those drugs throughout my teenage years and then in college, and found that when not combined with some kind of counseling, many situations were still difficult to cope with.

Not only that, but every drug regardless of its claims always came with at least one unexpected side effect. Like you said, sometimes that required compounding another prescription on top of the first.

I'd had enough of treating my body that way and decided to study a more holistic (yes it sounds hippy-esque) approach to well-being. I visited a counselor for awhile until I felt comfortable implementing the strategies for changing negative thoughts (and their subsequent emotions) on my own. Once I'd tackled that, I really focused on eating clean and remaining aware of how outside influences affected my mood. It has been, by far, the most successful approach.

I think that doctors would be wise to step back from these drugs and study other ways of dealing with depression. It doesn't have to mean a lifetime on a drug that's "okay, but I wish it wouldn't do (insert side effect)."

Daniel said...

@ neen: nothing "hippy-esque" about it, holistic practices have been around for thousands of years, anti-depressants have been around less than 100...

my wife did the same thing recently and she is extremely happy and centered. very smart choice switching your lifestyle, hats off!