There's Nothing Deep About Depression

[HuckleB]

There's Nothing Deep About Depression

http://www.nytimes.com/2005/04/17/magazine/17DEPRESSION.html?ex=1114056000&en=5af04cf989c2ba24&ei=5070

"...

A hearty, jovial man would rise and ask -- always the same question -- "What if Prozac had been available in van Gogh's time?" I understood what was intended, a joke about a pill that makes people blandly chipper. The New Yorker had run cartoons along these lines -- Edgar Allan Poe, on Prozac, making nice to a raven. Below the surface humor were issues I had raised in my own writing. Might a widened use of medication deprive us of insight about our condition? But with repetition, the van Gogh question came to sound strange. Facing a man in great pain, headed for self-mutilation and death, who would withhold a potentially helpful treatment?

It may be that my response was grounded less in the intent of the question than in my own experience. For 20 years, I'd spent my afternoons working with psychiatric outpatients in Providence, R.I. As I wrote more, I let my clinical hours dwindle. One result was that more of my time was filled with especially challenging cases, with patients who were not yet better. The popularity of ''Listening to Prozac'' meant that the most insistent new inquiries were from families with depressed members who had done poorly elsewhere. In my life as a doctor, unremitting depression became an intimate. It is poor company. Depression destroys families. It ruins careers. It ages patients prematurely.

Recent research has made the fight against depression especially compelling. Depression is associated with brain disorganization and nerve-cell atrophy. Depression appears to be progressive -- the longer the episode, the greater the anatomical disorder. To work with depression is to combat a disease that harms patients' nerve pathways day by day. Nor is the damage merely to mind and brain. Depression has been linked with harm to the heart, to endocrine glands, to bones. Depressives die young -- not only of suicide, but also of heart attacks and strokes. Depression is a multisystem disease, one we would consider dangerous to health even if we lacked the concept ''mental illness.''

As a clinician, I found the what if challenge ever less amusing. And so I began to ask audience members what they had in mind. Most understood van Gogh to have suffered severe depression. His illness, they thought, conferred special vision. In a short story, Poe likens ''an utter depression of soul'' to ''the hideous dropping off of the veil.'' The questioners maintained this 19th-century belief, that depression reveals essence to those brave enough to face it. By this account, depression is more than a disease -- it has a sacred aspect.

..."

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Worth a read, regardless of one's world view, IMHO.

[EFerrari]

1. Thanks for posting this great link. As one half of a circus couple

(writer, painter) + (writer, comedian), I want to raise my hand and say, proper meds properly monitored have made us both more productive in our various circus rings.

:thumbsup:

Beth

[DemExpat]

2. Good article, thanks for posting.

Although I for one have the view that disagrees with his premise that it is more a disease than existential angst or powerlessness. I experienced my own depression as having been first an attitude of how I stand in life here in the world which then became a physical disorder.

I believe that a spiritual component of depression (chicken or egg, anybody?) is something some people choose to acknowledge and deal with to a good measure of satisfaction.

I also wonder why depression/suicides have not been all but eradicated in the 20 plus years that anti-depressants have been around? And also wonder if medicating a growing number of the population (children included) will not lead to more passivity/less creativity/less impulse to find solutions to growing problems. Perhaps more ambivalence and impotence in the face of growing government and global tendencies away from democracy? (Of course this is a generalization).

From one who has tried the meds with no relief, and has found alleviation in other approaches.


I guess I am of the mind that depression may have many components, and whatever works for you in a satisfactory way is what matters.

No one pill fits all. IMHO.

Thanks for this thoughful article!

DemEx

[EFerrari]

3. Great questions, all

In my limited experience, it's not enough for a doc to write a script. S/he also has to be skilled at monitoring these powerful drugs.

I have found there are many script writers and few skilled monitors.

I myself would rather do deep breathing or walking or anything but take pills. And yet, in my situation -- as you know -- I had to seek these drugs out.

They're much easier to find than docs truly committed to supervising them.

fwiw,
B.

[politicat]

4. Perscribing is an art, not a science, and we practice medicine...

we haven't gotten it perfect yet.

A world with anti-depressants is a better world than one without; I for one do not want to go back to the days of Valium, Vodka Tonics and electroshock.

[momzno1]

7. back to the days of electroshock?

still happening, called ECT now, and used for long term intractable depressions... Much more humane, now people are put under for it.
I am a clinical social worker and have seen many clients who have undergone the procedure- some multiple times -
it seems there is still a risk of losing memory.

If you are depressed consider giving up all Aspartame "nutrasweet", as it messes with your serotonin levels and can make you depressed, not to mention give you seizures.

[HuckleB]

8. A question.

How does aspartame affect Serotonin levels?

[Lydia Leftcoast]

5. When I had depression, I found that it increased my creativity, BUT

made me too lethargic to do anything about it.

In other words, I got wonderful ideas for stories and essays, but I couldn't do anything but stare into space.

[kineneb]

6. depression is hell

So far, I have had at least five major episodes of depression and they have affected my memory. I am on a maintence dose of 40mg of generic Paxil and will probably have to take something for the rest of my life. For me, there is no choice of not taking meds: after being suicidal when I was 12, I do not want to take chances.

There is nothing "romantic" about depression at all. When one is depressed, it is like being at the bottom of a pit. There seems to be no way out, all of one's being is absorbed in a great sadness and crushed by a terrible weight. Everything is irratating, and at the same time unimportant. Exhaustion takes over the body, sleep goes away. Functions of daily life are exhausting, even just brushing teeth. I feel a physical weight on my chest, holding me back. At some point, the pain becomes too much and death seems the only way out.:cry:

Been there, done that, did not get a t-shirt.