pegkerr | Article re: treatment of depression

Depression != sadness, much as mania != productivity.

Also, the average living environment induces more misery than joy. We start in emotional debt, if you like, and I see nothing wrong with educating people on how to bank their happiness and find ways to make it earn interest. What's next, research on the character-building value of paying off student loans and subprime mortgages?

I don't believe in the whole concept of "overreacting" -- your reactions are your own, and you have a right to them. That said, I think this article is a great conversation starter -- not ender. I have had some value from times when I was down. (I got my heart seriously broken in late 1975. This prompted my moving to Los Angeles, making numerous new friends, trying out things that might help my musical career, and healing pretty well without medications. On the other hand, I think a combination of things -- moving to Los Angeles *and* taking an antidepressant -- might have worked even better.) I have also found out that I write far more songs, some of them quite good, when I am not medicated. The problem here is that there are other, more objective, measures -- it is incontrovertible fact that when I tried for 5 and 1/2 months to get by without drugs, in 1990 and 1991, I missed far more work than during any comparable period in my life. And that's not even counting the stresses on my friendships, though I am not inclined to go into more details right now. So I think that the right thing for me to do was and is to look at the article, say, "Hmmm, very interesting," and then use the drugs I was using anyway. My marriage matters; my day job matters; my career as a bar-band musician matters. I am simply not willing to sacrifice those things in the name of hoping I will be as musically productive as Beethoven. Maybe at some point you and I can talk in person, and I will tell you a bit more about why I think going off drugs threatened and in some cases demolished my friendships. (Note, though, that several of my songs were indeed written during this stretch.)

Nate

You're not over-reacting. The article conflates unhappiness with depression, which are definitely different creatures. I don't take my depression meds to feel happy, I take them to be functional. The birth of psychopharmacology has led some folks to think that there's a pill for everything.

Bah humbug.

Yes, I think that's the prime problem with the slant of the article. The guy in the article isn't saying "depression is a good thing." he's saying "being happy all the time doesn't solve all your problems." which are two totally different things squashed into one article here. The examples of people he has who don't want to be on medication there are i think people who are right to feel that way. (I wonder almost if it's biased by the older anti-depressants, the ones that for many people did tend to sort of level everything off into neutrality.)

See, and I read it exactly at that slant- that they were trying to say that depression and sadness are two different things, and as such sadness should not be treated the same way as depression.

Interesting how our own perspectives affected our reading of the article!

I understand --and totally identify with-- the almost kneejerk reaction to the idea that there's something wrong with wanting to be happy. As someone who has dealt with depression and with depressed friends and family members, I tend to look at the examples they're always listing of famous people who did amazing things while being depressed, and I wonder what more they could have done if they'd been alive in a time they could have been treated, or maybe just how much better they could have felt. I mean, I wrote more when I was a little unhappy. But that doesn't mean I want to be less happy--if that's the trade off I have to make, then I think it's worth it. I think that there is a value in sadness BUT that this sadness is just occasional sadness--the sort that everyone across the books can have--a bad day at work, bad news, feeling under the weather, etc. Not depression.

One of the hardest things one of my medicated friends has had to deal with is the idea that it's okay--even as someone who's on anti-depressants--to feel sad. That it's okay, that it doesn't mean your meds need fixed, or that you'll never be happy again. And i remember when I moved to Boston, and came out of a serious bout of situational depression, that I had those scary scary days too, where I was sad and I had to convince myself that it was okay.

I think what the article is saying is just that people who don't need them, shouldn't be on antidepressants. What this 'backlash' seems to be is a) the idea that being sad is a bad thing and b) against the idea that taking pills solves the problems. Which is okay for chemical issues, such as my friend has, but may not be as much help for things like situational depression where the best help is changing the situation. The examples they're giving are things that you'd probably consider as 'natural' sadnesses--I think it's fine to be depressed and mope after a breakup. I think there is a line which can be crossed where said broken-up person would benefit from something to help them get better, but I don't disagree with the saddness, just with the magnitude of the sadness.

I couldn't even finish reading it. And I'm really tired of the romanticizing of misery via the citation of people who were miserable and yet managed to accomplish things. How much more might they have accomplished if they'd been happier? Nobody ever asks that. Of course people try to make the best of whatever circumstances they are in, but that doesn't make the circumstances either necessary or sacred. Feh.

P.

I have always written far more and better fiction while on my antidepressants. But as far as I can tell, I write more and better songs when *not* on my antidepressants. I will never make the trade-off again, though; in many cases the songs I write from pain are songs nobody else wants to hear anyway. (And "Bleeding Faces" was written while I was on more antidepressants and antipsychotics than I had previously been on in my life.) That said, I think I'm glad you couldn't finish reading it; you would have only gotten more and more ired. Or do I mean "irate"?

Nate

*choke* "Ired." Hee.

I meant to say that possibly the individual people mentioned at the beginning of the article (who were experiencing normal, temporary sadness, if the narrative is to be trusted) perhaps didn't need anti-depressants; and certainly I should have said that other individual people might have perfectly good reasons for eschewing anti-depressants. The success rate of such substances isn't all that high, alas, and I don't think people should be on them who don't want to. But I could tell by the tone of the article that all these anecdotes were going to be pressed into service to prop up a set of the same old invalid arguments.

P.

Ya I kept thinking ya one of those guys cut off his own ear the other married his daughter. Huh is that really what we should be striving for?

I believe in being sad for certain things and certain limits of time and beyond some reasonable length of time seeking help. And obviously the loss of someone important takes a long time.

And depression should be treated be it therapy and or drugs.

I do think people like myself are susceptible to falling into situational depression that may start out with being sad though. I think left too long without any kind of support, help, treatment sadness triggers depression. I think the key identifier for do I need help is when you can't do the things you need to do and the things you use to enjoy doing. Most head doctors use the two week time frame loosely but I don't think that's without merit.

I just think the article was poorly written as I often find with Newsweek.

Van Gogh is not a very good argument against happiness, considering that a) he was psychotic rather than temperamentally gloomy, b) who knows how many more paintings he'd have done if he hadn't SHOT HIMSELF?

Frankly, I don't think genuine happiness is either so prevalent or over-valued that one needs to write a book decrying it.

Not only is he conflating depression with unhappiness, he starts out conflating the voluntary medication of those who have agreed with their doctors that they need it (or at least could benefit by it) with pressuring people to seek medication against their own inclinations and their doctors' advice. He further conflates empty chipperness with genuine happiness. ("I acted perky and it didn't help," is not the same as, "I was happy and it didn't improve my life." Not by a long shot.)

I also react badly to people who act like antidepressants make people happy. I have met dozens of people who take antidepressants. Some of them found that their current meds worked for their depression and some did not, but not a single one reported being hap-hap-HAPPY all the time. If they were supposed to be happy pills they would be an utter failure for all patients instead of a moderate success for some.

Me, I got the easy brain chemistry. I don't think that this is because I am a better person than people whose brain chemistry inclines them towards depression or other mood disorders, any more than my tendency towards vertigo makes me a worse person than those whose middle and inner ears don't try to dump them on the ground on a regular basis. If someone suggested that I shouldn't seek treatment for my vertigo because other people don't fall over as much as I do and I should just suck it up and deal because that's life, I would tend to get a little upset with them as well.

Here, here. At best, the meds take away the weight. They don't provide euphoria, nor anything like it. But of course "Prozac" has entered the lexicon as a happy-pill, quite contrary to anything it actually does.

Wow. Thanks for the link. I'm on the opposite spectrum as you though, I think this message is long, LONG overdue to the public. I have to say that I heartedly agree with the article. Though very brief, they did mention- "While careful not to extol depression—which is marked not only by chronic sadness but also by apathy, lethargy and an increased risk of suicide", that what they are criticizing isn't the treatment of depression, but the over-medication and labelling of sadness as a disease.

It disturbs me to see everyone being put on anti-depressants when it is episodic sadness or grief, because that is not the same as clinical depression. I'm all for the millions of people that need and are helped by these medications, they are literally lifesavers, however it sickens me that so many of our problems aren't even bothered to be properly diagnosed without slapping on a medical bandaid.

I also think the article isn't attacking anyone on anti-depressants for depression, I think it is trying more to say just that for those that are sad for specific reasons, or just aren't Mary F. Sunshine, that they aren't ill, they aren't unjustified. I think a LOT of people have been in that boat- "well, I'm still sad that I've lost someone, I guess I should be over it, everyone tells me so, there must me something wrong with me" is quite different than the apathetic bleakness of depression, but our society no longer distinguishes the difference.

I took so long writing my comment, that many others commented ahead... now that I've gone back to read those comments, I'm sincerely shocked. I didn't see the article as a slam against ANYONE with clinical depression at all. Not even a little bit. I saw it straightforward, as an article saying that as a society we've lost the distinction between depression and sadness, particularly when it comes to psychiatry. Being depressed doesn't mean you're just sad and need to cheer up. Likewise, being sad doesn't mean your brain chemistry needs to be 'fixed'. I feel almost at a lost reading the others' comments, because I didn't pick up on those interpretations at all while reading it. I felt like it just briefly gave a few artistic anecdotes, but that wasn't the drive of the article. I didn't feel like the article was conflates depression and sadness, but does just the opposite.

I dunno, it's hard to dislike an article that starts with a great line like "The plural of anecdote is not data."

I think you're taking the article (or perhaps more accurately, the attitude of the author of the book that this article is reviewing) a little too personally. There are some good points here, as well as a bit of "make an outrageous statement in the title of your book and you'll sell a lot more copies." I haven't read the book, but it doesn't sound like the author is actually arguing against the reality of organic depression or saying that genuine mood disorders shouldn't be treated; he seems to be suggesting that mood disorders are over-diagnosed. It's not about you and your mood disorder.

In short, if the shoe doesn't fit, don't wear it.

I think the article is having trouble verbalizing a popular perception, that a lot of people who don't need depression meds use them because they don't want to be sad. I'm not sure if that's true, but I think that there's a definite possibility that as you remove the stigma from a group (which is great and amazing and fantastic from people who legitimately belong to the group!) you always get some people who identify with the group to make themselves feel unique or supported or just part of something, and that can sort of backlash on the group as a whole, with the group losing some legitimacy, and just a sense of irritation and being mocked "This is an actual serious condition that I deal with and you really shouldn't pretend or affect it just because you want attention.". All a very humble opinion on my part, because while I feel strongly I have no proof of any of this.

(I mostly think of this in relation to homosexuality and college girls who are nominally bisexual, and primarily when they're drunk... not to say that there aren't plenty of people who are bisexual and plenty of ways to express sexuality, but I feel like the phenomena I'm describing is legitimate and not just prejudice on my part... and I think that it exists in the area of mental health as well.)

Too many people confuse depression with clinical depression. I think the article (which I just skimmed the first page of to get the gist) is trying to point out that sometimes it's normal to be sad. If something bad has happened to you, it's best to deal with the problem than it is to take a pill. If you're depression is chemical, then you should get it fixed medically, by all means.

Yes, I think you're overreacting, but not too much and for the right reasons. The problem with smoothing out the lows is that it smoothes out the highs as well. Life, as the Buddhists say, is suffering. The good stuff is, all too often, few and far between. Most people (it seems) will gladly forego the truly authentic life for one with less pain. Is this bad? At some level, no. But it can be taken too far.

Cf Norman Spinrad's "No Direction Home" (iirc the story).

If you were to ask Jeff and Val (who saw a LOT of my last depressive bout first hand) they'd tell you that I wasn't unhappy so much as that I "wasn't".

I'm also reminded of something that happend during my second depression. A friend of mine took me to a doctor, who asked him if I was acting differently. He said, "This isn't David", while I just stood there thinking, "Yes it is. This is what I'm really like deep inside."

Random thoughts:

One of the things the author is speaking of is an age-old dichotomy: shall I be content or shall I be ambitious? I think many of us have a tendency to slip so far in one of those directions that we forget to use the other one even when it would serve us better. (Like my ex-boyfriend who kept accepting worse and worse deals from employers, even though he could have done something about it, because he was able to adjust to almost anything and still be content.)

I do have a problem with determining the "value" of happiness based on criteria such as earnings or education, mostly because I view long-term happiness as one of life's central goals, which earnings and education merely serve to support.

By and large I agree with the premise that we as a society have come to a point where we believe that any measure of unhappiness (no matter how fleeting or how justified) is bad and should be eradicated posthaste. As someone who has suffered from depression, here's what I know about myself: If I am tempted to describe myself as "feeling unhappy", then by definition I'm not dealing with depression, but something much milder that I'll get over (although I may have to work at it). When it's depression I'm hopeless and immovable. From in here it's obviously an entirely different creature.

I would never consider medicating unhappiness; I would definitely consider medicating depression.

I think one danger lies in that our medical system has gotten so good at medicating depression (and so many people stand to make money from doing so) that they are now marketing the image that no-one ever has to be unhappy again. They aren't distinguishing between a normal range of human feelings - feelings that make us human - and a crippling condition.

Wow, sorry to be so long-winded. Thank you for the interesting link.

I do have a problem with determining the "value" of happiness based on criteria such as earnings or education

Exactly -- I was amazed that anyone would suggest that being too happy is bad because if you were less happy you might be impelled to make more money! (And where's the consideration of the flip side, that perhaps money, or the process of getting it, eventually causes more problems than it solves?) The only part of that argument that made sense to me was the political participation part, which incidentally is the one they didn't bother claiming to have evidence for.

This:

"Rather than "listening to Prozac," they want to listen to their hearts, not have them chemically silenced."

is utter bullshit. And yes, minimizing the pain of those with serious depression AND saying nasty things about their lives on medication in one breath.

Sadness does have value. Grief is necessary. They are part of the range of human emotion, and shouldn't be buffered or numbed by chemical intervention.

However, if the sadness and the grief extends past the "normal" grieving period (my psychologist mom says this should be approx. six months, after which people should begin to move on), or if the intensity of the emotion is debilitating, then some form of intervention is required.

But being emo and angsty is "in", and there are those who think that suffering provides some sort of social cachet. And this is unfortunate, because it tends to trivialize those who are genuinely, legitimately suffering from clinical depression.

I don't think you're overreacting.

Everyone has pretty much said what I would have, one way or the other. Your reactions are your reactions; I think that "overreacting" is a relevant concern only when someone is taking action based on their reaction--that calls for some objectivity. I also agree with whoever said, if the shoe doesn't fit, don't wear it.

I wrote a whole lot more, but I'm going to put it in my own LJ instead of taking up space here.

I thought the article was arguing that sadness is NOT the same as depression, and that some sadness is normal in life. It uses examples such as a woman whose lover of five years breaks up with her feeling sad, losing appetite, unable to concentrate--and says that given the circumstances, that is NORMAL. But that it is situational and counseling would be the most appropriate first step, not direct to medication.

I believe that if the woman had sadness, loss of appetite and inability to concentrate on her job for an extended period after the breakup, this article would support it as depression and believe medication would be appropriate.

My takeaway was that while there absolutely is depression out there that does need attention and medication in addition to therapy, but that American culture has demonized ANY variety of sadness, even situation appropriate sadness (depressed mood after the death of a parent, an example in the article).

So I thought it was pretty balanced, saying that there is depression and then there is just regular life sadness, and we shouldn't confuse the two.

Am I giving the authors too much credit?

I read it the same way.

Article re: treatment of depression

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"Over-reacting"???

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95% agreement, but....

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