Depression

Elsewhere on this site, I have argued that depression is not an illness, but rather is an adaptive mechanism that encourages us to make changes in our habits or our circumstances. I have written about what I call the seven natural anti-depressants: good nutrition; fresh air; sunshine (in moderation); physical activity; purposeful activity; good relationships; and adequate and regular sleep. But the question has often been posed: Why does this adaptive mechanism apparently not work in some cases? Why is it that for some people the unpleasant feeling fails to act as a spur to make changes, and instead the person sinks further into despondency and inactivity? ...

I’ve come across an article by psychologist Bruce Levine, PhD, How the “Brain Defect” Theory of Depression Stigmatizes Depression Sufferers. Dr. Levine convincingly debunks the brain defect theory, and also the notion that the illness theory destigmatizes depression. Here are some quotes: “Americans have been increasingly socialized to be terrified of the overwhelming pain that can fuel depression, and they have been taught to distrust their own and other’s ability to overcome it. This terror, like any terror, inhibits critical thinking. Without critical thinking, it is difficult to accurately assess the legitimacy of authorities. And Americans have become easy prey for mental health authorities’ proclamation that depression is a result of a brain defect.” ...

There is an interesting article in last month’s issue of the British Journal of Psychiatry. The article, titled Psychiatry beyond the current paradigm, was authored by Pat Bracken, an Irish psychiatrist, and 28 other British and Irish psychiatrists. The gist of the piece is that the current psychiatric paradigm, which the authors describe as “applied neuroscience,” is not supported by the evidence and needs to be abandoned. Here are some quotes: ...

This issue has been debated for years, but was finally considered to have been put to rest by NIMH’s 2004 Treatment for Adolescents with Depression Study (TADS). This study essentially “found” that fluoxetine (Prozac) was effective in treating depression and did not involve an increased risk of suicide. Robert Whitaker’s most recent post points out that TADS actually found that adolescents treated with fluoxetine had a markedly higher risk for suicidal activity than those who received a placebo. Robert also outlines the various statistical and methodological ploys that were used to conceal this finding and to sanitize the final report. ...

The debate is over. Antidepressants are only very marginally more effective than placebos. And yet the “depression-is-an-illness” lobby continues to grasp for straws. Fiona Godlee, editor of the British Medical Journal, recently cited “evidence” of the efficacy of antidepressants. For a critique of the Godlee article go to Duncan Double’s website “Critical Psychiatry.” Surprise finding! - Antidepressants are only very marginally more effective than placebos. What this means in effect is that people are “curing” their own depression (gasp), and perhaps don’t really need the mental health practitioners (double gasp). ...

Daniel Carlat in his blog post of August 15 mentions, and critiques, a so-called blood test for depression marketed (for $745) by Ridge Diagnostics. The essence of Dr. Carlat’s criticism is that the test is not predictive of depression, but merely enables one to tell (with some degree of accuracy) whether or not a person is depressed. Dr. Carlat makes the point that you can tell this with more or less total accuracy simply by asking the person if he is depressed or by observing him for a few minutes of conversation. ...

The National Institute of Health (NIH) is an agency of the U.S. Department of Health and Human Services. It is the primary U.S. Government agency responsible for medical research. The NIH has 27 sub-departments, one of which is the National Institute of Mental Health (NIMH). The NIMH has an annual budget of $1.5 billion, which they use to support research through grants and in-house work. Several years ago the NIMH approved a $35 million grant for the STAR*D study (Sequenced Treatment Alternatives to Relieve Depression). The study was conducted “…to determine the effectiveness of different treatments for people with major depression who have not responded to initial treatment with an antidepressant.” This was to be the largest and longest study ever conducted to evaluate depression treatment, the results of which are now available. ...

There’s some interesting reading at Mercola.com posted April 6, 2011. Dr. Mercola states that depression is not an illness! - and that this bogus illness was created by psychiatrists and drug companies in order to sell drugs! No surprises there for regular readers of this site. Unfortunately Dr. Mercola doesn’t take the logic far enough. Although he rightly debunks depression as an illness, he clings to the notion that other “mental illnesses” are bona fide. ...

Every society in every generation makes errors. Some of the errors are minor. Some are major. One of the great errors of the 20th century was this: we accepted the spurious notion that a wide range of life’s problems were in fact illnesses. This spurious notion was initiated with good intentions – to provide shelter and humanitarian care for a relatively small number of individuals whose plight was truly dreadful. But then the concept of mental illness took off, fuelled largely by the efforts of psychiatrists to legitimize their status as “real” doctors. ...

I have recently read a very interesting book by Irving Kirsch, PhD. It’s called The Emperor’s New Drugs, and the central theme of the work is that antidepressants are only very slightly more effective than placebos (i.e. sugar pills), and that the difference is not clinically significant. The logic is cogent and the research is rigorous. Read the book and decide for yourself. Dr. Kirsch argues in favor of psychotherapy as a substitute for pills. And certainly talking is usually helpful. However, as long as depression is conceptualized as an illness, I don’t believe we will see real progress in this field. ...