Tuesday, June 07, 2005

A Depressing Topic

by Anne Zelenka
My dad sent me the book Against Depression last week just as I hit a little patch of irritability and displeasure verging on a mini-depression. The book is by Peter Kramer, author of Listening to Prozac. In Against Depression, Kramer passionately argues for depression as disease not as temperament or bad attitude.

Don't we all know it already? "Depression is a chemical imbalance." But Kramer says that the chemical imbalance myth of depression doesn't go quite far enough in capturing the dysfunction of the depressed brain. If you looked inside a depressed person's head you wouldn't just see a dearth of serotonin or other happy-making molecules, he says. You'd see disordered and disorganized neurons in the prefrontal cortex and you'd see a shrinking hippocampus. The prefrontal cortex helps people motivate and plan. The hippocampus responds to stress. In depression, the body is permanently stuck in the stress response, unable to plan a way out of it. To Kramer, depression is too often a one-way ticket to hell.

Do I believe Kramer? I don't know what I believe. I have always held to the theory of depression as a bad attitude. I've suffered periods in my life that might have been considered major depression. But more likely they might have included just a couple symptoms from the diagnostic criteria for major depression. Kramer argues that even a low level of depression reflects brain malfunction and creates risk for problems down the line. He suggests that we don't think of having a touch of arthritis as being okay. We shouldn't think it's okay to be a bit depressed either.

I find Kramer's book kind of depressing. It reminds me of what my own depressive symptoms have taken away from my life. Whether the symptoms are my fault or not doesn't really matter--the harm has been done. The book has suggested to me that I may need to revisit my stance against anti-depressant medication. It seems noble to work through your problems without turning to the pharmacy. There's a sense in our society that too many people are taking too many anti-depressants. But conventional wisdom is often wrong. Maybe not enough people are taking them. Maybe I need to be taking them.

3 Comments:

Blogger Diana said...

No easy answers here; I've struggled with this issue, and with many of the concerns you broach here, for most of my life. I loved Kramer's first book and plan to also read this one. I find him very thought-provoking.

2:25 PM  
Blogger Cynical Mom said...

Speaking as someone who was diagnosed with clinical depression 9 years ago and has been on AD meds ever since... I fully believe in the medical nature of it. There was a period of time when I literally couldn't get out of bed. It was WEIRD. The drugs have helped me immensely, to the point that my husband even notices when I forget to take them sometimes, and I react to stress in a different way.

7:28 PM  
Blogger Marjorie said...

I'm one of those people who wonder if too many people take anti-depressants because of stories I've heard of doctors so willing to give them out and of pharmaceutical companies wanting to sell them. I suppose I also wonder how many people want to pop a pill to solve a problem and I wonder if there is a better way.

But I don't know what I'm talking about. I haven't read much on the topic but I read one article in Consumer Reports on a study of patients taking meds alone, taking meds and doing therapy and doing therapy alone. They were all had similar results, though I think the combo helped most. I suppose my fear would be that meds take care of the symptoms but not the problem.

But what do I know? My high school boyfriend was depressed. We dated a year and a half and when we broke up, my family commented on how much happier I seemed. Depression affects more than the person with it, it affects those who love them too. He wasn't on meds until after he attempted suicide.

You've done your research -- only you know how you feel. Give it a try and see if it helps, if it does, take them. No one begrudges a diabetic their insulin. And for those who think its over-medicating, tell them they don't know what they're talking about.

1:37 PM  

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