Close

Is Depression an Illness?

sadness 4Since as far back as she can remember, Carla, 19-years-old, has been having periods during which she has waves of deeply sad feelings. She has family members who say that depression runs in their family, and she should see a psychiatrist for treatment. So, off she goes, and after a few questions, the psychiatrist declares she has a mental illness called Major Depressive Disorder. Carla is prescribed pills referred to as antidepressants.

She soon feels a little better, but begins to experience a number of side effects, among them, her sex drive is diminished. Her boyfriend soon breaks up with her, and she has a new bout with sadness. Her doctor increases her dose of pills, and adds some additional ones as well, which seems to work. But in time, new waves of sadness occur, so she goes back to the doctor. ECTHe now sets her up with a series of electroconvulsive shock treatments, which her doctor calls Electroconvulsive Therapy (ECT). Her memory begins to suffer, but after each series she does feel her mood rise.

Some who know Carla, respect her for facing the fact that she has a mental illness and is seeking sound medical advice to have it treated. Others who know her, upon seeing her turning to pills and ECT, regard her as foolish and lose respect for her.

In contrast to how Carla construes her waves of deeply sad feeling, some view it as an artistic temperament, and learn to appreciate these visits of melancholy as something of extraordinary valueWilliam James. Thus, in an earlier post titled William James’s Personal Bout With a “Mental Disorder,” we looked at how the brilliant psychologist and philosopher came to view his “bass notes of experience.” On this subject, he wrote that many so called “healthy-minded” individuals believe that those who worry are “morbid-minded” and “diseased,” but it may very well be true that “the world’s meaning most comes home to us when we lay them most to heart.” He went on to write that,

there is no doubt that healthy-mindedness is inadequate as a philosophical doctrine, because the evil facts which it refuses positively to account for are a genuine portion of reality; and may after all be the best key to life’s significance, and possibly the only openers of our eyes to the deepest levels of truth.”

This Sunday in the New York Times I met up with another writer who genuinely appreciates periods of sadness.

Ms Laren Stover

Ms. Laren Stover

In an article titled “The Case for Melancholy,” Ms. Laren Stover weaves a very different perspective from Carla, the individual I described at the start of this post who has an image of herself as a “sufferer of mental illness, and a consumer of antidepressants and ECT.”

Ms. Stover, after telling us of her weariness of all those folks on the internet promising to show us how to be delightfully happy in just a few short steps, writes:

sadness 3“Whatever happened to experiencing the grace of melancholy, which requires reflection: a sort of mental steeping, like tea? What if all this cheerful advice only makes you feel inadequate? What if you were born morose?”

It is of course not alway easy to bear these experiences, but one can begin to observe the beauty of it:

“It visits you like a mist, a vapor, a fog. It is generally uninvited. And as some people are born into royalty, wealth and prestige, others inherit a disposition for sadness.”

Notice how Ms. Stover pairs this experience with images of being born into royalty, wealth and prestige. In contrast, the mental illness promoters would much prefer to have us associate such experiences with being stuck with an awful disease we can only learn to manage with psychiatric drugs and, if that doesn’t prove sufficient, ECT. 

Laren continues to weave her artistic images of melancholy with such words as:

sadness 2“Sadness has a bad reputation. But I soon came to feel that melancholy — the word itself is late Latin from the Greek melancholia — is a word with a romantic Old World ring, with a transient beauty like the ring around the moon.”

And in another fine phrase, she tells us:

it is fine to indulge in the cloudy charms of melancholy: to watch a sad black-and-white movie or to be swept away by the wind making a sound that Truman Capote described as a grass harp.”

sadness 6My favorite line in Ms. Stover’s article is actually a quote from her late father, a writer who published 24 books, and apparently also dealt with the many challenges of melancholy: “I don’t know if you’ll be a writer,” he tells his daughter, ” but you have the ‘up down’ thing too. Make creative use of it, otherwise, people will think you’re just plain nuts.”

sadness 5In our society, with its commercials every few minutes on TV telling us of all of the wonderful benefits of treating the terrible disease of depression with drugs, it is not easy to come to the artistic temperament point of view. And there are many good people that you will meet who genuinely believe that they have been saved from the depths of despair by doctors who utilize the medical model. If you choose to follow them down that road, I do wish you well. I have no desire to stop people from following the path that makes the most sense to them.

But for those who have not made their decision on what direction to head questionably into that dark night, I do gently ask for a momentary pause. Yes, in the physical illness domain, many medical procedures produce amazing outcomes. And it is therefore understandable that people will be eager to seek help from those who practice this medical approach to help in the domain of psychological distress. But it is worth noting that doctors can be terribly wrong at times. In the same issue of The New York Times as Ms. Stover’s article appears, we can find an article titled “How Doctors Helped Drive the Addiction Crisis.” It points out that,

OxyContin's long-acting formulation makes it popular but also prone to abuse.

OxyContin’s long-acting formulation makes it popular but also prone to abuse.

“The rate of death from prescription opioids in the United States increased more than fourfold between 1999 and 2010, dwarfing the combined mortality from heroin and cocaine. In 2013 alone, opioids were involved in 37 percent of all fatal drug overdoses.

Driving this opioid epidemic, in large part, is a disturbing change in the attitude within the medical profession about the use of these drugs to treat pain.”

A recent scientific analysis of the pros and cons of the so-called antidepressant, titled “Primum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm Than Good” concludes:

antidepressant_pillsWe have reviewed a great deal of evidence of the effects of antidepressants on serotonergic processes throughout the body. Some of the effects are widely known, but they have been largely ignored in debates about the utility of antidepressants. Indeed, it is widely believed that antidepressant medications are both safe and effective; however, this belief was formed in the absence of adequate scientific verification. The weight of current evidence suggests that, in general, antidepressants are neither safe nor effective; they appear to do more harm than good.

Recent findings with regards to the previous standard medical recommendations for breast cancer and prostate screenings now indicate they led to far more harm than good for millions of patients.

And so, pausing, and considering an alternative way to think about melancholy may be well worth your while. If you feel you just can’t go it alone, meditation has been an enormous help for me in discovering a deeper understanding of these experiences. Vipassana-and-mindfulness-300x200My son, Jack, has found his Vipassana meditation retreat experiences of enormous value, and the cost for these retreats is on a voluntary donation basis. Some counselors and psychotherapists who have not fallen hook, line and sinker into the medical model view of these types of challenging experiences, can be of great help to make the transition from ugliness to beauty.

Well, I hope this discussion has deepened the reader’s views of melancholy, sadness and tears. Until you join us again right here at “From Insults to Respect,” may all of your concerns be addressed with wisdom, love, and kindness.

——————————-

Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on.  This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence.  To begin at the very first post you can click HERE.

Mental Illness or Below Average Functioning?
Depression As Illness: A Case Study

About the Author

Jeffrey Rubin grew up in Brooklyn, received his PhD from the University of Minnesota and has taught conflict resolution there as well as at a psychiatric clinic, a correctional facility and a number of public schools. He has published articles on anger and conflict resolution and has authored three novels.

7 Comments

  1. Loved the read and for my life, at least, it is refreshing to find another that says…. you are perfect just as you are. Each is born with different talents. It is not what we are born with but how we choose to embrace those special gifts or reject them. Thank you for this lovely few moments of my day.
    Hugs,
    Sho

  2. Hi Sho,
    What a delightful comment. Much thanks for taking the time to let me know your reaction to this post.

  3. Julian David, the English Jungian psychologist, spoke about the theme of a descent to the underworld, which occurs so often in mythology and which he feels is a symbolic representation of depression. Having experienced it himself he feels that depression should be embraced, if possible, as a valuable part of growth and development. In mythology and in many rites of passage, there is a period of suffering and loss followed by a reemergence into the sunlight with some measure of transformation, wisdom and insight. Perhaps a more positive acceptance of the condition might help sufferers to cope better. He did qualify this opinion by saying that medical intervention should be used in severe cases.

    • Hi Wendy Vermeulen, thanks for introducing us to a Jungian’s perspective. With regards to Julian David’s theory that medical intervention should be used in severe cases, the scientific data is not clear about this. In the studies that are viewed as most scientific, a double blind methodology is used, but the most severe cases are not permitted to be part of these studies. Those cases that present with thoughts of suicide are excluded and immediately placed in a full medication, medical treatment program. There are countries that don’t typically use medications. Two World Health studies found that countries that don’t use drug treatments, or use it very little, have better outcomes than we find in the USA. However these are not double blind studies, and psychiatrists are quick to point this out. So, we are left in a kind of not absolutely sure state regarding this issue. My Best, Jeff.

  4. Thank you for a thoughtful piece about sadness and depression. Sometimes we don’t reemerge into the sunlight without some form of intervention. Throughout my adult life I experienced cyclic depression and GAD, generalized anxiety disorder. I’ve persued just about every form of therapy available, treated PTSD successfully using Bioenergetics, TRE or Trauma Releasing Exercises, SHEN PhysioEmotional Release and Empowerment Therapy, Rx meds, talk therapy, etc.

    The last cycle began in December 2012 and did not end until June 2014. Not only deep sadness for major losses, including my younger brother’s suicide in 2007, but also a truly deep depression with severe anxiety culminating in agoraphobia lasting 2.5 years.

    Many, many drug trials later with many paradoxical and adverse reactions, talk therapy, and several alternative approaches I became suicidal, made 2 attempts, and was admitted to the University of New Mexico Psychiatric Center. I received some nutritional supports of substances I was deficient in and short impulse, unilateral ECT series. In 5 treatments I was smiling and participating again. 2 weeks after discharge, while having continuation ECT to taper off, I drove again, went to a movie, and out to dinner. I hadn’t been able to do those things in 2.5 years. I was back!

    Since then I’ve been more stable and happy than ever before on my life. I utilize natural supplements to balance my brain chemistry in low doses, and saw a therapist for a year after discharge. I’ve opened my dream healrh and well-being practice, bought my first home at age 60, and am a Certified Peer Support Worker in training while volunteering as a Peer Bridger at the Psychiatric Center where I was a patient.

    I feel your portrayal of ECT is outdated. That photo is the worst representation of ECT harkening back to some movies showing the old long impulse, bilateral ECT methods.

    ECT has been reformulated significantly. Additionally, there is no associated memory loss with the newer short impulse, unilateral method. No bite block is needed. One doesn’t have a visiable seizure. In fact, there is no seizure with ECT now.

    Agreed, antidepressants as a class have more deleterious effects than ever and I believe, are highly over prescribed. However, there is a time and a place for them. Just as there is a time and place for ECT.

    • Hi Christiane, thanks for sharing a little of what you went through as you struggled with what you refer to as cyclic depression and GAD, generalized anxiety disorder. As I understand from what you wrote, once you had your experience medicalized with psychiatric terms, it legitimized for doctors the prescribing of pills referred to as “antidepressants.” You experienced this approach as leading to adverse reactions. During some of this period you also went through some grieving as a result of a loss of your brother and some other events. You struggled with this for a period of time and then, most recently, you received some nutritional supports of substances you believe you were deficient in, and short impulse, unilateral ECT series. As you were going through this process you found that you were were able to drive again, go to a movie and out to dinner, things you hadn’t been able to do in 2.5 years. As you continue on your life path, I wish you well.

      Later in your comment, you disagree with how I portrayed ECT. More specifically you wrote: “ECT has been reformulated significantly. Additionally, there is no associated memory loss with the newer short impulse, unilateral method. No bite block is needed. One doesn’t have a visiable seizure. In fact, there is no seizure with ECT now.”

      I respectfully disagree with you about this and encourage you to check these “facts” out more carefully. I believe that the newest forms of ECT, including the latest short impulse, unilateral method, does produce a seizure on each and every dose, and the treatment series requires multiple doses. A rubberized bite block is used. Moreover there continues to be some people who have undergone this type of treatment and report serious loss of memory. Death from the treatment procedure, in rare instances, does occur. There are those who experience no benefit even in the short run, but even for those who report some benefits in the short-run, it is well documented that the perceived improvement from the treatment soon fades. There are other side effects that have been reported, too numerous to go into here, mostly attributed to the anathesia and other drugs administered repeatedly during each ECT dose.

      So, these are some of my own beliefs about ECT. I encourage readers to thoroughly review the evidence about ECT, keeping in mind that there is an enormous amount of money that is made by administering this intervention, and therefor some of the medical research reports may be bias in favor of the treatment.

      With regards to some of the other things you are doing to deal with your experience, Christiane, getting involved in being a peer support worker and volunteering can be very uplifting, and I encourage you to continue to help out in these ways.
      Again, wishing you well,
      Jeff

Write Your Comment

You may use these HTML tags and attributes:
<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>