Is Depression an Illness?

Since 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. He 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 value. 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.”

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

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:

“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 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.”

My 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.”

In 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.

“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:

We 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. My 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.

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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.

DepressionLaren Stovermelancholymental illnesssadnessWilliam James