I’ve been thinking a lot about mental disorders recently, and how we love to categorise them. We also love to invent drugs to cure them.
On Monday I went to the doctor for blood test results, and I am starting to suspect that the issues for which we are trying to find a “cause” are caused by stress, anxiety or depression, or some combination of the three. The doctor, a bright-eyed and earnest young thing, probably fresh out of medical school, is referring me for scans and all sorts. I asked her if we found no “physical” cure, and it turned out to be stress, what would the treatment be?
Antidepressants.
So the idea is that the antidepressants would treat the stress, then the stress wouldn’t be there to disrupt the physical things, so the physical things would get better. Huh.
I understand that my American friends are very much used to drugging and being drugged. But as many of you declare yourself “freethinkers”, let’s try and think outside the box. Where is the evidence that drugs work for mental disorders? It’s varied, shaky, inconclusive and tainted by pharmaceutical companies.
Or think about this: according to R.D.Laing, psychiatry itself was founded on a false epistemology: illness diagnosed by conduct but treated biologically. Others claim that psychiatry is, in many cases, unfalsifiable, and a pseudoscience.
The more reading I do, the more evidence I see that depression is not, as many people believe, caused by a chemical imbalance. The imbalance is a symptom of the depression. This means that treating the symptoms does bugger all for the cause.
There is a movement of “critical psychiatrists” who believe that psychiatry is not credible as a science. You may want to read this if you are interested in that sort of thing: Psychiatric Imperialism: The Medicalisation of Modern Living
I’m starting to come around to this way of thinking. Antidepressants are increasingly not making sense to me. You are sad? Here, have some drugs, make it all better! No matter what the actual cause of your depression is.
Considering that we all have more or less the same amount of crappy things happening to us, what causes some people to become depressed? I suppose it is one’s reaction to the environment. How we respond and make sense of things.
I’ve also been reading up about a link between depression and so-called “over-dreaming”. See diagram below.
The Cycle of Depression from http://www.clinical-depression.co.uk/
Now I’m not saying that this is absolute gospel, but I think it’s an interesting idea. It’s certainly fit in with a lot of what I have been feeling in the last few months.
It’s redundant to say that obviously a lot more research needs to be done into this, but I think there are some general areas of progress that could be made with regards to mental illness.
1. Make psychotherapy more available to all. To do this, we need to start realising its importance in helping people, and we also need to realise that it’s not an indulgence or a luxury.
2. Stop prescribing drugs as an initial treatment. After my head injury I went to the doctor. I had to see a different doctor than my usual one. After a brief consultation he had decided I was depressed and prescribed citalopram. Bam. Job done. I could almost see him tallying up the symptoms in his head and thinking, “sounds like depr… GIVE HER DRUGS”
3. Stop implying causality with every discovery about brain functions. (I’m talking to YOU, Serotonin Hypothesis!)
4. Remove stigma from mental illness. I’m doing my part by talking about it with people in an open and honest way. I encourage you to engage in the debate. The most important thing I would advise is that you must never ever blame someone for their depression, because I guarantee you, they have already been blaming themselves for years.
DISCLAIMER: If you are experiencing severe depression please talk to your GP or the Samaritans, or someone… the internet is a huge resource. Use it. Don’t use my blog as medical advice, see it as a discussion point.
