Depressing thoughts

There have been a lot of articles and studies reported lately, regarding anti-depressant medications – SSRIs* in particular – over-prescription of such medication, and efficacy thereof.

*  SSRIs = Selective Serotonin Re-uptake Inhibitors; a class of anti-depressants that increases the levels of the neurotransmitter serotonin.  Basically [very basically!], increased levels of serotonin improves sense of well-being, activity levels, social confidence.  Brand names include Prozac, Seroxat, Efexor.

For the record I should state that I’m very much in favour of the use of SSRIs for the treatment of depression.  They do help a significant proportion of the population with very real problems.  I’m pretty familiar with depression in all it’s guises; my maternal family line in particular has a history of mental illness and chemical imbalances.  In those cases taking a tablet twice a day can balance levels of serotonin, dopamine etc and allow a person to lead a better quality life.

On a tangential note [who, me, go off at a tangent?], Prozac et al have a bad reputation for increasing the number of suicides, particularly in young people.  When Prozac was first introduced in the US, and doctors began handing it out like sweeties, rate of youth suicide soared, and Prozac was blamed.  The cause did not lie with Prozac, but with how SSRIs work.  Within a week of taking the medication, the previously depressed, inactive, almost-somnolent patient would start to feel more active, but the depression itself had not yet lifted.  So what does a now-active but exceedingly depressed person do?   The “mix” of many other SSRIs has since been modified and refined, but doctors should give a newly diagnosed patient two types of anti-depressants [the SSRI and a tri-cyclical] to allow for the overlap in effect.

Over-prescribing of SSRIs is becoming a real problem in the UK [over 31 million prescriptions for SSRIs were written in the UK in 2006], Australia and the US.  Doctors see it is a “quick fix” for patients complaining of depression.  I have quite a different view; not only are SSRIs being over-prescribed, they are being prescribed incorrectly, when the patient and their situation does not warrant that treatment.

. . . . . . . . . .

What is depression anyway?  I have heard so many people describe themselves as being “depressed” when they are in fact feeling a bit sad and sorrowful, stressed, anxious, worried about making it to pay-day, discontented, dull or bored, pissed off at a girl / boyfriend, embarrassed … None of that is fun, it’s awful feeling any of those things, but it is not the same as being depressed.

Merriam-Webster Online defines depression as “ … a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies.”

Winston Churchill described his depression as “the black dog”.  When I am depressed it feels like a dark, thick, oily whirlpool is sucking me down into ever-tightening spirals of hopelessness and an inability to see the use in doing anything.  I have had episodes of severe depression since I was ten years old; it’s that feeling of having no hope, no way out, of seeing no light at the end of the proverbial tunnel [even an oncoming train would be preferable, in a way], simply wishing one didn’t exist.

I have fought my personal demons for years, since I was ten years old, and yes, had contemplated suicide; I’ve had the pills and bottles of vodka lined up, the hot bath and sharpened carving knife with artery in wrist or thigh pumped up.  Why didn’t I?  I’m afraid when it came to the crunch, it was not for selfless reasons of not wanting to cause my family grief, but sheer stubbornness, a refusal to “give the bastards the satisfaction” [the bastards ranged over the years from bullying abusive kids to psychopathic bosses to all my nameless fears and despair].

I finally faced the fact that I simply wasn’t the suicidal “type”.  In recent years of course I have Tux to think about and care for, and that has made a huge difference.  I have also come to recognise that if I can just hang on long enough, dig my heels in and bring every bit of my tenacious and stubborn nature to the fore, I will get through the dark times and desperation, and bounce back.  That’s the way I am; I can’t be kept down for long, regardless of chronic health problems, major self esteem and confidence issues, financial worries, frustration, all those fears and demons.

. . . . . . . . . .

I’m no angel, that’s for sure.  I get seriously annoyed by “normal” people who have good health, good looks, jobs, a good quality of life – things I can never hope for – and take them totally for granted, never think of what they have, and claim to be “depressed”.  Not to take anything away from their enjoyment of wallowing in it, but honestly? They don’t know NUFFINK.

They don’t know endless screaming pain, frustration at being immobile and restricted, of having a reduced quality of life.  They don’t know discrimination, ignorance and plain idiocy.  Comparisons are odious, but I have it good; so much better than so many who suffer daily with more severe disabilities and disease.  Yet we all manage to continue fighting, remaining positive and optimistic and happy.  Sure, we have our bad days, but we keep going.  Without being sickeningly sweet Pollyannas, we appreciate the good things in life, all the joys and tears. 

So as far as I’m concerned then, unless you are in total dark despair and have no hope, or your quality of life is being seriously compromised, then you aren’t depressed.  If you don’t have a neurological condition, mental illness or chemical imbalance, you shouldn’t be swallowing SSRIs.  You may be sad, grieving, discontented, stressed, all of which are horrible things to be feeling, but there are better ways of coping with the problem than having your local doc scribble a note for mind-altering drugs.I blame the medical practitioners for misdiagnosing and over-prescribing, and the governments, organisations and drug companies that encourage quick fixes.  Wouldn’t it be a wonderful thing if doctors were able to prescribe counselling, cognitive therapy, holistic health programmes?

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  • Scary  On Sunday 9 March 2008 at 11:46 pm

    You are so educational and informative – even in your depression.

    As for the holistic health programs I am all for it. I read a book called The Alcoholism and Addiction Cure – A Holistic Approach to Total Recovery, and it was so enlightening on depression and addiction and self-medication. And the holistic approaches work!

    Thank you for being so wonderful! And funny.

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