“With the help of a number of local and world-renowned experts in the field, producer Mary O’Connell explores what we know – and what we think we know – about depression and the medications we use so often to treat it. The patient and interested listener (the entire series runs for three hours) will be rewarded with some really fascinating but often not well-publicized facts about the social, commercial and political factors that are conspiring to make psychotropic medications “a $20billion per year industry worldwide” and have led the World Health Organization to predict that depression will be the second leading caused of global disability by 2020.” Three Parts, 1 hour each.
Depression. It has been called the mean reds. The blue devils. The black dog. And through history, treatments for depression have varied wildly. In the Middle Ages, depressives were caged in asylums. In Victorian England, wealthier patients were sent to seaside resorts for a change of air. In the 1930’s, procedures like lobotomies and electroconvulsive therapy were used. Psychiatry’s tools were crude and limited. No wonder then, when the Age of the Antidepressant arrived, it was considered psychiatry’s triumph. Prozac came onto the market in 1988, followed quickly by many similar drugs. But, since then, the number of people afflicted with depression has soared. In this 3 part program, IDEAS producer Mary O’Connell explores the short and troubling history of the antidepressant.
Over the years, the descriptions have varied: melancholia, the Black Dog, down in the dumps. The term most used today is “depression”. The World Health Organization says depression is set to become second only to heart disease as the world’s leading disability by the year 2020. An alarming conclusion when you consider the history. One hundred years ago depression was thought to be extremely rare, with 1% of the population suffering. Today it’s often called the common cold of mental illness. But just how effective are antidepressants in treating depression?
Unpublished clinical trials have come to light and they reveal that the antidepressant was never the triumphant treatment many psychiatrists hoped it would be. And we’re also learning that the theory that antidepressants restore serotonin in the brain could be false. However, despite this news about serotonin and sadness, the number of depressed people continues to grow. Now some researchers wonder whether the modern antidepressant has increased rates of depression instead of lowering them. In episode two of Rethinking Depression, IDEAS producer Mary O’Connell examines the debate around antidepressants.
The World Health Organization says depression is set to become second only to heart disease as the world’s leading disability by the year 2020. More recent research over the past decade tells us that antidepressants do not work very well, if at all, for mild or moderate depression. And in severe depression, antidepressants only work in a small number of cases.
So how can those who suffer from depression receive effective treatment and even possibly recover? In the third hour of Rethinking Depression, IDEAS producer Mary O’Connell brings us the stories of the depressed who are on the path to wellness and the methods that can be used to get them there.
The Medicated Me
It’s just after dawn, and I’m sitting on someone’s sofa in someone’s apartment somewhere in New York City. An attractive young woman I used to know is sleeping 15 feet away. Books I read, photos I took, CDs I reviewed as a music critic — all sit like props from a play I half remember. The sunlight looks toxic, radioactive. The murmur of distant traffic sounds alien, hostile, a predator’s low growl. Everything is exactly as it was yesterday yet feels totally different — in a bad way and down to a subatomic level. I feel like a character in some lame sci-fi novel who wakes up in a parallel universe or as a head in a jar. I’d skimmed over this sensation in nightmares and during extreme jet lag but never felt it descend as a full-blown totality, never felt it suck me down into it. I’d compare it with a bad trip if not for one terrifying irony now sinking in. This is my brain off drugs.
Six months ago, after 10 emotionally uneventful years on antidepressants — years that somehow included getting married, losing my job, and watching two skyscrapers implode from 20 blocks away — I began tinkering with my prescription, casting about for just the right med while the sturdy old Effexor trickled out of my system, a few milligrams less each week, a long goodbye to my silent partner of a decade.
Now, having decided to go off everything, putting my years-long chemistry experiment on pause, I am drug-free at last. For the first time in a decade, I am experiencing life in all its rich tones and vivid hues, and I’m about to throw myself in front of the 6 train.
The DSM-V reviewed as if it was a dystopian novel…
“Great dystopia isn’t so much fantasy as a kind of estrangement or dislocation from the present; the ability to stand outside time and see the situation in its full hideousness. The dystopian novel doesn’t necessarily have to be a novel.”
A new dystopian novel in the classic mode takes the form of a dictionary of madness
“As you read, you slowly grow aware that the book’s real object of fascination isn’t the various sicknesses described in its pages, but the sickness inherent in their arrangement.
Who, after all, would want to compile an exhaustive list of mental illnesses? The opening passages of DSM-5 give us a long history of the purported previous editions of the book and the endless revisions and fine-tunings that have gone into the work. This mad project is clearly something that its authors are fixated on to a somewhat unreasonable extent. In a retrospectively predictable ironic twist, this precise tendency is outlined in the book itself. The entry for obsessive-compulsive disorder with poor insight describes this taxonomical obsession in deadpan tones: “repetitive behavior, the goal of which is […] to prevent some dreaded event or situation.” Our narrator seems to believe that by compiling an exhaustive list of everything that might go askew in the human mind, this wrong state might somehow be overcome or averted. References to compulsive behavior throughout the book repeatedly refer to the “fear of dirt in someone with an obsession about contamination.” The tragic clincher comes when we’re told, “the individual does not recognize that the obsessions or compulsions are excessive or unreasonable.” This mad project is so overwhelming that its originator can’t even tell that they’ve subsumed themselves within its matrix. We’re dealing with a truly unreliable narrator here, not one that misleads us about the course of events (the narrator is compulsive, they do have poor insight), but one whose entire conceptual framework is radically off-kilter. As such, the entire story is a portrait of the narrator’s own particular madness. With this realization, DSM-5 starts to enter the realm of the properly dystopian.”
—Read the entire review by Sam Kriss in The New Inquiry—epitomizing perhaps, the function of artful perspective