If you would believe all the information which reaches us from the mass media – we are facing an epidemic of depression. Major depressive disorder is said to afflict approximately 10% of population at some point during their life. Theoretically one of the things which differ depressive disorder from deep sadness in most of the diagnostic tools is that major depression is defined as depressed mood on a daily basis for a minimum duration of 2 weeks. Suicides caused by depression is one of the leading causes of not natural deaths in the world. The number of antidepressant medication prescribed is constantly rising. But have you ever thought that the current medical science is sometimes simply transforming a normal sadness to a pathological illness which is aimed to treat by medicine at any case.
To understand why there might be a big misguidance while saying that the number of depressive disorders’ cases is constantly rising firstly we should discuss the way this statistical data is collected and analyzed. Johanna Olexy from American Sociological Association tells that the high percentages of depression have been greatly exaggerated firstly due to the methodology of community surveys. Johanna and her colleague were encouraged to do a research on methodology when some community surveys reported almost half of American population to be suffering from depression. According to her colleague Alan V. Horwitz community surveys rely on standard, closed-form questions about symptoms with no context provided to differentiate between normal reactions to every day stress and a mental condition. Image if you get this kind of survey and one of the questions would be asking whether you are suffering from a lack of motivation. If you don’t like your job you will obviously answer ‘yes’. The other question is asking whether you lost interest in activities you used to enjoy. If you are working overtime every day you will answer ‘yes’ again as you know you just didn’t have time for these activities the past days. So imagine you score 5 ‘Yes’ which is enough for the researches of the community survey to indicate you with depression. But does the fact that you don’t like your job and the week was stressful so you had to do over time indicate you to be suffering from a psychological disorder? It is natural you are tired and stressed, but to call you depressed would be way too far.
The second source which states that the number of depressed people is constantly and intensively growing is the data on prescribed antidepressant medication. However, if you would look closely where the data comes from there are two facts that make it not fully valid. First of all, the current medics, especially the ones which lack psychological insights and considering the fact that most of the antidepressants are prescribed by GPs, tend to merge depressive disorder with a natural human reaction which appears after a loss or major disappointment in life. Before 1980, only symptoms that were ‘excessive and inexplicable relative to their provoking context were considered signs of the depressive disorder. After 1980 all symptoms, even those that are proportionate to their provoking cause, were defined as disorders. As Paul Koeck, MD and a psychiatrist says, most of the times medication relieves the symptoms but not the causes which trigger them. Many doctors have too much statistical and medical attitude which makes them believe that removed symptoms will mean a cured person. But actually sometimes these symptoms does not mean depression disorder but rather a natural reaction to the things the person is unhappy about and they have to be dealt with in psychological therapies rather than with the help of medication.
The second reason why so many people get antidepressants prescribed, according to Horwitz and Wakefield, professors of sociology, who been researching the depression phenomenon, is that mental health advocates, for instance, liked the fact that it produced high estimates of the amount of depressive mental disorder so that it seemed as if depression was a “public health problem” of massive proportions. Clinicians could get reimbursed for conditions that might actually be non-medical problems. Clinicians simply needed a disorder to write down in the documents in order to keep receiving money for treating the person. That most of the prescription cases were due to a wrong diagnosis (diagnosing with depressive disorder than the person was actually suffering from complex psychological problems) can be illustrated by a study led by researchers at the University of Pennsylvania. This study indicated that the antidepressants Paxil and Imipramine work no better than placebos for people with mild to moderate depression. In this case mild and moderate depression could just have been an intense sadness rather than mental disorder which explains why the medicine did not work on such a large amount of people. And doctors were simply prescribing it as it was easier to put one more number in statistics rather than spend time applying therapies. Study has shown that the pills don’t work for people who aren’t really depressed — people with short-term, minor depression whose problems tend to get better on their own. For many of them, it’s often been observed, merely participating in a drug trial (with its accompanying conversation, education and emphasis on self-care) can be anti-depressant enough.
Other thing we should not forget is the interest of pharmaceutical companies.They found that they could portray people who suffered from widespread psychosocial problems in their advertisements while at the same time marketing their products as treatments for depressive mental disorders. And at the same time, people cached the idea of ‘being depressed’ and all the benefits you get from it. More and more people started seeking for treatment from depression sometimes only because it is much more ‘comfortable’ to say that you have a mental disorder rather than admit you have some psychological problems and you need to change the way you behave with people around you and your attitude if you want things to become better. And the fact that there is more and more articles, information on the traditional media and internet which spreads awareness of depression while describing symptoms, etc on one hand makes people more educated in the field of psychology and psychotherapy. On the other hand, some people tend to diagnose them selves and go to the physician already demanding for the antidepressants as they are sure that what they suffer from is a mental disorder even it is not.
What is important to understand first of all is that intense sadness differ from depression which is a mental disorder and there are other ways than medication to deal with it. First of all it is various therapies which in most of the cases are proven to be same affective as medicine. Hopefully what people and their physicians don’t do is make the simple assumption that the presence of a particular group of symptoms for a short period of time always indicates the presence of a depressive disorder. “The message for patients with mild to moderate depression,” Dr. DeRubeis said, “is, ‘Look, medications are always an option, but there’s little evidence that they add to other efforts to shake the depression — whether it’s exercise, seeing the doctor, reading about the disorder or going for psychotherapy.’
To some up, as sociologists say there are number of reasons to make people believe they are suffer from depression than actually the are not. Certain health care institutions, which are interested in governmental funding would like the government to believe they are fighting against something affecting half of USA. Another reason is that pharmaceutical companies capitalize on these survey findings to broaden their markets and considering how much antidepressant medication been sold the past years and that the number is constantly growing just proves it. Even the general practitioners sometimes would rather make a personal statistical unit and get reimbursed than look to the underlying causes of emotional state person discovers himself at that moment.
Tags: antidepressants, depression, epidemic, sadness, Therapy (research)
