23 Jan Depression: Still A Mystery Despite Medication

Depression is a scourge, and yet despite its devastation of individual lives and its enormous cost to society, it has been popularized as a malady that can be cured with medication alone. Who hasn’t seen the advertisement for antidepressant medication that pictures a shadowy blue blob of melancholy being chased away by the latest antidepressant medication? And if the antidepressant medication doesn’t work alone, why not augment it with an antipsychotic medication that can double-down the medicinal attack on depression? Abilify, anyone?

I don’t mean to mock the use of medication in attacking depression. Anything that helps is a God-send to depression sufferers. Even in its mildest form, depression is a bleak experience. Classically, the sufferer thinks little of him or herself and little of their prospects in the world. It’s this mindset that consigns people with depression to lives of limitation. They can’t see what they’re capable of, and they can’t see the opportunities they have. Their minds are depressed; their lives are compressed. Even those who manage impressive achievements might never be able to acknowledge them in a way that nourishes them emotionally. Nothing they do seems to be enough, and nothing reassures them that they can achieve more. Each new venture is begun in doubt. They might succeed, they believe, but the process will be a slog. What can help them live more confidently and take more from what they do in life? Is the answer in medication? Can medication help them see themselves and life in a truer light? Well, studies show that common antidepressants might work for less than half the people prescribed them. And, meanwhile, scientists can’t claim with certainty that there is a gene driving depression or if there is a drug that can reach that gene and “cure” depression.

Fact is, nearly 25 years after Prozac arrived on the drug market amid great fanfare and hope, depression remains a mystery to society at large. And it is just as great a mystery to the researchers seeking an answer to depression in a person’s physical being alone — in the brain, in genes, in chemistry. Even if the biological researchers find a magic bullet, how long will it take them? Shouldn’t we be focused on helping those who suffer from depression in the here and now? Shouldn’t they live each day as fully as possible?

Again, I mean no knock to medicine and medication. My concern is that medication is marketed in a way that talk therapy, psychotherapy, never has been. Its bold advertisement and claims overshadow psychotherapy and create a cultural bias that favors medication as the answer, and a quick one. Despite studies showing its effectiveness in relieving depression, talk therapy is not touted in television commercials like antidepressant medication is. I think few psychotherapists would want that. Psychotherapy is a warm, person-to-person endeavor. The atmosphere of the therapy setting is a quiet, intimate one. Hard to conceive that psychotherapy would not be perceived by the public in an unfavorable way if boasts of its intimately-derived benefits were beamed into living rooms in TV advertisements, as the purported benefits of antidepressant medication are. How distrustful might a prospective client be if talk therapy marketed itself with such volume and simplicity — with a message equal to that of medication advertisements which say, simply take a pill and wash it down with a glass of water?

Trust is central to psychotherapy’s effectiveness. It works to a great degree because it offers the warmth of company, of belonging, of being seen as worthy and valuable by the therapist sitting across from you.To the person suffering the gloom and limitation of depression, the therapist is like a lighthouse in the dark, guiding the sufferer in a time when they are directionless because they see no hope, and motivating them toward even the smallest first step to healthy change. The art of it is to bring about that motivation with comforting and restorative discussion, using study-proven techniques along the way that lead to a change in thinking and behavior. The goal is to help those who suffer from depression to achieve a new appreciation of themselves and their prospects in the world. Can a medication of any kind achieve that?