Thursday, August 16, 2012

Medicine for melancholy

Katherine Sharpe here has a deep and rich look at the history of depression as a concept. The idea that melancholy and sadness are in and of themselves a kind of illness, and that they should be treated as such, is fairly new. And as with many things, my own instinct is to follow the money. There is a big profit to be made from psychopharmaceuticals, but to really maximize it, you need a big base of customers. Sort of like how the plastic surgery industry can't simply satisfy itself with burn victims and people born without skin. Sharpe sees more at work, though.
That’s why depression is not a disease like diabetes. Diabetes isn’t a metaphor. It was discovered, not invented. Its cause and nature are known. Depression exists—all those disparate societies acknowledged and named it. But it is among the most conceptually malleable of illnesses. Its borders are fuzzy: at the extreme, depression is eminently disease-like, a true madness, but its mildest forms are fleeting and banal, comprising thoughts and feelings that we’ve all had a taste of. Most of all, perhaps because it affects consciousness, depression cries out for interpretation. Throughout history, each culture has given depression a meaning, or meanings. Each has told a story about it, and the story reflects much about that culture’s values, fears, and aspirations. Chemical imbalance is our chosen story, and it speaks volumes about the way we would like to approach the world.
Breaking thoughts and feelings down into matters of chemistry makes them more manageable, more controllable. What's lost in poetry is, the hope goes, gained in certainty. But that control is quite likely illusory.


susan said...

I've read a number of articles that state the incidence of depression has increased tenfold during the past hundred years. It's easy to joke that there are a lot more reasons to be depressed than there were a long ago but the numbers do seem to be impossible in reality. The major reason for this diagnostic disaster is the fact that Big Pharma got in the drivers seat and lots of psychiatrists suddenly found it was easier to prescribe than to treat mental illness with the sensitivity required.

What we don't want to see is every human thought, feeling and emotion turned into an over-treated disease, disorder or condition. Some mood swings and emotional adjustments are simply normal reactions to life and shouldn't all be labeled depression.

Ben said...

While I know a few psychiatrists to be conscientious people, I'd be leery about seeing one myself. The odds of being put on a drug that's not good for you in the long run are high. I'd only do it if I were in real danger of doing something rash.

Because yes, all sorts of things can seem like a disorder. Subjectively if they happen to you. "Objectively" if you have a professional interest. But they may just be part of being human.