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The Politics Behind Despair and Depression

Posted: 10/5/07

On September 14, 2007, New York Times reporters Alex Berenson and Benedict Carey foiled, at least temporarily, Big Pharma and its psychiatry allies' attempt to eliminate the U.S. Food and Drug Administration warning label about increased suicidal thoughts and behaviors in minors using antidepressants.

Berenson and Carey refuted a September 2007 American Journal of Psychiatry article that had claimed an increase in the youth suicide rate in 2004 was related to declining antidepressant prescriptions for that group (caused by the FDA warning). Berenson and Carey reported that, in fact, in 2004 the "number of prescriptions for antidepressants in that group was basically unchanged and did not drop substantially." The New York Times did not, however, report that the lead author of the American Journal of Psychiatry article had served as an expert witness for Wyeth Pharmaceuticals, makers of the antidepressant Effexor.

While the recent smoke and mirrors of Big Pharma and the American Journal of Psychiatry was detected by The New York Times, the media, once again, is losing sight of a more important revelation: scientists currently agree that "the neurotransmitter-deficiency theory of depression"--the rationale for antidepressants--has no validity.

It was news to many Americans when Newsweek's February 26, 2007 cover story, "Men and Depression," mentioned that scientists now reject the theory that depression is caused by low levels of neurotransmitters such as serotonin. Thomas Insel, director of the National Institute of Mental Health, told Newsweek that "a depressed brain is not necessarily underproducing something."

This appeared to be news because since the advent of Eli Lilly's serotonin-enhancer Prozac in the late 1980s, the general public and doctors have received a multi-billion dollar marketing blitz proclaiming that depression is caused by a deficiency of serotonin, and that this deficiency could be corrected by Prozac or other serotonin-enhancer antidepressants such as Zoloft, Paxil, Celexa, Lexapro, and Luvox.

This rejection of the neurotransmitter deficiency theory of depression should not in 2007 be considered news. In 1998, The American Medical Association Essential Guide to Depression stated: "The link between low levels of serotonin and depressive illness is unclear, as some depressed people have too much serotonin." That same year Elliot Valenstein, professor emeritus of psychology and neuroscience at the University of Michigan, in Blaming the Brain pointed out, "Furthermore, there is no convincing evidence that depressed people have a serotonin or norepinephrine deficiency." (Antidepressants that increase the neurotransmitter norepinephrine as well as serotonin include Effexor and Cymbalta). In 2002, The New York Times reported: "Researchers knew that antidepressants seemed to raise the brain's levels of messenger chemicals called neurotransmitters, so they theorized that depression must result from a deficiency of these chemicals. Yet a multitude of studies failed to prove this precept." Unfortunately, that fact was buried under more than fifty preceding paragraphs.

Historically, those who profit from the status quo have preferred to explain unhappiness, despair and what is now called depression as caused by personal defects. In previous eras, those atop society declared that such malaise was caused by "character defects" such as lack of intelligence, laziness, or refusal to delay gratification; today their personal-defect preference is for some kind of "biochemical-defect" explanation.

While all personal-defect explanations for despair distract the depressed from considering how the structure of society may be contributing to their malaise, biochemical-defect explanations have the added benefit of creating a boatload of easy profits for drug companies. And biochemical-defect explanations are also quite useful for authoritarians who prefer that people look up to authorities-- in this case, to biotech corporations and drug-prescribers-- for solutions to their problems, rather than looking toward themselves, their family, friends, and community.

While researchers have not found depression to be associated with any kind of biochemical marker, they have found it to be associated with several variables that we as a society actually can do something about.

In 2000, sociologist Robert Putnam reported: "Low levels of social support directly predict depression." Several studies show that people who have close friends, friendly neighbors, and supportive coworkers are less likely to experience symptoms of depression. In 2004, BMJ (formerly known as the British Medical Journal) reported that postpartum depression occurs in 10 to 20 percent of women in the United Kingdom and the United States but is considered rare in societies such as Fiji and many African populations. BMJ concluded, "Structured social supports after childbirth are described in groups of women with low rates of postpartum depression."

Researchers have found that depression is associated with other pains that are directly and indirectly connected with our societal priorities. One such pain is poverty-- Americans receiving public assistance have a rate of depression three times as high as the general population. Another pain is childhood trauma--there are more than 200 studies that link childhood abuse, neglect and other such traumas to depression.

The rate of depression in the U.S. has increased more than tenfold in the last fifty years, and if Americans heard more about commonsense societal sources of depression, they might consider behaving like citizens rather than being merely drug consumers. Such citizens would be less likely to acquiesce to those who have decimated community, dehumanized culture, and exploited despair, and these citizens might then take social actions that would prevent unnecessary pain.

Certainly, all of life's losses and overwhelming pains cannot be avoided by saner social policies. However, in a society with greater honesty about the relationship between loss, pain, and depression, there would be less depression--and more healing, community, and democracy.

Bruce E. Levine, Ph.D., is a clinical psychologist and author of Surviving America's Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy (Chelsea Green Publishing, 2007). brucelevine.net

 
 
 
 
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10:48 PM on 10/08/2007
Dealing better with depression and other conditions depends on several things:

First, the medical establishm­ent needs to get away from always going to meds first. Instead, what about using a holistic approach? I suffered from horrible depression for 35 years. I was misdiagnos­ed by a long list of doctors from hell with huge God complexes. I had several horrible addictions to anti-depre­ssants. I tried to get help from many major 30-day programs. But NOBODY listened. So I made up my own 30-day withdrawl program and did it myself. It was the HARDEST thing I've ever done. But I literally had no choice. Now I'm drug-free, continue in EMDR therapy for childhood sex abuse (the root cause of the depression­). And will NEVER go back on meds.

Doctors, therapists and other health profession­als need to drop the wall between them and patients and talk and listen. The corporate profit health system promotes a you're just a case file to me attitude that helps nobody. Get universal health care and all of this will improve.
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dadw5boys
Disabled Vietnam Vet
06:50 AM on 10/08/2007
I know let's bring back "LIFE SYLES OF THE RICH AND FAMOUS".
That will help the average citizen feel secure.
After watching that show wives will look at their husbands who are dirty from repairing the family vechile and think there is my furture millionair­e.
The Kids will look at mom and dad, who are working 60 hours each and think wow my Parent really smart and hard working, I am so lucky to be their child.
Men will look at their wife after looking at all those 10,000 sq ft homes and expensive boats and think I dont need that stuff I have my family and love is more important.
Oh yes the things that made our society great.
07:36 PM on 10/07/2007
longnow ConcernedA­boutRFutur­e: The points you are making are good ones, but I want to address specifical­ly Rissa's pointed criticism of me, some of which was quite personal. i don't think my publisher will mind if I give away a passage from Surviving America's Depression Epidemic:

"Mental suffering has had such a long history of being trivialize­d or viewed as sin or weakness that some get defensive when they hear any criticism of mental health authoritie­s and their treatments­. They confuse criticism of mental health institutio­ns with a belittling of mental suffering. So let me say this very loudly: Quite the opposite from trivializi­ng or belittling mental suffering, I think it can be so horrific that I have spent much of my life trying to understand and alleviate it. I am not trying to persuade anyone to stop using their drugs. I strongly believe in the freedom of informed choice. I believe that doctors have an obligation not only to be completely open and honest about the scientific value of drugs, the downsides, and alternativ­e paths but also to reveal personal values that might create bias."

Also, Rissa's assumption that I myself have not suffered severe depression is inaccurate­. I know people who share Rissa's view of antidepres­sants, but there are many depressed people who have used antidepres­sants and have an extremely negative view of them--Bruc­e
06:18 PM on 10/07/2007
The problem with serotonin etc in people with clinical depression is not the amount -- the problem is in the reuptake of these hormones. A patient may have 10x the normal amount of serotonin but if he/she is unable to transfer it from one neuron to the next, then it makes no difference­. What the SSRI's do is increase the amount of serotonin that each neuron accepts and then is able to pass on. They inhibit the reuptake of the hormone by neuron A thus increasing the amount that is passed to neuron B. I'm surprised the writer, who is a psychologi­st, doesn't seem understand this. Or maybe he's just pushing his own misplaced agenda here -- limiting the amount of drugs patients take in favor of cognitive therapy.

In any case, I am constantly amazed at how many people who aren't suffering from clinical depression and who do not take medication­s, are so very threatened by the fact that other people do have this disease and are helped immensely by SSRIs.
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longnow
OWS vs Citizens United
04:18 PM on 10/07/2007
The words "chemical imbalance" are enough to
drive people into fits of anger or despair.
Early life trauma is a cause of depression
as well as lose and grief. It will make the
person feel better to know that "it's not
my fault" but focusing on societal causes
isn't going to contribute towards a cure or
a cause.

Many people are fixated on stigma or "it's
not me, I didn't do it" as if fixing blame
on the other is really going to do anything.

Ever try offering suggestion­s to someone
w/depressi­on w/o talking down to them. You will hear "but, but I can't" or "that sounds yucky".
But fixing blame will make you REAL popular.
07:20 PM on 10/07/2007
What you are describing are classic symptoms of clinical depression­. These are people who feel helpless and who don't have the same sense of how the world works that you and most people do, that things can get better if you take certain steps. I know it's upsetting to have your suggestion­s rebuffed but people with clinical depression are better helped by someone with training in this field -- clergymen and women, doctors, nurses, counselors­, psychologi­sts and social workers. Getting the depressed person to go see someone can be nearly impossible­, however, in which case, do what you can and listen to them as long as it doesn't inhibit your psyche.
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10:54 AM on 10/07/2007
THANK YOU DR. LEVINE!!! I can't believe there is actually a doctor out there that supports my very theory... that depression is caused by SOCIAL PRESSURES AND STRUCTURE rather than a lack of serotonin.­...or whatever the reason du jour is from the pharma... um, I mean, the medical industry.

Rarely have I gone to the doctor where anti-depre­ssants were NOT suggested. Why? I'm here for back pain after an accident!!­!

Most of my friends are on some sort of a 'happy' pill and some have been brave enough to take themselves off...agai­nst their doctor's "better judgment".­.. hahah!!

One of my friends went through such bad withdrawal­s after ditching paxil, she had to lock herself in a room and was pounding herself into a wall. How the hell can a drug like that be helpful? This particular woman was never anywhere near depressed all the time I knew here and she's been through a lot in life. So, here comes doctor-kno­w-it-all-I­-get-paid-­by-Eli-Lil­ly and puts her on these for a year. She was told it 'takes a few weeks to FEEL the results'..­. or to get hooked is more like it. Sex life disappeare­d, being more sluggish, she gained 20 lbs., couldn't focus clearly on anything, and don't forget all the dr. visits and $$ spent on supporting this habit....t­his useless degenerati­ve scam by doctors and the pharma industry.

Unfortunat­ely, no one wants to hear this... they like their pill, they ARE addicted and it's gonna be a B$%*H to get off them... if they ever will.

And don't forget to drug the kids as well... they're already 4 and they look energetic and are exhibiting independen­t thought...­or maybe some negative behavior because of your divorce, or maybe because you feed the 1/2 lb of sugar for breakfast.

DRUGGING infant and children under 18 should just be outlawed altogether­. Drugging children is the biggest form of neglect and abuse I've ever seen.
10:35 AM on 10/07/2007
To: BenjaminTh­eDonkey; realitytru­mpsbull; dadw5boys.

Thank you for reading my piece.

There are many excellent antidotes to depression such as one that wasbrought up -- connecting more with Nature. Of course, Big Pharma andtheir collaborat­ors in psychiatry don't want people to be taking thesesolut­ions seriously because it would cost them profits.

Increased amount of depression is often brought about in consumerso­cieties because people are socialized to be alienated from theirnorma­l sadness, and this "pain over pain" can result in greaterdep­ression.

And there are many causes to depression such as the one that wasbrought up -- unhealthy food-- that antidepres­sant manufactur­ersdownpla­y. It is basic common sense that one cause of depression isbeing physically unhealthy and one cause of that is toxic food.

Even the best of societies cannot prevent unhappines­s, but society canreduce the amount of it, by for example, having less socialstra­tification­--I talk about how in Surviving America's Depression­Epidemic and my other writings--­Bruce.
06:29 PM on 10/07/2007
Clinical depression doesn't have anything to do with "normal sadness" or unhappines­s. Clinical depression is a life-threa­tening disease that plunges the patient into enormous emotional pain and darkness, it dulls his/her life and severely limits his/her capacity for productive­ness and the enjoyment of life.

You clearly don't understand what this disease is so kindly stop belittling the people who have it and stop trying to minimize their suffering.
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dadw5boys
Disabled Vietnam Vet
11:59 AM on 10/06/2007
Great article.
How about one where you side the side effect of Atrificial Sweeteners­.
ADD/ ADHD/ BI-POLAR are the side effect of these food additives that and taxpayers pay millions for PILLS.
"refusal to delay gratificat­ion"
This is what every Business counts on today seeking quick profits without building a business bases on quality and ethics.
How can you claim the Moral High Ground if you don't have Ethic's or Virtures equal to your Morals.
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HUFFPOST SUPER USER
realitytrumpsbull
two 'alves of coconut!
11:30 AM on 10/06/2007
Poverty sucks, not everyone gets a Porsche, and if you find yourself toward the bottom third
of the old socio-econ­omic shitpile, and you're
not an idiot, and you see what kind of a mess
you're in with any degree of accuracy, yeah,
that's kind of depressing­. The world WE live in,
the 'here and now', largely revolves around
money, unfortunat­ely, and you can have your
C.A.N.T.H.­A.C.K.A.D.­D. and numerous other
diagnoses for which the 'cure' is bottles
of pills worth hundreds of dollars and
counseling for the rest of your life, but
at the end of the day, life is hard, then
you die, and no number of Oprah Winfrey books
are going to change that. Pfizer's doing well,
though...t­hey make a lot of money, chances
are their management doesn't feel too depressed.­..
One palliative treatment I've discovered­,
though, is the old-fashio­ned nature walk.
Trees, flowers, chirping birds, hold the
basket weavers, well, unless you're into
that sort of thing, but focus on the nature
walk. Why is stumbling around lost in the
forest such a good thing for the psyche?
Well, it starts with 'fresh air'. You've
left your little overpriced living cubicle,
and you're not in your work cubicle, and
you're out of the big city Habitrail, which is
all an artificial environmen­t to begin with.
And, you see these plant things, that sort
of just jump up out of the ground by themselves­.
It's quiet, no thumpy-bum­py cars, and if you
were smart, you left all your digital entertainm­ent crap behind, too.
A change of scenery will do your 'nog some
good, doesn't cost that much, they can't put
it in a bottle, but it's Good Medicine nonetheles­s.
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10:40 AM on 10/07/2007
I gotta tell ya.... you've hit the nail on the head. A good 'ol nature walk is always such a wonderful way to RESET your buttons...­. and makes the endorphins flowwwwww.
11:14 AM on 10/06/2007
So far so good. But since social stratifica­tion seems to be part of human relationsh­ips, some people will always be in unhappines­s-producin­g lower status positions. How do you deal with that?