Posted by dj on February 19, 2001, at 12:25:17
In reply to Re: ??s raised in Active... » niborr, posted by dj on February 19, 2001, at 12:08:04
There are many interesting, questioning and provocative articles in Salon about mental health and treatments, which one can find by poking about, perhaps starting at:http://search.salon.com/
For example at: http://www.salon.com/health/feature/1999/08/23/depression/index.html is an article by another Dr. Bob (Dr. Robert Burton, who is a neurologist and novelist)who writes that: Many people who claim they are clinically depressed may only be disgruntled and concludes his article with the following commentary/summary which I suspect both Cam and Mr. O'Connor would concur:
"Depression is not about ideas and postures. It isn't about laziness and a languorous desire to spend the day in bed. It is a feeling of sickness. It is brain chemistry gone awry. In someone who is clinically depressed, functional MRI scans would show areas of altered brain metabolism. The spinal fluid might show decreased levels of vital neurotransmitters; there would be alterations in hormonal levels.
But, having said that, we still haven't solved the chicken-and-egg dilemma. Did some psychological malfunction trigger bad feelings that, in turn, triggered the biological response, or was the chemical aberration primary?
If you believe the biochemistry came first, then you opt for anti-depressants. If you think that some psychological malfunction triggered the chemical response, you opt for therapy. Already you can sense the problem of treatment. The patient immediately is subject to his own bias for/against the psychological. Ditto the doctor.
One possible answer is to look for biological markers -- like a strongly positive family history, or a pattern that suggests one of the classical mood disorders, such as a history of manic behavior pointing to a true bipolar (manic-depressive) disorder. Soon there will be more precise genetic markers, maybe even nice neat lab tests that indicate predisposition.
But even if there were such lab tests, would we really understand the triggering mechanisms beyond saying that someone was predisposed? If you knew you had a tendency toward depression, could you control it with therapy, exercise, meditation, mind control, willpower? Or would you opt for the latest serotonin modulator?
There is no easy answer. Not to recognize depression is to misdiagnose a wide variety of chronic complaints (headaches, back pain). To diagnose depression when the problem is based in character is to create a drug-dependent nation. Pretty soon Prozac will be added to public drinking water. To not acknowledge the complex interplay between psyche and chemistry is to abandon any sense of personal responsibility, and create a generation of victims.
At the same time, we must recognize that depression may be beyond a person's control, can be a serious medical problem.
At bottom we are struggling with the very notion of how to define our sense of self. We see our chemicals as not being a part of us; only our psyche counts, is responsible. But this line of reasoning reduces each of us to a machine with a superimposed little man or woman sitting at the top, wearing the driver's hat but not really having a grip on the wheel. It's not a very healthy self-image. It's even a bit depressing."
salon.com | August 23, 1999
poster:dj
thread:4748
URL: http://www.dr-bob.org/babble/social/20010209/msgs/4761.html