Independent and unbiased blog about a wide range of depression-related topics
As we all know, the pharmaceutical industry can keep the price of antidepressants artificially high because for the time being, their patents give them a monopoly.
But what will happen in the future, when these patents expire?
Something like this?
• source: a 1928 ad for LUDEN’S MENTHOL COUGH DROPS.
If you Google for the truth about depression, you’ll be amazed: you get over 12 million results. Looking for the exact phrase (in quotes) will still get you nearly 50,000 results.
But frankly, when any website promises me “the truth about depression”, my first reaction is one of wariness. What do they mean, the truth? I estimate that at least a thousand contradictory “truths” about depression can be found online, and I’m still counting. ;-)
The nice thing about this multitude of truths is that if you’re suffering from some kind of serious depression, at first sight it looks like without much effort you can pick your own “truth about depression”: a truth (and a theory) that best suits you.
Of course the bad side of this is that many of us tend to adopt one “truth about depression” that is easy on them. A “truth” that can serve as an excuse, that is not demanding. A “truth” that suggests one simple solution to explain and solve everything. One that avoids confrontation with yourself or with others.
But in harsh daily-life reality, a one-size-fits-all “truth about depression” simply does not exist. Even though you can find a thousand different “truths about depression” online, there will be no single ready-made “truth” among them that will happen to fit you perfectly. And this is why so many well-meaning self-help depression websites often prove, from our own personal perspective, inadequate or even useless. They’re simply too general. Like a pair of shoes too big or too narrow for our own uniquely shaped feet.
According to global health statistics, at least 600 million people on this planet are seriously depressed. So in a way, we can assume there are 600 million individual depression truths: 600 million personal depression stories.
Of course all those depressed people do share some similar traits and symptoms and experiences. If that were not the case, then the word “depression” would be just a meaningless empty shell.
But this common definition is by necessity very general. In order to be applicable and shared by us all, it has to be flat.
What we really need to find out is not some general prefabricated “truth about depression”, but the truth about our own depression.
If we assume that all individual depression “truths” are like different constructions made of little Lego bricks, then the common, shared base definition of depression is like a Lego base board, on top of which we each have to reconstruct our own personal depression maze using our own particular depression bricks.
So what you would need to do is collect an imaginary box full of loose Lego bricks, all sizes and shapes and colors, that represent all kinds of problems people can have. And next, you would need to use and combine those bricks to painstakingly – with trial and error – reconstruct the maze (the shapes and corners and dead ends and pathways) of your own individual depression truth: all on top of the flat general base definition.
And you know what? This is exactly what, sometimes, a good therapist can help us to do. Reconstructing, by bits and pieces, a more complete and precise picture of our own specific personal depression situation. Analyzing what in our own individual case might be depression causes and potential solutions – ways out of the maze. Working together to slowly find out, define, recognize what might be your own depression truth.
To switch back to the shoes metaphor: on the internet you may at best find yourself some not-quite-fitting shoes; and when you try using those to walk out of your depression, those ill-fitting shoes may give you blisters, may only worsen your problems. A good, personal therapist may (after some complex measuring) help you to get a pair of well-fitting shoes. Shoes that really befit your own special depression truth, and that in the end may enable you to walk all the way to a better place.
In short: it does not always make sense to keep seeking online for that one final, definitive, complete, all-solving “truth about depression”. Such a truth does not exist. And of the many different “truths about depression” that are offered online, none may really fit your own situation. It may be better to go simply for a little bit of “truth about yourself”. If possible, with the help of someone (a therapist or a friend) who knows not just about depression, but also about you.
• Even shorter: when browsing for online advice, never forget that you (and your depression) are unique.
There are many ways to sabotage, blow up, completely ruin your psychotherapy before even giving it a chance to start properly. One of the best and most popular ways to do so is viewing your therapist (even before you’ve actually met him or her) as someone threatening you, threatening the status quo, threatening to destruct the core of your personality.
In other words, you tend to see your therapist as someone to be afraid of. So consciously or subconsciously, you prepare for a therapy session as for a defensive fight:
Last week, psychologist Ryan Howes wrote a nice satirical post at Psychology Today: Seven Mistakes Therapy Clients Make – How to sabotage your therapy. He suggested not just one, but seven common ways to make sure your therapy will fail:
1. Rush to Choose;
2. Don’t Ask;
3. Lie/Withhold/Downplay/Avoid/Obfuscate;
4. Communicate through hints, riddles, gestures, or tokens;
5. Triangulate;
6. Compartmentalize;
7. Vanish.
What exactly does he mean with all this? Well, I’m not going to rewrite or rephrase Howes’ thoughts here. Please do read his full post to learn more about these seven brilliant strategies to achieve total therapeutic failure!
Just let me add that the same Ryan Howes also has a post at Psychology Today that is not satirical but serious: 21 Tips for Clients in Psychotherapy – What should you talk about in therapy? I suggest you read this post by him as well. Maybe you’ll find some points there worth considering.
One important thing that Howes didn’t go into, was the obvious (but also potentially painful) question of exactly why we would sometimes want to sabotage our own therapy. There are several different answers possible here. To highlight just three of them:
One reason may be just plain conservatism or lack of energy: you’re afraid of any kind of change, or you feel not up to trying something new.
Another reason may be an irrational fear to lose your identity: if you got used to define yourself primarily as “a person suffering from depression” and a therapist would take away that depression, then what would you be left with? An empty shell?
Yet another reason, often suggested by so-called evolutionary psychologists, may be a subconscious fear that with a successful therapy you might lose not just the nasty effects of your depression, but also some perceived perks of depression (like not having to work, or having a valid excuse to withdraw from company).
I’ll get back to this in a future post about those “perks” of depression: for this is a subject that deserves a honest discussion in its own right. Anyway I feel that much of this is based on misunderstanding. Those “perks” are misunderstood by others (who sometimes may wrongly think we simulate depression as a kind of excuse, while in fact we are really and involuntarily suffering from it). But they are also often misunderstood by ourselves (when we tend to accept such “perks” while in fact we should reject them as negative, destructive temptations inherent to depression).
To get back to the question why we might feel inclined to sabotage psychotherapy: what is the best general answer? I guess the basic cause is fear: any kind of fear that successful therapy might take away something we cannot afford to lose. And if you try to think rationally about this, you’ll come to the conclusion that such fear is nonsense.
The well-known folk singer Melanie (Melanie Safka, do take a look at her official Melanie website) once sarcastically criticized old-fashioned Freudian therapy in her song Psychotherapy. Not coincidentally she borrowed her tune from the Battle Hymn of the Republic: this is indeed a battle song, fighting psychotherapy.
Sure, there is truth in some of Melanie’s biting comments. But frankly, I myself cannot help wondering: was she perhaps also singing about her own irrational fear of psychotherapy? Judge for yourself.
(click the “Play” button – if it does not work, install Flash)
• tip: It really makes no sense to sabotage your own therapy. Ask yourself if you see your therapist as someone to be afraid of, as some kind of adversary. Does your therapy feel like a fight instead of the joint effort it should be?
If the answer is yes, then something is wrong. Now ask yourself: why? Of course you may simply have chosen the wrong therapist. But maybe it’s just your own attitude? Try to see your therapist not as a threat, but as someone who’s trying to help you.
• footnote 1 : The “Training For Psychotherapy” image showing Rorona Zoro: with credits to Nemesis X at the Killermovies.com Forum.
• footnote 2 : The “Sure I want to fight” image: adapted from a 1950s Cold War poster, original text was “Sure I want to fight Communism – but how?”
I wish I could say that for the past few weeks nothing happened here on this blog because I was away on a wonderful vacation in sunny France. The truth, I’m afraid, is that I’ve been far too depressed to write a single word. Luckily, I’m recovering now.
So how to celebrate my return to the land of the living?
Well, to go a little easy on myself, here is another image from my collection of old pharmaceutical advertisements. Showing how in the good old days, pharmaceutical companies tried to convince psychiatrists of the magical qualities of their newly-invented medicines.
Often, what strikes us today in these old ads is that they demonstrated little respect for the patients for whom the medication was intended. In many cases, these ads tried to visualize mental illness in ways that we nowadays would find crude or even disturbing. For another example, see the Nembutal ad here.
Below is a circa 1960 advertisement for Thorazine (American brand name; known in Europe as Largactil). Based on chlorpromazine hydrochloride, it was introduced in the 1950s as a calming antipsychotic drug and quickly became very popular. Psychiatrists were happy to prescribe it to patients with psychotic tendencies.
I will let the ad speak for itself:
With this frightening ad, the people of “Smith Kline & French Laboratories, leaders in psychopharmaceutical research”, wanted to show what they thought psychosis did look like.
Shall we try to find a musical equivalent? How would it sound?
Maybe the Finnish rock band Poets of the Fall has something that comes close to an answer. If you want to know more about them and hear more of their fascinating music, please go to their official Poets of the Fall website.
This is just their song Psychosis from their 2008 album Revolution Roulette – and if you feel inclined to complain that it doesn’t sound soft and sweet, the answer is of course that this really shouldn’t sound soft and sweet:
(click the “Play” button – if it does not work, install Flash)
There are still ignorant people who maintain that depression is just the result of a personal character weakness, and therefore is just one’s own fault. They ignore all modern research into the complex causes and mechanisms of depression. By claiming that this “weakness” can easily be corrected by a simple change of attitude, in fact they only make matters worse by grotesquely stigmatizing everyone who suffers from depression.
Some people make matters even worse by perversely distorting and misusing religion to corroborate such primitive views. Of course I won’t deny that for many of us, religion can be a source of comfort and support. Sure! But these fanatics turn religion into a kind of Snake Oil that is supposed to forcefully and instantly drive out the Devil of Depression.
One of them is the English evangelist Malcolm Bowden, who recently was interviewed on TV about his bigoted views on depression (and other forms of mental illness, including schizophrenia).
On his website, he claims that depression is just the consequence of patients having “taken one or more evasive and bad decisions that are rooted in their pride, self-centredness and self-pity. [...] Their basic problem is their wrong attitude to life and the problems are of their own making.”
Well, Bowden’s unique “True Biblical Counseling” will solve all problems! But in fact, it will of course make things only worse: by not taking depression seriously and by reinforcing negative, unnecessary feelings of guilt.
I’m glad I don’t need to go further into all this because yesterday, Emily Band wrote an excellent article in The Guardian newspaper about Bowden and his caricatural, prejudiced and (my addition) potentially life-endangering views. You can find her article here: Sorry, but Christianity doesn’t cure depression. Please do read what she has to say!
I want to add only this.
Extremists like Bowden do not only fail to take depression seriously as an illness that can happen to anyone of us. They also do not take religion seriously, by distorting it, by robbing it of some of its essential core values: compassion, understanding, and true involvement with others.
Again: sure, religion can be a source of comfort and support to many of us. But in Bowden’s caricature of religion, depression becomes a kind of sin. This is a cruel distortion of religion.
Do you know what this reminds me of? It’s like someone preaching (1) “That you lost your leg when this speeding truck ran over you, is all your own fault;” and (2) “Just by repentance and prayer you can regrow your amputated leg;” and (3) “If your amputated leg doesn’t regrow, it’s because you don’t pray enough, so that’s your fault, too.”
This is not religion. This is not even respectful to religion, just as it isn’t respectful to people. This kind of thinking is more akin to the evil swindle of medieval witchcraft.
It’s high time we leave the Middle Ages behind us. Once and for all.
• tip: No one of us has chosen to be struck down by depression. A little self-criticism can certainly be constructive and enlightening; sometimes it can be good to ask yourself if there are some things you also have to blame yourself for.
But it is fundamentally wrong and very self-destructive to blame yourself for your depression as a whole.
• update. To prevent misunderstandings: of course with the metaphor I used here, I did not mean to say that severe depression is just as irreversible and definitive as an amputated leg…
Please don’t worry. This is not going to be some kind of dumb rant against pills or the pharmaceutical industry. I just want to show you how what was considered normal in psychiatric health care 50 years ago, is seen a very different light by us today.
And by implication, how what we now think is normal, may be considered weird 50 years from now.
50 years ago, a popular tranquilizer was the drug Nembutal. It is based on pentobarbital, which as a barbiturate is rather dangerous. It’s not only addictive, easily creating drug-dependency. An actual overdose will simply be lethal. It has long remained in use as a strong tranquilizer, for example to reduce anxiety. But in modern psychiatry it has largely been replaced by other, hopefully less dangerous drugs. It is now mainly being used by veterinarians: for euthanizing animals.
In the USA, it has recently also been used as a simple way to carry out executions, replacing more complex mixtures of lethal drugs. In March 2011, Ohio prison inmate Johnnie Baston was the first to be executed by a single-drug dose of pentobarbital (see this Washington Post article). In July 2011, when already 18 people had been executed in this way, the Danish pentobarbital producer Lundbeck announced that it would no longer accept the use of its drug for execution purposes (see this Guardian article).
Flashback to 50 years ago. Here is an old advertisement that shows how back then, this same drug was promoted (and used) for psychiatric treatment of children:
For us today, this advertisement looks just weird. Not just because it presents the use of Nembutal to tranquilize children as something normal. It also looks weird by itself.
It shows a friendly slogan “when gentleness is important”. But this strangely conflicts with the crude, caricatural, in modern eyes almost disrespectful and disturbing way the child is depicted in the image. The kid looks like a little Frankenstein, a little monster. One look at him and we’re supposed to understand immediately why, yes of course, this boy does need a gentle Nembutal treatment, real quick, before he… (fill in your darkest Dracula fantasies here).
I’ll happily leave all other interpretations of this weird advertisement to you.
Now, instead of flashing back 50 years, flash forward, to 50 years from now. To 2062. How will people then look back to today’s practices of easily diagnosing unruly, not-concentrated children as “ADHD” and sedating them with medication, instead of taking adequate educational steps?
Frankly – Frankensteinly – I think those people in the future will find this way of treating children just as unbelievable and weird, as we find this old Nembutal advertisement.
We can repeat this same time-travel thought experiment for many other primitive practices within psychiatry, such as the still far too easy and liberal use of electroshocks. What will people in 2062 think of the fact that I, a depression patient, got electroshocks even after I got a heart failure during one of those treatments?
There are many more examples of still-existing psychiatric primitiveness: again, I’ll leave this little bit of thinking to you.
The point is: if we can clearly guess how 50 years from now people will find us weird, then why should we wait those 50 more years before making some simple, obvious improvements in psychiatry? Let’s be a little more critical about what we’re doing today! Let’s work a little harder! Let that future begin now!
• note: OK. I admit, maybe this whole demonstration here was a little on the demagogic side. But in essence, I don’t think it’s untrue.
Maybe I’m just too impatient? And now I come to think of that, would this impatience be one more cause of depression?
June 19, 1783 –
Birth date of German pharmacist Friedrich Sertürner, who in 1803 (formally a year before his French competitor Armand Séguin) discovered a way to isolate the alkaloid (the active component) from the opium plant.
He named the resulting substance “Morphium” after Morpheus, the ancient Greek god of sleep and dreams. In due course it became known as morphine. Later (around 1900) the German firm Bayer would develop a stronger semi-synthetic variety: heroin.
Morphine soon became popular as a pain killer, for example when practicing surgery on wounded soldiers – who then found out it was highly addictive.
While working as a pharmacist in Hameln from 1822 until his death in 1841, Sertürner suffered much from depression, which he tried to overcome by using morphine. So he ended up addicted to the drug he had invented himself.
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