Repressing Depression

Much has been written and said over the last few weeks about anti-depressants being the most prescribed drugs for Americans today. The implications are many. The first implication is that depression is being used as a catch-all diagnosis for people who just can't deal with life. The other implication is that anti-depressants are used like candy as a crutch for those who cannot deal with life. Both implications are common stigmas attached to depression and other mental illnesses.

While it may be true that many more people are being treated for depression now than ever before, there are many reasons why. First of all, in the past people were not encouraged to be open and accepting of the results of stress in their lives. People in my parents generation were told to grit their teath and bear it during tough times or told to pull themselves up by their bootstraps when they were sad or down. In those days, people did not openly share their problems with others. Therapy was a new form of treatment not utilized by many people and Psychiatry was still a young science. But more than that, people were taught that it was a sign of weakness or lack of character to complain about their lives or problems. They were told to keep silent about things like sexual abuse, workplace stress, personal shortcomings or weaknesses. So they were repressed and buried. There was no less depression in that generation, just more suffering. People just dealt with it privately or in silence.

Another reason more people are being prescribed anti-depressants is because the treatments work. Many don't know that depression and bi-polar are physical illnesses which are caused by chemical deficiencies in the brain or the lack of certain receptor activity in the brain. Anti-depressants in combination with talk therapy have helped lift many out of depression and given them new hope for life. I know when I was first diagnosed bi-polar, I had no idea I was actually physically ill. I thought it was all just in my head and that everybody lived like me. It took my diagnosis and treatment to help me discover that it was not just personal weakness that gave me suicidal thoughts, the inability to tell or distinguish the truth from what I made up in my own mind, insomnia and severe lethargy. I thought everybody had these things. It wasn't until I was in treatment for several motns and even years that I was able to process, admit and learn how to live with these feelings. Many people who have been affected by my illness have been quite unforgiving, mostly because they don't understand the illness. The good news is that most everybody else in my life have accepted my ilness and gave me the time, space and love to go through a healing process. The meds were a big part of the healing.

Although many primary care doctors will prescribe anti-depressants for people who exhibit symptoms, that should only be the beginning of the process. Referals to psychiatrists, therapists and other mental health professionals must be done and followed up on. Mental health is a medical specialty not unlike cardiology, orthopedics or dermatology. It takes great expertise to diagnose and find the proper therapy. What a PCP might initially see as depression might actually be seen as bi-polar, schizophrenia or anxiety disorder by a psychiatrist. The meds that deal with these specific illnesses are all different and only a specialist can provide the right combinations and dosages. The problem is that most people do not follow up. The PCP prescribes an anti-depression and the treatment stops there. Either the symptoms improve or the crisis passes and nothing more is done. But healing requires the right meds and proper talk therapy solutions to fully take effect.

The other truth is that mental-ilness once diagnosed is never completely cured. Symptoms can come and go or change and only a specialist can track the condition and make adjustments in the treatment plan. But the truth is that there is a negative stigma attached to the practice of psychiatry. If someone goes to a shrink they must be crazy or out of their mind or dangerous. But we have to overcome these misconceptions so people are not afraid to seek help.

Are anti-depressants over prescribed? I don't know for sure, but I consider it a sign that people are choosing to share their symptoms and to no longer suffer in silence and live with despair. If that is the case, then amen to that.