“Depression hurts,” is the tagline of this TV ad for the antidepressant drug Cymbalta. The commercial features a woman who is the picture of dejection. She sits alone, slumped over in the corner of a plaid couch. The pattern begins to stretch over the woman until it virtually covers her. She is literally fading into the background.
Some feel that this image is, far and away, the most accurate of any portrayed in recent major media coverage of a mental illness that affects 17 million Americans each year. Whatever the merits of big pharmaceutical companies spending billions to advertise prescription drugs, the Cymbalta ad, unlike the published articles, puts a human face on depression.
Are Antidepressants Just as Effective as a Placebo?
Major articles in The New York Times, Newsweek and The New Yorker launch an assault on what some researchers claim is the ineffectiveness of antidepressants. They cite the similarity in some studies between recovery rates of subjects on antidepressants and those on placebos (essentially, non-medication sugar pills) – both around 75 percent. Whatever their intent, these three reporters – Sharon Begley in Newsweek, Jonah Lehrer in The New York Times, and Louis Menand in The New Yorker – come within an inch of concluding that depression is “all in your head.”
Newsweek’s Begley says recent information lowers antidepressants to the level of “expensive Tic Tacs.” The Times’s Lehrer sets out on the premise that “depression might be an unpleasant yet adaptive response to affliction...We suffer — we suffer terribly — but we don’t suffer in vain.” Depression allows sufferers to focus on problems by shutting themselves away from the world. In fact, Lehrer’s article is headlined: “Depression’s Upside.”
The New Yorker’s Menand refers to “suspicion that the pharmaceutical industry is cooking the studies that prove that antidepressant drugs are safe and effective, and that the industry’s direct-to-consumer advertising is encouraging people to demand pills to cure conditions that are not diseases (like shyness) or to get through ordinary life problems (like being laid off).”
No Distinction Between Types of Depression
Among primary sources, Menand cites two new books, Manufacturing Depression by Gary Greenberg; and The Emperor’s New Drugs by Irving Kirsch.
Begley focuses on Kirsch’s research over several years. Lehrer begins by building on the tenet that depression may have “a secret purpose and our medical interventions are making a bad situation even worse.” Lehrer centers on the work of Andrew Thomson, a psychiatrist at the University of Virginia, and Paul Andrews, an evolutionary psychologist at Virginia Commonwealth University. The two published a controversial, 36,000-word paper in the July 2009 issue of Psychological Review.
Whether or not they do justice to their sources with their interpretations, some say the three journalists share a glaring omission in their reporting: they do not distinguish sufficiently (if at all) between situational depression and chronic or clinical depression. Feeling depressed over losing your job is far different from chronic or clinical depression, which seems to have no rational basis, no triggering event. To the sufferer, there seems to be no way out – for years at a time.
In addition, there is another issue that none of these reporters address: knowledge of the brain. Some argue that scientists simply do not know enough about how the brain works to make a firm determination of antidepressant efficacy.
Depression as ‘Bitter Mortification' and an 'Endless Loop of Woe’
According to Lehrer, Charles Darwin was afflicted with “bitter mortification” that made him unable to work on one day out of every three. Lehrer concludes that “the pain may actually have accelerated the pace of [Darwin’s] research, allowing him to withdraw from the world and concentrate entirely on his work.”
Yet Lehrer also cites the case of the writer David Foster Wallace, who described depression as “an endless loop of woe.” Wallace was not able to shut out the world and accelerate the pace of his work during his ongoing battle with depression. He hanged himself on September 12, 2008.
This has some wondering, "How is suicide a manifestation of 'a secret purpose' with some personal or evolutionary 'upside?'"
But there is worthwhile investigation and reporting to be found in the media, and perhaps surprisingly again, it is on television. The Public Broadcasting Service put together a three-part series for television (and video) called “This Emotional Life.” The middle segment focuses on depression and its devastating effects on the lives of those who fight an exhaustive daily battle to achieve anything even remotely resembling normalcy – sometimes even to get out of bed each day.
Exploring Real People With Depression in ‘This Emotional Life’
“This Emotional Life” explores the cases of real people with depression – such as the actor and comedian Chevy Chase, afflicted with major, profound depression. Such as a young woman named Caitlin Davies, who ran out of medication options over the years and underwent electroconvulsive therapy (ECT, once described as “shock treatment”) during her senior year in high school.
Studies widely quoted have shown that ECT is effective in about 84 percent of cases that have resisted improvement from medications. Caitlin came back and, despite struggling with her studies initially, made the Dean’s List in college. She continues with antidepressants and psychotherapy.
Whatever research studies show or do not show, those suffering from this life-wasting mental illness are all too aware that “depression hurts.” All the time.
Sources
Sharon Begley, "The Depressing News About Anti-Depressants," published in Newsweek on February 8, 2010
Joanah Lehrer, "Depression's Upside," published in The New York Times on February 28, 2010
Louis Menand, "HEAD CASE: Can psychiatry be a science?" published in The New Yorker on March 1, 2010
Gary Greenberg, Manufacturing Depression, published by Simon & Schuster, New York 2010
Irving Kirsch, The Emperor's New Drugs, published by Basic Books, New York 2009
Mike Perricone - For nearly a decade, I served as Senior Editor and science writer in the Office of Public Affairs at Fermi National Accelerator Laboratory ...
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