After examining the debate about antidepressants, I found two clear distinct rhetorics; one of rationalism and one of humanism. Both elements of argument do not serve those that matter the most in this debate, the millions of people who are taking antidepressants. The old one size fits all "cure" for the disorder known as depression came straight out of the flawed neuroscience. The idea of a "chemical imbalance" was originally a rational explanation for what in our brains affects our mood. An entire industry of psychopharmacology was built around the idea of a serotonin deficiency in the brains of the depressed. SSRIs were necessary to put patients back into "balance." This mini paradigm within neuroscience and the rational view of science itself seemed to have framed the serotonin hypothesis as a causal factor for the condition. This opens up a new world of psychiatric treatment for varied degrees of depression.
As the rationalism of neuroscience prevails over this mini paradigm and the concrete evidence shows that "chemical imbalance" is not valid, proposing new theories of how the brain functions in regard to mood, the tendency is to render antidepressants, SSRIs void of any actual benefit in treating depression. The dangers of side effects and the studies showing their ineffectiveness have emerged(even if they have been there for decades) to suggest a shift within the science. The field of Psychiatry takes a more humanistic approach. The nature of this science one can argue is of treatment. If the goal of the psychiatrist is to best treat the symptoms of depression then he or she must opt for what works. Some studies have shown the benefits of antidepressants on patients and professionals have attested the merits of prescribing them for treatment coupled with talk therapy. Just as there is no one causal factor for Major Depressive Disorder in the field of psychiatry, there is no one single cure either. Each patient must be evaluated individually in order to assess the best treatment, even in that means giving them an antidepressant with no benefit other than a placebo effect.
The problem with this more humanistic approach of psychiatry is that it perpetuates the myth of the chemical imbalance. With seventeen million people currently taking antidepressants one might think an epidemic of chronic Major Depressive Disorder had broken out... and maybe it has in a way. As I discuss briefly in my essay, there are written accounts of depression or "melancholia" dating back to ancient Mesopotamia. Through history some of the assessments were of a spiritual nature claiming that the chronically morose were plagued by demons. But non medicinal treatments for the milder forms of melancholia are not much different than today; physical exercise, a change in diet, meditation ora form of talk therapy(prayer, confession). These require a change in lifestyle and an ability to confront and express one's own emotions. In our society most people commonly accept the idea that depression is an imbalance in your brain. If there is a quick fix for the everyday sadness that accompanies loss then why would a depressed person navigating a difficult time in their life not ask their doctor about Prozac. The pharmaceutical industry has a big incentive to keep people using the scientifically disproven description of depression as a chemical imbalance. The more people self-diagnosing themselves as depressed, the happier they are with their bottom line.
*Cymbalta is the highest selling antidepressant drug on the market. Check out how much revenue it has made for Eli Lilly each year for the the last five years. Yes those figures are in the billions.
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