|
By
Nathaniel
S. Lehrman, MD
Psychiatry
And The Growth Of Depression
Depression has
become very big. Feelings of "helplessness, loss of hope,
sadness, crying, sleep or appetite disturbances, or difficulty
concentrating, for at least two straight weeks" are sufficient
for the very common diagnosis of "clinical depression."
Over the past half- century, hospitalizations for depression
have increased almost thirty times, from 9.8 per 100,000 in
1943 (in New York, which had more per capita than any other
state) to an estimated 280 per 100,000 (nationally) in 1994.
And that's only
the beginning. Scientists estimated in 1997 that 18 million
Americans suffer severe depression each year, with one in
five of us experiencing a depressive episode during his or
her lifetime (that's 20,000 per 100,000).
Drugs
For Depression
Ann Landers maintained
that 80% of depressions "can be treated successfully
with medication" (listed first), "psychotherapy,
or a combination of both," and noted happily that on
National Depression Screening Day in 1998, more than 85,000
people visited screening sites, with over 70% of them then
"referred for a full evaluation."
Some experts, claiming
that 50 percent of "clinically depressed" people
will have another episode, note that a growing number of doctors
are writing prescriptions for them for years on end. One expert
even insists "there is a subgroup of people who will
stay on medication for the rest of their lives." These
views of depression, based on today's drug-oriented approach
to treatment, conflict almost totally with the experience
of many, including myself, who treated depression successfully
before the drug era began.
It
is estimated that 28 million Americans now take prescribed
(doctor-controlled) anti-depressant medications.
Production of these drugs has consequently become a huge business,
with "global sales estimated at $6 billion a year and
rising." Prozac sales alone amounted to more than $1.7
billion in 1999 - a third of the Eli Lilly and Company's total
business - while prescriptions for its major current competitors,
Zoloft and Paxil, also continue to rise rapidly.
Despite the side-effects
experienced by a quarter of Prozac users, Lilly recently spent
$15 million to advertise the drug directly to the public -
to increase patients' demand for it from their physicians.
And at a time that our churches, moral guides to the nation,
face many grave financial problems, the major backer of the
Public Broadcasting System's "Religion and Ethics Newsweekly"
is the Lilly Foundation.
The
Dangers Of Anti-Depressant Drugs
Although all the
long-term side-effects of these central nervous system drugs
are still not known, those which are known have evoked much
less attention than they should. Anti-depressant drugs' greatest
danger is their evocation of suicidal and/or homicidal feelings
and behavior; both teenagers who attacked their fellow students
at Columbine happened to be taking anti-depressants. Another
danger from "feel-good" drugs is the creation of
dependency or addiction. Many who are hooked will turn to
street drugs since they are cheaper, more available, often
stronger - and under a user's own control, rather than under
a doctor's.
We find ourselves
in this increasingly difficult situation because psychiatry
has badly mishandled depression in its all-consuming reliance
on drugs as the first line of treatment.
Dr.
Nathaniel S. Lehrman is the former Clinical Director of
the Kingsboro Psychiatric Center in Brooklyn, NY
Red
Flags Weekly August 15, 2002
| 