COLUMN: Cure for depression is twofold

Published: Tuesday, November 18, 2003

A recent article in "Mother Jones" ("Is it Prozac or placebo?" December, 2003) investigating the efficacy of prescription drugs questions whether antidepressants like Paxil and Zoloft are truly effective in combating the psychological trauma associated with depression.

The scientific community often leads the public to believe that depression has a biological or genetic root, and this may be true. But a biological predisposition does not necessarily implicate a biological treatment as effective.

Because depression is still primarily considered a psychological disorder, not genetic, efforts to treat it that exclude psychologically trained professionals is clearly counterintuitive; taking prescription medicines designed to alleviate psychological burdens without entering therapy or counseling is tantamount to addressing the symptoms of an ailment without honesty attempting to cure it.

Because studies in neuroscience have been unable to determine if depression is purely biological or if the onset of the disorder is a combination of psychological trauma and biological propensity, to believe that depression can be cured with a little tablet is to completely disregard it as a predominantly psychological syndrome.

According to the article, less than 50 percent of the leading six antidepressants outperform sugar pill placebos in 47 trials. When partnered with a 2002 worldwide gross of $8.3 billion, it seems absurd that the 92 million people given prescriptions in the same year were paying billions for medicine that is statistically hit or miss.

Even more startling is that corroborating data shows antidepressants to have only a 50 percent chance of working on any afflicted person. Further complicating matters, most statistical trials of medication reveal that placebos are only effective 35 to 45 percent of the time. Thus, because of the prevalence of the placebo's power of suggestion, as little as 5 percent of clinically depressed individuals currently taking Prozac or Celexa may actually benefit from the medicine itself versus the idea of medicine.

A major medical concern with antidepressant prescriptions is that doctors with no experience in diagnosing and making prognoses of cognitive and behavioral disorders are given room to do so. Consequently, ill-stricken people seek out the wrong type of doctor to treat them. If you believe you have leukemia, it would not be reasonable to visit an ear, nose and throat specialist. For the same reason, people who are suffering from post-traumatic stress disorder should not be receiving medication from general practitioners - but they do.

Unfortunately, many people are unwilling to enter therapy for fear of social stigmatization. There exists a preconception that when one enters therapy, one is tacitly making an admission of insanity. And, sadly, the anticipated shame of entering therapy is magnified through such films as "Me, Myself and Irene," "Seven," "The Cell" and "Conspiracy Theory." For the most part, the depiction of psychologically disturbed individuals is portrayed as either villainous or humorous, and this is rarely the case. On the flip side, those suffering from biological diseases such as cancer, AIDS or diabetes are always portrayed as victims, and people would much rather be a victim and admit to a biological disease than be viewed as laughable or murderous.

People taking antidepressants who are not in therapy are only superficially addressing a potentially harmful condition. To treat psychological disorders with medicine alone is becoming ubiquitous because it is all too convenient. (Even a podiatrist can prescribe Prozac!) However, using medicine alone in an attempt to break the hold of depression is to treat a staph infection with local anesthesia - the pain may go away, but the infection will only swell and fester until it does some serious damage.



Eric Howerton is an English-philosophy and psychology double major. He can be reached at erichow@unm.edu.