Anti Depressants?...

Carrol Cox cbcox at
Wed Aug 30 11:36:46 PDT 2000

Doug Henwood wrote:

> Reese wrote:
> >You disagree with the approach? Fine, hope you, yours, and everyone
> >else can afford the prescriptions for a problem that predates
> >psychiatry. I'd rather take my dose of reality from a couple laps
> >around the block, than from a pill bottle.
> Isn't it nice you have the choice.

Marta speaks of "ableism," and partly in reaction to multiplying "isms," I've been reluctant to adopt it. But it is looking better and better. The slogan (before the civil-rights movement pretty much killed it) of happy taken-for-granted racism in the United States was "free, white, and twenty-one." Squeaks and howls about "political correctness" are mostly mourning for this lost paradise of racism, in which one could unselfconsciously preen oneself on the moral superiority of whiteness. As Doug's comment brings out, Reese exults in his freedom from illness just as the white racist exults in his/her white skin. I think we should accept Marta's proposed ism, and award it the same honor we award blatant racism and sexism. One might add, that even for those who are helped by exercise it takes a good deal more than a couple of laps around the block to have any effect. My merely personal experience is that it takes around a minimum of five hours of aerobics and at least two hours of weight lifting a week to be of much. A minority of those suffering from depression find that exercise is counter productive, and a somewhat larger minority find that it has no effect either way. (It was Reese's easy assumption that he possessed knowledge denied to the rest of us poor slobs that provoked the diction of my first post.)

A few more observations. I have been trying in all my posts (not wholly successfully) to introduce a new 'rule' into the manual of political correctness, and it is a rule that entails some rhetorical clumsiness. I speak of those who suffer from depression, those with schizophrenic illness, etc, *not* of "depressives" or "schizophrenics," terms which are as ridiculous as "TBers" or "Fluers" or "Coldites" would be. (In the 19th century and earlier people did regularly refer to "consumptives," the implication being that infection by tuberculosis wiped out all other human features. "Consumption" had a closer relation to the symptoms of tuberculosis that "depression" has to the symptoms of depression.

On describing unipolar affective disorder to those who have not experienced it for themselves. Actually it can't be done. When other members of the local DMDSG complain of this, I point out (and they all agree) that within a week or two (or even less) of pulling out of a period of depression, we ourselves can no longer imagine what it's like. The experience of infantry combat seems equally resistant to description for those who have not experienced it -- but our culture has at least taught us to *believe* where we cannot imagine in the case of combat veterans, while the inability to imagine leads to the denial that the experience exists in the case of depression or other mental illnesses.

On DSM-IV. Undoubtedly some of those diagnoses will be found to be false. I rather hope that that fate befalls Borderline Personality Disorder -- when made a remark about that diagnosis to my therapist, she remarked that it might be a psychiatrist's way of saying "Fuck you!" to a patient. The changes in it are not only in respect to changing medical knowledge, but also reflect social forces, e.g., insurance or disability regulations. You can't get disability unless you have a named illness. Hence it becomes crucial that conditions be named even if medical knowledge does not really justify a given name and diagnosis. The blame, if any, for this should not fall on the psychiatrists offering what is a social/political necessity. There can also be a placebo effect in naming, as there may be in ascribing a cause even when a cause is not known. My therapist tells me she has some patients who demand to know *why*. There is no answer to this in most cases, but if the demand/need for an explanation is insistent enough, she will offer something. The purpose of therapy is not in any case "cure" but aid in enduring. Good therapists accumulate a large stock of gimmicks which the patient can use for self-manipulation.

Some mention should be made of SAD, Seasonal Affective Disorder. This form of depression is easily relieved: you need a few hundred dollars to buy a special lamp, then spend about 30 minutes a day in its light from early November through February (longer I suppose if you live in Canada or Siberia). There couldn't be a better example of a mental illness (often an extremely severe one that can lead to suicide) that is obviously "physical" than SAD. It is caused only by insufficient daylight; it is "cured" only by special lighting. Since complaints of the "Winter Blues" are widspread, it is possible that almost everyone suffers from SAD to varying degrees. (People near enough to the equator would never know they suffered from it, unless they went north [or south] for the winter.) While my own unipolar is not primarily SAD I've begun to suspect I suffer from it marginally -- I had noticed all my academic life (as student and teacher) that the fall semester was rockier than the spring semester. I intend to buy a lamp this year and use it.


P.S. Without realizing it, Reese has an idea by the tail but only by the tail when he speaks of an illness that predates psychiatry. His intended point is of course mere nonsense. It's as though he were to announce triumphantly that gravity existed before Galileo and Newton came along. BUT there almost certainly *are* social elements in most, perhaps all, mental illnesses. And there are certainly modes of production (sets of social relations) within which depression would be less, or more, difficult to endure. And that which is relatively easy to endure is not so apt to be remarked upon, identified as a distinct syndrome, and labelled. The invisible relations which hold capitalist society together (and which make the future such a tyrant over the present) almost certainly intensify the pangs of depression, whether or not they cause it. PTSD is (though just how is not known) one definite cause of depression, and the fact that more women than men suffer from abuse sufficient to trigger PTSD may be one element in the larger number of women patients. But then this is complicated by the fact that such attitudes as Reese's (which unfortunately are not confined to berserk libertarians) can cow men into not admitting, even to themselves, that they suffer the ailment. Real men don't have psychic problems -- they just get drunk.

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