[lbo-talk] The Economics of Depression (was: Merry Christmas!)

[Devine, James]

as I understand it, anti-depressants should be complemented with cognitive therapy. Depression involves a vicious circle in which being depressed (due to situational factors) leads to a paralysis of the mind and of behavior (due to biological factors) that makes one even more depressed. The medication (allegedly) deals with the biological basis for the depression, while cognitive therapy helps one develop the mind-set to engage in behaviors that make the situation better. The point is to create a virtuous circle.

 
The drug companies and many psychiatrists don't see it this way. They hope that the pill is the magic bullet which will solve the problem with no help from psychotherapy of any sort. This encourages the over-prescription of the pills, which feathers the nests of both the drug companies and the psychiatrists. But the over-prescription does not mean that they should never be prescribed. Some people really need them. Others are helped by them.
Jim

	-----Original Message----- 

	From: bgramlich at runbox.com [mailto:bgramlich at runbox.com] 

	Sent: Fri 12/26/2003 11:57 AM 

	To: lbo-talk at lbo-talk.org 

	Cc: 

	Subject: [lbo-talk] The Economics of Depression (was: Merry Christmas!)

	

	

	Depression is a difficult illness to diagnose and treat. After working for a couple of years in the Emergency Psychiatric department at a county hospital, I've come under the impression that many doctors prescribe anti-depressants as a cautionary tool. It is better, so they say, to be safe than sorry. Many of the individuals presenting at my department are often suffering from situational depression (i.e. depression caused by the loss of a relative, friend, job, pet, or other difficult life problems) as opposed to Chronic depression, which tends to be caused by biological factors. The people suffering from situational depression often receive medications just the same as the chronic sufferers. Additionally, within my restricted world a college campous, it appears that more young adults are being treated for depression and anxiety than ever before. Both depression and anxiety are treated with the same medications. I've also noticed that these drug companies are advertising th!

	 eir products en masse. I can't count the amount of times I've seen myself portrayed as a shaky little circle in the Wellbutrin commercial. These commercials could give anyone the impression that they are suffering from depression.

	

	All of this has led to question mental illness. Not because I don't believe in biological causes for mental illness, but because I believe that there could be social factors that play into it as well. With depression in particular I wonder: Has depression actually been on the rise in the world, or are we just now beginning to understand that these seemingly unrelated symptoms are indicative of an chronic illness, and thus able to diagnose and treat them? Are normal life stressors leading people to believe that they are mentally ill and in need of drugs instead of learning coping mechanisms and life skills? Does the rise in the treatment of depression have more to do with the increase in advertising than the increase in actual cases?

	

	I'm asking these questions as an insider to mental illness, and I am not trying to discredit any individual's experience with depression. I'd just like to know the economic and social factors that play into the diagnosis of depression. We all know that the more people that are on Prozac the more money Lilly makes.

	

	Respectfully,

	Benjamin Gramlich

	

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