Depression is widespread in today’s society and is called ‘the common cold of mental health problems.’ But despite its prevalence, people are wary about the use of a pill in order to chase the blues away. Some even liken anti-depressants to Soma as depicted in Aldous Huxley’s Brave New World. Soma is the perfect pleasure drug that provides a mindless, inauthentic happiness, which makes people comfortable with their lack of freedom. Depression is often disregarded as a serious illness. Society, as a whole, stigmatizes depression and sees anti-depressants as a way out instead of a legitimate medicine. But the people that feel this way, often have not had any personal experience with this illness.
The physical basis of depression involves neurotransmitters in the brain. Neurotransmitters are chemicals that carry messages from one nerve cell to another. Nerve cells do not touch. There are microscopic gaps between them called synapses. For a nerve impulse to travel from one nerve cell to another, the sending cell releases a tiny amount of one of the neurotransmitters, which transmits the signal to the second cell, and so on around the body. After a nerve impulse has been sent across a synapse, special enzymes clear away the neurotransmitter so that another impulse may be sent.
The first antidepressants, monoamine oxidase (MAO) inhibitors, were discovered accidentally during the 1960’s by researchers who were trying to develop new drugs to treat tuberculosis. MAO inhibitors didn’t help TB, but they elevated mood. Since then, many other types of antidepressants have been developed. They are all about equally effective. But the newer drugs are safer and for most people, have fewer side effects. In order of their development, here are today’s antidepressants: MAO inhibitors, Tricyclic medications, Tetracyclic medications, Wellbutrin, Desyrel, Selective serotonin reuptake inhibitors (SSRI), Effexor, and Serzone.
The anti-depressant that is known by most people is Prozac. This anti-depressant falls under the grouping of selective serotonin reuptake inhibitors as does Zoloft and Paxil. SSRIs block the recapture of the neurotransmitter serotonin by nerve cells. The first SSRI, Prozac, was approved by the FDA in 1988. The other SSRI’s were approved as follow: Zoloft, 1991; and Paxil, 1992. Antidepressants help 60 to 80 percent of those with moderate to severe depression. It usually takes two to four weeks to feel any benefit. Drug treatment typically lasts six to twelve months.
Depression is strongly associated with abnormally low levels of certain neurotransmitters, among them: serotonin, epinephrine, and norepinephrine. Antidepressants increase the levels of these chemicals by interfering with the enzymes that eliminate them from the synapses, a process called “reuptake inhibition.” The diagram below represents the basic way that an anti-depressant such as SSRI works. Serotonin is created on the presynaptic nerve end. It is then released into the synapse and continues to the postsynaptic nerve end. Unused serotonin is returned to the presynaptic nerve end for reuse or destruction. Prozac, Zoloft and Paxil keep the serotonin in the synapse for a longer time.
There are numerous stigmas that accompany mental illness. A Massachusetts survey was done to raise awareness of these stigmas. Ninety percent of the four hundred adults surveyed said that mental illness comes with a stigma. Forty percent of those surveyed believed mental illness is the result of character flaws and personality defects. (“Survey finds Stigma”) The effects of a sort of ‘coming out’ for depressed people can result in political, professional and personal problems.
The slightest hint of mental health problems can result in the end of a political career. Mental illness is used as a weapon to cast doubts on a candidate’s fitness for political office. During the 1988 presidential campaign rumors were circulated by Lyndon LaRouche supporters that Michael Dukakis had been treated for depression. These allegations were intended to knock Dukakis out of the race. However, there does seem to be a more positive shift in voter’s attitudes toward mental illness. Last fall it was reported that Alma Powell, wife of a could-be presidential candidate, suffered from depression, she and her husband appeared at a nationally televised press conference and casually said it was so. Colin Powel did not deny this statement and stated that it was not a family secret. He also said that it is controlled as easily with medication as his blood pressure is.
Going public is very hard to some sufferers professionally. It helps to be in the right career. The arts are probably the most tolerant. Rod Steiger’s agent was afraid that when he went public he would be blacklisted. However, as it turned out his next feature was Tim Burton’s ‘Mars Attack!’.
Hollywood is considered easy when compared with more traditional jobs. Those in the field of business may want to think twice before revealing their depression. In the macho cultures of law and investment banking, he says, if you admit vulnerability. You’re a pariah. Many people will lie on job applications that ask if they have ever been treated for a psychological disorder. In most cases, if there are two qualified applicants and one has been treated for a disorder, he or she will not be chosen.
It is hard to let people know that you are on anti-depressants. In fact, there is even a site on the Internet that lists different scenarios and what the best way to let people know you are taking the pill. Many family and friends will not understand the need for anti-depressants. They may even state that a depressed person is just ‘in a funk’ and will get out of it. They might see anti-depressants as a weakness-the inability to deal with problems.
These stigmas of mental illness may cause many people from getting help, either counseling or anti-depressants. Many people do not feel comfortable ‘spilling their guts’ to a stranger and welcome the relief that an anti-depressant brings. It is obvious that a combination of talk-therapy and pills would be the best solution to depression.
Some people look for solace in anti-depressants as a mood booster. They are not clinically depressed but have are still given a prescription anyway. One television show believes that this may create unfairness in the business world by their increased alertness and drive. “Would everyone feel compelled to take it just to keep up with the competition?” (Breggin, 5) There is a belief that anti-depressants are over-prescribed. Doctors do not see five of the nine symptoms of depression, yet they are still referring their patients for anti-depressants.
Kramer and Breggin, authors of Listening to Prozac and Talking Back to Prozac, both believe that this is an anti-sensitivity drug. Breggin believes that there is no such thing as being too sensitive. In being desensitized, less aware, and less in touch a person loses basic human nature. Kramer agrees that Prozac may take away those emotions that make us most human. As their depression disappears, so does their sensitivity to their own and others’ problems. Should we feel our emotions deeply, even if these emotions may cause harm to others and ourselves? Or should we be medicated and become ‘less of a person’? The sufferers of depression must answer these questions for themselves.