Depressed, or just sad? It seems that our society may have an inflated case of the blues.
Karen Masman, author of the book ‘The Uses of Sadness’ has expressed the danger that can result from confusing depression with a period of sadness.
“Experiences of sadness that come and go are not medical conditions. Difficulty with misnaming them as depression is that it encourages us to look for a medical solution. Our society is over-medicalising this mood,” she said, “in our culture we seem to be afraid of sadness, and we don’t really have enough words to describe the whole range of experiences to this emotion. All too often we are left with one word: depression. In 2007, more than 12 million prescriptions were written for anti-depressants in Australia.”
Masman contends that there are important flags that distinguish between sadness and depression, and that our society is blending the lines, leading us to “pathologise” this mood, “Depression is real, debilitating and serious… There are five primary markers of difference: functionality, interpretation of meaning, responsiveness, a feeling of overwhelm and other conditions like chronic illness that can accompany depression,” she said.
In 2008, Dr Irving Kirsch from the University of Hull in Great Britain and colleagues accessed all the trial data submitted by pharmaceutical companies to examine the effectiveness of anti-depressants. They found no clinically significant difference between placebo and drugs for all but the most severe cases. There was the same efficacy for drugs and placebo: 60 per cent of people will get better.
Kirsch’s research shows that within two years of ceasing anti-depressant medication, 80 per cent will have had a relapse. However, ten weeks of therapy with a professional, cuts relapse rates down to 25 per cent.
“Very practical actions and therapies can also make a big difference; things like meditation, yoga, attention to diet, sunlight and exercise, hobbies—attitude to life,” Masman said.
Jane Bennett, author of ‘The Pill: are you sure it’s for you?’ said that the issue extends into the effects of other medications, such as the contraceptive pill. “Research at the Alfred Hospital showed that almost 50 per cent of women had depressive symptoms, who had never had them before, because of the pill. It’s huge. And you’ve got to wonder, how many of those are on anti-depressants as well? It’s taking one medication to counter-act another,” she said.
Bennett said that the contraceptive pill is a unique drug, one in which, among other things, interferes with normal bodily receptors that allow us to track and regulate our mood and emotions. “Our hormones are incredibly finely-balanced. The pill effectively smashes our body’s warning lights with synthetic hormones,” she said, “my research has found that almost 90 per cent of Western women take the pill at some point in their life, and 80 per cent will have started taking it before the end of their teens. So if a woman at 30 has been taking it since she was 17, how will she know the difference between sadness and depression?”
It would seem that it is useful for our society to learn to distinguish between a case of the blues, and something more serious. “Rather than automatically assuming sadness means something is wrong, it is useful to get to know the landscape of melancholy,” Masman said, “a time of sadness offers a fruitful time for reassessing goals and habits, developing compassion and learning to embrace the contradictions of a rich inner-world.”
Perhaps, in many cases, doctors should write more prescriptions for boxes of tissues, scheduled down-time, therapeutic conversations and a brisk walk in the park.
Alice Masman