Coping With Clinical Depression?
Q.I have the suspect that at least some (perhaps most) cases of incurable depression may start as depression caused by some negative experience, then the patient starts taking antidepressants which alter his or her brain chemistry and make him or her addicted, possibly for life.
A.It is my understanding that most of major depressive disorder is related to genetic predisposition. Mine is genetic in nature and comes on every so often for no reason. Most of the time I am able to get through without medication as I have some very good coping tools I have learned and practiced as a skill. At times I need the help of the medication. We do not really know the action of the drugs but being a reuptake inhibitor, it allows certain circuits in the brain to fire more. I have always conceptualized it as helping the circuits that keep you from being depressed. They are not feel good pills. What antidepressants do is give enough relief so you coping skills can kick in. Depression takes these away. What I think most important; unless you have fought it, you cannot even imagine how much pain in involved. Most who commit suicide with this do not do it to end their lives but to stop the pain. If a medication will help this, it is a lifesaver not an addiction. Might I suggest that most antidepressants are probably prescribed by the personal physicians. The psychiatrists usually work with the more severe cases and those that do not have success with the normal medications. The point is that the brain isn't a pot where you mix neurotransmitters. It is a complex system where it matters which neuron is sending which neurotransmitter to which other neuron at which time. It may turn out that a depressed brain has normal total levels of neurotrasmitters. Or that the levels of some neurotransmitters are abnormal because some particular sets of neuron in certain situations have abnormal firing patterns. The measured "imbalance of neurotransmitters", if you can actually measure it, is more likely to be a symptom rather than a cause. Clinical depression IS a disease of the brain (or chronic condition, if you prefer). It has a physiological basis, just as diabetes has.
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