Depression has kept me standing at the ledge of suicide’s cliff my entire life. The drop looks long, but not scary. I remember a hard morning in the second grade. I stood in front of the bathroom mirror, alone, sick inside, tears in my eyes, praying to God that I would die. I was serious. I begged him to let me die rather than live in torture, preferably before the first bell. I suppose I lacked faith because I am alive still.
I grew up with this feeling, but many people do not understand what major depression is. Most believe it’s just not feeling happy. They underestimate its power. Bill Scott wrote an engaging, though misguided, piece for Blogcritics titled “Treating anxiety and depression: What’s faith got to do with it?” He uses news and personal experience to discuss major issues in mental health, pharmaceuticals, medicine, and psychiatry.
He expresses his feelings with sincerity, starting off with some minor scandals in the pharmaceutical industry, and follows up with the healing power he found in spirituality. Spirituality healed his depression. I respond in order to engage his ideas, not degrade them.
I shudder, however, when people suppose their own experiences with depression are universal – that everyone else must feel the same. Specifically, I am affronted when people with a form of depression overgeneralize their subjective experiences, believing that all depression is alike. They assume themselves experts because they have gone through it. Often, these people bash the science of medicine with the thin stick of mythology and spiritualism.
God is the giver and taker of depression in their view. God controls who experiences depression, or at least who recovers from it.
Until a few years ago, I prayed to that God almost everyday, pleading for him to kill me to escape the pain. In those years, I also have sought the solace of the great, healing power. I have yet to hear from the man and regret having believed for so long that he might speak. Many faithful words have left my mouth, entering the silence of the air.
In his article, Scott falls into the trap of the faithful who try to undermine medicine in mental health by exploiting isolated instances of scandal or error. In terms of logic, this fallacy is called poisoning the well – a few problems are dropped into the well, and all the water turns bad.
In Scott’s case, the horror he picks at is that Eli Lily and Company markets Prozac for depression, while selling the exact same drug under the name Serefem, a pre-menstrual remedy. He complains, “Essentially the same pill is being prescribed for entirely different mental and physical ills.” He refers to a few similar examples in order to conclude:
- Pills with the same chemical composition are being used to treat entirely different physical and mental conditions.
- At least one manufacturer notes it is “unknown” how the drug works.
- The theory upon which the design of antidepressants is based is “probably not correct.”
Scott discredits makers of meds like Prozac, asking sarcastically, “Does this sound scientific?” Well, Mr. Scott misunderstands science. I will consider each of his three arguments.
First, identical medicines frequently assist with completely different problems and are marketed under different names. This prevents consumers from confusion as to the purpose of the medicine they purchase. A couple of examples will illustrate. Benadryl is marketed to control allergies, and the identical drug is sold as a sleep aid in Nytol. It’s the same drug under different names for different purposes. This makes sense. Even more commonly, aspirin is marketed as an analgesic and separately as a heart medicine. The drug works for multiple symptoms. In short, drugs can serve more than one purpose, and can be marketed under different names to reflect that.
Second, in human history, rarely have we known why medicines work. For millions of years humans have used willow bark to ease pain. They consistently ingested it because the bark worked well. Now we know that willow bark contains aspirin, and we understand how aspirin regulates pain. Does this mean that humans were stupid for using it without knowing how it worked in the brain?
In fact, knowing how a drug functions in the body is rare throughout history. When you move to depression, which affects the brain, the most complex thing in the universe (as far as we know), we should expect not to understand why and how certain drugs work. We do not understand how our own brains are conscious, so how can we expect to comprehend exactly what an antidepressant does in the brain? In reality, however, we know much about how Prozac probably works in the brain.
Third, the theories that antidepressant therapies are based on could very well be incorrect, and the drugs could still function effectively. Scientific theories frequently are changed or negated; this is the nature of science, the way it is supposed to work. The scientific method operates as described by Kim Ann Zimmerman of Live Science:
A scientific theory summarizes a hypothesis or group of hypotheses that have been supported with repeated testing. If enough evidence accumulates to support a hypothesis, it moves to the next step – known as a theory – in the scientific method and becomes accepted as a valid explanation of a phenomenon.
When used in a non-scientific context, the word “theory” implies that something is unproven or speculative. As used in science, however, a theory is an explanation or model based on observation, experimentation, and reasoning, especially one that has been tested and confirmed as a general principle helping to explain and predict natural phenomena.
To suggest sarcastically that the processes in medicine are not scientific is to fundamentally misunderstand science. Scott views medicine and science through an inaccurate, colloquial definition, in order to dismiss pharmaceuticals. Theories change, evolve, and are sometimes thrown out. This is a system of error detection that works brilliantly.
The scientific method detects and corrects errors in the pursuit of accuracy. Scott dismisses Prozac as a legitimate antidepressant for no grounded reason. Prozac has been one of the most scientifically tested medicines in history, and has been proven safe, with relatively few side effects. If you just look at the work the FDA has done with Prozac, the amount of research is massive and favorable.
To dismiss science, evidence, and investigation of a drug and substitute it with a few flimsy tales and accusations is far from benign rhetoric. It does the public harm by perpetuating the stereotypes of mental illness and pharmaceuticals.
Scott shares his personal faith and story, which I will not attack. However, I will share my story too. Having coped with chronic major depression for 40 years, my experience has some validity. For 40 years I have dealt daily with suicidal thoughts, stemming from emotional pain. I have faced illness every day, feeling extreme lethargy, hopelessness, headaches, desperation, darkness, anxiety, and self-loathing – a fundamentally physical, though also mental, anguish.
Over these years, I was constantly counseled by religious zealots that I needed to be more positive, read more scripture, pray more frequently, buck up, and snap out of it. To me this sounded like being asked to snap out of cancer or heart disease. I could not do it. People might have at least suggested therapy, which might have been useful.
About a year ago, my psychiatrist added Prozac to my rainbow of medicines, and within a week, I felt better than I had in 40 years. I improved dramatically because of the Prozac. I don’t feel happy all the time, but I do feel happiness sometimes. I feel much less sadness. Science and medicine are the miracle workers here.
On the surface, the whole argument may seem trivial to you, but a massive population of sufferers like me exists all around you. The type of argument Scott makes hurts us, those with major depression. The rhetoric does us damage. Because of ignorance and fear spread by such people, many who suffer from major depression probably fear medicine and avoid doctors. I know many personally who feel guilty for taking medicine. Many depressed people won’t receive treatment because of the stigma that comes with mental illness.
Far from trivial, arguments such as Scott’s spread fear and ignorance, hurting people with major depression. Telling us that turning up our spiritual heat will heal us creates feelings of guilt in those already suffering.
Prozac is not perfect. We do not fully understand how or why it works. Prozac and its related medications (SSRIs) may be over-prescribed and may have flaws. However, one cannot simply discount the research and testing, nor the personal accounts of the millions of people it has saved, and instead assume you can wave depression away with a spiritual wand. For some that may work, but for many it does not, and people should be sensitive and sensible about the illness and treatment.
I’ll answer Scott’s question “What’s Faith Got to Do with it?” I say, nothing.