Sean O’Conaill takes a look at a book which queries many of our received notions about depression, and he wonders if people who suffer from this condition might not need deep friendships more than prescription drugs.
According to the World Health Organisation, serious depression will hit one in every three of us by 2010. It will become one of the two most important causes of premature death by 2020. Many blame it for the growing problem of suicide, especially among young men.
The WHO also say that 20 per cent of the global population now suffers from depression. If this is true of Ireland, we have close to one million sufferers. Many of the most seriously affected will under psychiatric care.
But the recent book by Limerick’s Dr. Terry Lynch insists that there is no scientific basis for the theory used by most psychiatrists to explain what they call ‘clinical’ depression and other forms of ‘mental illness’ (1).
In particular, Dr Lynch insists, there is no scientific basis for the belief that any form of depression is a result of a chemical imbalance in the body, or of inherited factors.
Dr Lynch points out that lack of insulin is a provable cause of diabetes. Insulin levels are initially tested and then continually observed as part of the treatment of diabetes, and adjusted where necessary. The illness then comes under complete control.
But psychiatrists do not usually make any such test for any chemical, according to Dr Lynch. The reason is that no relationship has been scientifically proven between depression and the presence or absence of any known substance in the body. Nevertheless, psychiatrists will frequently insist that depression is a ‘biological disorder’ to be treated by drugs which will somehow compensate for this.
The reason for this, Dr Lynch argues, is that this explanation allows depression, and other forms of ‘mental illness’ to be diagnosed after an often superficial examination, and then treated simply by the application of drugs. This suits the manufacturers of these drugs. It is vastly profitable to insist that unhappiness can be cured through purchasing their products. It is also this industry that pays for the vast bulk of scientific medical research.
“Where does my depression go every Wednesday?”
Dr Lynch, a GP who now specialises in treating the depressed, tells the story of a patient who had been told by another GP that antidepressants would cure her depression, because it was due to a chemical problem.
“Then where does my depression go every Wednesday?” she had asked.
On that day of the week, she regularly met her counsellor who knew her life story, and communicated sympathy, appreciation and esteem. Because counselling and psychotherapy require careful self-examination, and especially the time and concern of the professional helper, many psychiatrists are inclined to prefer a diagnosis which will justify their lack of time to learn about the personal lives and experiences of their patients – and the chemical imbalance/genetic theory suits admirably.
Experience of life
In most cases, Dr Lynch insists, the symptoms given by people who are diagnosed as depressed simply reflect their long-term experience of life.
These could be low self esteem, a sense of hopelessness, an inability to cope with work or study, a lack of interest in everything around them, a loss of career ambition and drive, a sense of deep sadness, a fear of socialising, a problem with close relationships. But all can be explained by the background of neglect, bullying, parental domination, abuse or insecurity or desertion from which such people come.
These experiences can make people liable to an onset of depression at any later stage. What they need to hear is that their sadness or grief is a reasonable reaction to experience. That it is a means of withdrawal from the constant demand our society imposes upon us to be ‘okay’ at all times. We humans are very fragile creatures, and modern life is often awful, denying us close, loving relationships. These facts placed together should shape our way of thinking about mental illness. Generally, sufferers want desperately to be told that there is some understandable basis for the way they feel. To be told that they have some biological or genetic problem can make things worse – and besides, it cannot even be scientifically established.
Simply to impress
Questioning terms such as ‘clinical depression’ and ‘endogenous depression,’ Dr Lynch alleges that these are used by psychiatrists simply to impress.
They give authority to a diagnosis which often rests on no thorough examination. ‘Endogenous’ simply means starting within, so that to be told one has ‘endogenous’ depression is to be told that the cause lies not in any external event (such as the death of a close relative) but in some unknown internal factor. But this is often no better than guesswork, and is often delivered after a short interview. It ignores the possibility that an external event years earlier, or difficult early life circumstances, or a problem in close relationships with others, may in fact be the cause.
As for ‘clinical depression,’ this simply means that we score high on a checklist of symptoms of emotional pain and sadness. Effectively, it is a medical declaration that beyond a certain point sadness must be considered a medical illness: there are limits to the degree of emotional pain we can express before we can become subject to a diagnosis of mental illness, which is then to be treated by drugs. Yet psychiatrists will differ on where this point lies. And this in turn means that the same person could be judged mentally well (though sad) or mentally ill by different psychiatrists.
Unless Dr Lynch can be proven entirely wrong in questioning the scientific basis of drug-based psychiatry, it is clear that all the churches need to re-examine the whole question of ‘mental illness’. Especially because of the growing problem of youth suicide. We now know something of the extraordinary long-term impact upon human well-being of child or adolescent sexual abuse. What of persistent school bullying, or neglectful parenting, or the alcoholism or indeed ‘mental illness’ of a parent, or of desertion by one or more parents? What of the long-term impact of being unable to win any of the glittering prizes of our school system, no matter how hard one has tried? What of the disappointment parents may have expressed over this?
What of an experience of nothing but sarcasm from a parent also disappointed in life? What of the drip-by-drip effect of commercial advertising directed at young people, which tells them so often that they lack the ideal body depicted in their ads, and must therefore become socially outcast? We all have deep-seated emotional needs – which is to say that we are not in fact strong, independent creatures from childhood who can ‘normally’ be expected to be psychologically okay and self-reliant all our lives. The more we discover of these needs, the more we realise the blessings we have also received from affectionate relatives and friends who have loved us as individuals, for our own sakes.
And love is a deeply spiritual thing, as it involves an ability to honour and celebrate another person, a genuine ability to forget ourselves when we interrelate. Modern culture strongly encourages us instead to be self-absorbed, to follow a path of personal ‘success’. Our careers are increasingly all-demanding, as the business world seeks to realise its ‘investment’ in us as human ‘resources.’ This inevitably means that we expect our friends to be self-reliant in their own lives and we know that they will expect the same of us.
Don’t really listen
A Thatcher-era wit once defined the word ‘bore’ as “someone who, when you ask him how he is, he tells you!” Sadly, this comes close to the truth of what most of us expect when we ask this question. We do not want an answer that will stop us in our tracks. We are not ready or able to put everything on ‘hold’ while we listen to a friend. And the friend will know this from our body language – and give us the undemanding answer we want to hear even if it comes nowhere close to the truth. We feel morally and socially compelled to be ‘okay!’
Thus, when we come across a person disabled by sadness, we are generally totally at a loss. We feel incompetent, as well as overburdened, and look for an expert to take over. But what if that expert is already inclined to find our friend biologically unbalanced, or genetically predisposed, to his condition? It will follow that absolutely no-one may take the time to join such people in a deep search for the meaning of their sadness.
And why make overwhelming sadness a medical condition? Doesn’t it mean that health must be defined as maintaining emotional coldness at all costs, in an increasingly tragic world? That the ‘normal healthy’ person is defined as one who can never be disabled by emotion?
Could any definition of ‘normality’ be better suited to the globalised business world now gathering around us? That we humans should condition ourselves to behave as though we were shrink-wrapped machines, guaranteed for life, must be the ideal of a business world that has so far failed to clone humans in the factory farm, or to develop a robot that can completely replace us.
Such humans will bear any pain easily – especially the pain of a world increasingly subject to commercial exploitation. The ideal consumer is one who can accept a world that cares for us only if we can buy – and only until we have bought – what it has to sell.
When we reflect that the drugs industry is part of that world, and that most medical research is funded by that industry, we need not look far for an explanation for the current psychiatric bias against what it sometimes chooses to call ‘endless talk.’ Psychiatrists too have a career, a timetable, and a wealth status that favours rapid treatment of individual patients. A drug-treatable explanation for the pain whose history they have no time to listen to is just what the doctor ordered.
Could it be friendship sensitive to the woundedness of the typical human soul that is more desperately needed, and a way of life in which friends make time for one another? If so, our salvation in Ireland lies only in the recovery of the full meaning of the old Irish concept of ‘anam chara’ (soul friend). Our churches, seemingly sidelined by modern science, need urgently to look into this. Terry Lynch’s book should be high on their reading lists.
REFERENCES
1. Dr Terry Lynch, Beyond Prozac: Healing Mental Suffering Without Drugs.
This article first appeared in Reality (January, 2002), a publication of the Irish Redemptorists.
