For example a friend I knew had marital problems. She and her husband went to marriage counseling. Within the 1st 2 counseling appointment, my friend was advised to go on Prozac because she was “depressed”. She and her husband changed counselors and as of this writing (5 years later and no prozac) they are happily still married.

I am convinced that Television and advertising have a great deal to do with our society’s rejection of melancholy seasons inour lives. Celebrate Turn off the TV week by doing some of the things suggested on the article!!!

One additional thing I have done to help me out of my melancholy days — I write a success journal… a book where I can write anything, as long as it is a success. No analyzing or rationalizing about how it might not be a true sucess by some other measure is not allowed. It’s great to be able to go back and read through it (and I’ve only been keeping it for about 2 months)

What I’ve discovered is that antidepressants don’t replace “melancholy me” with a strange, twitchy “un-me”. I’m still melancholy, I still have negative emotions. The medication simply helps me respond more appropriately, as well as allowing me to live my life with all it’s ups and downs.

On the other hand, I have seen the drugs make a huge difference in those with clinical depression. I hope the article draws a distinction between those who are well and those who need the drugs because they are ill.

Schooled from a young age to medicate as a last resort rather than a matter of course, I educated myself on the symptoms of depression and the possible ways of alleviating those symptoms naturally. I implemented many of the suggestions you list here, and fortunately, they did *enough* of the trick that talk therapy could do the rest.

The one thing you don’t explicitly mention which I think is a must is reducing dependence on chemical stimulants and depressants. I dramatically cut back on my caffeine and alcohol consumption, both of which had crept up (and it makes sense that they crept up hand in hand). Drinking a lot of water helps, but cutting out the crap is integral for those of us who have grown dependent.

I have two things to note. One, I do not have a Harper’s subscription, but of course the psychometric tests have to rely on each other for statistical validity. We are starting to see depressive indicators in neuroimaging and neurobiology, but this is not yet diagnostic. It is not like there are antibodies we can just check for and cross-confirm that way. The paper tests tend to have construct validity according to the psychodynamic theories. This may not be relevant to the Mr. Greenberg; one almost gets the impression that the quotation tries to deny the existence of depression altogether. It would be interesting to note (from a bias standpoint) what his therapeutic and philosophical/religious slants are.

Two, Americans seem to adopt psychological terms for their own use, especially for insults (he’s retarded) but also descriptively (depressed instead of “blue,” crazy instead of unusual). This is confusing enough, but even clinically the words are pretty stretchy. For example, even DSM gives modifiers for mild, moderate, and severe depression along the continuum, with axes for other contributors to the problem. In short, my depression is not your depression, is not their depression. I think it’s true that pharma marketing tends to encourage thinking that medication is the first answer for everything, but it is still true that medication is part of the answer for some people, and as TSD notes above, in that case you should talk to a professional (and note that internists often do not have much training in these areas).

Depression is a real disease caused by a real chemical imbalance in the body’s neurotransmitters. Some people can manage it without medication, just as some diabetics can manage their disease without insulin. But some people need help. Please don’t make it any harder for them to ask for that help.

Another point I want to make is that, especially for women, depression can be an indication of thryoid hormone problems. 18 months ago I was depressed, and just thought I was depressed because I was tired and hated my job. Instead it turned out that my thyroid had completely stopped working. A simple blood test can diagnose these problems, and hormone replacement can fix it.

First, what is depression? It is not one or two symptoms (you feel sad, low energy) – check out the DSM IV for criteria – you need to meet several symptoms and over a certain period (and no, not after a relative died.

Second, the info that the Harper article cites (placebo versus meds) – sadly, yes many studies have this problem because they only test patients with mild depression and exclude patients with suicide ideation, etc. I could probably test patients with mild migraines and also generate effects for the placebo.

However, there is new data over the last year – trials that actually used patients with moderate-to-severe depression (the star*D trials) – there are several peer reviewed papers published on this topic, you can find them in pubmed.

I tried therapy and self-help books. I was active and social. But finally I got on the stuff and phew, I can’t tell you how relieved I am.

I will say that it took awhile to feel like this. It doesn’t happen overnight, and my particular medication wouldn’t work for everyone. You have to find the one that works for you.

Thanks for another great post–this actually helped me get motivated today.

The funny thing is, I probably have enough slack in my current circumstances to make changes and still be okay, but I’m not sure it’s the right thing to do. Time will tell… In the meantime, thanks for the reminder that it’s not just me.

It seems that if I don’t pull myself back from the day to day grind and look at the larger picture, I can easily get dragged down in to the somewhat inconsequential stresses that are more fabricated than anything.