The Politics Behind Despair and Depression

Posted October 5, 2007 | 01:52 PM (EST)

On September 14, 2007, New York Times reporters Alex Berenson and Benedict Carey foiled, at least temporarily, Big Pharma and its psychiatry allies’ attempt to eliminate the U.S. Food and Drug Administration warning label about increased suicidal thoughts and behaviors in minors using antidepressants.

Berenson and Carey refuted a September 2007 American Journal of Psychiatry article that had claimed an increase in the youth suicide rate in 2004 was related to declining antidepressant prescriptions for that group (caused by the FDA warning). Berenson and Carey reported that, in fact, in 2004 the “number of prescriptions for antidepressants in that group was basically unchanged and did not drop substantially.” The New York Times did not, however, report that the lead author of the American Journal of Psychiatry article had served as an expert witness for Wyeth Pharmaceuticals, makers of the antidepressant Effexor.

While the recent smoke and mirrors of Big Pharma and the American Journal of Psychiatry was detected by The New York Times, the media, once again, is losing sight of a more important revelation: scientists currently agree that “the neurotransmitter-deficiency theory of depression”–the rationale for antidepressants–has no validity.

It was news to many Americans when Newsweek‘s February 26, 2007 cover story, “Men and Depression,” mentioned that scientists now reject the theory that depression is caused by low levels of neurotransmitters such as serotonin. Thomas Insel, director of the National Institute of Mental Health, told Newsweek that “a depressed brain is not necessarily underproducing something.”

This appeared to be news because since the advent of Eli Lilly’s serotonin-enhancer Prozac in the late 1980s, the general public and doctors have received a multi-billion dollar marketing blitz proclaiming that depression is caused by a deficiency of serotonin, and that this deficiency could be corrected by Prozac or other serotonin-enhancer antidepressants such as Zoloft, Paxil, Celexa, Lexapro, and Luvox.

This rejection of the neurotransmitter deficiency theory of depression should not in 2007 be considered news. In 1998, The American Medical Association Essential Guide to Depression stated: “The link between low levels of serotonin and depressive illness is unclear, as some depressed people have too much serotonin.” That same year Elliot Valenstein, professor emeritus of psychology and neuroscience at the University of Michigan, in Blaming the Brain pointed out, “Furthermore, there is no convincing evidence that depressed people have a serotonin or norepinephrine deficiency.” (Antidepressants that increase the neurotransmitter norepinephrine as well as serotonin include Effexor and Cymbalta). In 2002, The New York Times reported: “Researchers knew that antidepressants seemed to raise the brain’s levels of messenger chemicals called neurotransmitters, so they theorized that depression must result from a deficiency of these chemicals. Yet a multitude of studies failed to prove this precept.” Unfortunately, that fact was buried under more than fifty preceding paragraphs.

Historically, those who profit from the status quo have preferred to explain unhappiness, despair and what is now called depression as caused by personal defects. In previous eras, those atop society declared that such malaise was caused by “character defects” such as lack of intelligence, laziness, or refusal to delay gratification; today their personal-defect preference is for some kind of “biochemical-defect” explanation.

While all personal-defect explanations for despair distract the depressed from considering how the structure of society may be contributing to their malaise, biochemical-defect explanations have the added benefit of creating a boatload of easy profits for drug companies. And biochemical-defect explanations are also quite useful for authoritarians who prefer that people look up to authorities– in this case, to biotech corporations and drug-prescribers– for solutions to their problems, rather than looking toward themselves, their family, friends, and community.

While researchers have not found depression to be associated with any kind of biochemical marker, they have found it to be associated with several variables that we as a society actually can do something about.

In 2000, sociologist Robert Putnam reported: “Low levels of social support directly predict depression.” Several studies show that people who have close friends, friendly neighbors, and supportive coworkers are less likely to experience symptoms of depression. In 2004, BMJ (formerly known as the British Medical Journal) reported that postpartum depression occurs in 10 to 20 percent of women in the United Kingdom and the United States but is considered rare in societies such as Fiji and many African populations. BMJ concluded, “Structured social supports after childbirth are described in groups of women with low rates of postpartum depression.”

Researchers have found that depression is associated with other pains that are directly and indirectly connected with our societal priorities. One such pain is poverty– Americans receiving public assistance have a rate of depression three times as high as the general population. Another pain is childhood trauma–there are more than 200 studies that link childhood abuse, neglect and other such traumas to depression.

The rate of depression in the U.S. has increased more than tenfold in the last fifty years, and if Americans heard more about commonsense societal sources of depression, they might consider behaving like citizens rather than being merely drug consumers. Such citizens would be less likely to acquiesce to those who have decimated community, dehumanized culture, and exploited despair, and these citizens might then take social actions that would prevent unnecessary pain.

Certainly, all of life’s losses and overwhelming pains cannot be avoided by saner social policies. However, in a society with greater honesty about the relationship between loss, pain, and depression, there would be less depression–and more healing, community, and democracy.

Bruce E. Levine, Ph.D., is a clinical psychologist and author of Surviving America’s Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy (Chelsea Green Publishing, 2007). brucelevine.net