Nearly 12,000,000 Americans suffer from it. It
is an illness that can cause as much pain and
be just as debilitating as a chronic heart condition.
And it is life threatening; a factor in 70% of
all suicides. The disease is depression. And it
costs the nation more than $43 billion a year
in treatment and lost productivity; more than
the economic cost for heart disease.
"My sister committed suicide. My mother
was in a mental hospital most of her life,"
a woman relates. And she goes on to describe herself
as suffering too from the disease that plagued
her immediate family. But today she copes well
with her manic-depression, avoiding those radical
up-and-down mood swings, with the aid of the drugs.
In the days not long after bloodletting, the mainstay
treatment for depression was electroshock therapy.
Years went by and Lithium became the godsend.
Now the depression drug market is a billion dollar
business. t used to be that Lithium was the mainstay
of drug treatment but the depression drug market
has burgeoned. It's a billion dollar business
that's thriving because, while depression can
be controlled, there's no cure.
A twenty-one year old has multiple scars on
her wrists from prior suicide attempts. "She
was abused as a child," her mother says.
"She has a history of bulemia and drug abuse."
But she's back in college now, and doing well.
She's on Lexapro.
There are several forms of therapy for depression.
Mild cases can be treated with talk. Talking with
family, a counselor, or a clergyman can help.
Sometimes a professional psychotherapist is needed.
When drugs are prescribed, just to name a few,
they may be antidepressants like Prozac or Wellbutrin,
Zoloft or Effexor; or antianxiety medicines like
Xanax or Ativan. And despite the bad rap that
Jack Nicholson gave electroconvulsive therapy
(ECT) in the movie "Cuckoos Nest," ECT
still has a reputation for working in severely
depressed and suicidal patients, non-responsive
Though depression can be attributed to both
biological and social factors, research seems
to show that chemical pathways in the brain are
altered during depression, particularly the neurotransmitter
chemicals, dopamine and serotonin. Drugs and ECT
act by affecting those chemical pathways in the
One woman, about forty, whom I shall call Nancy,
came in with medics recently. "I feel like
I'm going to die," she moaned. She had the
same feeling several months before during an earthquake,
when she lost her home. She described that then,
"my chest tightened. I couldn't breath."
It happened again just prior to coming in, after
an argument with her son who threatened suicide.
And that wasn't the end of Nancy's misfortune.
Her husband was unemployed; her mother was dying.
Though everything seemed to point to depression
as being the cause of her symptoms, we still ran
her through a battery of tests. Every depressed
people have heart attacks.
Only one-third of people with depression receive
any professional help. Some refuse help because
they fear being stigmatized as having a "mental
illness." Some say they would rather just
live with the disease. Some turn to self-abusive
remedies like drugs or alcohol. And some refuse
to admit the root cause of their pain.
Though everyone occasionally suffers the "blues,"
sometimes there can be an avalanche of burdens.
Tranquilizers and antidepressants can help. But
Nancy wanted none of that. She was sure she was
having a heart attack or dying of some other medical
problem. "I don't want drugs. I'm not crazy,"
she said adamantly. She left he ER, angry, still
depressed, and still in pain.