How Everyone Became Depressed (29 page)

But the public is not interested in the technical issues of psychopathology: People simply want to feel better; they want relief. It is important to understand that what you are experiencing at the level of your whole body and the various sensations it sends to your brain and mind is not capable of being reduced to depression. It is a more general bodily illness. But it responds to exercise. It responds to the skills of psychotherapy. If you are so anxious that you need to be sedated, you must be aware that sedation is not a curse word (as most physicians see it, conditioned by decades of pharmaceutical advertising about “anxiolytics”), but a blessing that may be pharmaceutically achieved. If you are so leaden that you need to be stimulated, the same logic applies. Stimulants are not just for superenergetic young lads with supposed attention deficit disorder, but legitimate treatments to wrest adults as well from the slough of dysphoria.

There is help available. But physicians must be thoughtful in diagnosing their patients’ problems, and the patients must be alert in making sure that the diagnosis and treatment they receive are appropriate to their needs and not the fruit of punchy pharmaceutical advertising.

A JP American Journal of Psychiatry
Annales MP Annales M édico-Psychologiques
AZP Allgemeine Zeitschrift f ür Psychiatrie BJP British Journal of Psychiatry
BMJ British Medical Journal
JAMA Journal of the American Medical Association NEJM New England Journal of Medicine

It is my privilege to work with a highly gifted little band of researchers and once again I have the opportunity to acknowledge their help. They have been led by Susan B élanger, and include Esther Atkinson, Ellen Tulchinsky, and Kathryn Segesser. Beverly Slopen, my agent and dear friend, has been a font of wise advice. At Oxford University Press I am glad to thank editor David D’Addona and production editor Emily Perry, who made so many useful suggestions.

Earlier versions of this book were read by Max Fink, David Healy, Walter Vandereycken, and, on behalf of Oxford University Press, Clark Lawlor, all of whom made valuable suggestions for improvement.

Research in this volume was partially financed by grants from the Social Science and Humanities Research Council of Canada and the Canadian Institutes of Health Research.

1. See the review of “depressive psychoses,” meaning serious depression, in six epidemiological studies conducted between 1933 and 1960 in Charlotte Silverman, “The Epidemiology of Depression—A Review,” AJP, 124 (1968), 883–891; the prevalence rates for minor depression were “generally two to three times greater than the rates for psychoses” (p. 889). M. Olfson, “Prevalence of Anxiety, Depression, and Substance Use Disorders in an Urban General Medicine Practice,” Archives of Family Medicine, 9 (2000), 876–883; according to data from the National Institute of Mental Health, the rate of outpatient treatment for depression rose from 0.73 per 100 population in 1987 to 2.33 in 1997. Mark Olfson et al., “National Trends in the Outpatient Treatment of Depression,” JAMA, 287 ( Jan. 9, 2002), 203–209.

2 . Dan G. Blazer et al., “The Prevalence and Distribution of Major Depression in a National Community Sample: The National Comorbidity Survey,” AJP, 151 (1994), 979–986; 17.1% was the estimated lifetime risk for major depression.

3. Aug. 1, 2011.
4. Junko Kitanaka, Depression in Japan: Psychiatric Cures for a Society in Distress (Princeton: Princeton University Press, 2012), 78–79.
5. Laura A. Pratt et al., “Antidepressant Use in Persons Aged 12 and Over: United States, 2005–2008,” National Center for Health Statistics, Data Brief, no. 76, Oct. 2011, 1.
6. Bernard Carroll, personal communication, Jan. 13, 2012.
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8. Joseph Zubin, discussion comment, in Lee N. Robins and James E. Barrett, Eds., The Validity of Psychiatric Diagnosis (New York: Raven, 1989), 244; the occasion was the 1988 meeting of the American Psychopathological Association. Chapter 2

1. “Nervous Breakdowns by Any Name, Aren’t What They Used to Be,” Wall Street Journal, Dec. 3, 1996.
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3. The term “symptom cluster” is currently fashionable; the symptoms that typically cluster are depression, anxiety, and fatigue. See, for example, Sergio Baldassin et al., “The Characteristics of Depressive Symptoms in Medical Students,” BMC Medical Education, 8 (2008), 6.
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11. J.H. Blount, “Essayon the Classification of Mental Alienation,” Asylum Journal, 1 (1854), 93–96, 137–141; quote 93–94.
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13. Angelo Hesnard, Les syndromes névropathiques (Paris: Doin, 1927), 1–8. 14. Oswald Bumke, Lehrbuch der Geisteskrankheiten (1919), 2nd ed. (Munich: Bergmann, 1924), 414; for neurasthenia, he drew upon the opinions of his psychiatrist colleague Paul Julius Mö bius.
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16. Psychopharmacological Drugs Advisory Committee, FDA, Transcript of Proceedings, Mar. 21, 1977, 104; obtained from the Food and Drug Administration through the Freedom of Information Act.
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1 . JohnPurcell, A Treatise of Vapours, or Hysterick Fits (1702), 2nd ed. (London: Place, 1707), 13.
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10. William Buchan, Domestic Medicine: Or, A Treatise on the Prevention and Cure of Diseases, 10th ed. (London: Cadell, 1788), 466–467. According to Christopher Lawrence, the text of Domestic Medicine changed little across the many editions, and presumably the quoted passages are close to what Buchan and Smellie wrote in 1769. Smellie’s name was absent from later editions. C. J. Lawrence, “William Buchan: Medicine Laid Open,” Medical History, 19 (1975), 20–35.
11. Ralph M. Wardle, Ed., Collected Letters of Mary Wollstonecraft (Ithaca, NY: Cornell University Press, 1979), 118, 126, 171.
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20. Flavio Gregori, Blackmore, Sir Richard (1654–1729), Oxford Dictionary of National Biography (Oxford University Press, 2004); online ed. Jan. 2009. [http://www. oxforddnb.com.myaccess.library.utoronto.ca/view/article/2528, accessed 16 June 2011.] 21. Richard Blackmore, A Treatise of the Spleen and Vapours: Or, Hypochondriacal and Hysterical Affections (London: Pemberton, 1725), 17, 25–27.
22. Robert Whyte, Observations on the Nature, Causes, and Cure of Those Disorders Which Have been Commonly Called Nervous, Hypochondriac, or Hysteric (Edinburgh: Becket, 1765), 172, 312, 520. He spells his name “Whytt” in this edition and “Whyte” in later editions.
23. W. Buchan, Domestic Medicine, 10th ed., 500–501.
24. Leslie A. Marchand, Ed., Byron’s Letters and Journals, Vol. 4 (London: Murray, 1975), 26.
25. Edward Bulwer Lytton, Confessions of a Water-Patient (London: Colburn, 1845), 14–15.
26. Louis Verhaeghe, Du traitement des maladies nerveuses par les bains de mer(Brussels: Tircher, 1850), 50–51.
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39. Alfred T.Schofield, The Management of a Nerve Patient (London: Churchill, 1906), 4, 184–185.
Chapter 4