I think I'm smarter today than I was two years ago. At that time had someone forwarded me Newsweek's interview with James Gordon, founder of the Center for Mind-Body Medicine and author of "Unstuck: Your Guide to the Seven-Stage Journey Out of Depression," I would have stewed on it and obsessed about it, worrying that I wasn't dealing with my illness the RIGHT way.
Just like I reacted when my friend who is anti-medication handed me an article in Oprah magazine called "The Valley of the Dulls: Taking Antidepressants" that argued SSRIs (selective serotonin reuptake inhibitors) repress feelings, dull cognitive functions, zap creativity, and steal sex drive. (They've subsequently added a note: "Nothing in this article should be taken as medical advice." ... I wonder what happened to make them add that disclosure.)
"You might want to read that before talking to all those doctor up there," my friend said, referring to the consultation of Hopkins doctors Eric and I had scheduled as our last-ditch effort to get me well. The entire ride up to Hopkins I fretted about the points argued in the article. "What am I doing?" "I'll be ruined." "This isn't the right way!"
In other words, I gave the author of that O Magazine my authority. She obviously knew better than ME what I should do for my health.
Now I have more faith in me as the authority. Because I have studied the biological origins of depression like a fourth-year med student, and I have listened to the arguments of my doctor and others that I hear at Hopkins lectures.
James Gordon says in the interview:
Depression is not the end stage of a disease process but a wakeup call to examine our lives. There are better ways to do that than taking drugs, which have side effects and don't address the underlying message that depression is bringing--that our lives are out of balance and significant change is necessary. Instead they tell us, "You have a biochemical disorder, here's a drug."
But I know that's not true in my life. My depression isn't about some unresolved issue. I thought that at one point. I don't anymore. Gordon may be from Harvard, but I've studied with Hopkins doctors, and I know myself much better than he ever will.
In his book "Against Depression," Dr. Peter D. Kramer, Professor of Psychiatry at Brown University, provides an overview of research studies that sketch out the effect of stress hormones in the prefrontal cortex of the brain. Based on a survey of cutting-edge medical research, he believes that it's the devastation in the amygdala and hippocampus regions--the significant cell death and shrinkage, and the diminished capacity for nerve generation--that contributes to fragile moods. "The longer the episode [of depression]," he writes, "the greater the anatomical disorder. To work with depression is to combat a disease that harms patients' nerve pathways day by day."
Kramer is trying to use his synthesis of research to change attitudes among psychiatrists and patients.
"Psychiatrists have learned that depression is progressive, and there is widespread agreement that we need to interrupt it very promptly and decisively to prevent further deterioration," he writes. From a public health perspective, Kramer believes that "depression is the most devastating disease known to mankind."
I also have my own empirical evidence or data from the days I weaned off almost all of my drugs in an effort to try to combat my depression with yoga, meditation, Chinese herbs, acupuncture, homeopathic remedies, deep breathing techniques, and fish oil.
How did I do?
I needed a caretaker. In fact, Eric took the equivalent of three months off of work. Because I couldn't drive, work, or take care of the kids. I was completely disabled by my depression and anxiety.
Finally, I have the conclusive and convincing results from other people's experiences. At least three people I know have severe mood disorders but chose not treat their illness, or they do so very minimally with a yoga class here and there.
The result? One has so much anger that she threatens to divorce her spouse every time we vacation together; one has created mounds and mounds of work for Eric and I because she can't handle her responsibilities--she's content relaxing in the river of Denial while her family picks up all the pieces; the other can't socialize without drinking at least a bottle of wine.
And I know at least three (much more actually) people who are on meds and work their recovery much like I do: go to therapy, try to meditate, keep a mood journal, apply cognitive-behavioral therapy, exercise regularly, eat healthy, get consistent sleep, write down their blessings, and so on.
Conclusion? I'd much rather hang out with these people than the ones refusing meds.
I wholeheartedly agree with the points argued by Judith Warner in her New York Times blog post titled "Overselling Overmedication," as a response to Charles Barber's book, "Comfortably Numb":
Let's get beyond statistics, percentage changes in diagnosis rates and billions earned off human suffering by Big Pharma. And let's just try for a moment to get real.
Most of the critics decrying the over-medicalization of the American mind rest their arguments upon the bedrock assumption that people who have nothing wrong with them - happy-go-lucky types who essentially make a wrong turn on their way to Starbucks or soccer and end up in the consulting room - are being medicated for largely fictitious concerns.
But search your minds and memories: Have you, or people close to you, ever taken medication in a lazy or thoughtless way? Eagerly? As a lark? Ask around a bit; find out what kind of desperation led others to the point where they had to accept psychopharmacological help.
(Write and tell me. Tell us all. But please don't send abstract social observations or share stories about people you don't actually know. First-hand knowledge and real life only, thanks.)
The psychiatrists I've interviewed over the course of the past four years say that they have yet to be swamped by frivolous patients showing up in their offices looking for pills to help them tweak troublesome little aspects of their personalities. "Not only have I not encountered many [such patients], I haven't encountered any in my office or even in detailed phone calls," Kramer, most recently, told me.
I guess I trust myself more now. And I know myself better.
I knew yesterday I was too fragile to read the article. It would have done damage. So I said "thanks" to the folks who forwarded it to me, and instead of engaging myself in an internal debate on whether or not I was treating my depression in the best possible way (which I do when I'm most vulnerable, because it is then that I have the least amount of confidence in myself)--fretting that I'm going to turn into a total blob of a brain by the time the kids graduate from high school because I have allowed myself to take these toxic pills for so long, and agonizing about the idea that I might be running from my REAL ISSUES, and so I will be forever chased by anxiety and depression, and how I'm just a big loser for taking the easy way out--I pulled out all my ammunition against this beast and gave myself a mental-health day.
In the morning I meditated and prayed at a special spot on Back Creek. In the afternoon, I swam with a new swimming buddy who challenged me big-time with a set of intervals, I walked around the picturesque grounds of the Naval Academy, and then I asked Eric to cut out of work early so that we could go kayaking along the Severn River.
Buttressed by yesterday's day of healing, I was ready to read the piece this morning.
I have no doubt Gordon's techniques work for those struggling with mild and moderate depression. My doctor confirmed that. Alternative therapies are wonderful for folks with uncomplicated mood disorders. Maybe I wouldn't need meds if I was in that camp.
But I'm not. What I have is serious, and even Gordon didn't sound all that convincing when Newsweek's Anne Underwood asked him, "And for severe depression?"
His response: "That's harder to work with. That's where we need studies."
I will look forward to reading those when he has them.
To read more Beyond Blue, go to www.beliefnet.com/beyondblue, and to get to Group Beyond Blue, a support group at Beliefnet Community, click here.
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Wow, way to paint with a broad, brooooooooooad brush there, Ms. Borchard. Nothing like boiling down a detailed, integrative, meticulously researched & time-tested method like Dr. Gordon's into a nice little capsule of "Drugs are always bad for you--don't take them!"
I agree with Christine and Wes. I think you're gravely misrepresenting the message in Dr. Gordon's book. Not only that, you're doing it in a lazy way. I HAVE read the book. And the message isn't "don't take drugs" . . .it's "take drugs as a last resort."
More than anything, Dr. Gordon is saying there's no one way to treat depression, and that different approaches work for different people. Because of the way our healthcare is structured, a lot of doctors see pills as an easy first step. Drug companies also tend to minimize/obscure the potential side effects (or the actual efficacy) of these drugs, INCLUDING a difficult and often painful withdrawal process . . . so the only thing worse than going on them is getting off of them. I've watched too many friends struggle with drugs that were supposed to be "safe" and "nonaddictive" that did affect them when they tried to stop.
Reading Dr. Gordon's book helps you make an informed decision about what to do about your own life & health.
I'm glad drugs are helping you, Ms. Borchard. It sounds like you may be one of the people with severe depression who ARE actually helped by SSRI's/antidepressants. I'm also glad you're giving the alternative methods Dr. Gordon describes in "Unstuck" a try, like Christine says above. The studies Dr. Gordon quotes in his book show some very convincing evidence for the ability of "alternative" methods to boost endorphin/serotonin levels, improve mood and outlook, and increase plasticity in brain cells & cortexz.
At least you know some of your options. Nobody wants people with depression to go untreated. But some people are getting way overmedicated----a hatchet instead of a scalpel, to use the current vernacular?
Hi, Therese. I think you painted Dr. Gordon's book with a broad brush----a hatchet instead of a scalpel, to use the current vernacular. You are misrepresenting his message in your tabloid-journalism review here.
Everyone wants people who are suffering from depression to get the help they need. But a lot of people get prescribed SSRI's as a first step by a doctor with only 1-2 semesters of neuroscience & pharmacology behind them. And given the time constraints on doctors and the way our healthcare is structured, prescribing a pill is a lot easier than undergoing the thoughtful, progressive therapy Dr. Gordon describes in his book.
I'm glad pills are helping you. It sounds like you're one of the people with severe chemical depression for whom SSRI's ARE more effective than placebos. I'm also glad you're taking some alternative steps--like Christine said, yoga, meditation, et al--that have been scientifically proven to change brain chemistry, boost serotonin & endorphins, lift mood and outlook, and even stimulate brain growth & plasticity.
Got as far as the hippocampus regions and then decided to write this comment. Lack of Omega 3 oils will cause this and correct this also.
Common sense tells us that we are what we eat.
Eat a good diet, high in foods that are as nature made them, meats from animals that were fed without drugs etc...and don't forget to exercise. Deal with your thought life. Find joy were you can. Make yourself laugh!
Thank you so much for your article! :)
I read the first two chapters of Unstuck and really wished I hadn't because it had me second guessing myself and my therapy. I know for a fact that what I have isn't something I can make go away with JUST meditation, yoga, and nutrition. I've tried everything else for ten years and it was medicine along with therapy where I was able to get better.
I would highly recommend UNSTUCK. It helps present new perspectives for one to consider. As Wayne Dyer says, "When you change the way you look at things, the things you look at change." The saying of "You are what you eat" also applies to the mental thoughts that we can be chewing on for years.
I've suffered from depression and heavy suicidal thoughts for many years. I was hospitalized twice in my last year of high school for intentions of suicide. I was put on different several different medications. None of them made me feel like a real person. I was discontent at the notion of having to take a pill the rest of my life to be 'normal'. I'm now 25, I haven't used pharma-drugs since I was 17.
I began to learn more about myself and have now studied and used hypnosis to help me hurdle over a lot of resentment, guilt, shame and anger.
In the highly toxic environment we live in pills might be necessary for emergency treatment- to get one out of the deep darkness and to a point of stability. But one also needs to understand the importance of balance in regards to our own personal ecology.
I think Gordon is entirely correct stating it's not a disease. I choose to look at depression rather as a state of dis-ease. You can too.
Please visit my good friend and mentor's website www.depression-hypnosis.com to learn more about yourself and your mind. It just may help you on your journey.
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