Wise investors are noting a story from this week’s front pages: A panel of experts is recommending that depression screening become part of every American’s standard check-up. Depression, the panel says, goes widely undiagnosed, and with quick and proper detection the patient can be set on the path to mental equilibrium.
The investment opportunity is in the dope business. As the Washington Post reported, primary care doctors are either missing or mistreating “more than half” the supposed cases of the disease. “About 19 million American adults suffer from depression, and estimates suggest that as many as two-thirds do not get treatment. The new recommendations could bring many of these people into treatment and add millions to the numbers who are taking antidepressants such as Prozac.”
No doubt, this news has the folks at Prozac Central in high spirits, and who can blame them? If the panel is taken seriously, a major new horde could be beating down their doors in search of Instant Karma.
Meantime, it is worth remembering that there was once something of a stricture against getting up in the morning and gobbling down pills, unless you were an oldster who needed something to keep your joints from fusing or heart from grinding to a halt.
There were, to be sure, visionaries who argued that a generalized drugging of society would yield positive results. They hoped that mankind’s tendency toward violence, whether manifested in outright war or domestic instability, could be controlled by adding dope to the water system. This plan was never adopted, perhaps in part due to opposition from the alcohol industry.
But turning your troubles over to your pharmacist was widely seen as a type of moral weakness. Feeling down was not considered something to get doped up about, unless the depression was extremely deep. Quite the contrary. If you didn’t fall into a funk from time to time, you were considered insane. After all, life is hardly without its depressing side, even in the rosiest of times. As one great philosophical mind put it, we are all sailing through the stars on a pellet of mud. Man is born, struggles, then dies. For what?
We shall proceed no further down that path lest the writer be inspired to head for the Guiness Garden (this is written quite early in the day). The long and short of it is that pain was seen as part of life, and to some degree an ennobling element. Life, by this calculation, was part of an eternal journey, and one should patiently bear suffering in order to see what lessons it might hold.
That attitude is clearly in steep decline. Pain and suffering are considered unnatural aliens. Untold millions of Americans start their day with a dose of something or other, and continue through the day in a monochromatic hum — as few highs and lows as possible. Children are raised according to the same principle.
Therapists don’t have the allure they once had; their work is expensive, might take years, and is often of questionable quality. If the therapist happens to be a priest, other surprises may lay in store. Drugs are the lightning response, by comparison, and since this is the only life we’ve got, why waste time. Accordingly, many psychiatrists are less interested in therapy and have taken on a new role as drug pimps (as they call them at the nuthouse where my wife is employed).
Medications are surely helpful and necessary to some patients. The can and do work wonders. But to suggest they aren’t vastly over-prescribed is hardly controversial. And it is safe to say that trend will be well served if depression screening becomes routine.
Consider the two questions doctors are instructed to ask patients: “Over the past two weeks, have you felt down, depressed or hopeless?” and “Over the past two weeks, have you felt little interest or pleasure in doing things?” If the answer to either is yes, the patient may well end up in Prozacville.
Yet one wonders how many people have not felt down in the past two weeks. The cause may be hard times at the office. Or any number of other aggravations. You can simply be worn out. Besides that, with every public official from the president down promising terror attacks, huge numbers of people are probably in a funk. As they should be. The prospect of being blown up by a walk-in suicide bomber while waiting in the check-out line at Wal-Mart is hardly the sort of thing to keep you on the sunny side.
The anti-depressant industry was no doubt distressed by the recent study showing that sugar pills had about the same effect on patients as their wonder drugs. This development should remind them, and all of us, that often things fix themselves if you have the patience to wait.
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