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.
