The most recent treatment for depression is a group of drugs known as selective serotonin re-uptake inhibitors or SSRI's. Serotonin is one of several naturally occurring neurotransmitters and the condition for which these are prescribed is known as neurotransmitter deficiency syndrome. These new drugs do not increase the production of serotonin. Rather, they inhibit the breaking down and elimination of serotonin from the body. The result is that the brain has more serotonin available, and thus, the individual taking this form of medication gets relief from whatever is disturbing or agitating the mind, whether it be depression or anxiety, panic, phobia, obsessions, compulsions, food cravings and bulimia. The precise understanding of how this works is unknown.
However, since the function of a neurotransmitter is to facilitate the movement of electrical impulses between nerve synapses, then, I think one may assume that when the movement of that energy is impaired, the aforementioned symptoms seem to appear. So, how does it happen that your supply of the neurotransmitter serotonin is lessened?
There many situations that are associated with depression and anxiety, but what is interesting is that the incidence of depression is far more prevalent in the last fifty years than prior to 1950. Between 1993 and 1995 the number of Canadians diagnosed with depression has increased by one million from 2.72million to 3.75 million. $12 billion worth of SSRI's were sold world wide in 2002. The number of prescriptions written in Canada increased 53% in the last five years for a total of 13.8 million presecriptions last year in Canada. Ten percent of the population is taking anti-depressant medication! And professionals say that many more remained undiagnosed and untreated because of their reluctance to seek help. Before the advent of Prozac in 1990, .0000005% of the population was diagnosed with depression, and now it is between 10% and 20%! Why is this happening?
Three contributing factors come to mind--diet, exercise, and the marketing of medications: As a result of the prevalence of junk food in our diet over a third of Canadians are clinically obese and more than a half are overweight. Prior to the fifties, we all ate rather simple food that had few additives, was relatively unprocessed, and did not have a lot of fat, salt, sugar, and many other additives added to it. Since the human organism has been accustomed to eating a simple spartan diet for thousands of years, it has not yet adapted to all the additives, hormones, antibiotics, food colourings and calories of the late 20th Century diet of North America. It is well known that poor nutrition is a factor in mental health and one treatment modality for depression uses megavitamins and dietary changes.
The lack of exercise is another factor. In 1900 about 95% of the population worked on the farm with none of the time-saving household gadgets, and by the year 2000 less than 5% of us live this agrarian, active lifestyle. The majority of us no longer engage in dawn to dusk physical activity. With all the labour saving conveniences in the home, the automobile to get around in, the modern office environment, and home entertainment, we mostly lead sedentary life styles. Many studies have shown that exercise increases the amount of serotonin in the body and endorphins, which are naturally occurring painkillers. In fact, exercise is often used as part of a holistic treatment regimen for treating depression and is effective as an anti-depressant in 90% of the patients who engage in a workout program.
A third factor is the promotion of medication by the pharmaceutical industry. The multinational drug companies spent in the US US$9.4 billion on marketing to doctors in 2002 (this does not include print advertising of drugs, which is not permitted in Canada). The number of drug sales reps has tripled from about 30,000 to 90,000 in the US since 1995 although the number of physicians as barely increased. The drug companies know that every dollar spent on marketing yields about 17 dollars in sales. As a result the first thought and the first response from most physicians to an emotionally based patient problem is to prescribe medication. For the physician this is the easiest and least time consuming approach to a mental health problem. For the giant pharmaceutical companies, marketing strategies modeled after those of Proctor and Gamble, Gillette and Pepsi, are the way to promote sales. Another marketing strategy is to define normally occurring human conditions as an illness in need of a medication. An example is the recently created disorder that they call female sexual dysfunction (one characteristic of which was feeling too tired to have sex) in order to create a new market for their anti-impotence medicines. And as an interesting corollary to that note, women are twice as likely to experience depression as men. Are women subtle marketing targets for the anti-depression pharmaceuticals?
If a person has found his or herself so far down the path of depression and anxiety that they cannot function in relation to themselves, others, work or school, then medication is certainly in order as a means of righting the ship of the mind and getting it moving again. Moreover, as we have noted, serotonin is a facilitator of energy transmission or movement between the synapses and in order to resolve the root causes of depression, a person must be relatively functional. However, once the energy is moving again, the question then arises as to why it got blocked in the first place and what can one do about the underlying causes of this lack of movement, which we call stasis or rigidity.
In a sense, we are all somewhere on a continuum between free movement and rigidity, mentally, emotionally, physically and spiritually. Some get really stuck on an addiction and cannot get off of it. Some get up tight and panicky in social situations. Some react to their boss with the same resistance and defiance. Others get stuck on patterns of thinking and emoting. And some are plagued by blocked feelings of helplessness and hopelessness and low energy that can devolve into full blown depression.
Most of us may recall the moments in our lives when we felt our own power of spontaneous movement, clearly, unobstructed, and free. This condition called motility is quite evident when we observe an infant playing: they are just spontaneous creatures with no inhibition as long as they are in the safe universe of the mother or father. Motility is the opposite of depression and by freeing ourselves from our blocks we can restore this natural motility and liberate ourselves from those depressive tendencies of helplessness and hopelessness.
As stated above, SSRI's are effective in treating a wide variety of conditions such as depression or anxiety, panic, phobia, obsessions, compulsions, food cravings and bulimia by improving transmission of electrical impulses between synapses. If a person wants to wean themselves from these medications, then they must look at every aspect of the life and being: diet, nutrition, exercise, family of origin issues, addictions, cognitive problems, energy blocks, spiritual questions and be willing to make significant lifestyle changes.
For an excellent analysis of the depression industry and alternative modes of healing depression, listen to the three part CBC Ideas podcast series on depression at http://www.cbc.ca/radio/podcasts/documentaries/the-best-of-ideas/