Rethinking Depression: Is Mental Illness Overdiagnosed?

Rethinking Depression
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The Centers for Disease Control and Prevention estimates that one in ten US adults are clinically depressed. As a mental illness, depression can be costly and debilitating to sufferers. But is there really an increase in depression, or do we need to rethink our current methods for diagnosing true depression and offer better treatment advice to those who are temporarily experiencing sadness or unhappiness?

Eric Maisel PhD has authored a book entitled “Rethinking Depression: How to Shed Mental Health Labels and Create Personal Meaning.” In Chapter One, he opens the discussing on depression by asking a few questions.

I think we can agree that most people are made anxious by public speaking, he begins. Our anxiety in this situation is common, understandable, and normal. But how is it that the symptoms that accompany the anxiety surrounding giving a speech are also associated with a mental disorder called “Generalized Anxiety Disorder?” Just because the feelings are unwanted (ie: you would like to be able to feel confident and not anxious when speaking in front of others), does that make them “abnormal” enough to require a diagnosis of GAD?

“It is a grave mistake to make every unwanted aspect of life a symptom of a mental disorder,” Dr. Maisel says. “A heart attack may come with symptoms such as chest tightness and shortness of breath (which) occur because an artery is blocked or a valve is failing. Unhappiness too may come with certain symptoms such as sleeping a lot and eating a lot. But these are not evidence of organic malfunctioning. They are what come with unhappiness.”

Dr. Maisel feels that the term “depression” has virtually replaced the word “unhappiness” in our vocabulary, bringing about a “monetizing” of the disorder. Recently the CDC reported that there has been an increase in antidepressant prescriptions of nearly 400% since 1988. Some observers feel that antidepressants are being “handed out like candy” without digging deeper into the true cause of the symptoms of sadness and despair, which may be temporary due to a particular situation rather than a malfunctioning of the brain (which is what the medication is intended to correct.)

“We’ve seen a marked increase in antidepressant use among individuals with no psychiatric diagnosis. Nearly four out of every five antidepressant prescriptions are written by non-psychiatrist providers,” said Ramin Mojtabai, MD, PhD, MPH, lead author a recent Johns Hopkins study published in the Journal of Affective Disorders and an associate professor with the Bloomberg School’s Department of Mental Health.

Additionally, “Just because antidepressants are popular does not mean they are helpful,” Dr. Maisel points out. Many patients taking antidepressants either don’t respond or have only a partial response.

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But is this discussion intended to keep people away from seeking help for their concerns about their mental health? Absolutely not, says Dr. Maisel. But probably we need to seek appropriate help instead of tossing around diagnoses and offering expensive, but possibly unnecessary, medications.

First, recognize the symptoms of clinical depression set forth by the National Institute of Mental Health. Depression is persistent sad, anxious or empty feelings that do not go away after a fewf days or do not appear to have an actual related cause. People may feel hopeless, guilty, irritable, and/or fatigued. Patients may have aches or pains that do not ease even with treatment. Their symptoms have interfered with their activities of daily living. The situation is very serious, particularly when patients begin to consider suicide.

Second, seek help in the appropriate place. Family doctors are a very helpful first step in getting help. But if you feel your physician is just throwing you a pill and saying “come back in six months to review your symptoms,” it may be best to find another doctor. Antidepressant medications may help you get over the hump in the short-term, but if you don’t deal with the actual root of your unhappiness or feelings of hopelessness, they will return.

Seek out someone to help you work through your emotions such as a professional psychotherapist, social worker, or support group. For example, if you have experienced a loss of someone you love, seek counseling from someone experienced in grief. If health issues have you feeling scared and hopeless, join a support group for those with the same issues to see if you can offer each other some solutions.

Family and friends can be helpful support as well. Do not isolate yourself, as this almost always makes the symptoms worse. But do not allow anyone to tell you to “just get over it.” You have nothing to feel guilty about for feeling depressed or unhappy.

Lastly, take care of yourself. Remember to eat a healthy diet, get daily exercise (which reduces depressive symptoms), avoid alcohol and illegal drugs, and get plenty of sleep. Try keeping a journal which can help improve your mood by allowing you to express your painful emotions privately.

Rethinking Depression: How to Shed Mental Health Labels and Create Personal Meaning was published by New World Library in February 2012. It is available for purchase online and in local bookstores.

Note: A copy of the book was provided to this author by the publisher for the purpose of review. The review is not intended to offer specific medical advice and anyone with depressive symptoms should seek individualized help from their personal physicians.

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