When I first came to Los Angeles over a decade ago, the city's love for psychiatrists was already a longstanding joke. And when Prozac and its ilk first arrived on the scene they were hailed as miracle pills that would bring instant happiness to the metropolis' two-hundred buck an hour couch surfers. But when it comes to depression, as a new study has shown, there are no quick fixes, though promisingly it seems the blues may actually serve a purpose, and indeed have the potential to make us happier in the long run.
While at my first job at a record label here in L.A. I struck up a friendship with a young girl who worked on reception. She'd just moved to the entertainment capital and this was her first job out of school. Lonely and vulnerable, she'd stumbled into a relationship with a much older, and very married man. After the initial excitement of the illicit affair had worn off, depression set in and she began to see a psychiatrist who soon prescribed Prozac for her troubles.
At the time, this struck me as beyond wrong. As a young girl alone in a big city, away from her family for the first time, it was only natural for her to feel a little home sick and down. Add a lousy relationship with a love rat into the mix and any sane person would have been depressed in her situation. It seemed to me that giving her happy pills to make her life more bearable was counterproductive. She needed to feel depressed. She needed to feel bad enough to be driven to make positive change in her life. In short, she needed to ditch the cheating dude, and learn to cope with life alone, rather than popping a pill to make life with him more livable.
And it seems that scientific studies are now supporting my inexpert observations. One new study, which for the first time combined all results from clinical drug trials, including those that had previously been withheld by the pharmaceutical companies but had become accessible under new FDA freedom of information rules, found that, "the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression, but show significant effects only in the most severely depressed patients."
The research, which was published in the Public Library of Science medical journal, drew information from trials of four popular drugs: fluoxetine (Prozac), paroxetine (Seroxat), venlafaxine (Effexor) and nefazodone (Serzone). Given these results, Prof Irving Kirsch and his team concluded that, "there is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective."
Furthermore, Dr Paul Keedwell, of the Institute of Psychiatry, argues that depression serves an evolutionary purpose, and may in the long term actually be good for us. "There are benefits and that's why it has persisted. It's a tough message to hear while you are in depression but I think that there's a life afterwards," said Keedwell in an interview with the BBC. "I have received e-mails from ex-sufferers saying in retrospect it probably did help them because they changed direction, a new career for example, and as a result they're more content day-to-day than before the depression."
So it seems, at least where depression is concerned, what doesn't kill you really can make you stronger. Depression can serve as a useful mechanism that lets us know we need to make profound change in our lives. And if you can work your way through your troubles, rather than reaching for possibly ineffective pills, you'll be better equipped to deal with obstacles down the road. But try telling that to someone who's depressed.
