Depression from Both Sides

To paraphrase Joni Mitchell, “I really don’t know depression at all.”

Do you believe in coincidence? Yeah, I don’t know about that either. But it seemed a little strange that I get a whisper in my ear this morning that it’s time to write a Sidebar article for LAP; I sigh because I’m really not inspired to do so; then I open up the New York Times Book Review on my iPad while I’m waiting for my case to be called, and the first review to catch my eye is “Mental Illness Is All In Your Brain—Or Is It?”

The review by Jennifer Szalai is of a new book by Anne Harrington titled Mind Fixers—Psychiatry’s Troubled Search for the Biology of Mental Illness. I haven’t read the book yet, but my review of the review leads me to believe that the thesis of the book involves psychiatry’s century-plus struggle between “hard science” and “soft science.” It goes from the early hard scientists who lobotomized, to the soft scientists who blamed it all on your parents, to the hard scientists who trumpeted better living through chemistry, to the soft scientists who say that maybe we don’t really understand the chemistry well enough to be prescribing as much as we do. It is a profession seeking respect from the medical community, which withholds respect because they think they do science better. No wonder we’re so screwed up.

Well, I’ve looked at depression from both sides now, and I feel very strongly both ways.

My first diagnosable experience with depression was a deep, dark hole in my mid-30s, from which I saw no light nor hope. I was dragged kicking and screaming into therapy and also into a prescription for Prozac, the early cure-all for depression. I found that the drug was not helpful, but that a year of weekly talk therapy saved me and lead me to a better life. So, I became an expert on depression, giving talks about the advantages of counseling over drugs.  

Fast forward 15 years. I had a medical crisis that I survived, but which took out my endocrine system. I had not thought of my endocrine system since eighth grade biology, which I did not excel in. But I know now that it controls all the hormone glands that send chemicals to your brain. That, in turn, allows your body and your brain to adjust to all of life’s curveballs, from a change in temperature, to a bear attack, to a response to a personal insult. In other words, your endocrine system chemically controls your personality and every phase of your life.

So, after years of believing that one must just master one’s psyche, I now find out that my psyche is being determined by a pharmaceutical cocktail of replacement hormones, which may have little to do with my free will.

Now, I understand that one cannot always talk oneself out of any malaise of the brain. Our brains work on chemicals, whether naturally produced or from Big Pharma. But, I also think that I believe the premise of the book—that Big Pharma may have over-promised.

I’m kinda stuck with my hormone replacement therapy, as they have convinced me I will die without it. It is not anti-depressants, per se, but it does lead me to understand that brain chemistry is not something that can be totally determined by wise counseling.

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