Pill popping nation

Helen Razer embraces some old fashion sadness.

You’ve just found your no-good, whore girlfriend in bed with half a netball team. Just as she’s about to climax and shriek “GOAL”, the Wing Defence bobs up her head to reveal that she is, in fact, your sister. You enter a fug of self-loathing and do not bathe or eat for a week. When your boss calls you in for a hygiene warning, you decide to patch the fragments of your crazy-quilt life back together. Using the DSM, as most General Practitioners  do, Doc pronounces you medically depressed.

Every fucker is depressed. Seriously. If you read the standard definition for Depressive Disorder in the Diagnostic and Statistical Manual of Mental Disorders (the DSM) you’ll likely find that you have been medically depressed, too. It’s easy. Everybody’s doing it.

Just a few years ago, my grandmother found herself at the end of a long and messy brawl with cancer. She was always a genial lady but the loss of hope, twenty kilos and a good deal of one’s bowel all tend to dampen the spirits. Dying is an untidy, miserable business that no one can manage with grace. I never expected her to be upbeat about the matter.

An attending doctor, however, had a different view. One afternoon in the hospice, he asked her how she was feeling. That she did not answer, “Like upending my colostomy bag on your head” was to her credit. She was a gracious woman.

“Are you having trouble sleeping?” he asked. She answered yes. And she answered yes to all his questions in a rhythm familiar to millions of Australian patients. Yes, I find it difficult to concentrate. Yes, I am anxious. Yes, I think occasionally about death. If you’ve been feeling this way for longer than a fortnight: congratulations. You are not a garden-variety miserable human. You are, in fact, depressed.

Cancer. Whore girlfriends. Colleagues who cannot abide your stench at work. For the past twenty years, such misfortunes have been deemed irrelevant to a knee-jerk diagnosis of depression. If you don’t believe me, look it up. The only exception in medicine to a diagnosis of depression is recent bereavement. Not even terminal illness cuts it as a reason for sorrow, these days.  

The doctor prescribed my Nan Cipramil; one of the Selective Serotonin Reuptake Inhibitor drug family that includes more famous treats like Prozac and Zoloft. In a sound medical universe, this might be shocking. The fact is, though, these prescriptions are written out to Australians at the rate of 12 million a year.

My Nan was not depressed. She was, quite justifiably, angry and sad. She was not depressed and, so, responded to anti-depressive drugs not by smiling to a medically acceptable standard. Instead, she got diarrhoea and indigestion. Side-effects, to be fair, that are barely noticeable in a frail 97-year-old who has had much of her gut removed. So, win-win for the pharmaceutical industrial complex.

This, of course, could be read as an extreme case of lazy diagnosis. I wish it were. The fact is, though, so many of us are shoving drugs in our pie-holes for problems which, however serious, should be neither medicalised nor medicated.

This is not, for a minute, to suggest that serious depression does not exist. It is, however, to suggest that on your next encounter with sadness, you find a practitioner whose first response is not to pump you full of drugs and diagnoses. It is also to suggest that over-diagnosis of depression compromises the genuine science for a disease which, still, has no biological markers.

Life can be fairly shitty. At the shitty end of her otherwise good life, my grandmother found that it was warm soup and kind words that worked where the eagerness to diagnose and prescribe had failed.  

Folk bang on and ceaselessly on about the “stigma” of mental illness when, in fact, it is everyday sadness that has become stigmatised right out of fashion. We now take it as read that feelings of sadness are not normal reactions to life but evidence of disease.

SO, if you know of a good therapist who serves warm soup and wisdom, drop me a line.