The benefits of depression

There's been a lot in the press this week about depression, partially provoked by a new meta-analysis of studies of SSRI drugs for this 'illness'. When unpublished studies were included, the overall benefits of SSRIs were not greater than those conferred by placebo.

A huge proportion of the first world population take SSRIs; perhaps one in ten in the USA, where unhappiness is both a malady and quite possibly unpatriotic. In the UK, 3 million people were prescribed these drugs last year. Some (like me) have taken them for years and some will have thrown the pills in the bin after a few days. Depression is a much greater problem in the first than the third world, partially because we privileged folks have more time to think about our emotional well-being and more money to pay Big Pharma to make us happy. Despite the money spent and the pills popped, psychological inventories continue to show that the poor in the first-world remain happier than their counterparts in Europe and North America.

I can't hope to disentangle the co-factors in this epidemiological finding, so won't even start. Possible significant factors include genetic traits, family ties, religious beliefs, engagement with material reality, etc. I won't even go there.

I first achieved a label of clinical depression at age 16 and the symptoms wax and wane since with 'bad' stress and life events. They've definitely eased with time, but I can't attribute this to the SSRIs, which I've taken for at least 12 years. These pills despite someimes large doses didn't stop me experiencing severe meltdowns, and (thankfully) do not block natural and usually appropriate emotional reactions. At one time I thought them necessary to block my 'malady' of depression, but I'm less sure now. Firstly, because they don't stop sadness, and secondly because it's more than likely that I have a predisposition (inherited and/or acquired) to being prone to emotional sensitivity.

I was intrigued by a discussion on Radio 4's 'Today' program between Lewis Wolpert and Paul Keedmanwell on depression this week. Prof Wolpert, a confessed sufferer, very much saw depression as a defect and an illness, while Dr Keedman implied that depression could be an adaptive evolutionary strategy to deal with unbearable stress. Depression, Dr Keedman implied, can be beneficial when it helps its owner realise that the current environment cannot sustain life and happiness, and that new strategies are necessary.

Workers in the mental health field realise that depression-the-disease can be life-threatening, and clearly depression so severe as to provoke suicide reduces fitness to zero, in evolutionary terms. On the other hand there may be some 'depressives' like me for whom milder yet debilitating symptoms can provoke a beneficial lifestyle change.

Three years ago I jacked in the job that made me miserable. I'm financially poorer since, but have rediscovered the roots of happiness. While unemployed, I reconnected with the happiness in pleasing myself, reading, dog-walks, Botanic Gardens, time with the kiddos. Work-wise, I wouldn't go back for all the tea in China. I'd also reflect that there may be some other benefits from mild expression of the depressive trait, such as empathy, philosophy and cultural pursuits. Certainly the depressives I know in personal life are amongst my favourite people. Its all a question of degree.