Vijai P. Sharma, Ph.D
In the medieval times, Timothy Bright wrote "A Treatise On Melancholie," in 1586 which is credited as the first psychiatric book in the English language. In 1621, Robert Burton wrote "The Anatomy of Melancholy," arguably the first self-help book in English language on an emotional disorder. Burton saw depression as a fact of life, "even in the midst of our mirth and jollity, there is some grudging complaint, our whole life is a glucopicron, a bitter-sweet passion, honey and gall mixed together, we are all miserable and discontent, who can deny it?" We can safely conclude that the humankind was struggling with depression then and it's struggling with it now. Now, perhaps, depression is far more prevalent than it was ever before.
Findings of the Studies of Environmental Catchment Area (ECA) indicate that only 4 percent of people born around 1925 suffered from depression. Depression was much less prevalent in people who were born before the first world war. Among the people born before World War I, only 1 percent had suffered depression. That is a fourfold increase! If that sounds like an incredible rise in depression, compare that with the present rate of over 9 percent. Nine out of one hundred people will, in their life time, have at least one episode of depression.
Ironically, the increase in the incidence of depression is not the result of the two world wars. People born after 1967, twenty-one years after the second world war, are ten times more likely to suffer depression than people born before 1933. The National Institute of Mental Health (N.I.M.H.) also conducted a study on the incidence of depression in the general population, called the Relatives Study. This study too showed a tenfold increase in depression over the course of the century. Compared to the present times of prosperity, fewer people were depressed during the period of Great Depression. Ours is the era that deserves the title, "Great Depression," with a different twist, of course.
Since you heard the bad news first, it is of course time to hear the good news. Good news is that now there are far more effective medical and psychological ways to treat depression. There were sure fewer depressed patients in the society as a whole when I started to train as a psychologist, but those who I saw at my training hospital and outpatient clinic, were in abject physical and emotional misery.
The word "vegetative depression" was used in all earnest to depict the plight of these patients. They had no desire or energy to move and didn't get out of bed for months. Change in their appetite and weight during depression used to be enormous. It appeared like their whole physical and mental system had shut down. Nothing could be done except wait until the depression was "lifted." Then came the tricyclic antidepressants that shortened the duration and severity of depression. Now, we have even more effective medicines to deal with such physical signs of depression.
The newer antidepressants, called SSRI, unlike the tricyclic, does not make one drowsy which is a blessing for people who have to remain alert and productive and lead a normal life. As one becomes more active, their outlook on life changes and they can get back to normal functioning with continued use of medication. Not only have the antidepressants become more effective, psychological therapies have also become sharper and shorter. Therapists can identify more precisely the thoughts and feelings that produce and maintain depression. Therapists of cognitive and behavioral schools have developed precise tools to change those thoughts, feelings, and behaviors that "produce" and perpetuate depression.
Psychological therapies alone can be highly effective with depressed people.
Especially with those who have not developed severe disturbance of biological functions, such as severely disturbed sleep, gross suppression of appetite or rejection of food, drastic weight change, or incapability to perform simple movements due to exhaustion or lack of energy. For such biologically depressed individuals, psychological therapies must be combined with medication. A person who is severely biologically depressed, may be too exhausted or hopeless at the beginning to make any significant use of psychological therapy. In such a case, medication alone may be utilized to bring a person up to the level that he or she can make the effort to change his or her thoughts and feelings.
At some point, everyone with a tendency for
depression must examine his thoughts, feelings, attitudes
and beliefs that lead to depression. To just depend
on antidepressants without changing the psychological
make-up is like taking medication for a heart disease
without attempting to change one's lifestyle, in the
areas, such as diet, exercise, alcohol consumption,
etc. In some cases, people just need skills and in
some cases, they need pills and skills. Thoughts
create feelings. Thoughts and feelings create
corresponding chemicals in the brain and the body just as
chemicals in the brain and body manufacture corresponding
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