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He Current Drug Treatment For Depression Represents One Of The Greatest Fallacies In The History Of Medicine.

August 15, 2002

DEAD WRONG

By Nathaniel S. Lehrman, MD

The current drug treatment for depression represents one of the greatest fallacies in the history of medicine.

Depression is not a disease, such as pneumonia or malaria. Rather, depression is usually a psycho physiological reaction to an individual’s current psychosocial interactions. Depressive reactions are also seen in animals exposed to continuing levels of stress from which they cannot escape.

When thinking of depression, think of fever, which is also a reaction of mind and body to a set of complex conditions.

It has been known for centuries that talking with a caring counselor can help depressed people. If the counselor is cheerful and confident (which seems less frequent today), and conveys that confidence to his client, the latter’s chances of relief will be greater. Religion and its officiants have provided these services over the years. And personal caring has been seen as an essential part of the doctor-patient relationship and is known to have a considerable impact on medical interactions; in psychiatry, that impact may be even greater.

The Effectiveness Of Counseling In Depression

The therapeutic effectiveness of caring dialogue is still greater if it addresses the real psychosocial issues evoking the depression - a statement based on personal experience since I began the private practice of psychiatry in 1953, long before the drug era.

I was certain then, having just finished my psychoanalytic training, that depressive and other psychiatric complaints were the products of childhood traumata, and that these complaints could be resolved by digging out those experiences. My confidence had a tonic, cheering effect on my patients. But I soon found that recovery depended more on attention to current problems than a focus on the past.

I learned this most sharply from a patient, depressed in a foundering third marriage, who wondered what in her childhood was responsible. But...