Comment from my doctor
Sometimes I diagnose what I believe to be biologically-based depression and I give a patient a prescription for antidepressants, only to have the patient go to a spiritual advisor who then counsels them with a “five-Bible-verses-and-you’ll-be-better” prescription.
I get it, doc. It’s wrong for these spiritual advisors to reduce people to purely spiritual beings who simply need more Bible verses. However, I am sure that you agree that we equally should not reduce people to merely physical beings with only neurological needs. The primary prescriber of antidepressants and anti-anxiety medications are you and your fellow family practitioners.
I understand that you have a list of nine characteristics for assessing depression, but my concern is how quickly a diagnosis is possible and how misleading it could be to think of the medicine as the remedy.
By the way, how much time do you spend with each patient? If I get ten minutes of your time, it seems like a lot. You have patients waiting in other rooms. How adequately can a diagnosis be made in such a short amount of time? And how often do we misdiagnose normal sadness as disordered sadness?
Don’t misunderstand. I sympathize with the pressures on doctors ever since the unseating of therapeutic psychology by bio-psychology. I realize that the convergence of medicine with pharmacology, insurance, lawyers, and big business has made work complicated for doctors. I am also grateful for the benefits of drugs for neurologically related needs.
My concern is how often a patient assumes that medicine is the whole answer for her needs. Is consideration given to her social circumstances? We are also social beings with relationship needs. Perhaps we also have unrealistic expectations for happiness. Do we have an adequate understanding of the anatomy of normal sadness and how it differs from disordered depression?
(From my book – “The 18-Year Factor: How our upbringing affects our lives and relationships”