I think the last paragraph is worth quoting in full:
> The book ends with Scialabba’s own advice for depressives. In contrast to the political and economic themes set forth in the earlier sections and the clinical diagnoses of the documentia, this last chapter is personal, with deeply compassionate advice both to the suffering and those who live with and care for them. Friends, food, water, rest, exercise, caregivers, and reading are ways to take control, and if all else seems lost, remember what he calls a truth “close to a scientific certainty; depressions virtually always end.”
It is difficult, perhaps impossible, to describe the experience of severe clinical depression to anyone who has not had it. Gerald Russello's review of George Scialabba's book makes a valiant start.
For those who are not moved by this, and wonder to themselves why George didn't just take a pill, consider also reading another book, written in a different mood, mode, and format by Robert Whitaker, an American journalist and author, who writes primarily about medicine, science, and history.
Looking at your reference, here's the top liked review (in part)
"
I would have given this book four stars if not for the fact that I felt the Mr. Whitaker was overly antagonistic in his writing, and at times even dishonest in his presentation of "facts."
His citations are frequently careless, and he cherry-picks not only the studies he presents, but also the which ones he provides access to through his website. At one point I checked a cited quote to find that he found it in a blurb on a book jacket! Unprofessional. " (reviewer gives 2 stars out of 5)
"
As for my depression, I was prescribed pills and they worked. They weren't a cure but they were the first and very major step out of the blackness. I presume you're taking an anti-medication stance, well please be aware that they work for some people. Sure they have a cost but it's probably a lesser cost than killing yourself.
"Whitaker begins by reviewing the discovery of antipsychotics, benzodiazepines and antidepressants. These were discovered as side effects during research for antihistamines (specifically promethazine), gram negative antibiotics (specifically mephenesin) and the anti-tuberculosis agents isoniazid and iproniazid respectively. The psychiatric mechanisms of action of these drugs were not known at the time..."
He goes on to show, by citing studies, that the drugs were not efficacious in treating depression - quite the opposite. The mechanisms cause disease and chronic dependencies. But the drugs earn billions for big pharma, who covered up the studies and spent millions on spin and obfuscation. The story is akin to the corporate tobacco experience.
They worked for me and they prescribe them because they work - or can. They aren't THE answer, they are AN answer - for some people. Please don't dismiss them.
> But the drugs earn billions for big pharma, who covered up the studies and spent millions on spin and obfuscation
Having worked in the area, this is something I have no trouble believing. And believe me, the side effects of anti-depressents are something I am aware of acutely. They could be very tough indeed.
Edit: from your link (and thanks!): "Whitaker acknowledges that psychiatric medications do sometimes work but believes that they must be used in a "selective, cautious manner. [...] And honestly, they should be used on a short-term basis."[12]"
This is something that makes acute good sense to me.
Edit: let me draw a comparison with painkillers for the body (antidepressants might perhaps be likened to painkillers for the mind). Body painkillers are good, they're useful, but if you need them long-term, someone needs to start looking for some root cause. Some unfortunate souls will develop chronic persistent pain that will need them to take physical painkillers for a long period or even their whole lives, but these should be the rarity. Same with antidepressants.
> They worked for me and they prescribe them because they work - or can. They aren't THE answer, they are AN answer - for some people.
I'm glad you got a constructive result! Thank you for clarifying, throwaway_pdp09. As with many medications, efficacy is specific to (in this case unknown) personal aspects of biology. If they knew how to test for who would be helped and who wouldn't be, the drug therapies could be targeted to exclude the patients who would be harmed.
> Some unfortunate souls will develop chronic persistent pain that will need them to take physical painkillers for a long period or even their whole lives, but these should be the rarity. Same with antidepressants.
The striking differences between those and the drug studies reported in Whitaker's book are (a) the percentage of subjects who obtain negative results; and (b) the rapidity and irreversibility with which these drugs induce dependency.
Whitaker details and examines the ruse peddled by drug companies - that depression and bi-polar are the result of "chemical imbalances" which are "restored" by the drugs. If only it were that simple! But there is no evidence to support that global advertising myth.
In fact, the drugs induce upregulation of neurotransmitter receptors within weeks, which is responsible for chronic dependency, confusion, and tragically in some people, psychosis upon withdrawl. For a better, more detailed and nuanced response, read the book (which quotes the studies).
> If they knew how to test for who would be helped and who wouldn't be...
I am pretty sure there is work in this area. More precisely targeted treatments can only be a win.
I don't dispute whitaker's findings (well especially since I haven't read his book! Nor will have time too sadly) but what trifle I've picked up indicates he's making sense.
> In fact, the drugs induce upregulation of neurotransmitter receptors within weeks, which is responsible for chronic dependency, confusion, and tragically in some people, psychosis upon withdrawl.
It's difficult to address this. All I can say is that I did not find most of these problems, and of psychosis I think I got that while taking the drug, not upon withdrawal. And note this: that psychosis was not a bad thing at all. One side effect I'd happily live with again, even at the cost of memory loss and whatnot. Just a data point.
That's not the "top liked review", throwaway. It only got two stars. It's at the top of the list because it is the most recent. He's just complaining about Whitaker's sarcastic style. In fact, that reviewer goes on to say "So much of this book, though, is true that it boggles my mind how easily Mr. Whitaker could have toned down his sarcasm".
46 likes · Like · see review
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(edit: shortened for space but it is so ordered in full)
OK. But I'm not sure of the source of the reviews or the qualifications/interests of the reviewers. I just linked to goodreads in a hurry since you asked for an indication of the synopsis, which is fair enough.
Whilst Whitaker's tone does get polemic at times, that's because his conclusions are evidence based, and this is a public health crisis, on a similar scale to the opioids crisis in USA, and corrupt in the same way that tobacco corrupted the medical industry for a time.
Whitaker presents references to the studies and he does seem to have made sustained, energetic efforts to research this subject exhaustively.
> The book ends with Scialabba’s own advice for depressives. In contrast to the political and economic themes set forth in the earlier sections and the clinical diagnoses of the documentia, this last chapter is personal, with deeply compassionate advice both to the suffering and those who live with and care for them. Friends, food, water, rest, exercise, caregivers, and reading are ways to take control, and if all else seems lost, remember what he calls a truth “close to a scientific certainty; depressions virtually always end.”