The Loss of Sadness

The Loss of Sadness: What a uniquely poignant phrase. A new book with that title examines ‘How psychiatry transformed normal sorrow into depressive disorder.’

Normal sorrow seems like a hard thing to quantify. Remember how Freud hoped to transform hysterical misery into common unhappiness? Things have changed. Now, our society has little tolerance for common unhappiness. Being unhappy is both a personal shortcoming and a huge source of concern to the World Health Organization, which now projects that by 2020 depression will be the second leading cause of disability for people in midlife and women of all ages.

The DMS-IV doesn’t allow for factors such as stress, hardship or socioeconomic class in its checklist for depression. Maybe the DMS-V (due in 2012) will de-pathologize some instances of depression, but that seems doubtful. There was a time when shyness wasn’t considered a treatable illness, but that’s over. Social Anxiety is another pox, defined as such in a brilliant and wide-reaching publicity campaign launched in 2002 by GlaxoSmithKline, makers of Paxil.

I am a product of Big Pharma’s influence on our culture, specifically, Wyeth Pharmaceuticals. Effexor has transformed me from an introverted self-loathing misanthrope into an outgoing people-person. Once, I writhed in an agony of self-consciousness in any social gathering. Now, I have to be dragged away from all the new ‘friends’ I’ve made. Once, I looked around and saw strangers who seemed boring or repellent. Now, I see potential soul-mates. My social confidence is almost sickening.

What bothers me is that no one knows exactly what happens systemically when you tamper with serotonin. Depressed people and their physicians have been led to think it’s as simple as ‘the brain needs more serotonin to reduce depression.’ Studies showing conclusively that Proxac causes an increase in both suicidal and violent behavior have been brushed aside until recently. Getting off antidepressants is a well-documented nightmare. So much for the innocent non-addictive medications we thought we were taking. “No Free Lunch” comes to mind. Also, “Shit, what if Wyeth goes out of business?”

I would like to hear what Freud would say now. Probably something about his mother or his penis. Maybe we need more philosophers who are physicians, or vice versa.

A society that promotes changing one’s personality to achieve a very limited standard of normal is kind of depressing, but my meds keep me from despairing about it. If the ideal character type is now a cheerful extrovert, fine, but our inability to be reserved or reflective or despondent is bound to have a profound effect on every aspect of our culture. Maybe reality shows are an early warning sign.

Those of us on antidepressants who have traded our libidos and intestinal functioning for a sunnier disposition would not likely join the argument that depression fuels creativity. But I believe it does involve a certain pessimistic clarity that we forfeit as part of the deal. Studies suggest that optimists are actually less able to perceive things realistically than pessimists. For many of us, though, the clarity is unbearable. One psychiatrist I met compared it to an allergy; reality was the pollen.

Among my friends and loved ones are people with difficulties they haven’t chosen to medicate…yet. For the most part, I salute them for being able to stand themselves. And for holding out when they could be calmer, perkier, or more even-tempered. Perhaps they just aren’t sad enough to seek relief. The best way I can communicate my own process on Effexor is this: I still feel kind of hopeless, but I just don’t care that I do.

The pharmaceutical   companies are probably working around the clock to perfect a drug that creates a sense of detachment, at the same time producing an insatiable urge for consumer goods. (As I type this, I realize that I’ve just described TV!) Okay, then maybe we need a drug that allows the perfect interface for sadness, allowing us to cry at “Forrest Gump” and funerals and stories about abused dogs, but filtering out any deeper sense of existential discomfort.

What I’d like is to alleviate my worry that I’ve become the person I used to hate at cocktail parties.