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Monday, November 23, 2009

CHAPTER THIRTY EIGHT: CURING AMERICA’S DEPRESSION





Written by: Rick Staggenborg, MD on Oct 13, 2009 9:01 PM PDT



This essay is dedicated to Aaron Beck, the father of cognitive therapy. He taught us that depression is most often a self-inflicted injury and developed the model for its treatment.



Depression is characterized by a pervasive mood of sadness or loss of interest in most activities, and impairment of the ability to carry out routine activities of daily living. Psychiatrists recognize that sadness is often masked by anger, so depression may present as unreasoning, pervasive anger. While the specific symptoms of depression vary among individuals, it must be recognized that America is suffering a Great Depression, the likes of which we have never seen in our history until now.

Drug manufacturers have managed to largely convince psychiatrists to abandon the notion of “exogenous” depression, or depression caused by external events. Increasing numbers of young doctors leave their training convinced that all depression is the result of faulty genes and therefore drugs are the logical first choice of treatment. 

Although it is acknowledged that psychotherapy increases rates of response to medication and helps guard against relapse, few psychiatrists are skilled in this art and it is too frequently unavailable to the patient in our expensive, fractionated medical care “system.” As a result, very few of the brave individuals who are willing to admit that they are suffering and to seek help actually receive it. The rates of “cure” of depression with drugs alone are dismal. What is needed is to treat the cause of depression, not merely the symptoms.

Seligman introduced the concept of learned helplessness to explain much of our depression. He observed that rats placed in a stressful situation from which they cannot escape despite all effort they might make develop a stress response that mimics depression in humans. In both rats and humans, the normal response to inescapable stress is to develop a persistent elevation in the stress hormone cortisol. 

This is manifested in humans as high arousal or if overcompensated for as a failure of arousal, with lethargy resulting. Constant exposure to cortisol has many deleterious effects, among which is damage to the centers of short term memory consolidation in the brain. As a result, we have difficulty learning from our experiences and may even forget what is causing the problem, leaving us to conclude that our mood is our natural fate, and entirely rational.

A consistently negative mood colors our view of reality. When it represents a change from our normal, functioning, we or others around us recognize that something is wrong. Unfortunately, too many of us grow up with a depressive mindset that prevents us from recognizing that it is neither natural nor necessary to suffer in this way. Our fractured society contributes to the problem by preventing believers in the bootstraps theory from seeing that the simple solution to the problem is to love their neighbors as themselves, and treat them accordingly. If this circle were unbroken, the result would be a healthy society that cared for its citizens.

Typically, conservatives of today sense that something is wrong so are constantly aroused and angry but are helpless to know what to do about it. Because they have been raised with the fallacious belief that they control their own destinies and are therefore responsible when they find themselves suffering from circumstances beyond their control, they must either blame themselves or someone else.

In their helpless, blind anger and confusion they are ripe targets for the propaganda of their leaders and of commentators more interested in their popularity ratings than truth. Knowing that anger is the enemy of reason, these purveyors of fear and loathing work hard to keep their followers in a constant state of fear and anxiety, which are the roots of anger. It is a sad twist of irony that just as fearful people have a morbid fascination with death and disaster, the angry are drawn to Rush, Glenn and Bill like moths to a flame.

Economic hardship is the principal driver of increased rates of depression in recent years. Studies have shown that when a conservative government is in power during times of economic distress, rates of suicide go up substantially. Since Bush convincingly demonstrated that the term “compassionate conservative” is oxymoronic, the reason is clear to see. 

We are in fact not masters of our own economic destinies in the increasingly complex world in which we find ourselves. When government abandons its function of providing for the general welfare in favor of providing corporate welfare, Depression is the natural result. With the US government consisting largely of meat puppets dancing on the strings of their corporate puppet masters, America is at grave risk of suffering an incurable Depression.

The US is not yet moribund, but is suffering the effects of a life-threatening Depression due to its depression. Americans have become so convinced that they are helpless to influence events that they are unable to perform the essential duties of citizenship. These are to educate themselves about what is important, to talk to each other about what sort of society we want and to protect and exercise our right to determine our common destiny through the vote.

It is simply not true that all politicians are corrupt. It is the process of selecting our leaders that has been corrupted by corporate influence and we have allowed this to happen to ourselves. During happier days we became complacent, believing that prosperity was somehow the birthright of all Americans. Now that we suddenly find that this is not true we cast about angrily, looking for a scapegoat. We have decided that we have met the enemy, and it is our own neighbors.

We must quit warring among ourselves if we are to marshal the strength to defeat the corporatist forces arrayed against us in the halls of our Congress. If we appeal to the better angels of our nature, we will recognize that the phony liberal-conservative split is meaningless when both Republicrats and Demicans are working as bagmen for the corporate Mafia. 

Let us abandon the paradigm of political war and begin to work for our mutual interest. We can only do this by looking beyond labels and recognizing our common humanity. The real enemy is found in the inhuman face of the corporatocracy, and it is our responsibility to free ourselves by cutting the strings of its puppets in the Senate, excising the tumor from the body politic, and curing America’s depression once and for all.




In the immortal words of Bill Withers:

Sometimes in our lives.
we all have pain.
We all have sorrow.
But if we are wise
we know that there's always tomorrow.

Lean on me, when you're not strong.
And I'll be your friend,
I'll help you carry on.
For, it won't be long
'til I'm gonna need
somebody to lean on.

Please swallow your pride,
if I have things you need to borrow,
for no one can fill those of your needs,
that you won't let show.

You just call on me brother, when you need a hand.
We all need somebody to lean on.
I just might have a problem that you'd understand.
We all need somebody to lean on.

Lean on me, when you're not strong.
And I'll be your friend.
I'll help you carry on.
For, it won't be long
'til I'm gonna need
somebody to lean on.

You just call on me brother, when you need a hand.
We all need somebody to lean on.
I just might have a problem that you'd understand.
We all need somebody to lean on.

If there is a load you need to bear,
that you can't carry.
I'm right up the road.
I'll share your load,
if you just call me.

Call me (if you need a friend).
Call me (Call me).
Call me (if you need a friend).
Call me (if you ever need a friend).
Call me (Call me).
Call me and I'll come runnin'.
Call me and I'll be there.



Rick Staggenborg, MD

Coos Bay, OR

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