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Nashaly Ruiz-Gonzalez Dr.

Padgett ENGL 1102 December 3rd, 2013 From Neglect to Prozac According to Bloomfield, depression is the #1 public health problem in this country; it has become an epidemic on the rise (Bloomfield). Depression is one of the most common mental illnesses that the population of the world suffers from. Depression, in Wells terms, is defined as feelings of sadness or apathy accompanied by [other] symptoms. Some of the symptoms that depression presents can be mild, though others can be debilitating and persistent enough that they require clinical intervention (Wells). This is where the treatment of depression comes in. I believe that as time has passed, the treatment of depression has improved thanks to the introduction of physicians specializing in mental illnesses and the tools that are now at their disposal. Early doctors had little to no knowledge on how to treat mental illnesses. According to Callahan, primary-care physicians in the early part of the twentieth century had no special skills, training, or empathy in regards to mental illnesses like depression. Doctors were likely to be specialized in only physical illnesses, such as the flu or a broken bone. Mental illness, however, requires much more than a shot or cast, and practicing physicians at the time were not prepared to aid those suffering from mental illness, or did not want to occupy themselves with the task at hand. Callahan writes of Cuthbert A. H. Watts, who is a general practitioner in the United Kingdom who trained in the 1930s and his view on the reaction to those who would seek

psychiatric care during his time as a practitioner. According to him, any psychiatry casualty was viewed as the usurper of a useful hospital bedsomething to be removed with almost unseemly haste. To physicians of his time, someone suffering from mental illness was unworthy of their time and was taking up the space that a real patient would otherwise be occupying, as there was a bias that people with depression are just unable to cope with lifes disappointments (Downing-Orr). On that train of thought, the treatments that mental illness patients were able to receive were often lackluster and not as effective as they should have been. There were several problems with the available treatment, one large one being the high risk of an unreliable misdiagnosis (Ban). Prior to the boom in psychiatric treatment, there was limited information on the signs and symptoms of psychiatric disorders (Ban). According to Ban, there needed to exist a more unitary approach to psychiatric disorders. He goes on to state that there needed to be more specific diagnoses and an increase in studies of clinical psychiatry in order to further evolve the availability of a diagnosis that could be trusted by the receiving patient. Bans logic is, ultimately, correct. Without any concrete knowledge of the mental illnesses that people are affected by, psychiatrists and physicians alike would be unable to determine a diagnosis, which would make it impossible for them to receive the care they require. Its no surprise that most mental illnesses were likely to go untreated, even if physicians thought mentally ill patients worthy of the time, effort, and care that they required. However, now we have physicians that specialize in the trade of treating mental illness without the presumption that these patients do not deserve the care that they are providing. The process for determining the diagnoses for each mental illness has greatly improved, which enables physicians to easier get to the root of the problem and use treatment that is proven to

be more effective. For example, there are areas of the brain that are affected by depression, and those areas can be highlighted using Magnetic Resonance Imaging (MRI scans). When a patient or someone suspected of suffering from depression undergoes an MRI scan, the parts of their brain that are affected by the hormonal imbalance of depression are shown, and physicians can be increasingly sure that what they are required to treat is a care of depression as opposed to a physical illness. There are also effective methods to treat depression. Patients can be prescribed antidepressants, like Prozac, that have shown to be successful in 65 to 70 percent of patients in the acute care phase of major depression (Wells). Antidepressants are, however, often seen as ineffective by patients that want a quick fix because they require several weeks to fully kick in and have a therapeutic effect (Wells). The antidepressants that are available can have a range of effects on the patient receiving them that can either aid their depression or worsen it. With agitated depression, depression medication that has a sedative effect would be ideal, but sedatives should not be used for every type of depression. More commonplace antidepressants, like Prozac, do not cause sedation or any of the side effects of older antidepressants, but they do cause insomnia and agitation, which can lead to more problems (Wells). It is up to the patient and the physician to work together to find an antidepressant that works well with the patients symptoms and allows them to live comfortably. That is the key to an effective treatment. In addition to prescription medications, therapy is another effective way to treat depression. It has become increasingly more available to the population, as some institutions, such as our own University of North Carolina, offer it free of charge. Its highly beneficial for those that do not want to just rely on antidepressants to help with their disorders. With therapy, patients are able to sit down and discuss what they believe could be the root of their mood

disorders. Therapists are able to offer unconditional positive regard and allow their patients to get themselves together and lift themselves back up as they need to, with help and support. There are many ways that therapists are fitted to their patients, based on what the issues the patient is having are, their availability, and their willingness to work around and with problems. As a population dealing with depression, we have come a long way from ignoring those that are suffering to being more than willing to lend a hand, as just people and as physicians and institutions. If it were not for the information that has been gathered and made available to physicians, as well as the proper treatment tools, I am sure we would still be turning away those suffering from depression and its effects.

Works cited Ban, Thomas A. Prevention and Treatment of Depression. Baltimore, Md: University Park Press, 1981. Print. Bloomfield, Harold H, and Peter McWilliams. How to Heal Depression. Los Angeles, Calif: Prelude Press, 1994. Print. Callahan, Christopher M, and G E. Berrios. Reinventing Depression: A History of the Treatment of Depression in Primary Care, 1940-2004. Oxford: Oxford University Press, 2005. Print. Downing-Orr, Kristina. Rethinking Depression: Why Current Treatments Fail. New York: Plenum Press, 1998. Print. Wells, Kenneth B. Caring for Depression. Cambridge, Mass: Harvard University Press, 1996. Print.