Did you catch the segment 60 Minutes did last year about the placebo affect in treating depression? What are your thoughts? I personally am anti-drug, but I am far from having the knowledge of any professional…in other words it’s an emotional choice.
No I did not see that. But I do have some thoughts. Placebos certainly raise issues about antidepressants and the other psychiatric drugs. When the antidepressants are tested, the standard that is used to prove effectiveness is done by comparing them to placebos. For instance, if placebos work 30% of the time and Prozac works 40% of the time, then Prozac is declared an effective treatment. What this really means is that Prozac works 10% of the time more than a sugar pill. And what about the other 60%? The more important conclusion from this is that 90% of the time the actual drug effect isn’t doing anything. As you can see, this is significantly misleading. However, the accepted standards of science are so bizarrely low that this is taken to prove that Prozac is an effective treatment. These standards are not only absurd on the face of it, but they have been corrupted by the power of the pharmaceutical companies.
In addition, the actual criteria being used to measure effectiveness for Prozac isn’t clearly defined. It isn’t even definable, since there has never been any proof of biochemical causation in the brain for so-called biological depression in the first place, nor a clear cut definition of depression. Nonetheless we are led to believe that proof is just around the corner. But it never comes. Consequently measurements of Prozac’s effectiveness aren’t based on anything real. I give an explanation about what depression is, where it comes from, and how it is manifest in the brain, in my forthcoming book. (And I apologize that publication is still about two months away.)
I wouldn’t say that depression is exactly the result of a human choice, either. It’s a common but false dichotomy to say it’s either a biochemical disease or an emotional choice. Its is actually a complicated break down of a person’s character under the duress of significant life struggles and losses. Real depression follows along the fault lines of a character composed of particular temperamental elements, that had formed in concert with the impacts of deprivation and abuse. And suffice it to say, it is not ‘a biochemical disorder.’ It is not a brain problem, as pharmaceutical psychiatry promotes. It is a human problem, as is all the rest of psychiatric suffering. This has been so since the dawn of humanity. Depression and other psychiatric suffering is very real and not something that can just magically be eradicated. Depression requires a real psychotherapy to foster an actual recovery, where the suffering of the present is mourned in concert with its resonances with the past.
In the meanwhile, the placebo effect is intriguing, but rather straightforward to understand. Basically the placebo effect is a form of belief. Short term effects can be seen as a result of belief systems all the time. Beliefs operate from what is called top-down cortical functioning. That is to say, if we believe something, it has considerable self-hypnotic power. This is a built-in manifestation of human consciousness. But this only lasts as long as the flavor lasts. There is no real change. The placebo-effect is simply a form of the temporary power of belief. I want to emphasize that it would be misleading, as well, to assume that placebos actually treat depression. To reiterate, neither a sugar pill believed to be magic, nor a Prozac pill believed to magic, addresses real human suffering and never can.