Preventing Depression

I love it when people who actually know what they’re talking about confirm something I’ve believed for ages.

In this case, a study at the Feinberg School of Medicine (that’s Northwestern’s med school) showed that one out of every four or five college students who come to their school’s health center may be suffering from depression. The study also recommended that colleges should start screening students for depression. This way, they might even be able to pinpoint students with minor depression and help them get treatment before their depression worsens.

Ever since I’ve started seriously reading about psychology and depression, I’ve felt that we should start taking a preventative approach to it–not just in colleges, but everywhere. Depression tends to worsen with time, and even when it does remit on its own, it usually comes back later, with more intensity. Furthermore, distorted thinking patterns seem to precede the development of a full-blown depressive episode, so why not address those earlier rather than later?

For instance, parents take their kids to the doctor to make sure that they’re growing at a normal rate and developing the cognitive abilities they’re supposed to develop–why not also check to make sure that kids aren’t developing negative and maladaptive thinking patterns that could increase their risk for becoming depressed later?

You might think that kids are too young to show definitive patterns, but I think that’s false. My own little brother, who’s eight years old, constantly complains that he’s fat and needs to exercise, despite being underweight for his age. He also says that everyone at school hates him (they don’t) and that his school is awful and should be burned to the ground (and various other sentiments that have gotten him sent to the principal’s office before). Perhaps most importantly, he also has a pervasive family history of depression.

The unfortunate truth is that society views mental illnesses as fundamentally different from physical illnesses. One is a straightforward matter–you go to a doctor for checkups, and if something is wrong, you receive treatment. The other is for some reason shrouded in mystery, and people generally don’t go seek help for it until they’re already barely functioning.

As recent scientific developments are beginning to show, however, it may be that all mental illnesses actually have a physical basis. More and more psychologists and psychiatrists (notably, Peter D. Kramer of Listening to Prozac fame) are starting to take this view. If they’re right, it follows that we should try to take a preventative approach in treating mental illness, not a palliative one.

However, many people still have negative attitudes about the idea of psychological screening. One of the students quoted in the article linked to above said that these screenings are a bad idea because someone could just “be having a bad day” and–oh, the horrors–get recommended for counseling. First of all, however, counseling isn’t exactly the same as taking antibiotics or getting a spinal tab. Second, that just means that we need to develop better depression screening tools, not that we shouldn’t screen for it at all.

In college especially, conditions like depression can take a turn for the worse rather quickly, as evidenced by the several suicides we’ve had on campus while I’ve been a student here. Every time a tragedy like that occurs, friends and family are often quoted as saying that they “never saw it coming.” Maybe a professional psychologist would’ve.

Middle Class Sexuality

I saw this interesting op-ed at the New York Times’ website today. It talks about the “Viagra for women” (flibanserin) that was recently rejected by the FDA and how the sexual problem for American women isn’t medical but societal, because the “white upper middle class” has essentially become uptight and frigid.

I agree with the op-ed in some ways, because it’s true that American culture is actually extremely Puritan despite the gratuitous amount of sex present in its media (including advertising and entertainment, of course). Once when my grandma came from Israel for a visit, she was shocked that at the swimming pool, men wear huge, baggy trunks rather than the tight little briefs they wear in Israel. That’s a rather trivial example, but it showcases one of the many strange contradictions in American culture. Nearly-naked men abound in the movies and in advertising, but they’re unacceptable at the pool (which, one would think, is a place where people go to be nearly naked).

In any case, there are probably better examples of this, like the fact that the government spends millions of dollars on teaching junior high students that one should never have sex before marriage, and high schools will make students call their parents and ask them to bring a different shirt if they wear one that bares–gasp–their shoulders. (The fact that schools try to send such a strict message when kids are bombarded with highly sexualized media every day is nothing short of ludicrous. It’s media literacy they should be teaching, not abstinence till marriage.)

The fact that all of this eventually leads to a complete lack of sexuality is unsurprising. When you spend your entire life being told that sex is sinful and shameful, I can see how you’re not going to get terribly enthusiastic in the bedroom. However, where I take issue with Paglia (the writer of the op-ed) is her suggestion that this is all attributable to “white” culture. Christian culture, maybe. But white culture? The op-ed uses the example of female celebrities to argue that since Latinos and African Americans seem to be more sexualized, the overall sexual deficiencies of American women can be attributed to white women:

Furthermore, thanks to a bourgeois white culture that values efficient bodies over voluptuous ones, American actresses have desexualized themselves, confusing sterile athleticism with female power. Their current Pilates-honed look is taut and tense — a boy’s thin limbs and narrow hips combined with amplified breasts. Contrast that with Latino and African-American taste, which runs toward the healthy silhouette of the bootylicious Beyoncé.

I’m just not sure about this generalization. After all, Beyoncé may be African American, but plenty of white people love her, too, and it’s pretty much universally agreed that she’s gorgeous. Does the fact that black women tend to be curvier than white women make black women more sexual? And aren’t there plenty of thin black women and curvy white women?

I suppose I’m just uncomfortable with the idea that women of color are somehow more sexual than white women. I think Paglia takes it too far there. However, white culture has been the dominant culture in America since its inception (due to demographics and discrimination), so I guess you can blame most of our societal quirks on it.

Aside from that, though, the op-ed made many great points. This paragraph struck me as very insightful:

In the discreet white-collar realm, men and women are interchangeable, doing the same, mind-based work. Physicality is suppressed; voices are lowered and gestures curtailed in sanitized office space. Men must neuter themselves, while ambitious women postpone procreation. Androgyny is bewitching in art, but in real life it can lead to stagnation and boredom, which no pill can cure.

I can’t say I could offer up a solution to that, but it’s a keen observation all the same. Yes, in terms of sexuality, American culture is downright boring, and no pill can fix that. Or rather, I’m sure they’ll find a pill to fix that eventually, just like they find pills to fix everything else, but it’d be nice if we didn’t need pills.

Paglia ends the op-ed by writing, “Pharmaceutical companies will never find the holy grail of a female Viagra — not in this culture driven and drained by middle-class values. Inhibitions are stubbornly internal. And lust is too fiery to be left to the pharmacist.” No one would suggest that we return to all being poor and leaving 99% of the nation’s wealth to a few elites, but clearly, a culture mostly controlled by the middle class has some unfortunate drawbacks.