A recent study has concluded that SSRIs, when treating for major depressive disorder, are not that much better than placebo. Depression as a symptom and as a formal diagnosis, is too simple a label to attribute to a person who feels and experiences life without joy or pleasure and who may have real physiological changes that render his/her life unpleasant, if not unbearable. By attributing a diagnosis to a person such as “depression,” the patient and the diagnosis become frozen in time and separated from all possible antecedents, mediators and triggers. All further enquiry into the timeline of causation comes to an end and the patient (and the doctor) now objectify and identify with the diagnosis, as if some foreign entity, called “depression” just mysteriously fell out of the sky. Add to this scenario the fact that ones entire medical school training is not aimed to enquire as to upstream causation. In the truest N2D2 tradition of medicine (name of disease, name of drug), we are trained to thread together a constellation of symptoms, arrive at a diagnosis and prescribe a treatment1; all under the 15 minute timeline and the approximately $40.00 fee that the Canadian health care system provides for a consultation. It does not take much to deduce that this is a hopelessly inadequate scenario and not one to foist onto ones worst enemy.
Depression, as a diagnosis, has a litany of possible antecedents (ancestral and genetic predispositions and inheritances), triggers (events that trigger the manifestation of the constellation of symptoms that coalesce to form a diagnosis) and mediators (lifestyle events and behaviours – diet, sleep, food, stress, exercise – that continue to contribute to the diagnosis). From ancestral trauma (that we now know to be epigenetically inherited), to early conception and birth trauma, to adverse childhood experiences and complex trauma, to head injuries, to genetic weaknesses in detoxification and methylation (creating scenarios of over and undermethylation) nutritional and hormonal inadequacies, to toxic insults such as mercury, lead, copper toxicity, mold, Lyme disease and co-infections, to sleep apnoea, to relationship struggles, workplace difficulties, transition from first half of life ego demands to second half of life soul demands; the list is long and complex.
Unless doctors/healers of the future are trained in a new paradigm (Functional Medicine is putting up a valiant effort to educate future health care providers in this methodology), have sufficient life experience and have spent a large portion of their learning years investigating and researching the multiple layers and levels of complexity (7 Stages to Health and Transformation) that may contribute to the origins and continuations of symptom or disease processes, you, as a health care consumer, will always be at the mercy of their experience (or inexperience) along this continuum. That is why it is imperative that all patients, as much as they can muster the lifeforce to do so, become advocates of their own health and treatment protocols. Patient self-advocacy, combined with a serious intent to do what it takes to get well, is always at the root of successful health outcomes. Or, if faced with a depressive illness or episode, we can hand over all power to the physician/healer we have consulted, take an antidepressant and hope for the best. Your choice.
Dr. Bruce Hoffman, MSc, MBChB, FAARM, IFMCP is a Calgary-based Integrative and Functional medicine practitioner. He is the medical director at the Hoffman Centre for Integrative Medicine and The Brain Centre of Alberta specializing in complex medical conditions. He was born in South Africa and obtained his medical degree from the University of Cape Town. He is a certified Functional Medicine Practitioner (IFM), is board certified with a fellowship in anti-aging (hormones) and regenerative medicine (A4M), a certified Shoemaker Mold Treatment Protocol Practitioner (CIRS) and ILADS trained in the treatment of Lyme disease and co-infections. He is the co-author of a recent paper published by Dr. Afrin’s group: Diagnosis of mast cell activation syndrome: a global “consensus-2”. Read more about Dr. Bruce Hoffman.