Stressed out Blissed out U.K.

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The Independent Culture
More and more of us are depressed. More and more of us are being prescribed drugs to take the pain away.

But in a society that promotes stress and depression, how is tinkering with your brain chemistry going to fix anything?

Last week I did something I'd never before done in my adult life. I went to the doctor, not because I had a specific physical symptom, but because I felt that something less definable was wrong. Since the birth of my first child 18 months previously, I've been needing huge amounts of sleep to keep going. Occasionally, I've had to spend the day in bed to top myself up.

At first, I considered my exhaustion to be natural. I'd stopped working a month before my baby was born, and had spent all my time until the birth itself moving house. I'd gone back to work when my baby was 10 weeks old, to a stressful job as a newspaper executive, even though I'd continued breast-feeding until he was six months old. I put my profound tiredness down to all of these physical demands, and had assumed that the pressure and the stress would ease with time. It didn't and eventually I'd decided that what I needed was a change. I'd thrown in the towel, taken a month off and changed jobs, becoming a writer with this newspaper. Now I could spend more time with my son, and of course, in bed.

But I still wasn't feeling too springy in the step area, so I thought it was time for a check-up. This was what I told my doctor, who I'd never met before. The doctor looked at the rim of flesh at the edge of my eyelid, and said that it seemed quite pink. Although she didn't think I was anaemic, she would give me a blood test anyway. She also asked me if I'd been feeling low or tearful or ever had suicidal thoughts. I said that sometimes I did, and at that moment the consultation turned for me into a fait accompli. I couldn't fail to see what she was getting at, and found myself falling into a pattern of call and response which, although I'd never taken part in it before, was utterly familiar to me.

Within a couple of minutes, she delivered her diagnosis. I had depression, and I ought to go on a six-month course of anti-depressants. I could also consider cognitive or analytical therapy. But the former was the course of treatment she'd recommend. Why didn't I take a week to think about it, then come back and see her again?

So I've spent a week thinking about whether or not to go on a course of Seroxat, a slightly more sophisticated cousin of Prozac. I've talked about it to my husband and to my closest friends, all of whom seem agreed that this is not a good idea. I'm still not sure, and feel that since I'm not sure, I shouldn't start taking the drugs. I still believe I have sound rational reasons for feeling the way I do. I understand that depression is an illness and that one shouldn't feel stigmatised by it. But I believe as well that being tired, fed-up and maybe a little unhappy is not an illness, and that the answers can't always lie in adjusting your brain chemistry - in this case your seratonin levels - to fit your situation.

I've been heartened to find arguments backing up this gut-feeling in Malignant Sadness, Lewis Wolpert's exploration of depression which was inspired by his own descent into clinical depression (which I'm certain I don't have) and his eventual recovery using a combination of Seroxat and cognitive therapy. He reckons, though, that doctors are too quick to reach for pharmaceutical solutions and puts this down to cost.

But I don't think that my doctor had cost in mind when she made her recommendation. I think she sees loads of people like me. I think that, in a country where a third of adults are expected to find themselves on anti-depressants at some time or another, and where one in five children suffers from some form of mental illness, she's doing the best she can, helping individuals with depressive symptoms but unable to make broader diagnoses about a society which appears to promote depression.

Several reports have concluded that rates of depression have increased over the past 30 years and are continuing to do so. And it's not just depression that is on the rise. A report from the United Nations, released yesterday, warned that while worries have been expressed in the US, where one in five children are on Ritalin, this amphetamine-based treatment for attention deficit disorder is over-prescribed to children more broadly. The UN identified around 30 countries where Ritalin was being over-used, with Britain up at the top of the list. Ten years on from the day when we were told that Prozac had arrived, depression is more prevalent than ever.

But what no one, even the masterly Wolpert can explain, is why so very many of us are succumbing to this debilitating condition.

Wolpert does, however, make some suggestions: "A striking finding in recent years that could account for the apparent increase in depression has been its growing incidence in the younger population. The mean age for the onset of depression is now less than 30 years. It could be that changing cultural trends, such as breakdown of traditional family life and increased social mobility, may be responsible..."

Wolpert also asks why the loss of a loved one should be so devastating. "The answer," he says, "seems to lie in attachment. Attachment - the need for a child to maintain a close bond with its mother, and for the mother to be attached to her child - is adaptive, helping to ensure the survival of the child and therefore of the mother's genes. For attachment to be effective, the loss or removal of the mother from the child must necessarily cause it distress. Attachment also promotes survival in reproductive couples."

These observations strike a chord with me, and even though it's now considered reactionary to place stress on the importance of the family, it seems a remarkable coincidence that the rates of depression among women have increased so much since the sexual revolution and that the rates of suicide among men have increased so much in the same period.

In effect, the breakdown of the traditional family has meant more parenting for women, as well as work. For men, it has meant less parenting, as couples break down, and more work, when they have more than one home to support. Is it too fanciful to suggest that women get depressed because they have to be successful in too many arenas, but that they can't consider suicide because they have the children to think about? And is it too ridiculous to ask whether men might become suicidal because they feel the stress of their failures, and whether their failures mean that they can't think positively about their children, so feel free to end their lives?

Hideous generalisations both, but again research backs up the idea that both sexes have difficulty in dealing with the new patterns of parenting, while the mental state of children suggests that it's not doing much for them either.

Since I got married and had a child, I've started thinking a great deal more about my own mother and father and how they brought me up. I find it amazing that, until I went to school, I was with my mother all the time, except for a few days when she went into hospital to have my brother. I'd never thought before about how hard that must have been for her, with her own mother and family far away, as mine is now from me. I did always think, though, about how much my father worked - six days a week until he retired.

Both of them did everything in their lives for their children - a way of life I'd rejected by the time I was 14, not ever thinking about the time when I would raise a family of my own, but always thinking about what work I might do. These were the difficulties and challenges to be faced by women. The rest would just happen.

Now I've learned that the rest doesn't just happen, that it's more difficult and more fragile than anything else. I know that despite my new-found admiration for her, I couldn't be like my mother. And anyway, look how much trouble women who needed "little helpers" got into then. But I do know that my own family feels precarious and that that makes me feel stressed. The solidity that I took for granted in my parents is something that has to be worked at long and hard. I feel foolish for having failed to recognise this before. It may be that the condition this realisation has brought me to is depression. But it may also be that I'm suffering a normal reaction to taking on a huge project that I didn't prepare for.

I was tickled to see the report last week which found that lesbians make the best parents. At first it seemed like proof of the old feminist joke, that for a woman to be successful in the workplace, all she needs is a wife. As I read further, I realised the report said something more important. Lesbians appear to make better parents because they are better at dividing up household tasks, at making time for their children, and at organising alternative methods of work whereby each can spend more time at home.

That isn't an option for me, as my husband, like many men, has not one family to provide for, but two. At the moment, both sexes are stressed in both areas, and the social costs of this are huge. Surely that's enough to make anyone feel a little depressed. And surely there aren't any drugs which can fix it.

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