Depression is not the same as "being sad", Giles Fraser

Casual “let’s not pathologise sadness” musings don't contribute much to the debate about medication for depression.

I’m writing this post to dispel a few myths about depression and the use of medication. I should mention, however, that I’m none of the following: psychiatrist, psychologist, pharmacist, biologist, philosopher, renowned expert in happiness and the inner workings of every human soul. That said, neither is Giles Fraser, the Guardian’s Loose Canon, but he hasn’t let that stop him. Besides, unlike Fraser, I’m in a permanent fog of drug-induced pseudo-contentment, hence I’m even less likely to demonstrate any degree of restraint.

In a piece entitled "Taking pills for unhappiness reinforces the idea that being sad is not human", Fraser rehashes many common stereotypes about depression, mental illness and SSRIs. To be fair, he doesn’t do it quite as nastily as some people. He’s no Julie Burchill, for instance (sorry, Giles!). Nonetheless, making tired, half-baked claims in a seemingly well-meant manner can be even more damaging than just being an out-and-out bully.

I’ve taken Prozac, on and off, for 18 years. Mostly it’s been on. I’m not sure whether I should say it’s “for depression” as I’m conscious this can get people’s backs up, as though I’m positioning myself as one above those who merely get a bit fed up. Ooh, look at me, I’m depressed and that means I’m special! is what no one who suffers from depression actually says, but other people hear it all the same, since the alternative — that depression is something which none of us quite understand — is too annoying for words.

So let’s not bother with a diagnosis. I take Prozac not for fun, but because my life functions better with it. I don’t know the precise cause and effect. To be honest, I don’t think it should be my job to mount a detailed scientific defence of the drug when the main reasons for which it is attacked seem to come more from the arts side. People don’t like Prozac and similar drugs not because they are harmful — it is for those taking them to weigh up pros and cons — but because the whole SSRI narrative just isn’t aesthetically pleasing enough for the critics’ exacting standards.

Fraser argues that diagnosing depression “is already to classify a particular kind of experience as something quasi-medical, thus leading one to think in terms of medical treatment”:

Sometimes I am just sad. Sometimes pissed off. Sometimes smothered in darkness. But we often lump all these experiences together simply because pharmaceutical companies have developed a certain sort of treatment. And, once you have a hammer in your hand, it is convenient to see every problem in terms of its being a nail. We have found the solution, now let’s make the problem fit the solution we have available. It’s a form of reverse engineering.

So depression is over-diagnosed simply because anti-depressants exist. There is no question as to whether legions of merely “pissed off” people would seriously go along with this (repeat prescriptions are not cheap), nor any question as to whether Prozac and the like have any effect whatsoever on “pissed off-ness” (believe me, they don’t – on the contrary, once you’re taken out of your own bubble, it’s amazing the number of things which will now piss you off). But no matter; Fraser has a neat story he wants to present, and it doesn’t involve depression being messy, or people having overlapping and/or contradictory motives for supporting the use of drugs to treat it.

I might take Prozac because it helps me. But wait! It also helps The Man, aka Big Pharma, therefore it must be dodgy!

Thus we are encouraged to think of our problems in terms of the lucrative solutions to problems we didn’t know we had. In this way, the pharmaceutical companies are responsible for the very conditions they propose to alleviate.

Thus many people like me are depressed merely because they want us to think that. Without the existence of drugs we’d just be anything from mildly perturbed to suicidal, the solution to which would be … Well, I’m not exactly sure (but — and I’m guessing here — perhaps not just St John’s Wort and a daily bike ride, thank you very much).

The most worrying thing about Fraser’s thesis, however, is not merely that he positions the motives of pharmaceutical companies as the driving force in a much more complex narrative, but that he thereby makes sufferers of depression complicit in their own suffering and the suffering of others:

Forget the fact that some people are miserable because they are struggling on zero-hours contracts, or have lost their partner or have been watching the news too much – if we translate misery into some sort of chemical imbalance then someone can make big money out of it. But unhappiness is often a perfectly proper response to the state of the world. If you have a shit job or a shit home life, being unhappy is hardly inappropriate. At best, many of the drugs we are popping only deal with the symptoms of all this, not the causes. At worst, they pathologise deviations for normalcy, thus helping to police the established values of consumer capitalism, and reinforcing the very unhappiness that they purport to cure.

This is a tidy way of putting things, and one that seems to speak for the little man. But it doesn’t represent the truth. Drugs do not deal with the symptoms of unhappiness. SSRIs do not simply allow people to drift along in a delusional haze, believing all is well in the world while they themselves and everyone around them is trodden into the dust. For some people, medication is what enables you to no longer turn in on yourself. Unhappiness is indeed often a perfectly proper response to the state of the world, but it needs to be directed and understood before change is possible. If you are too numb to feel pain or anger, you won’t even recognise your shit job or your shit home life. I don’t know the precise relationship between mental illness and external social influences — isn’t this still hotly debated? — but I do know that for social change to include those who need it most, you need these people to feel strong. Some of them might, right now, need to take medication for that to happen. That might make idealists feel uncomfortable but there it is.

I don’t wish to cheerlead for drugs to treat all mental illnesses. Many drugs — those used for schizophrenia, for instance — have hugely damaging side-effects, and I wonder whether the sacrifice is always worth it (and whether it’s a sacrifice we’re forcing on others, without allowing them to choose their own destiny). I don’t, however, think the casual “let’s not pathologise sadness” musings in which Fraser indulges contribute much to this debate. At best, they’re frustrating. At worst, they make people who take anti-depressants feel accused of being too weak to deal with reality. In truth, I think Fraser is the one unable to deal with a reality that’s far more flawed and poorly understood than he would like.

This piece originally appeared at Glosswatch, under the title "Sweeping it under the carpet: depression, Prozac and Giles Fraser"

A rainy day. Photo: Getty

Glosswitch is a feminist mother of three who works in publishing.

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Jeremy Corbyn is not standing down - 172 people cannot drown out democracy

The Labour Party could right now be exploiting a bitter Conservative leadership contest, writes shadow chancellor John McDonnell. 

The shadow chancellor writes exclusively for The New Statesman amid one of the most turbulent weeks in politics this century.

The “coup” taking place in the Labour Party

The instability from Brexit has extended into the Parliamentary Labour Party with members of the shadow cabinet standing down. I would like to thank all of those who have participated with me for their work.

Frustratingly, this has come at the worst possible time for our country. And at a time in which we our party could have used to reset the economic narrative that the Tories planted in the public during the summer of 2010 when our party was in the midst of a leadership contest.

Our party right now could be exploiting a bitter Conservative leadership contest that’ll probably lead to electing a Tory leader who will be responsible for any economic fallout from Brexit. The Tories have peddled lies over the past six years over the management of our economy and the state of the public finance, which the decision last Thursday is sadly exposing.

I strongly believe that if some colleagues are not careful then they may cause irreparable damage to our party and the country. 

The Labour Party changed last September. Jeremy was elected with the largest mandate of any political leader in the history of our country. Our party’s values of democracy and solidarity seem to be asked of the membership and always met. Sadly not by some members of the PLP. 

There are those in our party who could not come to terms with the fact that a quarter of a million members could clearly see that the our party’s broken election model has lead to two back to back defeats and needed replacing. Like the wisdom of crowds, our membership understands that we cant keep going on doing the same thing electorally and getting the same results.

I believe that we can all still work together, but I feel some MPs need to get off their chest what they have been holding back since last Autumn. Maybe then they will hear the message that our membership sent them.

The truth is that Jeremy is not standing down. In the Labour Party our members are sovereign. There was an election held and a decision made, and 172 people cannot outweigh a quarter of a million others. 

It would risk sending the worst possible message we could send as a party to the electorate - that Labour does not respect the democratic process.

The economics of Brexit

The Leave vote delivered an immense shock to the political system creating great instability. Of immediate concern is the deteriorating economic situation. Credible economic forecasters virtually unanimously warned that leaving the European Union would be an enormous shock to the economy. 

The disagreements centred on the severity of the shock, and the long-term damage done. To that initial shock must be added the realisation that there was no plan made for a post-Brexit Britain. 

George Osborne has not secured the foundations of our economy and the market volatility reflects that missed opportunity. With turmoil continuing, and major employers already threatening redundancies, the immediate task is to stabilise markets and reassure investors and savers that financial institutions remain rock solid. 

The measures announced by Bank of England Governor Mark Carney early on Friday morning, and the later statement from the Chancellor, are to be welcomed and we have requested a briefing under Privy Council rules on the financial authorities’ contingency plans. It is also reassuring that George Osborne has now moved a threatened, post-Brexit austerity Budget until at least the Autumn. 

Nonetheless, with a recession now forecast, any attempt to push further austerity measures in response to the crisis would be an act of exceptional economic folly. The Chancellor’s own fiscal targets have long since been missed and simply redoubling the misery of spending cuts and tax rises will not bring them any closer to achievement. 

What is needed in a crisis like this is urgent government action to shore up investment, already falling before the vote. Shovel-ready projects should be brought forward, creating jobs and focused on beginning to rebuild those parts of the country currently most deprived – and where the vote to Leave was strongest. As a country we will get through this crisis, and we will do so when we no longer tolerate a situation in which too many of our people are excluded from even the chance of prosperity.

The referendum result

I have been in consultation with many economist, trade union and business leaders since the early hours of the morning when we learnt the result. I hope to give a speech this Friday going into further details of Labour’s economic response, but the result last Thursday came as a blow to many of us in the Labour Party.

All wings of the Labour movement fought hard, and two-thirds of our voters swung to Remain – the same as the SNP, and far more than the Tories, who split 60:40 for Leave. 

Labour will now be fighting to ensure whatever negotiations now take place, and whatever proposals the government chooses to bring forward, will maintain hard-won protections for working people in this country.

The new Labour leadership inherited the Labour In campaign last year. Obviously as with any campaign we will now have to reassess, but the hard work of the staff who worked on the campaign cannot be questioned. They did a fantastic job. 

Jeremy Corbyn also managed to help get out a larger number of our voters than the other main Westminster leaders across the country. 

But the sad truth is that we lost regardless. We need to learn lessons of the referendum and the General Election campaigns, and question whether the way we campaign as a party needs to be changed. 

It is clear that we cannot fight the next election using the same outdated practises and policies that were in place at the last two general elections, and the recent referendum. 

We cannot continue to do the same things in the same ways and get the same results. Those people who need a Labour government the most cannot afford it.


John McDonnell is Labour MP for Hayes and Harlington and has been shadow chancellor since September 2015.