期刊
PSYCHOLOGICAL MEDICINE
卷 52, 期 8, 页码 1401-1410出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291721005031
关键词
Depression; antidepressants; electroconvulsive therapy; placebo; adverse effects
This article critically evaluates the effectiveness and value of antidepressant drugs and electroconvulsive therapy (ECT), and proposes an alternative understanding of depression as an emotional and meaningful response to unwanted life events and circumstances.
The dominant view within mental health services and research suggests that feeling depressed is a kind of medical illness, partially caused by various biological deficits which are somehow corrected by physical interventions. This article critically appraises evidence for the effectiveness and value of antidepressant drugs and electroconvulsive therapy (ECT), the two principle physical treatments recommended for depression. It also describes the negative effects of these interventions and raises concerns about how they impact the brain. We propose an alternative understanding that recognises depression as an emotional and meaningful response to unwanted life events and circumstances. This perspective demands that we address the social conditions that make depression likely and suggests that a combination of politics and common sense needs to guide us in providing help for one another when we are suffering in this way. This alternative view is increasingly endorsed around the world, including by the United Nations, the World Health Organization and service users who have suffered negative consequences of physical treatments that modify brain functions in ways that are not well-understood.
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