Black dog

摘要

I fear silence. People are often silent about their mental health. Life is harder than we ever imagine; we are dogged by responsibility and defined not by what we have but what we have lost. Unhappiness is one of life's few absolute certainties. I wait for my emotional weather to change. So I keep myself busy, trust to my saviour "routine," and ignore the yelling temptation of drink and drugs. Not nihilism, nor fatalism: just acceptance.So what of depression? If I use the current oversensitive and non-specific screening questionnaires, I find I know of no one who has not had "clinical depression." And what have two decades of selective serotonin reuptake inhibitors (SSRIs) given us? Controversy still rages—over potential suicidal ideation, manipulation of study results, and new research that questions whether drug treatment is any better than placebo. But SSRIs seem to work for some people, and certainly the profession believes in them.