Therefore, it is not unreasonable, or necessarily fruitless, to prescribe antidepressant treatment or psychotherapy for people who qualify for neither the diagnosis of Major Depression nor that of Dysthymic Disorder. In fact, some of these other, so-called “depressive spectrum disorders” have been proven responsive to antidepressant medications.
However, it has yet to be widely accepted by psychiatrists that grief alone warrants drug treatment.
Still, one can find popular books, written by psychiatrists that seem to propound the usefulness of new antidepressants for an immense variety of problems, including what we might ordinarily call quirks of personality rather than mental illness. Behind this lies a quite unjustified supposition that newer antidepressants present no significant issues of side effects or other toxicity.
To illustrate this point with an amusing anecdote, I just recently became aware through my Internet news service (“Accidental Antidepression,” by Robin Esiner at ABCNews.com) of a problem drawing attention from veterinarians-that of dogs overdosing on antidepressant medications. They ingest these not with suicidal intent, but with the usual penchant of dogs to eat anything consumed by humans and left within their reach. This attention becomes more noteworthy when considering that antidepressants have been around for about four decades. The difference now is that the newer antidepressants, with their alleged safety even in overdose, have become so common as to tempt significant numbers of pets to try them. Dogs, sometimes used as involuntary subjects to test toxicity of drugs, usually at mega-dosage, early in their development for human use, do not seem to tolerate these drugs in the quantities of human over-dosage very well!
When a clinician has wandered this far afield in such human clinical “experimentation” with psychotropic medications, the patient cannot rely on the doctor’s restraint to avoid embarking on unproven pharmacotherapy for anything at all. The slow progress of psychiatric diagnosis towards a common understanding of what we call treatable depression can thereby be overleaped at a single step, leaving doctor and patient in a situation where “anything goes” and no rules apply.
But when grief has gone this far-in severity and/or duration-I consider inappropriate treatment a far lesser risk than the potential consequences of untreated depression, all the more so now that somewhat less troublesome or expensive treatments, with good effectiveness, exist for depression-even if it does emerge from irresolvable grief.
