Yet another entry about drug access restrictions.

Oh, I am so depressed again. I apologize to those of you who were hoping for deep, incisive economic analysis, but this is a blog, so I have a whining-about-me quota to fulfill. Those of you who don't know me will (eagerly) want to skip to the auxiliary rant, which I wrote after the drugs kicked in.

Most SSRIs have a half life of about two weeks, so in one day, the level in your blood drops about 4.8%, and that's normal, but anything beyond that is bad for you. It's been about three weeks, so I'm 65% below my normal level (=73 mg in my blood, vs normal=207 mg).

I have some backup Wellbutrin. Wellbutrin always comes with a little can of desiccant (Do Not Eat.) because if it gets the slightest bit soggy it starts to smell and taste like sulfur. But that's what I'm choking down lately, and maybe it'll kick in any minute now.

The primary way in which this depression thing manifests itself is, coincidentally, the same way that age manifests itself: the realization that everything has been done before, and it's not funny any more. It's like being trapped in a room full of high school students. Oh, they're not bad or evil or anything, but in your mind the jokes are already worn to tatters, all the cadences and politics and things people do to be unique that they'd just come up with feel awkward and less-than-brilliant to you because your pals had been doing exactly the same things to be funny and unique for a decade. Everything is tedious from the repetition.

So that's what being depressed feels like, except I'm the only person in the room.

There are only so many adequately sullen pop songs out there, and I've worn out their grooves on the hard drive, so to speak. I've probably heard Alfred Schnittke's "Collected songs where every verse is filled with grief" over a thousand times; it's a nine minute track, so that's about a week. Even Transatlanticism is getting old, and I've had the thing for just a month or two. Gee, Ben, tell me again how the Atlantic was born today?

I've already lived in this apartment and sat in this chair. I could go for a walk, but how many times have I done that before. How many thousands of times have I written sentences with `I' as the subject? You don't have to laugh, dear reader; I know you've seen self-referential humor before. Every time I do a half-life calculation, I have to start from scratch: OK, so exp(-k * 14) = 1/2, so what's k again? You don't understand how many dozens of times I've solved for k. Solving for k is just not fun anymore.

I don't know what to do. Everything has been done before, all of it, and that knowledge is causing me to age faster than the speed of light. The joke that is living is just not funny any more.

Auxiliary rant Type II errors are when you give somebody drugs but they don't need them. Here in the U.S.A., the medical rule makers are obsessed with type II errors. [In another context, the type II error would be when you diagnose somebody to be a terrorist but they're not. Somehow the rule makers don't care about those errors so much.] Access to Lexapro is so carefully controlled that I can't get any unless I pay somebody several hundred dollars to certify and verify that I really do feel depressed, and I'm not just taking it `cause I get a kick from the side effects (nausea, anxiety, and in my case, tooth grinding).

Since I hang out with goths so often, I know that there exist people who believe they're clinically depressed but aren't, and the drugs they think are helping are either a waste or harmful. But what is the harm from a type I error (depressive doesn't get drugs) and the harm from a type II error (nondepressive takes extraneous drugs)? If the harm from a type I error is orders of magnitude greater---which it is---then don't build barriers around blocking access to the darn drugs. No offense to my dark pals, but writing the nation's drug policy around goths is just silly.

On the other hand, working in concert with the medical establishment, are the folks at Adbusters who believe that depression, panic disorders, and even PMS are "inventions" of drug companies to sell us more drugs. The conclusion follows the same puritanical streak as the Congressmen who pass laws blocking access: if you don't need a drug, then you shouldn't take it---and in the case of anxiety or depression, you never need drugs, because these states are inventions of the drug companies.

I actually generally follow a life the Adbusters would approve of: I have no TV, don't let my browser load ads, and generally just don't see advertising, and yet the drug companies still got through to me that I have the ailment they invented. When I briefly lived in Venezuela, a short walk to the stream we drank from and bathed in but a long walk to the nearest town, subsisting on the mangos that fell from the trees in the yard, I was still depressed, and I knew it.

Yes, drug companies are evil multinational corporations. They also manufacture stuff that makes us better. Further, I have to give the evil multinationals a big YAY! for advertising aggressively that depression shouldn't be stigmatized, and that we shouldn't feel ashamed for our brain chemistry, and that it's OK to come forward and seek constructive treatment when just getting more sun doesn't work. The adbusters would point out that they're destigmatizing it to sell us more drugs, and so write articles that re-stigmatize depression.

So why, then, is the rate of depression so high in the U.S.A. compared to everywhere else, as shown in the articles in this sporadically scholarly Adbusters lit review? Some of the citations have quite the literary flourish, saying that there is a mismatch between what my psyche needs and what is provided by the consumerist culture in which I live. But I have a simpler answer: since there are drugs that can adjust the chemistry of my body to make me feel less miserable, and there is a gatekeeper between me and that drug who won't allow me to have that drug unless s/he is absolutely certain that I need it, I'm going to report the most severe depression I can conjure up. If only I could cry on command.

How does one collect statistics about depression? Any survey of people who got out of bed this morning and are willing to talk to the surveyor is going to be horribly skewed away from depressives. In other countries, and before SSRIs became prevalent in the U.S.A., there was just no reason for me to find myself a statistician and report my depression, while now, because of the philosophy espoused by both Congress and the adbusters, there is every reason for me to over-report.