A few years ago I was simultaneously working with two middle aged men whose wives had left them. Both of them were completely devastated by the loss of their marriage and family. Both of them showed serious signs of grieving. Both of them went to their doctors, were diagnosed with "depression" and placed on medication. It was interesting to see side by side two different ways this could play out. For one client this was a major factor in his process of healing while for the other it significally complicated the grieving process. What was the difference?
Let's call these two clients Joe and Bob. Both of them were so devastated by the loss of their marriage and family that they were; crying uncontrollably, not getting out of bed, not grooming themselves (bathing, shaving, brushing their teeth, etc.), not eating, not sleeping, experiencing mood swings, feeling almost suicidal, feeling hopeless and helpless, and being unable to go to work. They both lost their jobs because of being unable to function and were living in the homeless shelter.
The first problem with the diagnosis of "depression" is that the clinical symptoms of depression are identical to those of grief. Clinical depression is a biological problem and requires medication. Grief is not a biochemical problem. It is a situational problem. It requires living through the experience, feeling the feelings associated with the situation and learning coping skills for dealing with life's difficulties. It cannot be medicated away. Why then do I say that medication assisted one of these clients in healing? Why did it help one and hinder the other? Let's look at them individually.
The minute his wife left him, Bob went to the doctor and requested medications for "depression". However, in hindsight what he really wanted was medication to numb the immense feelings of loss he was experiencing. The doctor obliged by prescribing heavy duty "mood stabilizers" and a very tranquilizing antidepressant. Bob reported feeling much "better" though he also complained of feeling emotionally "numb". His grieving process took almost two years. He was not able to begin to grieve until he went back to the doctor and had his mood stabilizer stopped and changed to an antidepressant that didn't completely tranquilize him. The grieving process finally began and he was able to begin to heal. But he lost a year of his life wandering around in a drug-induced insensate fog. He is still on medication to this day and is convinced that he has Major Depression and will require medication for the rest of his life.
Joe, by contrast, initially refused to go to the psychiatrist despite the fact that he was not functioning at all. He strongly resisted taking a pill fearing it would make him "high" or that he would get "hooked" on them. Finally, after some urging, he saw a doctor for a mild dose of an SSRI. He began to get out of bed, found a job, was able to attend and participate in counseling and express his grief. The antidepressant enabled him to function well enough to be able to work his way out of the homeless shelter. It also allowed him to participate in counseling in order to process what had happened to him. He eventually came to peace with the separation and restarted his life as a single person. He then slowly weaned himself off the medication and continued on with his life - medication and counseling free.
In watching these two cases I was impressed by the very different way in which psychotropic medications could be utilized. One client used them as a mental straight jacket to try to handle his intense emotions single handedly. He learned to rely on doctors and medications to deal with his problems. It seemed to reinforce that he was not capable of handling things himself. The other client decided to turn and face the emotions and the loss, using the antidepressant as an aid to the work he was doing for himself. He developed coping skills and found strength and courage he did not know he had.