Madam, - Dr Michael Corry's article, "Taking the disease out of depression" (Health Supplement, July 6th) suggests that the dominant approach in psychiatry sees chemical imbalance as the primary cause of depression and medication as its cure. Dr Corry believes this pathologises sufferers and turns them into damaged goods or victims of flawed chemistry and defective genes.
In my view this is an inaccurate and naïve position, particularly if one accepts Dr Corry's definition of depression as ranging from mild disillusionment and lack of drive to the black hole of despair, self-loathing and hopelessness. No sensible practitioner is going to treat the former group in the manner suggested.
People who tragically find themselves in the latter state often respond very well to appropriate medication. The therapeutic effects of medication are best augmented by evidence-based psychological input, the most effective approach to date being cognitive behavioural therapy. Few psychiatrists or psychologists would subscribe to an exclusive disease model that ignores or denies the importance of social, economic and other factors.
Dr Corry also notes that he has yet to sit in front of one depressive patient who did not have a symptom logic. The example he cites is intra-uterine rejection. I know of no evidence to support this notion and would be interested to see any that he might provide.
People with depression and those who work to help them do seek meaning, in the sense of trying to understand the depression and to design strategies to combat it. Some interpretations are more sensible and useful than others.
This latter position is not accepted by Dr Corry as illustrated in his book Going Mad: Understanding Mental Illness (co-written with Aine Tubridy). He sees all interpretations as equally valid - except, it seems, the medical one.
He states (in the same book) that "symptoms at whatever level - be it mind, body or spirit - can be traced to the chakra system, whether it be a heart attack, cancer or a schizophrenic state" (pp. 136-137).
The chakra system is an imagined energy system for which there is no objective evidence. Dr Corry's interpretations of serious conditions such as endogenous depression, schizophrenia, and bipolar disorder are esoteric and without scientific foundation. His symptom logic includes the attribution of cause to episodes occurring in past lives.
If given a choice between current mainstream approaches to the treatment of depression and approaches suggested by Dr Corry, I would certainly pursue the former. Dr Corry's prescriptions need to be approached with a great deal of scepticism. - Yours, etc.,
PAUL O'DONOGHUE, Principal Clinical Psychologist, Highfield Road, Dublin 6.
Madam, - Dr Michael Corry's article of (July 6th) is both compelling and well informed.
He correctly identifies depression as "an emotion and not a disease reflected by a change in brain chemistry". I doubt that many of his Psychiatric peers would agree with his assertion.
For many years various psychiatrists have triumphantly announced the finding of some rogue gene or neuro-transmitter that explains the genesis of mental ill-health. At the same time we are routinely informed of a new "magic bullet" drug that will cure the brain's apparent dysfunction.
Curiously, these studies are almost exclusively funded by pharmaceutical companies manufacturing the new drug.
Psychiatry defines a delusion as "a false fixed belief". Dr Corry stat writes that "the dominant approach in psychiatry sees chemical imbalance as the primary cause of depression".
Could it be possible that mainstream psychiatry is in fact suffering a delusion in continuing to maintain its own fixed beliefs? Dr Corry deserves credit for his open criticism of psychiatry. Let us hope that his less informed and somewhat delusional peers get the help they so badly need. - Yours, etc.,
EOIN FLYNN, Blasket Square, Dublin 15.