Times of sadness are a normal part of the Christian life. To see the world rejecting the Saviour and accepting other gospels that are no gospels is grievous. The prophet Jeremiah lamented the state of the people of God and the destruction of Jerusalem. Our Lord wept over Jerusalem sinners. He wept also at the tomb of Lazarus as did the early church when Stephen was murdered. To bear the burden of Ďthe cares of the churchesí is at times to feel one is going to crack under the strain. Sometime a congregation must encourage its pastor to weep, and sometimes he must sympathize with their tears.
If Christians weep, how much more sadness must there be in the world because of the weight of unforgiven sin, lack of purpose in life, and the muddles that people without the Bible fall into? On January 15 2009 in the Daily Express, Dr Theodore Dalrymple wrote this piece on the theme that 'no one is unhappy these days; everyone is depressed'. It makes salutary reading. It is only by the gospel of Jesus Christ that a sinner can fulfil the exhortation to rejoice in the Lord always. Without that good news they are condemned to a life of melancholy.
NO ONE IS UNHAPPY THESE DAYS, BUT EVERYONE IS DEPRESSED
No one is unhappy these days but everyone is depressed. Jerome Wakefleld, a professor at New York University, has sounded a warning against the tendency of medical science to apply drugs to block natural human emotions.
In the last few years of my practice as a doctor, I must have heard hundreds or even thousands of people say that they were depressed but only two or three admit that they were unhappy (and one of those was in prison).
When I started out in prac≠tice 35 years ago there were de≠pressed people but they were relatively few in number. Their illness was truly incapacitating. They were often very subdued and slowed down, lacking in interest, neglecting themselves, not eating or drinking properly and feeling profoundly guilty for no good reason. Rich people with this kind of depression sometimes believed that they were destitute. They wanted to die, or at least not to live. Some even believed that they were already dead.
In the days before there was effective treatment such people would be admitted to an asylum and would spend their days sitting on a chair at a table set against a wall to prevent them from going anywhere. They would be watched, day in, day out, by an attendant until - two, three or four years later - the fit of melancholia passed. It was a dreadful business. Effective treatment means that such extreme cases are now very few and far between. That, of course, is all to the good.
Unfortunately the replacement of the word 'unhappiness' by 'depression' is not all to the good. It turns a normal human experience - that of unhappiness - into a medical condition, to be treated and cured by doctors. Most human unhappiness is understandable. If a recently widowed person appears too happy too soon after the death of his or her spouse we suspect that the marriage could not have been a very happy one. It is one thing to make an effort not to cry in public, but another not even to be sad.
Unhappiness usually arises from the situation in which people find themselves, either through circumstances beyond their control or as a result of their own choices. It is like pain: undesirable but necessary for us to learn from experience and to avoid whatever causes it. We think that a person who could feel no pain would be fortunate but in fact those few people who are born without a capacity to feel pain suffer many serious injuries and lead short lives.
The world, said Dr Johnsonís biographer James Boswell, is not to be turned into a great hospital; but that is precisely what the replacement of the word 'unhappiness' by the word 'depression' does. For if unhappiness is an illness, why not every other human experience as well? When a person tells a doctor that he is depressed he is in effect asking for a cure, in the same way as he expects the doctor to cure a cough. The doctor has very little time at his disposal so he colludes with the patient. Instead of trying to find out what it is that is making the patient unhappy and suggesting that he change it, he hands the patient a pill.
Since pills are only handed out for illnesses, the patient now has confirmation from the doctor that he is indeed ill. He does not have to change the circumstances that are making him unhappy, which is a great relief because no one likes to change. That is because change s difficult and painful and can be impossible. Sometimes the pills actually work: the patient feels better. But as often as not he feels better because of the placebo effect. A sugar pill would have done just as well. At other times the pills do not work and the patient returns to the doctor, who tells him to double the dose. When the double dose fails to work the doctor switches him to another pill and, when this does not work either, to yet another.
Each time, of course, the patient has to take the pills for a certain number of weeks before they can be said not to have worked and since there are a large number of pills for a doctor to choose from, this slightly ludicrous foxtrot in the surgery between doctor and patient can go on for years. In the meantime, the cause of the patientís unhappiness goes unexamined and unchanged.
The effectiveness of anti-depressants against most forms of unhappiness is very slight, if it exists at all. This is not altogether surprising because at first they were tested in the Fifties on seriously depressed people, in whom they appeared to work miracles. To call everyday unhappiness depression and then to treat it with anti-depressants is like calling every swelling cancer and then treat it with anti-cancer drugs.
The drug companies feared at first that there would not be enough seriously depressed people to make the manufacture of anti-depressants profitable. But the abandonment of the word unhappy for depressed came to their rescue: they became among the most profitable drugs ever developed. The American psychiatrist Thomas Szasz once published a very funny article in The Lancet. Dr Szasz suggested that henceforth happiness should be considered an illness. After all, it is quite rare and often leads people to do foolish things. As a result, it is potentially dangerous. Therefore, those few people who suffer from it need treatment. Luckily, there are plenty of medicines available to doctors that can make their patients feel worse and thereby control their happiness.
This makes no more (or less) sense than treating unhappiness as a disease.