Letters

Depressions rooted in experience

It is professionally reassuring to read the critical study of the diagnosis of depression ("Depression Gets Doleful Diagnosis," SN: 2/14/98, p. 100). Unfortunately, psychiatry has succumbed not only to the demands of managed care, but to a society that has come to expect instant gratification. It has almost abandoned dynamic psychiatry for the quick fix of pills and brief, superficial psychotherapy.

In an attempt to gain scientific credibility, it has resorted to an elaborate diagnostic system based primarily on symptoms that are about as indicative of a specific diagnosis as a fever is in general medicine.

However effective an antidepressant may be, ignoring a detailed personal history and stress stemming from a patient's lifestyle as contributing causes to depression borders on incompetence. The fact that biological changes found in "depression" may not be genetic or organic, but produced psychologically by history and stress is rarely considered adequately.

Warren A. Baker
Denver, Colo.

The healthy debate over depression as either "a diseaselike process" or "the extreme end of a symptom continuum" is based on a rather dubious premise: that depression is a single mental disorder. Some organically based depressions are seriously debilitating. Others are appropriate responses to life situations of loss, trauma, disappointment, or despair.

Thinking inside the medical box (political need notwithstanding) will continue to rob us of the wider view of depressions rooted in individual experiences. Stretching the box to include a wider range of symptoms, and thereby expanding the diagnostic application of "major depression," is even more depressing.

Eugene J. Webb
Houston, Texas

Sauce for the gander

I question the notion in "Valuable Vices" (SN: 2/28/98, p. 142) that longevity might be a consequence of an active sex life rather than being correlated with it. How "the analysis [of the study cited] accounted for the possibility" and still allowed the author to suggest a cause-effect relationship is beyond comprehension.

Savely Savva
Carmel, Calif.

Your article implies that the frequency of sexual intercourse was a measure of frequency of orgasm. Was the "trained interviewer" too embarrassed to ask how often the men of Caerphilly masturbated?

Later in the article, the investigator speculates, "One endearing explanation is that pleasure is actually health-giving." Endearing? How about obvious?

Barry Evans
Palo Alto, Calif.

Why weren't the women of Caerphilly studied? There are a lot of us middle-aged, sexually active women out here, and we warrant the attention of epidemiologists, too.

Susan Bury
Washington, D.C.

I was very disturbed by the cover. A picture of indulgence does not necessarily need to be sexist and demeaning. Who in the picture is indulging? In what? And whose longevity is extended by the implicit assumption that it is the lives and pleasures of men, and not women, that really count?

Christine Morales
Northfield, Minn.

"Valuable Vices" credits Plato with the phrase "nothing in excess." This phrase is usually attributed not to Plato but to the legislator Chilon of Sparta, a rather shadowy member of the group of "seven sages" from the sixth century B.C.

When Plato quotes this sort of thing, it is hard to feel that he really believes it. The organization of the ideal state in the Republic and the education of its guardian class do not tend in the direction of even moderate indulgence, and certainly not indulgence in the amorous and gustatory pleasures that are the subject of the article.

The outstanding proponent of moderation is Aristotle, and the outstanding proponent of pleasure in moderation is Epicurus. Indeed, the whole theme of the article is splendidly Epicurean.

Let's hear it for Epicurus, a most useful and underestimated fellow.

Pierre A. MacKay
Emeritus Professor of Classics
University of Washington
Seattle, Wash.

I showed my wife the article and pointed out that if she wanted me to be my healthiest, she'd have to go along with my increase in sex, which of course would include multiple sex partners.

She replied, "Sauce for the gander is sauce for the goose." Great, I thought, she's already back talking food.

Carl Haeberle
Surfside, Fla.

How to boost -- or not -- uric acid

If uric acid may benefit multiple sclerosis patients ("Uric acid linked to multiple sclerosis," SN: 1/31/98, p. 68), could a diet high in organ meats and other purines prove beneficial?

Terence W. Moran
Las Vegas, Nev.

Immunologist D. Craig Hooper says any food rich in purines will raise uric acid concentrations and might be beneficial.  -- M.N. Jensen

Bee sting therapy is sometimes used to treat multiple sclerosis sufferers. Does the injection of bee venom into the human body promote the formation of uric acid?

Larry Miles
Independence, Mo.

"There's no data to suggest that bee sting therapy is useful in MS," says Stephen Reingold of the National Multiple Sclerosis Society.  -- M.N. Jensen

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Table of Contents -- April 11, 1998

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