Depression: Why a dog is better than Prozac
Renowned psychologist Martin Seligman says we should stop treating depression as an illness to be fixed with pills (October 13 2018, The Times)
Martin Seligman has spent decades trying to help miserable people to feel less unhappy. Now, at the age of 76 and acclaimed worldwide as “the father of positive psychology”, he believes that our approach to depression is all wrong. We are, he says, treating it as an illness when often it is not. As a result, doctors are too quick to prescribe antidepressants when other remedies, such as therapy or even getting a pet, may be more effective.
“Depression doesn’t just fall on you like a brick wall,” he says. “You can choose the way you think and what you focus on. There are plenty of things you can choose to do that increase your happiness in a lasting way.”
Pharmaceuticals are an important part of treatment for patients who have bipolar depression, with its intense highs and lows, because “it is a biological illness, has a known neuroscience and is medically treatable” with a mix of drugs to stabilise mood and prevent manic episodes. However, Seligman is not convinced when it comes to the more common “unipolar” (ie no highs) depression. “It is not a biological illness and it doesn’t have a known neuroscience,” he says. He believes that for this form of depression, treatments such as cognitive behavioural therapy are a better option than antidepressants. “It allows you to be an active participant in your own therapy,” he says. “You try to change the way you behave, the way you think. And you tend not to give up.”
Seligman, director of the University of Pennsylvania’s Positive Psychology Centre, has written widely on subjects such as optimism, resilience and what he calls “learnt helplessness”, in which depression results from a sense of powerlessness over a situation. His original experiments were with dogs so it’s interesting that one of his simplest tips for improving mood is to get a dog. “There is very good evidence that dogs improve your mental health and they are incredibly loving and loyal partners.”
In England last year one in six people between the ages of 18 and 64 was prescribed antidepressants, and Seligman argues that we’re heading down the wrong path. The main problem with antidepressants, he says, is that they don’t encourage people to change their thinking or behaviour, and since depression typically recurs every three years, people who are treated with antidepressants end up back at square one.
Of course, when you are feeling really low, it’s easier to just pop a pill, but Seligman says that this is a reaction to the increasingly common belief that depression is an illness.
“When you say alcoholism is an illness or depression is an illness it makes people helpless,” he says. “It makes them think they should take a pill. It does not make them think that how they lead their lives will have any effect. The medical model is passive.”
A better understanding of appropriate treatments for depression is particularly important for women because they are 70 per cent more likely to experience it. One of the most frequently alluded to explanations for this is research by the Yale University psychology professor Susan Nolen-Hoeksema that focuses on the female propensity to ruminate. But Seligman points out that although “in every wealthy country in the world, women are roughly twice as depressed and have twice as many anxieties, in poor countries the ratio is much closer to one to one; men and women are depressed to the same degree”.
When he first started working in depression in 1967, he says, “it was essentially a middle-aged housewives’ disorder. Now the average age for the onset of depression is between 14 and 15 and it has become a teenage disorder.”
In his latest book The Hope Circuit, Seligman reveals his own struggles with depression. He has just found out that his beloved dog, Lily, has cancer. He says that for “a normal depressive like me, it means that in the middle of this conversation I start thinking about Lily, and that she is dying and we have to deal with the question of putting her down.
“But then I recognise those thoughts and I tell myself that I am in the middle of a good interview, and that cheers me up and puts me back on track. So even someone like me, who knows every trick in the book, is still working at it. It doesn’t come naturally.”
