Comments

SSRI's (selective serotonin reuptake inhibitors) are just one of several classes of medications that are marketed as agents that are alleged to be palliative and/or remedial for "depression". First of all, they are not any more effective than the previous generation of medications, the tri cyclics. Secondly, and this is the wierd part, they are not significantly more effective than placebo's. Third, there is no evidence whatsoever, except in the eyes of marketers, for the so called "chemical imbalance" hypothesis. That they "work" is subject to interpretation of what "work" means and how it's defined. A lot of things "work". In medication it typically means a 50'% reduction in symptoms, something that may be statistically valid, but clinically meaningless. Especially, since most improvement is rated not the by the "patient" but rather by an observer. As to why people report symptoms of depression is an idiosyncratic complex of reasons that typically revolves around themes of loss, helplessness, and anticipation of negative events, along with sadness. There are very very few people who actually have a "biological" unipolar depression. Typically these symptoms result from the bad luck of acquiring current stressors, sometimes overlaid upon lack of skills enabling one to cope with those stressors. And most people find a way to cope: sometimes the side effects and hope generated by taking medication are what "turn people around" sometimes it's simply a combination of things other than meds. The bottom line is that if people who are distressed believe in whatever cure they seek, the probabilities are that they will experience relief. The problem with taking psychotropic medications for the pilot, is that these medication produce side effects initially, sometimes for weeks afterwards, during their usage, and finally after discontinuation, such that persons are typically warned to not stop taking the meds, but rather to titrate off of them slowly. All in all, pilots would do better in counseling. Counseling doesn't produce side effects and typically keeps the client in control of change.