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Erin Tepe

Professor Cassel

English 1201

23 July 2017

Research Essay (Final Draft)

Up until my later years of high school, I was genuinely happy and healthy most of the

time, just like the rest of my family. Illnesses, mental or physical, were rare with us. When I

became a senior, the stress of school, family life, and looming college choices seemed to be

affecting me more than some of those around me. It wasnt until the end of my freshman year at

college that I reached out for help, and found out I had depression. I wish I had known then what

I do now about depression and how to spot it, get help, and even just how it all works. If I had,

working through the huge changes in my head mightve been a lot easier. While it is usually

thought that depression is an occasional feeling of sadness that can be treated quickly with a pill,

basic lessons on how depression and antidepressants really work could disprove this, and in turn

raise understanding and awareness of the disease. This might help those affected get the help

they need more quickly and efficiently, encouraging them to find a drug or way of treatment that

fits them the best.

Learning about what depression is and how it affects the brain is the first step for anyone

to get a better understanding of what someone suffering from it deals with. The National Institute

of Mental Health defines depression as a mood disorder that causes distressing symptoms that

affect how you think, feel, and handle daily activities, such as sleeping, eating, or working

(NIMH, 2016). The institutes states that for a physician to diagnose someone with depression,

the patient needs to have expressed symptoms nearly all the time for a couple of weeks. These
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doctors look for symptoms like changes in mood, especially irritability and emptiness, sleeping

and eating habits, and even physical issues that never let up. And these symptoms arent just

feelings, either. They are caused by a chemical reaction in the brain serotonin being taken up

within the neurons of the brain. In laymans terms, if this molecule is being taken up more than it

is floating around in the brain, a person is more likely to be depressed (Konkel, 2015).

Determining whether these issues are from daily stresses or actual chemical imbalances

in the brain can sometimes be difficult, but being screened by a specialized doctor can help

someone figure that out. To make it even more complicated, there are many different kinds of

depression; they affect different kinds of people in various ways. Some of these types are more

general, like persistent depressive disorder (basically long-term depression), and others are more

specific, like seasonal depression, which comes and goes with the seasons, usually worsening

in the fall and winter (NIMH, 2016).

There are many factors and feelings that contribute to and stem from different types of

depression and their treatments (Sloan).

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Just like there are different kinds of depression, there are different kinds of treatments.

Some peoples conditions improve with simple therapy, and others require a drug accompanied

with therapy to help them. These drugs arent always all that theyre cracked up to be, but that

will be touched on more later.

For those who think they might be struggling with depression, getting a base of

knowledge on the subject, whether it be from school, work, or home, could help them identify

certain uncertainties or issues they find in the way they are behaving. On the flip side, even

though someone may not be suffering from these symptoms, knowing the basics of the illness

would help them notice these issues in others that they think might be dealing with it. Educating

people in both of these roles enables faster diagnosis and treatment, along with encouraging a

better atmosphere surrounding depression, as opposed to the stigma it is too often encompassed

by.

Feeling down in the dumps every once in a while or being stressed and overwhelmed by

work, school, or whatever else is pretty normal, and also often easily treated and recovered from.

These feelings dont always add up to depression, and self-diagnosing for whatever personal

reason is never a good idea. Depression, though it may to some seem to be a simple problem

with a simple solution, is far from easy to understand or deal with and should not be thrown

around as an attention-grabber or scorned like a sickly contagious disease. It should be taken

seriously by everyone. Depression usually cannot be fixed in a short amount of time by a magic

pill, or be resolved by talking about all of ones feelings in an hour-long session with a strange

therapist. While one or both may work for some, it takes a lot of time, research, and trial and

error to find what works best for one specific person. Having a basic foundation of knowledge on
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the subject, whether it be from school, the workplace, or home, could jumpstart that process of

research for someone in need.

Think about schools for example. Should mental illnesses be touched on in certain classes

like physical illnesses are? In certain classes, kids are taught about STDs, how bones are broken

and mended, etc. But do a lot of schools touch on the mental things? From my experience, not

many do. Why? In 2010, about 20% of kids (high school aged) were affected by a hindering

mental illness, and that percentage has since then gone up (NIMH, 2015). Since such a large

percentage of students are affected by these illnesses, why are they not talked about just as much

as other debilitating physical issues? These disorders affect the way children are able to learn and

interact with others, and in school, both of those aspects are a large part of the wellbeing of the

child.

So, should mental health education be encouraged? Some parents believe that

encouraging in-school discussions can become too invasive and encourage kids to think they

have something that they dont. Some school and business administrators have instead suggested

that screening just be made available, since it cuts to the chase, providing a quick fix to the

question of whether someone is struggling with a disorder, and would discourage self-diagnosis.

While these tests may indicate that a child needs help before they suffer too much, there are other

concerns that come from screenings. Parents and administrators are afraid that there will be

over-diagnosis of students as well as giving them life-long labels to bear (Eco Childs Play,

2014). With these labels come judgement from peers, especially in high schools, which could

worsen the way one feels after being diagnosed and cause their condition to spiral downward

from social pressures.

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Along with added concerns for their children, when faced with this proposition of

screening, parents also expressed that they fear[ed] that experts only wanted to medicate the

problem rather than providing educational support (Eco Childs Play, 2014). This leads to the

understandable notion that parents dont want to simply pump their children full of drugs without

really knowing what is going on and how the drugs might affect their kids. Instead, some parents

feel that they would be better off just knowing what signs to look for in a struggling child.

By bringing up mental illnesses, depression in particular, in the classroom or workplace,

those struggling might be able to identify with some of the symptoms or feelings that go along

with those illnesses. They may find that it is important that they reach out and get help to find out

if what theyre feeling is serious or only temporary and easily solved. Sometimes it can be

difficult for people with depression to reach out, due to fear of judgement or feeling isolated and

not knowing how to reach out. Talking about these illnesses out in the open might make people

feel more comfortable reaching out because they have a better understanding of what is going on

inside their own head.

Knowing more and being encouraged to keep researching a heavy topic like this is

important for anyone, and peoples minds work in different ways. Some want to give themselves

to the experts and let them do their work, but others might want to know more going into the

next step of getting help, so that they know more of what to expect. For scientific minds, a

scholarly article might be a good way to better understand how depression and some treatment

options work. For example, William Schafer, a professor that often does studies pertaining to

depression, explains the way chemicals interact within a person with depression:

levels of serotonergic neurotransmission in the forebrain are a key determinant

of mood: high activity results in euphoria, low activity results in dysphoria.

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Depression is said to be caused by chronically low levels of serotonergic

transmission. SSRIs interfere with the activity of the serotonin transporter (5-

HTT), a reuptake molecule that removes serotonin from the synapse; thus, the

putative low levels of synaptic serotonin in the depressed patient are elevated, and

depression is relieved. (Schafer, 1999)

In simpler terms, a certain chemical in the brain is linked to the way someone feels and

behaves. With lower levels of the chemical, someone would feel down, tired, and probably not

want to do much, but with higher levels, the opposite would be true.

Shafer continues on to talk about the way the mentioned SSRIs affect someone, besides

altering their mood. He states that some of them may be more beneficial than others, and other

kinds of antidepressants are available that work in different ways. While SSRIs usually have

more mild side effects, they still could include stomach problems, changing sleep patterns, etc.

These antidepressants, along with other types, have the ability to target and alter other points of

function in the brain and body as well; some of these changes may be good and some may be bad

(Schafer, 1999). A main point in this article is that although some antidepressants are better than

others, many come with side effects of varying severity, and it is important to know what those

are so one can know what to expect and what to do if they experience certain side effects.

The thought of what comes next can be intimidating to someone coming to terms with

their depression. Sure, there are obvious well-known treatment options, like therapy or

prescriptions, but what kind of prescriptions? What therapists? Going into the doctors office

blindly asking for help might not be the best idea, and by even just touching on possible ways to

get help or more information on treatment options in schools or workplaces, the thought of

asking for help or talking to someone about what theyre feeling wouldnt be so uncomfortable.
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Going deeper into the treatments of depression may not seem to be important to some,

but at least knowing how crucial it is to research drugs before one takes them would be a good

lesson for anyone; and that goes for all drugs, not just antidepressants. Knowing how an

antidepressant might affect you is important because if something goes wrong, it will be easier to

identify the issue and get help for it, and eventually try something different. Not reacting well

with certain drugs is also common for many people. Mentioning resources for information could

benefit someone trying to find out what might work best for them.

The Mayo Clinic provides an article on antidepressants and how to determine what

would work best for someone, providing tips for things to keep in mind like cost, and where to

start, like identifying symptoms and severity. The piece also runs through many different kinds of

antidepressant prescriptions, explaining what each one is and how it affects the brain, and lists

things to be aware of when taking these antidepressants (aka how they might affect an unborn

child or someone with ADHD), like the fact that other residing health issues may affect the way

the drug works. Lastly, the article covers ways to help the drug work for you (things like staying

sober or paying attention to possible side effects). Of course, following all of this advice still

leaves the success of the medicine up to the person, as sometimes drugs just dont do what they

need to for some people. Mayos article does a great job of providing accurate information that is

easily understandable and supportive with other references for additional information.

A big lesson comes from this article: antidepressants are not a one type fits all kind of

deal. Reading through all of this information would be so helpful in coming up with questions

and concerns to talk to a professional about, and the emphasis on the variety of treatment types is

meant to reassure the reader that just because one may not work, doesnt mean nothing will

work, and that being patient will help them in the long run. Overall, this seemingly simple
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reassurance could be very helpful or comforting to someone who feels overwhelmed by

everything that comes with dealing with depression.

In an article published in the New York Times, Benedict Carey brought up decent

concerns that researchers had about certain antidepressants. He highlights the effects of one

specific type of antidepressant, reanalyzing the original work done in a study surrounding Paxil.

Carey states that researchers are checking [their] work, and doing what science is supposed to

do self-correct (Carey, 2015), meaning that reanalyzing this study from years ago was crucial

to finding out why some people were having bad side effects. The new study shows how Paxil

initially caused a significant improvement in the patients scores on the Hamilton Rating Scale

for Depression, meaning their symptoms of depression had lessened or that they had a better

mood about them in general. However, after long-term use, part of the trial noticed that serious

issues arose in young adults. A rise in cardiovascular issues that was looked over in the original

study and found again in the second study proved that the extended use of this drug may not be

entirely safe. This article and the case study it is based upon is a reminder that it is always

important to do extensive research on what kind of drug one is taking, and making sure that

information is up to date may have an effect on how efficient the drug is perceived to be.

Running with the example of high school and mental health education, providing little

notes on sources of more information or help could make all the difference in someones

understanding of depression. Thats not to say that teachers must go into detail about all different

kinds of treatments and antidepressants like so in the above, but just mentioning places that could

help might send someone down the right path, helping them get the information that they need

and gather deeper questions they might have on the topic to bring up with a health professional.
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This information could be crucial in finding a drug that is effective but proven to be safe and that

works well with the persons conditions.

People should be encouraged to do their research on treatment options, just like anything

else. Drugs affect everyones bodies in different ways but they still cause more changes than

many people initially think. Considering the best antidepressant for each person and

understanding the possible risks and benefits is an important step toward becoming healthier, and

if educators can do a small part by providing beginning sources of information through classes or

interaction, it could go a long way.

But why might it not be such a good idea to openly educate people about this topic? In

schools, some parents may feel that knowing about all of the symptoms or feelings of depression

may cause them to think they have them, kind of like the placebo effect. However, wouldnt it be

better for the child to know what feelings to look out for in themselves in others so that they can

be aware of it instead of just wondering? Worst case scenario, if a child may think they are

dealing with depression, they can visit someone to work through their confusion, and they may

find that they dont have it. They may instead walk away with even more insight on the topic

from their experience. Additionally, in both schools and workplaces, some people may feel that

learning about mental illnesses, especially depression, makes them uncomfortable; if they

already have been diagnosed with something along those lines, they may feel embarrassed. In

this case, it is arguable that being educated for the benefit of peoples health outweighs the

discomfort level of the subject. Schools teach sexual education in health class, do they not? From

personal experience, many teenagers are more uncomfortable with that matter than they are with

mental illnesses. If more people were educated on the subject, especially young adults, less

stigma and judgment would surround the topic because they would understand that depression
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and other mental illnesses are real and have great affects. Less judgement would mean less

reason for those suffering to be embarrassed about it. Obviously, like with any sensitive topic

like this one, there will always be pros and cons, and not everyone will feel the same about it.

However, in this instance, education and the ability to more easily give and receive help resides

over possible feelings of discomfort.

From my own experience, I can attest to both perspectives brought up in this essay. I have

both seen close friends struggling with depression and dealt with it myself. I have known my

friend Connor since freshman year of high school, and while I didnt know him in his early

stages of depression, I saw him digress and struggle more and more as time went on. As an initial

bystander, it was hard for me to see him deal with everyday pains mental and physical that I

couldnt understand or help with. To date, he has been on almost 20 different pharmaceuticals,

and that is just for his depression. When he was first diagnosed, he had no idea how depression

worked or how he would go about treating it for however long it hung over him. While he wasnt

immediately prescribed meds, the ones that he eventually did try only made things worse for

him. Starting off with the most common antidepressants, he didnt do much research himself to

find out how these medicines might affect him, and he didnt know what they were supposed to

really do on a chemical level. Long story short, many of the meds had horrible side effects, and

the ones that did not have side effects either didnt help or started to cause another psychological

problem. He was on a trial-and-error basis, but he could have made informed decisions about

what drugs he was taking by ruling out ones that didnt fit with other issues he dealt with,

influencing the way the drug worked on him.

If his peers had been taught anything about depression, they might have thought more of

his condition and he may have been able to get help sooner, and found some way to ease the pain
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he was in. Basic education on mental health for those who dont deal with the issues enables

them to become a support base for those who do deal with the issues.

In my own case, I dealt with the same thing. No one around me really thought my

thoughts were serious, and no one knew any better except Connor. Had I not met Connor and

constantly had his support and advice when it came to how I felt, I would probably still be

wondering what caused my moodiness and feelings of emptiness. Had I been taught about what

common mental illnesses were and how to spot signs of them, I may have been able to relate to

some of the symptoms in myself and gotten help sooner. Had I been taught that it is important to

research what certain drugs are doing to your body (in the sense of the illness but also how it

affects other functions), I may not have gone through so many different prescriptions and been

overrun with side effects before finding a medicine that worked right for me.

Even though depression or other mental illnesses may not affect you personally, chances

are they are affecting someone close to you. It is easier for others to talk to someone about their

deeper issues if they feel that that person has a basic understanding of what theyre saying.

Acquiring knowledge on the broad subject of depression, whether it be through school, work,

home, or on your own, could make all the difference in getting you or someone you know the

help necessary for starting toward a better place.

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Works Cited

The American Academy of Child and Adolescent Psychiatry. Journal of the American Academy

of Child and Adolescent Psychiatry, Elsevier Inc., July 2001,

http://www.jaacap.com/article/S0890-8567(09)60309-9/abstract. Accessed on 8 July

2017.

BBC. The Truth About Depression. BBC, commentary by Stephen Nolan, 13 May 2013,

https://www.youtube.com/watch?v=sDXIu8IL1rM.

Carey, Benedict. Antidepressant Paxil is Unsafe for Teenagers, New Analysis Says, New York

Times, 16 September 2015, https://www.nytimes.com/2015/09/17/health/antidepressant-

paxil-is-unsafe-for-teenagers-new-analysis-says.html?rref=collection%2Ftimestopic

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July 2017.

Ding, Jiannan. Bioconcentration of the antidepressant fluoxetine and its effects on the

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http://www.sciencedirect.com/science/article/pii/S0147651317301860. Accessed on 8

July 2017.

Grabowski, John. Psychopharmacology: Basic Mechanisms and Applied Interventions.

Washington: APA, 1992. Print.

Mayo Clinic Staff. Antidepressants: Selecting the one thats right for you, Mayo Foundation, 25

November 2014, http://www.mayoclinic.org/diseases-conditions/depression/in-

depth/antidepressants/art-20046273. Accessed on 9 July 2017.

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McDonald, M. Danielle. An AOP Analysis of Serotonin Reuptake Inhibitors (SSRIs) for Fish,

Elsevier Inc., July 2017,

http://www.sciencedirect.com/science/article/pii/S1532045617300704. Accessed on 6

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McDowell, Connor. Personal Interview. 6 July 2017.

National Institute of Mental Health, NIHM, 2016,

https://www.nimh.nih.gov/health/publications/depression/index.shtml. Accessed 9 July

2017.

The Pros and Cons of Mental Health Screenings at Schools. Eco Childs Play, 2014.

http://ecochildsplay.com/2014/05/20/the-pros-and-cons-of-mental-health-screenings-at-

school/. Accessed 20 July 2017.

Schafer, William. How do Antidepressants Work? Prospects for Genetic Analysis of Drug

Mechanisms, Elsevier Inc., 3 September 1999,

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