Falsifiable Theories of Depression

I offer a hypothetical.

Suppose that the best, most effective treatment for depression or emotional trauma was to suck it up and get on with your life?

Remember– this is a hypothesis. You don’t have to assume it’s true or that I am saying it’s true. You certainly don’t need to politicize it. I provide it in the spirit of Karl Popper’s idea — which I endorse– that it must be possible, theoretically, to prove any theory false, in order for it to be proven true. It must be falsifiable.

For example, if we assert that a certain bird eats worms, then we must be able to describe a method by which we could prove it false. Let’s say we are able to monitor the bird for every hour of every day for a week and to record with a camera everything that it eats. I think most of us would accept that if the bird never touched a single worm, the theory would be false. That seems silly on one level– don’t we only have to see the bird eat a worm to know that the theory is true? Yes. But that is because we can, theoretically, prove it if it didn’t. We think it’s a silly proof because it is so easy to do, but that’s why it works.

Here’s a more difficult one: preparing for war increases the possibility of war. In order to prove this hypothesis, we need to find an example of how it could be proven false. Let’s say, for example, that there was a country that never prepared for war. Like Costa Rica, which does not have an army. Costa Rica, sitting there in one of the most violent areas in the world, Central America, has never been invaded. Nobody is scared of Costa Rica. Nobody is worried that Costa Rica is going to invade their country and take their gold.

That’s only one example, so it’s not a very strong proof. We do have lots and lots of countries that do prepare for war and have prepared for war and got their wars. We don’t have so many countries who prepared for war and were thus able to avoid war. The big obvious one is the U.S., prepared– on a very large scale– for war with the Soviet Union, which, it would be argued, never happened because the U.S. was prepared. But our proxy nations like Guatemala, Iran, Chile, El Salvador, and so on, were not so fortunate.

Of course, the U.S. does go to war, often.  Point made.

Here’s another more anodyne example: pulling the goalie in the last few minutes of a hockey game does not improve the chances of victory.  Nobody dares to defy this piece of conventional wisdom.  Just imagine the crowd watching the home team trailing by one goal with one minute left and the face-off in the opponents end of the rink and the coach does not pull the goalie.  The crowd– and every sportswriter– would howl with derision.  But unless someone starts doing it regularly–not pulling the goalie– we’ll never know if it’s true or not.  (In fact, apparently in the KHL, Russia’s professional league, pulling the goalie is rare.)  My theory is that pulling the goalie doesn’t increase your chances of winning, but I’ll never be proven wrong, because nobody will test that hypothetical.

Anyway, suppose that you believe that the best way to deal with depression is to go see a therapist, get counseling, maybe some chemicals to adjust the serotonin levels in your brain (an idea which now seems to have been proven dubious). How would you know that was true? Well, you would have to be able to — theoretically– prove it was false.

Here’s the problem. If it is false, you would have a substantial number of people out there who were depressed but took the attitude that it was best to just suck it up and get on with your life…. and were less depressed because that’s what they did. In other words, just sucking it up and getting on with your life can be effective for some people who are depressed.

But here’s the catch: the clinicians and theoreticians and pharmaceutical companies who believe in therapies would say, those people are not really depressed.

Therefore, they are excluded from the sample that we analyze when discussing what works. In other words, the successes of the alternative approaches are simply excluded from the sample, so that only those who seek therapy and receive chemical treatments are in the pool of subjects.

That’s a self-fulfilling hypothesis.

I Want a New Drug

According to the American Journal of Psychiatry, a new drug named Paxil (paroxetine) alters the personalities of people, making them more “easy-going and cooperative”.

Psychopharmaceuticals is what they call them.

Specific serotonin reuptake inhibitors.

Don’t like your personality? It can be fixed. But remember, we are against drug abuse.

This drug is now available to doctors everywhere. They will probably be receiving colorful brochures advertising its virtues shortly. Maybe they will receive an invitation to take a free cruise to Latin America where the excellent effects of the drug can be described in luxurious detail. They will be given free samples of the drug to “try out” on patients. The drug will be expensive to prescribe. But that’s okay. Don’t worry– be happy: the American Psychological Association will be pressured to include it in DSM VI or VII or VIII or whatever, as a recommended treatment for “unhappiness”. That way, it will be covered by the real pimps of our drug culture: health insurance plans.

How far are we really from the idea that we should drug everyone in our society into placid, carefree submission? How long before we officially acknowledge that our dope laws are really concerned with stamping out competition, and not with eradicating “bad” behaviours?

It all stinks.