Dr. Keith: When the Economic Depression Turns Medically Depressing

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As Congress wrestles with the $700 billion bailout package, many proclaim the country is already suffering a depression. It is no accident that the word "depression" can be applied in an economic context, as well as a psychological one. The pathology and prognosis of an economy on the ropes and of a mind under siege have similarities that can learn from.

In both cases-whether an individual or a nation is depressed- the mood is low, or irritable, or both. But when people become clinically depressed, they suffer more than a loss of joy or sense of peace. They often lose concentration, energy and self-esteem. Without help from professionals, many cannot imagine the darkness that has descended upon them will ever lift. The greatest danger comes when they can see no future. For losing hope is even more toxic than deep personal losses that may have sparked the depression, to begin with.

An uplifting message coupled with an understanding of which wrong turns were taken in the past, can be extremely helpful at such times. But very often medicine is needed to alter the flow of chemical messengers in the brain, freeing up more calming and energizing neurotransmitters, like serotonin and norepinephrine.

The bailout package (or powerful components of it) is the equivalent of an antidepressant or anti-anxiety medication. If it works, it allows the public and the markets-as medicine would allow a patient-to begin again to focus on a brighter future and to have the energy to take steps toward actualizing it.

The writing and dispensing of a "prescription," medicinally or economically, also has a kind of immeasurable benefit, beyond the balm of chemical messengers or dollars that begin to flow. The "treatment" itself is a positive, forward-moving action that can confer new momentum on a nation or an individual. That's why even placebos (sugar pills) prescribed by doctors to people with real major depression can have inexplicable healing effects. The expectation that a prescription should work, can make it work.

One of the reasons decided action combats the stagnation of depression is that indecision is such a prominent feature of depression itself. I've treated patients (even executives and politicians) in the grips of clinical depressions that render them unable to choose which clothes to wear, let alone which deals to make. Watching a confident healer take needed treatment steps with them helps them begin taking action, too.

I've always cautioned patients that major depression takes time to lift and that it often yields in jagged, unpredictable stages-like ice in the way of a ship powering through a frozen body of water that's melting. The ice cracks, then chunks of it break free. There's forward motion, then halting, then more forward motion. A change of course may be necessary. Then, another. But the first signs of a clearing path shouldn't be underestimated. They predict victory over darkness and stagnation. We should all remember this if measures to combat our economic "depression" begin to bring victories that seem uneven, or initially un-sustained.

I've also learned that depression is a tenacious adversary. Declare victory too soon, and it can be snatched away by a second falling of the curtain. When depression is severe, a doctor shouldn't be overly cautious about increasing the dosage of a medicine or adding another or studying the roots of the problem from another psychological (or, in the case of the nation, economic) perspective. Depression is always a boulder with the potential energy to roll downhill, until it can be pushed to undeniably safe, stable ground.

If the nation is in this case a patient, if we as a people are facing an economic depression with some of the characteristics of a clinical one (as I believe we are), then we need a firm, confident, multidisciplinary, unyielding and repeatedly reassessed course of treatment.

One other thing_ While it may take a psychotherapist or neurologist and/or internist and social worker to battle the worst cases of depression, one healer has to be firmly in charge of the effort to defeat the illness. There can be differences of opinion about treatment within the team, but the treatment should ultimately be administered as a team, with one voice and an unquestionable and singular concern for the well being of the patient. Grandstanding or obstructionism for the sake of personal or professional (or political) gain is unthinkable when the enemy is a clinical depression. It should be no less the case when the enemy is an economy under siege.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement. Check out Dr. Ablow's website at livingthetruth.com.