Another strength of antidepressants is the fact that they are easily accessible and cheap. This means that nearly every depressed person would be able to get hold of them and use them if they need to. This is a good thing because for example, if someone is suffering from severe depression, they can be able to get hold of antidepressants quickly and use them before they attempt to commit suicide- the antidepressants may be able to relieve some depressive symptoms quickly which could then stop a person from taking their own life.
However, because antidepressants are easily accessible and cheap, this can also be a weakness as depressed people can get addicted or dependant on the drugs. For example, if a person gets depressed, they will just rely on the antidepressants to cure them. This a problem because if the antidepressants are no longer available, this means that the depressed person can potentially commit suicide as they will not be able to cope, so they may just give up and kill themselves in order to stop themselves from feeling anymore depressed.
Another weakness of using antidepressants to treat depression is the fact that there are some ethical issues that are raised. One ethical issue that is raised is consent. It is questionable as to whether depressed patients are well enough to give fully informed consent. For example, if a person is severely depressed, they may just agree to take antidepressants in order to relieve their depressive symptoms, but they may not how those antidepressants will affect them. For example, if a patient takes Prozac, they may not know that the Prozac will increase their serotonin levels in their brain. Because the patients may not be aware of this information, this denies them the opportunity to give their informed consent.
However, having said that, antidepressants have proven to work, so they can potentially save someone’s life. Although patients may not give their informed consent, their lives can be saved- for example, if a patient was severely depressed and about to commit suicide, the antidepressants could save their lives. Surely it is more important to save someone’s life than to get their informed consent.
Another ethical issue that is raised is protection of participants. Antidepressants such as MAOIs and SSRI are known to have side effects. For example, one side effect of Prozac, a type of SSRI, is that it can cause a patient to attempt to commit suicide, so if a severely depressed patient takes Prozac, there is a risk that they can end up killing themselves as they may not be able to cope with the depressive symptoms.
However, not everyone who takes Prozac will attempt to commit suicide. In fact, it has proven to work effectively for most people. So, it is better for a depressed patient to take antidepressants and get better (even if it means getting a few side effects) than to not take antidepressant which may cause the depression to get even worse.
So, it seems as though there are advantages and disadvantages of using antidepressants. Whilst some argue that antidepressant are a good treatment and work effectively, it is important to note that there are also other treatments such as CBT that also work and have fewer side effects than antidepressant, so the patients do not always have rely on antidepressants.
Another biological therapy for depression is ECT. ECT stands for electroconvulsive therapy. It was introduced in the 1930s but frequently misused causing physical and emotional damage. However, it is used safely today.
Before the treatment begins, patients are first given sedatives and muscle relaxants. They are given sedatives so that the treatment can begin whilst they are asleep. They are also given muscles relaxants so that they do not hurt themselves during the treatment. Oxygen is also given to them so that they can be able to breathe during the treatment.
Electrodes are then attached to the scalp and a small electric current is passed through the brain for a fraction of a second, causing seizure which last for about one minute. After this procedure, the patient normally has no recollection of the treatment.
It is believed that it is the seizure that generates improvement in depressive symptoms. The seizure appears to restore the brain’s ability to regulate mood. It could be because blood flow is improved or enhances the transmission of neurochemicals (e.g. serotonin). According to the biological approach to depression, neurochemicals such as noradrenaline and serotonin cause depression, so when ECT balances the neurotransmitter in the brain, this should reduce depressive symptoms.
ECT is usually given 3 times a week, with the patient requiring between 3 and 15 treatments.
There has been research conducted to check the effectiveness of ECT. Gregory et al compared ECT with fake ECT (placebo). They found that patients given real ECT made more improvements than those given fake ECT. This shows us that ECT does work and that it is effective as depressed patients showed improvements after they received ECT treatment. If ECT did not work then the patients who received the ECT treatment wouldn’t have made more improvements than those patients who were given fake ECT treatment- they probably would have made the same improvement as those who received the fake ECT treatment.
However, there were ethical issues that were raised in this research. For example deception- those patients who received fake ECT were deceived into thinking that they were actually receiving real ECT treatment, so this means that they couldn’t have given their fully informed consent.
Another ethical issue that was raised is protection of participants. For example, those patients who received fake ECT may not have seen changes in their depression, so they may have thought that nothing could treat their depression and so this could have given some patients dangerous ideas, such as to commit suicide, since they may have thought that nothing could ever make them feel any better.
Another research which looked at the effectiveness of ECT was carried out by Scott. They reviewed 18 studies which consisted of 1114 participants. They compared ECT with drug therapy and the findings of this research suggest that ECT is more effective than drug therapy in the short term treatment of depression.
However, because none of these trials compared ECT with newer antidepressants such as SSRIs, it is not clear as to whether ECT is still more effective than drug therapy in the short term treatment of depression today. For example, SSRIs may actually prove to be better than ECT treatments, so it shouldn’t be assumed that just because Scott’s research shows that ECT was better then, it is still better now.
One strength of using ECT for treating depression is the fact that it has proven to work. For example, ECT has worked for some people who are severely depressed. This is a good thing because if other treatments such as antidepressants and CBT do not work, there is always ECT to rely on. However, having said that, it is not guaranteed that ECT will work for everyone. If depression is caused by psychological factors such as too many major life events, then according to the psychological explanation of depression, ECT wouldn’t be able treat the depression. This is because even if ECT does balance the neurochemicals in the brain, this will not have any effects on a depressed patient as the cause of depression wouldn’t be due to biological factors- it would be due to psychological factors instead. So, a more appropriate treatment would be CBT.
Another strength of using ECT to treat depression is the fact that some researchers have found that even though this treatment invasively assaults the brain, it does not cause any lasting effects on the brain, such as impaired memory. So, for example, after the ECT treatment, if a patient has cognitive problems, these problems will only be there for a short period of time and they will eventually go away. However, having said that, The Department of Health Report, in 2007, found that out of those patients receiving ECT within the last 2 years, 30% reported that it had resulted in permanent fear and anxiety. This just goes to show that ECT still comes with a few side effects which can last for the of a person’s life and it is rather unethical as a person’s life can potentially be ruined. For example, even though ECT may treat a person’s depression, the person may develop an anxiety disorder which may prevent them from doing something that they usually do, like swimming, as they may fear that if the swim something bad may happen to them.
Another ethical issue raised by the use of ECT to treat depression is consent. The department of health found that out of 700 patients who received ECT when they were sectioned- 59% of them hadn’t consent to the treatment. Also, it is questionable as to whether depressed people are well enough to give their informed consent when it comes to receiving ECT treatment. For example, if a person is severely depressed, they may agree to receive ECT treatment even though they may not know how it works because all they will care about is to rid of their depressive symptoms. This just goes to show that the patients cannot then give their informed consent as they will not know all the information about ECT. However, having said that, since ECT has proven to work, it can still save someone’s life, especially if they are severely depressed, because it can stop a person from committing suicide.
So, it seems that ECT works for some people, and it is quicker, to an extent, than antidepressants because changes are usually noticeable even after one section of the treatment, whereas, antidepressants usually takes at least 2 weeks for a person so see changes. However, it is important note that both antidepressants and ECT do have side effects which can put a person at a risk. For example, Prozac can cause a person to attempt to commit suicide, whilst ECT can cause a person to develop an anxiety disorder. It is also important to note that there are also other treatments such as CBT which offer less side effects than ECT and antidepressants.