Hamlet, the fascinating protagonist of the play Hamlet by William Shakespeare, is known by his so called madness and the way he seeks answers to fundamental questions of life while taking a stand against his painful fortune. In Shakespeare’s time, it was probably considered as a normal behavior for a man to suffer intolerably and therefore consider suicide after going through many seriously damaging events such as the ones Hamlet suffered. Nowadays, however, this state of mind is being labeled as depression and a big percentage of the people are seeking its cure in medical companies’ catalogs. Since the discovery of the specific nerve receptacles in our body for opiate drugs (such as opium and marijuana – having a tranquilizing effect) in 1973 by two scientist named Candice Pert and S.H. Snyder, the theory of biological depression survives and is supported by the great efforts of the psychiatric industry who earns a large amount by targeting these very neurotransmitters using different kinds of anti-depressants (Harper “History”). The advertising tricks of the modern world currently hide a big part of the truth; that the concept of biological depression, defined also as severe unhappiness, is created and supported by both the psychiatric industry and the drug companies in order to have a new source of income, and the usage of anti depressants is completely unnecessary to overcome it.

The reason of depression, whether it is chemical or environmental, has been causing many arguments since the idea of the disease first came out. Medical industry defines the reason as the disfunctioning of the neurotransmitters which are chemical messengers between the brain cells. According to this theory, if these messengers are not produced at enough amounts at the parts of the brain which control mood and emotion, the nerve cells become unable to communicate effectively, and the result may be depression (“Neurotransmitters and Depression”).

On the other hand, even if there is a biological change in the brain during depression, the reason may not necessarily be an illness. In an experiment made using brain-scan equipment, people were asked to think about a sad experiment from their past which affected them negatively. The results showed that the blood flow of the brain has changed immediately – and these people had perfect mental health (Stevens). Therefore, the negative thoughts can easily cause chemical changes inside the brain, and that should not label anyone as mentally ill. In his book Measuring Human Problems: A Practical Guide, David Peck and Colin Shapiro mention “it is possible that there are subgroups of depressed patients who have particular profiles of measures (behavioral and psychological) and who may have different clinical symptoms and/or different treatment responses. For there reasons, a broader approach in the measurement of depression is now highly desirable, if not imperative” (55).

Clearly, the psychiatric point of view for the reason of depression is still not proven to be neither right nor wrong; however the drug companies have already created various types of medication to overcome it. According to Lawrence Stevens, the industry has two main reasons to hold on to the concept of biological depression which makes it perfectly understandable; the legend of Big Pharma and the ease in the diagnosis due to lack of proven information on the medical reasons – thus the ease in prescription.

If the reason for depression is proven to be the environmental factors instead of the chemical changes in the brain, the whole psychiatric treatment methods such as drugs, electroshock, or psychosurgery, will melt into nothing and the big market – known as Big Pharma - built around it will suddenly have to collapse. According to the report Loren Mosher, the former head of the schizophrenia research unit at the National Institute of Mental Health, has presented, Big Pharma is “the third largest industry in the world, it spends 40% of its revenues on marketing and 12% on research and development (most of it on new wrinkles for old drugs), and earns between 18 and 25% in annual profits” (Lehrman).

The strategy that drug companies fallow in order to make such big income is highly impressive. Not only do they use all the media sources for advertisement of their drugs, but they also invent many tests and special days for promotion of depression – like “Are You Depressed?” test which would qualify almost everyone who take it as depressed. As a result, the ideas of depression being completely chemical and how it is the new disease of our age keeps spreading around between both adults and even children.

Since the Food and Drug Administrations (FDA) changed its policy allowing the advertisement of the drugs in 1997, drug companies had spent $5.3 billion adverts each year, and the number of them increased by 40% (Lehrman). One of these  belonged to a drug called Sarafem, another antidepressant produced by Eli Lily – the company which also produces Prozac -, that was being advertised for a condition called Premenstrual Dysphoric Disorder (PMDD) which is not very easy to diagnose. The advert showed a supermarket where a frustrated woman was struggling with a shopping card – an ordinary event that everyone can face whether she has PMDD or not. It was giving the impression that even the smallest problem in life can now be cured with a pill. In addition to this, instead of informing the consumers on a new type of drug developed for their problem, the advert was trying to persuade people on asking for their product when they go to the doctor. When a patient asked for a specific drug instantly, it was putting the doctor under pressure. Recognizing these two important points, FDA asked the company to cease its broadcast (“The Marketing of Sarafem”).

Apart from obvious adverts, drug companies also use more social ways to promote their drugs. As an example, they have created a “National Depression Screening Day”, held in October each year, right after the arrival of new anti depressants. They show these “fresh” drugs as “more effective” or “producing less side effects” in order to sell more (Whittle and Thorpe). In another National Depression Screening Day in 2003, the companies traveled to college campuses to introduce depression medication. While achieving this goal, they did not forget to hand out samples of their drugs – which should not be taken without at least taking an exam by doctors - to students (“Depression: Drug Company Sponsorship Raises Concerns”).

Second reason for the industry to promote biological reasons theory is that depression is the most common mental illness that allows doctors to prescribe drugs easily depending on a few continuous symptoms. This, in parallel, provokes the drug companies to actually pay or award the doctors in some way for supporting their medicine – seeing this as another way of promotion. Julian L. Simon, the author of Good Mood, mentions that three main symptoms of depression are feeling sad, having low self regard, and feeling hopeless (11). Considering each person goes through these emotions time to time, it is easy for doctors to prescribe anti depressants to almost any patient they talk to that is not happy with his/her life because s/he may be showing symptoms of depression. It may seem like a very unethical thing to do but unfortunately “thousands of people are diagnosed as having biochemical disorder of the brain every week but there is no test to prove that. Some people are diagnosed as having mental illness within three or four minutes of walking into doctors’ surgeries. Doctors are enthusiastic to prescribed anti-depressants” (Burke). Freedom Magazine reports an example where a doctor offered an antidepressant to a patient who was complaining about headaches, when he actually had an undiagnosed broken neck (Whittle and Thorpe). Sometimes, this enthusiasm of the doctors goes beyond the limit. “Of nearly 600 family physicians and pediatriciand who responded to a 1999 University of North Carolina survey, 72 percent said they had prescribed antidepressants to children under 18” (Shute).

To see what doctors are so excited about prescribing antidepressant to almost all of their patients, and the industry - doctor relationship; there is no need to look any further than the marketing of a new anti depressant called Lexapro by Forest Laboratories – a drug company in Manhattan. While other drug companies spend millions of dollars on media adverts, Forest chose to use its budget on organizing expensive dinners for physicians. Each doctor, besides “dining on tournedos of beef and cabaret sauvignon”, was paid $500 for attending on these dinners. According to the ethic rules of the industry, free meal was no problem as long as it took place in a modest restaurant. However, the federal government had warned drug companies in guidelines on the previous month not to give doctors gifts or cash to influence them on prescribing because that would be illegal (Peterson).

The amount of money earned from prescription of certain drugs seems to blind many doctors’ eyes because there are many cases on this issue – some of them even affecting children under 18s.  On 10/04/99, it was reported that a Brown University professor  “was paid more than $500.000 in consulting fees in 1998, most of it from pharmaceutical companies whose drugs he touted in medical journals and at conferences” (Bass and Staff). Similar to this, The Guardian reported that in 2002, doctors in the UK wrote 170.000 prescriptions for children under 18s, some of them as young as six, not considering the comments of many experts saying that therapies would work better (Boseley). According to a report given by the researchers of The Journal of the American Medial Association, use of anti depressants in 2 to 4-years-olds tripled between 1991 and 1995 which makes the issue even more serious than it already is (Okie).

It is obvious that many people, including small children, are being forced to use anti depressants in many different ways for economical benefits of both doctors and drug companies. During all types of promotions that are being made, the side affects naturally become the less mentioned side of the so-called miracles for the “mental disease of our age”. Only Prozac by itself has almost a hundred side affects listed, from headaches to bone necrosis (bone death) while other anti depressants cause creativity problems for artists (Harper “Prozac Side Effects”). According to Julian L. Simon, many reasons can be listed for not using anti depressants as a way of solution (71):

First, the chemical depression still remains a theory and it’s not very logical to cure a problem without knowing the reason – especially if the cure method is chemical and has the chance to affect your both mental and physical well being. In 1987, a major drug company released the first anti-depressant drug to target the neurotransmitter serotonin, using a huge amount of marketing budget, which was also the first member of a class of drugs known as Selective Serotonin Reuptake Inhibitors (SSRIs). “The company managed to force the drug through the release process by altering test results and hiding information.  Two months prior to the drug's release, there had already been 27 deaths in the drug's clinical trials.  Yet the FDA approved it, and it was released.  By 1992, more than 28,600 adverse reactions to this drug, plus an additional 1,700 deaths, had been reported to the FDA. It is now 2003, and many, many more adverse reactions -- and deaths -- have been reported.  Yet this drug remains firmly on the market” (Harper  “Profits Over Science).

They are not only a source of danger for yourself, but for people around you as well. On February 2000, an important Eli Lily case took place where a man called Christopher DeAngelo was being accused of first-degree robbery. His eternity claimed that the defendant lacked substantial capacity and was unable to recognize the wrongness of his behavior. Apparently Mr. DeAngelo had been taking both Prozac and Xanax. Although he had no prior history of any crimes or aggressive behavior, Mr. DeAngelo had been committing several strange robberies in the past few days such as robbing with his wife’s bank with only a fake moustache and then walking past a cordon of police with guns. The case resulted with judge attributing Mr. DeAngelo’s state to drugs he is using by quoting from the report written by psyhiatrist Peter R. Breggin, M.D. The report stated; "Both syndromes are characterized by lack of self-control, judgment, and insight. Both can cause or include out--of--character, irrational, senseless, impulsive, bizarre and destructive behavior," and "They can produce criminal actions that make no sense in terms of the individual's self-interest, and which are bound to be discovered." Therefore, if the defendant were not using these drugs, he would not have committed these crimes (Breggin).

Secondly, the usage of drugs decreases the self confidence and the person becomes addicted. It is very similar to other substance abuse cases. Alcoholics drink excessive amounts in order to feel confident and good. Anti depressant users do the same thing, they take the pills for exactly same reasons – when in fact those drugs secretly decrease their self regard because they are not achieving anything on their own. “Some patients are very upset by the idea that is not their own will but a medication that is responsible for preserving control over their behavior  mood ,or judgment…as a weakness. These feelings can lead to a rather negative attitude…” (Simon 72).

Many people go through such problems as they use anti depressants when in fact they do not work at all in a lot of cases – which, by the way, is another good reason for not counting on them. “Research presented [in 2002] American Psychiatric Association meeting found no significant differences in mood outcomes in patients with bipolar disorder taking antidepressants and those not taking antidepressants. Thirty-eight patients with DSM-IV bipolar disorder entered mood, sleep, medications and other data on their home computer for three months. Of the 38 patients, 21 were taking anti depressants and 17 were not. Of the 21 taking anti depressants, 19 were taking a mood stabilizer as well. The researchers found no significant difference in the frequency of mood switches between two groups” (Bauerr and Glenn).

Perhaps the most common question that comes to mind is why anti depressants do work for some people if they are useless. Reminding the whole chemical cure method still remains a theory, it is possible to say these drugs make a Placebo affect on people. In 1998, a study took place in University of Connecticut on the possibility that antidepressants serve as placebos, only producing side affects as a difference. The result was not surprising; “the effectiveness of antidepressants [was] mainly in the placebo effect of treatment, not in the medication itself” (Aldrich).

As such games Big Pharma play on patients keeps coming out, people start to look for alternative solutions to their severe unhappiness. This leads them to psychological or spiritual methods each fallowed by thousands of satisfied people. Since they are drug free, there is no risk of any side affects. Plus, these types of solutions encourage people to overcome their problems by themselves, without feeling the need to receive help from chemicals. Thus, people who choose to use drug free methods carry less risk of going through depression again because they become – in a way - mentally immune to it.

In his book The Psychosurgery Debate: Scientific, Legal, and Ethical Perspectives, Elliott Valenstine mentions “[a] technique referred to as cognitive therapy has recently been demonstrated to be effective in treatment of neurotic depression” (308). The basis of cognitive therapy is the assumption that the responses a person gives to certain events are born from his/her previous experiences. Treatment process tries to avoid the negative thoughts – also referred as negative self comparisons – by giving certain affirmation tasks.

Another method highly recommended is called values treatment. It basically goals to help people find the things that make their life worth living; such as the sake of God or the sake of family etc. “When a person’s negative self comparisons no matter what their original cause are expressed as shortfalls between the person’s circumstances and her most fundamental beliefs (values) about what a person should be and do, values treatment can build on other values to defeat depression” (Simon 232).

Similar to values treatment, another technique called religious conversion has also worked on number of people. It is mostly supported by church groups who are fighting against substance abuse – including anti depressant usage. Religious conversion point of view focuses on man’s soul rather than looking at the issue from a biological or a psychological side. According to the followers of the method, religion and love of God helps them to get over their problems by providing hope. Although it may not be appropriate for the ones who do not hold a strong religious belief, still it stands as a tested and approved alternative to anti depressant usage (Stout).

A more spiritual way for overcoming depression is Yoga. Amy Weintraub, the author of Yoga for Depression, explains that Yogis believe that the separation feeling caused by depression is actually the separation from one’s source – which is known as the “wholeness”. Yoga, by breathing exercises and meditation, brings the person back to wholeness and helps to maintain a constant spiritual and mental well being (Weintraub). Many celebrities find their inner peace with Yoga. Madonna, the super star of the music industry, states in one of her interviews that Yoga has helped her getting through rough times in physical, spiritual, emotional and all other kind of ways. She says, “Now I just [can not] imagine going through the day and not doing it. It has completely changed my outlook on life, not just yoga but it has had a huge influence on me. I mean it really.... it centers you in a way” (Madonna  “Interview”).

Over the past years, the concept of biological depression has been spreading all around the world like a piece of gossip; consequently the pharmaceutical industry which profits by it has been growing excessively by exploiting the people who see themselves as a victim of the “mental disease of our age”. Many people have become addicted to antidepressants, and many of them suffer from its physical and social side affects. Yet, the game survives and Big Pharma keeps growing day by day by producing pills targeting the unproven causes of a so-called illness. Tragically, if he lived in our modern world, Hamlet would probably be diagnosed as clinically depressed a few minutes after he walked into a psychiatrist’s room, and would be forced to use antidepressants – most probably Prozac or Xanax – by all the media sources and the doctor himself. Maybe he would choose to try them, or maybe he would take the other path and try the alternative methods. In both ways, the big fraud of medical industry would not lose much and keep inventing new advertising techniques for more and more money; because “Though this be madness, yet there is method in’t” (II, i, 211). The doctors would still be paid millions of dollars in order to remain silent and keep doing what they are supposed to; prescribing the pill of the company which pays the most to almost every patient no matter how old s/he is. Some would win and some would lose. In the end there would be only one thing to say:

“It is not nor it cannot come to good:
But break, my heart; for I must hold my tongue”  ( I, ii, 160-161).