Treating mental illness: Quality of life matters

Quality of life matters.

This straightforward assertion gets complicated when we discuss the treatment of depression. Depression is common, part of a family doctor’s daily schedule; it can affect anyone, although certain groups are at higher risk. There have been many hypotheses as to why we as a species are susceptible to depression (and its frequent companion, anxiety), but in the day to day practice of medicine, those proposed etiologies end up being less important than the nuts and bolts of management.

Mental illness is often a chronic condition that needs to be managed, rather than a brief episode that can be cured. There is no equivalent of a course of antibiotics for mental illness — the vagaries of the human brain that leave it prone to depression and anxiety are currently best understood as a multi-factorial model, where genetic predisposition interacts with environmental conditions in an endlessly recursive loop to produce symptoms. The most feared and obvious outcome of depression is suicide. Suicide is relatively rare, but treatment for depression is often thought of in terms of suicide prevention, particularly in popular culture.

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