For some years I have suffered from clinical depression. I'm not bonkers, do not suffer dramatic mood swings, and am in no way a suicide risk or self-harmer. But to deal with the symptoms of my depression, I, along with millions of others, am prescribed an antidepressant drug that works on serotonin hormone levels. In my case, this is the selective serotonin reuptake inhibitor (SSRI) Citalopram.
Treating depression with SSRIs is bog standard practice in medicine, and to some degree it works. But antidepressants on their own do not address the underlying causes of depression, whether these be psychological or physiological.
To use a signals and information analogy, controlling serotonin levels is like compressing moods into a narrow band, so that the subject is not prone to deep, debilitating lows, or wild emotional swings. The problem with this approach is that a wide bandwidth of feelings is what makes us human: it lies at the root of creativity, allowing us to feel joy and sadness, and interact empathically with others. Compress the bandwidth, and you run the risk to turning into an emotional zombie.
With me the effect of mood compression is that I often struggle to find inspiration for writing, at least in long form, which is why I spend so much time posting random snippets on Twitter. Given that writing is how I make my living, we have a problem, so I've decided to look at other ways of treating my depression. This, while heeding the counsel of my GP, and continuing with the Citalopram, albeit lowering the dose over time.
The medical focus on treating depression with SSRIs and similar drugs is symptomatic with an age-old unwillingness within the scientific community to let go of a strict demarcation between brain and body. We may recognise to some degree the holistic nature of the human organism, but still there is an inability to accept that psychological abnormalities may be due to physiological causes.
With depression, it has long been thought that the condition may be linked with inflammation, and there is plenty of scientific evidence to back this up. But correlation is not causation. We know that depression is associated with inflammation, but from where does the inflammation come? If inflammation in the body contributes to psychological state, it makes sense to treat depression by reducing the inflammation.
To that end I am taking part in a clinical trial of an experimental drug designed to do just this. The ATP Trial is testing a new medication for people who still experience depression despite taking a standard antidepressant. If successful, drugs such as the p2x7 antagonist used in the ATP Trial would further break down the (intellectual) brain-body barrier, and open the way to further treatments for mental illness that address the underlying problem in a holistic manner.
Following an initial psychological and physical assessment earlier this year, and a research MRI scan last week, I am now in the ATP trial proper, and have started taking what may or may not be the experimental drug. For selfish reasons I hope it's the drug and not a placebo, and that it works. But in taking part in the trial I contribute to medical science that may help others, and that is motivation enough.
I have no plans to keep a full diary of my time in the ATP Trial, but I may publish further thoughts and feelings as the trial progresses over the coming weeks.