Sir, - It was with great interest that I read Dr Muiris Houston's medical matters on various approaches to depression (December 17th). As a family doctor of 25 years' experience with a welcome ear on the problem I have often found that this hopeless feeling - often a personal interpretation - becomes a learnt set of feelings or patterns of responses to life vicissitudes.
Family doctors are ideally suited to help patients to interpret scenarios, explain pathogeneses, reassure and by just holding hands, chaperone recovery. I sometimes feel pressurised by peers, medico-legal and pharmaceutical influences to prescribe anti-depressant medication, but it has been my experience that patients respond better to regular, structured, brief psychotherapy. Comparing depression to diabetes, as described by Dr Houston in his article, can deny the doctor the opportunity of challenging the patient's feelings and sometimes lead to the increased sense of helplessness often experienced by depressed patients.
Anti-depressant medication has its place in the management of certain depressions and many patients have found peace of mind through their chemotherapeutic effects. But I have found that with time, care and a little skill many patients can be encouraged, enlightened and empowered back into recovery without them. - Yours, etc.,
Dr Michael Griffin, St John's Square, Limerick.