The writer hesitated for a long time over whether to write this piece, but in the end decided to go ahead. As an organisation that cares about mental health, we ought to encourage people not to shy away from treatment when depression won't lift. Following the UK's NICE guidelines, anyone with severe depression, or whose depression has dragged on without recovery, may wish to consider antidepressant treatment. The vast majority of meta-analyses have found antidepressants to be effective against depression, and they can be considered an effective way to treat it. Some readers may well have considered taking antidepressants themselves — but whether or not you have, have you ever wondered how these medicines came to be?
Like any drug, antidepressants go through a series of animal tests before they reach the clinical-trial stage. At this point you might ask: well, how do we know whether an animal is depressed in the first place? To test a drug you first have to define depression, and an animal can hardly tell you whether it is feeling low. On this question, psychologists have devised a number of testing methods, and I'll share two of the more famous ones — the "Pit of Despair" and the "Forced Swimming Test". The Pit of Despair was a cage built in the shape of an inverted pyramid, fitted inside with a water dispenser and a food box. The researcher Harry Harlow placed young monkeys inside it for at least three months. Why was it called the "Pit of Despair"? The whole design was meant to ensure the monkeys had no form of communication with the outside world at all — even when staff came to top up the water and food, the monkeys would never see them. On top of that, the inverted-pyramid shape made the monkeys deeply uncomfortable. So they sat at the bottom the whole time, with no companions, no idea what was going on, and tormented day and night. At first the monkeys would try to climb up along the walls and escape, but no matter how they clawed and scrambled, they could never make their way out. At that point they would fall into utter despair, give up resisting, and — having learned that nothing they did could change the suffering they were enduring — slip into a state of Learnt Helplessness. The principle behind the Forced Swimming Test is much the same: the researchers drop the test animal into a round tub filled with water. At first it tries to escape, but it soon discovers there is nothing it can do, and so it stops struggling — once again, it is the sense of helplessness in the face of reality that drives the animal into a state of learnt helplessness.
So what does any of this have to do with antidepressants? The researchers assumed that an animal's learnt helplessness closely resembles the despair felt by a person with depression, so they would test whether antidepressants could relieve that helplessness. For example, twenty-four hours after the first Forced Swimming Test, the researchers would drop the test animal back into the water tub, and then record whether the animals given antidepressants persisted longer before giving up resisting than those given none. If they did, the researchers would conclude that the antidepressant was effective.
This kind of experiment is enormously contentious, both academically and morally. At the heart of the controversy is whether the "despair" shown by an animal's helpless behaviour is the same in nature as human despair. If it is not, then animal experiments of this sort have no scientific basis to begin with, because what they measure has nothing to do with the human state of depression. And if it is the same in nature, then it becomes a moral controversy. Some schools of thought that support animal experimentation hold that animals are no more than machines responding to environmental stimuli — the famous French philosopher René Descartes, for one, held this view; or they argue that while animals do have feelings, their suffering is of a lower order. Take cosmetics testing: researchers will smear cosmetics onto the eyes of rabbits. Yes, those eyes get inflamed and sore enough to make any onlooker wince, but that physical pain is held to be of a lower order than the mental anguish — the despair, the rage, the heartbreak — that humans feel, and so animal testing is deemed acceptable. But antidepressant testing is different in nature, because it assumes, in principle, that the suffering inflicted on the animal is no different in essence from a human's. If that is so, should we go on with this kind of research? Animals do not have our capacities — but if that alone is the reason, is it really reasonable for us to keep offloading our own suffering onto the weaker?
These questions lead us into the realm of ethics, and they cannot be settled in a few words. In writing this article, the writer only wanted to point out a truth about antidepressants that is rarely known — and in the end, whether or not to take them is a personal choice. But at the very least, the writer wants to leave you with one message: the well-being of humankind today is built upon the suffering of countless animals. Even if we cannot change our way of life overnight, we should at least hold on to a sense of gratitude, and do all we can to lessen their sacrifice.
Image: My daily life with my pet
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