Defending Antidepressants

I probably find this more interesting than most of you, but I wanted to call attention to this article in the New York Times by Judith Warner on antidepressants. This week a study on Paxil and imipramine said the antidepressants worked no better than a placebo on people with mild or moderate depression. Lots of studies have said this. However,

Antidepressants do work for very severely depressed people, as well as for those whose mild depression is chronic. However, the researchers found, the pills don’t work for people who aren’t really depressed — people with short-term, minor depression whose problems tend to get better on their own.

There is a regular cult of people trying to get antidepressants banned because they believe them to be dangerous and fake and just a scam for the pharmaceutical industry to make money. And one of the arguments I hear is about all the studies that allegedly have shown they don’t work any better than placebos.

Warner goes on to document that, in America, people with clinical depression are more likely to be undertreated than overtreated.

This is the big picture of mental health care in America: not perfectly healthy people popping pills for no reason, but people with real illnesses lacking access to care; facing barriers like ignorance, stigma and high prices; or finding care that is ineffective.

9 thoughts on “Defending Antidepressants

  1. When one considers that we’re about 90 to 99% sacks of water, supported by sticks of calcium, with a little carbon, nitrogen, phosphorous, and a smidge of other minerals and chemicals thrown in for good measure, it is astonishing that anyone is born with an even moderately functioning brain and body.

    Fact is, sometimes the proportions of those chemicals is less or more than one’s system requires. On these occasions, some form of chemical intervention may or may not help, depending upon whether or not a specific medication addresses that individual’s particular problem(s). In a way, this can still be pretty hit or miss, but it’s still a step in the right direction. If the cause is chemical in nature, then it follows that altering the chemistry may prove beneficial.

  2. Considering that there are people out there arguing against immunizing children it’s hardly suprising that there are people who’d like to ban anti-depressants.

    From the website of a Dr. Joseph Mercola that promotes a report that tell you how to legally avoid immunications of all kinds:

    American children are the most vaccinated kids in the world. A newborn baby barely 12 hours old gets his first shot. At two months, he gets eight more vaccines. Before he reaches his second birthday, he’s pricked at least a dozen times more. And yet during the last 25 years, the number of kids with learning disabilities, ADHD, asthma and diabetes have more than tripled, all because pediatricians have doubled the number of vaccines that they give babies and children under the age of six.

    One can always find someone to argue ANY point with. Unfortunately, if that person happens to have some letters after their name, others are likely to assume that person knows what they are talking about and swallow their talking points, especially if they were predisposed to agree with their opinion.

    “Many were increasingly of the opinion that they’d all made a big mistake in coming down from the trees in the first place. And some said that even the trees had been a bad move, and that no one should ever have left the oceans”

  3. I have personally benefited from medication for severe depression. It helped. (That’s an understatement of monumental proportion.) I conclude that my depression was chemical rather than just the result of a bad mood, and I suspect that the benefits will be hit-or-miss because testing for normal levels of seritonin (a neurotransmitter that anti-depresants works on) isn’t done (that I know of).

    There’s faulty login in attacking anti-depressants that don’t work equally for all patients. The symptoms of depression with a chemical basis (and will respond to medication) can be identical to symptoms of purely psychological depression which won’t respond to anti-depressants.

    IMO, researchers on either side of the argument about anti-depressants who don’t admit this fundamental fact are being dishonest.

  4. When I see the statistics re: the number of Americans taking antidepressants, I can’t help but thinking that there must — in many of those cases — be a better way. At the very least, I’d like to see the prescription of antidepressants being accompanied, always, by some kind of therapeutic support — providing psychological and/or spiritual tools, that can be applied in conjunction with the chemical support.

    Having said as much, I should also add that I’ve seen many instances of people being hugely benefited by an intelligent use of antidepressants — taken either for short or longer periods of time. I also know a handful of folks who’ve had huge success with micronutrient & enzyme supplementation regimes such as EMPowerplus.

    • I’d like to see the prescription of antidepressants being accompanied, always, by some kind of therapeutic support — providing psychological and/or spiritual tools, that can be applied in conjunction with the chemical support.

      Although that sounds sensible, I’m not sure I agree. Some of us just have screwy brain chemistry. We don’t need therapy any more than anyone else does. I would like people to understand that some of us don’t need better “tools” except pharmaceutical support to correct whatever is wrong with our wiring.

  5. Bob K: In Latin, it’s post hoc ergo propter hoc. They believe their correlation, but they can’t prove causation. And, as I recall, we used to lose hundreds of thousands to all manor of horrible childhood diseases. They forget this.

    I remember that we spent billions fixing software before Y2K to prevent a global computer meltdown, then when the global computer meltdown didn’t occur, a bunch of CEOs were complaining in the trade rags that the predicted meltdown never happened, so why did we spend all that money? Same “thought” process.

    And thanks for the Douglas Adams quote – always appropriate!

    Doug: I have a mild bipolar condition with some horrible seasonal swings. I’ve also benefited from medication. I’ve tried a lot of different meds and found that many make the symptoms much worse, but there are a few that work. One size certainly does not fit all.

  6. Thanks for putting this issue on the table and giving the reader a chance to throw in our points of view…because medicine is a science it is a learning work in progress where sometimes even the experts don’t have all the answers.It is easy to see why some treatment works well for one and not another based on the fact that our detailed chemistry is all as different as we are.

    I have no personal experience with medication to control depression but I have seen the difference first hand that they have made in the lives of friends.I have watched depression reduce once vibrant lives into people who are unable to function to perform even the most basic tasks…Because of these drugs their lives and the quality of their lives and that of their families were restored.Do I believe the drugs magically solved all of their troubles? No. But what it did give them was the boost that they needed to return to their lives and work thru their problems …being able to fuction again was key!

    The damn stigma is a killer….and just what the hell is the problem????People need to pull their heads out of their asses and see it for what it is….a medical condition… treatment is not gonna be the same for everyone…For crying out loud have you gone to the store with a simple headache lately? IF you don’t have one when you go weeding thru all the different pain relievers will give you one…but if just one thing like aspirin worked for everyone there wouldn’t be aleeve or advil or Tylenol…migraines, sinus, tension…you name it,,,they have it…Sex is the best cure I know… perhaps they should do a study and find out how many people disagree…

    The proof this works for some people maybe was not seen in their study group…but it sure as hell can be seen in the lives of everyday people

    With all of that said…I also know someone like me…I was homeless with her..She has no real mental issue that kept her homeless…she escaped on abusive relationship like me and had no place to turn for help while she and I saved and worked towards getting into homes…She is depressed for a good damn reason…but they gave her pills anyhow and they have not helped at all …she didn’t need pills,,,she needs a better life..She works 60 hours a week or more and like me and after bills she can’t afford a box of tampons.Food stamps here afford us working poor less than 3.00 a day to eat on and let me tell you when you eat on that kind of budget the quality of the food you can afford does NOTHING to fuel your body or mind..but when she tried to tell them those things were the problem they told her depression is never normal… even when you are living in a tent, working 12 hour days in an Iowa winter…

    I ran into a situation when I had my back broken in a crash where everytime I said I was in pain to a doctor his solution was never to repair me… it was always to medicate me….I didn’t like the pain(I still don’t!) but it is there for a reason…I found when I took a bunch (the prescribed amount) of drugs I was so wasted I didn’t know how bad I hurt so I didn’t know to stop over doing it..pain was my bodies way of telling me that I needed to rest or get treatment.. the drugs they wanted me to take were never going to make me better.. they were masking the signals my body was sending.My point here is some doctors when dealing with this kind of medical issue at least were so fast to whip out the script pad everytime I said “I feel,,,,,,,”….it is like they don’t want you to “feel” anything.. it is easier to tone you out and drug you…..It all came to a head for me when a team of doctors looking at my back a few months after surgery One said to me”How do you feel?” I responded I had good days and really really bad ones but in general it really hurt.. to which he replied”Well thats your fault for not taking pain medication”…..I snapped!!!!! I said “Oh really? I thought I was in pain because my back is broken and on top of that it is trying to heal from being cut open for repairs…I had no idea it only hurt because I wasn’t shooting chemicals in my veins once an hour!” What a jack ass! If I had taken the drugs I would have felt good enough to get up and kick his ass, but since I didn’t I had enough pain to know better…

    I guess my point here is being pro active when it comes to YOUR medical care and whats best for you and then the rest of us should just stay the hell out of it.We don’t even realize the great contributions people with all kinds of illness’s make everyday to keep this world moving forward and how lost we would be if every finger on our hand is not working up to it’s potential …..may they never shut off the life line for those who depend on these drugs to be productive members of our society

  7. Although that sounds sensible, I’m not sure I agree. Some of us just have screwy brain chemistry. We don’t need therapy any more than anyone else does. I would like people to understand that some of us don’t need better “tools” except pharmaceutical support to correct whatever is wrong with our wiring.

    I’m with you on this 100% — agree that when it’s clearly a brain-chemistry issue, pharmaceuticals should be made available, no strings attached.

    My comment was intended mostly in relation to those who “pop antidepressants” as a way of numbing out a sense of malaise or dis-ease — which is a very sane response to beginning to wake up to the fact that we’re living in a rather insane culture & world right now — that we humans, in many ways, have made a mess of the planet, and are running around with our heads in the sand, trying not to notice.

    If this moment of feeling dis-ease could be recognized as an opportunity to stop and really assess, in a deep and honest way, our situation — and generate an aspiration to cut the problem at its root — we might collectively be able to make some genuine progress in the direction of global and individual healing. To pop antidepressants (or whatever else) as a means of habitually avoiding seeing things clearly, simply keeps the cycle of unconsciousness going.


  8. I conclude that my depression was chemical rather than just the result of a bad mood,

    Doug, I don’t want to contradict you, but I do want to mention something that current research suggests.

    It is now widely believed that there’s no such thing as exogenous (outside caused) and endogenous (inside-caused – i.e., “chemical”) depression. It’s thought that the researchers who found a difference were actually measuring the difference between mild-to-moderate and moderate-to-severe depression.

    If you think about this, it makes sense – people who attribute depression to “just” moodiness probably do have milder symptoms, because it more easily maps to everyday blahs.

    And, if you think about it, it also makes sense that the symptoms of depression are brain chemistry related – pleasure sensing/seeking, appetite, feelings of despair (despite circumstances), sleep issues – these are all brain-chemistry connected. Often, the question is whether or not a person can re-normalize them through personal action (talk and group therapies, exercise, good nutrition, etc.), or whether it will take stronger interventions to help them get to the point that personal actions can help.

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