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Do antidepressants work?
Dr. Richard Grossman:
Hi everybody,
Do anti-depressants work? The debate continues in the Boston Globe:
An op-ed piece by Alex Beam: “Battling over happy pills” (7/26/2011)
http://www.boston.com/lifestyle/articles/2011/07/26/do_antidepressants_work/
A reply by Peter Kramer (“Listening to Prozac” author):
http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/07/30/plenty_of_evidence_to_support_pill_use/
And a reply by me:
http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/07/30/everyone_responds_differently_to_these_powerful_drugs/
All thoughts/comments are welcome!
Richard
BonesMS:
Thanks, Dr. G.
My family history is very similar to yours....multiple suicides on NWomb-Donor's side of the family and a WHOLE LOT of dysfunction on my father's side. Like you, I had lapsed into a dangerously deep depression after experiencing two deaths, within the immediate family, within a four month period. At the psychiatrist's urging, I did try Prozac. Its effect did not last long as I quickly developed a tolerance. (I told the psychiatrist of my history of addiction, which I feel is a factor when I experience drug tolerance.)
For those who may not be familiar with addictions and developing drug tolerance, what happens is that more and more of the substance is needed to achieve the same effect. Eventually, it reaches a point where the substance no longer has ANY effect at SAFE levels. Beyond that, the danger of overdose increases while addicts/alcoholics feel compelled to self-medicate and continue to increase their intake of the substance until the brain is damaged, (substance-induced insanity), and/or the body shuts down, (death).
Unfortunately for me, when I developed a tolerance for Prozac, my depression returned. What made things worse was that one of the side effects of the Prozac was that my weight blew up and I became dangerously obese. No matter what I did, my weight continued to increase. The psychiatrist kept insisting I should eat less and less, (which felt like a set-up for an eating disorder that I did NOT need). I had numerous arguments with the psychiatrist because he wanted to push benzodiazepines on me and I repeatedly told him that I have a history of ADDICTION to them and do NOT want them back! It was an insane merry-go-round that helped NOTHING! I finally stopped the anti-depressants altogether, and fired the psychiatrist because I had HAD ENOUGH!
I still live with depression as I also struggle with PTSD. (Growing up with a Narcissistic Rage-aholic is equivalent to living in a war zone!)
Bottom line, anti-depressants do not work for me and I'm not certain what an appropriate alternative would be available. I feel part of my issue is being unable to find an appropriate mental health professional WHO GETS IT about being a Survivor of a Narcissist as well as possibly being on the Autism Spectrum as an Aspie. (That's a long story in itself.)
I think I'll get off the soap-box for now.
Bones
sunblue:
I am clinically depressed and have taken a variety of anti-depressants in my life. Have they cured the depression? No. Will they? No. However, during times when I was very severely depressed, when I was suicidal and unable to function in my life, the meds helped deal with the immediate symptoms (constant crying jags, need to over-sleep, etc.). I never really felt them "kick in" as I was told they would several weeks after taking them. Truth be told, I never felt the difference but those around me said during those severe times, the meds helped. I'm not convinced....but I also think they have a place when the goal is to get the individual in functioning mode so they can address the real causes of the depression.
Dr. Richard Grossman:
Hi Bones and Sunblue,
Thanks for your comments.
As I have posted here over the years, my belief is that depression is a complicated phenomenon—both biologically and also psychologically. My experience with Celexa—and again, one can only speak for oneself when talking about these drugs--was that it was crude. It was if all the information in my brain was being channeled through one small serotonergic happy circuit. To experiment when I was on the drug, I would try to get my brain to “hold onto” negative or painful thoughts. I couldn’t do it. So, of course my depression scale numbers dropped to “normal” levels. As a result, Celexa felt like a vacation drug—a nice, relaxing escape from real life. Still, it is a comfort to know that I’m always three weeks to the day away from being on vacation should I choose. No travel or passport required…
Richard
Hopalong:
I think medicating emotional pain as a substitute for healing it, is not good. I am sure they're overprescribed, because they are a symptom reliever, not a cure. And our insane culture IS something to be depressed about.
At the same time, I believe that for severe, life-squashing clinical depression, they are/can be miraculous.
For me, they were an extraordinary help until I received or established enough of the OTHER forms of help I needed in my life, that I became confident enough to stop taking them. And if I need them again, I'll take them gratefully.
I wouldn't want anyone who really needs them to be discouraged from taking them. They've saved lives.
I think what matters, or how to look at it, is to see if you have a T or a doctor who is respectful of your own thinking about medication.
When my T suggested I restart anti-depressants, I told him I would consider it. I got the new Rx, tried a few nights, side effects (not intolerable but real) began...and I paused. I personally really LIKE having to take less Rx (and I am definitely committed to my ADD Rx because of the extraordinary help it's been). Anyway, I thought about it.
REAL BEHAVIORS also change the brain. I know that from years of writing health books. am not doing all these religiously but I know the effects are real. I told him I didn't want to restart until I had given a fair try to these:
--excellent nutrition (I'm doing WAY less junk and have added a "green superfood" power shake 5 days/wk)
--regular exercise (I had just quit, in depression. I'm now walking about 4-5 mornings a week, and need more.)
--discipline about sleep (there's another Rx, but I am taking it earlier in the evening and getting more sleep)
--stopping self-isolation (I am back at church every Sunday and making weeknight friend-dates)
If I get to the max I can with all of these things, and fall again into a crushing depression, I will take anti-depressants again for a period with no hesitation at all.
Hops
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