misconceptions about antidepressants

As someone who suffers from seasonal depressive disorder (S.A.D.) I applaud your post. Although antidepressants didn't help me, I'm glad they're available and do help others. There's enough shame in depression without adding guilt to it. Bravo.

I'm glad you wrote this, Liz. I think it is extremely important to make the distinction you did. Without effective treatment, many people suffering clinical depression would see no way out of the nightmare of their lives. The word 'unhappiness' doesn't even begin to describe what they might be experiencing.

Yes, some people can fight severe depression without the use of anti-depressants; but the fight itself can take a horrible toll. And may never end.

Unfortunately, though, those without medical insurance in the US may have no choice as to whether they have access to these medicines or not, and that is a true tragedy.

Oh you've said SOOO much there. I spent three years on anti-depressents, which saved me from the chemical imbalance in my own brain. I did recover, and then I realized the medication was working against me, so I found alternative treatments and weaned myself carefully off the pills. I still have to maintain awareness of my moods and keep up the work I have to do so as not to need pills again. (Yes, I hated the idea that my whole life was shaped by a pill.)

There is no happiness to be found in a pill. There is refuge, for a time, but it does not fix everything. It can help, if you are willing to do all the other things that must be done. The comparison to diabetics was a good one -- just because a diabetic takes her pill does not remove the necessity of checking her blood sugar regularly, monitoring her diet, exercising, and visiting the doctor.

Medication (for depression or anything else) isn't everyone's answer, and it shouldn't be the ONLY answer, but it also shouldn't be seen as "the easy way". It is only a portion of the overall treatment required. With or without the pills, I'm still responsible for doing everything else to maintain my health, mentally and physically.

Thanks for an important reminder. It's going to take a long time and a lot of education to change people's attitudes and common stereotypes.

Misconceptions about depression and anti-depressants are widespread. Here's my nonspecialist understanding: I believe the most prevalent class of anti-depressant medications right now are selective serotonin reuptake inhibitors. Without the right amounts of serotonin in your system, you can fall into deep depression. These medications counteract depression by ensuring that your body maintains the proper level of serotonin, thus ameliorating depression.

No artificial sense of happiness is created. Rather, your body's natural ability to maintain a feeling of well being is supported. Not all causes of depression come from body chemistry, but on the other hand, not all environmental causes are without effects on body chemistry, either. Anti-depressants do not work for all people who suffer from depression. Talk therapy is also a good treatment, either in addition to or instead of medication. Some people take anti-depressants only long enough to get them through a depressive episode, while others decide they need to be on anti-depressants for life because of their body's inability to maintain serotonin levels.

Serotonin is a potent vasoconstrictor and functions as a neurotransmitter. It is concentrated in certain areas of the brain, especially the midbrain and the hypothalamus, and changes in its concentration are associated with several mood disorders. Some cases of mental depression are apparently caused by reduced quantities or reduced activity of serotonin in the brain. Several antidepressant drugs achieve their effect by inhibiting the body's physiological inactivation of serotonin, resulting in the accumulation of that neurotransmitter in the brain (and a consequent elevation of mood). Conversely, excessive serotonin activity in the brain appears to cause such symptoms as migraines and nausea.

"serotonin" Encyclop dia Britannica from Encyclop dia Britannica Online.
http://www.search.eb.com/eb/article?eu=68584
[Accessed January 9, 2004].

Another way to help alleviate depression.

You are what you eat, or perhaps more accurately, you feel what you eat. Research continues to show that at a specific nutrient contained in fish can help alleviate depression. The nutrient is an omega-3 fatty acid called EPA.

Healthy brains and nerve cells depend on omega-3s because the nervous system is made mostly of fat. The fats that you eat influence the composition of your brain cells. Unlike many nutrients omega-3 fatty acids are not produced by our bodies. Fish are an excellent source.

And if you don't like fish, you can also get your fill from walnuts or flaxseed.

Well said Liz. My girlfriend suffers from a severe depression and has to take medication for it, on top of meds for a few other things. The few times she's forgotten have been painful to witness because she really does change. For some people the drugs are necessary, for others, they arent.

@Zach: Vitamin B is also linked with moods. Taking a B multi-vitamin seems to have a smoothing effect on peoples moods, or atleast in the people I've known who take it. It can also have the adverse affect with people who take massive amounts - ~5g+ which has been proposed on some boards as an acne treatment and actually works suprisingly well but can really mess with your moods)

Hi Liz,

I applaud your posting. I was clinically depressed about 10 yrs ago. The anti-depressants managed to create just a little bit of quiet in the storm raging in my head that gave me the change to start recovering. Took the meds for a year or so, and all in all it took 3 yrs to recover. Even if me and my university friends joked about me taking "happy pills" it was never like that. It lulled the storm just enough for me to survive.

I had lunch recently with Sam Barondes, head of biopsychiatry at UCSF, and author of "Better than Prozac" where we discussed the future of mental health and our emerging neurosociety. (see Way Beyond Prozac for our discussion.)

My blog,Brain Waves: Neurons, Bits & Genes, indeed, my entire life, is totally focused on the future of mental health and the societial impacts of neurotechnology, so I'll share only a few thoughts:

1-We are moving from an information society to a neurosociety.

2-In 15 years, mental illnesses will be defined by brain imaging and biochip information and treated with extremely effective neuroceuticals...

However, back to today's world, just be glad that you can actually get the latest tools, unlike most of China

As one who has been friendly with anti-depressants (on and off) for twenty years, I have to echo the statement that new research shows they are only part of the answer for depression, however a miraculous part in my opinion. But those who take andidepressants prescribed by their primary care doctor and never bother with therapy--group, individual, whatever--are indeed putting a bandaid on a very large wound.

New books out like "The Truth About Depression" and "Does Stress Damage the Brain" show the undeniable link that trauma actually causes the chemical and physical changes within the brain that we'd like to think we inherited genetically. We inherited them, alright, but aside from Schizophrenia (which is not depression), the genetic link hasn't been proven. The trauma, PTSD, abuse link has.

So, my two cents: Thank you, God, for psychotropic medications. Thank you also for providing safe places to tell our stories so we can heal in a deeper and longer-term way.

Jeneane, I agree that they're not the only answer.

For me, it's clear that external stresses trigger my imbalances, and the medication just helps me regain normal functioning again. Would it happen without the medication? Yep. But it would be much slower, and much more difficult--not just for me, but for my family.

Liz, agreement here too. It's hard to do therapy without medication when you're in the throes of depression. Anti-depressants, I think, help us also retrain our brains to remember what it is to feel okay (or semi-okay, or even a little bit okay), which is a feeling you just can't conjure when you are clinically addressed.

I'm just pointing out the latest research that trauma plays a larger role in depression than its cousin genetics, which was once thought to be the "answer" on why some of us get depressed.

P.S.--I'm on Celexa these days and am glad I can still afford to get it. As Shelley says, today's health insurance woes don't make it any easier on those who need help.

addressed? I think I meant depressed. Must be the meds. ;-)

Just one more voice saying "yep, anti-depressants aren't happy pills." For me, fluoxetine is the difference between being able to count to ten and being perpetually dysphoric.

I'm just starting down this road. As someone who normally rejects most forms of medication I am putting a lot of hopes on Prozac right now. Since accepting that I'm struggling with depression I've been amazed at my own perceptions of the word 'depressed'. I have never judged anyone else by a medical/mental condition - ever... But this isn't the case for me judging me...

Anyway, my point is that I agree with Anil. The term 'depression' is still far too loaded. According to a report (link below) on the BBC, one in five people suffer from it. More open discussion is needed...

http://news.bbc.co.uk/1/hi/health/medical_notes/1079434.stm

I suspect it is almost impossible for us depressives to recognise the enormity of the life-price we pay for the 'help' we recieve from our medications.The complete loss of ones sensual/erotic life is hardly small beer.And that is just for starters -- the sound of depressives being positive /hopeful/affirmative I recognise in my own voice and it is dismal.

dimitri, the side effects you describe aren't inevitable. I had problems with reduction in libido on one of the medications I tried, but a switch to a different medication took care of that problem. Welbutrin, in fact, is believed to have quite the opposite effect (see this Salon.com article for details).

Liz,

Here is a basical ppt on depression from Lilly. Note depression is both an emotional and physical illness.

http://www.psychopharminfo.com/index.html

Presentation link:

https://www.depressionadvances.com/downloads/depression2sides.ppt

Thanks for the links, Zack.

How do you see disorders like PMDD fitting in to the overall picture of depression?

I've suffered near-constant depression for many years. I hesitate to describe it as severe, so we'll call it moderate. It goes as far as affecting my sense of taste, numbing my personality and physical sensation; there are related anxiety type symptoms like dizziness, vagueness and a couple of memorable occasions where the world around me simply dissolved and disappeared.

I've long avoided drug therapy, along with proper diagnosis and any other treatment, partly for the reasons that dimitri offers, and partly because several immediate family members have been through a decent number of such drugs and finally decided that they prefer to manage without because the side effects outweighed the relief. Oh yeah, and I'm a pig-headed male.

Anyway, about 3 or 4 months' back, I found this site: http://www.clinical-depression.co.uk/index.htm. I'd been looking for it for a while after a New Scientist article.

What I read here made enormous sense to me. And really hammered home to me the truth that, in most cases. it is our thinking patterns that ultimately create depression, including the very real chemical imbalances that SSRI address. Certainly, I immediately became aware of my own black-and-white, catastrophising thinking and endless introspection.

So, for me, I see that drugs patch a debilitating symptom rather than address the underlying cause. Of course, this may be enough to break the cycle of depression and allow a person sufficient purchase on normal function to recover. A toehold if you will.

I decided that I would rather fix my thinking. It's slow going but it's working. I'm sure of it.

I am slowly trying to document this journey on my own blog, even if I'm a bit confused at this stage exactly how best to do this.

Let me be clear here, I do not doubt that drugs work for people as they claim. I speak only for me. Also, my wording is no doubt a little clumsy because I'm tired and don't always think straight right now, so please don't anyone jump down my throat because you perceive that I've trivialised your suffering.

And perhaps I'll undermine myself here by admitting that I do take a drug to control my depression: I drink alcohol of an evening. Put simply, a couple of hours each night of freedom from my beserk brain, from my own self, makes an enormous difference. It stops me introspecting, it allows me to relax. I guess yoga would do the same, but I like the wine :-)

Andrew: be careful. Self-medicating with alcohol can be very dangerous--especially if you're already depressive, since alcohol is itself a depressant.

Would a conversation with a doctor or counselor really be so bad?

Lisa,

this is possibly not the forum for this, but firstly, I'm talking about small-to-moderate amounts of alcohol, not excessive.

I am aware of the depressive effects, but when I stopped drinking for a while, I plunged into the worst depression of my adult life. And I understood it to be caused by the unrelieved exposure to excessive instrospection and worrying.

Put it this way: I drink modest amounts of wine *anyway* as a cultural and lifestyle thing; I find it to be mentally beneficial in addition to its other benefits because it relaxes me. OTOH, drinking too much definitely causes problems.

And I have had chats, simply declined to pursue the treatment on offer.

But thank you for the concern :-)

Please inform me with which type of detector is possible detect exactly point of neurotechnology implanted in human head?

Thank you.

Sebastjan Videtič
Malija 44
6310 Izola
Slovenia