But based on the actual statistics, they are a small percentage of the people actually taking them. We are going through a period of massive abuse of prescription psychoactive drugs. We had a similar period where everyone was getting antibiotic drugs for problems that had nothing to do with bacterial infections. This caused problems because of the rise of resistant strains and doctors are cracking down on writing prescriptions when there is no reason to take antibiotics.
Cite?
Harriet Tubman suffered from epilepsy due to a severe blow to the head when she was young. I have no doubt that if she knew there was a way to control her seizures, she’d take it.
I know what you mean about feeling weak, I really do. Which is why I don’t think that just “popping a pill” is the answer – I think therapy is equally important, and I wish that people would remember that.
One phrase that REALLY irritates me is “medication is just a crutch”. It makes me want to ask, “so, if you saw some guy with only one leg, would you grab the crutch away from him and tell him to walk on his own?”
JoelUpchurch – OCD is not caused by situational depression. Stress may aggrivate, but it doesn’t cause it.
Not a very good analogy. You can actually x-ray a broken hip. Also there are objective statistics we could use to evaluate the effectiveness of antidepressants like the suicide rate. With the millions of people taking antidepressants we should see a big drop in the suicide rate, but the rate is at about the same as it was in 1980 before there were any antidepressants.
Actually that number actually surprises me. I would think there would be a big drop just from the improvement in trauma care. I attribute some of the drops in auto fatalities and homicides to improvements in trauma care.
I’m glad that you are middle class and that the psychological problems of poor people are not relevant to your life. Their brain chemistry is probably completely different from yours.
The thing is that most prescriptions are written by non-psychiatrists or at least without a through psychiatric evaluation. Those evaluations are expensive, while antidepressants are cheap. Recent studies have shown that these drugs don’t help for most cases of depression.
http://jama.ama-assn.org/content/303/1/47.short?home
Let me repeat. There is no such thing as an antidepressant. There are drugs that will address a specific chemical problem in your brain. If you don’t have that chemical problem those drugs can not help you. Calling those drugs antidepressants was simply a masterful piece of marketing by the drug companies.
I have absolutely no idea why you think that makes it not a very good analogy. Honestly. 110 years ago, you couldn’t actually x-ray a broken hip. Does that mean broken hips never happened until the invention of medical x-rays?
Do you also think there are no such things as painkillers, by this logic?
WhyNot…no, I get it now. What Joel is failing to convey is this:
Anti-depressants do no good if the person isn’t actually depressed. I don’t think you’ll get much debate from me on that. Putting a cast on a person’s arm won’t do any good if the arm isn’t broken.
His hangup is the whole ‘anti-depressants’ don’t make someone happy…but you know, there are LOTS of other pharmacological compounds that’ll work there.
The rest of his debate skills are what makes it difficult to understand just what freekin’ point he’s trying to make. Seriously, how ‘the evil people do’ translates to my inability to empathise with the lower class? WTF?
Well what, exactly, do you think the Brain IS but a big mass of chemical balance?
Yeah, I get ya, anti-depressants won’t make you happy. Got it.
Oh, yeah, I get that. And I agree, of course.
What **JoelUpchurch **doesn’t seem to get is that the presence of external factors can, indeed, *cause *genuine, chemical based brain hormone imbalanced Depression.
He seems to think it’s either or. Either you have stress in your life and all you need is to address that stress and then you will feel better OR you have a chemical imbalance in your brain and you have Depression and an anti-depressant will correct that imbalance. What he doesn’t seem to understand is that for the hugely vast majority of people, it’s actually both at once. For any particular patient there’s a chicken-or-egg question that, in actual treatment, is utterly unimportant. Does my patient have Depression because her brain chemistry was messed up and a particular stressor pushed her over the edge into Depression? Or does my patient have Depression because a stressor caused a brain chemistry imbalance which pushed her over the edge into Depression. I (and most doctors) don’t care. Once you’ve got Depression, you need to treat *both *facets to most effectively return the patient to heath.
ETA: And because there really is no way for us to do a blood test or brain scan that will show us if there is a serotonin reuptake problem in the brain, the way we diagnose it definitively is retroactively. We give you the drug, and if it works, then it’s a good assumption that you had the thing the drug treats. Is it ideal? Nope. We do end up medicating some people who turn out not to need it, I totally agree. That’s why we’re still doing research to try and find a lab test that works.
No because you are comparing conditions that be diagnosed by laboratory tests with conditions that you say can’t .
No because painkillers are designed to block pain signals from getting to your brain. Of course, you have to be cautious about painkillers also, since there is a large placebo effect there also.
Your problem is that you seem to resent the suggestion that any relief you experience from antidepressants may strictly be a placebo effect, even though the multiple clinical studies that indicate that is case.
http://healthlifeandstuff.com/2009/07/do-we-know-anything-about-antidepressants/
If I understand your point correctly, you don’t really care if a antidepressant is only a placebo, if it is effective in treating the symptoms. From a philosophical point of view I can’t really disagree. There have been many times I have fixed a technical problem without understanding why the fix worked or understanding the underlying cause.
There is also the an issue about environment-caused “depression” (which I think we all understand is different than "brain chemical imbalance depression). Ideally, you want to change what’s wrong with the environment, but sometimes you can’t, or you can’t do so immediately.
For example, my last month and a half in corporate America I was so stressed I literally could not sleep - just about 4-5 hours every three days. That’s not compatible with being functional. But I couldn’t (for a variety of reasons) just up and quit. I was miserable, yes, you could call it “depressed”, but it very much was entirely job-related.
I went to a doctor. I explained that this situation was only going to last about 5 more weeks, but I couldn’t just quit and yet I couldn’t sleep. So I took a “sleep aid” for those weeks which enabled me to get sufficient rest to function, after which the source of the problem was gone and I had zero problem sleeping without medication.
So, even if the problem is environment caused, sometimes treating the symptoms is entirely appropriate if you can’t change the environment and it makes the person more functional. You do have to be careful, of course, because it would be easy to over-medicate, or medicate inappropriately, in that situation. I think over-medication does happen, and far more frequently than it ever should. On the flip side, there are plenty of under-medicated folks out there, too, who would benefit from either their mental or physical ills being better managed.
Not necessarily. It’s a both/and situation, not either/or. I believe this is the point that WhyNot was trying to make. Depression can arise spontaneously for purely chemical reasons (post-partum depression is probably the most obvious example of this), but for most people a bad environmental situation starts the slide into clinical depression. The criteria for diagnosing it is exactly the same for either situation. There’s also the consideration that many people experience antidepressants not as ‘making them feel happy’, but as lifting a mental fog so that they can think normally again. Once that happens, they’ve got a much better chance of being able to do something about the crappy situation they’re stuck in. The mind/body divide is really, really fuzzy here, and there’s lots of chicken-or-egg problems.
The problem is that drugs alone is not the best way to treat depression, but it is the easiest and the cheapest, so it tends to be overused.
No, you don’t understand my point at all. But I’m not convinced that restating it yet again will help, so I’m done.
We can’t NOW. Who’s to say that in the future we won’t be able to?
Yes, but by then we might not use something so primitive as biochemical pharmeceuticals… by then we might be able to manage the cure with gene therapy and other genetic treatments… though they might still use biochemicals… nothing so crude as the current “blunt edged weapon” of the spectrum of psych meds today.
I think you totally missed my point.
I was just reading an article on that very topic the other day. Researchers at Kings College London have made the some advances in identifying the genetic markers for depression. That is the first steps to developing a gene therapy for depression.
http://healthlifeandstuff.com/2011/12/in-the-genes-is-depression-genetic/
Call me cyncial, but I also see it as a first step towards genetic discrimination and forced prophylactic medication of “carriers”.
I have encountered people in my life, upon hearing that my mother and oldest sister suffered severe, clinical depression automatically assume that either I have it myself or I inevitably will have it - they perceive increased risk as destiny. Such people treat anything other than the most positive expression from me as “proof” of this, and their solution to any problem I might have is “take a pill”, even if there are other extrinsic factors that would deflate anyone’s mood.
I suspect being tagged as a genetic carrier will only make this sort of thinking more prevalent, where the kneejerk reaction is to treat the person and ignore the environment that might be contributing to the problem.
This is also my concern. There are some conditions where a genetic cause is obvious and straightforward (e.g. cystic fibrosis, where one specific gene has a defect), but there is no one gene or even a couple genes that can be reliably used to diagnose depression.
Genome association studies can show if particular patterns of genes tend to be associated with a particular condition, but their specificity and sensitivity is not always very good. People have depression without having those genes, and many people with those genes will never develop depression. Also, I think that while the idea of gene therapy holds a lot of promise for the future, the timeframe for actually developing that treatment is generally optimistically over-hyped. I wouldn’t be surprised if it’s decades at least before there are effective gene therapies for conditions that aren’t just straightforward genetic defects (like cystic fibrosis).