# What's the appropriate use for antidepressants? **URL:** \ **Category:** Great Debates\ **Created:** [May 17, 2003, 7:09pm UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932 "2003-05-17T19:09:54Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [May 19, 2003, 12:31am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/21 "2003-05-19T00:31:59Z")
The appropriate use of anti-depressants is the same as for any drug. When the drug’s good effects outweigh the side-effects (and the cost), then they are appropriate. ADs don’t make everything rosy. They just enable some people to get out of bed in the morning. That tends to be a Good Thing. Julie ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [May 19, 2003, 12:34am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/22 "2003-05-19T00:34:59Z")
> [@](#): > > \*Originally posted by jsgoddess \* > \*\*The appropriate use of anti-depressants is the same as for any drug. When the drug’s good effects outweigh the side-effects (and the cost), then they are appropriate. \*\* Incorrect. Proper medical treatment should be used only when it’s _medically necessary_, which is not merely when treatment might be beneficial. The standards for intervention are quite stringent. The fact that they’re ignored is irrelevant. ---
**Author:** ![MLS](https://avatars.discourse-cdn.com/v4/letter/m/919ad9/32.png) [@MLS](https://boards.straightdope.com/u/MLS)\ **Post date:** [May 19, 2003, 12:36am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/23 "2003-05-19T00:36:36Z")
TVAA, you are absolutely right that what I wrote was a great oversimplification; I was just trying to give a couple of examples. Indeed, as Guinastasia said, they are not “happy pills,” and would not take away all negative feelings, as Calculus fears. They might help you to deal better with the negative feelings, though. In the tragedies mentioned, they might help a person to grieve and be sad without, say, becoming suicidal. Again, just an example. I also agree that one must be careful, since indeed there are some doctors that are too willing to just give a pill because it’s perceived to be easier than counseling and other remedies. After all, it is well known that 50% of all doctors graduated in the bottom half of their class. To put it another way: What do you call someone who graduates last out of med school? “Doctor.” ---
**Author:** ![Papermache\_Prince](https://avatars.discourse-cdn.com/v4/letter/p/f05b48/32.png) [@Papermache\_Prince](https://boards.straightdope.com/u/Papermache_Prince)\ **Post date:** [May 19, 2003, 12:36am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/24 "2003-05-19T00:36:44Z")
> [@](#): > > \*Originally posted by TVAA \*. . .And the criteria for depression are routinely ignored, because insurance companies won’t pay for any type of treatment if people don’t fit within the DSM standards, or the practitioner feels the person would benefit from treatment… or because the criteria are intentionally so broad that no one actually takes them seriously. I’m going to need some cites here. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [May 19, 2003, 12:51am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/25 "2003-05-19T00:51:54Z")
I’ll see if I can find some… my discussions with psychiatrists and years of research into applied psychology don’t really qualify, after all. You might be able to find references yourself… the tendency of practitioners in the field to sidestep the DSM has been a major in-house problem for years. ---
**Author:** ![lander2k2](https://avatars.discourse-cdn.com/v4/letter/l/7ea924/32.png) [@lander2k2](https://boards.straightdope.com/u/lander2k2)\ **Post date:** [May 19, 2003, 12:56am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/26 "2003-05-19T00:56:01Z")
I’d like to throw in some questions: When mind-altering drugs—be they be the illicit variety or the prescription variety—weren’t available, how do we suppose that those folk got by? Did they crumble into perpetual anxiety attacks and depressive states or did they simply deal with it and get on with life? If anti-depressants cure physiological ailments why do people seem to become dependant and not get cured so that they can cease medication? With penicillin, you take it for a couple of weeks and the ailment is cured and you cease treatment. With Prozac and such, often people become addicted and can’t stop without serious side effects. Is this really medicine? Or is it simply legal drug dealing? What is the difference between taking Prozac or Zoloft and smoking pot or snorting cocaine (other than the laws of the land)? ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [May 19, 2003, 1:03am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/27 "2003-05-19T01:03:57Z")
People can’t become addicted or dependent on antidepressants, **lander2k2**. They are habit-forming (and tend to lose effectiveness with time) despite constant claims to the contrary by corporate interests. There’s also little basis to the claim that antidepressants have no effect in “normal” individuals. Without pronounced negative affect, though, their effects aren’t so obvious. ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [May 19, 2003, 1:32am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/28 "2003-05-19T01:32:38Z")
> [@](#): > > \*Originally posted by lander2k2 \* > **When mind-altering drugs—be they be the illicit variety or the prescription variety—weren’t available, how do we suppose that those folk got by? Did they crumble into perpetual anxiety attacks and depressive states or did they simply deal with it and get on with life?** Why do you think that society’s taboos on suicide are so strong? Throughout history, people have been killing themselves, going into hermithood, becoming alcoholic or just plain going crazy. If you read older books, you’ll see that a lot of characters have the same sorts of mental issues that people deal with today. They didn’t deal with it much better than we do. Depression and anxiety disorders have been around for a long long time, and so have the many ways people deal with it. > [@](#): > > **If anti-depressants cure physiological ailments why do people seem to become dependant and not get cured so that they can cease medication? With penicillin, you take it for a couple of weeks and the ailment is cured and you cease treatment.** Major depression is a chronic disease. It may never go away. Anti-depressents are treatments, not cures. Are diabetics “addicted” to insulen? No. They have a chronic disease that can be helped by certain chemicals. ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [May 19, 2003, 1:47am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/29 "2003-05-19T01:47:37Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\*Incorrect. Proper medical treatment should be used only when it’s _medically necessary_, which is not merely when treatment might be beneficial. > \*\* What is “medically necessary”? I don’t really _need_ to take birth control pills. I don’t _need_ laser eye surgery. Heck, I don’t _need_ to see any better than well enought not to accidently step in front of a truck. Maybe I can start a thread about how contact lenses are overprescibed. A suicidal person doesn’t _need_ treatment, they can just be tied down. A person with gangrene doesn’t _need_ for their arm to be saved. Amputation is good enough. You got a headache? Well you don’t really _need_ that tylenol. Heck, people don’t _need_ anathstic during surgery. Need I go on? Look, I’m no drug pusher. In fact, I have _a lot_ of issues with the way that anti-depressents are currently prescibed. I don’t like seeing them used as a replacment for therapy. I don’t like seeing them pushed on people with the only goal being to get them happy enough that they can go to work every day. I don’t like how side-effects, physical dependence and the eventual loss of effectivness are glossed over. I don’t like how instead of looking at the problems in our society, we demand that everyone’s head lines up lock step. But I really don’t see what is wrong with people who are hurt taking steps to make it better. Anti-depressents have helped a lot of people. Who the heck are you to tell them that their condition doesn’t merit treatment? What exactly is your agenda anyway? What is your experience with phsychiatry, and what is your experience with depression? What are you trying to prove? ---
**Author:** ![occ](https://avatars.discourse-cdn.com/v4/letter/o/8c91f0/32.png) [@occ](https://boards.straightdope.com/u/occ)\ **Post date:** [May 19, 2003, 1:50am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/30 "2003-05-19T01:50:27Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\* > Antidepressants are often given prophylactically to patients recovering from surgery, “in case they become depressed”. > B] Got a cite for that? Considering that the SSRIs are generally given a couple weeks before their effectiveness is verified, it seems unlikely that they would be given for surgical recovery, unless a specific problem with depression is noted. Hell, painkillers would be much more effective for, you know, the physical pain that often accompanies recovery. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [May 19, 2003, 2:38am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/31 "2003-05-19T02:38:12Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\*Incorrect. Proper medical treatment should be used only when it’s _medically necessary_, which is not merely when treatment might be beneficial. > \*\* If the AD is beneficial, it should be used. My getting out of bed in the morning isn’t “medically necessary.” Julie ---
**Author:** ![lander2k2](https://avatars.discourse-cdn.com/v4/letter/l/7ea924/32.png) [@lander2k2](https://boards.straightdope.com/u/lander2k2)\ **Post date:** [May 19, 2003, 2:41am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/32 "2003-05-19T02:41:29Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\*People can’t become addicted or dependent on antidepressants, **lander2k2**. They are habit-forming (and tend to lose effectiveness with time) despite constant claims to the contrary by corporate interests. \*\* What is “habit-forming” if not a euphemism for addictive? Yes, anti-depressants lose effectiveness over time. People build up tolerance. A hard-core drunk can down enough whiskey to knock out a rhino and a heroine junkie can shoot up enough junk to kill three non-users. Doctors up the prescription, other drug users just drink/smoke/inject/snort/inhale/swallow more. What’s the difference? > [@](#): > > \*\*There’s also little basis to the claim that antidepressants have no effect in “normal” individuals. Without pronounced negative affect, though, their effects aren’t so obvious. \*\* I’m beginning to think that you were being sarcastic with your post and that you actually agree with me. Now I feel a little silly. ---
**Author:** ![occ](https://avatars.discourse-cdn.com/v4/letter/o/8c91f0/32.png) [@occ](https://boards.straightdope.com/u/occ)\ **Post date:** [May 19, 2003, 2:45am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/33 "2003-05-19T02:45:18Z")
> [@](#): > > \*Originally posted by lander2k2 \* > \*\*I’d like to throw in some questions: > > When mind-altering drugs—be they be the illicit variety or the prescription variety—weren’t available, how do we suppose that those folk got by? Did they crumble into perpetual anxiety attacks and depressive states or did they simply deal with it and get on with life? > \*\* No, those unable to cope committed suicide. More functional people were able to get by, but lived extremely difficult lives. > [@](#): > > \*\* > What is the difference between taking Prozac or Zoloft and smoking pot or snorting cocaine (other than the laws of the land)? \*\* Pot and cocaine produce highs. SSRIs do not; they address specific symptoms of depression. Pot and cocaine tend to impair one’s functioning, whereas SSRIs tend to be activating. (Well, cocaine improves functioning in the short term, but is unsustainable and thus not useful as an antidepressant). There’s no conspiracy here; these drugs can and do help many. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 19, 2003, 2:53am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/34 "2003-05-19T02:53:13Z")
> [@](#): > > \*Originally posted by occ \* > \*\*Got a cite for that? Considering that the SSRIs are generally given a couple weeks before their effectiveness is verified, it seems unlikely that they would be given for surgical recovery, unless a specific problem with depression is noted. Hell, painkillers would be much more effective for, you know, the physical pain that often accompanies recovery. \*\* I suspect the poster is referring to post-surgical depression, a very real and difficult to treat phenomenon which often occurs a few weeks after major surgery or illness. SSRI’s can be quite helpful here, as in post-partum depression. QtM, MD ---
**Author:** ![lander2k2](https://avatars.discourse-cdn.com/v4/letter/l/7ea924/32.png) [@lander2k2](https://boards.straightdope.com/u/lander2k2)\ **Post date:** [May 19, 2003, 3:10am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/35 "2003-05-19T03:10:34Z")
> [@](#): > > \*Originally posted by even sven \* > \*\*Why do you think that society’s taboos on suicide are so strong? \*\* Because things like suicide, like drug use, are a general barometer for the depravity of a culture. > [@](#): > > \*\*Throughout history, people have been killing themselves, going into hermithood, becoming alcoholic or just plain going crazy. If you read older books, you’ll see that a lot of characters have the same sorts of mental issues that people deal with today. They didn’t deal with it much better than we do. Depression and anxiety disorders have been around for a long long time, and so have the many ways people deal with it. \*\* I agree completely. People with problems have always either sunk into some dependence of some sort or they have confronted life’s slaps in the face and moved on. Why is it that people buy all this medical disorder crap when it is just plain drug use like it always was? Pharmaceutical corporation = supplier. Doctor/psychiatrist = dealer. Medicated patient = user/junkie. Seems like we’re adopting euphemisms so that money can be made by the manufacturers of these drugs. I don’t especially have a problem with the stuff that people take. The thing is that they could brew in their basement or grow in their back yard stuff that is just as effective as the junk you get in a pharmacy—the behavioral medications that is. > [@](#): > > \*\*Major depression is a chronic disease. It may never go away. \*\* Because the drug companies and their doctors tell you so? > [@](#): > > \*\*Anti-depressents are treatments, not cures. \*\* Then any drug from smack to peyote is a treatment. Agreed? > [@](#): > > \*\*Are diabetics “addicted” to insulen? No. They have a chronic disease that can be helped by certain chemicals. \*\* I love it when diabetes is brought up. Do you all read the same script or what? Insulin is not mind altering. Are you addicted to oxygen? Do you have a chronic disease that is alleviated by the intake of oxygen? Diabetes is a specific physiological condition. From what I understand it is spawned by diets full of processed junk food, but that is another issue. These “chemical imbalances” in the brain seem to be just manifestations, not causes of the conditions that are diagnosed. Take a so-called mentally healthy individual and monitor his/her brain chemistry during a major emotional upset like a death in the family. You think any change in brain chemistry _caused_ their grief? ---
**Author:** ![lander2k2](https://avatars.discourse-cdn.com/v4/letter/l/7ea924/32.png) [@lander2k2](https://boards.straightdope.com/u/lander2k2)\ **Post date:** [May 19, 2003, 3:34am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/36 "2003-05-19T03:34:12Z")
> [@](#): > > \*Originally posted by occ \* > \*\*No, those unable to cope committed suicide. More functional people were able to get by, but lived extremely difficult lives. \*\* Or they used alcohol or opium or whatever. Lots of people are still committing suicide. Lots of them had been on anti-depressants as well. Some of them are even going nuts with guns while on this mood altering medication. And I’ve personally known people on these psychotropic drugs that still led extremely difficult lives despite their medication. They were merry right after taking a pill but when that wears off, the difficult life is still there. Those unable to cope committed suicide? Don’t psychiatrists have the highest incidence of suicide? Why aren’t they coping? They have access to the drugs. > [@](#): > > \*\*Pot and cocaine produce highs. SSRIs do not; they address specific symptoms of depression. Pot and cocaine tend to impair one’s functioning, whereas SSRIs tend to be activating. (Well, cocaine improves functioning in the short term, but is unsustainable and thus not useful as an antidepressant). \*\* I’ll contest the “high” claim based on personal experience. I’ve seen changes in mood in people taking the stuff. Is it because we’re dealing with “prescription” doses and that the high is more subtle that it is different to cocaine? I’ve seen pot and cocaine address specific symptoms of depression, right along with alcohol and magic mushrooms. You seem to have conceded that cocaine effects the serotonin in the brain in a similar way to Prozac etc. So why is it that Prozac is legal and cocaine isn’t? > [@](#): > > \*\*There’s no conspiracy here; these drugs can and do help many. \*\* Ask a junkie. The drugs help him. Ask his dealer. They help him too. I never said there was a conspiracy. Making and selling Prozac is no more a conspiracy than making and selling cocaine. Is that next in the list of empty remarks behind diabetes as a counter to the notion that anti-depressant are just more drugs. You guys do have a script don’t you. ---
**Author:** ![MLS](https://avatars.discourse-cdn.com/v4/letter/m/919ad9/32.png) [@MLS](https://boards.straightdope.com/u/MLS)\ **Post date:** [May 19, 2003, 3:39am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/37 "2003-05-19T03:39:36Z")
So many things wrong, lander. Many people with diabetes have nothing wrong with their diet at all. It’s a chemical imbalance, a malfunctioning organ, in this case the pancreas. You are confusing temporary sadness and grief with chronic depression. Believe me, people don’t get into clinical depression because they wanted to. Do you think we choose to feel that way? A drug addict becomes addicted when he starts taking heroin or whatever. His initial aim is to become high – an abnormal state. A clinically depressed person is in an abnormal state to begin with. He takes the anti-depressant in order to feel normal. In some cases it’s necessary to at least start with some medicine in order for the person to be accessible to therapy. For some of us, without the balancing agent, we are anxious, afraid, and/or continuously sad FOR NO REASON. Without the balancing agent, a clinically depressed person can go outside on a beautiful spring day, having not a single ache or pain, hear birds singing and feel the gentle breeze and have no joy at all. Hearing children laughing deepens the depression as one realizes that this is all beautiful, and others are happy, and you cannot be. Do you have any concept of what it would be like to go through life like that? Every single day? Having nothing to look forward to? Not wanting to sleep because you knew you would wake up to yet another day of mental horror? A suicidal person is not depraved. He or she is attempting to escape from unendurable pain. Chronic depression and anxiety sometimes is a chronic condition that will never go away by itself. This is known first hand by many of us for years and years before any doctor ever said any such thing. “Any drug from smack to peyote” is not a treatment. Many such things will make you sicker or dead. Throughout history, though, in the absence of knowledge we have now, many people have tried these and other chemicals such as alcohol in a futile effort to get rid of the symptoms. No, I’m not addicted to my anti-depressant. But I’d rather take a little pill every day than to go through life in fear and gloom. I don’t feel “hyped” or “zombie-like.” I feel normal. I can go to work and love my family and enjoy the world’s beauty. I can feel angry at injustice and sad about tragedy. I just don’t have to cry for hours on end for no reason. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [May 19, 2003, 3:39am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/38 "2003-05-19T03:39:49Z")
> [@](#): > > \*Originally posted by lander2k2 \* > \*\*Take a so-called mentally healthy individual and monitor his/her brain chemistry during a major emotional upset like a death in the family. You think any change in brain chemistry _caused_ their grief? \*\* And if you have someone who didn’t just suffer “a major emotional upset” but whose behavior is indistinguishable from someone who did, what then? Julie ---
**Author:** ![FranticMad](https://avatars.discourse-cdn.com/v4/letter/f/c68b51/32.png) [@FranticMad](https://boards.straightdope.com/u/FranticMad)\ **Post date:** [May 19, 2003, 3:55am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/39 "2003-05-19T03:55:52Z")
> [@](#): > > \*Originally posted by lander2k2 \* > **Pharmaceutical corporation = supplier. Doctor/psychiatrist = dealer. Medicated patient = user/junkie.** Yes, let’s take the “War on Drugs” into the psychiatrist’s offices, shall we? Let’s toss those pathetic patients out of the doctor’s offices and onto the street where they can buy their drugs from non-corporate entrepreneurs. And no more junk food either. No smoking. No red meat. No sugar. Sigh. So many things wrong with your posts, as MLS pointed out. It’s late or I would proceed to dismember your point of view into tiny pieces, backing each of my disputation with citations from several sources more reputable than your assertion “personal experience”. Moan. Another anti-corporate ranter who knows nothing about biology or psychology but thinks he has the answers for the world. ---
**Author:** ![spectrum](https://avatars.discourse-cdn.com/v4/letter/s/9fc29f/32.png) [@spectrum](https://boards.straightdope.com/u/spectrum)\ **Post date:** [May 19, 2003, 7:16am UTC](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932/40 "2003-05-19T07:16:05Z")
There is a stigma, a hateful, destructive stigma, in our society, that objectifies and punishes those with mental illnesses. Calls us weak, pathetic, blames us for our condition. Then when some of us get the help we need, people like Lander slime their way in and compare us to junkies and drug abusers, simply because we’re trying to live normal – not high, not special, normal – lives. It is one of the more evil components of our society, one of the last acceptable prejudices. It’s okay to hate the mentally ill, the depressed, the suicidal, because obviously, we deserve it. It’s our fault. People like Lander help perpetuate and spread this myth. Lander, I hope all your children suffer from crippling manic depression. [Previous page](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932.md?page=1) [Next page](https://boards.straightdope.com/t/whats-the-appropriate-use-for-antidepressants/175932.md?page=3)