 |
|
|
|
June 16th, 2011
04:41 PM ET
Are antidepressants glorified placebos?Which came first, the mental illness or the drug? While in other areas of medicine this is a no-brainer (no pun intended), some argue that certain psychiatric conditions are created and classified because of the effects particular drugs have on the body, and not the other way around. Three new books, reviewed in Dr. Marcia Angell's article "The Epidemic of Mental Illness: Why?" in The New York Review of Books, raise startling possibilities about the truth behind the explosion of prescriptions of pharmaceutical treatments for mental illness. (Dr. Angell, by the way, was the first woman to ever be editor-in-chief of the prestigious New England Journal of Medicine). All of the authors of the new books agree on two thought-provoking viewpoints: 1. Our understanding of categories of mental illness and their treatments has been influenced by drug companies, through both legal and illegal marketing. These views, however controversial, are documented well, Angell says. For instance, even though the goal of psychoactive drugs is to alter levels of neurotransmitters - brain chemicals - which affect mood, scientists have not found good evidence that it's the chemicals themselves that cause the mental illness. Before treatment, neurotransmitter function seems to be normal, they say. "By this same logic one could argue that the cause of all pain conditions is a deficiency of opiates, since narcotic pain medications activate opiate receptors in the brain," writes Daniel Carlat, author of "Unhinged: The Trouble With Psychiatry - A Doctor’s Revelations About a Profession in Crisis." So if drugs don't treat the cause of mental illness, what are they doing? Irving Kirsch argues in "The Emperor’s New Drugs: Exploding the Antidepressant Myth" that antidepressants work merely because patients believe they work, and the pills' side effects reinforce that belief. As I wrote earlier this month, the placebo effect is the idea that a sham medical treatment, with no inherent healing properties, can sometimes operate as if it were an actual drug in alleviating pain and changing blood pressure, digestion and other involuntary functions. The more complex and involved the fake treatment, the more effective it's likely to be. So keep that in mind when you consider that, according to Kirsch's research on Food and Drug Administration reviews of clinical trials of antidepressants, placebos were about 82% as effective as the drugs. And non-antidepressant treatments such as sedatives and opiates were just as effective. In fact, he found that "nearly any pill with side effects was slightly more effective in treating depression than an inert placebo," Angell writes. Kirsch speculates that, in fact, the side effects themselves are what convince patients that their antidepressants are working, and lead to them saying they feel less depressed. Our CNNHealth.com mental health expert - Dr. Charles Raison, a psychiatrist at Emory University School of Medicine - says there is some truth to the idea that antidepressants work at least in part by the placebo effect, and science has borne that out. And that's not necessarily a bad thing, as physicians can harness this effect - for instance, in terms of the doctor-patient relationship itself being therapeutic - he says. But in patients with more severe depression, the placebo effect diminishes, so the drug must be doing something. You could even look at it like this: antidepressants may potentiate the placebo effect. "Antidepressants are not perfect, but they definitely have saved many people’s lives," he says. And if the myth of the chemical imbalance suggests that depressed people simply need more or less of certain brain chemicals, that's right, Raison says: "It’s pretty clear that depression is not like you’re running out of gas." But, of course, all emotions and thoughts are generated by physical interactions in the brain and the body, so at its core, depression is indeed a biologically based disorder. The brain is obviously quite complex, and antidepressants seem to help reset and recalibrate systems in the brain to help you feel better. Angell will address the "wonder drug" popularity of mental illness treatments in the second part of her series.
Next entry »Cancer deaths down but disparities still exist
« Previous entryGupta: The friend I can't fix
|
  About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
 |
|
|
|
more like ADDICTIVE placebos.
Pharmacy = Sorcery
Tell that to people who need anti-seizure medication to get through the day. Your comment only shows your ignorance.
You're right and you're wrong. Many mass-market depression medications are prescribed to individuals who do not need them, which leads to dependencies. That's the hard part of psychiatry...you're really just taking someone's word for it most of the time. For individuals with real psychiatric disorders: major depressive disorder, bipolar disorder, schizophrenia, etc, these folks didn't know how good life could be until they were prescribed the right medication. As someone who suffers from bipolar disorder, I can tell you that without the medication, I'm not functional and I can be downright dangerous. Since I was properly medicated, I haven't shown a single symptom, and that was 6 years ago. Medications have their proper applications...but if you're just bummed out because your life sucks, get a hobby and save yourself the copay.
Yes, because one person questions one class of drugs then the whole profession is a scam.
Outlaw all the cholesterol, blood pressure, asthma, diabetes, and thyroid medications. They clearly aren't working.
The improved health is from the placebo effect as clearly you can will your blood pressure and blood sugar to their proper levels.
Stick to World of Warcraft message boards dude.
My now-adult daughter would not be alive today without the chemical "balancing" that was provided by anti-depressants when obsessive-compulsive disorder attacked her in her childhood. While in the throes of OCD, she refused to believe that she had any problem, and she was not expecting medication to change anything. Yet it saved her life.
Scientologist alert!!! Prepare for nonsensical arguements about science, medicine, and how a "religion" can fix everything!
I only wish that were true for me.
I have spent the greater part of my adult life miserable. I have seen at least 3 different psychologists and tried at least 4 different SSRIs. None of these treatments managed to do a thing. Then, after consulting a psychiatrist, I was diagnosed with inattentive ADHD; believed to be caused by low levels of dopamine. I was never diagnosed with ADHD because the inattentive type does no show the typical ADHD symptoms as well as having a well above average intelligence which allowed me to limp my way through school and even acquire a BSME. Nevertheless, I had the "chemical imbalance" of low dopamine levels; the doctor prescribed a DRI as well as an SNRI. The DRI makes me feel good, for once in my life. The SNRI I'm not so sure about; placebos won’t work on me, I'm too smart, I do my research on anything I take. I know whether they are working or not. The DRI does something for sure; I just feel better. So you can't tell me that chemical imbalances are a myth. The people who say that obviously don't know what its like to spend 2 decades interminably miserable.
Why is the first comment always the most stupid?
All these pills, for me marijuana helped me work through some crippling anxiety and depression. I haven't used for years, but when I did, it was like a switch flipped and I wasn't paralyzed by fear crying daily. If I ever get bad off again, I'll go somewhere where it is legal
There is something that exists in pot that does help people with mental health issues. I'm a therapist and I think that most people who smoke do so to deal with some form of PTSD. I also think that many of the mental heath issues out there are caused by PTSD. If you've ever noticed someone who self-medicates with alcohol they do so because of PTSD. I think that most people who initially smoke do so because getting high feels good however they start seeing other things. When I used to smoke I felt great for the next few days, not like I could conquer the world but that I could deal with it. I'm not advocating people to smoke pot but there is something beneficial in there.
I think pot is great for anxiety and depression. I don't use, but would like the option if I needed it once in a while just to feel a bit less anxious.
Pot MAKES me feel anxious, paranoid, confused, rapid heartbeat...not mellow, calm and happy...there is no 'one size fits all' drug for everyone - legal or not
CL, a "therapist" would NEVER claim that they think "most" people do something like that for the same reason...especially PTSD....the very concept of preconceptions contradicts your very purpose. A "therapist" would understand the scientific method and would not claim knowledge of motivations of people they never met.
When they work, they do wonders but when people are misdiagnosed and put on this stuff, it can be unpleasant. Paxil and Prozac totally screwed up my metabolism and I was told to take it because the pain I was experiencing from intractable migraines HAD to be related to depression.
It wasn't but it took me moving to another city and seeing a top neurologist before anyone would believe me.
TJ, I agree !!
When I was going through a terrible divorce, I was first perscribed Prozac and then Paxil. The only way I could describe the horrors was, imagine you were awake for 2 days and then drank a pot of coffe !! I couldn't sleep and I was on edge. My work and personal life went downhill quick. The doctor kept telling me " you have to build up a tolerence and blood level". 4-6 months each and I was a mess !! I asked the doctor if he was ever on it, which he never was. I then realized I had to get off the crap and I was fine. DANGEROUS STUFF in my opinion...
Very True!!
I see patients suffer all the time because their health care providers refuse to look at other possible diagnoses.
I've never heard of depression causing migraines though.
Ah yes, Paxil. Crippling insomnia when I started taking it, violently nauseous when my dose got doubled to 20mg (which I gather is still on the low side of normal), nine years and counting of white noise in my ears since I stopped taking it. Oh, and the best part, it didn't help my depression at all. What I really needed was a proverbial kick in the ass, but as I was living overseas without any friends, it was easier to throw drugs at the problem.
Just a little bitter 🙂
Me too with the metabolism.
I was put on Prozac in 1993, and I've never been the same since. My husband had been seriously injured in an accident in 1990, and it took more surgeries than anticipated to get him back to work. I continued to work full time and deal with the legalities of the injury, and do all the things around the house by myself.
I got into a bad sleep pattern during and after, and by the time I sought help, I was only sleeping 90 minutes a night in broken segments. Prozac was supposed to 'fix me'. It made me so ill I thought I was having a gall bladder attack at first, but got the same 'you have to build up a tolerance' speech. I was put on a MLOA.
And after three months I still wasn't sleeping. So the psychiatrist added Desyrel to the schedule. I slept so hard the first night, my husband (who was back to work at this point) thought I was dead.
But. I gained weight. And got more – apathetic. After 6 months, I told the psychiatrist and the therapist that the whole treatment thing wasn't working, none of it, and I needed to discontinue the drugs.
The psychiatrist said, 'So, stop taking them'. (He turned out to be a bit of a dismissive snobby snot.) So I stopped, and had an anxiety attack at work (never had one before), and eventually got fired. I thought I should have been weaned but the psych said my doses were too low, and that was back when I trusted and respected doctors.
It's been determined though, that what was really happening to me was Chronic Fatigue Syndrome.
And I've never recovered.
antidepressants and antianxiety medications are horribly unhealthy placebos. They cause osteoporosis, heart attacks, strokes, hernias, suicide and you end up worse not better when you get off of them if you can get off of them. How crazy is that? Psychiatry has always been a scam and it still is.
They are a tradeoff between benefits and side effects, like every other drug in existence.
Psychiatry is a scam? Erm...I invite you to spend a day at work with me. I help individuals with schizophrenia, bipolar 1, and psychotic disorders rebuild their skills and their lives. Strong anti-psychotic (psychiatry!!!!) drugs are the ONLY thing keeping these folks out of a locked ward. Without the drugs, my folks hear command voices telling them to do awful things, experience crippling paranoia, crushing panic, frightening visual hallucinations, delusions which leave them unable to remember their actual pasts and unable to understand what is happening to them in the present, and thought disorders which make it impossible to communicate without "word salad."
Yeah. Let's take them all off their med and then YOU come spend a week with them.
Good luck.
the ONLY "cause" of suicide is mental and emotional weakness....not drugs
"So if drugs don't treat the cause of mental illness, what are they doing? Irving Kirsch argues in "The Emperor’s New Drugs: Exploding the Antidepressant Myth" that antidepressants work merely because patients believe they work, and the pills' side effects reinforce that belief."
The above paragraph highlights the fundamental misstep in logic with this article. A drug can treat the symptoms without treating the cause. It doesn't matter if low serotonin is the cause of depression; increasing its concentration improves mood (along with a host of side effects). Many drugs only target symptoms rather than the root cause, including antihypertensives and anticholesteremics. This article is essentially using a straw man argument to try to stir up controversy over antidepressants. I notice that CNN's best resource for medical articles, Dr. Sanjay Gupta, is not the author.
Well said!
Exactly. The drugs do work in their goal, which is to make people not feel depressed. My family doctor put me on an antidepressant once because I was tired a lot / sleeping too much. I was personally quite sure I was not depressed, and I was right. However, the drug Did work. It leveled my moods. Too much, since I didn't need leveling. It didn't make me feel "good" but took off any of the high and low points, which I didn't like and stopped taking when it didn't improve the tiredness. That was a medical condition that the doctor just didn't take enough time to figure out.
So, one problem that exists is that doctors, sometimes just GPs will throw antidepressants at people with actual medical conditions that aren't at all related to depression.
Thank you, thank you.
Zero references to peer-reviewed journal articles, research, or any other solid body of evidence for these claims which many misled relatives of people with mental illness will use to make the ill person's life hell. It's maddening.
I think it's fair to say that there is a placebo effect in any psychotropic medication but I challenge the idea that mental illness is not caused by an imbalance of neurotransmitters in the brain. For example, psychotic disorders have been shown to be induced by taking L-Dopa, a synthetic form of dopamine. Simply by altering one's brain chemistry we can mimic psychotic disorders. How can we say that the root of these disorders in not due, at least in part, by chemical imbalances?
This is a very dangerous article.
I couldn't agree more.
I agree this is a very dangerous article. There are many scholarly articles published in journals demonstrating the neuro-biological basis for many mental health issues. Environmental factors also contribute, but often in is the combination of appropriate medication(s) with therapy that support people in overcoming their unique mental health issues. Unfortunately our society stigmatizes individuals with mental illness and the use of psychotropic medications to relieve symptoms. Hopefully with enough outreach and education peoples views will begin to change and understand the importance of utilizing a multifaceted approach to treating mental illness.
This is a great article because if one looks at the facts anti-depressants do not outperform placebos in probably more than the 82% of depressed patients stated in the article. Furthermore, anti-depressants are potentially very dangerous, addictive, and can cause permanent damage. Anti-depressants have their place, but are WAY over prescribed.
well said.
have a read of Irving Kirsch's book "The Emperor’s New Drugs: Exploding the Antidepressant Myth". you may fine it very interesting how the clinical trials for these antidepressants are ran and how they are approved for use. it may make you think twice before putting those chemicals into your body. i strongly recommend this book if you are having to face the decision of taking an antidepressant.
I agree 100%.
Hopefully this is just a passing article that will not catch the public's attention and lead to catastrophic consequences like the spate of diet books did a few years ago.
Dangerous, irresponsible AND ill-written.
This article is one of the most irresponsible I've ever seen on this website. I'm a 21-year-old soon-to-be graduate student who has had depression since age 14. I can say that, without a doubt, I would have been dead at 14 if I hadn't been helped immensely by anti-depressants and caring and observant therapists and psychiatrists. If positive thinking and "pulling yourself up by your bootstraps" works for you, you should count yourself as lucky. Not every fares quite as well. So before you make blanket statements and spout theories, try talking to the people whose experiences you claim are just lack of willpower to feel better. As someone who has been to hell and back with depression and is now doing better than I thought I could after several close calls with suicide. I'm still here, for me that's enough proof that anti-depressants can make a difference in treatment. You may never need anti-depressants, many people don't, but please do not discount the experiences of others who have. My life is not a placebo effect.
Well said
Huh, studies show that neurotransmitters are functioning just fine? Really? Because hundreds of thousands of studies on the human brain have shown just the opposite to be true in people w/ mental illnesses. I'm studying psychology, and although neither myself or my psych student peers are studying to be psychiatrists(MD's), we are taught about these studies in our psych classes. Please know that these other students, along with myself, do know our stuff. I'm fairly certain that these "scientists" who authored these books are simply tools of insurance companies. Think about it. Insurance companies won't be spending as much of their precious money if these so called "studies" "show" that these medications don't work, because they will use these "studies" as a reason to quit covering the cost of psychiatric medications for patients. Also, another thing that the public should be aware of is that these medications have indeed been shown to alter the behaviors of patients who take them. These alterations have helped people lead normal lives. Please don't take these "experts" seriously, as they most likely have ulterior motives for publishing their "studies." As a side note, everyone leaving comments should know that those of us who study this stuff (for real) could instantly disprove these "experts." Just keep that in mind. We read studies on the brain pretty much every day, and we are well aware of what is and is not true about the brain's functions. On a side note, you are very gullible and foolish if you don't realize that the name of the game as far as the mass media is concerned is sensationalism. If it's not outlandish, unbelievable, and shocking, it doesn't sell. Think for yourselves. Listen to real scientists, not these crackpot fools. Move along. Nothing to see here. Next.
Actually insurance companies like spending money on pills as opposed to psychotherapy because it is cheaper. Psychotherapy usually consists of hourly long sessions that can go on for months. These drugs do, in fact, alter people's behavior. Sometimes for the good, and sometimes towards utter disaster such as suicide and homicide. There are also numerous "experts" and "scientists" such as Peter Breggin, David Heally, Joseph Glenmullen, and Robert Whitaker to name a few, who have come to similar conclusions long before this book by Irving Kirsch. The reason more people are not critical of anti-depressants is because psychiatry systematically rids and discredits those who do so. And what ulterior motive would someone have for taking all the studies given to the FDA on anti-depressants and crunching the numbers other than the TRUTH? And as for the mass media, the mass media is in the pocket of big pharma. For Pete's sake, CNN's main health page has a Cymbalta ad, an anti-depressant, on it. Pfizer sponsors CBS's 60 minutes. The mass media is not nearly as critical enough of pharmaceuticals and, to be more specific, psychiatric drugs. It seems big pharma PR is in full swing for this article.
Anyone who denies that clinical depression is never caused by a chemical imbalance does not understand depression. Write what you want. Present any research or opinions. But when people like me get their lives back from antidepressants that do change my brain chemistry, nothing will change my belief in their effectiveness. It is interesting that blood problems, and other chemicals in other parts of the body are readily accepted as the cause for illnesses. But many people do not believe that chemicals in the brain have no effect on the health of the brain. And BTW, the person above who says psychiatry is all a scam should see a psychiatrist. He obviously has a mental problem.
i know exactly what you mean. i completely agree
It's funny to watch the antidepressant commercials on television. One promises a free two week supply. This is how drug pushers get kids hooked on drugs. After they are hooked they sell the drug to them. These antidepressants have heavy side effects and are not always appropriate.
Don't some insurance companies limit hat a Dr. can prescribe a patient. They are not even to disclose all the various treatments, unless the patient asks. This is partly why the Rx companies advertise, the patients can then get access o other drugs simply by asking and having a bit of knowledge. I emphasize partly.
Umm, actually, you can get a free two week trial....WITH a doctor's prescription. No drug companies can just "hand out" medication without some sort of oversight. And I know this from experience as I currently have a "free" two week trial that I have NOT taken yet- still debating, but I could not just walk into the pharmacy, even with my coupon, to get the medication without my doctor's prescriptionn.
Brian, what planet are you on man? Patients "play" doctors all the time. They hunt down those fly-by-night phara dispensaries and can get anything practicallly anytime. You think Big Pharma gives a rat's behind whether the pills you paid a small forturne for where proscribed by Albert Schwietzer or Dr. Nic Riviera?? It's almost tougher buying liquor.
This article is so insensitive and dangerous. As a patient of depression myself, I'm very offended by the callous arrogance of the author of this article. Antidepressants gave me my life back.
I suffer from postpartum depression, and couldn't agree with your statement more. Without my medication, I'm suicidal... and it's not like I could eat skittles and "pretend" I was taking an antidepressant to make it all go away!
The stigma that comes with mental illness is as painful as the condition itself.
The stigma is a as bad as the disease?
Source?
Disregard my above comment.
I misread.
Sorry
I agree. Would not be here if I listened to those who don't believe in meds.
This article is very dangerous.I have been fighting depression over 20 yrs and without antidepressants I would not have made it.They should not put this garbage on TV.
Really? I had no idea that my debilitating depression is not a result of a chemical imbalance in the brain! Tell me why all of the scientists can show you exactly where the synapses are overloaded from too much or too little of necessary chemicals. I know for a fact that anti-depression medications are NOT placebos. I could take tylenol or any other pill for that matter and try to make myself think that it was curing my anxiety and depression, it didn't work. Only until I was prescribed specific medication was I allowed to finally have a let up of my symptoms. I still experience them but it is something that has to be combated emotionally and mentally.
Realize that persons with severe depression, especially those with suicidal thoughts are often excluded from drug trials for ethical reasons (can't ethically give a placebo to someone who is suicidal). Thus, drug trials are often biased towards those with milder depression (which is likely biologically distinct from more severe forms) that are more likely to have a placebo response.
Thank you for mentioning this. You are absolutely correct. Having conducted psychological studies myself, I can honestly say that the APA Ethics Code along with the Hippocratic Oath (that's right-I was studying to be a doctor before I sustained a brain injury that took away my chemistry and biology talents) dictate that people who are suicidal cannot be used as subjects in medical and/ or psychological studies. So, to those of you that might have thought I don't know anything about "real medicine," I say: "OWNED!"
You have GOT to be kidding me.
I have a brother who is schizophrenic and if he doesn't take his medications (that were prescribed AFTER the mental illness) he will hear voices, sometimes see things, and have huge paranoid delusions. When he has them, he is much better.
I took Xanax, and I KNEW it is addicting because doctors are very aware of the strongly addictive nature of it. It is why a lot of doctors won't prescribe it before testing anti-depressants and lower-in-strength tranquilizers. If had a CHOICE to wean myself off of it, or continue. The choice is up to the individual and his/her primary physician.
Psychiatry = Science
To many people on their high horse. The anti-psychiatry movement is ridiculous.
I completely agree. I have bipolar disorder and a lot of issues with anxiety, and without treatment, I'm a dysfunctional wreck. What a lot of these anti-psychiatry wingnuts don't realize is that the stigma that comes with a mental illness is just as painful as the disease itself.
I heard bi-polar girls are promiscuous...wanna hook up?
All I know is that people can get medications for anything they 'sell themselves' as needing. For those folks, taking antidepressants is like me taking Lunesta just to sleep EVEN BETTER EVEN LONGER. In other words, I don't need Lunesta. But for people with true chemical imbalances that cause any number of mental or emotional disorders, the drugs help. I know, because I fought a fairly blatant case of OCD for years, medicating with alcohol and denial to get through. Then one day, with the help of sobering up FOR GOOD and getting some Paxil, I am a different guy, yes a little heavier than I'd like, but stable, happy, and dealing with OCD. I WILL say however, that drug alone doesn't cure. It takes UNDERSTANDING the disorder, therapy around DEALING with the disorder, not using the disorder to bypass normal ethical human behavior, and a long term support structure within family that also understands the disorder. But the meds, if prescribed for the right reasons, do help. There's really no argument against that.
Well said!
There is almost always a non pharmacological component to any disease state and mental health included.
Those with hypertension of diabetes are advised to exercise and eat healthy foods.
Mental illness has its psychotherapy component.
Wow, so you mean that the debilitating and life threatening postpartum depression that I have hasn't been helped by my anti-depressant prescriptions? Seriously, this article should be removed. This is probably the 6th article in the past year that I have read in the CNN Health section that has been either 1) dangerously stupid, or 2) facts not checked. There are millions of people out there that suffer from horrible depression for one reason or another, but I have my medication to thank for saving my life, getting me out of bed on a daily basis, and being able to take care of my children. You just can't put a price on that.
Nothing is life threatening if you have self mastery.
I know, because I used to not have any...I'd lose my temper, be angry at myself, and do stupid stuff all the time. It made my life difficult. Then I learned to accept myself, faults and all. I learned to not expect perfection. I learned how to analyze my emotions, calmly, and to know wHy I felt a certain way, and just acepted it. I also learned to muster myself around like a soldier, with self discipline rivaling that of any Marine. Drop me off 50 miles out to sea, I'll survive. I can do that, anyone can do that, if you learn to accept yourself, if you accept that life is full of bad and good, and that love is the most important thing in anyone's life.
The drugs didn't save your life. It just made it temporarily possible for you to stop thinking about yourself/your condition constantly. It's the thinking about the BS in life that makes the suffering so bad. Just stop doing that...no drugs needed.
Antidepressants saved my life and my sanity..period. No "placebo" could have done the same. Only people who are ignorant about mental illness would say such a thing..and unfortunately ignorance is rampant. More rampant than mental illness!!
When I was a kid (and had no choice but to take the drugs), I was prescribed every drug under the sun to treat my "ADHD" and "depression".
It turns out I was just bored with school and I had a clueless family full of selfish people. Once I learned some coping skills and learned to enjoy the journey of life...amazingly, no more depression, no more "ADHD".
But the drugs had a lasting effect...I now have a damaged thyoid, thanks to the lithium. And I never bulked up like I should have as a teen because I never ate enough (thanks to Dexedrine).
Drugs are not your friend, ALL drugs have negative side effects. Do not kid yourself, a drug, whether legal or not, is a substance dependancy. Learning how to manage on your own is far, far better. You cannot be truly happy if you have to rely on any form of a crutch to get though life. Drugs don't save lives, they just make it easier to make you behave in a way that is convenient for lazy people.
Most anti depressants are NOT addictive.
Please educate yourself.
E N OH.....lithium is STRICTLY for bi-polar disorder, not depression or ADHD....you might want to get your facts straight before you try to form an opinion, let alone express that opinion....
This article is irresponsible. Shame on CNN for publishing it. I have suffered from depression and anxiety for over 2 decades, and have only been treated for about half of that time with an excellent response. I have two wondeful children, a happy marriage and a successful business. My treatment includes medication and talk therapy. While I consider the talk therapy the more important component of my treatment, medication has also been critical. I am an intelligent, rational person who has some challenging brain chemistry. Medication, in conjunction with work with a therapist, have kept me alive. In fact most people I know have no idea I suffer from depression. Thank goodness for good mediciine, both in the form of pharmaceuticals and good docs. Shame on CNN for their sensational headline.
I'm glad I did not read this article before I got treated for my depression. It might have stopped me from getting the I needed.
You forgot the word "help." Freudian Slip?
This article oversimplifies the issues considerably (though I was glad to see my colleague, Dr. Raison, quoted). For more on the effectiveness of antidepressants, please see:
http://www.psychiatrictimes.com/home/content/article/10168/1520550 [this site equires a free registration; or, go to the next link for access to the article]
http://blog.beliefnet.com/beyondblue/2010/02/dr-ron-pies-newsweeks-topsy-tu.html
Ronald Pies MD
This article is VERY misleading. I was married to someone who has had depression since childhood. Within 6 months of being married, she wa sin the corner of our condo, crying her eyes out, in the fetal position (yeah, I would be depressed if I married me, as well! rofl). All kidding aside, I got her to try anti-depressants three times duing our 18 year marriage. She opposed taking the drugs each time (the third time she did them, it was via a court order. she had to take them to see our children, as her behavior was down-right scary). In each case, her behavior was markedly better than without the drugs. Even my kids said they did not recognize the person who was their mother. As for me, I'm a stone-cold believer in the medication, and it's ability to help with depression. And there are MILLIONS who would agree.
I am a US Marine with PTSD. I would be dead if not for anti-depressants along with psycho therapy.
This article is very irresponsible and smacks of junk science. Are the authors Scientologists?
Shame on CNN for the over simplified headline put up simply to generate hits.
I agree.
Tough to generalize here but I had terrible panic attacks for years until I went on paxil which controlled them. Took a bit of trial and error on the dosage but has enabled me to live a much better life. I had tried a number of other medications without success so I don't buy into the placebo concept although I do think you need to find what work for you. Also, its very important to start gradually and come off gradually with these drugs because of potential side effects.
The authors of this article totally and cowardly miss the point of Marcia Angell's article. Angell say psychiatric drugs are being sold to the public as the equivalent of antibiotics but this is an untrue comparison because psychiatric drugs are not prescribed for anything scientifically testable, provable, or real. The drugss JUST make people feel better, unlike antibiotics that actually cure disease. And placebos work just as well, Angell says, because they ALSO make people feel better, but without the risks of early death, long term disability, etc.
I've tried anti-depressants. They seem to work for a little while, then stop. I don't believe in the chemical imbalance theory. Depression comes from anxiety, which comes from PTSD. After several years of therapy I no longer needed the anti-depressants, because I was no longer depressed. The issue wasn't the depression, it was only a symptom. There is a lot of abuse out there, don't medicate the victims, TALK to them.
It worries me that people will read this article and be afraid of trying the medications out there that are so effective in helping ease the debilitating effects of depression...especially hard for me was the lack of energy, lack of interest in life, and the deep feeling of shame because I couldn't make myself better. Saying it is just a placebo effect is insulting for those of us who can now live a normal, productive and full life. If you are suffering, find a doctor you trust and ask about the wonderful advances in drugs...it gets BETTER.
i firmly believe those who never experience the despair of a true depression, the irrational and excruciatingly fearful derealization of a panic attack, the suffering of someone with ocd, etc, etc, will always believe that it is something one can control.
i find it a slap in the face and very disheartening that people think anyone would choose the hell of mental illness. i find the arrogance behind the statements frustrating. the 'i was sad but i got out of bed, made myself go to work, applied to schools, etc...why can't you?'...'stop dwelling on it'...'stop crying'....'you don't have cancer'...these statements are the epitomy of misunderstanding.
i spent a decade and a half trying to explain to the same people over and over again...to this day, they say the same things. there is no point reasoning with those who haven't experienced it. they will never grasp what is going on...and lucky for them. i would never wish any of it on anyone.
i just wish there was better help out there and mental illness was treated with the same respect other diseases are...but it isn't. some of us really don't want to waste our lives away. some of us actually want to live and accomplish our dreams and feel something aside from an anhedonia.
Your logic is faulty. No one here is saying that these conditions are "controllable" with or without meds. They are just saying that meds don't actually treat the cause of the disorders. No one is saying you need to pull yourself up by bootstraps, etc. In this article, there is no alternate answer to meds offered, just the assertion that that the meds "work" based on a placebo effect. And I don't know why people get all up-in-arms about that. So what? Who cares if it's working due to a placebo effect? If people feel better when they believe they are ingesting wonder drugs, let them. Just make sure the wonder drugs don't have so many side effects that will require even more costly medical intervention. Oh, but I forget...that's kind of a perk to pharma.
my logic is faulty? are you kidding me? did you read the article? really...reread it. then read what i wrote. then comment on someone else's post...b/c i'm fairly certain my post was more about my experience.
Big Pharma wants us to pop pills for everything .. and then we pop more pills to counteract the side effects of the first pills... and big Pharma gets richer and richer.
You with the DNC dude?
Gilligan, he's expressing a republican POV...why would you ask about the DNC?....why is it that no one seems to understand what the parties actually stand for? They go around accusing everyone with a different perspective of being part of the "other" political party even when their own views match that political party....
I have hypothyroidism which contributed to a severe, debilitating depression. Shortly after taking my first pill, maybe a few days later, it was like I was awake for the first time in years.
I know my depression was no worse than the depression many people experience for no known reason. I really wish there was a treatment for them that was as effective as synthroid was for me. antidepressants can help, especially for very severe depression, as can CBT and other forms of evidence based talk therapy. But it isn't the same, it isn't remedying the deficit, it is just covering it up like opiods cover up pain. which, no doubt, is important. But the only way to go off of the medicines is therapy and lifestyle changes, and that only works for some people.
If hypothyroidism is causing you to be depressed, then take thyroxin, not an SSRI. Treat the real underlying phsyiological condition. Hypothyroidism has a lot more risks to it than just depression...obesity, diabetes, circulation problems, etc. the "happy" pills are just a crutch, get off of them and get active, you'll feel much better.
no they are dangerous drugs that kill especially when mixed with other persrciptions
I was horribly abused as a child and hence had depression issues, exercise, nutrition, supplements, doing the mental work, mindfulness meditation and other techniques work better and have beneficial instead of scary bad side effects, it's work and what works varies from person to person but why not get started on what DOES work instead of popping a pill?
People need to realise that these are NOT benign, harmless pills, they can seriously mess with your body if you take them for too long. I wish I could go back and tell my 20 year old self that all she needed was to eat better – once I had a bit more money and could afford a better diet, I was fine.
you are contradicting yourself.....what point would there be to going back and telling your 20 yr old self to eat better if you then acknowledge that the issue was the inability to afford to eat better? You might as well have someone born with one arm go back and tell their younger self that all they need to do is become a star football player in the NFL to make good money...
I consider the whole of the "therapy" movement to be fraudulent. Not only the drugs, but the diagnosing of peoples problems by humanistic counselors, when most of them just need a friend to talk to. I watched a person very close to me go hook line and sinker down hill after getting involved with this system, even after being warned. She was a person who was completely normal, and suddenly believed all kinds of lies about her past, things that never happend, false memories implanted by a "professional". After the drugs came, then came the glazed over look in her eyes, then the suicide attempts etc. This person was literally turned into a drugged up shadow of her former self. She now wanders around unable to work, unkempt, and has lost her family and friends. This is the result of "professional" therapy in her life.
Yep, that's really all someone needs, is a friend that will listen. Why pay a therapist $150 an hour to do the same thing as a good friend.
And I hate to say it, but far too many people are mentally and spiritually weak. Needing pills and a therapist is not healthy long term. Just learning to analyze your own emotions, and allowing yourself time and space to vent and decompress is more valuable than anything anyone else could offer.
Normally, I have a happy disposition. And yet I have been amazed at how swift doctors are to prescribe antidepressants. I've been advised to take them four times in my life, each after a devastating event. My best friend died, got divorced, father died, major illness. I finally found a therapist to work with who explained the difference between situational depression and clinical depression, as well as the necessity of working through feelings of grief, fear and sadness associated with these times of my life. I'm perfectly happy today, and I am so glad that I just said NO to prescription antidepressants (one doctor wrote me a RX for Zanax, which is highly addictive). I'm not saying that there aren't some people who don't need them - I can't pretend to know what it's like to feel depressed for no identifiable reason. That these medications were foisted on me by the medical community is astonishing - and I'm talking about a hard sell here, not just suggestion.
You have to be careful what you tell doctors. I wouldn't have even told them about your friend and father dying, or the divorce either, unless you presented it as a positive thing.
Jenny, I think I have to agree with you. I should be able to trust my treating physician enough to recommend a support group or psychologist/therapist without him having to pull out a prescription pad (I no longer see that doctor, BTW). I was never suicidal and was always able to function normally, despite what I might be feeling. It's perfectly normal to feel sad after such big losses. My current IM refuses to prescribe antidepressants and anti-anxiety medications to patients personally - he refers to a psychiatrist instead. It's good to know that I have a doctor who listens to me rather than one who tries to find something that needs to be "fixed" with a pill.
you should ALWAYS tell your doctor EVERYTHING....let the trained professionals make the decisions....if you disagree with their perspective, go to another doctor and get a 2nd opinion. but whatever you do, don't expect a doctor to be able to treat anything with any accuracy if you are withholding the truth, facts, and reality from that doctor...heart medication can save your life but your doctor won't prescribe it if you hide the fact that you are having heart issues....you might as well just not go see a doctor if you are going to lie to them
people say anything to sell a book and make money
they could care less about those inflicted
Antidepressants should be a last line tool for managing anxiety and depression, not a first line "cure all".
Nothing beats learning how to "be your own therapist", learn how to spot triggers and how to cope with episodes of sadness, anger, and despair. Use a network of friends and loved ones to buoy your spirits and find enjoyment in life.
Drugs are just a bandage, by themselves they will not lead to healing...YOU have to do that youself, with or without professional guidance. But pills will never correct anything, they'll only take the edge off. Staying on meds long term is bad for your health, will make you broke, and just breeds another type of dependency.
I've been through all kinds of hell in my life, and the only way to manage is to learn coping skills and just learn to accept the good with the bad. Do not be afraid of failure, and just take charge of your life. Do not ever allow a substance to fill in the void in your soul.
Paxil saved my life. I know it was not the placebo effect, as I had tried 2 others before Paxil completely lifted me form an inability to get out of bed. Burning in my ears, tinnitis, throwing up at the site or smell of foods, being unable to sleep for days and days and days on end. My anxiety was so out of control, had there been no medication for me, I would have withered away and died. I was down to 80 lbs from 100 in 3 months, and not because I'm anorexic. I wanted to eat so badly, but even chocolate or pop tarts tasted like paste. The only thing I could get down were milkshakes. Milkshakes kept me alive just long enough to find the answer.
I think the statistics on why there is such a remarkable placebo effect is because too many people take them who should't be. These medications should be reserved for the upper end of dangerous depression, although I would never want to deny someone something that might actually help them. I, for one, would left 2 orphans and a widower without them.
Consider a lifestyle change. Most people are unhappy when they feel powerless to make any changes with their life and get stuck spiritually. That is enough to make anyone depressed. a pill is not going to fix it. I have had better results painting a picture.
Depressing.
Pot is the best drug out there for mental illness. I am 40 and have suffered from mental issues my whole life. I have tried several medications and the side effects were horrific. Pot is the only thing that has helped me over the years. It is natural and grows straight from the earth. Where are you gonna find a better medication than that. Heck, as soon as I can afford to I am leaving Florida and moving to a medical marijuna state so I can lead a normal life amd not be some raging insane person who can't cope with the little things due to being bi-polar.
Poppy plant is natural and grows straight from the earth....same rationale but it doesn't make opium or heroin good for you....
You are another of the uneducated idiots when it comes to marijuana.
I smoke every day fool...the point is that your argument and logic is just plain stupid and, if anything, hurts the cause for legalization....we don't need stupid stoners getting in the way of the movement by posting stupid stoner comments that make everyone else that smokes look bad. Nothing about growing from the earth mandates that marijuana is good....the medical facts about its effectiveness with such a wide variety of issues while only producing minimal side effects is a valid point with merit that indicates the potential benefit from legalization. Just because you smoke weed doesn't mean you have to be a t-arded stoner
many posters here are missing the point of this article. the researchers are not saying that anti-depressants are placebos and don't work, but that in clinical trials the actual placebo pill that was given had a similar effect, 82% of the time, as the anti-depressant. so yes, an anti-depressant may be effective in helping to alleviate ones depressive and anxiety symptoms, but is it the actual chemicals in the AD doing this or is it the side effects brought on by the chemicals in the AD making the patient believe that the pills must be working?
i strongly suggest reading Irving Kirsch's book "The Emperor’s New Drugs: Exploding the Antidepressant Myth". it is an easy read and does an excellent job in explaining the subject of this article. it may change how you view ADs, clinical trials for drug approval, and pharmaceutical companies.
.
I have been on antidepressants for over ten years. I don't doubt that there may be people who are getting better due to the placebo effect. But I am virtually certain this was not the case for me. After I began taking the drug, it took me almost nine months to receive substantial relief from the symptoms that nearly crushed me. For me the side effects were not a regular feature of the drug, as they only manifested themselves for about 3-5 days in the very beginning. I would love to believe that I did it all by myself but that does not fit with either my experiences as I listed them here or the memories of how painful it was until it was quite suddenly better. When relief finally did arrive, it came very fast and without explanation. It's not that I suddenly started to randomly "believe" in the drug after I had been taking it for nine months.
Perhaps we should attempt to bridge the gap that is nihilism rather than fog the mind with delusions of deities, afterlives and hardly understood medications. No one wishes to address the reality that is the root of depression: we are mortal beings, aware of our mortality, and we are in an age where a great number of individuals are awaking from the great slumber of humanity. When one is fully aware of the nothingness that awaits, and looks around to see the masses breeding and overpopulating, destroying all other forms of life around them, creating an unimaginable amount of suffering in the present, and the inevitable future collapse of civilization, it's a bit hard not to be depressed. Pills are just another means of denying the reality that we're all fully aware of, whether or not we wish to admit it.
..................Psychiatry itself is a placebo , there's no proven treatment , it's up to the patient if they want to accept it .
Psychiatrist's vote on every mental illness , nothing actually proven , they vote .
Imagine if your doctor said , " try this, we voted on it and tell me how it works because your a genie pig "
Response : YES THEY ARE, for the most part and for most people.. Read the "Emperor's new drugs".. read " An American Epidemy",, get informed.. Big Pharma (i Hate the name, but it does work) has done an extraordinary marketing con (like in confidence game) on our country and on most other countries, claiming resullts from less than hard evidence, from biased research, lacking meta analysises or never bothering to consult them. Lying about the non addictive properties of their anti depressants (like Paxil), exagerating the effects of the chemicals, and never ever having proven that there is a firm link between neuro-transmitters levels and pathologies. Yes, we have been snowed, like we are continuuously being snowed by most products that Pharmaceuticals launch..Let us face facts..They are in the busness of selling stuff, like "Squeeze the Charmin" is in the business of selling toilet tissue. No difference, in spite of all their mighty moral claims..It is ALL about the bottom line...Nothing but the bottom line...and to achieve that bottom line, they will sell us anything with any claims... FDA be damned.. Oh well, such is the nature of free enterprise.
Placebo or not, they work for me. My life is much, much better using anti-depressants. Generic Zoloft costs me $10 a month. Well worth the cost . . .
I've been on Zoloft for at least 10 years. I call them my happy pills because other people are happy to be around me when I take them. If I'm off these meds for a few days, I just get mean. After 4 years of talk therapy, I started taking anti depressants because I just couldn't let my anger go when I got upset. Once I started taking the meds, I was able to continue with talk therapy and deal with issues and I was much more pleasant to be around, even for myself. Does everyone need anti depressants? No, but if they do, life is better for all concerned. I suspect I will take my last dose on my last day of life.
My doctors have had me on a huge progression of one drug after the other for Major Depressive Disorder... when something doesn't work (which has been all of them thus far), they just move on to the next Pharmo "Pet" drug of the month. Now, my new clinician is recommending Electric Shock Therapy, which absolutely blows my mind (pun intended). I am a well educated, talented mother of two... how will I be once the EST erases a piece of who I am, never to be returned to whom I was before the EST? At least with the drugs you can quit taking them, suffer the withdrawals and be back to your old self once more eventually. Honestly, I didn't even know EST was still around for mental health issues. I will refuse any sort of EST therapies, but just wanted to show how this whole "medicine Russian Roulette" is being played for some of us. Also, due to my insurance, I am limited to the one place locally to see a therapist, so therein lies my inability to run screaming to someplace "safer".
Who cares! Placebo or not, give me my Zoloft. I feel better on it than any of the other "placebos" I have tried.
Well, praying never eased my physical pain after a concussion. Vicodin on the other hand...good stuff.