There is a growing movement on the web against anti-depressant medication. I’m not going to link to such ludicrous filth, but you can find it easily, written by “qualified” professionals no less. They’ll cogently promote different treatments such as psychotherapy, herbal remedies, exercise, proper nutrition, sleep regimens, mega-vitamin therapy and copious altneratives for the treatment of depression. But, they warn, do NOT take anti-depressants, under any circumstances. As someone who works primarily as a therapist, it’s tempting to agree with such a strong position, one that advocates a more “natural” approach to mental health. The problem with this mind set, however: like everything else in mental health, if you take a one-size-fits-all (or, in this case, one-size-doesn’t-fit-any) viewpoint, you’ve completely missed the boat on what treatment for depression is all about.
My admonishment of unilaterally bashing (or praising) a singular approach to complex animals was first delineated here for the treatment of alcoholism , and the same holds true for depression. The sheer number of possible symptom clusters, the ever-changing life circumstances of the patient, sleep and eating differences between depression sufferers, even their differences in basic access to recreation and support all play a role in the disorder and its amelioration. To slab the wall with paint from the broadest brush possible, to claim that a singular treatment option simply has no use, despite documented evidence that points to at least some utility, suggests you’re not only guilty of malfeasance and hidden agendas, but also basic stupidity.
Do pharmaceutical companies stash away research that suggests anti-depressants have not been adequately effective in certain studies while pimping the positive outcomes. Probably. Why wouldn’t they? They are a business and they want you to buy their product. Is this unethical, perhaps evil? Of course. But any practitioner worth his/her salt will point to data (both empirical and anecdotal) that shows anti-depressants do have their place. But here’s the kicker: for the right person.
If you have any interest in mental health, whether it be as a professional or layperson, tattoo that last phrase into your brain. Nothing, at all, works for everyone. And because of this, all options should be explored. Some patients respond perfectly well to anti-depressants and never even step into my office (and keep in mind that I’m a Psychologist, someone who doesn’t even prescribe medication). Others get no effect and need psychotherapy. Some respond better to both in tandem, others to neither, which lead to less traditional options. Exercise and diet have their place for certain clients, increasing support and recreation works wonders for others . Some people even go into spontaneous remission. And make no mistake: sometimes Electroconvulsive Shock Therapy is a necessary treatment mode. You want to claim that some anti-depressants give nothing but a placebo effect? Be my guest. That doesn’t change the fact that the “treatment” worked and, again, you’re taking the baton that says “it doesn’t work for some, therefore it doesn’t work for anyone” and running off of a cliff with it.
Even after years upon years of theory and research, the sad reality is that we don’t know all that much about most mental illnesses, whether it be their causes or treatments. And, therefore, assuming you’re not going to kill someone with one treatment choice or give them unbearable or irreversible side effects, everything should be put onto the table for consideration.* Not simply in a, “hey, let’s try this for shits and giggles” manner, but from the knowledge that many treatment options (including anti-depressants, again for the right person) have a viable likelihood for success.**
If you’re one of those “doctors” out there who is passing off your “no meds under any circumstances” bullshit, you should be shot and, ideally, killed from either the bullet or the pistol whipping that would likely follow you as you crawled down the street. Failing that, you should at least be yelled at, like I’m doing right now. You’re actually a disgrace and should consider your motives and bumbling idiocy. Your patients are likely to be suffering needlessly from your myopic take on mental health treatment and they’d be best served seeking help elsewhere. Please retire and let the practitioners with open minds and the ability to at least consider various options do their jobs. Everyone will benefit.
* Granted, you can find studies that suggest an increase in suicidal ideation in patients with depression when given certain anti-depressants. However, well-qualified professionals balance those risks with careful consideration of the symptoms and projected response. This is not to say that any treatment option is risk-free, far from it. But people experience horrific side effects and even death from the most traditional treatments of essentially every organ in the body. Do you avoid a triple bypass on a patient whose heart is a ticking time bomb because a number of patients have died during the procedure? No, you do not.
** How is it decided which anti-depressants are given to which patient? That’s beyond the scope of this post and my expertise, but most prescribers consider, at a minimum, the symptom combination, medical history, family history and patient concerns about possible side effects.
There is a growing movement on the web against anti-depressant medication. I’m not going to link to such ludicrous filth, but you can find it easily, written by “qualified” professionals no less. They’ll cogently promote different treatments such as psychotherapy, herbal remedies, exercise, proper nutrition, sleep regimens, mega-vitamin therapy and copious altneratives for the treatment of depression. But, they warn, do NOT take anti-depressants, under any circumstances. As someone who works primarily as a therapist, it’s tempting to agree with such a strong position, one that advocates a more “natural” approach to mental health. The problem with this mind set, however: like everything else in mental health, if you take a one-size-fits-all (or, in this case, one-size-doesn’t-fit-any) viewpoint, you’ve completely missed the boat on what treatment for depression is all about.
My admonishment of unilaterally bashing (or praising) a singular approach to complex animals was first delineated here for the treatment of alcoholism , and the same holds true for depression. The sheer number of possible symptom clusters, the ever-changing life circumstances of the patient, sleep and eating differences between depression sufferers, even their differences in basic access to recreation and support all play a role in the disorder and its amelioration. To slab the wall with paint from the broadest brush possible, to claim that a singular treatment option simply has no use, despite documented evidence that points to at least some utility, suggests you’re not only guilty of malfeasance and hidden agendas, but also basic stupidity.
Do pharmaceutical companies stash away research that suggests anti-depressants have not been adequately effective in certain studies while pimping the positive outcomes. Probably. Why wouldn’t they? They are a business and they want you to buy their product. Is this unethical, perhaps evil? Of course. But any practitioner worth his/her salt will point to data (both empirical and anecdotal) that shows anti-depressants do have their place. But here’s the kicker: for the right person.
If you have any interest in mental health, whether it be as a professional or layperson, tattoo that last phrase into your brain. Nothing, at all, works for everyone. And because of this, all options should be explored. Some patients respond perfectly well to anti-depressants and never even step into my office (and keep in mind that I’m a Psychologist, someone who doesn’t even prescribe medication). Others get no effect and need psychotherapy. Some respond better to both in tandem, others to neither, which lead to less traditional options. Exercise and diet have their place for certain clients, increasing support and recreation works wonders for others . Some people even go into spontaneous remission. And make no mistake: sometimes Electroconvulsive Shock Therapy is a necessary treatment mode. You want to claim that some anti-depressants give nothing but a placebo effect? Be my guest. That doesn’t change the fact that the “treatment” worked and, again, you’re taking the baton that says “it doesn’t work for some, therefore it doesn’t work for anyone” and running off of a cliff with it.
Even after years upon years of theory and research, the sad reality is that we don’t know all that much about most mental illnesses, whether it be their causes or treatments. And, therefore, assuming you’re not going to kill someone with one treatment choice or give them unbearable or irreversible side effects, everything should be put onto the table for consideration.* Not simply in a, “hey, let’s try this for shits and giggles” manner, but from the knowledge that many treatment options (including anti-depressants, again for the right person) have a viable likelihood for success.**
If you’re one of those “doctors” out there who is passing off your “no meds under any circumstances” bullshit, you should be shot and, ideally, killed from either the bullet or the pistol whipping that would likely follow you as you crawled down the street. Failing that, you should at least be yelled at, like I’m doing right now. You’re actually a disgrace and should consider your motives and bumbling idiocy. Your patients are likely to be suffering needlessly from your myopic take on mental health treatment and they’d be best served seeking help elsewhere. Please retire and let the practitioners with open minds and the ability to at least consider various options do their jobs. Everyone will benefit.
* Granted, you can find studies that suggest an increase in suicidal ideation in patients with depression when given certain anti-depressants. However, well-qualified professionals balance those risks with careful consideration of the symptoms and projected response. This is not to say that any treatment option is risk-free, far from it. But people experience horrific side effects and even death from the most traditional treatments of essentially every organ in the body. Do you avoid a triple bypass on a patient whose heart is a ticking time bomb because a number of patients have died during the procedure? No, you do not.
** How is it decided which anti-depressants are given to which patient? That’s beyond the scope of this post and my expertise, but most prescribers consider, at a minimum, the symptom combination, medical history, family history and patient concerns about possible side effects.