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RSSThirty-five years ago, I received a phone call from my friend Lily about a car accident involving a mutual friend of ours, Terry. The three of us had just graduated from UCLA the week before. Terry, along with her sister, brother-in-law and niece, had gone on a trip to the Colorado River. En route, along a two-lane highway, another vehicle tried to pass them and the line of cars ahead. The driver mis-calculated the distance and as a result, a semi-truck coming from the opposite direction swerved to avoid the passing car, struck our friends’ car and instantly killed Terry’s sister, brother-in-law and niece. Terry survived but suffered severe and irreparable brain damage.
I had given up my apartment following graduation and was briefly staying with my parents before leaving on a long trip. When I came out of my room after the call, deeply upset and in tears, my mother immediately went to her bathroom and returned with a blue, 10 mg Valium tablet which she pressed into my hand. Her response to my grief was to offer me the same medication she used to keep her own pain sedated. I hadn’t thought about that incident in years, but recently, in considering some of the wrong reasons people take antidepressants, the memory came back to me.
As I’ve said in other posts, I believe that antidepressants have their uses, especially in the short-term, but I also believe they are grossly over-prescribed by untrained physicians and medicating psychiatrists who run prescription drug mills. This criticism lays most of the blame at the feet of the medical profession, but a conversation with an old friend from Los Angeles reminded me that insistent patients are just as much a part of the problem. Many people choose to take an antidepressant in order to avoid dealing with a problem they might otherwise have to confront.
My friend — let’s call him Brian — has worked in the film industry for more than 30 years and knows everybody. Brian told me that he is close with quite a few women who (in his opinion) are on antidepressants because their married life would be otherwise unbearable to them. They’re married to wealthy, powerful men in the industry whom they don’t love; divorce would mean giving up a financially privileged and superficially glamourous style of life they don’t want to relinquish. So they take SSRIs … not because they’re depressed but because those drugs make tolerable an emotional situation they wouldn’t otherwise be able to bear. Brian says this is not an unusual Hollywood story.
A mutual friend of ours is quite candid about using an antidepressant for similar reasons. She has a child growing up with Asperger’s syndrome, and the very low dosage of her medication makes life bearable. She tried getting by without the meds but found she simply couldn’t cope. This friend is not struggling with depression per se but with an extremely stressful life situation. Her drugs “take the edge off,” numb her out just enough so that she can manage.
Another friend of ours, after her divorce, decided to become an elementary school teacher, though many of us felt she was, by temperament, ill-suited to the profession. Despite some judicious advice, she went ahead with her career change and suffered a nervous collapse during her first year of teaching. With mostly sleepless nights and several panic attacks, she wound up in the emergency room more than once. Instead of reconsidering her career choice and trying to find something more suited to her, she opted for antidepressants instead.
Medication might be the right choice for our friend with the Asperger’s syndrome child; after all, as his mother, there isn’t much she can do to change her basic lot in life. But in the case of our friend who chose drugs over a career change, it seems to me she’s using antidepressants to avoid confronting something dysfunctional in herself and in her life.
Likewise, the Hollywood wives who take SSRIs rather than file for divorce are surely using those drugs in ways for which they were never intended.
One of the primary rationales given for using antidepressants is that they may get a depressed mind “unstuck” when psychotherapy is making slow progress; meds are seen as an adjunct to talk therapy, helpful in promoting insight and understanding for the psychotherapy client. But those Hollywood wives and our friend who made a disastrous career choice are using medication for just the opposite reason; they don’t want insight so they can understand themselves better and thereby confront important choices. Instead, they’re using drugs in order to avoid facing their problems.
One visitor to this site commented that depression, like pain, can be the body’s way of telling us that something is wrong. If we listen to our pain and our depression, we might understand what’s wrong and over time, figure out what to do about it. But if we reach for the little blue pill as my mother did, numbing the pain instead of confronting it, we remain stuck and will never move forward.
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While we’re on the subject of antidepressants, you might want to check out an article from the Sunday New York Times by Peter D. Kramer, author of the famous book Listening to Prozac, which gave an enormous public relations boost to antidepressants when it was first published in 1993. At a time when study after study is questioning whether SSRIs have anything other than a placebo effect, Kramer has written an article in their defense. He raises some interesting points about how drug trials are structured and carried out, but for the most part, it struck me as dishonest and self-serving. He criticizes a number of famous studies by name, but resorts to vague language like “studies have shown” when it comes to trials that have reportedly demonstrated the benefits of Prozac and other SSRIs.
From the very beginning, he seems disingenuous, or at least illogical. His initial piece of evidence is entirely anecdotal, about a friend who suffered a stroke and received some benefit from taking an SSRI. According to Kramer, an important study has shown that stroke victims who received Prozac rather than a placebo “recovered more of their mobility. Antidepressants are good at treating post-stroke depression and good at preventing it. They also help protect memory. In stroke patients, antidepressants look like a tonic for brain health.”
This is specious argumentation and deceptive prose. It’s clear from the quoted passage that the study demonstrated how stroke victims recovered “more of their mobility”; but are the following two sentences the author’s opinion or a conclusion of that study? The statement that antidepressants are “a tonic for brain health” is quite a reach. Given that the so-called “antidepressants” are actually stimulants (like cocaine and the tricyclics before them), maybe taking Prozac minimized the damage resulting from a stroke by stimulating the brain during a critical period. That’s very different from concluding that Prozac prevents and relieves post-stroke depression. Maybe those stroke victims who benefitted from the stimulating effects of Prozac felt less depressed because they recovered more of their mobility.
Read the whole are article here, as well as the comments that follow. Many highly informed readers, including physicians and researchers, have weighed in on both sides of the subject.
Finding Your Own Way:
Do you know anyone who is taking an anti-depressant when you can see that he or she needs to confront an external problem area instead? Do you know anyone taking an SSRI because he’s unhappy in his marriage or hates her job?
How do you feel about my friend who is taking an antidepressant, not because she’s depressed, but because it makes a very painful and difficult life situation bearable to her? Do you think it’s any different from, say, having a couple of stiff drinks every evening to “take the edge off”? Do you think it’s any different from people who smoke pot at intervals throughout the day? How much difference do the side-effects make?
If antidepressants don’t actually correct a chemical imbalance in the brain (the evidence is clear on that point), how do we account for their supposed benefits? Maybe they function like a sedative, for lack of a better word — numbing us out to pain we can’t tolerate, blinding us to problems we need to face. What if taking an antidepressant is like taking a pain reliever? It’s a well-known fact that, when under the influence of a major analgesic, athletes are unable to heed the warning signs their bodies give off and as a result can severely injure themselves. Maybe in taking an antidepressant, you run the same risk: by numbing yourself to your depression, one of your body’s ways to signal that something is wrong, you’re in danger of hurting yourself even more.
Thoughts?
I’ve been though myriads of therapy, most of which was useless (save for the last stint, which was useful). Medication has saved my life on several occasions. Placebo? Maybe, though the anti-psychiatry literature has failed to convince me of that. Whatever the case, if it works for some people, it does.
I agree that taking anti-depressants due to ‘normal’ life events is a bit crap, and they’re certainly over-prescribed by many a cynical and overworked GP. But for some of us, they’ve brought us out of a depression so crippling it’s barely describable. I couldn’t even have started my recent-ish trauma therapy had I first not found relatively stability through anti-psychotics and anti-depression. Dealing with the issues therein would have been way too big, and I’d probably have found myself Google Mapping Beachy Head.
But that’s only my experience. The thing about all of this, to me, is that we’re all individual and have, where applicable, individual pathology. Medication and psychiatry fail many, work for many; mindfulness and behavioural therapies ruin lives, but complete others; blah blah blah.
I’ve been accused of being “pro-psychiatry” in the past. I’m merely pro-what-works, and what works in terms of easing mental distress is (or can be) as unique as the sufferer in question.
*ducks*
I think your experience describes the actual way these drugs should be used. They can be enormously helpful in pulling people out of crippling depressions and enable them to stabilize enough to confront the core issues. And I agree, that no one answer fits every situation. Unfortunately, the way these drugs have been sold is that depression = chemical imbalance and therefore every depressed person should take these drugs to correct the imbalance.
Hi Joseph, my partner is on anti-depressants while working through issues from a very awful childhood of physical and sexual abuse. The effect is to not so much to numb the lows as to limit their duration.
Many years ago now she was on another anti-depressant. It’s effect was to increase motivation. All she was thinking about at the time was suicide, so the boost to motivation meant that she attempted suicide. It would be funny if it wasn’t so awful.
I think most psychiatrists (in Australia where I live) are really pharmacists. Most of them dispense drugs and have a brief chat about whether the dosage should be adjusted. I don’t know if you find this offensive or if you agree.
I don’t find that offensive as I agree; it’s pretty much the same here in the United States. There has been a lot of press lately about how psychiatry has moved from talk therapy to the 15-minute med consult. The docs can make more money via insurance reimbursement 4x per hour than they can with one talk therapy client per hour.
The highest risk for suicide, even without meds, is when the person begins to recover from a debilitating depression — because then they have the energy to follow through on their plan. It makes sense that, with a suicidal client, putting her on meds might increase the risk of actual suicide as her symptoms are alleviated. All the more reason why these drugs need to be carefully monitored, in conjunction with psychotherapy, and not dispensed by an overworked GP or a medicating psychiatrist who sees her once a month for 15 minutes.
i really agree with what you have written, i feel that there is little difference between the prescribed drugs, and alcohol or cannibis all of these do numb out feeling but some are just framed as legal and “proper”,
i have come off my antidepressants and stopped drinking 6 months ago, and my emotions are really coming to the fore in my therapy and so i manage without drugs now, but occasionally use valium when things get really bad,
this for me means that the numbing out is no longer permanent but just a choice when things get overwhelming and scary,
i was on prozac for a few years, and still made progress with therapy, but something in me just knew it was time to make more progress and to be honest i think the drinking had more of a numing out effect on me,.
i wasnt encouraged to come off though, and i had to do it secretly, and i went for a year being off them before i told my medic,and because there was no evidence i had gotten worse he couldnt say for me to stay on them,
i do think that sometimes a person isnt ready to face some deep stuff inside them, and if they face it alone then severe illness can happen, so i can understand having meds as a support to stop crisis (this was me) but there comes a point when a person is perhaps stronger and the crutch has to come away for you to fly solo and work through stuff to live life to the full, otherwise the crutch is no longer a help but a big stick tied to your leg that is getting in the way!
i think its everyones choice whether they decide to numb out or not, but i think there should be more awareness of what these medicines actually do, so that people really realise the sacrifices they are making when they take these meds, short term alleviation but in the long term not working through stuff that would make there life so much better and more fulfilling,
i thinks its very personal but i dont regret stopping the daily alcohol and the prozac as i feel ready for the next step of challenging myself to work through deep issues, its bloody hard and scary as some of the emotions hit me like an express train, but i know its where the rewards are already coming, cos any changes i make will not be a drug induced false sense of a cure but a permanent change i have made within me,
Exactly. I admire your courage in coming off the Prozac in the face of professional opposition. I find it truly disturbing that the medical community so often puts people on these drugs “for life.” Your experience, of using them for a time while you develop some inner strength to address your painful emotions, seems an appropriate use of these drugs.
Yes I agree with you, I never thought that taking an anti depressant was a way to not deal with the problems. I feel like that i am very unhappy about where I live, very isolated and that is what the real problem is . I take an anti depressant because of it.
I suppose the question is — is it possible to change your situation instead? Sometimes it’s simply not possible, but I hope you’ll find a way to become less isolated and live in a place where you can feel more content.
I’ve been taking a low dose of Celexa for some time now, on the advice initially of my talk therapist and now under the direction of a psychiatrist specializing in this sort of medication. My family of origin was violently alcoholic, with early severe trauma, eg., seeing my mother stabbed with a bayonet (not fatally).
The primary effect I notice from the SSRI is a decrease in the feeling that someone is about to sneak up and hit me on the back of the head. I didn’t know I felt that way until it stopped, and then I realized I had always lived that way. At times when I reduced my Celexa dose, the feeling gradually came back. I know I don’t want to live that way.
My life today is stressful – a severely disabled grandson for whom I’m responsible (a genetic problem from the non-alcoholic side of my family. Sheesh!) and some of the same financial issues most of us are facing now. I do feel the pain and work hard to learn from it and to find the germ of opportunity at the heart of every situation. But when I’m living in a constant flinch, waiting for the next blow, I am much less resilient.
I’d appreciate your thoughts on whether this is an appropriate use of SSRIs. Thanks for your response and for this blog. So glad I found it.
I have a good friend who suffered from severe OCD for most of her life until her late 40s; at that time, under the guidance of a skilled psychopharmacologist, she began taking a cocktail of psychoactive drugs that have given her emotional freedom and a kind of life she never had before. I do believe that meds have their place, and surely it’s better to take them for a time rather than living in constant anxiety that someone will club you from behind. If combined with psychotherapy, if you’re carefully monitoring the side effects and working toward developing the mental skills to manage those emotions yourself one day without the meds, that seems like a viable plan.
Joseph! You keep writing posts that i just have to read and then have to comment on. How relevant this post is to me! Thankyou for allowing me to read your blog and think about it in the context of my journey.
I felt a deep sense of sadness reading about people that are ‘blocking’ their feelings by using anti-depressants. I am not against anti-depressants but personally cannot take them as they make me suicidal. That is both a blessing and a curse.
The curse is that our healthcare system (at least here which is not in the US) is a drug based medication model (heavily skewed now towards drug and alcohol rehab). Drugs are therefore seen as the first defence in mood disorders. It is not labour intensive and is cheap because medication is heavily subsidized. Everyone is happy (except possibly for the person taking the anti-depressant!).
The blessing is that I have had to find other psycyological ways of coping and I am genuinely excited about the research that has been done and is gradually being accepted by the mental health community. Here are some of the things I have tried.
- Mindfulness is actively now supported by the public health system here.
- Exercise is seen as crucial for maintaining good mental health (and is now subsidized if you have mental health issues).
- Somatic expressions of emotions is in my experience often effective in getting extreme feelings in balance. Examples of this are Yoga which combines mindfulness with movement. Also why having a damn good cry is still really effective (if only you remember to stop!) because it releases a lot of hormones. I also do things like hit golf balls really really hard at the golf range when I am angry! It works! If I am sad I listen to a great song on my ipod and walk whilst singing very badly and loudly. The combination for me is really effective for me. Of course we all know the term comfort eating but it is done in a negative context and we forget that a warm milky drink still has its role in comforting us. Knitting is also increasingly promoted within the health system as providing a gentle rhythm that is calming. It does not minimize the feelings that I have but it allows me to reduce the emotional intensity to a point that I can tolerate them.
- What ultimately works for me however is ‘accepting’ the feeling without judgement, then practicing distraction (get busy preferrably with something I have to concentrate on) coupled with problem-solving (around the current stressor(. It takes effort but it works.
- Neuroplasticity (which is my current passion) shows that through a sort of positive repetition you can change your experiences. I think this is so crucial because it suggests that change is possible.
The rationale as you state is that our feelings are stalways stuck. Sometimes they are but in the examples you give it is us that are stuck. My experience is that I am only stuck if I stop. The temptation is so strong when you are not well to do so.
I realise that mostly why I am sad because of the stories you shared is the impression that these people will never feel joy if they dont feel pain. My experience of myself is that until I move through my extreme negative feelings I cannot feel the positive feelings. Sacrificing feeling happy for not feeling sad. Now that is sad.
I’m on the same page. I think mindfulness and yoga are excellent tools, and I’ll have to educate myself about “neuroplasticity” — don’t know anything about it. And of course I agree, that you can’t selectively decide what you’re going to feel and what you won’t. If you “numb” out your pain, you’re also quashing joy.
THIS IS SUCH A USEFUL ARTICLE. NON JUDGEMENTAL…CLEARLY USING EXAMPLES ANYONE CAN RELATE; TO OF BAD DECISIONS THAT CAN RULE YOUR WORLD. I LOVE THAT THE MESSAGE CLARIFIES COURAGE AND THE CONFIDENCE TO ADDRESS CHANGE WITHOUT BEING PREACHY…AND I THINK IT MIGHT BE EASIER FOR A LOT OF PEOPLE TO BE REALLY HONEST WITH THEMSELVES WHILE NOT BEING, IN FRONT OF A THERAPIST. I AM VERY GRATEFUL YOU TAKE THE TIME TO WRITE COGENTLY ABOUT THINGS EVERYONE NEEDS TO BETTER UNDERSTAND. THANK YOU
You’re welcome. And thanks for taking the time to leave a comment.
Does therapy fix a “chemical imbalance of the brain?” When mania happens, a fire alarm goes off that no talk can cure. Neuroplasticity suggests the ” job of living” as opposed to the “joy of living.” Doctors prescribe antidepressants so freely, they validate hiding your feelings behind a pill. People used to take hallucinogenic drugs, snort cocaine and smoke pot. If you can take medication legally prescribed by a doctor, which is condoned by society, why not? Or you can spend thousands of dollars on therapy, which most cannot afford.
Thanks for the insightful posts. I’m really enjoying them.
I personally have never taken anti-depressants despite being offered them on numerous occasions. My reasons – seeing both my NM and my damaged brother both taking pills to ‘prop themselves up’ but seeing very little change in their destructive behaviours. I am coming close to being healed by working very hard with psychotherapy and emotional mindfullness – allowing the pain.
I am however coming to realise that my experience was of people abusing these drugs.
I have friends who live anxiety and depression riddled lives and who I believe could heal themselves. But I have to admit to myself that I am the lucky one in terms of having the resources (time,money,resilience,inner strength) to deal with my past. Could it be possible that some people don’t have the resources, especially if they are too damaged and too scared to find their inner strength, (don’t get me wrong, I believe everyone has it somewhere), and their safety net is anti-depressants? In this case others can be encouraging and offer an alternative to drugs, or suggest therapy with medication, but only the individual can make the choice.
I think we’re going through a transition now where the truth about psychoactive drugs is being publicized and as a result, more and more people (health care providers as well as users) are questioning the prevailing paradigm. I do think that “talk therapy” will be given more credence as people come to understand that meds are not the answer we have been led to believe it is. Then it is, as you say, it is up to the individual to find the courage and strength to undertake the real work.
I would not be afraid of the work involved in good therapy, but being realistic in today’s economy, there is the financial obstacle. I know you do not care for analogies, but I don’t want to trust my mental health to Wal Mart, when what it really requires is Bloomingdales.
I think that’s a great analogy! However, not everyone who is good at this work charges an arm and a leg.
I would like to see a society which acknowledges that individuals may need to do this work and gives values to mental health and well-being. Rather than the current model which is only concerned with whether you can “function”. This would lead to people going through this process given the credit for the courage it takes. If they were given the same support as people get for physical life-threatening illness then -wow- how much easier it would be to ask for the help and get it in the first place. Less drug-pushing and more compassion. A pipe dream maybe, but worth aspiring to?
I hope you do not discourage the truly depressed/bipolar people to discontinue taking their medication. I am one of those people who was born with this crap. Being off my meds (and I have done that before) is extremely dangerous and leads to suicideal ideation (no attempts, knock on wood). If you are not a physician or even you are, please exercise caution when talking like this to impressional (reallly) sick people.
I don’t believe in giving most kinds of advice. If a client were considering taking meds, I’d encourage him or her to read up and get informed first. With clients already on meds, if I hear from their material that they have doubts about continuing on meds or hate the side effects, I’d encourage them to do the same. I would recommend that, whatever they do, they do it under a physician’s guidance.
Medication can be very helpful for some-your friend with the highly stressful situation would seem to be justified in taking an anti-depressant. However, I also know people who simply do not want to look at changing unhealthy lifestyles, toxic relationships, and unwise health decisions and take medication just to avoid doing anything proactive about their situations. Still, everything is relative and how do we decide for others what is appropriate? I do agree that medications should only be prescribed by a professional and after much consideration.
I have been taking an antidepressant for almost a year now, for anxiety. At first I was very hesitant to even consider taking a drug. Obviously sides effects are the main concern, but I am not a person who is a big fan of psychiatry and pill popping modern “medicine”.
Modern Psychiatry is a cycle of creating disorders and “treating” them with drugs, unfortunately. The diagnostic criteria of mental illness is so vague, and treatment is believed to be necessary for anything, such as a different personality or emotions.
Yes I think getting help for something that is interfering with your life is important, but the use of drugs is too much. Antidepressants are now prescribed for anything, ranging from anxiety to depression and even pain, autism, etc. The “chemical imbalance” theory is a joke. I will not trust greedy pharmaceutical companies to tell me what is wrong with me, nor would I trust corrupt psychiatrists to drug me who receive money from big pharma.
We say to the youth “Don’t smoke weed, it can cause anxiety and increased appetite. it’s terrible what it can do to your body”
And then turn around and say “SSRI’s are fine, even though they’re proven to double the risk of suicide in children, they are often addicting, have side effects ranging from anxiety to seizures and severe weight gain, can increase hostility and agitation, and their actions in the body are not even known. The only theories behind the chemical imbalance theory is done by a mass propaganda campaign, by the drug companies. Look in magazines, watch TV. Their advertising is pure propaganda. I say this even though I am 15 years old.
I’m glad you figured this out at such an early age. Too many people sucked in by the propaganda.
I have read an article about a survey, which says that about 40% of Americans qualify for a “mental illness” according to the DSM. How ridiculous this is, that nearly 150,000,000 people in this country are in need of powerful psychotropic drugs.
The reason psychiatry is so abused is that it can be. The criteria is so vague, the “professionals” seem so intelligent, and the medications seem so efficient. The truth is the disorders don’t exist. The drug companies can sell their drugs for so much, why should they give a discount? The patient isn’t paying it, the insurance companies are. They also need to save themselves from lawsuits, because Little Tommy just went on a shooting rampage on Zoloft.
Mental illness diagnoses have increased about 200% since the 1990′s. Why is this? I thought in the 90′s came the happy pills, and bipolar pills. Zoloft came out, etc. But depression, anxiety, and bipolar disorders have increased!
And of course, the chemical imbalance is their theory. In the 50′s, opioid were used for depression. Now, a magic pill that alerts brain chemistry is the new hope. Antidepressants cure depression by creating an artificial sense of well-being, antidepressants cure anxiety by acting as a sedative.
I do think thought that some drugs might be alright for symptoms that cause serious problems in life. I have lived with anxiety my life. Ranging from panic disorder, to OCD, SAD, etc. Zoloft has reduced by anxiety, and my obsessions are nearly gone. I am taking a low dosage. It can help some..
Psychoactive drugs do have their place; it’s the widespread over-prescribing, as you point out, that’s the real problem.
Definitely a complex topic.
There is certainly a popular groundswell of anti-medication feeling out there. That’s unfortunate …
I view it much like other areas of health. Yes, it’s great if someone can manage their blood pressure through diet and exercise. But we don’t (generally) make them the subject of social disapproval if medications are also used.
Your parent of a child with Aspergers – an “approved” life problem, I note in passing – what makes her different from a second parent, who also has a child with Aspergers, but can, for whatever reason, cope? It *could* be a different set of skills, a lack of trying new ways of acceptance or changing her own thinking or behavior. Or it could simply be that her brain is less resilient in the face of stress. Or it could be both.
If a simple generic med can help her have just enough resilience … is that a worse choice than five years of therapy that *might* help? We’ll know a lot sooner with a trial of the med, BTW.
Just some thoughts on the topic.
Interesting, and I wouldn’t disagree. I think it’s a little more complicated, however. For instance, what about the potentially quite serious side-effects of those meds? And as for the two parents with challenging children, I didn’t mean to imply that I approved of the decision to take meds in order to cope. I can understand that decision and I sympathize, but I think I better choice would have been to enter intensive long-term therapy (money in this case is no object) in order to develop the skills and resiliency possessed by the other hypothetical parent.
Very interesting question/topic indeed! I am one of those who uses meds to “numb” or take the edge off occassionally. I have been off and on different meds (seroquel, topomax, lexapro, lamictal, etc.) for many years and am currently not actively on anything b/c the side effects make it impossible to hold down a job and a couple of them make me more suicidal than usual. (many attempts, none successful-obviously). I have been off meds for almost a year and, due largely to a fabulous therapist, I am doing ok. They were originally prescribed for me by a Dr. who had known me all of fifteen minutes and saw me twice a year after that – even if I was needing dose adjustment. He’s still my doctor (limited hmo choices) but i dont go see him anymore – he considers me non-compliant and i consider him a prison officer who imprisoned an innocent person. But the thing is – even though I dont want to be on the meds and i dont like what they do to me, I cant throw them away. I am too afraid to be without them when things get really bad. That is when I take them. And even that I do less of now b/c I’ve been learning better coping skills (mindfulness, distraction, etc. As mentioned before). But I am pretty sure I would dead now if not for the occassional numbing.
I see anti-depressants as a bridge, back to level emotional state so that therapy can even take place. I have a teen who has gone off the deep end into depression and anger, stopped doing everything he once did, and has detached from freinds. He barely talks now and sleeps all day. To get any movement on this hard issue, we have to get him to level ground again, and I’m hoping AD will help. But right now he won’t even see a therapist so not sure how to get past that problem.
You’re right, sometimes anti-depressants are a necessary bridge to therapy. I hope they can help your son take the next step.
Hi Joseph
I’ve been going to a therapist for 5 years and he thinks that I should consider taking SSRIs for my depression. One of his reasons for saying so is that he thinks that the causes of my depression are partly “characterological” by which he means they can be traced to my life history, but they are also partly genetic. This is something he feels from having known me for 5 years.
As for me, I think my father has depressive tendencies too, so my therapist may be right. On the other hand, I might have picked up the depressive tendencies as a response to difficult life situations from my father, when I was a child.
What do you think of diagnoses such as these, where the therapist seems to clearly understand what is genetic and what isn’t?
Fiak
I don’t believe that a therapist can “clearly understand what is genetic and what isn’t.” So often, these studies are published that seem to indicate a genetic origin for this or that mental issue but they’re soon debunked. The important distinction is between something that is “heritable” versus something that is “genetic”. I think that depression, as a psychological tendency, can be inherited from one’s parents through identification, modeling, projection, etc. There are many different ways of “picking up” depressive tendencies, as you put it.
My concern is that, because your therapist views your depression as genetic, he also views it as a lifelong condition and will therefore assume you should take anti-depressants for life. I’ve written extensively about different books that discuss the very serious long-term consequences of taking SSRIs and you should educate yourself thoroughly before agreeing to take them. In my view, anti-depressants have their value for short-term, acute cases of depression but are a bad idea for long-term, chronic conditions.
Everything I’ve written on this subject can be found under the category heading “The Medicalization of Mental Health” over to the right.
Thanks so much for your opinion. My therapist prescribed me an SSRI (he’s a psychiatrist also), and asked me to take it for 6 months, if I see any change in 3 weeks. He said it does not cause dependence, and that I do not need to take it all my life, but might need it a few times in my life, for similar durations. I didn’t quite understand the logic behind that.
Anyhow, I am not taking them, partly because I feel better in the last fortnight and partly because I have indeed been reading your posts on medication, especially the ones that discuss Robert Whitaker’s book. And more generally, I don’t like to think of myself as a chemical machine.
At the same time, I don’t quite understand how a rational, mature person such as him (and several other psychiatrists) could so easily misunderstand and mislead others on the causes of depression and the effects of SSRIs, because what you wrote, especially in the third post on Whitaker’s book, seems to be so easy to grasp.
I think it’s because the theory has been so relentlessly pushed by the drug companies, and is taught in medical school, that everyone just believes it’s true. And while your therapist may be technically correct, that SSRIs don’t cause “dependence” per se, your body does habituate and if you stop taking medication later, you will go through withdrawal symptoms — often misinterpreted as “evidence” that the drugs were actually working.