Saturday, September 17, 2011

"happy" pills: are they magical or empty?

Gary Greenberg’s Manufacturing Depression: The Secret History Behind a Modern Disease explains why we have plenty of reasons to question whether or not depression is actually a disease.  Greenberg, a practicing psychotherapist who has experienced depression himself, uncovers how it came to be called a disease, as well as the events—including the pharmaceutical companies’ clever and deceitful advertising—leading up to the inflow of antidepressants.  It’s a history of “accident and misunderstanding and overreaching, of unwarranted leaps of logic and wishful thinking and the misapplication of scientific rhetoric, of bad faith and greed.”

flickr Creative Commons: farmer dodd
With twenty pages of bibliography, it’s clear Greenberg has researched thoroughly.  His work touches on the truth that science, though helpful in many ways, is flawed.  He emphasizes that when life pummels us down to the very bottom, we don’t have to accept that we’ve got sick brains.  We don’t have to hand our pessimism and anguish over to the medical industry.  We can instead take the opportunity to explore and develop our life stories.  We can let our suffering indicate our deepest spiritual yearnings, we can cry to God, we can search for the way to live.

This isn’t to say it’s wrong to take medication when you’re depressed.  Antidepressants are effective some of the time for some people.  But, as Greenberg notes, in trials for antidepressants, the placebo effect beats the actual drugs.  “A total of seventy-four trials have been submitted to the Food and Drug Administration for the twelve leading antidepressants.  Of those trials, only thirty-eight showed an advantage of drug over placebo.  That advantage, when it is there at all, is small.”  Also, a look at other clinical trials shows "that 80 percent of the effect of the antidepressants is due to placebo effects."

Faith in medication may help temporarily, but it doesn’t do anything to enlighten us or fill the deepest caverns within us that demand meaning and completion.  Furthermore, as Greenberg mentions, just because an antidepressant makes a person feel better doesn’t mean there was a chemical problem in the first place.  It only explains how the drug influences the chemicals already there.  For some people, it’s not important.  For them, all that matters is to feel better as soon as possible.  That’s okay, although I’ll be honest in saying I think it’d be much more worthwhile to get at the heart of things—to seek relief through honesty, by examining experiences and thought processes with a counselor or trusted friend—even if it hurts.

If you're ready for an intellectual challenge, I highly recommend this book (you can see more about it here).  In my opinion, the most important point from it is that we mustn’t let the medical industry dictate to us we are merely dysfunctional blobs of matter that can be fixed by science.  We are so much more than that.  It's true that all of us are dysfunctional to some extent, but we’re also mysteriously and wonderfully human, and we each have a story to tell.  Depression, although black and infernal at the time, ultimately serves to improve us, bringing us wisdom and greater freedom than we ever had before.  This is what I’ve experienced because I was open and brutally honest in emails to a loving, trustworthy friend while I suffered. 

What are your thoughts on this?  Have you ever been helped or healed by antidepressants?  Or, on the flip side, have antidepressants caused you more problems than not?  I know it's a difficult subject, but I’d love to hear from you.

Also, you might be interested in this post.


Anonymous said...

Great piece, Leah! I've taken antidepressants before, 2 different types during the same 5-6 months. I agree that it worked much better for me to realize why I was depressed and to work on that no matter how much it hurt. I got over the depression faster than I would have if I had continued to medicate myself. In reality, I felt that taking the pills made me feel a numbness to the world that I'd never experienced before. I felt like an emotional and physical zombie. I felt that if my arm were to be ripped off, I wouldn't notice. Sure, I didn't feel depressed anymore but then again, I didn't feel anything. I wasn't happy or sad and I couldn't find the joy in little things like my son or my marriage.
Depression sucks, no doubt, but is feeling absolutely NOTHING a fair alternative? I think that as humans, we should FEEL everything, good or bad and taking a pill for depression or for physical pain just makes us weak and dependent, like the pharmaceutical companies want us to be. Just because we can avoid unpleasantness with a little pill, doesn't always mean we should or that it will fix the root of the problem.

Leah Schouten said...

Thanks for sharing your experience. I wonder if there is sometimes some confusion about whether certain symptoms arise because of the medication or because of the depression itself. You must have noticed the numbness go away as you weaned off the antidepressants.

Greenberg would agree with you that taking antidepressants make people dependent. He says they cause "withdrawal syndromes and dependence." And he also talks about how they are "the spawn of LSD", chemically speaking. They get people high. Maybe not as high as LSD, but high, nonetheless.

Anonymous said...

I Haven't decided how much of this I actually agree with. Being in the drug business I do believe antidepressants are over prescribed. I believe that exercise is still the best antidepressant there is. I don't agree with them not being used at all because I have seen many people that really have benefited from them (especially in cases where suicides were a high possibility). Depression has scientifically been proven to be linked to lower than normal chemicals that are naturally found in the brain so just like diabetes with higher than normal sugar levels it is a real problem. The high I see you mentioned is nothing at all like LSD as it only brings up the chemical levels to amounts usually seen in healthy people(unless you call healthy people without depression high like LSD). I have also tried my share of antidepressants so i'm not being biased, but it also takes hard work to fight depression and sometimes you need that little kick to change your lifestyle and habits around (even I'm guilty of not wanting to do the hard work as well) but I realize that to truly overcome depression it requires the ability to change things in your life but you know what sometimes an antidepressant is good just to get you going on the right path until those changes are set in stone.


Leah Schouten said...

Jenn, I need to provide you with some context for this from his book. I will post on it, as soon as I have the chance.

Leah Schouten said...

Jenn, I have no doubt that you've seen people benefit from taking antidepressants, and I think Greenberg would probably agree with you that they can be helpful in some cases, to a certain degree. And I don't believe he's trying to disprove antidepressant efficacy as much as he's searching for the truth in all this. By the way, he talks about how antidepressants were "proven" to be effective, despite many studies proving their inefficacy. In other words, there were studies that proved it and studies that disproved it.

You mention that depression has scientifically been proven to be linked to lower than normal brain chemicals, but this is what I want to know (and I mean this with no disrespect): who proved it, and why?? Greenberg says it took American innovation and clever advertising to figure out how to give science the authority behind the hugely profitable claim that a large part of the world meets the criteria for depression (p.79). And, of course, he provides the historical details of this.

I understand what you mean about the high of antidepressants not being the same as that of LSD. What the author's getting at is that, chemically, antidepressants work to elevate mood in a similar way. It's not as high as LSD, but it's high enough to make a person feel better, if that makes sense.

According to Greenberg, within the history of how antidepressants came to exist, a British Psychiatrist was one of the first to use LSD therapeutically, and a pharmacologist named John Gaddum guessed LSD might be able to help him figure out what serotonin was all about, so he ran a bunch of experiments and so on. Basically, Greenberg's saying that scientists and psychiatrists were really going out on a limb when they were guessing that serotonin was the key to healthy mental functioning, and they came up with theories based on Gaddum's drug trips on LSD (this is found on p.168 of Greenberg's book).

Of course, there were many events that took place after that which led up to our modern antidepressants, but I just wanted to give you this bit to show you where the LSD comment came from.

I appreciate you sharing your perspective on it, especially considering your line of work.

Anonymous said...

In how depression was proven to he linked to different chemicals it was actually done through blood tests where patients had low levels if a certain chemical ie. Seratonin and when given medications to increase this level the patients actually had improved mood and other favorable responses. I believe they can also do scans to see certain chemical levels in the brain as well before and after treatments that show improved mood with the correction of chemicals. They can also compare levels of those chemicals in patients who do not have depression and there is also a difference. It's the same thing as if you wre to put someone in a cold environment with no clothes and one with clothes and see who is warmer and then give the no clothes person clothes and they get warmer. Even though I don't frown upon giving people antidepressants I do believe there are many other ways to increase those levels by non-drug measures, ie exercise, hobbies, even diet can help, but I still believe they help with depression by acting on those same chemical systems that the antidepressants do.


Anonymous said...

Good discussion question by the way! This is what you should be doing at you "book club" :-)

Leah Schouten said...

This still doesn't explain the success of placebo pills.

So then, this is what we have: studies/tests that show the actual drugs in antidepressants to be effective, and studies/tests that show them to be, more often than not, ineffective. And maybe it's okay.

It's alright to embrace the uncertainty--to admit we don't have all the answers about our suffering, to realize we can't ever be totally rid of our inner pains (and their effects on our bodies) as we journey in this difficult world. And maybe the best thing is to trust that our suffering at least serves the purpose of teaching us something about ourselves and giving us perspectives we may not have had before.

Thanks for all the discussion. It's been fun!

Bekkie In Wonderland said...

Sorry I got here late. I was put on antidepressants a few times during my life but found that for me, they not only didn't work but I seemed to get every side effect in the book. I would of loved to have suffered the placebo effect. Maybe I wasn't depressed enough or misdiagnoised? I pulled out of it on my own but I wonder what would of happened if I hadn't?
As far as understanding the placebo effect couldn't it be as simple as the power of having faith in what you are told? Like in the Bible? ♥

Leah Schouten said...

Bekkie, thanks for sharing. People are complex and, to me, depression is complicated, being intertwined with a person's experiences, expectations, beliefs, and maybe chemicals as well. It's mysterious.

Maybe you weren't depressed enough, or maybe you were misdiagnosed. Or maybe it would be best to simply define it as human suffering, the kind that has played an important role in making you who you are today.

I think you're right that the placebo effect has to do with a person's faith. How far can faith in a pill take somebody, though? Maybe it will help to overcome depression, but will it provide any deeper meaning or sense of purpose in life? Something to think about...

Florence said...

Great post Leah, like most here I was put on ADs, 3 different types but none helped me but I jade crazy side effects like crying non-stop with one and sleeping and feeling doped up 24 hrs a day with another. I strongly believe that depression is a spiritual thing, I have recently started an online wellbeing ministry where I want to talk more on these topics. The book sounds great, thanks for sharing.

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