a pill for every ill (health)
I’m going to spout off a bit about anti-depressants, since the issue has come up in one of my circles recently.
As a mental health professional, I have worked with many people on anti-depressants and I have recommended them to some. I have had clients say that they were life savers, and had others say that they felt numbed out on them, that the medications eliminated the emotional lows but also the emotional highs of life, if you will, and that they would rather deal with the lows through other means so that they then could also experience the highs.
In all honesty, what I have found in my own extensive personal and professional experience is that most people want to take the medications as a way to deal with the PROBLEMS instead of to deal with the SYMPTOMS. Most people would rather take a pill than allow themselves to feel the immense sadness that can result from the death of someone close to them, or to leave a job that they abhor but which pays extremely well, or to end a relationship that has become much more like habit than any semblance of real intimacy. That’s the American/Western way, isn't it, to pop a pill for every little ill? We don't want to feel our feelings, or take the time required to do so, for whatever reasons: finances; stigma; family responsibilities; the list could go on and on and on, couldn’t it? Nevertheless, the medications were designed to treat symptoms that have persisted too long or are particularly debilitating and therefore impede one’s ability to address the problem, and NOT to treat the problems themselves. In my opinion, that is exactly how they should be used.
Despite all the hoopla, recent studies have come out suggesting that the newer anti-depressants are in fact only slightly more effective, if at all, than the older ones. (Please don't ask me for references. I would have to google it too, just like you. <g>) Another recent study revealed that in fact anti-depressants work only slightly better, if at all, than placebos. This was a huge meta-analysis of all of the studies done over decades, of all of the drugs, and included a critical look at the very data that the pharmaceutical companies used to pursue government approval. It was discovered that big pharma selectively submitted results from their own research as well as twisted the results that they did submit, in order to make anti-depressants seem significantly more effective than they actually are. (How shocking!)
Other research has shown that people with depression (and other "typical" mental health challenges) who use only talk therapy get well and feel better within the same time frames as people who take anti-depressants. Six months seems to be the average, no matter what treatment you choose. Yes, I know that this begs the question: is it possible that everyone would get better regardless within the six months, then, with or without intervention of any kind; however, it is not within the parameters of this particular posting for me to muse on that issue!
I have taken a few of these medications myself. I took Paxil about 7-8 years ago for perhaps a year, when a series of events in my life cascaded into disaster (in short, I lost several close friends, my job, my income, my housing, and probably a few other things, all at once - and no, it wasn't due to drug abuse or addiction) and I found myself simply psychologically devastated. I didn't feel like it had much effect on my mood, frankly, or my sex drive and ability to perform in the sack, but I stayed at a pretty low dose.
Then I used Trazodone, which is often prescribed as a non-narcotic sleep aid and not for its anti-depressant effects, and is known to have an extremely low incidence of side effects. I took it because when I was taking sustiva 600 mg at night it felt like my brain forgot to sleep. I think at a regular dose, Trazodone did help me sleep another hour or so at night, but in the long-term it wasn't enough (from 4-5 hours to 6-7 and all the time fatigued anyway) and I had to change my sustiva dosing. Other than getting a bit more sleep, I didn't note any other effects of the medication: anticipated, side or (later) withdrawal.
Having said all this, it is important to note that lots of factors can influence feelings of depression: HIV in itself can be depressing, as can low testosterone (in men and women, which can also be caused by HIV), and so can not sleeping. On top of that, almost every single criterion for a diagnosis of depression can be a symptom of something else, including totally normal sadness and grief.
Some of my clients would see their psychiatrists periodically to pursue the often endless chore of cycling through every known anti-depressant instead of confronting the circumstances or events which lead to their depression in the first place. For the chronically depressed, it could be compared to HIV-ers having to switch meds when the virus develops resistance, because usually whatever anti-depressant the patient is taking stops working after some years and he or she has to try other ones in order to continue to medicate the symptoms. I think it’s critically important to note that HIV and AIDS can without a doubt be chronic mental health challenges, requiring on-going medication to address those symptoms. Just like I said earlier, that’s what the medications were designed to do.
Chemical imbalances can result from the way that we behave and feel and think and from what we put in our body (why do you think you can't drink something as simple as grapefruit juice with some HIV medications?), just as they can result from other factors that then influence the way we think and feel and behave. And you can often "cure" the imbalance by changing the way you think and feel and behave, just like you can "cure" the imbalance by popping a pill.
But good public relations and advertising go a long way, don’t they? And afterwards it is hard to unbrainwash the brainwashed. Besides, the placebo effect is extremely powerful and poorly understood (see the On Science article in the 3/17/08 issue of “Newsweek” magazine, which refers to some of these same studies). In a sense the studies showing little to no effectiveness on the part of anti-depressants "don't really matter"; if a patient thinks it is helping, it is.
