Monday, February 6, 2012

Owning Our Antidepressants

On Saturday, I happened to read this guest blog post at, about how the author believes that, contrary to what most modern medicine tells us, depression and anxiety are not physical ailments.  Instead, they really are "in the head," and, unlike a physical ailment like diabetes, medication is not the answer.  In her words, "attributing anxiety and depression to a chemical imbalance is horribly disempowering," and by prescribing antidepressants we're "throwing in the towel" and abdicating responsibility for our mental health.

The author, who is a Ph.D. in Psychology, cites some interesting statistics from a few "anti-antidepressant" books.  She says one doctor believes that as many as 75% of the people taking antidepressants could "significantly reduce" or eliminate their meds with the help of a doctor and lifestyle changes.  She also mentions one doctor who believes the whole "serotonin deficiency" approach to depression is a sham, and is based on some questionable, at best, science.

When I first read the article, I was irritated and a little mad.  I though her attitude was a little too simple, and a little too self-serving.  I also took some issue with her "research," as all her information seemed to come from the same two sources, and she goes on to contradict some of the research she presents.

Okay, so let's talk about the author (it's all about ethos, people).  Her name is Bethany Butzer and she has written a book called The Antidepressant Antidote, is a speaker on the topic, and is also a yoga instructor.  On her website, she classifies herself as a "Mental Health and Wellness Advisor."  The topic of getting off of antidepressants is obviously her passion and her platform.  She does say that she thinks antidepressants are good in some circumstances, and if they've helped someone get through a bad patch then fine, so she's not exactly "anti-antidepressants," she's more "uncomfortable" with antidepressants.

The more I thought about the post, the less irritated I got and the more reflective.  There were a few things she said that kind of made sense, that I think I agree with.

One point she made that I do, more or less, agree with:  she says, "I think our acceptance of this [idea that depression/anxiety are a result of a physical problem] reflects our longing and desire for a simple solution." I think most people who are depressed enough to consider going on antidepressants would love a "quick fix" -- who wouldn't?  And I think that in our society we tend to demand fast, easy solutions.  The irony here, I think, is that antidepressants usually take 3-6 weeks to work, and that's if they do work.  They really aren't that quick-acting.  

I think my biggest issue is with her general hypothesis, the idea that antidepressants are "disempowering."  I can see where the idea comes from; that if we have a medical problem, there's nothing we can do about it other than take medicine and wait for it to work.  But that's not entirely true.  If we think about diabetes, the go-to comparison illness for depression, there are lots of lifestyle changes a person can make that can improve their medical condition; the same goes for illnesses like heart disease and arthritis.  You may never be able to cure these problems, and these lifestyle changes usually have to work in tandem with medication.  But a person who manages their diet and exercise and takes insulin is going to be a much healthier diabetic than someone who takes insulin alone (something I'm trying to make my diabetic cat understand, but he's not buying).

My other thought is, what if we view antidepressants as empowering, instead of disempowering?  Rather than looking at medication as something that strips us of responsibility, it is something that enables us to be responsible. When someone is at the point where depression or anxiety has gotten so bad that they are visiting their doctor or a psychiatrist, the last thing they want to hear is, "It's all in your head.  It's up to you to fix yourself.  Start going to yoga and get on the treadmill."  Hell, I'd wager that 9 times out of 10, that's going to make someone more depressed.  But if the doctor says, "Okay.  I can give you this medication, but it's going to take a while for it to work.   It'll help you, but it will help more -- and quicker -- if you start going to yoga and get on the treadmill."  If you feel like you have a little bit of help, that you're throwing fixes at the problem from more than one direction, you are going to feel better faster -- regardless of if the antidepressant is really working on a serotonin deficiency or not.

In general, I kind of waffle about antidepressants.  I do think they are over prescribed, but I think they also help a lot of people.  I also think you'd have to be living under a rock to not know that exercise, a healthy diet, and other lifestyle choices help fight depression (that doesn't mean that people always make those healthy choices, but hey -- free will's a bitch, right?). 

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