Depression: Anatomy of an Epidemic
As a Middle America housewife and mother of four, I have noticed a disturbing trend over the last 10 years: more and more moms on antidepressants.
Well, it actually wasn’t disturbing to me until recently. I was under the impression that depression was a clear result of a chemical imbalance, a disease like diabetes and hypothyroidism. These wonder drugs were just curing a biological imbalance, right?
The more I paid attention to what I was putting in my body, however, the more I became weary. This led me to an eye-opening book: Anatomy of an Epidemic, by Robert Whitaker.
Since the 1950s, there has been a steady increase in psychiatric patients. One in 468 people were mentally ill in 1955, 1 in 184 people were mentally ill in 1987, and since the approval of Prozac in 1987, 1 in 76 people are considered mentally ill today. Now, 1 in 8 Americans take psychiatric drugs on a regular basis. Psychiatric drug sales currently exceed cholesterol-lowering drugs and are many pharmaceutical companies biggest cash cow.
So, what is going on? We have better drugs, but more depressed people? I thought the drugs were supposed to fix people…
Well, it seems as if there is really no proof that our brains were broken in the first place. In fact, it wasn’t until the 1980s that psychiatry reorganized and marketed themselves as “brain fixers.” This new pharmaceutical medical model was sold to the public and everyone bought in. The problem is that no studies or research have ever been able to prove the “chemical imbalance” theory, although many have tried.
Numerous studies have been done to measure the cerebrospinal fluid to find the levels of serotonin and dopamine metabolites in “normal” versus “mentally ill” people. None of these have been able to prove that mentally ill people have any different levels of serotonin or dopamine than healthy individuals.
As a matter of fact, they know now that the drugs actually cause the brain to act abnormally. Thus, a depressed person’s brain starts out looking normal, and end up looking very unusual after taking antidepressants.
Our brains will constantly strive to maintain equilibrium. When a drug like Prozac, Zoloft or Lexipro (selective serotonin reuptake inhibitors, SSRI) is introduced, it inhibits the reabsorbtion of serotonin, allowing more serotonin to be available in the brain. But, our brains react by altering its structure and pathways. It will turn off serotonin making neurons in order to bring the serotonin levels back down to normal levels. This is why once on psychiatric drugs, one will have to continually increase the dose or switch medications.
This also makes it going off the drugs almost impossible. The brain has been altered; so going off the SSRI will mean an even lower level of serotonin available than when the patient started. When patients attempt to go off the drugs, the dip back into depression is taken as proof that the drugs work, that they must need them. Instead it is really proof that the brain has been severely altered. Only time will slowly return the brain to normal, if possible. If the drug has been taken for a long period of time, the brain may never be able to recover to previous normal function.
But studies have proven they work, right? That depends on how you look at it. Pharmaceutical companies typically run short-term studies. In the short run, patients do feel better because the serotonin levels are increased. They feel relief. Long term studies not backed by pharmaceutical companies, however, have only found one result: patients who DO NOT take drugs are better off in the long run. It seems as if there is a benefit to letting the depression run its course and using alternative methods like talk therapy, writing therapy and meditation.
For example, a Vanderbilt University study, found that people on antidepressants had a 76% chance of relapse within a year when the drugs were discontinued compared to a 31% relapse rate for patients given a form of cognitive talk therapy.
Andy Thomson, a psychiatrist at the University of Virginia, says, “The high relapse rate suggests that the drugs aren’t really solving anything. In fact, they seem to be interfering with the solution, so that patients are discouraged from dealing with their problems. We end up having to keep people on the drugs forever.”
Seeing how psychiatric drugs create a cycle of dependence with diminished long-term outcomes, it is surprising that they are frequently being prescribed to the mildly depressed and anxious. Moms, who are exhausted, stressed and impatient, are being advised to go on Lexipro as if it was no big deal. There is still the belief that the brain is in imbalance and this little pill will fix the disease. Even though the US Surgeon General has readily admitted the exact causes of depression are not known, the illusion that biological imbalances cause mental illness still permeate public opinion.
Is there ever a place for psychiatric drug? Obviously, in severe cases, drugs can help. Is it ever appropriate for the mildly depressed? Maybe, maybe not. It looks like in the long run, it can do more harm than good. They may be helpful in a depressive episode when an exit strategy is discussed upfront. But, if you do not make a plan to get off the drugs, a life of psychiatric pharmaceuticals is highly likely.
Mothers out there have to realize that running a household, raising children, and also working outside the home can feel draining, stressful, and often unsatisfying. Feeling depressed, anxious, and overwhelmed is not abnormal. Before you turn to antidepressants, consider diet, exercise, yoga, meditation and writing to alleviate the depression. Consider simplifying your life and clearing your calendar. There are many therapies and options out there. Even though drugs may seem like the quick fix, the amount of work it could take to get off them may be more difficult and grueling than taking the time to deal with the problems in the first place.