Pills Are Not The Magic Genie In A Bottle
For Solving Problems
I haven't written about mental health issues since I gave up my private practice. But the article I just read in the New York Times made me angry enough to chew nails and spit rust.
"Overprescribing Prompted Warning on Antidepressants" by Denise Grady and Gardniner Harris. (March 24, 2004)
"The advisory issued Monday by the drug agency asked manufacturers to put detailed warnings about a possible increased risk of suicidal behavior and the need for monitoring on the labels of 10 antidepressants: Prozac, Zoloft, Paxil, Wellbutrin, Luvox, Celexa, Lexapro, Effexor, Serzone and Remeron. The warning included both children and adults."
A number of psychiatrists respond to the government's ruling by downplaying the potential danger of these drugs indicating that the drugs are "not really harmful for most people." They acknowledged that these drugs are sometimes over prescribed but shifted the blame for over prescribing on to family practitioners who presumably don't know what they're doing when it comes to treating depression. They also accuse family practitioners of not monitoring patients who are on these drugs closely enough.
Some of the psychiatrists who were interviewed acknowledged that the new warning was sound advice, but they worried it might discourage doctors and patients from treating depression.
Did I miss something here? Are these psychiatrists slyly supporting the perception that these pills are magic, albeit a little dangerous for some people.
The article states that "Antidepressants are the third biggest selling category of drugs in the world behind cholesterol and heartburn pills."
I'm angry because once again the public is duped into reliance on a magic pill to solve their problems of living.
Nowhere, I repeat nowhere in this article is there any reference to other legitimate ways to treat depressed people.
When a doctor prescribes a psychotropic drug for emotional problems, its easy to assume the drug is not only safe, its necessary to cure an illness.
How we get into trouble with drugs, is that we think we can use them to solve problems, or use them instead of solving problems. Psychotropic prescription drugs, do not cure the problems that cause our emotional pain.
An argument frequently used in favor of drug therapy for emotional problems is that when we suffer from a chemical imbalance in our brains, drugs are needed to rebalance these chemicals. However, it doesnt logically follow that ingesting drugs is necessary to rebalance brain chemicals. Vigorous and even not so vigorous physical exercise can affect brain chemistry. When were down in the dumps, talking with an empathic friend can make us feel better. Praying works well for some of us. Gaining a new perspective, playing and listening to music, better stress management, yoga, meditation, and relaxation techniques all have the power to change the balance of brain chemicals without the risk of harmful side affects from ingesting drugs.
Our brain chemicals are constantly fluctuating as we interact with life. This is normal. We feel sad (depressed) when something bad happens. We feel anxious when faced with an apparently insignificant but overwhelming challenge (anxiety). We experience a surge of adrenaline when another driver cuts in front of us nearly causing an accident. We feel euphoric when the mate of our dreams proposes matrimony, proud when we achieve a goal weve set, content when were in a loving relationship, and happy when were doing the work we love.
Solving a problem of living can also solve a brain chemical problem. That is, what we do, how we think, and what we value will alter the balance of chemicals in our brains, and consequently, how we feel. Eliminating or reducing the number and intensity of stressors for example will enhance our sense of emotional well being. Unfortunately, it doesnt work the other way around though. We may wish for a magic pill that could solve our emotional problems. Drugs however, do have potentially harmful side affects and they dont cure problems of living.
If you are currently taking a psychotropic drug prescribed by your doctor, please do not discontinue taking it without the guidance of your medical doctor. Abruptly discontinuing the use of a potent drug can be dangerous. Just as withdrawing from alcohol, or cocaine too quickly, can be dangerous, so too is the unmonitored withdrawal from a prescription drug. A medical doctor should monitor your detox from a prescription drug.
Back to the New York Times article: "We're going to continue to use these drugs pretty freely until we start seeing the ads in the newspapers from lawyers saying, `Have you or your family member been prescribed these drugs? If so, you may have a case,' " said Dr. Phillip Kennedy, a family practice physician in Augusta, Ga. "When the big L word, liability, raises its ugly head, that's when things will really change."
Critics of these anti-depressant drugs said, "The F.D.A.'s warning was long overdue.
These warnings are not as strong as I would like, but they're an important first step," said Tom Woodward of North Wales, Pa. Mr. Woodward's teenage daughter, Julie, hanged herself six days after starting therapy with Zoloft.
I know of no hard scientific evidence that drugs are superior to other forms of therapy for the treatment of even the most severe and devastating emotional problems. Barry Duncan, Psy.D. and Scott Miller, Ph.D., make a convincing case to the contrary in "The Heroic Client: Doing Client Directed Outcome Informed Therapy." See also, "Blaming The Brain" by Elliot S. Valenstein, Ph.D., "A Dose of Sanity" by Sydney Walker III, M.D.,"The Anti-Depressant Era by David Healy, and "Your Drug May Be Your Problem by Peter R. Breggin, M.D. and David Cohen Ph.D.