Friday, May 23, 2008

To medicate or not to medicate?

Antidepressants are the most prescribed drug in America. Which is understandable, considering that an estimated 18.8 million American adults (or 9.5% of the 18 and older population) struggle with some form of depression. But here's the amazing part, 80% of people with depression are not recieving any treatment for their illness. Most of us are toughing it out on our own.

Now, I am currently on an antidepressant. (For the story on why read here.) And I honestly believe it has helped me. However, every time I have started taking the pills I always start trying to calculate when I can be done taking them. I think that's because there are still so many myths out there about antidepressants and it complicates the issue.

So here's my attempt at debunking some of the myths surrounding antidepressants:

Myth #1. If you start taking an antidepressant you have to take it forever. Not true at all, you can quit taking them when you're dead! No, in all seriousness, while 9.5% of the adult population may suffer from some form of chronic depression 25% will suffer some sort of temporary depression. Many of people with temporary (or situational) depression take the medication for a only short time (six months is the shortest recommended time) to help their body readjust its chemistry. However, if you are like me and have the genuine crazies instead of temporary insanity, you usually stay on the meds for longer.

Myth #2. Antidepressants are only as effective as a placebo. This one is only sort of false. Back in 2002 a study was done that concluded a sugar pill was just as good as an SSRI. According to the study, it didn't matter what kind of "medicine" a participant was on. They all saw improvement. Some people take issue with the study because of all the extra care involved. Study particpants got checked on so frequently it basically amounted to therapy--and we all know that therapy is good for almost anyone!

Myth #3. Antidepressants are only for really crazy people. Let's just say that if they are the most prescribed drug in the nation then there are a lot more really crazy people out there than we thought. Oh, and most of us really crazy people look just like you.

Myth #4. Antidepressants are a miracle pill that will solve all your problems! I wish. Actually, antidepressants are most effective when combined with talk therapy. Turns out to manage this illness you have to do some hard work--usually solving the situational/environmental problems that contributed to your depression in the first place. Let's face it, when we're sad, there's usually a reason.

Of course only a doctor can help you figure out what's right for you. But I say, if you're struggling, why not try them and join one of the biggest clubs in America (but don't worry, we won't tell anyone who you are. We know you want to appear normal)! What myths have you guys come up against when considering antidepressants? I really want to know!


Charlotte said...

You forgot the "antidepressants will change who I really am and flatten me out to an emotionless, peronality-less blob" myth;)

Good post! As a medicated one myself, I totally agree:)

Laura said...

Good point! I guess every time I've gone on them I've wanted to be a little more emotionless. I mean, come on, who wants to cry all the time!? And as for changing who you really are, well, are you sure you REALLY want to be a depressed person. There are a lot of things about who I really am that I would like to change--starting with my desire to stay up too late internetting even though I know my kids will wake up at the crack of dawn ;)

Lura said...

My Grandma was always so proud of herself for not needing to take "nerve pills" as she called them. Near the end of her life, I was concerned about her. She seemed depressed most of the time. It was very rare that I ever saw her happy. But she absolutely refused to take medication for it. She spoke about those on antidepressants as if they were weak, and she didn't want to be one of them. She also refused to even think about therapy. I think it's sad that she was too proud to get help, because I think she could have been a lot happier.

Laura said...

Lura--one of the things that has een hardest for me about depression is how humbling it is. There are days that I honestly can't do things on my own. Maybe it's because of the LDS emphasis on self-reliance, but it's hard for us to ask for help--maybe even more so when we really, really need it.

Elizabeth-W said...

Hi Laura, I saw your comment on Segullah's Finding Faith post.
As an LCSW who shares office space with psychiatrists and nurse practitioners, I deal with these myths regularly. The biggest concern most people have is one you brought up, that once you start, you'll never be able to quit. For some people, that is true, but certainly not for all.
The trouble with antidepressants is how long they take to kick in. If you have a raging infection, a good dose of cipro or diflucan has you feeling better in 48 hours. With SSRIs, we're telling people 4-8 weeks before they see substantive improvement. That can be a miserable wait time, and you're likely to get negative side effects (feeling nauseated, etc.) long before any benefit is shown--now if that ain't a bummer I don't know what is.
Often, people just want medication, but don't want to do the therapy, which, if it is CBT, is often just as helpful as medication, and starts to work more rapidly than a pill.
The reason I decided to comment was because of your point on self-reliance. Like the Faith author's point, sometimes our culture makes us reluctant to raise our hands and say "Help...really struggling over here!"

Laura said...

Elizabeth W--thanks for stopping by and thanks for the information and perspective you offer. I hope you'll stop by again!

I think you are right about the lag time for SSRIs. It does take a long time for them to kick in. A recent PBS documentary about depression said that doctors are trying to find some sort of injection that will have a faster effect but that it is still years away.

Therapy is definitely helpful. I know for me, though, having the drugs reset my physical hormone levels make a huge difference on whether or not I'll be able to follow through with the CBT. Therapy has made a huge difference for me. I'm not currently seeing a therapist (I don't have the money) but I wish I was!

Thanks again, and really, come back! The more info and discussion that's out there, the better :)

Laura said...

Elizabeth-W--this was an afterthought. . .if you are interested I'd love a guest post from you with your perspective as a LCSW!

Elizabeth-W said...

Good point about using meds to help kick start things.
Sometimes when people are very entrenched in the depressive episode, everything is so bleak that the idea of doing any extra work (therapy) is just tooo much. In those beginning weeks, the therapy is just mainly support. "You can get through this, you will get through this, it will lift", and then once you get a little energy then it is certainly easier to do the therapy.
I don't know about the guest posting thing...I certainly didn't mean to take over your blog.
Why don't you email me and we can chat about what you might like to talk about--you seem to be doing just fine on your own :)
choriandchupke at yahoo dot com.