Reflections on Newsweek Feb. 8, 2010 Cover Story (Anti-Depressants).

8 Responses

  1. I agree that the Newsweek cover story was contentious and one-sided, and in a way that used to be uncharacteristic of the magazine. I did make a very partial reply, posted here: http://www.doublex.com/blog/xxfactor/how-do-antidepressants-work-newsweek-gets-it-wrong
    If you click on the hyperlinks in that posting (esp. “here” and “elsewhere” at the top), they will take you to other postings where I discuss the research at the core of the Newsweek piece.

  2. Kara says:

    Dave….a couple thoughts:

    We’ve subscribed to Newsweek for years (well, Brad has) and it’s quality has significantly deteriorated in the last year since their big ‘makeover.’ Seriously, it is not a news magazine anymore, but is trying to compete with alarmist blogs. Its like the People magazine of news now. So, it’s not surprising that they don’t have good reporting–that is few and far between now–and it wasn’t always like this.

    Secondly, from my own experiences and from what I read, there is a major problem in the US particularly with over prescribing antidepressants. It is easier for a doctor to simply prescribe them without taking the time to figure out what the problem is. For me…I had a vitamin deficiency caused by another prescription I was taking and once I started a multivitamin, I was 100% better than I was on antidepressants. I had to figure this out on my own though…my doctor didn’t take the time to figure this out. And I think this happens a lot. Plus, when a GP prescribes an antidepressant they rarely require counseling in addition to it, so it seems more like an easy fix that doesn’t necessarily address the whole problem.

    I am not saying that antidepressants are not necessary and helpful–they certainly are for some people. But as a population, we have so many issues of poor diet, poor sleep, stress, and other crap, that those need to be addressed first, or at least simultaneously with medicine. And you’re right, there are tons of different kinds of depression, so if the article doesn’t address that, that is a major fail. It also fails if it doesn’t explain how helpful antidepressants are for some people.

    Anyway, we’ve yet to get the issue (it comes to our house 5 days late, although it used to come on time, we’ve called Newsweek and they say they can’t do anything…any mark against them! We should call it ‘News-from-last-Week 😉 ), but those are just my thoughts. Phew, that was long…sorry!

    • davemackey says:

      Kara,
      Thanks for taking the time to post your thoughts. I think you bring up an interesting perspective on over-prescribing antidepressants – but I think this actually reflects different issues than the effectiveness of anti-depressants. Namely:
      1. As a nation we need to make the choice to pay our GP’s better. There is little attraction for individuals to enter the GP field – especially financially. Right now we are facing a severe shortage of GP’s resulting in a lowering of quality in the care we receive from GP’s. GP’s who overprescribe antidepressants do so not because of an overconfidence in their efficacy to fix problems but out of a need to churn out more patients in less time. I think that Walmart and similar super-chains have developed an innovative way to reduce this problem by allowing practices to be established within their walls that can handle most simple requests in a timely fashion with less qualified practitioners. This would free GP’s to be more involved in the long-term health of their patients, rather than the distribution of antibiotics, referrals, and other such distractions.
      2. The healthcare industry is one of a few industries that is remarkably antiquated when it comes to appropriate use of technology. There is a significant need to innovate technologically within the medical field which would yield nearly unimaginable improvements in the quality of treatments. Electronic health records, automatic number crunching and analysis of an individual’s health history, use of personal health monitoring devices, could all significantly reduce the costs in time and finances related to treatment. Issues such as your vitamin deficiency should be automatically recognized by computer analysis – rather than hoping that an overworked GP recognizes that the side-effect from a medication you are using can result in a vitamin deficiency.
      3. I wholeheartedly agree that as a nation we have many other significant issues. I know I personally struggle in the areas of diet, sleep, and stress. I think that ideally we should be dealing with these simultaneously to or sometimes even before medication – on the other hand, oftentimes individuals are not prepared to tackle these challenges until they have experienced some relief via medication. I do not think it is wise for individuals to appeal to anti-depressants as a cure-all, on the other hand, true depression, etc. (in my experience) receives only partial allayment via changes in diet, anxiety, and sleep. These may take a 10 point depression down to 7, but I don’t think they will ever take it down to 0 or even 3 or 4.
      Thanks again. 🙂
      Dave.

  3. happi ever after says:

    Lexapro is a permanent life long cure for any depression if you can survive the treatment. I was prompted by a marriage counselor to go to my doctor and request drugs for my OCD symptoms (checking, intrusive sad thoughts, previous eating disorders as a teen and heavy drinking.) I went to my husband’s pcp who never met me before. He gave me a depression self-test and diagnosed me with depression and anxiety, and then prescribed me Lexapro and Rozerem since I had a terrible insomnia problem. He also decided it was a good idea to start kissing me and grabbing me in his office. The Lexapro did such a good job getting me up and doing things, lots of things, but unfortunately, I believe it also may have made me nervous because it raised my blood pressure from it’s usual 120/80 to 145/110. I was really up, up, up. I could drink twelve shots of straight liquor and still be walking around for hours. This was the busiest year of my life. I managed to get 2 DUI’s 4 drunk in publics and an involuntary commit for suicide, attend 2 rehab’s, a hypnotherapist, weekly ASAP programs, all while working full time an taking care of a young child. During the course of my medical treatment, I was seen by 3 psychiatrists, 4 doctors, and numerous counselors. Most of the follow up treatment involved numerous more drugs, anti-buse, campral, and Buspar. All of which I had to stop taking due to side effects such as full body tremors and falling down. Finally, after the second DUI which I was also charged with a felony for pinching a police officers butt, I decided maybe I should stop taking the Lexapro b/c I seemed to have developed some obsession with alcohol and I could see I was also becoming delusional. So, while in jail, I requested no more medication for 1 week and was able to fully withdraw from Lexapro, although the depression side effects of the withdrawal lasted about three months. I met numerous other women in jail for DUI’s while on Zoloft, Lexapro and Abilify and others for shoplifting on Zanax. My depression is 100% permanently cured. I no longer ever feel sad about my life. I have never killed anyone driving drunk, I didn’t kill myself, I am no longer in jail, I didn’t get my kid taken away from me, I am not in a mental institution, and I don’t have a lethal diastolic blood pressure of 110 anymore. No matter what happens in my life now, I am always hopeful and never depressed. I know things could be much worse.

  4. Mark says:

    Thought you might find this article, from the New Yorker, of interest. Not so much an article that draws a conclusion as it is an exploration of the conflict between those who believe anti-depressants treat an actual disease via chemical action in the brain, and those who assign the medications efficacy to placebo effect. Well written and informative.

    http://www.newyorker.com/arts/critics/atlarge/2010/03/01/100301crat_atlarge_menand?currentPage=all

  5. I’m coming at this article from an entire different perspective. I’m a licensed, board-certified cognitive behavioral therapist, diplomate of the board–psychology, who’s been crying in the wilderness for years over the lack of accurate information about depression. Neuroscience has all the answers for getting out of depression without drugs for anybody willing to look. Depression is not a brain disease. It’s an agonizing neural pattern formed in the brain by chronic over-reaction to stress. The pattern can be replaced, through the brain’s neuroplasticity, by a healthier pattern.

    The key to change is: the process of pain perception. All pain and depression is produced in the subcortex. There’s no pain/depression in the neocortex. Signals, that pain/depression are being produced subcortically, must go up the brain, and not only be received, but be acknowledged in the neocortex before a human being can feel any pain/depression.

    That’s why hypnosis works. And why football players can even break a bone and feel no pain when concentration on their game thoughtjams acknowledgment, in their neocortex, that pain’s being produced in their subcortex. One can “brainswitch” out of depression the same way.
    Depression diagnoses are being widely discredited.

    • davemackey says:

      A.B. – I really appreciate you taking the time to post your comments, and I’ve bookmarked your blog so I can read through the articles in the near future. I would agree with you on the efficiency of CBT as a method of treatment for psychiatric illnesses. However, I am concerned by any treatment philosophy which emphasizes one tool to the exclusion of all others. In my, much less professional opinion, CBT should be one tool alongside of numerous others for the treatment of these illnesses – including medication.
      The variety of responses we see amongst individuals to various forms of treatment (e.g. medications, CBT, psychoanalytic, nutritional) indicate to me that there are significant varieties in the causes and interactions of various psychiatric illnesses. We oftentimes are unaware of how various factors interact to form a unique pattern which requires a certain form of treatment – but if we see success in one area we cannot discard all other areas due to this.
      I’d qualify my article by stating that I am not attempting to suggest medication is the sole or even primary remedy for mental illness but that it should not be excluded from the toolbox. I am a fan of other forms of treatment – CBT, etc. just doesn’t seem to be under the same criticism as medication (especially in the Newsweek articles).

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