This post is in response to The Overprescription of Antidepressants Has Become Simply Ridiculous by Jonathan Rottenberg
(c) Corbis www.fotosearch.com
Source: (c) Corbis www.fotosearch.com

There is broad agreement that something must be done to educate, prevent and treat those who unwittingly become addicted to opioid pain-killer medications.

Painkillers create in users a compulsion to keep taking them, at increasingly higher doses, which has led many pain-killer users to cut costs by using street drugs instead of those prescribed by their doctor. The street drugs are unregulated and therefore pose higher risks of death from overdose.

Do drugs to reduce emotional pain from depression bring a similar risk of making their users addicted?

The drug companies say no.  This answer rests on a subtle wording in the diagnostic manual that defines addiction as involving a craving.  No one craves antidepressants in the same way as they do narcotics or other officially addictive substances like alcohol.  "Oh, I can't wait to have my next dose!" 

At the same time, antidepressant users do become drug dependent.  If they cease abruptly to take their medicine, their emotional state can quickly sink into a severe depressive torpor.

In addition, even if antidepressant drug users taper off gradually, they risk development of a phenomenon referred to as "brain zapping," a non-fatal but significantly unpleasant buzzing feeling that occurs intermittently in the person's head. 

In sum, discontinuation of the drug, especially if it is done too rapidly rather than in a slow tapering off —and also if a person has been on the medication for too long a time (years rather than months)—can provoke serious consequences.

Side effects of antidepressant drugs also can be problematic. 

Antidepressant medications definitely do help help some people. They also disappoint many who try them.  Research suggests also that the medications help only about 60% of people, which is only slightly higher than the improvement rate for patients in the studies who have been given a placebo.

Weight gain, emotional numbing, and loss of libido are side effects from some of antidepressants.  These problems in turn can hurt self-image.  They also can have detrimental impacts on love relationships.  

At the same time, many of those whose depression is rated in the research as "improved" experience a reduction of some but by no means all of their depressive symptoms. 

In addition, many continue to be vulnerable to depressive episodes.  In fact, a Swedish study found that patients who had taken antidepressant medication actually become significantly more likely to experience a subsequent depressive episode. 

What are the results when depressed people utilize psychotherapy instead of medication?

Psychotherapy without medications is sometimes a somewhat slower process for lifting depressed feelings, but outcome research has established that the results of treatment  are more or less equivalent.

Some psychotherapy techniques however result in almost immediate relief.  See this frontal lobe energy-shifting treatment strategy and also this visualization technique.  The visualization can be done as self-help or with the aid of a therapist.

The main difference between outcomes with medication versus psychotherapy treatments is that psychotherapy results in less likelihood of relapse.  The lower rate of return of depression may be in part because medication increases the brain's depression vulnerability.  Also, by contrast with medication, psychotherapy methods often include building new habits and skills that enable more effective handling of subsequent life challenges.

Most importantly, psychotherapy generally helps depressed people to re-address and find solutions to the problems that have given rise to their depression.  Ultimately, problem-solving is the best antidote to depression.

What causes depression?

While depression does correlate with lower levels of serotonin, depression is seldom caused by a chemical disorder.  While some depression, such as depression from insufficient sleep or from a hormonal difficulty, may fit that description, most depression is triggered by giving up in the face of something of importance that a person wants.

The research is clear that psychological interventions can change body chemistry, alleviating depression without the use of pills. How will that message get conveyed to depressed people who need to know about treatment alternatives before antidepressant drug dependency spreads even further?

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Psychologist Susan Heitler, PhD is author of the newly released book Prescriptions Without Pills: For Relief From Depression, Anger, Anxiety and More and the free companion website prescriptionswithoutpills.com.

(c) Susan Heitler, PhD
Source: (c) Susan Heitler, PhD

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