Peter Lambrou Ph.D.

Codes to Joy

Happy Pills or Useful Skills?

Getting to the roots of lasting happiness.

Posted May 29, 2012

Today antidepressants are the single most commonly prescribed medication in America, with 1 in 10 adults taking one. For the patients who suffer from severe clinical depression, these new pharmaceuticals have been a godsend. For everyone else, the picture is not so clear.

Interestingly, the great majority of those 1 in 10 adults who take antidepressants do not have profound depression. Instead, they may suffer from mild anxiety, overwhelm, down moods, complaining they ‘just aren’t happy,’ feel down-in-the-dumps, have a sense of guilt or discontent, or any one of a hundred other forms of the vague malaise we term a fog of distress.

With the new class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which are generally not addictive and have a low side effect profile, many well-meaning primary care physicians feel more comfortable prescribing them when their patients “need something.” A severely depressed patient, after ruling out medical conditions, is more likely to be referred by their primary care doctor to a psychiatrist for a comprehensive evaluation.

But here is a critical question: while these drugs can help blunt the impact of the worst cases of deep depression, can antidepressants serve as happy pills?

Not So Happy Side Effects

In The Emperor’s New Drugs: Exposing the Antidepressant Myth, researcher Irving Kirsch, Ph.D. thoroughly examines both published and unpublished studies and comes to the conclusion that for most patients, many of the SSRI drugs seem to serve as little more than expensive placebos.

Among the published studies, some three out of four show antidepressants as being effective—but of those studies conducted that show no benefit from antidepressants, about 9 out of 10 remain unpublished. In other words, there appears to be a pronounced bias toward publishing primarily those clinical studies that demonstrate even the slightest effect. The studies that don’t simply get shelved. With their high cost these antidepressants drive up health care costs but don’t teach patients anything.

More worrisome is the fact that these drugs sometimes do have significant side effects. While many side effects are merely annoying such as loss of libido or digestive disturbances, for some patients the side effects are worse than what the pills were supposed to fix. Such side effects include serious agitation, the aggressive and even violent behaviors associated with Serotonin Syndrome, even suicide.

Other Paths to Happiness

Many forms of psychotherapy differ from medications in that they focus on the cause rather than symptom. Many therapies teach depressed or anxious people new skills in their thinking and their beliefs about themselves, about the world around them, and about their future, which can lead to new patterns of behavior. While not a panacea, psychotherapy can provide strategies and methods to change people’s thinking which produces lasting benefits.

If we teach people relaxation skills and appropriate assertiveness skills, improve their ability to communicate, and show them how to avoid negative distortions of reality, they get better. There is no pill that can teach these skills.

Relatively simple lifestyle changes can also make a significant difference. As just one example, in a study conducted at Duke University, a group of patients were given a thirty-minute program of exercise three times a week, which proved “just as effective as drug therapy in relieving the symptoms of major depression” in a matter of days. Even more remarkable was that after six months, fewer than 1 patient in 12 who continued the routine had their depression return.

Getting to the Roots of Happiness

Unproductive beliefs— such as I’m not lovable, I’m not safe, or I’m worthless —are often the result of distorted conclusions drawn from life’s bitter experiences, especially as children, before we had developed the capacity to better understand and interpret them. These life limiting beliefs are the focus of our book, Code To Joy: The 4-Step Solution to Unlocking Your Natural State of Happiness.

Just as major traumatic events can have a deep and long-term impact on mood and mindset, the far more subtle—and more common—events that we call microtraumas can also have profound and lasting influence. Such microtraumas can result from such seemingly innocuous experiences as criticism, harsh words and hurtful labels, or the pressure of unreasonably high expectations, repeated over time. These life-limiting beliefs that result can cause an adult to react to life situations with an overwhelmingly negative filter—that fog of distress we mentioned earlier.

Forms of psychotherapy that address the underlying life limiting beliefs and provide tools and skills can produce a fundamental change in perspective, allowing a natural lifting of mood and the ability to enjoy life to the fullest.

That's not a happy pill—just access to our natural state of joy.