March 30, 2017

Solutions for Depression

I had hoped that I would not have depression again, but after radiation for prostate cancer, depression comes and goes. This article keeps reminding me of my depression and why I dislike some doctors. Exercise, magnets, therapy, antidepressants, diets, herbs, music, and several other activities have all been tried and have shown success in the treatment of depression.

A recent study published in JAMA Internal Medicine reveals that that one out of every six people in the US has taken psychiatric drugs, and the great preponderance of those prescriptions are for antidepressants or anti-anxiety pills. The study found a significant increase in the use of antidepressants since 2009, when we wrote a blog post revealing that one in 10 people had taken antidepressants, a fact that we found alarming at that time. Now that statistic has risen to one out of every 8.5 individuals, with another one out of every 12 on sister drugs for anxiety. The majority of such prescriptions (85%) were refilled at least three times in the study year, meaning that these depressive crises and anxious states are not short-lived, one-shot deals.

As extraordinary as these numbers appear, they probably underestimate the actual numbers of people on antidepressant and anti-anxiety drugs, since the data relies on self-reporting from the 37,421 respondents, and you can bet that many were reluctant to reveal that they took such medications. It’s also interesting to note that the one in six figure represents an average for all subgroups, with twice as many women as men taking such drugs, and twice as many whites as other races. Among those over the age of 65, nearly one in every four people is on an antidepressant or anti-anxiety medication.

Exercise works just as well or even better than pharmaceuticals for alleviating depression and anxiety. So why on earth don’t doctors just prescribe exercise instead of prescribing the pills with dangerous side effects? Maybe it’s not just because they’re lazy or indoctrinated, but because they don’t want to encourage noncompliance. The sad truth is that when depression is severe, patients often can’t muster the energy to start exercising, or to take a class, or to even call a friend. One of the symptoms of depression can be a kind of catatonia where doing anything that requires energy feels overwhelming. Depression famously takes to bed and wants to stay there.

Depression is famous for seeking short-term comfort, and for many depressed people, the thought of avoiding chocolate, wine, coffee, cupcakes and so on is just too much to bear.

In other words, depression and anxiety crave short-term, no-sweat solutions and pharmaceuticals seem to suit the bill. Patients are willing to deal with side effects and with health risks in hope of finding some fast relief. And while the efficacy of antidepressant pills may be dismal for many patients, some do find they get a significant mood lift from them. Likewise, anti-anxiety medications often work fast, fueling continuing demand for them. Theoretically, prescription drugs might work as a short-term bridge until the patient is stabilized enough to switch to something that actually enhances health (like exercise), instead of continuing on medications that could potentially destroy it. (The problem, of course, is that the switch over doesn’t happen. Rather, the doctor writes out another prescription refill, leaving the patient to continue the same old unhealthy routines.)

I have been fortunate to avoid antidepressants and my depression does not last for long periods of time. I have only had one doctor try to prescribe an antidepressant and when I refused, he insisted. I told him that I would not fill the prescription as I had other ways to help my depression and prevent myself from developing severe depression. I did tell him that if that did happen, I would let him know and consider taking an antidepressant.

2 comments:

Denise @ Do you have that in my size??? said...

I don't think we can leave out the possibility that doctors are receiving some kind of incentive from pharmaceutical companies for prescribing their medications, unfortunately. And I am sorry to hear that you're battling depression on top of everything else you're working through right now - as someone who has dealt with major depressive episodes at least once a year for most of my adult life, I know it's not easy.

Bob Fenton said...

Yes, some doctors do receive incentives, but I have doubts about the numbers.