Next week I’m going to take part in a panel/project about whether antidepressants work for healthtalkonline. It could be a long discussion. The jury’s been out on this for a long time. It may be a question we can never answer.
Why? Because it’s very difficult to pinpoint the role that antidepressants play in any recovery. Or to say with conviction what would have happened if the sufferer had not taken the medication. There is no control experiment.
Take my own case. I started taking citalopram in October 2009 as the extent of my depressive breakdown became clear. Before I took it, I was unable to function and quite suicidal. As I’m still here to write about it, it must have done some good, right?
Well, yes… but. It was at least three months before I started to feel better. In fact I felt worse to begin with, and soon ended up taking a second anti-depressant, mirtazapine. At the same time, lots of other variables were changing: I took six months off work; I spent time quietly, doing very little; I learned how to meditate; I began to understand the meaning of “be gentle with yourself”. How do I know it was not one of these factors that spurred me to recovery, and not the pills?
Then there is my story of weaning myself off them. When I first dumped mirtazapine at the end of summer 2010, I relapsed. Quite quickly in fact. When I tapered citalopram a year later, there was a similar blip, though not as dramatic. Is that empirical evidence? Or an indication that I’d become used to the medication? Or just a sign that I don’t like September? Hard to say.
Data suggests two thirds of people will experience some relief after they taking antidepressants. I would count myself as one of those. But did the pills CAUSE the improvement? Of that I’m not so sure…
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Mark,
Firstly, may I congratulate you on your work to better understand depression, particularly the focus on male depression.
With regard to antidepressants, my experiences and conclusions are as follows.
I suffered severe depression in 1991 ( age 40), 1999 (49) and 2003 (52). I was prescribed antidepressants for the first two episodes (citalopram for the second, I can’t remember the first). Each time I recovered after taking them and was weaned off after about six months.
In the last episode, I was immediately prescribed Citalopram by my GP, but after the normal “kick-in” period, I was not recovering. I then paid privately to see a doctor attached to The Priory. He immediately prescribed Venlafaxine (high dosage) And recovery followed reasonably rapidly. The sting in the tail was that he said I should stay on Venlafaxine for life. It took me a little time to come to terms with this, but rationalised it by regarding it as the same as a Type 1 diabetic who has to take insulin for life.
It will soon be ten years since I started Venlafaxine and both my GP’s and the specialist’s advice is that if it ‘aint broke don’t fix it’ i.e don’t change the dosage. The last 9 years have been good and there is no doubt that I have far less ‘insecurities’ now than when I was in a non-depressive state.
Therefore in my case, I am 100% certain that antidepressants work and that my problem is an imbalance of chemicals.
In all of the episodes I had counselling and in the last one, CBT. I believe this treatment is essential in the period before the antidepressants kick in (way too long) In my case, I do not believe they worked in isolation.
I do worry about being on strong full time medication, however this disappears into insignificance compared with the fear of another bout of depression.
Of course depression is complex and there is no fix-all remedy. I think the best we can do is try and convince sufferers that it can be beaten, something which is so hard to believe when overwhelmed by this evil illness.
Good for you. You just improved your chaencs of beating depression by a hundred by gettingn off meds. Meds just alleviate symptoms like taking tylenol after getting your leg cut off. It won’t fix your leg. Try St Johns Wort and basically eating a good diet is so much better than a bad diet which causes a lot of anxiety and depression like corn syrup, sugar, and junk carbs. Get out and exercise too. I swear half of all depression is caused by poor diet and lack of exercise. Also, try volunteering or helping other people and hanging out with friends. Being sociable and doing social things helps out a lot bc it keeps your mind off your own problems and yourself. The problem with modern psychology is that it tries to fix you and focuses so much on you it turns you into a doped up narcissist. Fish also seems to be a good mood elevator as cultures that eat a lot of fish and omega 3 for some reason seem happier. Was this answer helpful?
Thanks David. Interesting to hear of your journey. I guess three years on I still tend to think “I’m over it now.” Am down to tiny citalopram dose now and wondering about ditching it altogether. Will keep you posted on that…
Hey.I’m a 100% non synthetically-medicated pstochyic kid. Diagnosed schizophrenic and have very serious positive symptoms and equally horrible negative symptoms. Here is what I do to keep on top of the depression that is one of my negative symptoms.1) Omega 3 Fish Oil. You may have to buy a brand manufactured for kids because adult brands don’t tend to be filtered for mercury and you DEFINITELY want a mercury-free product. 2) Multi-vitamins. Take something with a very high iron, vitamin D and magnesium.3) Exercise. If you’re overweight, a healthier bodyweight will help you out. If you’re not, exercise will still release endorphins. Personally when I’m at my worst I do yoga from flashcards, (this is when I cannot leave the house) boxing, and jumping jacks while a music channel (usually rock but I figure anything with a good beat that you like listening to when you’re happy will work) is on. I also go running, when I’m not as bad, usually in a forest on warm days or at a beach on cold days, somewhere where I’ll be alone with nature and my ipod. 4) Music. I mentioned the music channel & ipod above, but I also blare Queen, Bowling for Soup, Blink-182 and the All-American Rejects (aka nobody who sings about death, depression, suicide, sadness, or has a downbeat – less than 4/4 – track) and I HATE IT. It makes me MAD and MAD is better than depressed. It is more productive. ;]5) I force myself to do things I enjoy when I’m happy. I take a shower with the nice smelling soap and warm my towels on the radiator, I watch the funny episodes of Firefly and my favourite films and read magazines and This Book Will Save Your Life (A.M Homes – it’s my favourite book). And if that sucks, I do the laundry and hoover. For me what works is just keeping moving. Then even if my whole day sucks and I can’t bear it, the next day I can wake up to something good I’ve done and maybe feel better for it – or I have fond memories of my favourite movie etc.6) My favourite one – I read a book I’ve written. It’s a big old book that I bought ages ago and when I’m happy, I write things I like in the book. Stupid stuff like, Xander from Buffy, and the sound from line arrays, and Diamond 4′s, and sherbert lemons, and Harry Potter 1, and Gandhi quotes, things that have no consequence. If I’m only mildly down, it can get me back up.7) Meditation. Just sit quietly and concentrate on not concentrating on anything. If that makes sense. Don’t allow yourself to have thoughts. Let your only thought be the thought that stops you thinking about anything. It sounds complex but you probably get my meaning. I like to meditate either in the dark in my room but the sunlight is good for depression so I force myself to sit in the middle of the living room with all the shades open in the sunlight. Therapy. Not from a councillor – from a psychologist, in particular a psychologist who is a qualified Cognitive Behavioural Therapist – these people are like GOLDDUST. They will teach you how to get through your worst moments and help you tailor your recovery techniques to your own personality. Plus, they’re also usually really cool not-up-themselves people. Interview a few different psych’s if you can, and if they’re in an office and wearing a suit, don’t bother. Find someone who wears jeans and listens to the music you like and likes the TV shows you like, so you geniunely like their company and that way, you’ll get a lot more out of your time with them – it’ll be more friendly and less clinical. And that in itself will lift your mood.Please bear in mind that the most important thing to have to get over depression without meds is psychological resilience. You need to be the type of depressed person who says, this sucks, but I WILL GET THROUGH THIS. I WILL NOT GIVE UP.. I WILL FORCE MYSELF THROUGH THIS. If you’re prone to giving up (I am not saying this is something to be ashamed of, it’s just something to be honest about – I understand fully that being a can’t-be-f*cking-bothered/don’t-want-to-can’t-make-me depressive is horrific and not something the depressive can help) you may have to come to terms with the fact that you may need a low dosage of meds (Citalopram is good in low doses) to get you through, and you may have to rely more heavily on therapy. Either way, get a CBT and remember you are not alone, and you should never give up on yourself.’When all you’ve got to keep is strong, move along. And even when your hope is gone, move along.’Good luck. Was this answer helpful?
there are alot of things you can do daily to help fight off drivesspee moods. it really depends alot on your personality and why your feeling depressed though. if your mourning something painful in your life, eating healthy and excercising isnt going to make u feel happy. if your depressed because of genetics, and a chemical imbalance in your brain, then therapy/ friends wont help much either, and u might haveto look into medication. but some general tips i picked up were; find something you truly enjoy and do it regularly. if you do not have something, it is well worth the time you invest to explore. acting opposite is another helpful tool. if you are angry then listen to calming music, if you are sad watch funny videos on youtube. this one might seem annoying at first, but it does help de-intensify ur emotions. another thing to do is give back. a big helper with depression is to invest your time doing something charitable/ worthwhile. whether its volunteering, spending time with a sibling, planting trees, whatever. it can be very pleasing to feel that you are doing something good for others/ earth, and is verry effective in focusing ur thoughts elsewhere. hope this helped somewhat. Was this answer helpful?
Mark
You met Bryan, my partner when we came to the UK in 2008. Within 18 months of that visit Bryan was prescribed mirtazapine starting dose 15mg taken at night and then increased to 30mg 14 days later. He improved markedly on 15mg and promptly went to sleep all day and became totally non functional on 30mg. Six months later the Doctor (?) added venlafaxine to the mix and again small starting dose and then increased it. He went from 37.5mg in September 2010 to 150mg by the end of January 2011. On 31 January he had some kind of heart attack and his diagnosis was changed from chronic long term depression to dementia.
It was another 4 months before we discovered that both heart attacks and dementia are among a VERY long list of adverse reactions to venlafaxine.
Since then he has been prescribed just about every anti-psychotic available and reacted to them all.
He has been prescribed parkinsons medications and became even more parkinsonised than he was on the anti-depressants.
He is now on an Alzheimers medication which he is reacting to.
I pass this on to you not to frighten you but to encourage you to check the full list of adverse reactions/cause and effect of the pharmacological treatments that doctors swear will help.
You could also check a website that has heaps of information about the industry called mental health – http://www.cchr.org. It makes for interesting reading. Also investigate the knowledge of a Dr David Healy who is in Wales.
If fascinates me that doctors and drug companies continually prescribe for a deficiency in brain chemicals that can’t be measured. Testing for low serotonin or dopamine is impossible, unlike testing for low trace elements or iron or insulin. Deficiencies in trace elements, a lot of the vitamins and heaps of other things in the body do cause depression, amongst other things. Have you ever had your magnesium or potassium checked? How’s your iron?
Do yourself a favour and get those checks done – it COULD save you a lot of grief. My suggestions are based entirely on my experiences with Bryan and some of my own.
Love
Sally