I was on antidepressants for a year...various drugs as after a while I ended up reacting to each one of them. The last one I was on (and the one I was on the longest) was Cymbalta.

Let me state this first - I do feel that my meds helped me through a very difficult time. I had so much to cope with that I needed a form of emotional insulation (is the closest I can describe it) to get me through the worst of it.

However, coming off the medication was a nightmare. I've been off everything for about six weeks now and I still have lingering side-effects. The first two or three weeks were the worst though. For about half that time I was unable to work and I felt so sick I wanted to die. In fact, I had to battle thoughts of suicide. Since then I've discovered that thousands of others suffered through the same hell when coming off Cymbalta. I wish I'd known this before taking the medication.

I won't trash antidepressants because I think they have their place but that is just it...they have a place, they are not the complete answer. From now on I will certainly be much more selective and careful about what I use to manage my depression.

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It does suck that so many psychiatrists are no longer providing talk therapy (they're not even getting trained in it, much of the time). What also sucks is that, where I live, the majority of psychologists seem to be foaming-at-mouth CBT zealots, who are convinced they have THE way; the ONLY way.

Medication helps some; therapy helps others; a combination of those probably helps more. I'm so fed up, though, with people who have no experience with major depressive disorder, and so on, insisting that medications are *always* unnecessary, when they wouldn't have a clue. What's that saying - 'everyone's an expert'?

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Feeling blue is a necessary part of the human condition. Without downers, we would never appreciate the highs of life. The problem comes when downers are persistent, lasting weeks, months, even years.

Sometimes medications work. For other depressed people, talk therapy and group support meetings are the answer. But this I know from personal experience and a family tree infected with bipolar disorder. Depression is an insidious disease that can linger beneath the surface of healthy personalities.

You might call depression a "cancer of the mind." When the symptoms becomes apparent, the malady must be treated as soon as possible. The trick is finding out what works.

Fortunately in my family, a combination of medication, talk therapy and old-fashioned love has produced the happiness human beings seek.

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It's bipolar, schizophrenia, attention deficit, borderline personality. All of these are conditions - some probably nothing more than diagnoses for people who don't fit in or irritate those in power - that are routinely treated with drugs.

The current paradigm in medicine says that these conditions are the result of genetics, physical differences in the brain, and/or chemical imbalances. The reality is that not one of these so-called causes has any basis in fact. They are all constructs invented by pharmaceutical corporations, and then accepted by an all-too-willing bunch of doctors, so that drugs to "fix" them can be sold. It's pure corruption of the worst sort - preying on people in need.

A previous writer says that s/he needed drugs to get through a difficult time. However, the description of what they did - provide a "form of emotional insulation" - should horrify us. It's a form of drug-induced lobotomy, a separation of personality and self-awareness from one's self. This isn't a fix - it's merely putting off dealing with the problems of life.

These drugs are used routinely in nursing homes to keep residents placid, so they're easier to maintain - as if they were stock on shelves, not human beings. They are being used in children for questionable diagnoses, ones used to define children who are difficult, in spite of the fact that they cause brain damage - not just some of the time, but nearly all of the time.

Consider the so-called side-effects. They're horrific, and rather than being rare, they're typical. Movement disorders. Rapidly-developing obesity. Diabetes. Heart disease. Even the conditions that they're supposed to treat are caused by them. Then, consider the fact that what they're supposed to do is, in itself, destructive. The definition of effectiveness is apathy and the destruction of self-awareness.

Peter Breggin is a psychiatrist who has refused to go along with the current psychiatric drugging paradigm. If you question anything I've written, take a look at his books, which are full of references to studies that document what he says.

The truth is that the psychiatric profession has become little more than a shill for the pharmaceutical industry. People can draw their own conclusions about why this is.

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I have been on antidepressants for over half of my life, and am prepared to remain on them forever if need be. They allow me to function normally. I have heard many, many people refer to psychiatric medications as a "crutch," as though taking medicine in order to function is somehow cheating in life.

Antidepressants certainly don't work for everyone, nor are they a panacea (I still have "blue moods" occasionally), but at least now, I don't feel like death is preferable to life.

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The article ignores three realities in therapy and the use of medication.

First, the real culprit is for-profit health insurance companies - especially HMO's - whose entire business model is based on not providing treatment. Absent hospitalization, it is nearly impossible for patients with depression and related issues to obtain sufficient treatment through talk-therapy.

Second, far too many GP's prescribe anti-depressants for patients rather than referring out to a psychiatrist who is in a much better position to judge what treatment a specific patient requires. GP prescription rates distort the studies such as the ones quoted in the article. In fact, the vast majority of psychiatrists practice their craft ethically and professionally, and typically use a combination of talk therapy and - when required - medication.

Third, for some patients medications are not necessary or effective; for others, they are life saving. Despite advances in medicine's understanding of how the brain works, prescribing meds for depression is as much an art as it is science.

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I've never been to a psychiatrist who hasn't recommended a psychologist.

I did go off of my meds for major depression after I was in therapy for eight years. I figured I was cured. I followed the medication guidelines of cutting back slowly and was monitored by my psychiatrist.

I had a nervous breakdown and was suicidal for two years.

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And only 10 % of cases need the intervention of psychotropic or balancing drugs to help the person. Depression is just part of the human condition as much as is love, hate, passion. All of us naturally feel depressed when something doesn't go our way, or when we make a big mistake, or somebody in our life, dies. To chemically anaesthatise somebody is doing them a disservice.

The best approach is to talk it through with somebody you trust, and in the case of life's problems like debt, getting fired etc., to draw up a plan to solve the problem by stages (so not to overwhelm yourself and slip back into depression).

As for the 10 %, yes there are people who are a danger to themselves and to others. Drugs play a role in stabilising them as part of a treatment programme. And some people will have to be on these drugs for their entire life.

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All of the comments so far are helpful, mature and thoughtful. Clearly, depression is complex, with no one definition or treatment.

I have read somewhere that nearly half of patients treated with a wide variety of medication "families" do not respond to any of them. Is this true? Does anyone have any data?

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The word depression in our culture is now a word that is used to even describe one day of feeling really awful about something...we have pathologized sadness, grief, great disappointment, etc.---all NORMAL reactions to life circumstances and most surely when we try and stay awake to the realiites of a global community in much transition...
The word itself, like the word cancer, has taken on a hex quotient---it pulls one down or disempowers onr just to attribute it to oneself, so be careful about easy useage of that word.
Also, THERE ARE NUMEROUS other causes behind the symptoms that often get described as depression, such as low magnesium, low serotonin, low B12, life force stagnation, dehydration, brain damage from so many different chemicals present in the food and liquids that are NOT food, traumatic brain injury, side effects to medications being taken for other reasons besides depression, sleep deprivation, adrenal fatigue or burnout, thyroid depletion, poor nutrient absorption from low hydrochloric acid in stomach or inadequate enzyme production, etc., etc. Several of these health challenges are rampant in our culture and around the world at the present time, and receive almost no coverage where most people could easily see it.
This article did a great disservice to the subject of depression through omitting ALL these other factors...wake up folks. You may have much more power in your situation than you realize...and yes, the antidepressants DO actually change the brain so that it's extremely difficult to get back off the meds. The best option is to NOT get on them in the first place. And you can't EVER go off them cold turkey without some very, very heavy prices!!!

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try this stuff called EFT, emofree.com ... really amazing stuff to change the brain without paying anyone!!! DO IT YOURSELF!!

try searching for how to videos on youtube, search EFT, BRAD YATES, TAPP OF THE MORNING or GOALS ...


much much better than talk therapy OR big pharma ...

tapp on acupressure points and reset your system ...

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1) Not enough mental health providers in the system.

Talk therapy requires having providers available to do it - MORE providers than we currently have available to prescribe medication, given that it's a more "time-intensive" activity.

As it is, though, it doesn't seem to me that we have enough providers. Certainly we don't in my neck of the woods, given that as a general internist who frequently refers people for psychiatric care, I'm finding that even in severe cases it takes months for my patients to get appointments. In that context, proposing to shift the paradigm to MORE talk therapy and less drug prescription, however medically appropriate that may be, without addressing the shortage of providers, strikes me as an incomplete argument.

2) Too many depressed people.

Considering how "well-off" Western societies are, why do we have so many depressed people? I've heard lots of explanations - social / financial pressures on the poorer segments of society, excessive work stress and a lack of meaningful relationships and "life experiences" for the richer folks - and there may something to them. But the point is, perhaps we should address those underlying socio-economic-cultural causes in an effort to reduce the prevalence of depression in our society, rather than having to send so many people for any type of psychiatric care in the first place.

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Thanks Dr.Levine;

US workers are often suffer from tyranical bosses, erosion of benefits, job loss itself or chronic fear of job loss.

So they overutilize antidepressants in my opinion.

I was interviewd by Dr. Jay Cohen of Medication Sense.Com in 2004 on this topic. See my interview on this subset of the broader topic of antidepressant overuse/overprescribing.

Thanks for your interest,

Dr.Rick Lippin
Southampton,Pa
ralippin@aol.com

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is just that - talk. Fighting a disease with talking is pure shamanism and that`s where psychoanalysts rightfully belong. Of course Pfizer and others are making a buck with therapeutical medication, why not? Business does not have a very high moral treshold - so they market the same drug compound even to children.
Psychiatrists are whores and they get kickbacks from the pharmaindustry. As an informed consumer - separate bull and hype.

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Clinical Depresion is real. I have been diagnosed with Major Depressive Disorder and, like many with mental health issues, I figured I did not need my medication any longer so I weand myself off it. I ended up bottoming out and spending a few weeks not able to get out of bed. I have now resolved that I need the anti-depressants probably for the rest of my life!

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You take the soma and we get rich off it.

Please, refuse the soma and stop trying to artificially improve your life and actually try to improve your life.

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Please take my remarks below under the context or bias of my past training and experience which is as a clinical social worker and relationship coach:

I think the author raises a worthy point. And the comments so far on the article are, on the whole, thoughtful and pertinent to the issue.

I think patients 'collude', if you will, with the system too. It is often easier (and, is that so bad?) to take a pill for one's problem rather than face it head on.

Some argue it is bad when people are taking pills instead of 'working out' a problem. It may be true - do we become better people when we 'tough out' our problems? I think sometimes it's true - afterall aren't the pills sometimes just another distraction?

Then again - it's perhaps also true that, when a person has an emotional disorder - there needs to be enough patience and time to help them really 'deal' and many times therapists are overwhelmed and too busy to deal themselves. We underpay therapists (social workers, counselors, psychologists) terribly in our society. We don't give them nearly the training, money and support we give medical docs such as psychiatrists. And then we wonder why the really great ones leave the field.

There is a bias in the world still that psychiatrists just automatically make better therapists than non-psychiatrists. That's false - there are some very good non-psychiatrist therapists out there. People need to understand that. Many times the type of person who is drawn to psychiatry as a career is not the best communicator/people person anyway. Many psychiatrists are good medical technicians and may find their talents better used working from the drug angle anyway.

Again - what the article doesn't address is that there are TONS of non-psychiatric therapists out there practicing, so, perhaps that is another reason why psychiatrists are now working more on the BIOLOGICAL aspects of mental illness. This is a REAL intervention point and one that needs to be considered in virtually every client's case. Afterall, if there is a treatment alternative available and the client isn't aware of it, is that fair either???

I don't think psychopharm is all bad - surely in most systems there is corruption. As a therapist, I work to help the client who has free will, if at all possible, to decide the fate of his/her treatment. Sometimes tho, a therapist or doc has to take more aggressive action - when he/she thinks a persons life is in danger. And, often, drugs are a part of 'getting control of' a crisis situation.

So, to end at this point - I don't think the answer is to damn all drugs at all times. This is not to say I am naive and don't think there is some 'chemical lobotization' going on that may be of lower quality than what is ideal. There is - but, I don't know the solution to that problem.

I think we have to place MUCH MORE value on alternatives to drugs if we hope to improve the situation. Relationships DO take work - including the one between clients and their therapists. So people have a choice...at least if they are educated that they do - and that is a sine que non of treatment - that we do our best to get 'informed consent'. Perhaps it all goes back to empowering the consumer. As long as the financial decision-making for who pays for care is left in the hands of the insurance companies the consumer is less powerful. Now, if a consumer had the utmost control of his/her healthcare dollars perhaps we'd get that additional support for therapy....Again there are many obstacles to this ideal - including the fact many clients don't want to take charge anyway....they want to be taken care of!

Again - great article and discussion!

Barb Elgin, MSW, LCSW
http://www.coachsappho.com

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and the talkies have their businessmodel. Subtle dependencies make this very profitable for your rent-a-friend. Seriously folks nobody, and there are studies that show this, has ever healed from depression through talking. It`s all anectodal my friends...
Getting the right prescription eases you through those couple of years of depression and talking at some point might help or agravate the situtation - it is really 50/50. But believing that talking to a biological process gone wrong is helping is really a bit much!

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When people talk about depression, it's usually seen as an individual thing. That one person has emotional problems - and they should get help.

However, I view the large number of depressed people as systemic. We've made our society chalk-full of stress, denial of human desires, and not built for human comfort and desire. Every day many people repress emotions and what we want to do in order to keep that job.

The result of that stress is pretty naturally depression. It's about time we started remolding our society and economics so that the goal is human happiness rather than a higher GDP.

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I've been using a psychological technique, other than psycho-therapy, developed by Ilan Shalif over ten years, and have had very good results - can anyone point me at good papers checking the efficacy of his technique in general - i.e. whether I'm a false positive ;) or if it is really generally effective? Alternatively, which (academic) search engines might be most relevant? Links to papers or their abstracts would really be appreciated.

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Talk therapy is overrated. It is nothing more than a short period of questions & answers that can help, but rarely cure a major psychiatric problem.

While drugs are over prescribed, due to the push from drug companies to very receptive doctors, they can be very helpful in the right situations. Too often, doctors prescribe the drug of the month for temporary problems and without proper follow up and at too high a dose. Too often the patients don't understand what the drug is supposed to do and expect from it. Patients have side effects and these are not handled.

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Depression may be repressed anger or the reaction to deep unahppiness, but it's also the result of a chemical imbalance in the brain. I've suffered from recurrent bouts of depression for most of my life but have now been on anti-dpressants for quite a few years, and they make a world of difference. Crutch? Maybe, but why not?

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yes, there are alternatives to drugs to helping the client benefit from talk therapy - you can encourage client to exercise, for example. this is of course dependent on the person's physical condition and their medical doc's recommendation/opinion that exercise is not, as they say, 'contra-indicated'. many times it's not a question of exercise, it's a question of what sort of exercise. obviously, moving is necessary to sustain life!

however, in reality, it has been my experience (both working as a clinician and working on the side of the insurance co overseeing care), it is not often realistic to expect a person to address their 'lack of motivation' for therapy that way. sometimes it works, for others, sometimes drugs does a better job.

as far as dietary alternatives - there is still in my opinion not enough research and evidence to support any one dietary regimen for 'treating depression'. now, of course, i suggest to my clients that they 'eat a nutritious diet' and 'get at least 7 hours of sleep' a night and we often tracked it. but often improvement doesn't come soon enough for people's desires.

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again - i think there needs to be a respect for the medical understandings the medical field is beginning to make about mental illness. obviously the solution is not to trash all meds (and see a 'conspiracy' in the pharmaceutical industry), but to continue to weed out the negative aspects that plague the pharm field as best we can and continue to support the research going on that hopefully one day will be able to pinpoint and treat 'diseases of the brain'. you do accept the possibility that there may be diseases of the brain, right? now it may be that 1,000 years from now when we've transcended the paradigm of 'disease' and gotten more intelligent about helping the body heal itself, that we won't need pharmaceuticals....that will be a great day indeed!

Barb Elgin, MSW, LCSW
http://www.coachsappho.com

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I agree that talk therapy can be very helpful, but trying to find a therapist that can actually say things that help you is tough. I had one once who would say almost nothing the entire hour - I told him my best friend was more helpful than him and quit.

**The best therapists help you get a more objective perspective on your situation and help you root out destructive thought patterns.**

I had a wonderful therapist many years ago named Kevin Austin who helped my recover from my mother's suicide. He really helped me change the way I think, and that is helpful even now so many years later.

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The NEJOM published a piece a while back about the lack of coordination of care between physicians as a leading cause of mistreatment in the U.S. system (then cited the private insurance bullshit we all suffer under as the no. 2 problem).

So when I see a piece by a psychotherapist about the problem with Psychiatrists doing medication management, my suspicions go up and I'm looking for conflicts of interest right off. Bruce Levine is infamous and on the record about his anti-drug mindset.

That said, he's right about the money angle and the problem with that, and he's right about the distancing psychiatrists are making from "talk therapy" even though that's officially still supposed to be what they do. But what's missing in Bruce's analysis is the real damage that is done when psychotherapists don't communicate with psychiatrists and vice versa. They place that burden on the patient but the patient, being clinically depressed, isn't often able to do that sort of self-coordination of care.

Jim Phelps also talks about this and he talks about alternative therapy combinations and evidence based therapies. As someone with a family who got too much of a genetic good thing (depression and mania are actually adaptive genes that, when extant in smaller quantities, are really vital things and that's why there is so much in the population today, ecological crisis=species adaptation...but it's so much easier for the non-adaptive humans to label the adaptives as mentally ill *sigh*) the real problem is not merely medical management, private insurance malfeasance or even lack of coordinated care by physicians, it's the abject lack of evidence based care period.

You cannot hope to treat depression with CBT, drugs, or both if you do not track the evidence of their affects, and you certainly cannot do so without the inclusion of the biological alternative treatments such as light/dark therapy, etc.. I bet a beer that the average psychotherapist and the average psychiatrist alike does NOT know how to teach a patient to create data that can be used to refine therapeutic paths to balanced mental health. Now THAT's a problem.

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You know, when we the sheeple can go out of our ways to get rid of "gun control", we sure as hell can do the same for Cannabis and let it compete with all those petroleum manufactured Big Phrma bullshit for a change.

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just above this article is another one called "The Delusion Revolution- We're on the Road to Extinction and in Denial." How utterly ironic. If we're all gonna die, who cares if we use drugs to fight depression?

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Is that it doesn't cure anything. All medication does is manage, suppress and control. It can't get to the true cause of the issue; which is necessary for true healing.

Symptoms are an indication that something isn't right. Deal with the cause, and the symptoms begin to disappear.

If we suppress an issue for too long, it begins to devour us. We have to dig deep within ourselves and find the true root of the cause. Then, and only then, can we begin to truly heal.

I've been studying/practicing something called the LifeLine Technique for about fiv