Do you feel sad, blue, negative, worried, and unable to let go of thoughts that upset you? Do you have trouble sleeping, struggle with a low libido, and have you lost the zest and joy in your life?
These are all common symptoms of depression, and when you tell your family physician, internist or gynecologist about them, he or she often reaches for the prescription pad in hopes of giving you a quick fix. They only have a few minutes for you on their busy schedules, and antidepressant and anti-anxiety medications have been billed as offering fast, easy relief. But before you accept the prescription, you might want to give it a second, third, and even fourth thought and consider another way.
Let me be clear: I am not opposed to medication for anxiety and depression. I have been a psychiatrist for over 30 years and have helped many people overcome life-threatening mood disorders with these medications. But, unfortunately, I’ve also made people worse, especially before I started looking at the brain when I was metaphorically throwing medicated-tipped darts in the dark at my patients. Medications can be very effective when targeted properly after a thorough workup, but they can also be a disaster when not used appropriately.
While I am not opposed to medication for anxiety and depression, I am deeply opposed to the indiscriminate use of these medications and the way many physicians and other health-care professionals prescribe them, without a comprehensive workup and without clearly telling patients about the potential side effects, poor long-term outcome studies, and alternative treatment options.
The rampant use of these medications is hurting our society. It has been estimated that the use of antidepressants have gone up 400% in the last two decades and that nearly a quarter of all females (23%) between the ages of 40-59 are taking them.[i]
The overall effectiveness of antidepressants has come into serious question over the last decade with large-scale studies showing that when all depressed patients are started on the most popular antidepressants, selective serotonin reuptake inhibitors (SSRIs) such as Zoloft, Celexa, Lexapro or Prozac, they are no more effective than placebo (sugar pills), except for the most severely depressed patients. Dr. Thomas Insel, the Director of the National Institutes of Mental Health wrote in 2009, “The unfortunate reality is that current medications help too few people to get better and very few people to get well.”[ii]
Few physicians ever tell their patients that taking psychiatric medications can negatively affect their insurability and their ability to get health, life, long-term care or disability insurance. Insurance companies tend to view “psychiatric” patients as having more risk and often charge higher premiums or deny coverage. I have seen this happen repeatedly for patients I have treated over the years.
These medications are also not without their own side effects, especially in the area of sexual dysfunction, weight gain and relapse. Patients who start with antidepressant or anti-anxiety medications tend to have higher relapse rates than those who never start, or they use alternative forms of therapy such as exercise or talk therapy.