Anti depressants

Knitwitch

I know that other people on this board have been through depression so I thought this article might be of interest.

Personally, I found Prozac put me to sleep for 16 hours a day and my psychiatrist immediately stopped some of the a/ds my GP had prescribed as soon as he saw me, saying "These don't work and could be harmful for your case".


http://news.bbc.co.uk/1/hi/health/7263494.stm


Anti-depressants 'of little use'

Woman taking pill (Photo: SPL/file)
Anti-depressant prescription rates have soared

Study author
New generation anti-depressants have little clinical benefit for most patients, research suggests.

A University of Hull team concluded the drugs actively help only a small group of the most severely depressed.

Marjorie Wallace, head of the mental health charity Sane, said that if these results were confirmed they could be "very disturbing".

But the makers of Prozac and Seroxat, two of the commonest anti-depressants, said they disagreed with the findings.

A spokesman for GlaxoSmithKline, which makes Seroxat, said the study only looked at a "small subset of the total data available".

harlan

I think finding the 'right' drug to help with an individual's brain chemistry is definitely trial and error. I've known people who struggled with lifelong depression that finally found the 'right' one for them. Blessed relief...'it was like a light turned on.' Others, no difference...or worse...withdrawel. I know one man who became quite paranoid and violent AFTER deciding to stop taking the drug (against medical advice, he decided to simply stop taking the pill...vs. a slow quitting).

Of course, everyone knows at this point that the approval, regulation and PROMOTION of drugs is definitely a 'flawed' process. But like my grandma said...'don't throw the baby out with the bath water.'

Knitwitch

I think this has been mooted as part of the problem Harlan, certainly was on BBC Radio 4 this morniing - GPs chuck the same antidepressants at all patients, expecting the same results, but as you so rightly point out, each patient is different and can have adverse reactions.

I got the jitters on one antidepressant and one anti anxiety pill worked so well on me that I ended up staring into space for hours on end before coming out with a load of drivel (well even more drivel-ish than usual°. Old Feller said it was the most peaceful, if spooky, the house has been in years.

Simonthepilgrim

We laugh at the ancient practice of blood-letting and are horrified that some people were bled to death - all based on the then-accepted medical science of the humours. But few writers point out that more people got better from the practice than died. If it had been otherwise, I doubt we would still have been doing it so long.

The problem was that it was used in all cases.

Back in the '60s, The Scaffold sang about "Lily the Pink" who invented "Medicinal Compound, most efficacious in every case". It was a comic song.

There is no single panacea for depression, be it chemical or one specified talking therapy.

And this is because we have to start admitting that we are still very much in the dark about not only the diagnosis but even the aetiology of depression.

"Tell me where is fancy bred.
Or in the heart or in the head?
How begot, how nourished...?"
(That Warwickshire bloke)

jacx

Interesting new article from the BBC, some psychiatrists are saying that depression has an adaptive function for humans, and in its mild and moderate forms might even be good for people.

http://news.bbc.co.uk/2/hi/uk_news/magazine/7268496.stm

Knitwitch

Hmm - not entirely sure I agree with the article Jacx but the comments were quite good.

There IS a heightened creativity associated with manic depression but the price to pay is very high as suicidal tendencies are equally heightened.

I have suffered from severe depression in my down phases of Bipolarity and I have to say that I don't see how they can be positive at all - when a person is reduced to non-functional in any department, it can't be good for them

jacx

Hello, Knitwitch.

I thought the article was quite interesting, but that it didn't emphasise enough that they were only talking about mild-to-moderate clinical depression. I'd be quite upset if a psychiatrist/ therapist suggested that bipolar disorder or psychotic depression could be 'good for you.'

Knitwitch

jacx wrote: »

I'd be quite upset if a psychiatrist/ therapist suggested that bipolar disorder or psychotic depression could be 'good for you.'

No darling, at that point you would run from the room screaming because the berk obviously didn't know what they were talking about.

waking

Knitwich:

I think the question of where dukkha ends and where psychological distress/illness begins is a very deep one. On the one hand, following the path may not even be possible for someone who is profoundly depressed or with severe anxiety. In these cases in particular, medication can make meditation possible. On the other hand, antidepressants are currently being widely used for a lot of problems of living and existential concerns that would probably be better addressed by psychotherapy and/or spiritual approaches.

Note that the recent study you're referring to found that antidepressants are helpful in more severe depression, just not in mild to moderate problems. And studies only talk about averages, which means that some people may improve with antidepressants whereas others may not.

I think that these issues need to be addressed on a trial-and-error, case-by-case basis, figuring out what works best for any given person at any given time. The danger in this and all cases is falling into absolute, categorical statements. As Seung Sahn always said, "only don't know."

Thanks for raising this important question.

Ben

Simonthepilgrim

waking wrote: »

Knitwich:

I think the question of where dukkha ends and where psychological distress/illness begins is a very deep one. On the one hand, following the path may not even be possible for someone who is profoundly depressed or with severe anxiety. In these cases in particular, medication can make meditation possible. On the other hand, antidepressants are currently being widely used for a lot of problems of living and existential concerns that would probably be better addressed by psychotherapy and/or spiritual approaches.

Note that the recent study you're referring to found that antidepressants are helpful in more severe depression, just not in mild to moderate problems. And studies only talk about averages, which means that some people may improve with antidepressants whereas others may not.

I think that these issues need to be addressed on a trial-and-error, case-by-case basis, figuring out what works best for any given person at any given time. The danger in this and all cases is falling into absolute, categorical statements. As Seung Sahn always said, "only don't know."

Thanks for raising this important question.

Ben

As one who has lived with the Black Dog at least forty five years, my first experience of anti-depressants was in 1969 when Librium turned me from a trembling, sobbing wreck into a shambling, muttering wreck - an improvement only insofar as it was quieter for my colleagues and pupils! Since then, different medications have had different and sometimes life-saving effects.

I am not sure quite what you mean by "where dukkha ends and where psychological distress/illness begins". It seems to me that psycho-emotional distress and psychiatric illness are part of the general dukkha that is our inheritance in samsara. It is all dukkha.

Agreed, we have to be very careful about how and when we introduce the idea and practice of meditation. We know, for example, that "Type A" personality responds adversely in a first instance. This fact underlines once again the importance of a teacher or guide who can help us in our own particular circumstances to choose the right horse for our course.

Knitwitch

waking wrote: »

Knitwich:

I think the question of where dukkha ends and where psychological distress/illness begins is a very deep one. On the one hand, following the path may not even be possible for someone who is profoundly depressed or with severe anxiety. In these cases in particular, medication can make meditation possible. On the other hand, antidepressants are currently being widely used for a lot of problems of living and existential concerns that would probably be better addressed by psychotherapy and/or spiritual approaches.

Note that the recent study you're referring to found that antidepressants are helpful in more severe depression, just not in mild to moderate problems. And studies only talk about averages, which means that some people may improve with antidepressants whereas others may not.

I think that these issues need to be addressed on a trial-and-error, case-by-case basis, figuring out what works best for any given person at any given time. The danger in this and all cases is falling into absolute, categorical statements. As Seung Sahn always said, "only don't know."

Thanks for raising this important question.

Ben

And thank you, Ben, for reprimanding me - I will think further in the future before making generalisations or misrepresenting surveys.

Please do share your experience of depression or mental illness with us.

waking

Hi, Knitwich,
I promise I wasn't trying to reprimand you, I just found your thread very interesting and it got me thinking. I think that the "medication versus meditation" issue gets at very basic questions of how we understand suffering; how much is universal issues that all humans share (i.e. dukkha) and how much is specific to our own biochemistries, temperments, and life circumstances. In my own life, I often find myself falling into that either/or sort of thinking; am I unhappy right now because of this problem in my life, because of my own specific patterns of coping, or is there something more universal going on (e.g. greed, hate, delusion). I think for me at least, the answer is usually that this is a false dichotomy, and that we often need to deal with all of these levels at once.

Ben

Knitwitch

Please don't apologise Ben, we are all here to help each other and if someone makes a mistake, no offence is taken if another member puts them right.

Not being a card-carrying Buddhist, or very clever, I tend to feel that all suffering is suffering. Whether it is physical or mental, comes from delusional thinking, injury or illness or not practicing Right Everything ... it still hurts. And it is the human condition .. hence All life is suffering.

Some people suffer because they don't have a car as big as their neighbour - OK - you guys know more about this stuff than I do - that is not Right something.

I suffered because I had a chemical imbalance in my brain which led me to very strange perspectives on my self worth, which is not Right Perception but wasn't my fault. (No, really it wasn't, I asked the doctor)

I can only speak for my own case because I have never been anyone else but meditation didn't help because I could only meditate through the goggles that the chemical imbalance had put on my inner eyes ... if that is not mixing metaphors faster than a cocktail waitress in a hurry.

Medication has sorted out my problems enough so that now I can see without the goggles (on a good day) in order to meditate more effectively - it is not nice to meditate if all that happens is whopping great demons of the imagination come out to get you.

But also - meditation is a tool, not a magic wand. In the treatment of depression and mental health issues all tools are valid and as you point out, the right tool for the job must be determined by an expert.

With great respect.

waking

I think we're very much on the same page, Knitwitch. I'm so happy that you've got the goggles off, I know exactly what you mean...

Warmly,
Ben

Knitwitch

Well thank you Ben.

And I hope that you get your goggles sorted out soon - do you ever feel you might like to go to a spiritual optometrist? I did. But that's why we frequent boards like this.

(((((hugs)))))

srivijaya

Knitwitch wrote: »

But also - meditation is a tool, not a magic wand.

Well said Knitwitch. I think this is a very important point. People may expect fantastic results and feel that they have somehow 'failed' when they realise that (despite meditation) they are still prone to their usual shortcomings.

The mind or awareness is very complex and multi-layered. Meditation offers a way into it - a way we can access under certain conditions whilst conscious - but this is only one way and it's a small narrow pathway into a vast forest. We also have dream states and states of unawareness not to mention altered states due to depression and other causes, all of which lie beyond the scope of traditional meditation.

Kris

jacx

I think "where does dukkha end and psychological illness begin?" is a quite important question. If someone's mental suffering is caused mostly by a chemical imbalance, then ingesting other chemicals is likely to be helpful. But the majority of depressive episodes, the milder varieties that a large proportion of the population experience from time to time, are more to do with lifestyle and environmental factors. Just like there's no cold or 'flu remedy that works as well as taking rest and fluids, I don't think that anti-depressants can substitute for making necessary changes in your lifestyle. Of course, it's not an easy thing at all to 'change' a job or marriage or etc. that is causing stress and sadness.

Simonthepilgrim

jacx wrote: »

I think "where does dukkha end and psychological illness begin?" is a quite important question. If someone's mental suffering is caused mostly by a chemical imbalance, then ingesting other chemicals is likely to be helpful. But the majority of depressive episodes, the milder varieties that a large proportion of the population experience from time to time, are more to do with lifestyle and environmental factors. Just like there's no cold or 'flu remedy that works as well as taking rest and fluids, I don't think that anti-depressants can substitute for making necessary changes in your lifestyle. Of course, it's not an easy thing at all to 'change' a job or marriage or etc. that is causing stress and sadness.

I'm sorry if I am repeating myself but I simply cannot see "psychological illness" as other than a subset of dukkha, part of it not apart from it.

jacx

Dear Simon,

Of course, you are right. Illness and injury are dukkha, grief, sadness and disappointment are dukkha. Birth, old age and death are dukkha. Buying a new car is dukkha. Etc...

The point I was trying to make is that depression can have many causes. It's not always (perhaps not even often) an organic disturbance. I'm very much against such practices as prescribing heavy-duty anti-depressants to the recently bereaved. A person doesn't need to have a brain-chemical imbalance in order to feel "depressed, sad or anxious" after their mother dies!

Of course, this does not mean that brain-chemical imbalances do not exist.

Knitwitch

The question of depression is a bit complicated - depression per se falls into two categories - causal (where there is a reason - bereavement, stress, etc) and non-causal where someone is depressed for no apparent reason. In the second case, medication is usually indicated.

Then there are the more complex psychoses where the depression is part of a more well-defined psychological illness (schizophrenia, manic depression, SAD,)

But in all cases, I would agree that suffering is suffering - it is what we learn from it that is important.

jacx

Well, you know what they say, Knitwitch:

For every complicated problem, there is a solution that is simple, elegant, and wrong.

waking

I've seen some fairly hard-line views on some other Buddhist chat boards in which folks basically deny that there is such a thing as mental illness, and that see the Buddhist path as the only appropriate response for depression, anxiety, etc. At the same time, there is a real problem in mainstream psychology/psychiatry which basically pathologizes all suffering as psychologically or chemically based. There are times when one, the other, or both are the needed medicine.

Ben

federica

Ding-ding....

"Middle Way".....!!:thumbsup: