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Antidepressants: Not A Life Sentence

August 8, 2012
By Guest Blogger
|19Comments|


Many people are surprised to learn that I took antidepressants in my early 20s. On the surface, I looked like I had it all together. I was valedictorian of my graduating class, I had an active social life, and I was pursuing my PhD in psychology.

But inside I was screaming.

I’d spent most of my youth desperately seeking male approval. I was also an achievement junkie who was obsessed with getting good grades. I’d struggled with bouts of anxiety and sadness for as long as I could remember.

When my relationships with my boyfriend and my best friend started going downhill, I decided to see a therapist. The therapist referred me to a doctor, because she thought I might be suffering from dysthymia (a mild but long-term form of depression). The doctor spoke with me for 10 to 15 minutes, gave me a 10-item questionnaire and sent me home with a trial pack of Paxil (the latest and greatest new antidepressant back in 1999).

That 20-minute appointment led to me being on antidepressants for the next six years.

I spent most of those six years scouring the Internet and bookstores for someone who would help me get off the medication. At one point, tired of suffering from the side effects of the drugs, I told my doctor that I was interested in lowering my dose. She replied with a story that doctors around the world tell their patients every day:

“Taking antidepressants is like a diabetic taking insulin. The insulin helps the diabetic with their problem, so why stop taking it? If you have a chemical imbalance in your brain and the antidepressants are helping to regulate that, then often it doesn’t make sense to stop taking the medication.”

The problem with this story is that, in many cases, it’s false.

Don’t get me wrong — I am not completely against the use of antidepressants. Are antidepressants necessary in some cases? Yes. Do I believe these drugs are being over-prescribed? Absolutely.

Please know that there’s nothing to be ashamed of if you’re currently taking antidepressants. There are roughly 118 million prescriptions for antidepressants written in the United States every year, and you might need the medication to get through a rough patch in your life.

But I also want you to know that just because you’re taking antidepressants right now, that doesn’t mean you’ve been sentenced to life without parole.
There are alternatives to antidepressants. And in many cases, these alternatives work. You have a right to know that there is another way.

Here are three reasons.

Serotonin Is Only Part Of The Story
Much credence has been given to the idea that anxiety and depression are caused by a chemical imbalance in the brain. While current research suggests that serotonin (and other neurotransmitters) play a role in regulating our mood, equating mental illness with physical illness is premature, misleading and horribly disempowering.

Instead of feeling like you have any say in the matter, you throw in the towel and decide there’s nothing you can do about your mental health because it’s all chemical. So you stop going to therapy, you stay in your dysfunctional relationship or you forgo that yoga class. You tell yourself there’s no point bothering with any alternative approaches because there’s nothing you can do to change your brain. Unfortunately, this point of view closes the door on a huge number of resources that could be beneficial to your well-being.

It’s also important to keep in mind that the “serotonin deficiency” idea is still much more of a hypothesis than a fact. As Dr. Joseph Glenmullen points out in his books “Prozac Backlash” and “The Antidepressant Solution,” a serotonin deficiency for depression has not been conclusively found.

So before you lock yourself into a serotonin-deficient cell and throw away the key, realize that there are other options.

Talk It Out
Many studies have found that psychotherapy is as effective (or even more effective) than taking antidepressants, particularly for mild to moderate depression and anxiety. When it comes to the long-term effectiveness of psychotherapy versus antidepressants, several studies have shown that people who go through psychotherapy are less likely to have a relapse of their depression or anxiety than people who only take antidepressants.

Why? Because psychotherapy helps you develop a resistance to future bouts of depression and anxiety. It arms you with tools to keep your symptoms at bay. Antidepressants, on the other hand, simply mask your issues, which means these problems can easily return in the future when you go off the drugs.

The moral? If you’d like to stay off antidepressants over the long-term, find a therapist who resonates with you. Visit the Psychology Today Directory of Therapists to find a counselor near you.

Access Your Inner Pharmacy
Our bodies and minds are intimately connected. In fact, you have a buffet of brain-healthy neurotransmitters at your fingertips — if you’re willing to put in the work to access them.

A growing body of research suggests that mind-body practices like yoga and meditation are highly effective at reducing anxiety and depression. For example, researchers at Boston University recently found that yoga increases GABA levels — a neurotransmitter that is often low in people with anxiety and mood disorders. Research from Harvard Medical School also suggests that meditation might even change the physical structure of our brain.

The saying “It works if you work it” definitely applies here. A daily yoga or meditation practice might require more time than popping a pill, but the results are well worth it.

Where To Start
If you’re interested in going off of antidepressants, start small. Always consult your doctor, and don’t be afraid to get a second opinion. Find a therapist and commit to implementing some healthy mind-body habits.

After following this approach for several years, I appealed my life sentence and finally managed to kick my antidepressant habit for good. With a bit of hard work, courage and determination, I know that you can do the same.

Bethany Butzer, Ph.D. is an author, speaker, researcher, and yoga teacher who helps people create a life they love. Her book is “The Antidepressant Antidote.”

Photo credit: Luc de Leeuw



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19 responses to Antidepressants: Not A Life Sentence
  1. Hi Bethany,

    Fantastic post. When I read your paragraph “I’d spent most of my youth desperately seeking male approval. I was also an achievement junkie who was obsessed with getting good grades. I’d struggled with bouts of anxiety and sadness for as long as I could remember”….I smiled, because that was me too! I was also offered anti-depressants but from my university studies I had access to medical papers and I chose alternative routes….it led me to doing a masters degree in nutritional medicine where I specialised in nutrition for depression. I now use my knowledge in my business where I support women whilst they explore their emotional eating patterns. Thank you for highlighting such useful tips. Kind regards, Ani

  2. Could you please cite any study that has shown that therapy alone is more effective than antidepressants alone? I’m pretty up on my psychiatry-related evidence based practices, but I’ve never heard that one- just that a combination on therapy and antidepressants are more effective than either alone.

  3. Thanks for this – it’s a very balanced approach, which I appreciate. Thank you for sharing the many alternatives available, while also validating that some people do need medication, and also validating how difficult it is to get off of these medications within our system.

    I also spent part of my early 20s on antidepressants and am also living proof that it’s not a life sentence for everyone. :)

  4. I have a very similar story! I was put on Paxil while still in high school because I had anxiety so bad that I dropped out of driver’s ed and speech class. I was very easily prescribed Paxil after telling the doctor my anxiety and answering a questionnaire.

    I’m not sure how I feel about highschool aged kids being on medicines like this. After HS and in college I had a wonderful psychology teacher who talked about the over prescribing of medications today and he said that teenagers shouldn’t take medicines like this while our brains are still forming.

    So back to highschool…I took the medicine long enough to get me through the next year when I would have to retake drivers ed and speech and then without permission I stopped taking my medicine and you know what :) I was just fine!

    I still have anxiety but I would rather learn to deal with it and feel the pride when I overcome on my own. Guess what is up for me this fall semester of college? Communications 110 … an opportunity to face a fear head on and come out a better girl c:

    Love,
    Sarah

  5. Divorce and other losses sent me in quite the tail-spin of seemingly uncontrollable emotions. Even as a nurse, I fought the idea of taking meds, thinking irrationally they were only for crazies! Now in a master’s program for holistic health, I have come to appreciate the importance of discovering ourselves, mind, body and spirit. That is what will help the healing process. It sometimes can be a hard road, like peeling an onion to get to the sweet inner layer. It does not make you weak or less than to use some help along the way, including medication if necessary and finding the therapist you really click with. The trick, I believe, is to have faith in yourself and never stop learning about and loving yourself.

  6. Many years ago I was diagnosed with depression and thrown on antidepressants. They tried 4 different ones with no relief in symptoms. Then I heard Dr. John R Lee talk about hormone balance and how depression could be a symptom from hormanl imbalance. I quit the antidepressants and started using USP Progesterone cream and my depression went away in 48 hours. It was a miracle. I now realize that it was not a seratonin problem, it was a lack of progesterone problem for me. I recommend that anyone that wants to pursue the hormone solution get your hormones tested before just jumping into adding hormones.

  7. This is an interesting article, and I am glad to see that the author does not say that antidepressants are evil or totally not necessary like some previous guest bloggers have. I’ve posted this once, but will do so again. Lexapro saved my life. The side effects went away after a couple of weeks, and taking one small white pill is no problem for me. It certainly doesn’t make me giddy or euphoric, it just makes me face life normally and without dread and despair. It also doesn’t keep me from seeking a healthy lifestyle and from exercising and doing yoga. In fact, I doubt if I could do any of that without Lexapro. It’s amazing what happens when your brain is working right. Maybe antidepressants ARE over-prescribed, but I think each person has to make his or her own decisions based on their own experiences and reactions.

  8. My depression was hormone related as well. Our endocrine systems can play a big role in how we feel emotionally. Blood work can help figure out if that is the case.

  9. In science we measure what we can, theorize about what these measurements might mean, look for confirmation or further information. It is important to remember, I think, that the map is not the territory. It is important to understand, I think, that we are explorers in a vast territory that we have barely begun to see.

  10. Thank-you everyone for your lovely feedback! I wish I could respond personally to each and every one of you. Please know that I am sending you my warmest wishes. I love your stories and your personal experience – such wisdom!

    You are welcome to keep this conversation going by following me on Facebook here: http://www.facebook.com/pages/Bethany-Butzer-PhD-Mental-Health-Wellness-Advisor/117943314924607

    Much Love,

    Bethany

  11. @Jodie, below are a few references showing that therapy alone is more effective than antidepressants alone (particularly over the long-term as I mention in my blog). I also highly recommend that you check out the books “Prozac Backlash” and “The Antidepressant Solution” by Dr. Joseph Glenmullen for more research. There is also a great 60 Minutes segment on antidepressants vs. placebo here: http://www.cbsnews.com/video/watch/?id=7399362n

    Shea et al. (1992). Course of depressive symptoms over follow-up, Findings from the National Institute of Mental Health treatment of depression collaborative research program. Archives of General Psychiatry, 49, 782-787.

    Evans et al. (1992). Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 49, 802-808.

    Blackburn et al. (1986). A two-year naturalistic follow-up of depressed patients treated with cognitive therapy, pharmacotherapy and a combination of both. Journal of Affective Disorders, 10, 67-75.

    Marks et al. (1993). Alprazolam (xanax, a valium-type antianxiety agent) and exposure alone and combined in panic disorder with agoraphobia. British Journal of Psychiatry, 162, 776-787.

    Wilhelm & Roth (1997). Acute and delayed effects of Alprazolam (xanax, a valium-type antianxiety agent) on flight phobics during exposure. Behavior Research and Therapy, 35, 831-841.

  12. I have such mixed feelings about this. Antidepressants saved my life, and I believe I waited waaay too long to go on them. I didn’t want to put something unnatural in my body, was afraid of the side effects (which turned out to not be a big deal for me), and thought that if my circumstances got better, I would get better. In truth, on the outside, I had a life that others would envy, but inside I was drowining. When I think about the years, yes years, I spent immobilized, overly raw, and lashing out at myself and those who love me in despair, I am so so sad, as that is time I cannot have back. But in a way, I’m glad I didn’t get on them too fast, because by the time I went on them, I was absolutely sure that nothing else was working. I had nothing to lose, because I was in some terrifying quicksand sinking fast. But should I have waited until I had nothing to lose?? Other than the antidepressants, I am a plant-fueled, green juice loving, quinoa scarfing natural health gal…. And now I want to have a baby…so I am really really struggling with what to do. I have also seen catastrophic consequences of untreated mental illness in my family, and I think untreated mental illness is a huge problem in our society. I’m not saying the author is wrong, just thinking aloud… to say it’s complicated is a huge understatement.

  13. I’m so grateful for this post because I’ve been on and off antidepressants and many other psychotropic medications since the age of 16 (I’m now 23). I’ve suffered from horrible side effects and the unfortunate problem of medications that are effective for a while and then no longer assuage my pain. Antidepressants were a necessity when I was suicidal (and I was on medication while I attempted suicide more than once), and while I was in early recovery from anorexia, but now I am 9 months symptom free from my eating disorder and looking for alternative routes to help with my depression.

    I’ve also found Dialectical Behavior Therapy incredibly helpful for the management of my anxiety, depression, and personality disorders and for me recovery is a lifestyle, not just a pill. I should also mention I’ve been in therapy since I was 16 and last year alone went through 13 therapists between finding the right one and being transferred from various hospitals and eating disorder treatment centers.

    Thank you for this information!

  14. @Christy you are so right – this is definitely a complex issue! I’m glad you’ve been able to find an approach that works well for you. Keep it up! We’re all on our own unique journey.

    @Alex – I love your term that “recovery is a lifestyle.” I couldn’t agree more. I’ve been off antidepressants for almost 7 years now, but I still need to do things every day to manage my stress and mood (e.g. yoga, meditation, eating properly, etc.). Don’t give up!

  15. I’m glad that yoga was mentioned. Exercise is the best form of therapy for depression and anxiety. There is a rush of endorphin’s during the activity, followed by a sense of calmness and accomplishment afterwards. Quality of sleep is often improved as well, which has direct benefit to mood regulating hormones. I’m missing 1/4 of my brain from surgery to remove a tumor. My mood was out of wack despite being on the antidepressant Celexa. If anything, Celexa further soured my mood. I couldn’t sleep well and I gained weight. One day I just stopped taking it and went for a long bike ride and felt great. I now try to fit in exercise everyday, be it a long session on the elliptical or a casual walk with my dog. I also find it helps to escape to a quiet spot in nature. Going for walks on the trails behind my house brings on a sense sereneness and connection to things far greater than my own little worries.
    On a side note- I read a quote somewhere that said worrying about something is the equivalent to wishing for it to happen. That is so true and I keep it in mind when I feel the worry wart in me trying to take over.

  16. Bethany, the dates of the studies themselves are very telling. None of these articles are comparing modern-day SSRIs to therapy- they’re either comparing non-antidepressants (alprazolam, a benzodiazepine used for anxiety, not depression) or older tricyclics (imipramine). One of the articles I just tried but couldn’t get, but it was published the year before the first SSRI hit the market. When you look at studies done in the last 10 years, you find a very different story.

  17. @Jodie, thanks for your feedback. This is a very complex issue and I appreciate you following up with me. In my blog I mentioned that psychotherapy has been found to be as effective (with some studies showing it to be more effective) than antidepressants, particularly over the long-term. This is consistent with older data using various types of antidepressants, as well as newer data using SSRIs. Here is a citation for a recent meta-analysis that covers these findings:

    Spielmans, G. et al. (2011). Psychotherapy versus second-generation antidepressants in the treatment of depression: A meta-analysis. Journal of Nervous and Mental Disease, 199, 142-149.

    My main point in the blog is that psychotherapy is a viable alternative to antidepressants, since it is equally as effective, particularly over the long-term. I hope this helps and I do agree with you, this issue is not black and white. It was definitely not my intention to be disingenuous.

    As @Laurie commented: “In science we measure what we can, theorize about what these measurements might mean, look for confirmation or further information. It is important to remember, I think, that the map is not the territory. It is important to understand, I think, that we are explorers in a vast territory that we have barely begun to see.”

  18. Celexa transformed my life.
    I’ve done individual and group therapy. Practiced EMDR and CBT. I am a vegan and pretty athletic.
    I love my family and have a rewarding career. I was doing all the right things, and yet, I wrestled with my brain. I felt guilty about my anxiety and that chronic sinking feeling. I resisted taking the drugs for a long time. I felt weak and embarrassed.
    This medicine has profoundly impacted my overall well being, my mental health.

  19. I need your help.
    Can I talk to you via email?