Over use of Anti depressants?

[happyhippy]

Hi all,
Thought I'd bring this topic up as it might give me a better understanding of these pills and why people use them.Ok what got me thinking about this topic is I know 6 people at work who use them regularly.Most are long term users,one in particular 10 years! :shock:I had a chat with a "user"today at work and they told me there is two different forms of depression,clinical and non clinical.The clinical is apparently caused by a chemical imbalance within the brain.What I don't understand is this:Is'nt it thoughts that cause depression?And if so how can a pill fix that?I kind of understand people who use them short term,for example say you lose a loved one and you just can't cope with the grief type thing,but 10 years??????Surely said persons doctor should be realising that the patient is'nt obviously being helped,and look at other solutions,maybe long term councelling or whatever!I've heard co workers exclaim "Oh no I can't possibly go off them,I could'nt cope"Ok maybe they think that fear is real,but surely it would be worth a try right?God only knows I've been through some bloody tough times in my life,and have never resorted to taking pills to overcome these times.Last year I had something particularly bad happen,and I cried for a few days.Even though it was'nt nice to do that at the time,crying is healing,and I started to feel better.I could of easily visited my GP and said I needed pills and no doubt she would of prescribed them without much thought.I do hold alot of compassion for people who are depressed,but is taking pills for it really the answer?Your thoughts please!

[Green Aura]

they told me there is two different forms of depression,clinical and non clinical.

This isn't strictly true - "clinical" depression has very specific, and observable, signs and symptoms. These include disrupted sleep pattern - particularly difficulty getting to sleep and early morning waking (usually associated with speeded up/jumbled thought processes), lack of motivation, difficulty in functioning (even getting out of bed or having a wash feels like climbing Everest), lack of a future and possible suicidal ideas. These can be long term and very debilitating problems which, though they can be treated by other means (psychotherapy, change of lifestyle, increase exercise etc), can be treated with pills - this is the NHS treatment of choice because it's relatively cheap, manageable by a GP (usually) and is pretty effective. The downside is it can be really difficult to come off the pills - particularly some of the SSRIs - and your friends fears of going back to how they felt before the medication is understandable. The other types of treatment take much longer, may require hospitalisation, or changing jobs/ ways of life (and for many people, especially when depressed, it all seems a step too far). IMHO the long term recovery rate is probably much better but for most people they often aren't an option, unfortunately.

I'm guessing what they referred to as non-clinical are those periods when, as you describe above, you feel down or miserable following some event etc. As you said you may feel crap and cry a lot but it resolves itself over a period of time.

[MuddyWitch]

As you say, there are two forms of depression.

Non-clinical depression is the type we all suffer from when a loved one dies or some other trauma touches our lives. For some people, 'pills' can help in the short term. (A sudden, unexpected berevement, for example).

The second type of depression is Clinical. This is a disease in exactly the same way that, say, diabetes is. In the same way that a diabetic can never come off medication, because their body doesn't make a vital substance, neither can some-one with severe clinical depression do without life saving drugs.

Hope this makes it clear. (I think the main problem is the language; depression is an over used word.)

MW

[Green Aura]

I forgot to add that GPs sometimes have a tendency to dish out anti-depressants a little too readily and then not review their effectiveness/need regularly enough. This may also explain why some people are on them longer than necessary. Many of the newer anti-depressants need a weaning off period as well, otherwise symptoms can return - and it's still in dispute as to whether that's due to the depression or the tablets themselves.

[StripyPixieSocks]

It's really hard to explain to people who don't / haven't actually had depression because they don't often understand what depressed people are saying / thinking / doing.

I'm not being patronizing or clever but it is just my experience as I was diagnosed with depression / Manic Depression at 16 and have struggled to cope with it ever since and a year ago re-started treatment (taking pills)

People who have never experienced what I would call true depression (probably clinical depression) always say things like "Well I've been depressed you never see me taking pills" or "Just choose to be happy" and other things.

For instance... when most people are 'depressed' they just shake it off after a while, when I am un-medicated and depressed it just spirals out of control and you suddenly wake up one morning thinking that suicide is a 'normal' thought.

In summary, YES taking pills is AN answer but there are many levels of treatment, if the pills don't work I would end up being sectioned.

I agree there is alot of over-use of the word depression which does lead to confusion but for people with true, clinical, chronic depression medication is a very real and viable option.

[happyhippy]

Thankyou for the replies so far,it has given me a better understanding.I guess why I am doubting the effectiveness of the pills (and I take it there is more than one variety)is that two of the long term users I know at work swear by their effectiveness,yet both have had to have long term absentism from work,one took 3 months off,the other,5 weeks,so if they work,how come these people can't cope with work?Must be truly awful to suffer with deep depression.

[TheGoodEarth]

A friend of mine must take about 6 months off every year due to depression. He has a very understanding employer who send him off to various retreats for treatment.

The doctors still haven't given him a definitive diagnosis so he is on a cocktail of drugs.

I think I know what the real problem is - his wife! If I had to live with her it would make me depressed too.

[The Riff-Raff Element]

My brother was on anti-depressents and sleeping pills for about 8 years. In the end they killed him, in the sense that he was able to con his doctor into giving him a month's supply rather than a weekly script to "save on perscription charges" and washed the lot down with some kind of alcohol. He was 40 and had a young daughter.

This dependence of his started as a result of what has been refered to as sub-clinical depression (being very unhappy, in other words) following the death of our father in 2001. He was given the pills, but his condition was never really reassessed, so the cycle of depression became ever more vicious as his addiction to the drugs became more pronounced.

Depression is a grotesquely overused word. People use it too often to lend some glamour to unhappiness or the mediocraty of their lives, and I confess this does irritate me a little. Because true depression is a cancer of the mind, a gangrene of the spirit. It is illogical and malicious. It needs to be treated with the greatest respect.

I think that there is a tendency to rush a little too quickly into drug treatment for unhappiness. Mostly this is because people want to be happy and the medical establishment can offer them a quick fix, so doctors come under pressure to hand out the smarties. There is no other cure for unhappiness except sweating it out like malaria.

Hell, that was pretty serious for me.

[yvette]

I have suffered from depression too, and had three 'breakdowns' in my twenties. I had to stop working altogether for a while, and then make major changes to my life, as well as having a variety of clinical and therapeutic treatments. It has never altogether gone. I have never heard a better description than Jon's - 'a gangreen of the spirit' encapsulates it perfectly. It is not, as others have pointed out, another word for unhappiness.
Happyhippy wonders whether the pills can be effective if people are still having time off with depression - I can see how that can happen, because in my experience the pills did not cure me but simply enabled me to get my head up enough to carry on living for another day, and then another.... Maybe with the pills they can function most of the time, and without the pills they would be unable to function at all?

[happyhippy]

Thanks for your honesty folks,I know for alot of people,its not an easy thing to talk about,particularly if you suffer from depression yourself!

[Zech]

Is'nt it thoughts that cause depression?And if so how can a pill fix that?

I'm not sure the line between clinical and non-clinical depression is quite as clear as some people make out. I've suffered from something that showed all the signs of clinical depression, but was definitely the result of circumstances (my first husband). In my case, yes, thoughts caused depression.

Whether it makes sense to treat thoughts with pills depends on your stance on quite a deep philosophical question: The relationship between mind and body. If you believe the two are different kinds of 'stuff' and essentially separate, then it makes no sense to tackle a mental disorder with a physical treatment. On the other hand, if you believe that the world is made out of just one kind of stuff, then every 'thought' can also be viewed as physical events in the brain (chemical reactions; electrical signals). From this perspective, it makes perfect sense to treat disordered thoughts with pills.

In my experience, the pills helped... a bit. They lifted me off the bottom. I still had a long way to go, and had quite a lot of counselling before I was able to recognise that my husband wasn't going to change. After that, I left the husband and life has improved dramatically.

[AngeB]

Hiya, my twopeneth
I have been on antidepressants for nearly a year. My depression is, I think, is non-clinical and was in relation to something bad that happened over a period of time, initially I was in shock and stressed and then I had a couple of days off and my brain waved a little white flag. It was not a way to glamourise anything, it took me an hour to read a 4-lined email at work and everytime i was in a supermarket I'd be there for hours just staring not knowing what to buy. So in my mind, it is related to 'cognitive overload', like the serotonin cells have been used so much, they just get knackered. Anyhew, in these circumstances, though antidepressants have a short term benefit, really therapy is much more beneficial, otherwise it's easy to keep crashing. In my case, I have just started making complaints because I am still waiting for therapy after nearly a year - so there's a reason to stay on the anti-depressants, i'm sure it isn't just me. The other reason, is that I stopped taking them last year and it gave me flu-like symptoms for a week, so I can only come off the pills if I am able to have even more sick leave from work.

People have all sorts of ways of responding to some circumstances in their thought patterns, while some people if they are ignored by a friend on the bus, just assume that the other person didn't see them, others would think that their friend ignored them because they secretly hate them because they're a big fat failure. Then think of how the different thinkers might respond to a real crisis, they just get affected in different ways. That's just my opinion though, sorry if it sounds like I'm pretending to know stuff

[little blue duck]

Hi all,
.What I don't understand is this:Is'nt it thoughts that cause depression?And if so how can a pill fix that?!

depression is not "caused by thoughts" ... its an imbalance of chemicals in the nervous system, (neurotransmitters) specifically serotonin, norepinephrine and dopamine.
NTs pass the signal across the "gap" between the synapses of the nervous system.

different antidepressent drugs have different effects in the balance of NTs

In response to there being "two types of depression" .... thats a bit of generalisation
where would you classify post-natal depression?! Its clinical, but also a response to an event, surely!

As for the overuse ... my husband's doctor, in response to his admission of having anxiety attacks & agrophobia was to tell him "you're obviously not depressed" then promptly prescribed him anti-depressives ... which he had a massive reaction to & now refuses to even try any other medication as it sent him into a huge panic attack ..

[misslizzy]

Hi All

I agree with most/all the comments and sentiments above and just wanted to put in my 2c+GST

Here in Australia depression is usually categorised as 'minor' or 'major' and a person's eligibility for free psych treatment depends on which category they fall into. While a diagnosis of depression requires the patient to experience a list of things for a period of two weeks or more, the severity of those things determines just how bad things are in their head and which category they fall into.

I have had depression all my life - I see it a bit like being a junkie. I'll always have depression (addiction), I'm just not depressed (using) at the moment I've been medicated in the past but for me that was during a time where my usual course of action (cognitive behavioural therapy) wasn't going to cut the mustard, so deep was the disease at the time. Medication in this instance held the metaphoric door open wide enough so that I could shove my foot in there and hold it open to then push with the rest of my weight using the CBT. Without the meds I would probably be dead now. Many times over. St John's Wort and Fish Oil smooth out the dips for me now - tops stuff those things

I loved the comment 'glamorise unhappiness' - so true, and makes pharmaceuticals a no-fault-no-work option for people who could probably be successfully treated with therapy. Unfortunately, I think too many people rely on the meds and they actually only work for severe cases (did you know a part of the brain physically changes shape and size during a depressive episode!) because they don't realise therapy is actually skills acquisition... you learn to recognise depressive and unhelpful thoughts and use strategies to defeat them

What really kills me is the number of meds being prescribed to young people... and I think that will only really change as more sufferers talk about their experience and normalise both treatment plans, thus reducing the stigma attached to depressive illnesses.

Miss Lizzy
long-time lurker, first-time poster

EDIT: Blue duck, do some research on serotonin-norepinephrine reuptake inhibitors (SNRIs) - similar methods to SSRIs (traditional anti-depressants) but work exceptionally well on anxiety. And find a new doctor.

[dave45]

Be aware that some anti-depressants - SSRIs - can have significant sexual side effects - like ruining your sex life. And which may or may not be reversible - there is a lot of controversy. A friend of mine suffered from this, but seems to have recovered. He wasn't warned of the possibility. Sometimes SSRIs are used for positive aspects of these side effects - there is now lots of evidence that they cure male premature ejaculation. We're all a poorly-understood complicated bunch of chemicals underneath! Understand the risk v benefits before messing with it.