The average middle-aged person has probably noticed that we no longer live in the Sound of Music days when the hills were alive with the chipper sound of optimism. Certainly, the statistics showing how many people take antidepressant medications attest to the fact that many of us just aren't feeling bubbly on a daily basis. One in every 10 people in the US took antidepressants in 2005, and since then, the rate of use has risen by 43 percent.1 Antidepressants are the most commonly prescribed medication in the US.2 Use tripled between 1988-1994 and 1999-2000, and then rose again 48 percent between 1995 and 2002. At least 30 million people in this country alone take antidepressants, and antidepressants bring in over $11 billion annually in sales worldwide.3
But alas, as I've written at length in the past, antidepressants have a depressing track record in terms of efficacy. Plus, they bring a host of ugly side effects. And now, there's more bad news that by all rights should diminish enthusiasm for this class of drugs even more: studies show that antidepressants may up the rate of relapse into depression.4 The study, just published in the journal Frontiers of Psychology, found that people who took antidepressants and then went off of them had recurring bouts of major depression at almost double the rate of those who simply toughed it out through the blues, minus the drugs. The rate of relapse was 42 percent for those who formerly took antidepressants, compared to 25 percent of those who avoided drugs. So whatever good the drugs may do for the psyche in the short-run (and as Jon Barron has frequently explained, they don't do much) gets completely wiped out by the long-term effects.
These results came from a review conducted by scientists at Canada's McMaster University looking at dozens of previously published depression studies. The studies compared subjects who took antidepressants throughout the term of the research to subjects who took placebos and again to those who took antidepressants and then were switched to placebos.
Study director Dr. Paul Andrews believes that the boomerang effect happens because antidepressants mess with the regulation of the neurotransmitters serotonin and norepinephrine in the brain.5 The brain overcorrects when the drug is withdrawn, he says, triggering new bouts of depression.
Andrew says, "We found that the more these drugs affect serotonin and other neurotransmitters in your brain -- and that's what they're supposed to do -- the greater your risk of relapse once you stop taking them. All these drugs do reduce symptoms, probably to some degree, in the short-term [Dr. Andrew's opinion, not necessarily mine]. The trick is what happens in the long term. Our results suggest that when you try to go off the drugs, depression will bounce back. This can leave people stuck in a cycle where they need to keep taking antidepressants to prevent a return of symptoms."
All of this is interesting in view of the fact that at best, antidepressants only work in half of all patients who try them out. Sounds like the other half of the antidepressant-using population is doomed to eternal use of the drugs in order to avoid an even more dramatic return to psychological hell. That's a bit of good news for the pharmaceutical companies, who can keep selling the drugs to those who can't break free from depression once off the pills. But it's very bad news for the depressed public. In fact, Dr. Andrews concludes that the drugs should be avoided in the first place.
"If it were me," he says, "I would certainly avoid antidepressant medication if at all possible. Talking therapies work just as well if not better than antidepressants, and they don't have this increased risk for relapse." And he's not even considering the worrisome side effects Jon Barron has described in the past.
If you agree with Dr. Andrews and happen to be lucky enough to live near the water when the doldrums attack, you might try surfing instead of seeking a prescription. According to the National Health Service of Great Britain, surfing works wonders in combating PTSD, and at a cost of about $500 or so for a surfboard, it's quite a bargain.6 If it works for PTSD, it probably works for depression too, though no studies have yet validated this theory. Anyway, while surf therapy has its detractors who think it's a joke, the British NHS says surfing saves money otherwise spent on antidepressants. Apparently, representatives from the US Marine Corps agree. Lt. Col. Greg Martin at Camp Pendleton says. "Anything a guy really enjoys will ease combat stress, but there's nothing like surfing to touch the mind, the body and the spirit all at the same time. And that's our approach in the Marine Corps -- we have a whole-Marine focus, so it's not just the medical side."
But should you live in the desert or the polar regions or have no interest in riding the waves, you could try 30 minutes of exercise three times a week, which studies report works better than pharmaceutical drugs, or you might check out Jon Barron's newsletter, Depressed on Antidepressants, for a complete list of all-natural depression-busting options.
1 Szabo, Liz. "Number of Americans taking antidepressants doubles." 4 August l 2009. USA Today. 21 July 2011. < http://www.usatoday.com/news/health/2009-08-03-antidepressants_N.htm>
2 Cohen, Elizabeth. "CDC: Antidepressants most prescribed drugs in U.S." 9 July 2007. CNN Health. 21 July 2011. http://articles.cnn.com/2007-07-09/health/antidepressants_1_antidepressants-high-blood-pressure-drugs-psychotropic-drugs?_s=PM:HEALTH
3 "Recession and rise in antidepressant prescriptions." 11 April 2011. Flowing Data. 21 July 2011. http://flowingdata.com/2011/04/11/recession-and-rise-in-antidepressant-prescriptions/
4 Nauert, Rick. "Antidepressants May Up Risk of Relapse. 20 July, 2011. PsychCentral. 21 July 2011. < http://psychcentral.com/news/2011/07/20/antidepressants-may-up-risk-of-relapse/27903.html>
5 Freeman, David W. "Do antidepressants cause depression? What new study says." 20 July 2011. CBS News Health Pop. 21 July 2011. http://www.cbsnews.com/8301-504763_162-20081076-10391704.html
6 Grohol, John. "Surf Therapy for PTSD." 20 July 2011. PsychCentral. 21 July 2011. http://psychcentral.com/news/2011/07/20/surf-therapy-for-ptsd/27933.html.
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