Although I am a few years late, I finally got the chance to watch, 'Silver Lining's Playbook'. Not giving away any spoilers, but in the film, Bradley Cooper is diagnosed with Bipolar Disorder. The disorder causes him to experience episodes of extreme mania to euphoria in other words he enters emotional extremes of which he has no control over. He refuses to take his medication and uses running as treatment in stabilizing his extreme mood swings. So, I had an interesting thought that many have already asked themselves by now; do antidepressants actually work? ...or do they play a placebo affect on those taking such medications?
Antidepressants work by balancing chemicals in your brain known as neurotransmitters which affect mood and emotions. Drugs that improve mood, aid in better quality of sleep, increase your appetite, and improve concentration are considered to be 'antidepressants'. They give people the encouragement or boost to overcome their depression and the symptoms that come along with it. Once on medications, these individuals will be able to become involved in things they enjoy again and improve their decision making when it comes to their life or any decision that could impact them. Overall, this change in behavior also contributes to the overall mood of the individual giving them a positive mood and outlook.While many people find that antidepressants work well to help reduce symptoms of depression, you might not feel better right away. It usually takes at least three
to four weeks before you notice a change in your mood. Sometimes it can
take even longer. Taking the medicine every day as directed helps
increase the chance that it works.(B)
Like all medications, antidepressants can have side effects. Some of the most common include: headaches, agitation, nausea or vomiting, sleeplessness, drowsiness, reduced sex drive, dry mouth, and weight gain. Some antidepressants are more likely than others
to cause certain side effects. Selective serotonin reuptake inhibitors
(SSRIs) generally have fewer side effects than older types of
medications such as tricyclic antidepressants (TCAs) and monoamine
oxidase inhibitors (MAOIs). Because medications affect every person
differently, however, it’s difficult to know what side effects you may
experience until you take one. If you’re concerned about any particular
side effect, such as weight gain or nausea, tell your doctor. She may be
able to prescribe a medication that is less likely to cause that side
effect. Many side effects last only for a few days or weeks
and then get better. Others may continue until you stop taking the
medicine. If the side effects are severe or are a problem for you, talk
with your doctor. He may be able to find a way to help reduce them -- by
having you take the medicine at a different time of day, for example --
or switch you a different medication. It’s important not to stop taking a medication
without talking with your doctor. If you stop it suddenly, you may feel
sick or have headaches or dizziness.(B)
Research:
When people begin to take antidepressants the effects of the medications take at least 3 to 4 weeks before symptoms of depression are reduced or feel any noticeable mood alterations. For some, it might take even longer. Data from the Mayo Clinic reveals that 13% of Americans or 1 in 10 individuals take an antidepressant. Women between the ages of 50 and 64 or 1 in 4 take an antidepressant. Antibiotics are the first most commonly prescribed class of medication, the second being antidepressants. The most commonly known antidepressants are Selective Serotonin Reuptake Inhibitors or SSRIs (i.e. Prozac, Celexa, Lexapro, Paxil, or Zoloft). They’re
safer and cause fewer side effects than other, older types of
antidepressants. (A)
Antidepressants Don't Work When:
Study led by Dr. Irving Kirsch in a 2008 study caused a lot of friction and controversey in mental health profession arena. After re-analyzing 35 different antidepressant drug trials that have been submitted to the FDA to license drugs like Prozac, Effexor, Serzone, and Paxil. Dr. Kirsch applied the
Freedom of Information Act to get access to the studies conducted that 'showed' that the drugs worked and studies that did not show any effects (which were most of the medications). Individuals with mild-to-moderate depression experienced the placebo effect of taking 'antidepressant drugs',in other words the treatment with an antidepressant was the same as taking a placebo.(A)The placebo effect creates an
expectation of healing so powerful that it can actually decrease
symptoms. The placebo effect works with pain, irritable bowel syndrome,
knee pain and much more. Even though individuals struggling with depression may be improving with these medications but it is not due to the drugs but to the placebo effect. (B)
If antidepressants do not seem to work or affect the mood after a few weeks on an individual it could be possible that that antidepressant did not work for the brain chemistry of that specific individual. But, there are many others that will likely work. It has been recorded that roughly 60% of people on antidepressants feel better with their first medication however it is common for others to change their medication until they notice a change. The National Institute of Mental Health held a study in 2008 that revealed that half of patients needed a new or had to add a second medication to their first treatment. Sometimes it is the combination that works best for some. Taking antidepressants and deciding when to stop depends on a case by case basis where the intensity of depression varies. Most only take the medication for at least 6 to 9 months, but have to continue taking it a bit longer even if the person feels good. Then there are others who take antidepressants for several years.(B)
In Great Britain a review of studies on published and
non-published (which are often not published because they don't show a
positive benefit of medications) research showed the same lack of
efficacy especially for mild-moderate depression. The medications seem
to be more effective for moderate-severe depression. Great Britain has
now revised their recommendations for treatment of depression to limit
use of medications as first-line treatment to only those individuals
with more severe depression. For mild depression, exercise, for example
is as effective as medication.(B)
Integrative medicine is another option as it offers many substitutes to medication which may be better
first-line treatment for mild-moderate depression instead of
medications.Omega 3 fatty acids have shown to boost the effect of medication and reduce risk of suicide. Vitamins such as B-12, B-6, and folic acid are important for the body because the make the neurotransmitters that stabilizes moods through the dopamine and serotonin pathway (also increasing the effectiveness of medication). Inositol, another form of vitamin B, also improves depression without the need of medication. 5-Hydroxytryptophan, a serotonin precursor, is an amino acid that
has shown effectiveness similar to prescription medications in some
studies. Yoga, acupuncture, and massage have all been shown, along with physical activity to improve mood.(B)
Concluding Remarks:
Compared to Europe, the American lifestyle, western diet, lack of activity, and stress could be just some of the reasons as to why so many Americans are depressed and anxious. High levels of cortisone, the stress hormone, is associated with a higher risk for
depression. The culture in Europe is much more relaxed, moves at a slower pace, enjoy every bite of food, and only work when necessary. The imbalance of all work and no play might be the cause of such anxiety, depression, and stress.
Links:
(A) http://www.scientificamerican.com/article/do-antidepressants-work/
(B) http://www.webmd.com/depression/features/antidepressant-effects?page=1
(C) https://www.psychologytoday.com/blog/real-healing/201202/do-anti-depressants-really-work
*Please note! These images are not mine. They were
found on various tumblr sites! If any are yours please let me know so
that I can give you credit for them! Also the people in the images have
no relation to the diseases, illnesses, or cancers I write about. Thanks
so much & enjoy~
