Is the Proliferation of Antidepressants Good?

Antidepressants are the most prescribed drug in America.

Almost 20% of adult women, and 10% of men, are currently taking an antidepressant pill.

I can’t get the thought out of my head that we spend inordinate time debating whatever social or political controversy Twitter or cable news tells us to think about, but we spend so little time as a society discussing what is happening in our brains.

Antidepressants have brought positive, sometimes life-saving, benefits to many patients. But the fact that such a large proportion of Americans are taking a dependency-inducing, mood-altering drug daily seems to be a big deal. I actually couldn’t think of something more important because reality and perception itself is nothing more than what our brains perceive.

This proliferation of antidepressants (SSRI’s) represents so much of what is wrong with healthcare today. Antidepressants are a way for the medical system to earn recurring revenue without solving the root causes of what is actually making people depressed.

Right of Passage?

Mental health is an urgent national priority. Suicide is the second leading cause of death for people under 34, 25% of young adults said they contemplated suicide last year. These suicide stats are the canary in the coal mine of widespread struggles people are having navigating their brains. 88% of Americans said we are on the wrong track – a record. By my own experience, it is clear that far more than 20% of women and 10% of men are struggling with anxiety and their life’s purpose.

Taking an antidepressant is marketed today as almost an American right of passage. Pharmaceutical companies communicate that taking a daily antidepressant pill is a brave act. D2C websites target ads at millennials urging them to “take control of their mental health” by ordering daily antidepressants to their door with a couple clicks.

Clearly, patients are in need of help and dedicated psychologists are trying to help. And antidepressant pills have helped many people regain control of their lives.

But do these pills help cure the underlying causes of depression? Do they even effectively manage the symptoms on a population scale? Is the fact that such a large percentage of adults take these pills a good thing for those patients?

In recent weeks, I have dug into research on the subject and discovered some fact I found surprising.

6 Facts About Antidepressants

Antidepressants barely work better than a placebo.
- A review of studies that led to FDA approval of leading antidepressants showed that the pills “do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression” versus a placebo. This data was repressed by pharmaceutical companies and only recently uncovered. (2018: Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration)
- Studies have shown depressed patients can benefit as much by exercising as by taking antidepressants – with far less side effects. (Psychology Today)

Drugmakers exert significant financial influence on the psychology profession.
- When The New England Journal of Medicine, one of the nation’s leading medical journals, was looking for psychiatrists to write a review of antidepressants, they had trouble finding one who was not conflicted. (Selling Sickness by Ray Moynihan, page 25)
- Former Harvard psychiatrist Dr. Loren Mosher said “psychiatry has been almost completely bought and paid for by the drug companies.” (Selling Sickness by Ray Moynihan, page 27)
- Alan F. Schatzberg, Stanford psychologist and former head of the American Psychological Association, was forced to step down from leading an NIH panel to create guidelines on antidepressants because he failed to report more than $6 million of ownership in an antidepressant drugmaker. (Chronicle of Higher Education)

The vast majority of antidepressant advertising it spent targeting women.
- Prozac spent more money on advertising than Apple during many of the years its patent was active. (AdWeek)
- Antidepressant ads feature women about 90% of the time, usually in leisure activities, parenting, or sleeping – almost never in processional settings. (Psychiatric News)
- Drug companies have launched campaigns on college campuses to “educate” students about depression and prescribe pills. (The Truth About the Drug Companies by Marcia Angell, page 152)
- The marketing strategy for Valium, one of the earliest drugs to treat depression, instructed doctors to use it as a cure for the “unstable emotional equilibrium” and “panic states” of women. While Valium is a different and more addictive compound than SSRI’s (the primary antidepressants today), these marketing tactics that play on insecurity persist. (Pharma by Gerald Posner, page 205)
- Valium ran advertisements in the 1960’s and 1970’s saying the drug could help women who become “unpredictable grouch[es]” and alleviate the “neurotic sense of failure” for 35-year-old single women. 71 percent of prescriptions for Valium went to women, a trend that extends to SSRI’s today. (Pharma by Gerald Posner, page 207)

Antidepressants increase suicidal thoughts.
- The evidence is so great that antidepressant pills increase the risk of suicidal behavior (especially in young adults), that pill bottles are now required to carry a label. (FDA)
- In fact, increased prescriptions of antidepressants over the past four decades is correlated with increased rates of suicide. Today, the second leading cause of death for kids and teenagers is suicide. (CDC)

Antidepressants numb symptoms of depression, but don’t address root causes or cure anything.
- Antidepressants can reduce feelings of depression by allowing more serotonin to pass between nerve cells, but studies show depression comes back at the same rate once a patient stops using antidepressants. Antidepressants do nothing to help patients identify the root cause of what is making them depressed.
- Antidepressants help patients manage depression, and generate recurring (sometimes lifelong) revenue for pharmaceutical companies and hospitals (where patients are required to schedule appointments to re-subscribe).
- Pharmaceutical companies have not invested in areas to “cure” depression, because that would turn off revenue.

Antidepressants can lead to physical dependency and can result in withdrawal symptoms if not tapered properly.
- Patients who stop taking SSRI’s experience withdrawal symptoms such as insomnia, headaches, nausea, electric-shock sensation, and return of depression symptoms. (Mayo Clinic)

What is Causing Depression?

The proliferation of antidepressants represent so much of what is wrong with the medical system. They serve an important purpose at times, but represent an easy way for the medical system to earn recurring revenue without addressing the root causes of what is making people depressed.

The truth is, there are many underlying things that can lead to depression including thyroid hormone deficiency, vitamin D deficiency, chronic inflammation, underlying illness or infection, omega 3 deficiency, or chronic stress or sleep deprivation and the impact these have on underlying physiology. Antidepressants do nothing to identify or treat these things, many of which can be mitigated with dietary and lifestyle strategies and interpersonal support strategies.

We need to start looking at root causes.

I’m writing these articles to share facts that impacted me on healthcare, stress test my thinking, and connect with people who resonate with these ideas (particularly people building or thinking about building companies to address these issues). Reach out to me on Instagram, Twitter or email (calleymeans@gmail.com)