In a recent Western Massachusetts newspaper article about depression and its various forms of treatment, I was concerned to see that various popular serotonin "re-uptake inhibitors" (Prozac, Paxil, Zoloft and Effexor) were being referred to as kinds of modern wonder drugs that have "little or no side effects." As this opinion seems to be rather widespread, I would like to offer a quite different view of what I perceive as a possible sad crippling of the spirit of this country. This is considering that an estimated twenty million people are now using anti-depressant drugs!
First of all, it is curiously under-publicized that a percentage of people taking the above-mentioned drugs do indeed experience unpleasant side effects. One survey of people using Prozac, for example, found that 21% of users experience nausea, 20% get headaches, about 15% have anxiety and insomnia and in the 8-12% range are people who experience drowsiness, diarrhea, dry mouth, appetite loss, tremors and sweating. Some experience reduced libido. Worse yet, there have been many hundreds of reports of suicide attempts by people using Prozac and, in general, well over 20,000 reports of adverse drug reactions relating to this drug. And the question has been raised recently as to whether or not brain levels of serotonin dip lower after termination of reuptake inhibitors than the levels were before the therapy began.
Anti-depressant drugs may be THE answer for people with Major Depression, and may be very valuable in helping folks get through depressive crises. But if relied on in a long term way to deal with chronic low-level depression, these drugs may simply be "buying off" psychic pain that is being generated by self-crippling life-attitudes and unhealthy life conditions and unresolved repressed emotions originating from the past. The psychic pain may be ameliorated enough by the drugs so that needed action for deep-seated change is not taken.
The situation is analogous to taking aspirin every day for an ongoing headache. The aspirin reduces the pain just enough so that the headache does not goad one into investigating the source of the pain and taking action (which might mean challenging an overbearing boss, acknowledging and working through some tense unresolved family issue, or going to a doctor for a brain scan).
I have found in my therapy practice that depression is often related to the suppression of "outlawed" emotions of grief, anger or fear. Emotions have a natural tendency to express; it therefore takes biological effort to hold them down. (E-motion means outward motion.) A person chronically suppressing strong feelings will often have chronically tense muscles in parts of the body that would be involved in physically expressing the withheld feeling. Examples of chronic tension are tightness in the upper back and neck, pinched face, knots in the solar plexus, and constricted diaphragm with related tight "bands" around the chest. The chest bands and tight diaphragm are particularly related to suppressed grief: these tensions inhibit the expression of sobbing, but unfortunately at the same time inhibit breathing. (Haven't we all seen a young child hold his or her breath in an effort to choke back crying?) The result is shallow breathing and reduced oxygen intake. The lowering of metabolism that comes from this oxygen reduction may be in important element in the genesis of depression.
My experience in working with people taking anti-depressive drugs is that often the drugs seem to have numbed people to the whole suppressive process I am talking about here. The drugs act as an anesthetic to psychic pain, but not a cure. This anesthetizing effect can dampen motivation or willingness to dig into dark corners of the psyche to cleanse and resolve old, emotionally charged issues. The anti-depressive drug therefore becomes an inhibitor to effective psychotherapy. Although not always the case, it sometimes becomes necessary to wean people slowly off of the drugs before meaningful depth therapy can "engage."
If used indiscriminately, drugs such as Prosac, Paxil, Zoloft and Effexor can become the "soma" of Brave New World. A society that is in need of deep-seated radical change can stagnate as tens of millions of citizens' brains are rendered tolerant of spiritually adverse conditions through over-use of doctor-prescribed drugs.
If you are chronically moderately depressed, you may need to examine every aspect of your life. What may be needed is CHANGE! The following are some questions you may need to look at:
- Are you eating well? - with plenty of fresh vegetables and fruits and sufficient low-fat protein (resisting junk food, sweets, chronic alcohol....)? ...with adequate B vitamin and mineral intake?
- Do you have vigorous exercise several times a week?
- Do you get out into the sunshine and into nature with reasonable frequency?
- Are your values and related actions based on what you deep-down really believe in, or are they based on a lot of "shoulds" (therefore causing inner struggle and secret feelings that you may never "succeed" or measure up)?
- Is there a hidden storehouse of anger and grief locked up inside of you that you have not dealt with?
- Is there some important change that may need to be made in your life?
- Do you take time to relax and play and share loving times with family or friends?
- Have you counted the blessings recently of whatever is positive and beautiful around you?
- Do you make efforts to reach out and help others in need or to improve societal or institutional conditions that you abhor?
- Do you cultivate personal spiritual renewal, connecting with resources that may be available for this in your community?
To deeply look at these questions and take action for change is not easy; it could mean a revolution of consciousness and require courage and effort. When the effort if made, perhaps with the help of good psychotherapy, and action is taken, then your life and spirit will MOVE. The innate passion and power and meaning of your life can emerge and take flower. Does anyone honestly believe that something like this is more likely to happen on an extended (dependent) regime of anti-depressive drugs?
Dr. Bruce Brown is a Psychotherapist in Amherst, MA. For more information about his practice, see his listing in the directory by clicking here.
Bruce welcomes and encourages feedback to his article. You can provide feedback in the Whole Health Article Feedback Forum.