Depression Support Group
Depression is a real and debilitating condition that is often misunderstood by family and friends. Its meaning can range from a prolonged period of sadness to an actual mental illness with specific symptoms. Find and share experiences with others who are going through the same struggles.
I came across this board while surfing the Daily Strength list of sites. It seems as if there are a few misconceptions about meds used to treat depression.
I have a five year degree in Pharmacology and Medicinal Chemistry, so I know about meds. I want to try to give everyone the true facts about treatment of depression with pharmaceuticals. BTW, I am a respected poster on a few boards, so I am not a nut case. ha ha
I have read some of the comments here and some of you definitely need to be on some meds to help you cope with your depression and anxiety. Counseling and talking to a psychologist is fine, but there is a point at which just talking does not help.
Most depressive states are caused by a chemical imbalance of the brain, so meds are needed to restore the normal balance. There are three main chemicals in the brain called neurotransmitters and they are responsible for the transmission of nerve impulses to the brain tissue. Think of them as chemical messengers that carry the impulses back and forth along the nerve synapses.
These three neurotransmitters in the brain area that control our mood are seritonin, norepinephrine, and dopamine. Seritonin is by far the one that gets out of balance in most cases and is the most important, but the other two can play a role in depression.
In clinical depression, there is not enough free seritonin available to carry the nerve impluses in the brain area. The brain tissue releases seritonin to transmit nerve signals and when it is done the free seritonin is soaked back into the tissue. But in depression the shortage of free seritonin does not allow the nerve impulses ("the messages") to go from nerve cell to nerve cell properly. As a result this shortage of seritonin causes mood changes resulting in depression.
The goal in therapy with antidepressants is to increase that amount of free seritonin in the brain area so that the nerves messages can be transmitted properly. The modern antidepressants, the SSRIs, do exactly that and ease the depression.
SSRIs are Selective Seritonin Reuptake Inhibitors and here is how they work. The brain tissue itself releases the seritonin to help with nerve transmissions and when the job is done the seritonin is soaked back into the brain tissue; the seritonin is no longer "free" seritonin in that it is trapped in the tissue.
The SSRIs inhibit this reuptake by blocking the seritonin when it tries to go back into the brain tissue after it has completed it job. Thus the seritonin can not get back into the tissue and it stays out there as free seritonin. This allows more seritonin available to conduct nerve impulses.
The SSRIs are selective in that they only block the reuptake of seritonin and do not affect dopamine or norephinephrine.
Years ago the only antidepressants used were called the tricyclic antidepressants. This included amitriptyline (Elavil). They were not very effective and had some bothersome side effects such as dry mouth and sedation.
Now we have the SSRIs as antidepressants and they work much better. Prozac was the first one introduced and now we have Zoloft, Celexa, Lexapro and others to choose from. These are very effective and usually by trial and error with both the product and the dosage, most all depressed people can be helped.
There are a couple of common mistakes that people sometimes make when taking these SSRIs. First, they give up on them and don't take them long enough. Antidepressants are not quick acting. If you take one today, you will not all of a sudden feel better tomorrow. The full antidepressant effect is not seen in the SSRIs until anywhere from two to four weeks. So don't give up on them.
Another problem is that the SSRIs can be troublesome if a person want to get themselves off the drug. Any withdrawal must be done very gradually and the dose must be slowly reduced over at least a month's time.
If a person tries to get off the drug too quickly, the results will not be life threatening, but they will be bothersome (dizziness, nausea, flu like symptoms), so it is imperative to slowly withdraw if a person want to stop taking them. A quick withdrawal causes the brain to "rebel" as it is used to having enough seritonin to work properly. In a withdrawal, the brain has to adapt to the smaller amount of free seritonin, which cause these untoward side effects.
I have read some of the comments here and it is obvious that some posters here need to be on some antidepressant meds. When a person can no longer function in life, wants to stay in bed all the time, cannot sleep and has early morning awakening, cries, or contemplates suicide, it is time to find some help in the form of meds.
If some here are on meds and they are not helping, the med needs to be changed or the dosage adjusted. There are very few true depression cases where there is not a med out there to at least help and enable a person to live a decent life.
I am a humanitarian. It bothers me to see people suffering when there are drugs out there that could help.
I also see so much misinformation regarding SSRIs and other meds that it bothers me. This info I have given you here is straight from the horses's mouth so to speak.
Hope this helps everyone to understand depression better.
rewdiazepam
I have a five year degree in Pharmacology and Medicinal Chemistry, so I know about meds. I want to try to give everyone the true facts about treatment of depression with pharmaceuticals. BTW, I am a respected poster on a few boards, so I am not a nut case. ha ha
I have read some of the comments here and some of you definitely need to be on some meds to help you cope with your depression and anxiety. Counseling and talking to a psychologist is fine, but there is a point at which just talking does not help.
Most depressive states are caused by a chemical imbalance of the brain, so meds are needed to restore the normal balance. There are three main chemicals in the brain called neurotransmitters and they are responsible for the transmission of nerve impulses to the brain tissue. Think of them as chemical messengers that carry the impulses back and forth along the nerve synapses.
These three neurotransmitters in the brain area that control our mood are seritonin, norepinephrine, and dopamine. Seritonin is by far the one that gets out of balance in most cases and is the most important, but the other two can play a role in depression.
In clinical depression, there is not enough free seritonin available to carry the nerve impluses in the brain area. The brain tissue releases seritonin to transmit nerve signals and when it is done the free seritonin is soaked back into the tissue. But in depression the shortage of free seritonin does not allow the nerve impulses ("the messages") to go from nerve cell to nerve cell properly. As a result this shortage of seritonin causes mood changes resulting in depression.
The goal in therapy with antidepressants is to increase that amount of free seritonin in the brain area so that the nerves messages can be transmitted properly. The modern antidepressants, the SSRIs, do exactly that and ease the depression.
SSRIs are Selective Seritonin Reuptake Inhibitors and here is how they work. The brain tissue itself releases the seritonin to help with nerve transmissions and when the job is done the seritonin is soaked back into the brain tissue; the seritonin is no longer "free" seritonin in that it is trapped in the tissue.
The SSRIs inhibit this reuptake by blocking the seritonin when it tries to go back into the brain tissue after it has completed it job. Thus the seritonin can not get back into the tissue and it stays out there as free seritonin. This allows more seritonin available to conduct nerve impulses.
The SSRIs are selective in that they only block the reuptake of seritonin and do not affect dopamine or norephinephrine.
Years ago the only antidepressants used were called the tricyclic antidepressants. This included amitriptyline (Elavil). They were not very effective and had some bothersome side effects such as dry mouth and sedation.
Now we have the SSRIs as antidepressants and they work much better. Prozac was the first one introduced and now we have Zoloft, Celexa, Lexapro and others to choose from. These are very effective and usually by trial and error with both the product and the dosage, most all depressed people can be helped.
There are a couple of common mistakes that people sometimes make when taking these SSRIs. First, they give up on them and don't take them long enough. Antidepressants are not quick acting. If you take one today, you will not all of a sudden feel better tomorrow. The full antidepressant effect is not seen in the SSRIs until anywhere from two to four weeks. So don't give up on them.
Another problem is that the SSRIs can be troublesome if a person want to get themselves off the drug. Any withdrawal must be done very gradually and the dose must be slowly reduced over at least a month's time.
If a person tries to get off the drug too quickly, the results will not be life threatening, but they will be bothersome (dizziness, nausea, flu like symptoms), so it is imperative to slowly withdraw if a person want to stop taking them. A quick withdrawal causes the brain to "rebel" as it is used to having enough seritonin to work properly. In a withdrawal, the brain has to adapt to the smaller amount of free seritonin, which cause these untoward side effects.
I have read some of the comments here and it is obvious that some posters here need to be on some antidepressant meds. When a person can no longer function in life, wants to stay in bed all the time, cannot sleep and has early morning awakening, cries, or contemplates suicide, it is time to find some help in the form of meds.
If some here are on meds and they are not helping, the med needs to be changed or the dosage adjusted. There are very few true depression cases where there is not a med out there to at least help and enable a person to live a decent life.
I am a humanitarian. It bothers me to see people suffering when there are drugs out there that could help.
I also see so much misinformation regarding SSRIs and other meds that it bothers me. This info I have given you here is straight from the horses's mouth so to speak.
Hope this helps everyone to understand depression better.
rewdiazepam
My concern with drugs is: Doesn't the body build up a tolerance to them, so greater and greater dosages are required to achieve the same effect? And don't all drugs have side-effects, most of which are just as harmful as the depression itself, so the drug user has to take this drug to counteract the side-effects of that drug, until the body is completely toxified and out-of-wack?
Sorry to rain on your pharmacological parade, but it seems to me there are natural alternatives to poisonous drugs in fighting depression. Please educate us as to those as well, as I did.
Now, I challenge a nutritionist and an exercise/fitness trainer to jump in here to present alternatives and give this thread a balanced perspective.
and
what bothers me about them is, they dont address the causes of the depression or anxiety, and to me, if it were my kid, for instance, i would exhaust every other possibility before screwing with such a delicate organ in the body
flooding it was a toxic chemical is not my idea of being loving to brain/nervous system, so i'm with you koolman
we get vitamin D naturally from lots of sunshine, which is why people, especially those prone to depression get much worse during the winter months
its cheap, it has zero side effects, its something every system in your body uses, it wont hurt
give it a try
I take 3,000 units a day and have for years now
Sorry but your post reads like an ad for a psych drug.
I've actually spoken to a neuroscientist about this. He told me that all the stuff about neurotransmitters is really just a working theory.
I have seen so many misconceptions online concerning these subjects that I wanted to educated the people that are dealing with depression.
Everyone can learn from others. The only people who cannot are those who are willfully ignorant and already have their minds made up. To them, the facts do not matter and never will.
If we can have a civilized dialogue, I will try to answer any questions. But I am not going to argue about things I have seen in my 30 years as a pharmacologist.
@Koolman
If you can control any depression and anxiety you have by exercising, then by all means keep doing that. Exercise does elevate seritonin levels and if it is working for you, then great. But some people are not physically able to exercise or they do exercise and they find that exercise alone does not work for them.
Not once did I advocate everyone who feels depressed to find a physician and get themselves on a bunch of antidepressants or psychotropic. If a person can control his disease state without meds, then that is the best way to go. People are always better off if they do not have to take meds for their health problems.
But sometimes meds are necessary. For some conditions, pharmaceuticals are needed to control the problem.
Koolman,
You asked," Doesn't the body build up a tolerance to them, so greater and greater dosages are required to achieve the same effect?"
No, the body does not build up a tolerance to all drugs. Drugs from the opiate family (Codeine, Hydromorphone, Morphine Sulfate, Hydrocodone, etc) and other CNS (central nervous system) depressants as seen with the benzodiazepine family (Valium (diazepam), Ativan (lorazepam), Alprazolam, etc) do indeed cause a patient to build up a tolerance and yes, higher and higher doses are needed to receive the same therapeutic effect. Alcohol, a CNS depressant, also causes a tolerance to be built up in humans. This is why an alcoholic can drink a normal guy under the table---the alcoholic has built up a tolerance to ethyl alcohol.
But not all drugs are capable of causing a tolerance to be built up in humans. Antihistamines, antidepressants, anitbiotics, amphetamines, sympathomimetic amines, ACE inhibitors, beta blockers, alpha blockers, and an entire myriad of drugs do not cause any tolerance.
The tolerance aspect seems to be mainly confined to those drugs that act on the CNS.
Koolman,
You asked, "And don't all drugs have side-effects, most of which are just as harmful as the depression itself, so the drug user has to take this drug to counteract the side-effects of that drug, until the body is completely toxified and out-of-wack?"
All drugs have side effects---period. Most of your drugs approved by the FDA are very safe and few side effects.
I don't agree at all that the side effects of most of the antidepressants or drugs to treat depression are just as harmful as depression itself. No, I don't agree with that at all, and it is just not true.
Koolman,
You said, "Sorry to rain on your pharmacological parade, but it seems to me there are natural alternatives to poisonous drugs in fighting depression. Please educate us as to those as well, as I did."
You didn't rain on my "pharmacological parade" at all. I am just trying to give the people the facts. I taught pharmacology at a medical school in the midwest for many years, so if you don't want to accept the facts and have your own version, then that is OK, too.
I am just putting it out there. People can choose to do with it what they want after that.
No hard feelings either way on my part.
Koolman,
You said, "And these chemicals ARE foreign agents to the body, poison."
Of course these chemicals are foreign agents to the body, but they are hardly poison. Surely you do not believe that most pharmaceuticals that have been approved by the FDA are toxic.
The word "poison" here is just nonsense. I know that you are bright and have apparently done a lot of reading, but the use of the word "poison" surely is hyperbole. I know you do not want to put "poison" in your body, but let me ask you this: If you had double pneumonia, would you put antibiotics into your body? After all, they are a foreign substance, and according to you, they ARE poison---by using your own definition. Would you?
If you had neglected you blood pressure for years and were now suffering from congestive heart failure, would you put Digoxin (to strengthen the heart muscle) and diuretics such as Lasix (furoseminde) in your body in an attempt to alleviate your congestive heart failure? After all Digoxin and Lasix are foreign to the body and according to you they are "poison." Or would you attempt to cure your CHF by cardio exercises or bike riding?
If your were suffering from high cholesterol and the cholesterol values were averaging in the 400 to 500 range even though you were watching your diet, would you take that poisonous Lipitor 10mg daily in an attempt to prevent your veins and arteries from becoming so filled with plague that a massive myocardial infarction was inevitable?
After all atorvastatin IS a foreign substance, synthesized in a chemistry laboratory, and it is "poisonous" to the body.
I am trying to point out that no, not all drugs are poison to the body and that nutrition and fitness with exercise can only do so much.
@Justine,
You said, "what bothers me about the ridiculously high number of people on antidepressants and anti-anxiety meds is, firstly i dont believe THAT many people are chemically imbalanced, i think its a myth big pharma wants us to "buy" into..."
I am absolutely neutral on this issue. I know the big pharmacy companies such as Eli Lilly, Parke Davis, Pfizer, and others are making a lot of money. I am in academia and my goal is to educate people.
I don't know how many people are chemically imbalanced with improper levels of seritonon, dopamine, or norepinephrine, but I do know one thing for sure----depression is a big mental health issue in this country and many people's symptoms are alleviated when they start a drug which increases the amount of free flowing seritonin in the brain tissue.
@Spiky,
You said, "If what the OP said was true, the 25+ years I've been on various antidepressants (tricyclics, SSRI's, even an MAOI) would have produced SOME kind of result. So far they've been ineffectual.
Sorry but your post reads like an ad for a psych drug.
I've actually spoken to a neuroscientist about this. He told me that all the stuff about neurotransmitters is really just a working theory."
If you have tried ALL the antidepressants and varied the dosages for 25+ years and there has still be NO result, then you were misdiagnosed. There is something more going on than just depression.
You said, "My post reads like an ad for a psych drug."
You can't be serious. Did you even read the post closely. I only gave people information. I did not advertise for anyone.
There will always be skeptics. I have no axe to grind. I hardly would come on here and lie to the board.
The neuroscientist was correct---this is all theory. We have never captured a nerve synapse with an electron microscope any more than we have ever shed more light on the receptor theory for the way a drug molecule attacks a receptor on a cell to create its pharmacological effect.
I hope I have explained and clarified my original post. I am just trying to help.
I hope you all understand that.
rewdiazepam
Most mental health professionals I know also acknowledge that people's depression can have causes other than "chemical imbalances".
If you're interested in a thorough critique of claims made by drug companies AND the public about psych meds, I'm reading a book called The Emperor's New Drugs. It's very well-researched and compelling:
http://www.amazon.com/The-Emperors-New-Drugs-Antidepressant/dp/0465022006/ref=sr_1_1?ie=UTF8&qid=1390759647&sr=8-1&keywords=the+emperor%27s+new+drugs+exploding+the+antidepressant+myth
I made a much longer post just above your post.
There is a lot we do not understand about depression. Depression, like a lot of other medical diseases, is mostly theory.
But here is a key---when we increase the serotonin levels in most people who are depressed, they get much better.
So, we know that depression is linked to a deficiency of free flowing serotonin in the brain. If this were not true, a SSRI would never work, but it does in many instances.
rewdiazepam
"If you have tried ALL the antidepressants and varied the dosages for 25+ years and there has still be NO result, then you were misdiagnosed."
LOL. What would you call it, then? I was diagnosed with depression starting when I was 12 years old and the opinions of every professional, including psychiatrists and psychopharmacologists, has not changed.
I have tried combinations of drugs from every category. My symptoms have always been and continue to be classic depressive symptoms. If I have been misdiagnosed then it can only mean there is a condition which hasn't been identified yet for something that has identical symptoms to depression but isn't.
The fact is that none of these drugs have made any difference whatsoever in my life. The fact that I was raised by 2 depressed people explains my depression far better.
You said "when we increase the serotonin levels in most people who are depressed, they get much better. "
It's not most people. It's 30-something percent of people, and in many of those cases it's placebo effect.
i mean street drugs elevate dopamine, hell, eating chocolate does that too, but we dont assume then that we're dopamine deficient do we? how can we if there are no medical tests to show us?
i really do believe when we have a society that is growing ever further away from religious or spiritual groundedness, when we're ever isolating ourselves from each other and our families, when we read less and zone out in front of a screen more, when we eat far more chemicals and less and less fresh whole organic nonGMO food, when we ingest so many stimulants, alcohol, and take a pill for every little thing, when we get hardly any fresh air or sunshine, when we try to drown out our own dreams and or disappointments or grief by going to our doctors to give us a script to help us cope, or engineer our own tempraments to fit into some norm, or perform better, or sleep at night, or or or...then it makes perfect sense to me that there is an epidemic of depression and anxiety....and i hope explains why i think ingesting pharacological chemistry is not what humanity is asking for or needs, not really
i think what we really want and really need is to learn how to live while we're alive
because while depression has always been around in some for or another...it was never like this before
rather than swallowing more pills, i wish the powers thst be would spend more time figuring out whats causing depression and fixing the case, not medicating the symptoms
I think so many many many people are on meds to day.I wonder how is it possible that what seems like millions or thousands have so many diagnosis and need up to 4 or 5 meds to get thru the day.it doesnt make sense to me.Its like take one pill and then you need another to sleep and then another to stay stable.it goes on and on.til you need 4 ,5 or 6 to function and still feel bad..makes no sense to me at all.
I do believe somewhere under all this is money making scheming.the commercials in TV showing quick fixes thru meds...but yes some people do need medication and some are helped...just so overly prescribed....