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SciAm: Do Antidepressants Work?

Linkbait. From my understanding, SSRIs when combined with conventional talk therapy have proven very effective. To prescribe an SSRI without accompanying therapy, there is little benefit. To phrase it in my own language, the SSRIs put the brain into a more receptive state for change ... or that is the remnant of my admittedly ‘90’s knowledge of the subject.  To test them in a virtual ‘test tube’ is worthless. IMHO. I’m not defending, I’m just pointing out discrepancies. The fact that family practitioners used to (and may still) hand out these things like Pez, just fills the coffers of the pharmaceutical companies.

The drug ain’t enough. You’ve gotta talk it out. [See the comment thread; I’m wrong.] And picking a suitable psychiatrist/psychologist/social worker is like trying to find a good suit. Takes time and money.

A warning: If any doctor is handing you books about anxiety and you’re starting to manifest every symptom in those books - you’re getting played, in a most cruel and inhuman way. I saw this happen with about a dozen people in NYC in the 90’s. It’s a racket. Get you on benzos and then let the half-life of the drug addict you both to the medication and the therapy. SSRIs are added to the mix. Next stop: Agoraphobia. It’s not pretty, and the climb out is long and torturous. It can be done, however. And a normal life can be restored.

A step on the way.

08/27/14 • 08:18 AM • CorrectionsHistoryPsychology • (11) Comments

Comments:

Sorry but I’ve been on these pills for decades and stopped doing the talk therapy years ago. All I ever got was “Tell me what you did this week.” Nothing useful came the other way, and I saw at least half a dozen different psychologists and psychiatrists, whereas the pills do the job just fine.

Anecdotal is not evidence, I know, but your post is stated in absolute terms.

Posted by BillSaysThis on 08/27/14 at 08:48 AM

True. My experience. I need to watch those absolutes!

Posted by Garret P Vreeland on 08/27/14 at 09:04 AM

Once upon a time, there was a wide discussion about salespeople and Prozac. Prozac was touted as a ‘mood brightener’, and the physicians’ offices were filled with salespeople wanting that extra edge. The ethic was, if you didn’t take it, you couldn’t compete. Someone may even have done a study - can’t recall.

Ah, the ‘90’s.  And, as you point out, that effect was sans therapy.

Posted by Garret P Vreeland on 08/27/14 at 09:07 AM

I’m also hoping one of my ‘in the biz’ readers will comment and correct me if needed.  Always like to update my knowledge.  Book references appreciated also.

Posted by Garret P Vreeland on 08/27/14 at 09:14 AM

SSRis have been a boon to me since 1987. My experience is much like Bill’s. I was amazed what a brief test with Adderoll did a couple of months ago. Talk therapy is essential, I’m not sure if 35 years of it would have been necessary…

Posted by Hal B Rager on 08/27/14 at 10:02 AM

I actually hoped talk therapy would help but session after session of just repeating what transpired in my life since the last session, with no discussion of those events, hardly seemed therapeutic. The last psych appeared to be transcribing my reporting, after awhile I was tempted to ask him for a copy to use in my journal.

Posted by BillSaysThis on 08/27/14 at 10:12 AM

That’s why I said, “And picking a suitable psychiatrist/psychologist/social worker is like trying to find a good suit.”

Hard, hard to find.  But most research has shown SSRIs work better with skilled talk therapy.  A friend had good results using a Psychiatrist/Social Worker combination.  Psych monitored the drug regimen, social worker managed the talk/experiential therapy.  Worked well. Social worker set goals, worked towards those goals.

Posted by Garret P Vreeland on 08/27/14 at 10:30 AM

Sure, but I think my sample size is sufficient to judge given that I’ve seen 6-8 different doctors, split between psychiatrists and psychologists and in NJ and California. Several, although not all, came as recommendations from my dad’s social network, my dad being a child psychologist. Then again, my dad’s profession might be a negative bias.

Posted by BillSaysThis on 08/27/14 at 10:44 AM

I’m going to mark my ‘absolute’ statements with a line-through, and direct folks to the comments.  Give me a minute, and I’ll add more here.

Posted by Garret P Vreeland on 08/27/14 at 10:48 AM

I’ve had only a handful of direct experiences.  Talking with a speech therapist/psychologist when I was a child with a stutter. He talked to me for weeks, without any real aim - or so it seemed to me. What he was subtly doing was determining who was critiquing my speech, and how draconian were the critiques.  I’d say that was my best experience, with a targeted psychologist.  He knew his business, and unfortunately, I was old enough to where the damage had largely been done. His advice took the pressure off at home, but there was nothing he could do about the peer pressure and teasing.

Later, working in NYC, I began to crack. The daily commute (1+ hours each way, working endless hours of overtime, job frustration, more) was beginning to chip away at my native confidence.  I went to a psychiatrist. Terrible in every way. Benzos made everything worse, Zoloft did nothing. A repeat of what I’d seen countless friends go through in NYC. I ended up tapering carefully off the benzos, reading James Hillman’s books and fixing myself, sans drugs.

My greatest antidepressant: fitness. I exercise, my confidence builds and I forget about worries/anxieties/depressives. I need that outlet. As a psychologist friend said, “you’ve got the classic ‘rain barrel’ metaphor. When your ‘rain barrel’ of stress gets too full, it overflows into anxiety. Take time to empty it.”

If I were to venture back in, I would go to a Jungian psychologist - though the danger is, I’d spend more time quizzing them about Jungian philosophy than talking about my own maladies.

Posted by Garret P Vreeland on 08/27/14 at 10:55 AM

And, BTW, that’s why I’ve purposely pulled away from political commentary.  I just can’t get into it again, not yet.  Raises my stress level to ‘11’.  The next Presidential race ... and I usually get dragged back in because my traffic spikes during those periods ... may do me in.

Posted by Garret P Vreeland on 08/27/14 at 11:03 AM

 

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