The medical model of contemporary psychiatry relies heavily on the prescription of antidepressant medication. Indeed a multi-billion dollar a year industry is dependent on the ongoing prescription of psychotherapeutic medication, in Australia this is a practice largely undertaken by GP's. But what is the real efficacy of this medication. Does it work? And what are the long-term implications of it's use?
Journalist Andrew Purcell, in a compelling article, writes of the debate regarding an enormous recent increase in the prescription of psychiatric medication in Australia. SSRI's in particular (Selective Serotonin Re-uptake Inhibitors) are, due to their being considered non-addictive, prescribed regularly by GP's across the country.
 | The psycho-pharmaceutical industry is worth billions of dollars each year. Yet despite the many many trials tests and reviews, there is still no consensus on the efficacy of these kinds of medications for the kinds of presentations they are being prescribed for. There are no effective long-term studies, and no brain structure studies to see what occurs in the long term. Indeed, writes Purcell, |
psycho-pharmaceutical meta-analysis (the study of the studies) finds that in many cases placebo is as effective as medication for mild to average levels of depression. While the argument for medication in those people with debilitating depressive symptoms is compelling, the argument for medicating others is not.
This article reminds me of several things to consider.
Firstly, you are a consumer. You have the right and the opportunity to shop around, get a second or even third opinion regarding your medication. Find a GP who prescribes psycho-pharmaceuticals cautiously and sparingly. One clinical experience I'm aware of is an 18 year old who had just had his first relationship breakup and was "depressed." A GP, in a 5 minute consultation, prescribed him an SSRI. The person was cajoled into not stopping, and sent to another GP who was stricter in the insistence that the medication be adhered to. This young person was being set up for a life of drug dependence, and a potential to attribute his own achievements to his medication.
Secondly, medication is best used as part of a therapeutic regime that includes talking therapy - psychotherapy or counselling, to work towards not requiring medication.There are many reasons for being depressed or anxious. The brain is a part of the process - whether it is the cause or a symptom carrier is much debated, however medication as band-aid to a larger issue will decrease the effectiveness of any medication, and you may find depressive symptoms hard to overcome. Medication does alter how your brain works.
Thirdly, that if you are on medication and undergoing therapy, know that your successes are not just due to the drug. Own your success as your own successes. There is a danger in prescribing psycho-pharmaceuticals to a mildly depressed person, especially one who is depressed due to a significant life event or life hardships - that the person comes to believe the success belongs to the drug. That in itself sets up an addiction, and anchors attempts to get off medication in relapse.
Finally, each individual is different in the reasons for and make-up of their emotional life. A one-size fits all approach to mental health is not constructive, and in fact for those it doesn't work for, can only add to the sense of un-wellness and failure. Take your time, assemble your team, utilise your support network. In many cases, the journey is the cure, and the way you live with your symptoms is the definition of who you are. You may never comply with the standard soap opera definition of "well." But you will be you.Work towards being the best you that you can be.
Note that I do not recommend unilaterally ceasing to take medication. I encourage you to seek additional paths to mental health, and to seek those medical practitioners who are skilled and willing to take a more cautious and long-term approach. Guide your team to assist you to live in the way that your prefer. Ask questions, no matter how unimportant you think they are.
This article reminds me of several things to consider.
Firstly, you are a consumer. You have the right and the opportunity to shop around, get a second or even third opinion regarding your medication. Find a GP who prescribes psycho-pharmaceuticals cautiously and sparingly. One clinical experience I'm aware of is an 18 year old who had just had his first relationship breakup and was "depressed." A GP, in a 5 minute consultation, prescribed him an SSRI. The person was cajoled into not stopping, and sent to another GP who was stricter in the insistence that the medication be adhered to. This young person was being set up for a life of drug dependence, and a potential to attribute his own achievements to his medication.
Secondly, medication is best used as part of a therapeutic regime that includes talking therapy - psychotherapy or counselling, to work towards not requiring medication.There are many reasons for being depressed or anxious. The brain is a part of the process - whether it is the cause or a symptom carrier is much debated, however medication as band-aid to a larger issue will decrease the effectiveness of any medication, and you may find depressive symptoms hard to overcome. Medication does alter how your brain works.
Thirdly, that if you are on medication and undergoing therapy, know that your successes are not just due to the drug. Own your success as your own successes. There is a danger in prescribing psycho-pharmaceuticals to a mildly depressed person, especially one who is depressed due to a significant life event or life hardships - that the person comes to believe the success belongs to the drug. That in itself sets up an addiction, and anchors attempts to get off medication in relapse.
Finally, each individual is different in the reasons for and make-up of their emotional life. A one-size fits all approach to mental health is not constructive, and in fact for those it doesn't work for, can only add to the sense of un-wellness and failure. Take your time, assemble your team, utilise your support network. In many cases, the journey is the cure, and the way you live with your symptoms is the definition of who you are. You may never comply with the standard soap opera definition of "well." But you will be you.Work towards being the best you that you can be.
Note that I do not recommend unilaterally ceasing to take medication. I encourage you to seek additional paths to mental health, and to seek those medical practitioners who are skilled and willing to take a more cautious and long-term approach. Guide your team to assist you to live in the way that your prefer. Ask questions, no matter how unimportant you think they are.
What is your experience of medication?
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