Misconceptions about Antidepressants and Other Psychiatric Medications. Sometimes, they actually work.

Picture me.  And a soapbox.  Now I'm on it.

I would like to address the subject of antidepressant use.  It seems that every week I read an article or a book where antidepressant use is discouraged, because "they don't really work", they have horrible side effects, and they are bad for you.  Just yesterday I was reading "Food Over Medicine" by Pam Popper, which has a lot of great information about nutrition, but when she got to the subject of mental health, she said that some people experience depression as a result of a great loss and they just need time to "process their emotions".  Really?  That might work for some people, depending on the person, the loss, and their predisposition to depression.  But, for a lot of people, they can't function.  They can't see their need for help unless they have family or friends to point it out to them, and this might not be a time where "pulling yourself up by your bootstraps" is going to work.  Instead, they might need short or long term help with medications just to make them functional. Then, they might be able to see their situation more clearly and make plans to "process their feelings" with someone.  

She also said that if you do go to your doctor for depression, you should tell him that you are not interesetd in a pharmaceutical solution to the problem.  She claims that psychotropic drugs are addictive and "should be avoided at all costs".  A psychotropic drug is any drug used to treat psychiatric disorders.  I've been on several of these, and am currently taking two of them.  In Pam's words:

"Right now we know that taking antidepressant and antianxiety drugs not only increases your risk of suicide but they ultimately make people more depressed"

For this statement, she references one book.  One.  No scientific studies, just Petter Breggin's "Your Drug May be Your Problem".  If you read reviews of this book, several people say that their son/daughter stopped taking their bipolar medications after reading this book for a college course, and they ended up in a mental institution and took months to fully recover.  How can she make such a broad statement, that no one should take psychiatric medications and that they only have harmful effects?  I am lucky that my medications do not increase thoughts of suicide, in fact they do the opposite.  None of the other side effects are major enough for me to even consider stopping them.  What do they do? They allow me to be "me".  They enable me to get out of bed and function. They take away dark thoughts of worthlessness and hopelessness and allow me to stop thinking about death all of the time.  I don't cry for no reason, and I have energy to do things with my family instead of sleeping all of the time.  Now, if I had listened to someone like Pam Popper, I would have decided that these drugs would only make things worse and that I needed to solve my depression myself.  Can we say dangerous advice?

Another article I read recently was about a celebrity who claimed to have gone through depression. When asked if she needed medication to get out of it, she responded that "she was a really strong person so she was able to do without medication.  She worked through her feelings herself".  Why would it have been so terrible for her to say that she did need medication? Why is there still a stigma?  I'm sure a lot of depressed people read the article, hoping for some good advice, and felt even worse about themselves afterwards. What was wrong with them? Why couldn't they deal with their feelings themselves? They already feel worthless and useless, how is this attitude helping anyone?

Our bodies are fallen.  God created them perfect, but after the Fall in the Garden, sin and corruption began.  Our bodies are broken, people get heart disease, cancer, diabetes, digestive disorders and mental illnesses.  Would you ever say to a person with lung cancer, "Why don't you just try to fix it yourself?  Think positively, try exercising, and oh!  I just read about this new supplement that is supposed to do wonders!"  Now, there is nothing wrong with exercise (it has been proven to elevate the mood), or certain supplements, but my point is, if you had cancer, your friends and family would be researching the best doctors and hospitals trying to get you treatment as soon as possible.  Why?  Because if they don't, you might die.  Interesting.

To be fair, I will say that some doctors do overprescribe psychiatric medications.  They might automatically start with this solution after barely listening to the patient and they might not combine it with cognitive behavioral therapy when it is needed.  (And don't even get me started on the complete lack of good psychiatrists who can prescribe medications, it's often impossible to get an appointment, and you might end up with a general physician who is too scared to discuss mental health.  If this happens, drive.  Find a psychiatrist who will see you and someone who will drive you there).   There are lots of people who shouldn't be on psychiatric drugs, and there are a lot of people whose illnesses get worse on these medications.  BUT they do work for a lot of people.  And if they do, they are a literal lifesaver.  To tell people that they shouldn't even consider this option is dangerous.  You wouldn't tell someone with heart disease to go to talk therapy and take vitamins.  Watch out for your friends and family.  If they need help, drag them there.  They probably won't want to go and they will claim that they are fine.  A lot of people are still ashamed as if mental illness is their fault, so they hide their symptoms and suffer alone.   Hopefully it won't always be this way.

* My all-time favorite book on the subject of mental illness is "Beyond Blue" by Therese Borchard.  She is hilarious.  And straightforward.  There's a ton of helpful information.  She also has a blog by the same name.

Super Easy and Quick Guacomole Recipe

I have one simple recipe that I use for guacomole.  It's very easy and quick, and it is so yummy!  I don't miss sour cream at all when I can eat this instead

Guacomole

Ingredients:

2-3 avocados

1/2 cup cilantro, chopped

1/2 - 1 onion, minced

Directions:

1.  Cut the avocado in half, then peel the "skin" off of it, if it doesn't come off easily, it's not ripe yet.  Mash the avocados in a bowl with a fork.  Use 2 or 3 avocados depending on how much you want to make.

2.  Chop an onion (or 1/2, depending on how much onion you like).  Add onion to avocados.

3.  Chop cilantro into tiny pieces, then mix in with the other ingredients!  You can put everything in the food processor at this point, it will be more creamy this way.  I however usually just stir it together and it's ready.  

How do we know which nutrition advice to follow?

I've been interested in nutrition and dietetics since I was 14.  I knew that I wanted to major in Dietetics in college, and I chose James Madison Univ. for that reason.  It's interesting though to think back about what I was taught from 1995-1999 about nutrition.  Some of the things I learned have remained the same, but some of them haven't.  For example, in the late 90s dietetians were encouraging everyone to use  margarine instead of butter.  Margarine had less saturated fat, and no one taught about trans fats yet.  Today however, most people know that butter is the better choice because trans fats are so highly linked with cardiovascular disease.  

Another example is the diabetic diet.  At that time dietetians were still teaching the diabetic exchange program, where you could eat so many exchanges from each of the food groups, and diabetics were not supposed to eat too many carbohydrates.  It didn't differentiate a whole lot between refined carbs and whole, complex carbs.  And there was no mention of fat making a difference in diabetics' blood sugar levels, the focus was completely on carbs.  Today, a lot of studies have shown how fat can be the main culprit behind insulin resistance and diabetes; the fat can make the cells "sticky" and insulin cannot get into the cell with glucose.  Some people still teach diabetics to restrict all carbohydrate intake, whether it's refined or complex, but newer information shows that complex carbohydrates combined with a low-fat, vegan diet can reverse diabetes.  It worked for me.

So how do we know what to believe?  Is the nutritional advice 15 years from now going to be completely different from what it is today?  For some things it will be (my prediction is that high protein/low carb diets will be history, and hopefully by then the whole omega 3 debate will be settled).  But, I have a read a lot of books and articles about nutrition and there are 2 recommendations that have not changed over time:

1)  Eat a lot of fruits and vegetables

2)  Choose whole grains and complex carbohydrates over refined ones.

No one that I have read has argued with these 2 points.  Of course, most people suggest organic fruits/vegetables over conventional ones, but if you can't afford organic, it's probably still better for you to eat conventional fruits and vegetables than none at all.  And who would possibly claim that refined, sugary foods are good for you (beside the makers of Froot Loops who claim that they are "whole grain")?  If refined carbs and sugar were good for you, we would all be so healthy!  

So if you are confused by the information out there and aren't sure which diet is healthiest, start with the 2 recommendations above.  And maybe things will be a little clearer in the future.