By Dr. Mercola
If reading the news and watching TV advertisements for psychotropic drugs makes you wonder if Americans are in the midst of a raging epidemic of mental illness, you’re not alone. In a New York Times book review, Marcia Angell, former editor-in-chief of the New England Journal of Medicine, talks about how a shocking 46 percent of Americans now fit a diagnosis for some form of mental illness.
“What is going on here? Is the prevalence of mental illness really that high and still climbing?” she asks. The authors of three books she’s reviewed have posed some interesting — and alarming — answers.
Mental Illness Not the Result of Chemical Imbalance
Most of you have probably heard that depression is caused by too little serotonin in your brain, which antidepressants are designed to correct. Likewise, schizophrenia is said to be related to too much dopamine, which other psychiatric drugs help lower. Unfortunately for anyone who has ever swallowed these marketing ploys, this is actually NOT a scientific statement.
Instead, these explanations for the “causes” of mental illness were created only after the drugs were found to have these effects.
Says Angell:
“When it was found that psychoactive drugs affect neurotransmitter levels in the brain, as evidenced mainly by the levels of their breakdown products in the spinal fluid, the theory arose that the cause of mental illness is an abnormality in the brain’s concentration of these chemicals that is specifically countered by the appropriate drug …
That was a great leap in logic … It was entirely possible that drugs that affected neurotransmitter levels could relieve symptoms even if neurotransmitters had nothing to do with the illness in the first place (and even possible that they relieved symptoms through some other mode of action entirely).”
As Angell states, using this logic you “could argue that fevers are caused by too little aspirin!”
Unfortunately, the idea that mental illness is the result of chemical balance is a popular one that is now firmly rooted in the conventional psychiatric profession. Not only does it take away the stigma of mental illness, but it gives psychiatrists a solution, one that fits neatly on their prescription pads.
The trouble is, not only do the drugs not work, they may actually cause your brain to function abnormally. Medical journalist and Pulitzer Prize nominee Robert Whitaker, whom I interviewed in the video above, explains it this way, as Angell reported:
“Prior to treatment, patients diagnosed with schizophrenia, depression, and other psychiatric disorders do not suffer from any known “chemical imbalance.” However, once a person is put on a psychiatric medication, which, in one manner or another, throws a wrench into the usual mechanics of a neuronal pathway, his or her brain begins to function … abnormally.”
Are Psychiatric Drugs Making Mental Illness Worse?
Something has changed in the field of diagnosing and treating psychiatric disorders in the last few decades, and that something has led to a 600 percent increase in persons on government (Social Security) disability due to mental illness!
According to Whitaker, it used to be that depression was typically a self-limiting illness. Even in cases severe enough to require hospitalization, people would get better in six or eight months; they would recover and often never relapse, or if they did it would be years down the road and, again, self-limiting.
When antidepressants were introduced, it was with the intent that they would help people recover from depression more quickly. Unfortunately, what we’re now seeing, and have been seeing since antidepressants were introduced, is patients recovering faster but relapsing more, or recovering only partially and transitioning into a festering state of chronic depression that never really resolves.
Long-term studies now indicate that of people with major depression, only about 15 percent that are treated with an antidepressant go into remission and stay well for a long period of time. The remaining 85 percent start having continuing relapses and become chronically depressed.
“By the 1990s, this change in the long term course of depression was so pronounced that finally it was addressed by researchers,” says Whitaker. “Giovanni Fava from Italy said, “Hey, listen, the course is changing with antidepressants. We’re changing it from an episodic illness to a chronic illness, and we really need to address this.”
Not only that, but the depression is sinking into people [on antidepressants] in a deeper way than before.”
According to Whitaker’s research, this tendency to sensitize the brain to long-term depression appears to be the same both for the earlier tricyclic antidepressants and the newer SSRIs (selective serotonin reuptake inhibitors). Another famous psycho pharmacologist named Ross Baldessarini at Harvard Medical School also began asking whether or not these drugs may in fact be depressogenic (causing depression).
Unfortunately, the evidence points that way, and the long-term prognosis when taking antidepressants is quite bleak, as this type of drug treatment has a whopping 85 percent chronic relapse rate.
Psychiatric Drugs Cause Alterations in Your Normal Brain Function
Despite what the slick advertisements say, psychotropic drugs have no known measurable biological imbalances to correct — unlike other drugs that can measurably alter levels of blood sugar, cholesterol and so on.
How can you medicate something that is not physically there?
The answer is, of course, you can’t — and doing so is a dangerous game.
Psychotropic drugs can actually interfere with your neurotransmitters in such a way as to upset the delicate processes within your brain needed to maintain your biological functions normally, leading to side effects that may resemble mental illness! As Angell reported, Whitaker explains:
“It is well understood that psychoactive drugs disturb neurotransmitter function, even if that was not the cause of the illness in the first place. Whitaker describes a chain of effects. When, for example, an SSRI antidepressant like Celexa increases serotonin levels in synapses, it stimulates compensatory changes through a process called negative feedback. In response to the high levels of serotonin, the neurons that secrete it (presynaptic neurons) release less of it, and the postsynaptic neurons become desensitized to it.
In effect, the brain is trying to nullify the drug’s effects. The same is true for drugs that block neurotransmitters, except in reverse.”
In 1996, neuroscientist Steven Hyman, who was head of the National Institute of Mental Health at the time, and is today Provost of Harvard University, published the paper Initiation and Adaptation: A Paradigm for Understanding Psychotropic Drugs, in which he explains this chain of events. According to Dr. Hyman, once your brain has undergone a series of compensatory adaptations to the drug, your brain operates in a manner that is “both qualitatively and quantitatively different than normal.”
Angell continues, explaining how this vicious cycle leads to more diagnoses, prescription drug use and increasing side effects:
“After several weeks on psychoactive drugs, the brain’s compensatory efforts begin to fail, and side effects emerge that reflect the mechanism of action of the drugs. For example, the SSRIs may cause episodes of mania, because of the excess of serotonin. Antipsychotics cause side effects that resemble Parkinson’s disease, because of the depletion of dopamine (which is also depleted in Parkinson’s disease).
As side effects emerge, they are often treated by other drugs, and many patients end up on a cocktail of psychoactive drugs prescribed for a cocktail of diagnoses.
The episodes of mania caused by antidepressants may lead to a new diagnosis of “bipolar disorder” and treatment with a “mood stabilizer,” such as Depokote (an anticonvulsant) plus one of the newer antipsychotic drugs. And so on.”
Side Effects are What Let Patients Know Antidepressants are “Working”
Every year, 230 million prescriptions for antidepressants are filled, making them one of the most-prescribed drugs in the United States. Despite all of these prescription drugs being taken, more than one in 20 Americans are depressed, according to the most recent statistics from the Centers for Disease Control and Prevention (CDC).
The statistics alone should be a strong indication that treatment with antidepressants simply is not working, but the research bears this out also.
Studies have confirmed that antidepressant drugs are no more effective than sugar pills. Some studies have even found that sugar pills may produce BETTER results than antidepressants!
Personally, I believe the reason for this astounding finding is that both pills work via the placebo effect, but the sugar pills produce far fewer adverse effects, however research by Irving Kirsch, a psychologist at the University of Hull in the UK, and colleagues presents another interesting theory — that the side effects produced by antidepressants are the reason why they are sometimes perceived to work better.
In Kirsch’s book, The Emperor’s New Drugs: Exploding the Antidepressant Myth, he describes research he conducted using placebo-controlled clinical trials submitted to the U.S. Food and Drug Administration. A review of 42 trials revealed that placebos were 82 percent as effective as antidepressants, which translates to a 1.8-point difference on the Hamilton Depression Scale (which is used to measure symptoms of depression). Though “significant” clinically speaking, this difference would not mean much whatsoever on a treatment level.
Next, Kirsch also found in the research that virtually any pill that produced side effects was just slightly more effective at relieving depression than placebo. This included thyroid hormones, herbal remedies, stimulants, sedatives, and others.
So, the antidepressants did not appear to be unique in this action, since virtually every pill given produced the same results. What was really going on?
Well, the purpose of keeping a study double-blind, meaning neither the patient nor the researcher knows if they’re taking an active pill or a placebo, is to prevent bias. It’s well known that if a person believes they’re taking an active drug, they are more likely to “feel” a benefit. Kirsch reasoned that when a person experienced a side effect, it tipped them off that they were taking an active antidepressant rather than a placebo, and this is what gave them the slight advantage.
To test this, Kirsch then investigated trials involving an “active” placebo, meaning one that causes a side effect, and low and behold there was absolutely no difference found between the antidepressant and the active placebo. Angell reported:
“Everyone had side effects of one type or another, and everyone reported the same level of improvement.
Kirsch reported a number of other odd findings in clinical trials of antidepressants, including the fact that there is no dose-response curve—that is, high doses worked no better than low ones—which is extremely unlikely for truly effective drugs.
“Putting all this together,” writes Kirsch, leads to the conclusion that the relatively small difference between drugs and placebos might not be a real drug effect at all. Instead, it might be an enhanced placebo effect, produced by the fact that some patients have broken [the] blind and have come to realize whether they were given drug or placebo. If this is the case, then there is no real antidepressant drug effect at all.”
The Truth about the “Chemical Imbalance” Theory
As a family physician I have treated many thousands of depressed patients. Depression was actually one of my primary concerns in the mid 80s when I first started practicing, however at that time my primary tool was using antidepressants. I put thousands of people on these drugs and acquired a fair level of experience in this area.
Thankfully I learned more and was able to stop using all these drugs. It was my experience that the chemical imbalance was merely a massive marketing gimmick to support the use of expensive and toxic antidepressants.
Most of you have probably heard that depression is due to a “chemical imbalance in your brain,” which these drugs are designed to correct. As mentioned previously, this is not a scientific statement.. So where did it come from?
The low serotonin theory arose because they understood how the drugs acted on the brain; it was a hypothesis that tried to explain how the drug might be fixing something. However, that hypothesis didn’t hold up to further investigation. Investigations were done to see whether or not depressed people actually had lower serotonin levels, and in 1983 the National Institute of Mental Health (NIMH) concluded that
“There is no evidence that there is anything wrong in the serotonergic system of depressed patients.”
The serotonin theory is simply not a scientific statement. It’s a botched theory—a hypothesis that was proven incorrect.
The fact that this fallacy continues to thrive is destroying the health of millions, because if you take an SSRI drug that blocks the normal reuptake of serotonin, you end up with the very physiological problem the drug is designed to treat–low serotonin levels. Which, ironically, is the state hypothesized to bring on depression in the first place.
In 1996, neuroscientist Steven Hyman, who was head of the NIMH at the time, and is today Provost of Harvard University, published the paper Initiation and Adaptation: A Paradigm for Understanding Psychotropic Drugs, in which he explains this chain of events. According to Dr. Hyman, once your brain has undergone a series of compensatory adaptations to the drug, your brain operates in a manner that is “both qualitatively and quantitatively different than normal.”
So, it’s important to understand that these drugs are NOT normalizing agents. They’re abnormalizing agents, and once you understand that, you can understand how they might provoke a manic episode, or why they might be associated with sexual dysfunction or violence and suicide, for example.
How Did it Ever Get this Bad?
Part of the puzzle explaining why we now have a pill for every emotion and psychological trait is that psychiatrists were originally not considered “real” doctors—they couldn’t actually “do” much to help their patients, and they certainly couldn’t cure them. They realized that to increase their status, they had to make the field more scientific, and it was this decision that gave birth to the medicalizing and drugging of every conceivable behavioral tendency.
Medical journalist and Pulitzer Prize nominee Robert Whitaker explains the history of the treatment of those with severe mental illness in his first book, Mad in America. His latest book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America focuses on the disturbing fact that as psychiatry has gained ground, mental illness has skyrocketed.
Part of the problem is that the criteria for diagnosis has expanded exponentially—you can now be diagnosed as being “ill” if you have trouble controlling your shopping habits, and a child who often argues with adults can be labeled according to the diagnostic code 313.81 — Oppositional Defiant Disorder. A staggering array of normal human experiences now masquerade as “disorders,” for which there is a drug treatment available.
Another factor is the fact that psychiatric drugs CREATE more serious forms of mental illness…
What Does the Science Really Say about the Effectiveness of Psychiatric Drugs?
First of all, when looking at the research literature, short-term trials show that antidepressants do NOT provide any clinically significant benefits for mild to moderate depression, compared to a placebo. As you know, all drugs have benefit-to-risk ratios, so if a drug is as effective as a placebo in relieving symptoms, it really doesn’t make sense to use them as a first line of defense.
And yet doctors all over America prescribe them as if they were indeed sugar pills!
However, it gets worse. Research into the long-term effects of antidepressants shows that patients are no longer really recuperating from their depressive episodes as was the general norm prior to the advent of modern antidepressants. The depression appears to be lifting faster, but patients tend to relapse more frequently, turning what ought to have been a passing phase into an increasingly chronic state of depression.
Long-term studies now indicate that of people with major depression, only about 15 percent that are treated with an antidepressant go into remission and stay well for a long period of time. The remaining 85 percent start having continuing relapses and become chronically depressed.
According to Whitaker’s research, this tendency to sensitize your brain to long-term depression appears to be the same both for the earlier tricyclic antidepressants and the newer SSRIs (selective serotonin reuptake inhibitors).
In addition, SSRI’s have been shown to increase your risk of developing bipolar depression, according to Whitaker. Anywhere from 25 to 50 percent of children who take an antidepressant for five years convert to bipolar illness. In adults, about 25 percent of long term users convert from a diagnosis of unipolar depression to bipolar.
This is a serious concern because once you’re categorized as bipolar, you’re often treated with a potent cocktail of medications including an antipsychotic medication, and long-term bipolar outcomes are grim in the United States. For starters, only about 35 percent of bipolar patients are employed, so the risk of permanent disability is great.
Another risk inherent with long-term use is that of cognitive decline.
What Really Works for Depression and Other Mental Illness?
If antidepressants and other psychiatric drugs don’t work and might make you worse, then what are your options? There are five important strategies to consider if you are facing depression or another mental condition. These strategies have nothing but positive effects and are generally very inexpensive to implement.
- Exercise – If you have depression, or even if you just feel down from time to time, exercise is a MUST. The research is overwhelmingly positive in this area, with studies confirming that physical exercise is at least as good as antidepressants for helping people who are depressed. One of the primary ways it does this is by increasing the level of endorphins, the “feel good” hormones, in your brain.
- Address your stress — Depression is a very serious condition, however it is not a “disease.” Rather, it’s a sign that your body and your life are out of balance. This is so important to remember, because as soon as you start to view depression as an “illness,” you think you need to take a drug to fix it. In reality, all you need to do is return balance to your life, and one of the key ways to doing this is addressing stress.Meditation or yoga can help. Sometimes all you need to do is get outside for a walk. But in addition to that, I also recommend using a solid support system composed of friends, family and, if necessary, professional counselors, who can help you work through your emotional stress.
- Eat a healthy diet — Another factor that cannot be overlooked is your diet. Foods have an immense impact on your mood and ability to cope and be happy, and eating whole foods as described in my nutrition plan will best support your mental health. Avoiding fructose, sugar and grains will help normalize your insulin and leptin levels, which is another powerful tool in addressing depression.
- Support optimal brain functioning with essential fats — I also strongly recommend supplementing your diet with a high-quality, animal-based omega-3 fat, like krill oil. Omega-3 fats are essential for your optimal brain function, and that includes regulating your mood and fighting depression. In fact, the evidence has become so compelling that some experts in the field encourage all mental health professionals to ensure that their patients suffering from depression have an adequate intake of omega-3 fats.
- Get plenty of sunshine – Making sure you’re getting enough sunlight exposure to have healthy vitamin D levels is also a crucial factor in treating depression or keeping it at bay. One previous study found that people with the lowest levels of vitamin D were 11 times more prone to be depressed than those who had normal levels. Vitamin D deficiency is actually more the norm than the exception, and has previously been implicated in both psychiatric and neurological disorders.
My heart goes out to you if you, or someone you love, is struggling with mental illness. The solutions offered above will often help you to overcome your battle in the long run, but in no way are they meant to minimize the complicated puzzle of mental illness, or the extreme toll it can take on family units and in some cases extended circles of friends.
I’ve personally witnessed the struggles of two people near and dear to me who suffered from deep chronic depression for a number of years that actually resulted in multiple suicide attempts, so I am very familiar with its devastating effects. For those of you who are taking a prescribed drug based on appropriate diagnosis of a mental illness, just be aware of what the potential side effects are so that you can avoid more serious illness. By making key lifestyle changes you may be able to counteract some of the most devastating side effects, allowing you to maintain better health.
Read the Full Article Here: http://articles.mercola.com/sites/articles/archive/2011/09/13/the-epidemic-of-mental-illness–why.aspx
The Emperor’s New Drugs
Exploding the Antidepressant Myth
by Irving Kirsch Ph.D.
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