Challenging Depression & Despair: A Medication-Free, Self-Help Programme That Will Change Your Life (3 page)

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Drugs for despair

So you want help with ‘depression,’ do you?
Maybe you’ve tried everything else. That wouldn’t surprise me. For years I’ve been researching therapies and scientific studies on mental health issues and if I were you, I’d be looking for something different as well. Sigmund Freud once let slip to a friend that his patients were ‘only riffraff’.
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Although some therapists may be a bit more caring and prefer the term ‘client’ rather than ‘patient’, at the end of a hard day’s therapeutic endeavours the sufferer is still seen as a case (or even nutcase) with a syndrome, symptoms, treatment options, a prognosis. So what else is there?

‘PULL YOURSELF TOGETHER’

Pull yourself together. We’ve all heard it. When you feel down and out, somebody puts the boot in and says this. You may not like it and they may be insensitive, but they are right in one respect. If there is to be any pulling together,
you
have to do the pulling. The cavalry is not coming. Nobody is going to rescue you. Either you’re going to help yourself and get better, grow as a person and turn your life around, or you are stuck in a very bad place, annoying more robust people with your dismal attitude. This is the Heartless Bitch talking, but at least I’m giving it to you straight. It’s up to you.

In this first part we shall be looking at what has gone wrong with our emotional well-being, why so many people are depressed and despondent, and what we can do about it. We need to get you away from the fashionable ‘calm down’ culture and pseudo-medical twaddle that goes by the name of ‘stress management’ because despair may actually result from

•
a sedative lifestyle (the constant search for calm)

•
false labelling (giving ‘syndrome’ labels to normal emotions and states)

•
medicalising of feelings (like anger, worry, frustration or fear) and

•
timid and avoidant attitudes towards negative emotions.

Sure, people in the past suffered from despair, but not in the epidemic numbers that we do nowadays. They had very different ideas on tackling it as well.

Tackling tip: The law of momentum

Here is a useful tip for ‘getting going again’ if your motivation and adrenalin cease to flow. When children are learning to ride a bike, they quickly discover the law of momentum. If you stop pedalling, the bike keels over and you fall off. You need to keep pedalling, keep moving, even if you’re not sure exactly where yet! So it is with mental energy. If you stop taking action, you disengage the brain and it idles. You fall flat. Keep taking action! Even if it is something as simple as ‘get out of bed and clean your teeth’ or ‘clear out that cupboard’ or ‘make a list of what needs doing’, your brain’s first gear is engaged, and will gradually move you on from there.

Let’s start by looking at the most
common
method of treating despair today.

‘OUT OF THE MEDICINE CHEST INTO THE MOUTH’

Medicalising depression is part of the problem that modern sufferers face. Medical diagnosis does two things: first, it implies that you are mentally ill and therefore a patient, psychologically abnormal and possibly mad – compounding your misery and low self-esteem and increasing the likelihood that you will rely on others for help and rescue. And second, diagnosis holds out the hope of a medical solution. That may not be forthcoming.

Doctors are very busy. They haven’t got time to talk to you at length about your feelings. What would you do if one in three of your patients came in with this same ‘complaint’? The giant chemical companies command trends in research, publication and treatment.

They therefore influence your doctor’s methods of dealing with ‘patients’ like you who ‘present with depression’.

Task

If you are taking antidepressants, try this:

•
Calculate how long you have been on them (days, weeks, years).

•
Now multiply by the dosage.

That’s how many pills you have popped. It may surprise you!

‘SUNSHINE PILLS’

The 1990s saw the emergence of a new generation of antidepressants known as SSRIs (selective serotonin reuptake inhibitors), hailed, like all new-generation drugs, as ‘without the harmful side effects of the previous generation’. SSRI prescription exploded. In Britain in 1997, around 6.5 million prescriptions were issued. By 2002 this had risen to 13.3 million. In the US, by 2003 more than 142 million prescriptions were dispensed, a staggering 45 per cent increase in three years. Antidepressants affect the brain’s chemical messengers called neurotransmitters and may boost the level of serotonin. This slowly changes the brain’s communication system – for good or ill. Some patients swear by them and find they help them through crises. But others have suffered serious harm.

Prozac (fluoxetine), the so-called ‘sunshine drug’ manufactured by Eli Lilly, was licensed in the US in 1988. Since then, although some sufferers have praised the drug for helping them, many cases have come to court in the US blaming Prozac for suicide and violence. Psychiatrist Dr David Healy, citing a wealth of statistical and medical evidence, writes: ‘There is a long clinical tradition of recognizing antidepressant-induced suicidality … Companies have failed to report in full their clinical trial data on suicidal acts.’
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In early trials people who were
not
depressed had suicidal thoughts while on Seroxat, ‘and the same is true of some people who are given SSRIs for conditions other than depression’, MIND’s Information Officer Dr Katherine Darton tells us. ‘It is not always, or necessarily, the depression that makes people suicidal, as drug companies like to suggest. Some people have told us at MIND that they never felt like that before they started on the medication.’
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Some patients have reported feeling violent rather than suicidal.

A study of 2,776 consecutive cases of DSH (deliberate self-harm) attending an accident and emergency department in 2000 found that occurrence ‘was highest with fluoxetine (Prozac)’.
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In one American court case, 76 research papers were cited to demonstrate that Prozac causes violence and suicide.
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One patient, Joseph Wesbecker, a print worker from Louisville, shot eight colleagues, injured another 16 and then turned the gun on himself. Another, Bill Forsyth, a retired car rental company owner from California, took Prozac for 12 days and then stabbed his wife 15 times and impaled himself on the kitchen knife he had used. Ten days into his prescription course, Reginald Payne, a retired Cornish teacher, suffocated his wife and threw himself off a cliff.

Despite mega-dollar settlements out of court, Eli Lilly’s position is always to blame the depression not the drug, but the risks of explosive tension and violent agitation (akathisia) had been recorded by the company since the drug’s clinical trials in 1978. Plaintiffs claimed that Prozac had caused balanced individuals with mild depression to become suicidal killers.

OTHER SSRIs

In 2001 there was a landmark court ruling in the US in the case of Donald Schell, a retired oil-rig worker who had been taking the SSRI antidepressant Paxil for two days when he shot and killed his wife, daughter and granddaughter and then turned the gun on himself. The jury found that Paxil, made by GSK (GlaxoSmithKline), ‘can cause some individuals to commit suicide and/or homicide’ and awarded the surviving family members $8 million in damages.

In 2004, the US Food and Drug Administration asked the manufacturers of ten popular antidepressants to add suicide warning labels to their products. The drugs cited were:

Long-suppressed research in the UK linking certain antidepressants with suicide among children and teenagers
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had rung alarm bells in America. Of seven SSRI drugs under review by the Committee on Safety of Medicines – Celexa, Effexor, Lexapro, Luvox, Paxil, Prozac and Zoloft – four (Zoloft, Celexa, Paxil and Effexor) were found to increase the rate of self-harm. Official advice from the National Institute for Clinical Excellence (NICE) and the Medicines and Healthcare products Regulatory Agency (MHRA) in Britain is now to ‘contraindicate’ the use of SSRI antidepressants in patients under 18, apart from Prozac as a last resort combined with a talking treatment. Doubts have also been raised about the efficacy and effectiveness of Cipramil (citalopram) and Cipralex (escitalopram).
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SEROXAT

The best-selling antidepressant in the UK had been Seroxat (paroxetine), manufactured by GSK. The Committee on Safety of Medicines advises that patients should initially be given only 20 mg a day, but in 2003 it became clear that 17,000 patients had been started on higher doses and that Seroxat had been prescribed at unsafe levels since it was first licensed for use in the UK in 1990.
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The drug has potentially disastrous side effects. Seroxat may raise the risk of suicide by as much as seven or eight times.
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The British drug regulatory body, the MHRA, is now investigating other reported problems with Seroxat – dubbed the ‘anti-shyness pill’ – such as anxiety, nausea, violent rages and suicidal thoughts. Janice Simmons of the Seroxat User Group expressed the anger of patients like herself: ‘Prescribing of these drugs has become absolutely scandalous.’
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NICE cautioned doctors in December 2004 to exercise more care in prescribing antidepressants. NICE advised that in cases of mild depression they should not be used at all. Andrew McCulloch of the Mental Health Foundation observed: ‘The group of people who will benefit from these drugs is smaller than some GPs think.’
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The situation is under review.

AND FINALLY – HOW WELL DO THEY WORK?

In response to a request under the (US) Freedom of Information Act from two psychologists, Thomas Moore and Irving Kirsch of the University of Connecticut, in
2002, a review was published of 47 studies used by the US Food and Drug Administration for approval of the six most commonly prescribed antidepressants between 1987 and 1999. These were (brand name first, generic name in brackets): 

Overall the antidepressants performed slightly better than placebos, but in
more than half
the studies the drugs were no more effective than the sugar pills.
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So if you yourself have been prescribed antidepressants, take them out of the plastic pot or blister pack and look at them. Turn them over in your fingers. And then consider the following notes:

•
Drugs for despair have been developed and tested using laboratory animals, pitiful analogues of human psychology.
 

•
Antidepressant drugs are merely palliative. They may mask the effects of despair for a time, but they have a powerful attraction and you may develop a dependency on them in times of crisis, undermining your confidence to cope on your own.
 

•
The British mental health charity MIND produces booklets on mood-altering drugs and how they have harmed some of those who use them. MIND say they can help some people to get through severe episodes but that patients should not take them without being fully informed of the risks.
 

•
Patient groups like the Seroxat User Group, Beat the Benzos and Victims of Tranquillisers represent those who have suffered severe side effects from mood-altering drugs. Visit their websites and read their experiences.

Withdrawal

Side-effects – including suicidal thoughts – may increase during withdrawal and change of dose, but your GP can help you with this if you decide to go ahead. Withdrawal has to be sensibly managed – you can’t just suddenly chuck the tablets in the toilet. But still, under medical supervision you can be gradually weaned off your mood-altering drugs once and for all.
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I hope when you have read this book you may feel that little sparkle inside that says
Go
on – grow out of them
. Besides, unless you have recourse to a sensible strategy for dealing with it, despair tends to recur. The real cure lies not in your medicine cabinet, but in your brain: