Don’t you wish there was a magic pill? Something that we can take to make us happy and forget all of the difficulties in life? Sounds great, right!
Do antidepressants fit this definition?
Well, let’s talk about antidepressant medication. There are three generations of antidepressants as follows:
|Category||Drug Class||Generic Names|
|First-generation||Tricyclic antidepressants (TCA’S)||Amitriptyline, Clomipramine, Desipramine, Doxepin, Imipramine, Nortriptyline, Amoxapine, Protriptyline, Trimipramine|
|First-generation||Monoamine oxidase inhibitors (MAOI’s)||Tranylcypromine, Phenelzine, Selegiline, Isocarboxazid|
|Second-generation||Selective serotonin re-uptake inhibitors (SSRI’s)||Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram, Escitalopram|
|Second-generation||5-HT2 receptor antagonists||Nefazodone|
|Second-generation||Dopamine re-uptake inhibitors||Bupropion|
|Third-generation||Selective norepinephrine re-uptake Inhibitors (SNRI’S)||Venlafaxine, Mirtazapine, Duloxetine|
Did you know that antidepressants are the most prescribed medication in the United States even over high-blood pressure medication? Now I understand that many people do need to take antidepressants if they have an endogenous (having an internal cause or origin). However, when depression is situational (loss, molestation, violation, death, etc), antidepressants carry many side effects that may be worse than feeling the feelings of the loss or trauma or what caused the depression.
Two of the antidepressant drug classes, the TCA’s and SSRI’s, causes metabolic disruption with long-term use (approximately, 2 years or more). Metabolic disruption includes weight issues, insulin resistance and type 2 diabetes. Chronic diseases like type 2 diabetes leads to depression. This cyclical response is interesting that health care practitioners would prescribe a medication for something that it actually causes!! There are many other side effects of antidepressants that include nausea, low sex drive, tiredness, difficulty sleeping, dry mouth, blurred vision, constipation, dizziness, and oh I love this one – anxiety.
So, is this the magic pill after all?
When I was in my doctorate program for Lifestyle medicine at Loma Linda University in California, I learned and specifically researched healthy ways to overcome anxiety and depression. What consistently surfaced in the literature was healthy eating, good sleep, and exercise as the treatment for depression. Even when untreated depression has a remission aspect. Depression will naturally resolve with time even when not medicated. Many researchers found that high-intensity (running, cycling, fast walk) exercise in the treatment of depression was as effective as any antidepressant. I found this interesting because of the high use of antidepressants. The difficulty with treating depression with exercise is that exercise is the very last thing a person wants to do, especially when depressed.
The problem with treating depression with antidepressants (including the previous mention) is the reason for the depression is masked and mood and emotion are “flat-lined,” which allows minimal access to emotions even with therapy. In addition, at some point the antidepressant becomes less effective. I call this “break-though” depression. When this happens, many clinicians change the medication rather than deal with the pain that drives the depression.
I know when you feel depression that you just want to feel better. Feeling better comes with feeling what is causing the depression. Trauma recovery can happen in a safe and private place – Kinder in the Keys can help!