Althouse: "Antidepressants to treat grief?"

December 26, 2012

"Antidepressants to treat grief?"

"Psychiatry panelists with ties to drug industry say yes."

27 comments:

edutcher said...: To a certain extent, I can see it. Anti-depressants can give you distance and perspective to deal with some things that otherwise couldn't be borne.; 12/26/12, 8:32 PM
George M. Spencer said...: An antidepressant does not wipe away grief or depression. It does not turn a person into a zombie or a grinning fool with rainbow eyes.

What an antidepressant can do is somewhat ease the extremely severe mental anguish and physical pain caused by grief and make is somewhat more possible to get through the day.

And grief does cause physical pain. It feels like your chest has been torn in half and cheese-grater is attacking your heart.

Shunning antidepressants for grief or depression is like shunning aspirin for a fever....; 12/26/12, 8:44 PM
Wince said...: Antidepressants to treat grief?

Spokesman for the pharmaceutical industry association, Charles Brown, said "Good grief".

Actually he told assembled shareholders, "grief, for lack of a better word, is good".; 12/26/12, 9:01 PM
KCFleming said...: It's not unreasonable to treat the symptoms of grief. It has been going on for decades without ny official imprimatur.

But the relationships withthe drug companies is suspicious per se, and reduces the faith of patients in their care.

And Obamacare will make these sort of questionable financial ties more and more common.

Pay to play. Enjoy!; 12/26/12, 9:10 PM
Michael K said...: Anti-depressants have been abused by the pharm industry. They are recommended for every situation. Serious grief might be OK but the abuse is in other areas. David Healy is a psychiatrist who has written a very good book on this .; 12/26/12, 9:12 PM
Dante said...: I've been hearing of new attempts to re-structure what it means to be a good country to live in by things such as happiness, well living, etc.

Now, if the government puts your loved one on the Liverpool protocol, voila! Here is the solution. Drug them with Wellbutrin.

Somehow, I feel I would be doing my relationship with my loved one a disservice by easing my anguish. It's a part of the big cycle of life. But who knows. Perhaps it makes more sense to remove those human emotions in favor of a government constructed human.

Even in the San Jose Mercury News at one time carried an article advocating giving men estrogen, to get rid of those nasty male human qualities.

Of course, one might also imagine the human race becoming some soma induced organism being fed nutrients and drugs from out robotized work force. Cheaper than the real thrill, real achievement, etc.; 12/26/12, 9:16 PM
KCFleming said...: Highs and lows are good and necessary.

Being unable to function does no one any service. People have been self-medicating grief for centuries with alcohol. How is this any different?

The bullshit is medicalizing it, but insurers and the government demand a "diagnosis" for any treatment offered, so diagnoses are what you get.

The doctor is trying to relieve suffering.
The state and third party payers don't pay for the diagnosis "suffering".; 12/26/12, 9:37 PM
Anonymous said...: Anti-depressants treat depression like chemotherapy treats cancer: aim in the general direction and hope the bull in the china shop doesn't break everything in the process.; 12/26/12, 9:47 PM
KCFleming said...: And with the depression diagnosis, now you can go on disability, like millions of other Americans in the new permanent recession.; 12/26/12, 10:10 PM
MadisonMan said...: One pill makes you larger, and one pill makes you small

And the ones that mother gives you don't do anything at all.

I think if the grief triggers a depressive episode, then perhaps medication is warranted. Just throwing pills at someone who can't deal? I don't see what that does except line someone's pocket.; 12/26/12, 10:28 PM
gadfly said...: Dr Joseph Mercola writes:

Most of you have probably heard that depression is due to a "chemical imbalance in your brain," which these drugs are designed to correct ...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 ... 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.

As for the ethics of Big Pharma, Dr Marcia Angell writes:

What does the eight-hundred-pound gorilla do? Anything it wants to.; 12/26/12, 11:05 PM
30yearProf said...: Physicians MAKE MONEY off writing prescriptions. They accept CASH AND GIFTS from pharmacudical manufacturers.

They have a inirrradicable conflict of interest.; 12/26/12, 11:38 PM
Chip Ahoy said...: The only pills I care about right now are the blue pills and the red pills, because frankly, I find it impossible to talk to blue pill people in the Matrix. If you unplugged them they'd be shocked because the reality of it IS ugly.

Those people who are dreaming in the Matrix, I see what they get out of it, their whole reality from the machines, but what do they contribute? What's in it for the machines? Earth's resources, or what? Hang on.

while their bodies' heat and electrical activity are used as an energy source.

Yeah, okay, to what end?Sentient machines would conclude people are not worth the extra trouble. They could do better with potatoes.; 12/27/12, 12:08 AM
KCFleming said...: "Physicians MAKE MONEY off writing prescriptions. They accept CASH AND GIFTS from pharmacudical manufacturers"

Bullshit.; 12/27/12, 12:24 AM
Dante said...: Bullshit.

What's Bullshit? Pharmaceutical companies invite doctors to all kinds of events in nice locations, and it's all in the pursuit of selling more drugs.; 12/27/12, 1:06 AM
Anonymous said...: while their bodies' heat and electrical activity are used as an energy source.

Chip: That always seemed stupid to me too.

Stephen King used a similar device -- only it was human blood powering the machines -- in "The Tommyknockers." Years later King admitted he was so continuously drunk at the time of his life that he doesn't remember writing any of the book.; 12/27/12, 1:39 AM
Alex said...: I wonder if the erstwhile Julia ever would experience grief.; 12/27/12, 1:47 AM
Alex said...: It's not an unknown thing for a spouse to follow the deceased into the afterlife soonafter.; 12/27/12, 1:48 AM
Anonymous said...: Once you head down the path of managing emotions with drugs, it's hard to get off. But that's the conventional wisdom, so it stands to reason we will see more of it.

My take is that Americans are way over-medicated, especially with antidepressants. I know a surprising number of people who have been on antidepressants without a break since the mid-nineties. They believe they are like diabetics, and antidepressants are their insulin.

We are in new territory here. Whatever studies the FDA did on antidepressants did not include testing for effects over a decade out. Fortunately it appears that the long, long-term effects aren't too bad or we would have heard some real horror stories by now.

No thanks to modern psychiatry though. It could have gone another, darker way, and still might when we get a large population of seniors with decades of exposure to these drugs.; 12/27/12, 2:26 AM
Dante said...: For those who have read Megan Mcardle, she has gone through a lot of the issues with the pharmaceutical companies. They are making fewer "block busting drugs," at a time when one might think all this understanding of DNA, etc., would be providing great insights. But the number of new good drugs is dropping, and the cost is increasing.

Yet, once a drug has developed, it costs very little to make an extra 100,000 or extra 1,000,000 of them.

And once they are generic, they essentially cost little to nothing, and can be made cheaply offshore.

I wonder what the deal Obama made. And I wonder if he took into account that the drugs aren't doing as well as they once used to, in terms of innovation. What did Obama promise these companies? Yes, let's drug America into feeling it is doing well?

I wouldn't put it past him.; 12/27/12, 3:43 AM
DEEBEE said...: SOMA here we come.; 12/27/12, 4:45 AM
Astro said...: I haven't felt the need for anti-depressants to deal with my grief, but I have a lady friend who took them for a few months following a nasty divorce. I can see where they can help.
Before my wife died she was on some serious pain meds and anti- depressants. I don't think there were any 'agreements' between the doctor and the drug companies over the meds the doctor was prescribing. That may happen sometimes, but not often. I think that's just an overdone made- for-tv movie plot.; 12/27/12, 6:17 AM
HT said...: Dante is right. In fact, there's a database you can search on to see which doctors in the US have accepted speaking fees from the pharmaceutical companies. But there are other benefits too.

"Mathew Webb left a sales job in menswear for a sales job in pharmaceutical drugs 10 years ago and suddenly found himself surrounded by money.

"As a sales representative for a major drug company, he was expected to entertain doctors two or three nights a week. There were seats in elaborate sporting events in private stadium suites at major games and dinners at five-star restaurants.

"At that point, openly using gifts and money to influence doctors was considered standard practice."

It's too easy to find this stuff. However, you do have to actually try.

The article in the Post has the following heading:

Antidepressants good for the grieving? Panel with deep industry ties says yes.

So either Ann left out the subheading, or they added it subsequent to posting the original article.; 12/27/12, 8:28 AM
HT said...: More testimony from a doctor, called Dr Drug Rep.

http://www.nytimes.com/2007/11/25/magazine/25memoir-t.html?_r=2&ref=magazine&pagewanted=all&; 12/27/12, 8:30 AM
HT said...: "Fortunately it appears that the long, long-term effects aren't too bad or we would have heard some real horror stories by now."

That seems passive, to me.

Have you heard of tardive dyskinesia? Obesity? High blood pressure? Psychosis? Depression? Anxiety? Obsessive thoughts?

Just read the bad effects part on the back of the box.

Getting off Effexor often involves brain zaps.; 12/27/12, 8:40 AM
Anonymous said...: Have you heard of tardive dyskinesia? Obesity? High blood pressure? Psychosis? Depression? Anxiety? Obsessive thoughts?

HT: You left out suicide.

Yes, all those things happened to my mother after long-term treatment with just about all the drugs that psychiatrists had to offer before 1980. The tardive dyskinesia was the grimmest.

Yes, I know quite a lot about this stuff and I won't go near those drugs myself.

However, there is no question that the drugs offer some relief, have saved some lives, and have allowed some people to return to relatively normal, productive lives.

These meds are a devil's bargain and I don't know how it all balances out.

I was more of an alarmist 10-15 years ago. Since then I look at my friends who are still taking antidepressants and they look OK. I don't know who they would be without the drugs and I still worry what happens as they age, but I expected worse and that didn't happen.; 12/27/12, 10:25 AM
HT said...: **[My mistake - the original posting DOES include the 'panelist with drug ties' part/link.]

Here is what appears to be the crux of the matter, regarding this article - timing.

From a practitioner's blog:

"The change [in DSM manual] that most concerns me has to do with the "bereavement exclusion"(BE). In the current manual, the DSM IV, this exclusion means that a person who has suffered the death of a loved one may be diagnosed with Major Depressive Disorder (MDD) no less than two months following the loss. Prior iterations, the DSM III, stated one year.

"The new DSM 5, with a planned release date in early 2013, however, has again reduced that prescribed time frame from two months to two weeks, further pathologizing the authentic human experience of sorrow. So, a person may, at the discretion of a psychiatrist, social worker, or psychologist, be categorized as "mentally ill" as soon as two weeks following the death of a loved one. While I don't like or agree with either 'time limit', the arbitrary absurdity of "14-days post-loss-then-becomes-depression-label" has ignited a fire in the pits of my being against the DSM machine."

It appears there is a clear link between the pharmaceuticals and the diagnosis. IOW, the pharmas are just taking advantage of the new time limit of 'grief.'; 12/27/12, 10:54 AM