Are Anti-Depressants Good or Evil?

When did anti-depressants get marketed to TV viewers?

by Lissa Rankin, MD


I’m sitting in the green room, about to appear on Daytime TV, and the television is blaring in the background. Now mind you, I don’t have television in my home so I’m a bit out of the loop. But since I’ve been sitting here, I’ve seen one anti-depressant ad after another (mixed in with ads for lawyers who want to help you sue your doctor if you had complications from your anti-depressant). WTF?

When did anti-depressants get marketed to TV viewers? And why do they all promise peace, joy, tranquility, and the end to all of life’s suffering? I mean seriously people.

Now don’t get me wrong. I’m no Tom Cruise, and I swear I won’t be judging Brooke Shields if she takes anti-depressants for her postpartum depression. Anti-depressants can be a Godsend, and I have witnessed lives being saved. Sometimes, these drugs are a necessary step to get someone out of bed and back into life. Sometimes, they literally talk someone off the ledge. God bless Zoloft.

Holistic approach to depression

But…(and this is a huge but for me)… anti-depressants are just one of many tools to help people deal with mood disorders. These ads instill in me the fear that too many misinformed patients and busy doctors will run zero to sixty towards drugs, when treatment for depression should be much more holistic.

Even in integrative medicine practices, it seems to me that the approach is still way too allopathic. You come in depressed, and instead of giving you Prozac, they give you 5-HTP or St. John’s Wort. They might also delve into your diet and advise you about your exercise program, but I really care about why you’re depressed. Are you happy in your relationships? Are you doing work you love? Are you sexually satisfied? Are you nurturing your spiritual life? Have you discovered your calling and figured out what you’re here on Earth to do? Are you caring for the temple that is your body?

Another important question I explore is “Is your depression natural?” One of my friends just lost her best friend, who died in childbirth, leaving two children and a husband behind. At the funeral, they were passing out Zoloft like candy, and now, everyone in her family is taking anti-depressants. But isn’t it healthy and normal to grieve when something tragic happens? Sure, tragedies can lead to clinical depression, but technically, you can’t have a DSM-4 diagnosis of Major Depression in the midst of a crisis. We docs call it Adjustment Disorder, which seems so much more appropriate. You’re adjusting to a loss — and yes, that can make you cry and grieve. Do you really want to wash those feelings away with mind-numbing drugs?

Sure, anti-depressants may be the answer — in some cases.

And when you need them- oh baby, do you need them. But those people aren’t the ones these TV ads are aimed at. They’re targeting those who have lost their mojo — which is totally different than being depressed. It seems to me that disillusionment, dissatisfaction, and disappointment plague many people these days. It’s the epidemic of the developed world.

But drugs are not the answer. Instead, I encourage my patients to delve deep to discover who they really are at their authentic core. I ask them what’s missing from their lives. I invite them to explore what their body, mind and spirit need in order to heal. And then, after we’ve balanced thyroid, adrenal, and sex hormones, talked about diet and exercise, sorted through the emotional junk that weighs us down, and discussed lifestyle modifications that might help, we talk about supplements and pharmaceuticals.

I understand that I’m lucky. I get an hour with my patients at the Owning Pink Center, which gives me the time to go deep. When your doctor only has 7 ½ minutes to care for you, it’s easier to just write a prescription and send you on your merry way.

But you deserve to get your needs met.

You deserve to be treated like a whole, vital human being with a heart and a brilliant mind. You deserve to have a choice. It’s okay to question the TV ads and your doctor’s advice. You can be an empowered patient. It’s your birthright.

So do me a favor. Switch off the TV when those anti-depressant ads come on. You don’t need to fill your brain with those kinds of messages. If you need anti-depressants to feel joyful, more power to you. But don’t let marketing influence you, and don’t let your doctor push pills.

Mostly, listen to your intuition. It will tell you how to reclaim your joy.

Dr. Lissa Rankin is an OB/GYN physician, an author, a nationally-represented professional artist, and the founder of Owning Pink, an online community committed to building authentic community and empowering women to get- and keep- their “mojo”. Owning Pink is all about owning all the facets of what makes you whole- your health, your sexuality, your spirituality, your creativity, your career, your relationships, the planet, and YOU. Dr. Rankin is currently redefining women’s health at the Owning Pink Center, her practice in Mill Valley, California. She is the author of What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend (St. Martin’s Press, September 2010).

"Professor, Does My Dog Know I’m Blind?"

Can we know what animals know about what we know?

by Hal Herzog


My proverbial fifteen minutes of fame came this fall when my book Some We Love, Some We Hate, Some We Eat: Why It’s So Hard To Think Straight About Animals was published, and for a couple of weeks I found myself doing two or three radio interviews a day. The most interesting interview was in the middle of the night – a two hour-long, call-in marathon on Coast To Coast AM, That’s the radio network whose listeners tend to be conspiracy theorists, people with sleep disorders, and folks who swear they were once abducted by extra-terrestrials. (I suspect I was asked to appear on the show because I discussed the moral status of space aliens in my book.)

Even at three in the morning, the interview seemed to be going fairly well until a guy I will call Leo phoned in. First he asked me a question about why people love their pets but then he blurted, “Professor, do you think my dog knows I’m blind?”

The question stopped me cold. I had no idea that Leo was blind and I didn’t know if his dog did either. But Leo had raised a complicated issue – what do our pets know about the inner lives of their owners? First, I fumbled around a little, but then I confessed to the show’s 4.5 million listeners that I didn’t really have clue about what Leo’s dog thought about his owner’s limited visual abilities.

Leo’s question nagged me for the next couple of weeks. I am not a dog expert but I did meet some first rate dog researchers while writing my book. I decided see how they would answer Leo’s question and started firing off e-mails to them. Their responses were more nuanced than I can do justice to in a 1,000 word blog post, but I can give you a sense of their thinking. (For a list of people on the “panel” and some of their e-mails, see the “Comments” at the end of this post.)

What the Experts Said

As you might expect, nine of the world’s foremost canine ethologists did not all approach Leo’s question the same way, but they did agree that he had raised some fascinating issues. Patricia McConnell summarized the general feeling among my ad hoc panel when she wrote, “I doubt that anyone knows the answer to Leo’s question. But what great research project this would be!” Psychology Today blogger Marc Bekoff and ASPA scientific advisor Steve Zawistowski both pointed out that dogs do not have the abstract mental concept of “seeing” so Leo’s dog would not, at least in a literal sense, know what blindness is. PT blogger Stanley Coren, however, argued that dogs do have a “theory of mind” in that they will turn to their owners for advice by looking at their faces when confronted with a novel problem they have to solve. (Another of my experts, Adam Miklosi has demonstrated that this is one of the differences between domestic dogs and wolves.)

What About Seeing-Eye Dogs?

But what about trained guide dogs? I vaguely recall mumbling on the radio that night that a seeing-eye dog would surely know that its owner was blind. Was I correct? Three of my experts (Brian Hare, James Serpell, and Adam Miklosi) referred me to a set of elegant experiments recently conducted by a French cognitive ethologist named Florence Gaunet. If I was right, guide dogs should be less prone than pet dogs of sighted owners to look toward their owners’ faces for help when it comes to, say, locating hidden food or soliciting a round of play. To my surprise, however, Gaunet found that was not the case. Indeed, in one of the articles she flat out wrote,”Guide dogs do not understand that their owners cannot see them.”

Oops…I had inadvertently mislead Leo and four and a half million of his fellow insomniacs when I blithely proclaimed on the radio that seeing-eye dogs realize that their owners are blind. 

Are Pet Dogs Different?

But then James Serpell pointed out to me that the results of experiments on guide dogs might not apply to pets. As Steve Zawistowski suggested, whether pet dogs know their owners are visually impaired might depend, for example, on whether the owner lost their sight gradually or abruptly. And Barnard College’s Alexandra Horowitz hypothesized that a pet dog could figure out that its owner was blind but would probably not know what that blindness actually entails.

But leave it to canine ethology gadfly Clive Wynne to come up with a case of a dog that clearly knew its owner was blind and even used this knowledge to circumvent our expectations of canine good manners. I’ll let Clive speak for himself:

Hal, I was recently told a story by a dog trainer that is relevant to Leo’s question. She had “inherited” a dog from a blind lady who passed on to her. Soon after acquiring the dog, the trainer came downstairs to the kitchen. She was not terribly surprised to see the dog on the kitchen counter helping itself to some food that had been left out. What surprised her was that the dog, on hearing her footsteps on the stairs, did nothing to jump down. Instead the dog continued to eat! It was accustomed to the idea that just because a human was in the room, that did not mean that the human could detect her presence on the forbidden kitchen counter. This dog clearly knew what it meant for a human to be blind.

What Does It All Mean?

The bottom line is that even the best scientists are unsure whether Leo’s dog knows that Leo can’t see. Though it has not been done, we could easily design an experiment to find out whether the pets of sighted and blind individuals treat their owners differently. But Leo raised the much more difficult question – what do our pets think about us? Leo has reminded me of the essay “What Is It Like To Be a Bat” by the philosopher Thomas Nagel. (Nagel concluded that we can never know what a bat’s mental world is like.)

But Leo goes a step further than the philosopher. He asks, Can we ever really know what a dog knows about what its owner knows?  With apologies to Bill Clinton, I suppose it depends on what the meaning of the word know is.

                             *        *        *        *        *        *        *        *        *

Hal Herzog is Professor of Psychology at Western Carolina University and the author of Some We Love, Some We Hate, Some We Eat: Why It’s So Hard To Think Straight About Animals (Harper, September 2010).

Don’t Worry, Be Happy – By Stopping Smoking

By RICK NAUERT PHD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on December 3, 2010


Although the detrimental medical effects of smoking are well known, experts often question whether smoking cessation will have a positive or negative effect on an individual’s mood.

The concern (or perception) is that many people smoke to relieve anxiety and depression.

In a new study, researchers tracked the symptoms of depression in people who were trying to quit and found that they were never happier than when they were being successful abstaining from smoking, for however long that was.

Based on their results, the authors of the article, published in the journal Nicotine & Tobacco Research , recommend that smokers embrace quitting as a step toward improving mental as well as physical health.

In fact, according to corresponding author Christopher Kahler, Ph.D., quitting is not, as some smokers may fear, a grim psychological sacrifice to be made for the sake of longevity.

“The assumption has often been that people might smoke because it has antidepressant properties and that if they quit it might unmask a depressive episode,” said Kahler.

“What’s surprising is that at the time when you measure smokers’ mood, even if they’ve only succeeded for a little while, they are already reporting less symptoms of depression.”

Kahler and colleagues from Brown, The Miriam Hospital, and the University of Southern California studied a group of 236 men and women seeking to quit smoking, who also happened to be heavy social drinkers.

They received nicotine patches and counseling on quitting and then agreed to a quit date; some also were given specific advice to reduce drinking.

Participants took a standardized test of symptoms of depression a week before the quit date and then two, eight, 16, and 28 weeks after that date.

All but 29 participants exhibited one of four different quitting behaviors: 99 subjects never abstained; 44 were only abstinent at the two-week assessment; 33 managed to remain smoke-free at the two- and eight-week checkups; 33 managed to stay off cigarettes for the entire study length.

The most illustrative — and somewhat tragic — subjects were the ones who only quit temporarily. Their moods were clearly brightest at the checkups when they were abstinent. After going back to smoking, their mood darkened, in some cases to higher levels of sadness than before.

The strong correlation in time between increased happiness and abstinence is a tell-tale sign that the two go hand-in-hand, said Kahler, of Brown’s Center for Alcohol and Addiction Studies (CAAS).

Subjects who never quit remained the unhappiest of all throughout the study. The ones who quit and stuck with abstinence were the happiest to begin with and remained at the same strong level of happiness throughout.

Kahler said he is confident the results can be generalized to most people, even though the smokers in this study also drank at relatively high levels. One reason is that the results correlate well with a study he did in 2002 of smokers who all had had past episodes of depression but who did not necessarily drink. Another is that the changes in happiness measured in this study did not correlate in time with a reduction in drinking, only with a reduction — and resumption — of smoking.

Looking at the data, Kahler said, it is difficult to believe that smoking serves as an effective way to medicate negative feelings and depression, even if some people report using tobacco for that reason. In fact, he said, the opposite seems more likely — that quitting smoking eases depressive symptoms.

“If they quit smoking their depressive symptoms go down and if they relapse, their mood goes back to where they were,” he said. “An effective antidepressant should look like that.”

Source: Brown University

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Childhood Sexual Abuse May Be A Risk Factor For Later Psychotic Illness

Main Category: Psychology / Psychiatry
Also Included In: Pediatrics / Children’s HealthMental HealthSchizophrenia
Article Date: 02 Dec 2010 – 0:00 PST


An Australian study suggests that children who are sexually abused, especially if it involves penetration, appear to be at higher risk for developing schizophrenia and other psychotic disorders, according to a report in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Previous studies have established that abused children are more likely to develop depression, anxiety, substance abuse, borderline personality disorders, posttraumatic stress disorder and suicidal behavior, according to background information in the article. “The possibility of a link between childhood sexual abuse and later psychotic disorders, however, remains unresolved despite the claims of some that a causal link has been established to schizophrenia,” the authors write

Margaret C. Cutajar, D.Psych., M.A.P.S., of Monash University, Victoria, Australia, and colleagues linked data from police and medical examinations of sexual abuse cases to a statewide register of psychiatric cases. Rates of psychiatric disorders among 2,759 individuals who had been sexually abused when younger than age 16 were compared with those among 4,938 individuals in a comparison group drawn from electoral records.

Over a 30-year period, individuals who had experienced childhood sexual abuse had significantly higher rates than those in the comparison group of psychosis overall (2.8 percent vs. 1.4 percent) and schizophrenia disorders (1.9 percent vs. 0.7 percent). Participants experienced abuse at an average age of 10.2, and 1,732 (63 percent) of cases involved penetration of a bodily orifice by a penis, finger or other object. Those exposed to this type of abuse had higher rates of psychosis (3.4 percent) and schizophrenia (2.4 percent).

“The risks of subsequently developing a schizophrenic syndrome were greatest in victims subjected to penetrative abuse in the peripubertal and postpubertal years from 12 to 16 years and among those abused by more than one perpetrator,” the authors write. “Children raped in early adolescence by more than one perpetrator had a risk of developing psychotic syndromes 15 times greater than for the general population.”

The results establish childhood sexual abuse as a risk factor for psychotic illness, but do not necessarily translate into abuse causing or increasing the risk of developing such a disease, the authors note. Many cases of childhood sexual abuse never come to light, and the overall population of abused children maybe significantly different from those whose abuse is detected by officials.

“Establishing that severe childhood sexual abuse is a risk factor for schizophrenia does have important clinical implications irrespective of questions of causality and irrespective of whether those whose abuse is revealed are typical,” the authors conclude. “Children who come to attention following childhood sexual abuse involving penetration, particularly in the peripubertal and postpubertal period, should receive ongoing clinical and social support in the knowledge that they are at greater risk of developing a psychotic illness.”

“Such treatment in our opinion should focus on improving their current functioning and adaptation to the demands of the transition from adolescent to adult roles rather than primarily on the abuse experience itself. Such an approach should benefit all victims, irrespective of whether they have the potential to develop a psychotic illness.”

(Arch Gen Psychiatry. 2010;67[11]:1114-1119.)

Source:
Archives of General Psychiatry

Sugar May Lessen Aggression

By RICK NAUERT PHD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on December 1, 2010


Have you ever wanted to calm someone down? Researchers say a spoonful of sugar may do the trick — at least for a short time, and if the friend is not a diabetic.

Investigators discovered people who drank a glass of lemonade sweetened with sugar acted less aggressively toward a stranger a few minutes later than did people who consumed lemonade with a sugar substitute.

Researchers believe it all has to do with the glucose, a simple sugar that provides energy.

“Avoiding aggressive impulses takes self-control, and self-control takes a lot of energy. Glucose provides that energy in the brain,” said Brad Bushman, Ph.D., an Ohio State University professor and a co-author of the study.

“Drinking sweetened lemonade helped provide the short-term energy needed to avoid lashing out at others.”

The finding is more than just a medical curiosity, Bushman said.

In two published papers, he and his colleagues did several studies showing that people who have trouble metabolizing, or using, glucose in their bodies show more evidence of aggression and less willingness to forgive others.

The problem is that the number of people who have trouble metabolizing glucose — mainly those with diabetes — is rising rapidly to put it mildly. From 1980 through 2008, the number of Americans with diabetes has more than tripled (from 5.6 million to 18.1 million).

“Diabetes may not only harm yourself — it is bad for society,” Bushman said.

“The healthy metabolism of glucose may contribute to a more peaceful society by providing people with a higher level of energy for self-control.”

Bushman conducted the lemonade study with C. Nathan DeWall and Timothy Deckman of the University of Kentucky and Matthew Gailllot of SUNY-Albany. It appears online in the journal Aggressive Behavior and will be published in a future print edition.

In the study, 62 college students fasted for three hours to reduce glucose instability. They were told they were going to participate in a taste-test study, and then have their reaction times evaluated in a computerized test against an opponent.

Half of the participants were given lemonade sweetened with sugar, while the others were given lemonade with a sugar substitute.

After waiting eight minutes to allow the glucose to be absorbed in their bloodstream, the participants took part in the reaction test.

The reaction test has been used and verified in other studies as a way to measure aggression. Participants were told they and an unseen partner would press a button as fast as possible in 25 trials, and whoever was slower would receive a blast of white noise through their headphones.

At the beginning of each trial, participants set the level of noise their partner would receive if they were slower. The noise was rated on a scale of 1 to 10 — from 60 decibels to 105 decibels (about the same volume as a smoke alarm).

Each participant randomly won 12 of the 25 trials.

Aggression was measured by the noise intensity participants chose on the first trial — before they were provoked by their partner.

Results showed that participants who drank the lemonade sweetened with sugar behaved less aggressively than those who drank lemonade with a sugar substitute.

Those who drank the sugar-sweetened beverage chose a noise level averaging 4.8 out of 10, while those with the sugar substitute averaged 6.06.

“To our knowledge, this is the first study to find that boosting glucose levels can reduce actual aggressive behavior,” Bushman said.

“To be sure, consuming sugar should not be considered a panacea for curbing aggression. But the results do suggest that people who reportedly ‘snap’ with aggression may need some way to boost their mental energy, so they can override their aggressive impulses.”

In two other studies in the same paper, the researchers showed how problems metabolizing glucose may translate to problems on a societal level. Using 2001 data, the researchers found that the diabetes rates for each of the 50 states were linked to violent crime rates.

Those states with higher diabetes rates also tended to have higher rates of murder, assault, rape and robbery, even after controlling for poverty rates in each state.

“This suggests that diabetes did not predict violent crime simply because poverty contributes to both diabetes and violent crime,” he said. “There is a real correlation between diabetes and violence.”

In a separate analysis, the researchers tested whether another medical problem related to glucose metabolism was linked to violence worldwide.

They examined the prevalence, in the populations of 122 countries around the world, of a deficiency in an enzyme called glucose-6-phosphate dehydrogenase. This enzyme is related to glucose metabolism. It is the most common enzyme deficiency in the world, afflicting more than 400 million people.

Countries with higher levels of the disorder also had more violent killings, even outside of war.

“Taken together, these studies offer different types of evidence linking low glucose and other problems metabolizing glucose with aggression and violence,” Bushman said.

The findings were further corroborated in another series of studies, published recently in the journal Personality and Individual Differences.

In that paper, Bushman and DeWall, along with University of Kentucky researcher Richard Pond, had participants complete a commonly used and well-accepted checklist that measures the number and severity of Type 2 diabetes symptoms, such as numbness in the feet, shortness of breath at night, and overall sense of fatigue. In three separate studies, the same participants completed different measures of their willingness to forgive others.

On all three measures, people with higher levels of diabetic symptoms were less likely to forgive others for their transgressions.

In a fourth study, participants took part in a prisoner’s dilemma game, which is often used to understand how people deal with conflict. In this version, participants had to choose whether to cooperate or compete against an unseen partner in a computer game.

“We were especially interested in how participants responded when their partner behaved in an uncooperative, antagonizing manner when the game began,” Bushman said. “Would they forgive their partner or would they refuse to cooperate?”

Results showed that those who scored higher on diabetic symptoms were less likely to forgive an initially uncooperative partner, when compared to those who scored lower on diabetic symptoms.

“These studies are more evidence that diabetic symptoms may cause difficulty in how people relate to each other on a day-to-day basis,” Bushman said.

“It’s not an excuse, diabetes does not mean people have to act aggressively, but it may shed some light on why these behaviors occur.”

“With the rate of diabetes increasing worldwide, it is something that should concern all of us.”

Source: Ohio State University