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).

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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Discovery Of Biological Changes In Patients Who Are Suicidal And Depressed May Lead To Novel Treatments

On November 29, 2010, in Depression, Immunology, by Christopher Fisher, PhD


Depressed and suicidal individuals have low levels of the stress hormone cortisol in their blood and saliva. They also have substances in their spinal fluid that suggest there is increased inflammation in the brain. These findings could help to develop new methods for diagnosing and treating suicidal patients.

Dr. Daniel Lindqvist from the Psychoimmunology Unit at Lund University is presenting these results in his PhD thesis. He is part of a research group led by Dr Lena Brundin, which sees inflammation in the brain as a strong contributory factor to depression. This is a new theory that challenges the prevalent view that depression is only due to a lack of the substances serotonin and noradrenaline.

“However, current serotonin-based medication cures far from all of the patients treated. We believe that inflammation is the first step in the development of depression and that this in turn affects serotonin and noradrenaline”, says Daniel Lindqvist.

One of the articles in his thesis shows that suicidal patients had unusually high levels of inflammation-related substances (cytokines) in their spinal fluid. The levels were highest in patients who had been diagnosed with major depression or who had made violent suicide attempts, e.g. attempting to hang themselves.

The research group at the Division of Psychiatry in Lund is now getting ready to conduct a treatment study based on its theory. Depressed patients will be treated with anti-inflammatory medication in the hope that their symptoms will be reduced.

The researchers believe that the cause of the inflammation that sets off the process could vary. It could be serious influenza, or an auto-immune disease, such as rheumatism, or a serious allergy that leads to inflammation in the body. A certain genetic vulnerability is probably also required, i.e. certain gene variants that make some people more sensitive than others.

Other studies in Daniel Lindqvist’s thesis show that patients with depression and a serious intention of committing suicide had low levels of the stress hormone cortisol in their blood. The cortisol levels were also low in saliva samples from individuals several years after a suicide attempt. This has been interpreted to mean that the depressed patients’ mental suffering led to a sort of ‘breakdown’ in the stress system, resulting in low levels of stress hormones.

“It is easy to take and analyse blood and saliva samples. Cortisol and inflammation substances could therefore be used as markers for suicide risk and depth of depression”, says Daniel Lindqvist.

Material adapted from Lund University.

New Studies Examine the Many Facets of Depression

By KATHLEEN DOHENY Psych Central News
Reviewed by John M. Grohol, Psy.D. on November 18, 201


Treatments for depression have improved greatly over the years, yet there are still many patients not helped by traditional offerings of medications and talk therapy.

”Roughly 20 to 40 percent of people with depression aren’t helped by existing therapies,” said Robert Greene, M.D., Ph.D., of the University of Texas Southwestern Medical School in Dallas.  On Monday, he moderated a news conference at the annual meeting of the Society of Neuroscience in San Diego to update research on new options under study.

Among the promising research is new data on:

  • How being stressed out may play a role in depression;
  • How the immune system may play a role in depression;
  • The role of a specific molecule, Cdk5, in nerve cell signaling and how the information might be used for an antidepressant effect;
  • The role of a small protein known as p11 and how it affects antidepressant-like  responses.

To the first of these, Herwig Baier, Ph.D., a researcher at the University of California San Francisco, said, ”An inability to cope with stress may play a role in depression.” He found in a study that zebra fish who have a mutation in a receptor important for stress management displayed abnormal behavior similar to depression. Normally social fish, the zebra fish stopped swimming and hid in the corner of their tanks when isolated from others.

But when these fish were given fluoxetine (Prozac), the behavior disappeared, he found. Studying the fish makes sense, Baier says, as the ”stress axis” in this fish and humans is identical.

The zebra fish’s mutation is in the gene known as the glucocorticoid receptor (GR) gene, and one of its jobs is to ”dial down” the secretion of stress hormones from the brain. Either too much or too little GR activity has been linked with depression.

If the fish story holds true for people, Baier said, new strategies for depression could be developed that don’t block GR activity but activate it to just the right amount so mood is not depressed.

The immune system could also play a role in depression, said Simon Sydserff, PHD, a senior research scientist at BrainCells, Inc., a drug development company in San Diego involved in stem cell technology to develop CNS treatments.

Here’s how:  When you get sick, the immune system hormone IL6 or interleukin 6, carries ”sickness” signals to the brain. When Sydserff activated the immune system of mice to mimic sickness, they displayed behavior representing depression.

“Patients who are depressed who are medically healthy and also those who are medically ill, have high levels of immune system signaling cytokines such as IL6,” he said.

“Interferon alpha, a cancer treatment, increases IL-6 and has also been linked to major depression,” he said. If the research bears out, he said, ”blocking IL-6 may prevent or reverse depression,” offering another option.

He conducted the research, supported by AstraZeneca Pharmaceuticals, while on staff there.

In  another study, James Bibb, Ph.D., of the University of Texas Southwestern Medical Center, Dallas, found that mice lacking a molecule known as Cdk5 like mice given an antidepressant: They were more active, one marker of effective antidepressant action. Without the molecule, the wave of a signaling molecule known as cyclic AMP doesn’t stop as it typically does, and this was linked with antidepressant-like responses. Learning how to block this molecule in the future could provide more options, he said.

Meanwhile, figuring out why an antidepressant can take a while to ”kick in” is the focus of another study. Jennifer Warner-Schmidt, Ph.D., a researcher at The Rockefeller University in New York, zeroed in on a regulator of antidepressant responses known as p11.  It’s a small protein expressed in depression-related brain regions.

She found in animal studies that over-expression of p11 results in an antidepressant effect and that another key regulator, brain-derived neurotrophic factor (BDNF) is required for the serotonin-induced increase in the p11.

”Understanding better the role of p11 in antidepressant response could lead to faster acting antidepressants with fewer side effects,” she said.

SOURCE: Society for Neuroscience.

New CEUs: Grief, Depression, Loss & Substance Abuse

Complicated Grief
Standard CEU Hours: 5 CEU Cost: $15.00
NBCC CEU Hours: 4 CEU Cost: $12.00

This course provides personal and professional information, testimonies and time-tested tools for healthy ways to cope and adjust to life after sudden and/or violent loss. It looks at the reality of sudden loss with perspective and insight, including the author’s (Dr. Gabriel Constans) personal experiences, as well as his clients and colleagues, who have been walking, crawling and sometimes running in the midst of sudden, unexpected, often horrific circumstances.

Grief and Depression
Standard CEU Hours: 2 CEU Cost: $6.00
NBCC CEU Hours: 2 CEU Cost: $6.00

This short course discusses the differences and interrelationships between Grief and Depression according to the DSM-IV. This is another course in a series on Grief and Loss by Dr. Gabriel Constans.

Men and Grief
Standard CEU Hours: 2 CEU Cost: $6.00
NBCC CEU Hours: 2 CEU Cost: $6.00

This course explores the different ways in which men react to and heal from grief and sadness. The course weaves in the complex web of biology and environment to illuminate how and why men may respond differently than women, as well as how their responses are similar. By exploring some of the different and similar emotional responses and their roots, the hope is to be better able to support one another through painful times.

Behind Bars II: Prison Population and Substance Abuse
Standard CEU Hours: 12 CEU Cost: $36.00
NBCC CEU Hours: 15 CEU Cost: $45.00

This report constitutes the most exhaustive analysis ever undertaken to identify the extent to which alcohol and other drugs are implicated in the crimes and incarceration of America’s prison population. Any individual interested in this issue or working with inmates who abused substances prior to incarceration will benefit from this course.

Good Grief: Love, Loss and Laughter
Standard CEU Hours: 16  CEU Cost: $64.00 Exam Only / $96.00 with Book
NBCC CEU Hours: 12  CEU Cost: $48.00  Exam Only / $72.00 with Book

This course was developed from the book, Good Grief: Love, Loss and Laughter by Gabriel Constans, PhD, which was written for professionals and everyday people who face death and grief. The writing is complete with real situations and honest stories to help bring love and hope to this difficult situation. Those in the mental health, medical, or social work field as well as parents, teachers, students, friends, or anyone else dealing with death and grief could benefit from the practical and compassionate information presented.

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