Why Antidepressants Don’t Work for Treating Depression
Here’s some depressing recent medical news: Antidepressants don’t work. What’s even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they do work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.
A study published in The New England Journal of Medicine provides the evidence. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit, but almost none of the studies that show these drugs are ineffective.1
That warps our view of antidepressants, leading us to think that they do work. And it has fueled the tremendous growth in the use of psychiatric medications, which are now the second leading class of drugs sold, after cholesterol-lowering drugs.
The problem is even worse than it sounds, because the positive studies hardly showed benefit in the first place. For example, 40 percent of people taking a placebo (sugar pill) got better, while only 60 percent taking the actual drug had improvement in their symptoms. Looking at it another way, 80 percent of people get better with just a placebo.
That leaves us with a big problem: millions of depressed people with no effective treatments being offered by most conventional practitioners. However, there are treatments available. Functional medicine provides a unique and effective way to treat depression and other psychological problems. Today I will review seven steps you can take to work through your depression without drugs. But before we get to that, let’s take a closer look at depression.
What’s in a Name?
“Depression” is simply a label we give to people who have a depressed mood most of the time, have lost interest or pleasure in most activities, are fatigued, can’t sleep, have no interest in sex, feel hopeless and helpless, can’t think clearly or can’t make decisions.
But that label tells us nothing about the cause of those symptoms. In fact, there are dozens of causes of depression, each one needing a different approach to treatment. Depression is not one-size-fits-all, but it is very common.
Women have a 10-25 percent risk and men a 5-12 percent risk of developing severe major depression in their lifetime.2 One in ten Americans takes an antidepressant. The use of these drugs has tripled in the last decade, according to a report by the federal government. In 2006, spending on antidepressants soared by 130 percent.
But just because antidepressants are popular doesn’t mean they’re helpful. Unfortunately, as we now see from this report in The New England Journal of Medicine, they don’t work and have significant side effects. Most patients taking antidepressants either don’t respond or have only partial response. In fact, success is considered just a 50 percent improvement in half of depressive symptoms. And this minimal result is achieved in less than half the patients taking antidepressants.
That’s a pretty dismal record. It’s only made worse by the fact that 86 percent of people taking antidepressants have one or more side effects, including sexual dysfunction, fatigue, insomnia, loss of mental abilities, nausea and weight gain.
No wonder half the people who try antidepressants quit after four months.
Despite what we have been brainwashed to believe, depression is not a Prozac deficiency!
How We Have Been Deceived by the Antidepressant Hoax
Despite what we have been brainwashed to believe, depression is not a Prozac deficiency!
Drug companies are not forced to publish all the results of their studies. They only publish those they want to. The team of researchers that reported their findings in The New England Journal of Medicine took a critical look at all the studies done on antidepressants, both published and unpublished. They dug up some serious dirt …
The unpublished studies were not easy to find. The researchers had to search the FDA databases, call researchers and hunt down hidden data under the Freedom of Information Act. What they found was stunning.
After looking at 74 studies involving 12 drugs and over 12,000 people, they discovered that 37 of 38 trials with positive results were published, while only 14 of 36 negative studies were published. Those that showed negative results were, in the words of the researchers, “published in a way that conveyed a positive outcome.”
That means the results were twisted to imply the drugs worked when they didn’t.
This isn’t just a problem with antidepressants. It’s a problem with scientific research. Some drug companies even pay or threaten scientists to not publish negative results on their drugs. So much for “evidence-based” medicine! I recently had dinner with a step-uncle who runs a company that designs research for drug companies. He designs the study, hires the researcher from an esteemed institution, directs the study and writes up the study, and the scientist just signs his or her name after reviewing it.
Most of the time, we only have the evidence that the drug companies want us to have. Both doctors and patients are deceived into putting billions of dollars into drug companies’ pockets, while leaving millions with the same health problems but less money.
The scientific trust is broken. What can we do? Unfortunately, there is no easy answer. But I do think functional medicine, on which my approach of UltraWellness is based, provides a more intelligent way of understanding the research. Rather than using drugs to suppress symptoms, functional medicine helps us find the true causes of problems, including depression.
I see this in so many of the patients I have treated over the years. Just as the same things that make us sick also make us fat, the same things that make us sick also make us depressed. Fix the causes of sickness and the depression takes care of itself.
Here are a few things you can do to start treating your depression today.
Seven Steps to Treat Depression without Drugs
1. Try an anti-inflammatory elimination diet that gets rid of common food allergens. As I mentioned above, food allergies and the resultant inflammation have been connected with depression and other mood disorders.
2. Check for hypothyroidism. This unrecognized epidemic is a leading cause of depression. Make sure to have thorough thyroid exam if you are depressed.
3. Take vitamin D. Deficiency in this essential vitamin can lead to depression. Supplement with at least 2,000 to 5,000 IU of vitamin D3 a day.
4. Take omega-3 fats. Your brain is made of up this fat, and deficiency can lead to a host of problems. Supplement with 1,000 to 2,000 mg of purified fish oil a day. Consider a vegan source of omega-3 (such as this one).
5. Take adequate B12 (1,000 micrograms, or mcg, a day), B6 (25 mg) and folic acid (800 mcg). These vitamins are critical for metabolizing homocysteine, which can play a part in depression.
6. Get checked for mercury. Heavy metal toxicity has been correlated with depression and other mood and neurological problems.
7. Exercise vigorously five times a week for 30 minutes. This increases levels of brain-derived neurotrophic factor (BDNF), a natural antidepressant in your brain.
Overcoming depression is an important step toward lifelong vibrant health. These are just of few of the easiest and most effective things you can do to treat depression. For more information on how to optimize your health, see http://drhyman.com/.
Now I’d like to hear from you … Have you been diagnosed with depression? How have antidepressants worked for you? Do you plan to try any of the approaches mentioned here? Please let me know your thoughts by leaving a comment below.
References
1. Turner EH et al. 2007. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med. 358: 252-260.
2.Eaton WW, Kalaydjian A, Scharfstein DO, Mezuk B, Ding Y. 2007. Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981-2004. Acta Psychiatr Scand. 116(3):182-188.
Photo credit: walknboston
Disclaimer: The opinions presented in this article are those of Dr. Hyman based on his years of training and experience as a medical doctor. This information is not intended to treat, diagnose, cure or prevent any disease. All material in this article is provided for educational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health program.
77 Comments
As a Clinical Psychologist in private practice and an individual professionally and personally interested in holistic medicine/lifestyle options, I am discouraged to see this article on this site. I absolutely agree that antidepressants are over-prescribed without a thoughtful assessment of lifestyle and stress factors. However, in many of my patients it has made a substantial difference in their ability to function and start healing. I know that I am biased, but I’m really flabbergasted to note that psychotherapy has no mention in this article! Many depressive episodes can be effectively treated using cognitive-behavioral therapy alone. Therapists, unlike pharmaceutical companies, have very limited lobbying or funding to promote our craft, but many studies which show that therapy can be instrumental to healing. Humans are complex; to unequivocally state that antidepressants “don’t work” for treating depression is problematic at best.
it can be a batle and i think even with both medicinal,holistic therapy some without a support system and lots of effortmay need as much of a holistic approach incorporating an arsenal of things available to them
While I am all for functional medicine, I have actually had great success with anti-depressants – particularly aglomelatine, a newer drug with far fewer side effects.
I am vegetarian, exercise regularly, practise yoga every day, meditate, hardly drink andconsider myself pretty healthy. However, I have always suffered from crippling anxiety, and in 2010 this turned into a period of dark depression. I tried CBT, I tried psychotherapy, I stepped up my yoga practice, turned to green smoothies and increased my loving kindness meditations. Nothing really worked. Finally, I tried medication.
Now, I felt SO guilty for taking these medications. The wellness blogs I read and the yogis I surround myself with seem to look down on ppl who need chemical help. This article is disappointing, as it is contuining this trend. That said, I am going to try all the things Dr Hyman suggests – after all, I’d still rather not take too many drugs! But I do know that for me, medication was the last resort and the only thing that managed to drag me out of the deep, sad and stifling hole my brain had plunged me into.
Go ahead, try natural approaches and get out there and exercise, but depression is debilitating, and if ppl need medication I see nothing wrong with trying it.
I suffered a major depression 10 years ago and
did not want to go on an antidepressant. By the
grace of God, my family got me on one and it
worked quickly. I was able to heal myself
with medication, life style changes, exercise,
and talk therapy. But I would have never been
able to get myself out of the hole I was in
without medication. I really think this article
should removed. When you are considering
between suicide and taking medication, the
last thing you want is someone telling you to
take vitamins. It is apparent that you have never
been in this dark place. May you never be. I’m
afraid your list will not help you.
Again take this article down before someone
who is truly I’ll sees it. I love this site, but not a
great post today. Very disappointed and worried.
This is not helpful info to a truly sick individual.
“For example, 40 percent of people taking a placebo (sugar pill) got better, while only 60 percent taking the actual drug had improvement in their symptoms. Looking at it another way, 80 percent of people get better with just a placebo.”
In what other way of looking at it, do you ever get 80% of people getting better with just a placebo?? 40% in the control group + 40% in the experimental group still equals 40%.
(and/or 60%-40% = 20%… 100%-20% = 80% = the total percentage of people who DO NOT get better at all plus those who get better on placebo.)
As a resident, I have dealt with depression/SSRIs/alternative therapies in both patients lives as well as in my own life. I think there is a lot to be said for your non-pharmaceutical approaches (especially on behalf of the Vit D and exercise).
However, the validity of one’s argument is cast into serious doubt when one cannot professionally and accurately communicate statistical findings.
I am also disappointed in seeing this post. There is already such a stigma against mood disorders AND medication; I’m afraid this will convince more people not to try medication for their suffering.
Simply put: an SSRI saved my life. Period. I have recently stopped taking the medication, but it took me TEN years to stabilize. If I hadn’t had the medicine, along with a psychiatrist who found the right drug/dosage for me, well- I very well may have not been typing this response.
Diet, exercise, therapy, meditation etc. all have helped me along the way, but there is absolutely NO WAY I could have survived without the SSRI. What this post should be about is how you can find the very best treatment for yourself (it is DIFFERENT for every single human being). I am incredibly aware that there are many problems with the drug companies and their ‘marketing’/'studies’ but to read your post, I almost screamed when I saw the advice to exercise the depression away…. I won’t be reading Crazy Sexy LIfe anymore.
Saying that anti-depressants don’t work to treat depression is a very limiting statement that I believe is not true under all circumstances. I am in a similar boat as Em- I too have struggled with depression and anxiety and believe in a holistic approach to mood elevation and finding bodily peace. Deciding to take medication was a deeply personal and difficult choice, but it has been a real help in addition to changing my lifestyle- lots of greens, yoga, meditation, positive affirmation, and therapy modalities.
While I enjoyed the tips presented to cure depression naturally, it is hurtful to say that antidepressants are not in fact helpful to those they help. Dr. Hyman asked for a response and I’m glad that people have spoken. There are always two sides to a coin and it’s good to recognize this in the spirit of compassion. May we live in harmony with our minds, bodies, and spirits… and each other.
I’m unable to access all the comments. How can I read all 58?
I have to say that without my Celexa, my panic attacks take over my life. I agree that anti depressants are probably over prescribed today but to go as far as saying that anti depressants don’t work is wrong. They DO help some people
This is a truly disappointing and DANGEROUS article to read on an otherwise lovely site. I take antidepressants. I resisted for a long time, thinking something was wrong with me because I couldn’t just “be happy” like everyone else and thinking that I could just teach myself how to be normal, happy, and function. Those were honestly some of the worst years of my life. You wouldn’t tell a diabetic person to just stop taking their insulin; don’t tell a depressed person to just stop taking their anti-depressants. There is nothing wrong with me, there is a chemical imbalance in my brain that can’t be balanced by my healthy gluten-free, vegan lifestyle. Trust me, I tried. And honestly, I wouldn’t be as healthy as I am today without taking this medicine. I didn’t care about myself enough to try to be healthy before. I ate crap, I didn’t exercise, there was no self-love at all. But for the record, I don’t believe that the antidepressants are a magic cure-all. I still have to work at it. But happiness is attainable now, whereas before, it was impossible. And tell me this: are you going to tell a bipolar person to stop taking their medicine? Your medical license should be taken away if so! It is because of articles like this that some very sick people out there refuse help. That is truly dangerous to them and to the rest of us as well.
This article is sad. I am vegan and try to do everything on that list; but I have struggled with depression my whole life and medication is the ONLY thing that has worked for me. It makes me a whole new person (not a placebo effect).
The overly simplified, INCORRECT statistics alone dissolve any credibility in the article.
The blanket statement “Anti-Depressants do not work”, is generalized and VERY WRONG!
I am very disappointed in this article and the fact that it was featured on this blog has me questioning the rest of its content.
This article is sad. I am vegan and try to do everything on that list; but I have struggled with depression my whole life and medication is the ONLY thing that has worked for me. It makes me a whole new person (not a placebo effect).
The overly simplified, INCORRECT statistics alone dissolve any credibility in the article.
The blanket statement “Anti-Depressants do not work”, is generalized and VERY WRONG!
I am very disappointed in this article and the fact that it was featured on this blog has me questioning the rest of its content.
great i am going to stop taking serotnin right now……?
Oh dear. The article starts by trying to be “scientific”, and actually, as a summary for the mentioned study, it’s kind of okay… but then the over-generalizing starts. And then, you “beat” anti-depressants (which are soooo not evidence-based, in your opinion) by totally, absolutely, definitely non-evidence based items 1,3,4,5,6. Apart from the stupidity of critisizing anti-depressants and the method of studying them, and then “praising” something where there isn’t even any method to critisize.
And then of course, item 7 (exercising) is a great method, by all means, and totally evidence-based. However, if you’d actually KNOW what depression was, you’d know that you can’t simply “make” a depressive patient to work out. I mean, you can’t even make totally healthy people to get regular exercise… but you can’t compare healthy individuals to patients with clinical depressive people. Simply said (seems to be needed), a depressive patient can’t even get out of bed. So go figure.
And: The concept of “cause” for depression (causes, as you seem to mean, such as “my hamster died” or “I am not satisfied at work”) isn’t very up-to-date either. Still, depressive patients can benefit from psychotherapy – but this isn’t mentioned here, is it.
VERY, very disappointed by this article and even if there may be other (nicer) articles, I don’t think I’ll come back. It’s dangerous.
And written by a MD? Really?
As someone who has battled depression without any drugs, I applaud this article. I have known for awhile that the pharmaceutical industry only masks symptoms and only has to show that a drug is more helpful than harmful in two out of an infinite number of clinical trials in order to get the drug approved. This article speaks to figuring out the root causes of depression — which I did. Fix what is causing the mood problems and pair it with exercise and eating right. That can cure a whole lot better than any drug any day.
Wow! Thank the universe for actually having someone with the guts to post this! Kris I LOVE YOU!
There are SO many alternatives to fighting depression and so little about them is ever made public.
I had 2 friends who suffered from severe depression…the drugs nearly made one of them suicidal. She went off of them and she is better now. I myself suffered from serious depression…and found that there are a ton of alternative treatments out there to help. I started eating tons of cashews and got some sunshine + a lot of other healthy lifestyle changes. I am at peace with myself and the universe and the depression is gone :)
The drugs cause a serious disharmony in your body, and if no one has looked at what they can do to your body, then I suggest you do some research. They caused many health problems to someone very close to me, and that is not the first case that I know about. If your suicidal and absolutely cannot live without the drugs, then maybe start taking some, but try getting off of them ASAP and seek alternatives..like I said, there are MANY out there.
I myself battled depression without any drugs. I also watched 2 close friends go on the drugs…I saw what it did to them. One of my dear friends became suicidal on the drugs and had to go off…she got alternative therapy and is doing much better. My other friends suffered serious health issues after going on the drugs…Alternatives are not advertised in our society, probably due to the amount of $$$ the drug companies make with the anti depressant sales. If so many folks are depressed, don’t you think there is something going on with our nations lifestyle? C’mon guys, think outside the box. Thank you Kris for being so brave and honest and posting this!
Finally a blog that seems to post interesting articles. Can you please check out mine as well. We are writing about the same items.
http://www.drugstorediary.com
Thank a lot, Janet!
Does this apply for Bipolar and Schizophrenia? If not, why not? Are we saying that those mental illnesses are real and deserve treatment whereas depression and anxiety are not and do not?
Having lost a friend to suicide, and almost losing a sister, I am pretty freaked out by this article. I mean sure, we may overprescribe and should encourage more ppl to use complimentary therapies and natural health-boosters too, but really, depression is a serious illness that can kill. This is not to be messed around with. It’s great that some ppl manage to cure the blues with ‘cashews and sunshine’ but for others the black hole is too deep to get out of without help to fix the chemical imbalace in their brain. Indeed, that chemical balance may be worsened by bad lifestyle choices etc etc, but this article seems to write mental illness off as something easily fixed by going for a walk.
Where is the response to all these comments from Dr Hyman?
I am so, so disappointed by this article :(
I am currently on depression medication, and use the articles on this site to help me improve my life so that I can eventually be healthy, happy and depression-free without drugs.
I made the decision to take medication, because, without it I would have continued to struggle with everyday life, lost my job, and most likely taken my own life.
I feel deeply saddened and hurt that such an inspirational site would post such an article.
I was diagnosed with depression about 15 years ago, and began Prozac therapy. I immediately noticed a positive effect, and continued to take Prozac for the next 10 years or so, with a little side trip on Zoloft for a period ( which was not pleasant!). As I became Prozac-tolerant, my dosage was steadily increased until I was taking about 50% higher than the maximum recommended dose. I experienced rather significant side-effects, along with what I came to recognize as no noticeable benefits. I weaned myself off of the medication, and for the past 5 years or so, have been medication-free. While I probably demonstrate what some would consider depressive symptoms, I have learned to adjust to them, and I am at peace with who I am.
I was diagnosed with depression about 15 years ago, and began Prozac therapy. I immediately noticed a positive effect, and continued to take Prozac for the next 10 years or so, with a little side trip on Zoloft for a period ( which was not pleasant!). As I became Prozac-tolerant, my dosage was steadily increased until I was taking about 50% higher than the maximum recommended dose. I experienced rather significant side-effects, along with what I came to recognize as no noticeable benefits. I weaned myself off of the medication, and for the past 5 years or so, have been medication-free. While I probably demonstrate what some would consider depressive symptoms, I have learned to adjust to them, and I am at peace with who I am, but I would not have come to this place without teh benefits of anti-depressant medication when it was so badly needed.
I am extremely upset with this article. I’ve struggled for years with needing to take Prozac for my depression and the last thing someone like me needs is to feel like I’m weak or unhealthy for turning to medication. This is a foolish article with a “well just get over it attitude.” Maybe antidepressants are over prescribed, but SSRI’s have done wonders for me and so many others. We need to cultivate a culture of educated and questioning consumers–WITHOUT demonizing the drugs themselves.
To add to my first comment–I think this thesis of this article could be modified. The suggested “steps” for treating depression are valid, but for many people, drugs can be the crucial element in allowing for the subsequent steps to happen. Drugs, in combination with a healthy diet and therapy, is the best treatment there is. And nobody is saying that once you go on the drugs, you can never go off them–in many cases, the drugs are MORE effective when they are used at a crucial point in therapy.
I have been suffering with major depression for over 20 years, I have tried basically all the antidepressants but none seem to work for me. Now my depression is getting worse. I am starting to excercise hopefully that will work. What else can I do?
I have depression but not nearly as bad now as before and I really think Prozac has helped me in that area also with my anxiety. I think this is sad that there is still stimga among a physcian about taking medications, there’s nothing wrong with needing medication to get better. Depression is like any other illness. We wouldn’t tell a heart patient not to take meds would we even if there was some side effects.
Wow..I am upset. I have Bipolar disorder but serious crippling depression is my main problem. This disorder is a dominant gene which means 50% of your kids will have it in some form or other. I got the worst of it. Without Effexor, an anti depressant, I would be dead, plain and simple. My physician husband watched me live in the basement, in the dark, for months before someone offered me the kind of chemical help I needed..chemical help to aid a chemical problem.
A vegan lifestyle isn’t going to fix everything no matter how much one wishes it to be so.
I am very disappointed in this site for posting such gibberish.
January 30, 2012