‘Most researchers have long since moved on from the old serotonin model”..
Prof Simon Wessely (President of the royal college of psychiatrists UK)
An influential study which claimed that an antidepressant drug was safe for children and adolescents failed to report the true numbers of young people who thought of killing themselves while on it, re-analysis of the trial has found
Study 329, into the effects of GlaxoSmithKline’s drug paroxetine on under-18s, was published in 2001 and later found to be flawed. In 2003, the UK drug regulator instructed doctors not to prescribe paroxetine – sold as Seroxat in the UK and Paxil in the US – to adolescents.
I was on Seroxat (Paxil) for almost 4 years in the late 90’s/Early 2000’s. Back then, SSRI’s were relatively new to the market, doctors didn’t know a lot about side effects, and if drug companies knew, they certainly kept most of their knowledge of side effects suppressed from public view. I was told by my doctor that I would need to take Seroxat for life as I had a chemical imbalance in my brain which caused my depression. He didn’t seem to correlate the fact that that my parents marriage breaking down, my father’s alcoholism, or our family home being sold or the stress of a pending eviction from our rented house, would have had anything to do with my mental health as a vulnerable and distressed 21 year old. He didn’t even want to know how I came to be depressed, or about the traumas which led to it, and neither did the psychiatrists who pushed the SSRI on me. This approach was common practice, and apparently still is.
A lot of the bad effects of SSRI’s (such as increase in suicide, aggression, akathisia, severe withdrawal effects etc) were not disclosed to the public until relatively recent years. This is bog standard behavior for drug companies, they market the disease first, blitz the public with advertising, play down the side effects until they have made a profit, and when the inevitable law suits come, the drug companies have a legal war chest with which to fight them with. They always profit off their drugs, even if these drugs kill and maim people. I’ve been blogging about this stuff for nearly 10 years, and my research on drug companies and their behavior would make your hair stand on end. They are callous and sociopathic, and most drug pushing psychiatrists are not much better.
In the case of Seroxat (Paxil), a steady stream of information has dripped out about it for two decades. First we had the BBC Panorama exposing Seroxat as a very dangerous drug in the early 2000’s, then we had the NY attorney general forcing GSK (the manufacturer) to disclose information on the drug harming kids. After that came warnings about birth defects, and if you look at the gradual changes to the patient information leaflet over the years you will notice that side effects have increased exponentially. Just this year the BMJ published a study which indicates that Seroxat has likely caused many more suicides, and much harm, to thousands of young people, and children, who should never have been prescribed it.
The SSRI’s can cause extremely distressing side effects, but there is no doubt that they work- in the sense that you feel drugged, but of course you would feel different, and of course you would feel drugged, or that the drug works, because you’re on drugs! But they are not somehow defeating your ‘depression’, the effects of the drugs, like the effects of all drugs, affect your perception and feelings about yourself, but this is a dangerous game to play with your own mind. It’s essentially drug induced self deception. You are feeling the effects of a drug, but nothing is being cured. The drugs make you drowsy, sleepy, less interested in your problems, and less interested in most things generally. So do they work? yes they do work in that way because they are psycho-active and psycho-tropic, they make you feel different, just like MDMA or E would release dopamine, serotonin etc. These are drugs that work on similar chemicals, and in similar pathways, in the brain. Just the same as if you drank 8 beers, you might not think about your depression because you’re drunk, or if you smoked some weed, you would be stoned and it might alleviate your mood. You might be too drunk to care about your problems, or to stoned to obsess over your negative thoughts, but that doesn’t mean it’s helpful to chemically alter our minds in order to deal (or not to deal) with our psychological traumas and problems. The root cause of our malaise will always fester, and often drug treatment can exacerbate the conditions they supposedly treat, and sometimes, for some people, SSRI’s can be deadly.
SSRI’s are no different to street drugs, they are chemicals which drug you into a different state of being, however they are not curing anything. If drugging away our problems is considered the most acceptable first line treatment for people with emotional and psychological problems, then we need to seriously re-consider how we approach the human condition, and in particular, the human condition in distress. Medicating with dubious drugs is not the answer for most people suffering emotional or psychological distress, however it’s often the first thing that a doctor will suggest. A depressed person would walk on fire if they were told by a doctor that it helped depression. When you’re depressed you’re vulnerable, and all you want is the pain to end. That’s why is has been so easy for the drug companies, and psychiatrists, to exploit the ‘mentally ill’.
It’s much easier to drug someone, and spin them some yarn about a defective brain, when the patient is desperate for a cure. When you’re desperate you’ll take, or do, anything your doctors tells you to.
I am not anti-medication, I understand that some people might need a drug to give them a chemical lift out of a severe depression, however, the so called ‘science’ behind the prescribing of these drugs has largely been discredited, in particular the myth of the ‘chemical imbalance’ cause of depression. This theory was widely touted in SSRI drug advertisements for at least a decade, and even though you can’t measure Serotonin levels in anyone’s brain, and even though low Serotonin levels have never been proven scientifically to cause depression, that didn’t stop psychiatry and the drug companies from spreading these theories as if they were provable scientific facts. These are potent drugs so they affect your brain- of course (and your gut and other parts of your body)- but they are not fixing any kind of chemical imbalance, serotonin or otherwise. Even if these drugs were more sophisticated than they are, they would still be only addressing the symptoms of depression, not the cause. The causes are usually psycho-social, or emotional, in nature. With depression, there is almost always a trauma, life event, or stressor, preceding it. Depression without an external cause is rare (however it can come as a result of physical illness, poor diet, etc etc).
In recent years, psychiatry has backed away from this ‘chemical imbalance’ theory of depression, but conveniently it has never thought to inform the general public that it no longer fully endorses it. However, you will notice, that they have gradually tried to make it seem that they really never promoted the theory much anyway (this is untrue though- psychiatrists were the main promoters of this theory to the public).
Many doctors, and critical psychiatrists (and even- it seems- the head of the UK college of psychiatry), now acknowledge that the ‘serotonin theory’ for depression was little more than a marketing myth which was heavily promoted in order to sell, drugs, and the the ‘disease’ model of depression to the general public.
“…. The disease-model, however, is ultimately not helpful, as well as being unfounded. For all its attempts to incorporate social factors, the disease-model renders depression meaningless, because biology effectively trumps other influences. It conveys the message that we are powerless to change ourselves or our situations. When things go wrong, it persuades us we need a pill to put them right. This approach may appeal to some people, and I am in no way disparaging those who chose to follow it. But it is important that everyone knows how little evidence there is to support it….”
Although the Serotonin theory, and ‘chemical imbalance myth’ has been largely debunked in the scientific community, and many professionals are now moving away from it in droves, the ‘disease model’ and anti-depressant ‘chemical cure’ still profoundly permeates mental health discourse. Many people still mistakenly think that SSRI drugs fix a chemical imbalance in their brain, and some doctors are still promoting this myth to patients.
In a recent article on Vox.com by Elizabeth King (an online content writer) illustrates this perfectly. The misinformation in this article, and the general premise of it, is extremely dangerous. Her article on her experiences with SSRI’s exemplifies what I have just talked about: the depressed and misinformed patient goes to their doctor- their doctor spews some nonsense about a chemical imbalance, the patient – desperate and vulnerable- swallows the ‘depression as disease’ myth hook line and sinker, along with month after month’s supply of SSRI pills. Drugged and chemically altered, the patient now goes about telling everyone about how wonderful SSRI’s are. I don’t blame Elizabeth for wanting to believe that her depression will go away with a simple little pill, and I don’t blame her for wanting to believe that she can keep taking her little pill forever. I wanted to believe that too. Most people who end up on SSRI’s are willingly deluded, that’s how they get you on the pills. However, writing online content which potentially thousands of misinformed, vulnerable and desperate people will read, and further misinforming them, based on your own willful naivety, is highly irresponsible.
SSRI’s are seductive- all drugs are. All addictions are too. The psychological and physical dependence that SSRI’s induce is incredibly powerful, that’s why it is so difficult to come off them. That’s why the withdrawal effects are crippling, particularly in cold turkey or if you’re on them long term, and try to come off them. That’s also why the SSRI’s are a multi-billion dollar industry. They keep people in a chemical cloud of denial all the time they are on them, and who wouldn’t want that? Being on psychiatric drugs, even with the horrible side effects, makes you think that you’re treating your ‘illness’ right? and that’s validating isn’t it? It’s strangely comforting to think that you’re helping yourself by taking a treatment isn’t it? – even if that treatment involves reliance on a pill to do all the deep psychological work that you don’t want to face. You really want to believe that the drugs will keep your depression in check. And who would want the depression boogeyman to come knocking again? Much easier to have faith in the pills, and believe that you need them than actually going through the pain of soul crippling depression isn’t it? That would take actual work!
Getting off them though…now that’s another story…
Here are some quotes from the article:
“…I wanted to feel what I thought of as “normal,” my default state neutral instead of panicked. My therapist suggested SSRIs —selective serotonin reuptake inhibitors, common antidepressants that work by balancing the levels of serotonin in the brain. He told me they had been very beneficial for other clients with similar backgrounds. But I stubbornly resisted. I didn’t want to take SSRIs, I told myself, because I was determined to conquer my mental health issues “on my own.”...
Eventually I didn’t care how much I didn’t want to explore medication; I was willing to do whatever it took to feel better. I relented. I got a recommendation for a psychiatrist from a friend, made an appointment, and tried to keep an open mind
I left my psychiatrist’s office with a prescription for Lexapro and filled it at the pharmacy the same day. I swallowed my first dose the minute I got home.
I sat there for a second, tilting my head and focusing my hearing as if I’d be able to sense the medicine’s effects right away. Nothing happened, of course: It can take as long as six weeks to know if an SSRI is working. Eventually, mine did.
Today I’ve reached nearly a year of treatment on two antidepressants, Lexapro and Wellbutrin, and the results I’ve experienced were unimaginable to me before I started taking medication.
I was resistant to medication for so long because I didn’t understand what taking medication meant. I had bad information and bad assumptions. Here’s what I wish everybody understood about SSRIs: the good, the bad, and the anorgasmic.
I was cautiously hopeful when I started the meds. I wanted them to work more than anything in the world, and each day when I woke up, I wondered if this would be the day that I started feeling something different. For days, I thought it might be happening: My daily mood felt better, but it was hard to tell — what if I was just unusually hopeful, or experiencing some kind of placebo effect?
My troubles weren’t over, of course. My psychiatrist warned me during my first appointment that it can take as long as a year for some patients to find the right mix of SSRIs. Antidepressant medication is not like antibiotics: The same pills won’t cure the same disease in nearly everyone. We tinkered with my dosage of Lexapro and with combining Wellbutrin over the course of several months. But I was improving, and after seeing what one medication could do for me, I was eager to discover what was possible as my doctor and I fine-tuned my treatment.
While not everyone benefits from SSRIs, the zombie effect just isn’t universal, or even particularly common. It certainly wasn’t true for me. When they work, SSRIs do for your brain what a healthy brain would be able to do on its own: regulate healthy levels of serotonin in the brain so that you aren’t depressed or anxious by default.
I embraced SSRIs in part when I accepted that not all of my emotional troubles were the result of situational stress. Yes, having an uncertain love life, financial worries, and concerns about the future exacerbated my mental health issues. But they weren’t the root trouble. The “real cause” of unhappiness in depression and anxiety is often a chemical imbalance in the brain, something that can’t be talked out of existence any more than a headache.
With time, the anorgasmia faded and I was able to get off again, but by that point, my sex drive was down the drain. I could have an orgasm, but I didn’t really care if I did or didn’t. This was the first and biggest downside to my treatment, and one I wasn’t content to put up with for any great length of time.
I made another appointment with my psychiatrist. I told him that it wasn’t acceptable for me not to have a sex drive while on meds. I was a little nervous to bring it up: I didn’t want him to dismiss my concerns as frivolous or, worse, dirty.
Thankfully, he completely understood and prescribed me a second antidepressant — Wellbutrin — to help alleviate the sexual side effects. I was lucky: The combination worked well for me, and today my sex drive is more or less back to its pre-medication state.
When I began taking SSRIs, my psychiatrist told me that while some patients require medication for only a few months or a few years, others are in it for “the long haul.” He told me there isn’t a good way to predict how long a patient will need SSRIs, so I have no idea how long I may need to take mine. That worries me: What if I need to take my meds every single day until the day I die?
According to a recent Consumer Report on antidepressants, some antidepressants cost as little as $25 for a month’s supply, but others can cost more than $500 (certain dosages of Prozac can be very costly, for example). Unfortunately, the medicine that works best for a particular patient might not line up with what works best for her bank account.
Despite my newfound enthusiasm for SSRIs, I know that covering the costs of care could present a greater challenge in the future than it does now, and that scares me
When you’re in the worst throes of depression, it’s easy to believe that you have no chance of feeling better. Hopelessness, extreme nervousness, and feelings of shame are all classic symptoms of depression and anxiety. Before giving up on the idea of SSRIs, consider whether the very fears holding you back might be allayed by the treatment itself.
For many of us with chronic mental illness, taking the plunge and trying medication is the best single step we’ve taken for ourselves. It was for me.
If you even suspect that medication might help you live a fuller and healthier life, discuss it with a doctor. There’s no shame in trying. Even if the medication doesn’t work at first, or never works at all, you owe it to yourself to fight for your happiness in any way you can, and that’s the best chance any of us has to make it through.
I have already had a spat with Elizabeth on twitter, and I have tried to explain to her that her article is full of misinformation and unprovable, discredited- psycho-babble- about SSRI’s, but she is having none of it. Apparently , according to Elizabeth, I am a ‘troll’ who has ‘poor and minimal evidence for my beliefs’. Oh well, what can I say? good luck on your SSRI journey Elizabeth, don’t stay on them too long. Two to three years on SSRI’s and you’ll be coming close to the end of the honeymoon period. Soon your liver will start to get toxic, the sweats will get worse, and the bowel movements will become more than a drag. You’ll be functioning, but in a manic way, you’ll want to be on the drugs, even though deep down you know that you’re just running away from yourself. The nightmares, and muscle spasms will start to become more noticeable than the serotonin haze, but you’ll kinda not really care about that. If you do want to come off them, be sure to wean, that way you can take the edge off the homicidal and suicidal thoughts that they induce. I wasn’t told about these side effects and withdrawals when I was on them, some years ago, but there’s plenty on the net about them now.
I wish you the best..
Here’s a link to Dr Terry Lynch’s ground breaking work on SSRI’s and depression. I know you think that it’s just me and Terry Lynch quacking on about this bogus theory Elizabeth, but I assure you, Terry’s research won’t fail to impress. We’re not the only ones, that’s for sure.
It’s called ‘Depression Delusion – the myth of the brain chemical imbalance” and it has been endorsed globally by many of the top progressive mental health professionals in their field. Perhaps that’s not NEMJ or Harvard standard peer review enough for you, but hey! Can’t say I haven’t tried to warn ya!
Here’s a review by Phil Hickey (from the excellent Mad In America Site)
In this truly remarkable — and meticulously researched — volume, Dr. Lynch annihilates psychiatry’s cherished chemical imbalance theory of depression. Every facet of this theory, which the author correctly calls a delusion, is critically analyzed and found wanting. Example after example is provided of psychiatrists promoting this fiction, the factual and logical errors of which are clearly exposed in Dr. Lynch’s lucid, seamless, and highly readable prose.
The book runs to 343 pages, and is laden with factual details, case studies, alternative perspectives, and hard-hitting commentary. Dr. Lynch does not sit on the sidelines, nor does he seek any kind of collegial compromise with the chemical imbalance theory, which he unambiguously denounces as a groundless and destructive falsehood. Here are some quotes that I think will convey something of the content, style, and cogency of this vitally important work.
“The world is engulfed in a mass delusion regarding depression. The widespread belief that brain chemical imbalances are present in depression has no scientific basis. In fact, this is a fixed belief that meets all the criteria of a mass delusion. If you are one of the millions of people who believe that biochemical brain imbalances are known to occur in depression, then you too have become seriously misinformed.” (p 1)
“Despite the obvious complexity of the brain, some psychiatrists and GPs profess an understanding of this organ that is highly inconsistent with current scientific knowledge. Their comments smack of a level of arrogance that in my opinion is downright dangerous.” (p 65)
“The brain chemical imbalance delusion has dominated medical, psychological and public thinking about depression for the past fifty years. Parties with a vested interest see nothing wrong with this. Nor do the vast majority of the general public, for whom the depression brain chemical imbalance idea feels as familiar and logical as raised blood sugar in diabetes. There are two main reasons why psychiatrists and GPs have embraced the biochemical imbalance delusion with such enthusiasm. This notion portrays doctors and their drug treatment in a positive light, as real doctors treating biological abnormalities consistent with the treatment of diseases generally in medicine. Secondly, having observed for thirty years how my medical colleagues in psychiatry and general practice work, I do not believe they know any other way of understanding or responding to depression other than as an assumed biological abnormality. I remain unconvinced that there is sufficient breadth of vision within mainstream psychiatry or medicine to see or to move beyond the rigidly held belief that depression is primarily a biological disorder. Yet, the majority of the experiences categorized as depression are primarily emotional and psychological or have a significant emotional input.” (p 77)
“It is misleading to state that the brain chemistry of depression is not fully understood, when in truth it is really not understood at all. It is also misleading to state that ‘research suggests’ that ‘depression is caused by an imbalance’ of brain chemicals. It is drug companies, doctors and researchers who suggest this, not the research itself. As outlined in detail earlier the research itself does not suggest this at all and indeed contradicts this notion.” (p 149)
“In twenty years as a medical doctor, I have never, ever heard of a patient anywhere having their serotonin levels checked.”(p 153)
“Low serotonin cannot ever be identified since brain serotonin cannot be measured and we do not know what serotonin levels should or should not be.” (p 165)
“Providing societies with an apparently trustworthy rationale for avoiding the reality of human distress has resulted in increasingly costly mental health services within which recovery is a far rarer outcome than it should be. Since the core issues are repeatedly side-stepped, they are not addressed or recognized within these mental health systems. It is not surprising that the costs of such systems keep increasing with little hard evidence that these systems are providing value for money in terms of recovery.” (p 237)
“The most beneficial position for psychiatry is therefore the one that currently pertains. By nailing its colours to the biological mast, psychiatry has successfully set itself apart from talk therapies. As long as no biological abnormalities are reliably identified, there is no threat that their bread and butter will be removed from them to other medical specialties. Maintaining the myth that biological solutions are just around the corner satisfies the public and maintains psychiatry’s position quite satisfactorily from psychiatry’s perspective, albeit between a rock and a hard place. This position has no solid scientific foundation, but as long as the public do not realize this and psychiatry does not attempt to encroach on the territory of other medical specialties such as neurology, psychiatry’s position is secure.” (p 277)
“When basic principles of correct reasoning and science are applied to the brain chemical imbalance idea, the flaws and inconsistencies of this belief become obvious. When the depression brain chemical imbalance idea is rigorously examined, we find that like the emperor, it has no clothes. These flaws and inconsistencies were known prior to Prozac coming on stream in 1988. They were dismissed because they risked ruining a great story, from which many groups could profit enormously.” (p 342)
For those who wish to pursue topics further, there is a reference list at the end of each chapter. There is also a comprehensive index and table of contents which make it easy to find specific sub-topics.
Pharma-psychiatry’s chemical imbalance theory of depression is one of the biggest and most destructive hoaxes in human history. Dr. Lynch’s Depression Delusion might well be the work that finally lays this hoax to rest, and exposes the self-serving deceptiveness that has become a routine part of psychiatry’s endeavors.
Please read this book, keep it close to hand for reference, and encourage others to read it also. Ask your library to buy a copy. The spurious chemical imbalance theory is now so widely accepted that it will take enormous efforts to dislodge it. In any debate on this matter, Dr. Lynch’s book will, quite literally, put the facts at your fingertips.