Once again a large question mark has been thrown over antidepressants. A major analysis of previous studies shows that the effect of Selective Serotonin Reuptake Inhibitors (SSRI’s) is no more than placebo (a non active sugar tablet) in mild and moderate depression. It is only in severe depression where the drugs do more than placebo.
This backs up a previous large analysis in 2008, which showed the same result. These analyses have looked at both published studies and also unpublished data submitted to the FDA. Their have also at times been allegations that studies, which showed little benefit from the medications, were at best not published and at worst suppressed
What is interesting is that, of course most people who take antidepressants feel better, but in mild and moderate depression, it is the taking of the tablet rather than the tablet itself, which has the effect.
The rates of diagnosis of depression have increased considerably over the last two decades. Between 1995 and 2005 the number of Americans prescribed an antidepressant doubled and those being treated took more tablets. Some say this comes from better recognition of the problem. Others feel that it reflects a medicalizing of normal human emotion. However there is no data at all to show that the population is better off for taking all these pills. Around US$1billion is spent on promoting SSRI’s each year with the proportion devoted to direct consumer advertising quadrupling between 1999 and 2005.
The de-stigmatizing of mental health has been a good thing. Mental health issues are no less real than any other. However, it has also led people to feel that having a bad hair day is somehow the same as having depression. The number of people who feel that because they are facing challenges in their life, that they have got “a bit of depression” staggers me.
So what are some simple things that can we do to reduce the likelihood of feeling depressed and improve our mood if we are low?
1 Exercise. Regular exercise can reduce depression by around one third. Even regular housework (20 minutes per week) has reduced depression by 20%.
2 Eat real food. Higher rates of depression are found in people who eat lots of processed food whereas those who eat “whole” foods (fruits, vegetables, fish, nuts etc) had lower rates.
3 Get enough Vitamin D. This can be from a bit of sunshine, eating oily fish (e.g. salmon or tuna) or supplements.
4 Drink Green tea.
5 Manage your stress. For example take a walk in the park or listen to music. Meditation or yoga is also good
6 For those seeking a natural option instead of tablets, the herb St Johns Wort has been consistently shown to be as effective as drugs and has minimal if any side effects.
When “bad” things happen it is as normal to feel down, as it is to feel happy when “good” things happen. To feel down after a relationship breakdown or job loss is no more abnormal than to feel happy after winning a lottery. There is a range of human emotion and feeling-all of which are valid.
Life has its ups and downs. Often when you are feeling down there is some lesson in life to learn. It is from the hardest times that comes the greatest growth. Some people may need an antidepressant for severe depression. For most of the rest, the answer will lie in resolving the issue(s) that trouble you rather than in a pill.