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Using antidepressants

WHO (World Health Organization) in 2012 reported that 350 million people globally suffer from depression. In 2008 it was reported by the Agency for Healthcare Research that 170 million prescriptions for antidepressants were filled in the U.S. The National Institute of Mental Health reported that 14.8 million adults in the U.S. had depression, and 2 million teenagers (ages 12-18) were afflicted as well, which prompted the U.S. Preventive Services Task Force in 2009 to recommend that all American teenagers be screened for depression.

Antidepressants were first developed in the 1950s. Like the vast number of other psychiatric medications, they have played a huge role in getting and keeping people out of mental hospitals. In the old days when doctors knew much less about the nature and chemistry of mental illness, mental hospitals were pretty grim places where people were thrown when society didn't know what to do with them. In the Middle Ages, people used to go to these "hospitals" for a lark, just to watch the "crazy people," who were frequently bound up in chains or otherwise confined.

Several common symptoms of depression are: hopeless feelings, having too much or too little sleep, decreased or increased appetite, lack of interest in life or being emotionally traumatized. Completing simple daily tasks, such as showering, doing laundry, or cooking, may seem too daunting. A person may be thinking of suicide or concocting a plan to commit suicide.

How do antidepressants work? There are billions of neurons (specialized, impulse-conducting cells that are the functional units of the nervous system) in the brain. They communicate by using neurotransmitters. The main neurotransmitters that are affected by antidepressants are: serotonin, norepinephrine, and dopamine.

SSRIs (selective serotonin reuptake inhibitors) are most commonly prescribed today for depression. They block the reuptake of serotonin (a neurotransmitter, derived from tryptophan, that is involved in sleep, depression, memory, and other neurological processes) or norepinephrine (also called noradrenaline: a neurotransmitter, released by adrenergic nerve terminals in the autonomic and possibly the central nervous system, that has such effects as constricting blood vessels, raising blood pressure, and dilating bronchi).

When these chemicals are released in the brain, they cause positive, feel-good feelings. To make them stay active longer, SSRIs prevent the reuptake of neurotranmitters in the synapses (where nerve impulses are transmitted and received: very small gaps between nerve cells, across which the neurotransmitters travel).

There is some opinion that antidepressants may cause suicidal thoughts and behaviors, particularly in adolescents. Here are some research findings:

"The FDA has analyzed twenty-four past studies of about 4,400 teens and children who had taken antidepressants. No suicides had occurred in the studies. However, the agency stated that SSRIs may cause a very small proportion of teens to be at an increased risk of suicidal thoughts and behaviors. This slight risk seems to appear during the first four weeks of use and should be monitored very carefully by a person's prescribing doctor." (Teen Life: Frequently Asked Questions About Antidepressants, Judy Monroe Peterson, The Rosen Publishing Group Inc., New York, NY 2010, p. 10)

This writer's thinking in the matter is this: If a person is already predisposed to having suicidal thoughts or behaviors and then goes on antidepressants, who's to say that it is then those drugs that induce any of these thoughts or behviors if they show up? Maybe in this case, the problem is that the drugs aren't helping.

We should remember that medications alone do not cure the many-faceted demon of depression. Talk therapy, to uncover and heal underlying issues and to explore and deal with environmental factors, plays a vital role in recovery. Also a person suffering from depression must be encouraged to include methods of self-expression, relaxation, proper eating and sleeping patterns, and regular exercise, in his/her new plan for good overall health.

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