The available research findings indicate so called “antidepressants’ can increase the likelihood of strokes, heart attacks, falls and even death. Antidepressants can cause side effects, including nausea, agitation, weight gain, lower sex drive and indigestion. Research also suggests that people often experience unpleasant withdrawal symptoms, known as antidepressant discontinuation syndrome, when they stop taking antidepressants, sometimes for weeks or months. Thus, people seeking relief from a challenging emotional experience who turn to the most frequent prescribed treatment–antidepressants–are actually increasing their risks of suffering from these various negative consequences.

A very recent study titled “The impact of antidepressants and human development measures on the prevalence of sadness, worry and unhappiness: cross-national comparison,” the researchers conclude,

“In this study, we examine the relationship among individual symptoms (sadness, worry and unhappiness), human development factors and antidepressant use in 29 OECD [Organisation for Economic Co-operation and Development ] countries. We report that increased antidepressant prescribing is not associated with decreased prevalence of sadness, worry or unhappiness. However, income, education and life expectancy (measured using the Human Development Index) are associated with lower prevalence of all these symptoms. This suggests that increasing spending on depression treatment may not be as effective as general public health interventions at reducing depression in communities.”

An estimated 18 billion dollars a year is being spent on these drugs, (approximately 100 billion dollars spent every six years). This amount does not include the cost of appointment hours of psychiatrists and other prescribing doctors that is part of the required process of people getting access to these drugs. This appears to be a lot of wasted money that can be used more productively in other ways. Given this cost, along with the drugs’ side-effects, and negative health outcomes, framing depression as being so bad so that it ends up encouraging people to take “antidepressants” may be unwise.

So, why do so many who are taking these drugs come to believe they are enormously helpful? There are three major guesses about this.

1. Many people who become depressed start to feel better after a few months without taking this type of drug. If they do take the drug when they become depressed, and begin to feel better, they attribute it to the drug rather than the natural course of the experience.
2. If they start to feel better while taking the drug, they may try to stop taking it. Because of the withdrawal effects that feel awful, they are likely to think these awful feelings are due to their depression returning, so they quickly return to taking the drug while now more convinced that the drug is helpful.
3. Some people are very susceptible to the placebo effect, and therefore any drug that they are prescribed by a doctor leads to the perception that the drug is effective.

Depression as a Natural, Potentially Healthy Process

Conceptualizing depression as a mental disorder tends to fail to motivate active coping beyond taking a pill. Moreover, it fails to honor the labeled person’s perspective. In contrast, framing these concerns as potentially a healthy functional signal can lead to less self-stigma, and greater self-efficacy in making healthy life-style improvements.

One example of this line of thinking is provided in Joshua Wolf Shenk’s (2005) biography of Abraham Lincoln. There the author makes the case that Lincoln’s depression fueled his greatness. Similarly, David Yaffe (2017) has written a biography about the music legend, Joni Mitchell, titled Reckless Daughter. There, he writes of her frequent bouts of depression and quotes her saying,

“Depression can be the sand that makes the pearl. Most of my best work came out of it. If you get rid of the demons and the disturbing things, then the angels fly off, too. There is the possibility, in that mire, of an epiphany.”

Schroder, et al. (2023), recently carried out a relevant study. As the authors describe it,

“We describe the historical development of popular messages about depression and draw from the fields of evolutionary psychiatry and social cognition to describe the alternative framework that depression is a “signal” that serves a purpose. We then present data from a pre-registered, online randomized-controlled study in which participants with self-reported depression histories viewed a series of videos that explained depression as a “disease like any other” with known biopsychosocial risk factors (BPS condition), or as a signal that serves an adaptive function (Signal condition) …. The Signal condition led to less self-stigma, greater offset efficacy, and more adaptive beliefs about depression.” 

In a recent blog post, I describe in far more detail this healthy way to understand the nature of depression (see HERE) and a no financial cost process to maximize its benefits. There the reader learns that transforming one’s belief that depression is a “really so bad” experience, to one that develops a friendship with the experience is doable. Once the transformation is complete, I prefer the term “melancholy” for it becomes a distinctly different experience without all the insults directed at oneself and thoughts of being mentally ill.

For many people, it takes more than reading a few paragraphs about this way of thinking. It typically takes some practice over a few months. By beginning with my very first blog post (see HERE) many will find that for free the practice sessions provided are sufficient. Having a counselor/psychotherapist that reacts to such folks’ depression experiences with kindness and empathy, rather than with insults and seeking to convince them that their experience is so terribly bad, can also be enormously helpful. Such counselors/psychotherapists provide a model that leads one to emulate this way of being supportive of themselves throughout their days even when their therapist is no longer present.

Conclusion

Dr. Jeffrey Rubin

There is a subgroup of people who, upon becoming depressed, end up seriously considering, or even attempting, suicide. I am in no way attempting to make light of the experiences of people who reach this level of desperation. Some kind empathetic support can be very helpful to deal with such situations. What I am seeking to convey is that the vast majority of people experiencing depression don’t go to such extremes. For them, the argument that their experience is so bad they need to rush out and get someone to provide “antidepressant” treatment might not be wise.

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on.  This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence.  To begin at the very first post you can click HERE.