Marley2Hendrix wrote:The vast majority of people are placed on antidepressants by general medical physicians, not psychiatrists, and, the vast majority of this population receives antidepressants after reporting depressive symptoms to their general medical physician while not meeting the criteria for a Major Depressive Disorder (
a quick google yielded a 2013 journal article indicating 79% of people on antidepressants received them from their general medical physician, 60% of whom do not see a therapist, psychologist, or psychiatrist at any point in the future). Depressive symptoms generally pose a paradox - general malaise, anhedonia (diminished desire to engage in enjoyable/preferred activities), and lethargy, with the best known resolution to this being forced behavioral activation (i.e., pushing oneself to socialize, exercise, and, generally, being active). Unfortunately, this solution is antithetical to the experience of depressive symptoms and not intrinsically known by most. Moreover, the average adult in the united states experiences an uptick in depressive symptoms approximately two days per month, and, broadly speaking, we don't do a great job in this country in schools, media, and in general talking about what to do when depressive symptoms present.
Generally, the main utility of an antidepressant is boosting someone out of a severe depression, with the goal of giving them the energy to meaningfully engage in behavioral activation (i.e., socializing, developing a support network, exercising, meaningfully engaging in the therapy process, etc.). Ironically, this poses a dangerous and misunderstood situation of it's own, as there's plenty of research and lawsuits, primarily from the 90s, as their tends to be a statistically significant influx of individuals committing suicide approximately 4-6 weeks after initiating a trial with an antidepressant; why - because as the serious depression remits, energy rises but the underlying thoughts remain, thereby creating a scenario where they have the energy/psychic energy to commit suicide they didn't have before. To be clear, this is not the fault of the antidepressant, but the failure to ensure the individual is combining the modality of treatment with therapy and active involvement in a support system.
Lastly, and reiterating my prior point, we,
as a country, like quick, easy fixes (i.e., take paxil for the rest of your life and never worry about depression again; get vaccinated and you don't have to worry about your comorbidities).
Google it yourself - the long-term efficacy (i.e., continuing them for 6 months, 12 months, 4 years, etc.) of antidepressants alone isn't favorable. Moreover, for males in particular, many don't make the link when the medication causes, say, impotence, never link it to the pill, never discuss it with their prescribing physician (people aren't great about talking about these things) which then contributes to further embarrassment/withdrawal, only serving to further the source of the depression.
The stigma is mental health issues are embarrassing, so let's get on a pill and never talk about it again. As I said before,
I'm "anti-myopic view of very complex circumstances."
To me, your response was myopic, but, in an effort to try and be a good human, this is what I hope is a thoughtful response. I strongly disagree with your sentiment, "People like you are why there is a stigma around mental health," and I'm sorry you feel that way.
edit -
I haven't read the article, but, after posting, I quickly had the thought bubble maybe it does sound absurd that regular exercise, through random controlled trials, has demonstrated similar efficacy to antidepressants, and you don't want to trust what random licensed psychologist guy is touting on the internet, and that's fair.
Quick google and the very first result (I assure you, there's an abundance of studies):
Two categories of publications were examined: randomized controlled trials (RCTs) and meta-analyses or systematic reviews. Based on this reassessment, RCTs comparing exercise to antidepressants reported that exercise and antidepressants were equally effective. RCTs comparing exercise combined with antidepressants to antidepressants only reported a significant improvement in depression following exercise as an adjunctive treatment.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430071/Not to be myopic, but, think like a psychologist - forcing oneself to exercise is more than just the four or five days of exercise. It could mean, for many, going to a gym, forcing oneself out of his or her home, and at least engaging with others, even better if they have a workout buddy or friend, which yields further socialization. How about the enhanced self-esteem and sense of mastery for actual coming up with a goal of regular exercise, sticking to it, and, in basic terms, feeling better about one's health and general level of fitness, circumstances which may underlie some aspects of the depressive symptoms. There's a pretty vast list of correlates that come with exercise...
