Using Medication to treat Depression, Anxiety, and Other Mental Health Issues
(Part 1 of 5)
The use of medication as a first line defense against various mental issues has been under the spotlight for years. The reason for the attention is very simple – until 1952 when the drug chlorpromazine (more commonly referred to as Thorazine) there were no established or accepted pharmacological treatments for mental health issues. When going from a baseline of none a mere 64 years ago, to having 8 major classifications and well over 100 actual formulations, the question of actual need and reasons for the increase is bound to examined.
Many people have used terms like “unprecedented rise” when referring to the dramatic increase in mental health medications both available and prescribed. They are often decried as everything from unnecessary, and overused to actually causing more issues than they resolve. To determine if these are fair characterizations though, one would need to examine other similar medical revelations.
Antibiotics- Largely acclaimed to have begun with the introduction of venereal disease treatments in the first half of the 20th century, and truly commonplace with the discovery of penicillin in 1928 that by the 1940’s was the most commonly used medication in the US. In 80 years antibiotics have gone from one classification to 13 major classifications and over 300 formulations. In the press there are similar social issues of misuse and long term dangers.
Cancer Medications and treatments – While this includes more than simply oral medications, the original treatments of surgery and radiation have been supplemented by combination therapies that while nearly non-existent as little as 40 years ago now number in the hundreds. Even while 5 year survival rates have drastically increased in nearly every area, there are still many controversies in the treatment protocols and long term safety. Perhaps the reason the outcry is not quite as loud on the controversy of cancer treatments is the extreme mortality rate of non-treatment.
When comparing the rise in use of medication to treat mental health conditions to the very accepted practices of treating infectious disease and cancer, the term unprecedented is simply not true. What it does show is that it has followed a similar pattern of research and development that when combined with the results experienced in large scale use, has enabled greater and more effective development as the realm of knowledge in treating mental issues has increased. This leaves the real issues as a social taboo on mental health issues in general, and the difficulty in clinically determining either the exact issue or proving an issue has been “cured” as the real cause of the anti-medication movement.
What goes completely overlooked in all the debate of clinical proof of a certain illness and the taboos of mental illness is the very real devastating effect on the individuals effected. On many levels, those effected by severe depression and anxiety (even those might be classified as being on the “lesser end” of mental illnesses) suffer comparable quality of life issues to the most severe physical illnesses. If a person cannot work, cannot function normally in daily life, and is at risk of death through suicide it would have to be agreed that the symptoms and resulting lower quality of life are in fact profound.
While the public intolerance of discussions on mental illness is clear, the pharmaceutical industry and medical professionals have acknowledged the need for treatment and the treatments developed have proven effective. Studies have shown depression, for example, can be treated effectively in 80% or more patients.
While many argue that studies show the placebo effect to be nearly as effective as the actual drugs in mild depression there is no improvement possible if no medication is taken at all. Since it is not legal in most countries to use physician prescribed placebos, the argument of the difference in treatment is moot if the comparison is to a placebo effect which is highly effective in some cases compared to no treatment at all. If the worst case scenario is that the benefits of the treatment are entirely from the placebo effect, it still far more effective than not treating. In more severe cases of depression the anti-depressants outperform placebos by some magnitude. It is also worth pointing out the placebo effect tin many other areas of medicine such as pain management, digestive issues, and even coronary disease is distinct and measurable.
So why has medication become the first line defense in the treatment of many mental illnesses? Quite simply because it is effective more often than not and with the increase in the number and types of medications available it is becoming more effective and has fewer side effects. In addition to effectiveness, the compliance with medication is far easier than long term counseling, and that changes in lifestyle and environment are not always possible.
While far from a perfect treatment, it provides a way for millions of people worldwide to get relief from the symptoms of mental illness. When those symptoms are destroying all quality of life, and lead to job loss, destroyed families and even suicide it is worth considering as an option in consultation with your health care provider.
To be continued…..
Part 3 – Do Antidepressants Work?
Part 4 – Explanation of common medication classes and the uses (Upcoming)
Part 5 – Is it time to come off my medication? Am I cured? (Upcoming)