5 Facts You MUST Understand If You Are Ever Going
To Fix Your Sexless Marriage & Enjoy the Kind of
Intimacy You Deserve
1. A sexless marriage isn't a problem in itself. It's a symptom of something much deeper. Trying to solve the symptom instead of the problem can actually make things worse between you. If you really want to get the sex back into your marriage you must look deeper to find the real cause.
2. This isn't something which only you experience. It is estimated that over 15% of couples live in sexless relationships. For years this problem has been swept under the rug. On this website it will be ignored no longer. You have come to the right place to start getting your marriage back on track.
3. Sexless marriages aren't the result of aging. There are plenty of couples who have regular sex well into their 70's and 80's. On the other hand, there are many couples who fall into a sexless situation in their 30's or even 20's. Age is no excuse to stop having sex.
4. Trying to read one of those so-called expert books on how to improve a couple's sex life won't help. You need something which provides a true solution for YOU. The reason is that these books are written for men and women both. This isn't the way to go. You need something which is specifically for you.
5. Waiting for this situation to clear up on its own is like saying goodbye to sex forever. Don't bury your head in the sand, it is up to you to find the solution for your sexless marriage. Some couples go on for years without having sex. Don't let this happen to you.
So, let's see how you too can bring the passion and romance back to your marriage...
Women Click Here to discover how to get your husband or boyfriend interested in sex once more and restore the passion you once had.
Men Click Here to see how to eliminate the confusion and frustration and once again feel true intimacy with your wife
The statistics of sexless marriages
Does staying with your partner seem more and more like staying with a roommate than with a spouse? Has it been ‘ages’ since you’ve had some soul-refreshing, heart-warming intimacy? Well, you are not alone.
Sexless relationships, reports and surveys suggest, is on the rise. In fact, it is believed that more than 15% of marriages in the US are of the brother-sister kind.
Here are some shocking statistics relating to sexless marriages:
According to Newsweek, more than 18% of couples have sex as little as 10 times a year, making them fall into what experts call the ‘sexless marriage’ category.
Another survey in the Newsweek shows that most married couples have sex about once every week. By contrast, unmarried singles have sex up to three times a week!
About 20-25% of men and 30-50% of women complain about their lack of sex drive.
About 25% of Americans, mostly women, suffer from a condition called Hypoactive Sexual Desire (HSD) which is a condition in which the person feels a persistent lack of interest in sex.
While experts suggest that you can define your marriage as sexless only if you are having sex less than 10 times a year, the truth of the fact is that you cannot quantify sex. How much sex you want varies from person to person and age to age. For a couple in their sixties, sex once a month may be more than sufficient, but for a couple in their thirties, this is a worrying pattern indeed.
What with pressures from work, children, life and circumstances, the only way to keep your marriage going strong is to invest time and energy in the relationship continuously. Statistics notwithstanding, psychologists opine that every marriage faces these difficult conditions at some time or the other, but it need not really spell the end of the relationship.
Women Click Here to discover get your husband to want to have more sex.
Men Click Here to discover the real reason why your wife isn't interested in sex and how you can turn it around.
Labels: 5 Facts You MUST Understand If You Are Ever Going To Fix Your Sexless Marriage
Six Repair Tools for Your Marriage
By Dr. Tony Fiore
Rudy and Marjorie were on the verge of divorce. Married 12 years, they had constant verbal battles ending in what therapists call call emotional disengagement— meaning that they simply ignored each other for days on end.
Emotionally, they were simmering inside and also lonely for each other, but were unable to reach out and communicate these feelings. They were in a “cold war” with both waiting for the other to make the first move to melt the icy atmosphere.
This couple suffers a common marital malady—lack of skills to repair emotional damage done to each other. According to marital research, almost all couples fight; what often separates the "masters" of marriage from the “disasters” of marriage is the ability to repair the subsequent damage.
Acquiring good repair skills gives the couple a way to recover from the mistakes they may have made. These repair skills provide a “fix” for the damage caused in attempting to communicate to each other other in a way that caused emotional hurt to one or both of them.
It is common for partners to make relationship mistakes - after all, anyone can have a bad day, be under too much stress or just use poor judgment in dealing with a situation. Rather than emotinally disengaging from each other or staying angry, try to "fix it" if you are the offender.
And if you are the receiver of the damage, your challenge is to find a way to accept your partner’s repair attempt— that is, to see your partner’s repair attempt as an effort to make things better.
REPAIR TOOL Tool #1—apologize
A simple sincere and heartfelt apology can sometimes do wonders for a relationship, especially if your partner sees you as a person who never admits they are wrong or at fault.
Say things like: I’m sorry; I apologize;What I did was really stupid; I don’tknow what got into me.
REPAIR Tool #2—confide feelings.
Be honest and share the feelings that are underneath the anger such as fear, embarrassment, or insecurity. Your partner may respond to you quite differently if they see those other emotions, instead of just the anger.Confiding what is in your heart and in your mind can make a huge difference in promoting understanding, closeness, and intimacy.
Say things like:I was really afraid for our daughter when I got so angry;I didn’t want to hurt you; I just lost my cool.
REPAIR TOOL #3—acknowledge partner’s point of view.
This doesn’t mean you have to agree with it; just acknowledging it can decrease tension and conflict because it shows your partner you are at least listening to them. It also demonstrates empathy—the ability to see things from their vantage point instead of only yours.
Say things like: I can see what you mean; I never looked at it that way.
REPAIR TOOL #4—accept some ofthe responsibility for the conflict.
Very few conflicts are 100% the fault of either partner. Instead, most conflicts are like a dance with both of you making moves to contribute to the problem. Inability to accept any responsibility is a sign of defensiveness rather than the openness required for good communication.
Say things like:I shouldn't’ have done what I did; I guess we both blew it; I can understand why you reacted to me that way.
REPAIR TOOL #5—find common ground.
Focus on the issue at hand and what you have in common rather than your differences. For instance, you might both agree that raising healthy children is a common goal even though you differ in parenting styles.
Say things like: We seem to both have the same goal here; we don’t agree on methods but we both want the same outcome.
REPAIR TOOL #6—commit to improve behavior.
“I’m sorry” doesn’t cut it if you continually repeat the offensive behavior. Backup words with action. Show concrete evidence that you will try to change.
Say things like:I promise to get up a half hour earlier from nowon; I’ll call if I’m going to be late; I’ll only have two drinks at the party and then stop.
Dr Tony Fiore is a licensed psychologist, marital therapist and certified anger management trainer. He is a Fellow of the American Stress Institute and a Diplomate of National Anger Management Association. He has received advanced training in marital therapy at the Gottman Institute in Seattle,Washington. In addition to his active clinical practice, Dr Tony regularly conducts anger management classes in Southern California, consults and provides trainings to companies for anger and stress management, and trains anger management facilitators. He also publishes a monthly newsletter "Taming The Anger Bee." With Ari Novick, M. A. he has recently published a new workbook/manual: "Anger Management For The Twenty-First Century - The Eight Tools of Anger Control." Visit his website at http://www.angercoach.com and sign-up for his free newsletter.
Labels: Six Repair Tools for Your Marriage
How to Affair-Proof Your Marriage
Steven D. Solomon, PhD
It seems that every week we learn about another politician, sports star or celebrity caught having an extramarital affair. But public figures are hardly the only ones guilty of infidelity. Surveys show that between 40% and 60% of husbands and between 30% and 50% of wives will be unfaithful at some point during their marriages.
Loneliness is the most common cause of infidelity. Almost everyone who enters into marriage does so intending to remain faithful to his/her partner, but long-term relationships are difficult. Partners often drift apart. The romance and the excitement of the initial period eventually ends. Many people do not know how to recover the closeness of a relationship once it fades, so they look outside the marriage for the fulfillment that they no longer receive at home.
The secret to a fulfilling and faithful long-term marriage is maintaining "emotional intimacy" -- openness, trust, communication and caring between partners. When spouses feel this intimate closeness, they are unlikely to cheat.
Emotional intimacy is not just one skill -- it is a combination of several different abilities...
SELF-INTIMACY
In order to have an emotionally intimate relationship with someone else, you first must understand your own emotions. Men in particular tend to pay insufficient attention to their emotions.
What to do: Take one to two minutes a few times a day to ask yourself three questions -- What emotion(s) am I feeling right now? What specific situation is causing me to feel these emotions? What, if anything, do I need to do about this situation to take care of myself?
Example: I’m feeling anger... I’m feeling it because that guy cut me off on the highway... The best thing I can do to take care of myself is let the anger go.
Run through these questions two or three times each day for 60 days and you will become much more aware of, and in charge of, your own emotions.
CONFLICT INTIMACY
All couples fight, but couples with emotionally intimate marriages fight productively. They don’t just try to win arguments -- they listen to their partners and come to understand their points of view, even if they do not agree.
What to do: When you are at odds with your spouse, try an established technique called Initiator to Inquirer or I to I. One spouse serves as "initiator." This spouse raises a troubling issue and shares his feelings and opinions on the matter. The initiator presents these thoughts as his perspective on the situation, not as the only way to look at it.
Example: The wife, as the initiator, says, "I felt hurt because it seemed to me as if you intentionally were trying to hurt my feelings," rather than "You intentionally hurt my feelings."
The other spouse’s role is "inquirer." He is to repeat back the substance of what the initiator has said to show that he has heard and understood. The inquirer then asks questions that aid in understanding.
The inquirer is not allowed to question the validity of the initiator’s feelings. When the desire to do so arises (and it will), the inquirer should silently remind himself that "this is not about me... it is only about my partner’s perspective on the situation, and it is important for me to understand this perspective." When the initiator has had her say, the partners can switch roles. Avoid distractions during I to I time, and do not try this when one or both of you are exhausted.
This will not be a comfortable process at first, particularly if lots of negative feelings exist between you and your spouse. If you practice it two or three times each week for about 20 minutes at a time, it can become a very useful process for working through the marital conflicts that could lead to unhappiness. You and your partner will get good at fighting productively, which will end up bringing you closer.
AFFECTION INTIMACY
Being in love with your partner is not enough to prevent infidelity. You also must show your love and affection in the ways that your partner needs. Even a well-meaning spouse can run into trouble here if he fails to realize that the type of affection he is providing is not the type that his partner desires. Types of marital affection include...
Verbal. How often do you tell your partner that you love him? How often do you express your gratitude for the things your partner does for you?
Actions. How often do you do things just because your partner enjoys having them done? This might include buying a gift or doing some favor or chore for the partner that goes beyond your normal responsibilities.
Physical (nonsexual). How often do you hold hands, hug or kiss your partner? How often do you provide foot massages or back rubs?
Sexual. How often do you have sex with your partner?
What to do: Do not assume that your partner desires the same types of affection that you do or that you know what your partner needs because you have been together for years. Come right out and ask your partner what types of affection he/she would like you to provide more often. Get specifics. Then communicate your own needs. Do not take it personally if your partner says you have not shown enough affection. This reflects the partner’s personal affection needs, not your own shortcomings.
Example: A man thinks he shows his wife plenty of affection by buying gifts, holding hands and helping out around the house. His wife feels he is never affectionate, because she wants verbal affection and he never says, "I love you."
If you fail to provide the types and amounts of affection that your partner considers appropriate, your spouse may stray. Provide the desired affection, and your spouse is less likely to seek it from others.
TO TELL OR NOT TO TELL
My patients who have had or are having extramarital affairs often ask me if they should tell their spouses about the affair. I tell them that if the affair is ongoing and you have no intention of ending it, then you must. Infidelity is a major violation of marital trust, and the very least you owe your partner is the opportunity to deal with the violation as he sees fit, whether that means divorce, separation, couples therapy or something else.
If your infidelity has ended and you have no intention of repeating it, it might be better to leave the past in the past. Do not confess to unfaithfulness simply because it will feel good to get it off your chest. Telling your spouse could cause more pain and problems than it solves.
Bottom Line/Personal interviewed Steven D. Solomon, PhD, a licensed clinical psychologist based in La Jolla, California. He has more than 20 years of experience in couples therapy. www.therelationshipinstitute.org. He is past president of the San Diego Psychological Association and coauthor of Intimacy After Infidelity: How to Rebuild & Affair-Proof Your Marriage (New Harbinger).
Labels: How to Affair-Proof Your Marriage
How to save your marriage - save a failing marriage stop and prevent divorce
By Greg Winters
Quotes to help you save your marriage & prevent divorce
Here are some quotes to help you think about how best you can save a failing marriage and stop divorce. These thoughts should help you start to think more about your relationship and where it needs to be worked on. I'd also recommend that you read the "Save My Marriage Today eBook" which you can download by clicking here.
1. "It is not a lack of love, but a lack of friendship that makes unhappy marriages."
- Friedrich Nietzsche.
2. "Chains do not hold a marriage together. It is threads, hundreds of tiny threads which sew people together through the years. That is what makes a marriage last --more than passion or even sex"
- Simone Signoret
3. "Happy marriages begin when we marry the ones we love, and they blossom when we love the ones we marry."
- Tom Mullen
4. "All married couples should learn the art of battle as they should learn the art of making love. Good battle is objective and honest--never vicious or cruel. Good battle is healthy and constructive, and brings to a marriage the principle of equal partnership."
- Ann Landers Says Truth Is Stranger..., 1968
5. "The secret to having a good marriage is to understand that marriage must be total, it must be permanent, and it must be equal."
- Frank Pittman
6. "What counts in making a happy marriage is not so much how compatible you are, but how you deal with incompatibility."
- Leo Tolstoy
7. "The most important marriage skill is listening to your partner in a way that they can't possibly doubt that you love them."
- Diane Sollee
8. "A successful marriage requires falling in love many times, always with the same person."
- Mignon McLaughlin
9. "Marriage, ultimately, is the practice of becoming passionate friends."
- Harville Hendrix
10. "Ultimately the bond of all companionship, whether in marriage or in friendship,
is conversation."
- Oscar Wilde
11"Don't discuss sensitive subjects before dinner - eat first. My husband is very irritable when hungry."
- Renee Flager happily married for 50 yrs, New York City - Everlasting Matrimony
12. "More marriages might survive if the partners realized that sometimes the better comes after the worse. "
- Doug Larson
13. "Ask yourself, "What difference will this thing we're fighting about make in ten years?
In one year? In a month?"
- Author Unknown
14. "The most important thing a father can do for his children is to love their mother."
Theodore Hesburgh
I hope you've found these quotes helpful and I hope they point you in the right direction. For more information on how to save your marriage and stop divorce check out the Save My Marriage Today eBook if you haven't already done so.
Labels: How to save your marriage - save a failing marriage stop and prevent divorce
How To Fix A Troubled Marriage!
by Cucan Pemo
Sometimes you can fix a troubled marriage and sometimes you are past no return. Before you allow your marriage to get past the point of new return, you need to reevaluate your marriage as well as your feelings. How troubled is your marriage? Do you feel like your marriage is just rocky or is it falling into the gutter? Even if your marriage is still just rocky, you need to take the time to help your troubled marriage. Those who are in a rocky marriage you will want to put a just a little bit more into the marriage.
First, you need to do things around the house that you would normally need to be asked to do. Make the bed, do the laundry, help out a little bit. In a rocky marriage, only stress is your issue. You need to make sure that you help your mate during the rough times and be more emotionally and physically supportive. You need to make her feel like she is needed, but not a slave. You also need to do things that make her feel attractive as well. You need to put forth some effort to make her feel wanted and beautiful. If you put more energy into your marriage, it won't be rocky for long. If you fear that you have put off the marriage for awhile then you are probably in a failing marriage.
The reason why you are in a failing marriage is when things got rough you ignored the signs. You can't ignore the signs of trouble in a marriage or you could end up in a very troubled spot. It can be difficult to fix a failing marriage. There will be resistance. You not only need to put more energy forth into the marriage, but you may need to take a step back from the relationship for you both to breath. When it comes to saving a marriage, you need to put some space between the two partners.
This doesn't mean you have to move out, however, you need to back off with the romance and try to open up with each other. Talking can help resolve a lot of issues in a marriage; however, you have to talk openly to them. You have to learn how to listen and to send positive and clear messages.
Even though it can be hard to back off with wanting to be intimate, you will find that it will pay off in the end. You will be able to get to the wild bedroom behavior once you have been able to reconnect to your wife. Once you have reconnected to her, she'll be more likely to want to be with you and more open to your intimate ideas and feelings. When you have a basis of trust and deep admiration you will find that the intimacy will be better than ever.
The key to saving a marriage is to get to the point where you both were happy. You need to make sure that you talk about the things that you are concerned with and the things that they are concerned with. You will want to make sure that you are open to your partner so that you can get to the core of your troubles. Once you have opened up to the communication channels, you can then open up about things like your sex. It's all one-step at a time. Once you have a basis of understanding then you are able to build on that.
Once you have talked things through and have allowed a basis for a marriage, you can then start adding of your other concerns. Things like talking to your partner about the lack of excitement, the lack of pleasure, or even the lack of feeling wanted yourself. There are many men who think that their mate does not feel attracted to them, but there are a lot of women with the same insecurities.
As you grow and further your commitment to each other, you also need to keep the communication open so that you two can grow together. Once you have fixed your marriage, you constantly have to keep up with the marriage. You need to always be putting in effort to the relationship. You need to always be trying to keep interest in each other and keep the excitement in the relationship. When serious problems arise, you have to think about all the things that your mate must be feeling and allow her to have her feelings, but take a genuine step towards making that concern strength to your marriage. Remember, men and women see and think in a different light and if you are able to see the problem in both of our eyes, then your marriage will be saved.
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Labels: How To Fix A Troubled Marriage.
Nowadays, couples have become more and more liberated and open-minded about the complicacies and hardships of maintaining a good and harmonious marriage.
The emergence and rapid popularity of divorce and annulment make up a sudden and easy exit out of the relationship if ever one or both of the couple is not already comfortable with the marriage.
Thus, failing marriages now become a way of life, a natural occurrence between a married couple who would do anything to grow and prosper as individuals, even it means that they must separate and pull away from each other.
Here are the top signs or warnings that scream of a failing marriage. Take note, that some warnings signs are so common, that you would have to open up your eyes and look for the truthfulness and honesty in every action.
1. Cold treatment. The terms of endearment for each other is starting to fade away.
2. Frequent arguments that usually lead to significant and intense fights. For some, the dispute can go physical, and for some emotional and mental, which are far worse than physical.
3. Deteriorating or less intense sex life. Sex is one important factor that make up the relationship of a husband and a wife. If sex fails, the rest would follow. Sometimes, sex could also be great escape, like if there is great argument or misunderstanding, a hot and steamy sex could facilitate amends and reconciliation.
4. The search for other potential and prospective partners start. This is the ultimate sign that the relationship indeed is over. The love has gone out.
When any of these warning signs are evident and present in your married life, calm down and let things turn to its natural course. Saving the marriage would mean a joint effort between the partners. Talk about the marriage and the implications of a separation.
Is your marriage in trouble? To learn simple, easy strategies to save your marriage, please go to http://www.how-to-save-a-marriage.info/
Labels: Here are the top signs or warnings that scream of a failing marriage
Crook Alert. Drug Companies Are Bribing Our Doctors and Exerting Undue Influence on Medical Research78
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By Ralph Deeds
What are these doctors hiding from us?
How to cheat at everything.
Vermont Passes Law Requiring Disclosure of Payments to Doctors NYTimes 5-19-09
Disclosure of Medical Industry Payments to Doctors Required by New Vermont Law
The law, scheduled to take effect on July 1, is believed to be the most stringent state effort to regulate the marketing of medical products to doctors. It would also ban nearly all industry gifts, including meals, to doctors, nurses, medical staff,
4-29-09 Institute of Medicine Calls for Doctors to Stop Taking Gifts from Drug Makers
The Institute of Medicine issued a critical report calling for doctors to stop taking money, free drug samples and other gifts from drug and medical device companies. "It is time for medical schools to end a number of long-accepted relationships and practices that create conflicts of interest, threaten the integrity of their missions and their reputations, and put public trust in jeopardy," the report concluded.
The report calls on Congress to pass legislation that would require drug and device makers to publicly disclose all pamyments made to doctors.
Drug companies spend billions of dollars wooing doctors--more than they spend on research or comsumer advertising. Much of this money is spent on giving doctors free drug samples, free food, free medical refresher courses and payments for marketing lectures. the Institute's report recommends that nearly all of these efforts end.
In a tiny nod to appease critics, last year several major drug companies agreed to stop giving pens, pads, and other gifts of small value, but defended other practices as valuable to doctors and patients. Here's a link to a NY Times article by Gardiner Harris on the Institute of Medicine's highly critical report.
http://www.nytimes.com/2009/04/29/health/policy/29drug.html?scp=3&sq=Gardiner%20harris&st=cse
Are Big Drug Companies Bribing Our Doctors and Medical Researchers?
Minnesota is the first of a few states to require drug companies to disclose payments to doctors. The records of these payments are quite revealing. From 1997 to 2005 drug makers paid more than 5,500 doctors, nurses and other health care workers in Minnesota at least $57 million. Another $40 million went to clinics, research centers and other organizations. The median payment per consultant was $1,000; more than 100 people received more than $100,000.
Doctors typically receive money for delivering lectures about drugs to other doctors. Some of the doctors receiving the most money sit on panels that prepare guidelines inctructing doctors nationwide about when to use medicines.
Comments:
"I hate to say it out loud, but it all comes down to ways to manipulate doctors."
Kathleen Slattery-Moschkau, former sales rep for Bristol-Meyers
"If a doctor says that he got flown to Maui, stayed at the Four Seasons--and it didn't influence him a bit? Please."
Jamie Reidy, a drug sales rep for Pfizer and Eli Lily who was fired in 2005 after writing a humorous book on his experiences.
"You're paying him for the talk. You're increasing his referral base so he's getting more patients. And you;re helping to develop his name. The hope in all this is that a silent quid quo pro is created. I've done so much for you, the only think I need from you is that you write more of my products."
Gene Carbona, who left Merck as a regional sales manager in 2001.
Between 1997 and 2005, Dr. Grimm earned more than $796,000 from drug companies. In 2003 alone, Pfizer paid Dr. Grimm more than $231,000. Pfizer markets Lipitor, a cholesterol drug that last year had $12.9 billion in sales, more than any other drug in the world.
Dr. Donald Hunninghake served on a government-sponsored advisory panel that wrote guidelines for when people should get cholesterol-lowering pills. The panel's 2004 recommendations that far more people get the drugs became controversial when it was revealed that eight of nine members had financial ties to drug makers. The full extent of those ties have never been revealed.
In 1988 alone, Pfizer paid Dr. Hunningshake $147,000, and he earned at least $420,000 from drug makers between 1997 and 2003.
Comment: Judges are expected to disqualify themselves from cases in which they have a personal interest or even an appearance of bias. Apparently medical ethics don't include such a rule or expectation.
Here's a link to a 3-21-07 NYTimes story by Gardner Harris and Janet Roberts:
http://www.nytimes.com/2007/03/21/us/21drug.html?_r=1&hp&oref=slogin
Secret Drug Company Payments to Doctors
Big Pharma Payments to Doctors
Physicians Bribery a Look at This Common Medical Industry Practice
Physician Bribery
The Journal of the American Medical Association Says Doctors Should Stop Taking Bribes from Drug Companies
JAMA Says Stop Drug Company Bribes
IN SOME STATES THE MAKER OVERSEES THE USE OF ITS OWN DRUG
Drug Companies Oversee Use of Their Drugs
Conflict of interest? Hidden agenda? Or legitimate cost containment mechanism?
Labels: Crook Alert. Drug Companies Are Bribing Our Doctors and Exerting Undue Influence on Medical Research78
A Dramatic Case of Data Distortion
The Depressing Truth About Anti-Depressants
By STAN COX
A paper published January 17 in a prestigious medical journal demonstrated in the starkest of terms how pharmaceutical companies tend to publish research that's favorable to their products and leave unfavorable results tucked away in their files. It's a problem that everyone outside the industry already recognizes, but the results of this most recent study should really set off alarms.
Led by Dr. Erick Turner of the Oregon Health and Science University in Portland and published in the New England Journal of Medicine [1], the study took the results of 74 Food and Drug Administration (FDA)-registered trials of antidepressant medications (trials done by the companies that developed the drugs) and compared them with the results that the drug companies published in peer-reviewed medical journals. The study involved 12 antidepressants approved between 1987 and 2004.
In seeking approval of new drugs, companies are required by law to register their clinical trials with the FDA before conducting them, and then report results to the agency when they're done. Of those 74 trials, the survey found 38 that showed antidepressants to be effective, and all but one of those was duly published. But stunningly, out of 36 trials that showed the drugs to be of questionable or no benefit, the results from only 3 trials were published accurately. Of the rest, 22 were not published at all. All of the other 11 that were published concluded that the drugs did have a positive benefit, in direct contradiction of FDA's conclusion.
So, in the authors' words, "studies that the FDA judged as positive were approximately 12 times as likely to be published in a way that agreed with the FDA as were studies with nonpositive results." And it wasn't just a matter of holding back results. Trial-by-trial, the beneficial effects of antidepressants as published in medical journals were 18 percent bigger than those recorded in the official FDA data. The authors don't speculate on how this effectiveness-inflation occurred, but combined with selective publication of positive results, it made antidepressants look a lot better than they really are.
Antidepressants are the most frequently prescribed class of drugs in the US, with about 60,000 prescriptions written every working hour. Encouraged by all those favorable journal papers, doctors tripled their prescription-writing for antidepressants between 1988 and 1998 [2], and prescriptions had shot up another 31 percent by 2005. The greatest increase has come among doctors who are not psychiatrists. The products have become a convenient way to deal with people who find themselves in rough situations. Soldiers in Afghanistan and Iraq are reportedly being given "bags of antidepressants" and upwards of one-third of nursing-home residents are taking antidepressants at any given time.
FDA registration is designed to curtail the kind of deceptive publication practices that can boost unnecessary prescribing, and their data for more recently developed drugs are available on the agency's website. (But getting data for the eight older drugs examined by Turner and colleagues required use of the Freedom of Information Act). Most academics, journalists, and others looking to inform the public on a drug's overall usefulness rely on studies published in medical journals as being the "gold standard" for reliability. So biased publishing, coming on top of heavy advertising [pdf], overtesting [3], and close interaction between sales reps and doctors, is a highly effective way to improve the market for a drug.
Turner's study looked only for exaggeration of antidepressants' benefits, not at their often terrible side effects. But selective publication can also keep the public in the dark about serious harm that drugs can do. Most infamously, Merck & Co. was accused of leaving out some negative results and spinning others from trials of the pain-reliever Vioxx, when a study of the drug's association with an increased risk of heart attack was submitted to the New England Journal of Medicine. By the time Vioxx was withdrawn in 2004, FDA estimated that it had caused in the range of 25,000 to 50,000 fatal heart attacks.
Each year, the drug industry churns out enough product to fill more than 15 prescriptions per American, and that adds up to more than $200 billion in annual sales. An international survey of the medical literature showing that around 5 percent of hospital admissions result from avoidable adverse drug reactions [4]; that means about 2 million of the pharmaceutical industry's customers end up needlessly hospitalized each year. Countless other people are suffering side effects without even taking the drugs; they are simply living too close to pharmaceutical factories in India and other countries that export to the US.
It's a depressing situation, one that can be resolved only by taking drug testing out of the hands of the corporations themselves.
Stan Cox is a plant breeder and writer in Salina, Kansas. His book Sick Planet: Corporate Food and Medicine will be published by Pluto Press in April. They can be reached at: t.stan@cox.net.
Notes
1. E.H. Turner et al., 'Selective publication of antidepressant trials and its influence on apparent efficacy', New England Journal of Medicine, 358: 252 (2008)
2. S.M. Foote and L. Etheredge, 'Increasing use of new prescription drugs: a case study', Health Affairs, Jul-Aug, 2000
3. D. Studdert et al., 'Defensive medicine among high-risk specialist physicians in a volatile malpractice environment', Journal of the American Medical Association 293: 2609 (2005) and D. Merenstein et al., 'Use and costs of nonrecommended tests during routine preventive health exams', American Journal of Preventive Medicine 30: 521 (2006).
4. H.J.M. Beijer and C.J. de Blaey, 'Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies', Pharmacy World and Science 24: 46 (2002)
Labels: The Depressing Truth About Anti-Depressants
The Truth About Antidepressants: 10 Facts You Should Know
“The best prescription is knowledge.”
If you decide to take depression medication, it’s prudent to learn all you can about your prescription. The more you know about your antidepressant, the better equipped you’ll be to deal with it’s both positive and negative effects.
Here is a list of helpful information about antidepressants:
1. Symptom relief can take weeks
Antidepressants are not a quick fix and take time to work. It may take several weeks (or more) before positive results are noticed. Because everyone’s brain chemistry is different, antidepressants will affect individuals differently.
You may start to feel better within one to three weeks of taking antidepressant medicine. But it can take as many as six to eight weeks to see further improvement.
How antidepressants work is a subject of ongoing research and speculation. The prevailing theory is that they boost chemicals in the brain, especially the neurotransmitters serotonin and neuropinephrine, that make you feel better.
2. Antidepressants are not “happy pills”
Don’t expect a “high”. Antidepressants aren’t like narcotics or alcohol. They don’t make you high, or cause hangovers. Their effectiveness is gradual and the benefits are subtle.
3. Side effects
Antidepressants may cause a wide range of side effects. For many people, the side effects are more unpleasant than the depression itself, so they discontinue treatment. In fact, for every 4 people starting a Selective Serotonin Reuptake Inhibitor(SSRI), treatment is stopped in 1 due to side effects4.
There are two side-effects that people seem to find the most troubling: sexual dysfunction and weight gain.
Rather ironically, just about all medications used can also potentially cause sexual side-effects. If these problems are of great concern, trazodone3, bupropion (Wellbutrin)2 and mirtazapine (Remeron) are medications which have fewer sexual side effects.
Regarding weight gain, paroxetine (Paxil), mirtazapine (Remeron) and citalopram (Celexa) are the worst offenders1. Venlafaxine (Effexor), bupropion (Wellbutrin), and fluoxetine (Prozac) do not seem to cause weight gain as badly, and may even cause some people to lose a few pounds.
In general, SSRIs cause fewer types of adverse effects than do Tricyclic Antidepressants (TCAs). With many tricyclics, the most troublesome effect with ongoing use is sedation.
4. Most antidepressants are equally effective
Most of these drugs are equally effective. While drug companies have reduced medication side effects with the newer antidepressants, there’s still not much improvement with onset of action or efficacy.
However, finding the correct antidepressant can be hit and miss. With some people it can mean going to 5-6 different ones before finding the one that works best.
5. If antidepressant doesn’t work
If one antidepressant doesn’t do the trick, your doctor may consider the following options:
Increasing the dose of the antidepressant you’re on.
Continuing at the same dose and adding a second drug: either another antidepressant (combination therapy) or another type of drug (augmentation therapy)
Switching, which involves gradually stopping the first drug and starting a second.
Starting alternative therapy
6. “Poop-out” effect: It is possible that one day your antidepressant will stop working
This phenomenon affects approximately 20 percent of people who take antidepressants - the so-called “poop-out” effect. In such cases, the medications simply stop being effective. Psychiatrists don’t fully understand what causes this.
The good news is that adjusting the dosage, changing medications or adding other medications is usually effective in countering thiseffect. Alternative therapies (cognitive behavioral therapy, psychotherapy, exercise) also can help.
7. Antidepressants work only 40% to 50% of the time
Researchers agree that when depression is severe, medication can be helpful - even life saving. However, some studies show that the benefits of depression medication have been exaggerated - with some researchers concluding that, when it comes to mild to moderate depression, antidepressants are only slightly more effective than placebos.
The effectiveness of a dozen popular antidepressants has been overstated by selective publication of favorable results, according to a review of unpublished data submitted to the Food and Drug Administration. The suppression of negative studies isn’t a new concern. The tobacco industry was accused of sitting on research that showed nicotine was addictive, for instance.
For some people antidepressants become true life-savers: read comments on “Antidepressants Don’t Work, Says Study”
8. Discontinuation syndrome
Once you have started taking antidepressants, stopping can be tough. Many people get withdrawal symptoms following the interruption, reduction or discontinuation of the antidepressant. This make it difficult to get off of the medication. The most common symptom is “Brain Zaps” which are said to defy description for whoever has not experienced them, but are described as a sudden jolt likened to an electric shock originating in the brain itself, with associated disorientation. These symptoms are considered to be caused by the brain’s attempts to readjust after such a major neurochemical change in a short period of time.
People also might have trouble sleeping, have an upset stomach, have shock-like sensations in the arms and hands, feel dizzy, or feel nervous.
9. Antidepressants aren’t a cure
Medication may treat some symptoms of depression, but can’t change underlying contributions to depression in your life. Antidepressants won’t solve your problems if you’re depressed because of a dead-end job, a pessimistic outlook, or an unhealthy relationship. That’s where therapy and other lifestyle changes come in.
Studies show that therapy works just as well as antidepressants in treating depression, and it’s better at preventing relapse once treatment ends. While depression medication only helps as long as you’re taking it, the emotional insights and coping skills acquired during therapy can have a more lasting effect on depression. However, if your depression is so severe that you don’t have the energy to pursue treatment, a brief trial of antidepressants may boost your mood to a level where you can focus on therapy.
10. Antidepressant uses: “Off-label” & “On-label”
Antidepressants were initially developed to relieve depression. Although the FDA has approved these medications for treatment of a variety of conditions, they are prescribed for a number of “off-label” (unapproved) uses. Importantly, off-label drug use is legal and often beneficial. But there is growing concern that it’s on the rise, it’s not always wise, it’s getting riskier.
Some off-label uses of antidepressants include:
Sleep aid, insomnia (trazodone, amitriptyline)
Premature ejaculation (paroxetine)
Migraine headaches prophylaxis (fluoxetine)
Fibromyalgia (fluoxetine, amitriptyline)
Pain management (tricyclic antidepressants, duloxetine, venlafaxine)
Weight loss (bupropion)
Tip: When your doctor prescribes a drug - any drug - ask if it’s an approved use or an “off-label” use. If you get an off-label prescription, ask your doctor whether the scientific evidence really supports this use.
References
1. Maina G, Albert U, Salvi V, Bogetto F. Weight gain during long-term treatment of obsessive-compulsive disorder: a prospective comparison between serotonin reuptake inhibitors. J Clin Psychiatry. 2004 Oct;65(10):1365-71. PubMed
2. Thase ME, Haight BR, Richard N, Rockett CB, Mitton M, Modell JG, VanMeter S, Harriett AE, Wang Y. Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors: a meta-analysis of original data from 7 randomized controlled trials. J Clin Psychiatry. 2005 Aug;66(8):974-81. PubMed
3. Montorsi F, Strambi LF, Guazzoni G, Galli L, Barbieri L, Rigatti P, Pizzini G, Miani A. Effect of yohimbine-trazodone on psychogenic impotence: a randomized, double-blind, placebo-controlled study. Urology. 1994 Nov;44(5):732-6.PubMed
4. Kroenke K, West SL, Swindle R, Gilsenan A, Eckert GJ, Dolor R, Stang P, Zhou XH, Hays R, Weinberger M. Similar effectiveness of paroxetine, fluoxetine, and sertraline in primary care: a randomized trial. Journal of American Medical Association. 2001 Dec 19;286(23):2947-55.
Labels: The Truth About Antidepressants: 10 Facts You Should Know
The Truth About Antidepressants
This is what the drug companies don't want you to know. They cause weight gain, are addictive, and cause withdrawals when you get off them! Also, they can cause or make worse hypothyroidism. On top of that, they can make your depression worse! The drug companies don't have proof that their drugs even work! In studies, sugar pills were more effective! These drugs slow down your metabolism so much that no matter how much you exercise and diet you will gain weight. SSRI's are addictive! These drugs are not a natural pill, they are addictive. Severe withdrawals are experienced when you get off these drugs lasting from 2 weeks to 2 months. Some even have less severe symptoms for months to up to 3 years after! Even missing one day's dose can cause withdrawals. Such severe withdrawals that cause many to lose their jobs, relationships, etc. You will be disabled for at least 2 weeks. I know from personal experience. I experienced two months of complete hell. I had sweating and the chills alternating, night sweats that woke me up, insomnia, daytime drowsniness and exhaustion, diarrhea, anxiety, headaches, severe & painful PMS, weight gain, memory problems, unable to concentrate, blurry vision, joint pain, dizziness, hypersensitivity to motion/sounds/smells, fainting, grinding of teeth during sleep, itchiness, nausea, heartburn, involuntary muscle twitching, numbness, and increased depression. Any side effects I had on the drug were magnified when I got off them. I tried many times over 14 years to get off these drugs. No doctor ever told me about these withdrawals, instead they said that was a sign that I needed to go back on these drugs. I finally found out the truth, so I am spreading the word so others don't have to suffer as long as I did! I wish someone had told me the truth 14 yrs ago! What a waste of my life! Spread the word, tell others! Don't let your doctor push these drugs on you! Everyone is now being told to go on these drugs for problems not even relating to depression! They are writing these prescriptions to get their patients out of the office quickly instead of taking time to find a diagnosis for the symptom! Unless you can't get out of bed and are suicidal, please don't take these drugs. If considering them, don't take them! Or at least educate yourself thru the links on this web site. Don't trust your doctor to inform you. If on them, get some time off work and get off them! This includes all SSRI's (Prozac, Effexor, Paxil, Zoloft, Wellbutrin, etc.) Effexor has the worst withdrawals.
Depression - Often A Symptom,
Not A Diagnosis
If you have depression, please look for a CAUSE of your depression. Often depression is a SYMPTOM not a diagnosis! Too often doctors hear "depression" and just write out a prescription for an antidepressant without looking for a CAUSE and correct diagnosis! Turns out my withdrawal symptoms that I still have after 7 months off the SSRI are symptoms of hypothyroidism. Depression being the symptom, hypothyroidism the diagnosis! 14 years on an antidepressant suffering with side effects and finally I find out the real reason for my depression! My doctor read my test results and said they were normal, NOT! I got the numbers myself and found out he was wrong! Get your blood test numbers yourself and compare them to this chart. Basically TSH - 0.3 to 3.0 (under .3 hyperthyroidism, over 3.0 hypothyroidism), T4 - 4.5 to 12.5, FT4 - 0.7 to 2.0, T3 - 80 to 220. Sadly, doctors make this mistake often! Anyone who has depression should have their thyroid tested EVERY year! A simple blood test done at your family doctor is all that is necessary. Even if your blood work comes back normal, if you have all the symptoms some doctors will prescribe the inexpensive pill "Synthroid". I went through years of misery due to this misdiagnosis at least 7 yrs, possibly 14-18 years! Common symptoms are but not limited to: fatigue (drowsiness), depression, feeling cold, constipation (or IBS), headache, PMS increased, weight gain, anxiety, memory problems, hair loss and dry hair, joint and muscle pain, and dry skin. Some say twitching eye lid, blurry vision and ear ringing also. Also postpartum depression can be caused by this and may be temporary. IBS (irritable bowel syndrome) is also often hypothyroidism. Remember often depression is a SYMPTOM and not a diagnosis! Depression can often be easily and quickly cured when you find out what is wrong with your body! Don't let your doctor push these antidepressants on you without looking at the rest of your symptoms! Don't be ignored and mistreated as I have been. Stand up for yourself. Find another doctor if yours wont listen! Unfortunately, everyone has to be their own doctor and only use their doctor for prescription writing. So research every drug you are prescribed and every symptom you have. Find your own diagnosis as I have.
PLEASE COMMENT
Labels: The Truth About Antidepressants
Antidepressants and natural alternatives
by Marcelle Pick, OB/GYN NP
Topics addressed in this article:
How are antidepressants designed to work?
The depressing truth about antidepressants
Why antidepressant use is so widespread
Side effects of antidepressants — known and unknown
Women to Women’s approach to dealing with depression
Do you really need an antidepressant?
Serotonin, nutrition and stress
How to restore healthy serotonin levels naturally
Jackie was just 42 when she came to Women to Women for help. She had gone to her prior healthcare provider complaining of fatigue and “feeling low” two weeks out of every month. She had two active children, kept house, helped her husband with his business, and cared for her aging parents. No wonder Jackie was tired. But her doctor put her on Prozac.
Tips for Personal Program Success
Timing is everything. Take your first packet of nutrients with your breakfast, when your body can best metabolize the rich ingredients and benefit from the energizing boost they provide.
Almost 75% of the new patients at our medical practice come to us on antidepressants prescribed by their prior healthcare provider. There are often other underlying issues needing to be balanced, and few of them suffer from major depression, the one diagnosis that clearly justifies their use.
Some of these women went to their primary care provider’s office with situational mood disorders like seasonal affective disorder (SAD) or post partum depression. Others were in a minor depressive state brought on by emotional or physical stress. Many had common symptoms of hormonal imbalance such as PMS or hot flashes. Like Jackie, many suffered from fatigue, insomnia, or simple aches and pains. But all left their doctor’s office with a prescription for antidepressants.
If you go to a conventional healthcare provider, the odds are pretty high that you will be prescribed antidepressants at some point in your life. Should you take them? And if you’re on them now, what are your alternatives?
Antidepressants: a brief overview
Chances are, either you or someone you know has a prescription for an antidepressant. They have become conventional medicine’s default drug of choice: when in doubt, you’re probably depressed.
There are three different families of antidepressants, each with a different chemical mechanism. (Here’s a list of common antidepressants.) All of these drugs work with your neurotransmitters — the brain chemicals that regulate mood, sleep, and appetite, among other things.
In the 1960’s and 1970’s it was thought that norepinephrine, epinephrine and dopamine were the primary affectors of mood. The first two families of antidepressants, MAOI’s and tricyclics, were developed to increase available levels in the brain, but it turns out that they can burn out the brain’s receptors within several weeks. They also have very strong side effects. As a result, physicians have come to prescribe them with care just to people who really need them.
At about the same time, some scientists began to view another neurotransmitter — serotonin — as the missing link in treating mood disorders. In the 1980’s a new family of antidepressants — SSRI’s, or selective serotonin reuptake inhibitors — was developed, and appeared to deliver results in regulating mood without the more serious side effects of its predecessors.
Due to the seemingly attractive risk/benefit ratio of SSRI’s, physicians expanded antidepressant use exponentially: in the 1990’s, spending on antidepressants grew by 600%! Today the various classes of antidepressants under such tradenames as Prozac, Paxil, Zoloft, Celexa, Lexapro, Wellbutrin, Effexor, Cymbalta, and Sarafem are among the most widely prescribed drugs in the world. And while we know now that diminished serotonin reuptake does factor heavily into the mood regulation equation, SSRI’s and their pharmaceutical cousins are not the magic bullet pharmaceutical companies would have us believe.
The depressing truth about antidepressants
Can so many of us have the major form of depression that warrants such rampant drug use? Of course not.
This doesn’t mean that a lot of you don’t feel depressed, or have symptoms that could be related to depression. Such symptoms are usually related to some kind of stress — emotional and/or physical — that can be resolved without pharmaceutical drugs. This is especially true when it comes to subclinical forms of mood disorders such as SAD, PMS, or post partum depression. It’s also true for many situational or reactive depressions.
Some studies have shown that antidepressants are no more effective in treating this kind of mild to moderate depression than a placebo. (In a clinical trial half the participants are given the real drug; the other half are given an inactive pill called a placebo.) Furthermore, depending on how one defines depression, as many as one-third to a half of depressed patients do not show significant improvement with prescription medication, while as many as half of those who receive no such treatment improve anyway.
Numerous recent studies also tell us that regular exercise — 20–30 minutes, three to six times a week — can be a powerful antidote to mild or moderate depression. Even small amounts of exercise can make all the difference in the world (though we will generally benefit more from a higher amount). Most of us have heard of the mood lift that accompanies the endorphin surge or “runner’s high” that occurs with exercise. These studies show that sticking to a regular workout provides long-term mood stabilization, especially when combined with other antidepression measures, such as talk therapy.
In fact, antidepressants are contraindicated for short-term treatment of minor depression — something the drug companies don’t want publicized. Clinical practice guidelines indicate that SSRI’s need to be prescribed for at least six months for minimal treatment of major depression — longer than most episodes of minor depression last.
So with such doubt about their efficacy, why are so many doctors (most antidepressants are prescribed by PCP’s, not psychiatrists) handing out prescriptions for an ever-growing list of symptoms — such as headaches, insomnia, PMS, menopausal symptoms — that are not exclusively linked with severe depression?
Managed care and antidepressants
To get a clearer picture, it’s important to understand how the healthcare system works. For most people under managed care, when you feel unwell your first stop is your primary care physician (PCP), not a specialist. To figure out the real issues requires a lot of time. One must look at the person’s unique history and presentation. PCP’s have very little time to spend with you and they are usually not experts on mental health or natural methods.
PCP’s are well-intentioned, but antidepressants may be the best option they have for you. They may believe that antidepressants, particularly SSRI’s, provide an adequate solution with relatively little risk (at least in the short term). And antidepressants often will help you feel better — if you don’t mind the side effects.
Certain chronic pain conditions that primarily affect women, such as fibromyalgia, endometriosis and rheumatoid arthritis, can cause mild depression and multiple trips to the doctor’s office. While your primary care doctor may be unable to resolve your chronic pain, he or she can help make you happier about living with it. If they can satisfy you and the HMO with a prescription, they feel they’ve done their job.
Off-label use of antidepressants
While doctors are under pressure from the managed care system on the one hand, the influence of the pharmaceutical companies who make antidepressants is truly pervasive.
Drug companies typically get a new product approved by the FDA for a specific diagnosis for a limited period of use based on the results of clinical trials. The companies then use a range of tactics to support the use of that drug for other diagnoses and for longer periods of time. This is referred to as off-label use, and it is an enormous source of sales and profits for Big Pharma, as the pharmaceutical industry is sometimes called.
Years ago a tactic used to promote off-label use of antidepressants was to suggest to doctors that women’s complaints have no medical basis — i.e., “it’s all in her head” — and won’t go away without a mood-altering drug.
Today Big Pharma’s tactics are subtler. They fund research, conferences, and speakers and direct free samples and sales efforts toward physicians in support of off-label use of their products, including antidepressants. Not to mention the multimillion-dollar direct-to-consumer advertising campaigns. A 2003 study found that over 70% of surveyed patients reported exposure to these persuasive advertising efforts.
One specific recent tactic in recent use is the widespread promotion of antidepressants as a “safe” substitute for synthetic HRT. When the WHI studies on the dangers of HRT were published in 2001, about 13 million women were taking those drugs. Many of these women were put into a panic by the news about the health risks of HRT.
The drug companies seized this opportunity to promote antidepressants for menopausal symptoms, especially hot flashes. Millions of women were switched directly from Prempro to Prozac or other SSRI’s. Unfortunately, in our clinical experience, they don’t work for very long, particularly in their use for hormonal, inflammatory issues, and women aren’t being told enough about their health risks and side effects.
Side effects of antidepressants, known and unknown
We must not forget that these products are drugs — very powerful, significant chemicals that alter your hormonal balance and perhaps permanently change your brain’s biochemistry. No one knows what the long-term effects of antidepressants are because most clinical trials to date study 3–5-year outcomes of a single drug at a time — never a combination.
There is evidence now that SSRI’s actually decrease levels of serotonin over time. Some kind of disruption of the neurotransmitter pathways occurs, because SSRI’s don’t create a new equilibrium: at some point in time the patient must be moved to a new drug to maintain the same effect.
The side effects of SSRI’s include weight gain or loss, intense restlessness, insomnia, fatigue, sexual dysfunction, panic attacks, and anxiety. And these are not rare side effects: for example, studies indicate that 18–50% of patients experience sexual dysfunction.
Other studies show an increased risk of bleeding disorders, such as GI bleeding, bruising and nosebleeds, with use of SSRI’s. Although recent studies and anecdotal evidence strongly suggest an increase in suicidal behavior in children and adolescents, the data do not present a clear picture. Despite years of analysis, this link remains highly complex and not well understood. SSRI’s also carry strong potential for drug interactions. Clearly, more research needs to be done on all fronts.
In short, for all but those suffering from major depression, antidepressant use carries the risk of serious side effects to address what is, in most cases, a temporary problem. SSRI’s were just introduced in 1988. Synthetic HRT was used for 60 years before government studies finally showed their health risks. Who knows what the next 50 years will reveal about the risks of extended use of antidepressants?
A new view of ordinary depression
What makes this all so frustrating is that many forms of depression are natural, normal and temporary — rather like menopause. Indeed, the philosophically minded might simply attribute many of these feelings to the human condition. Likewise, they can be relieved through safe, gradual methods using your body’s natural mechanisms.
As with other symptoms of imbalance, depression is your body’s way of sending you a signal that something is awry. Antidepressants don’t address the underlying problem; they drown it out with a booming Don’t worry-be happy! But for how long? What happens when you want or need to come off antidepressant medications?
Think for a moment about how SSRI’s work. The idea is that you don’t have enough serotonin, so the drug conserves the limited amount in your body, blocking it from being changed into the next substance on its metabolic pathway.
At Women to Women, we look at the problem differently. We ask, “Why isn’t your body making more serotonin? And what can we do about that?” Moreover, we question the simplistic view that depression is solely the result of low serotonin — the real biology is probably more complex, arguing for a holistic solution that supports the whole neurotransmitter cascade.
I’ve seen so many of my patients turn their lives around — naturally — who never thought they’d be free of depression. You can, too. But first you have to know what you’re dealing with.
How depressed are you?
I want to be clear about one thing. If you have major depression, you need to stay on your antidepressants. We are not recommending that anyone with this diagnosis quit their medication cold turkey (some patients have severe reactions when they get off SSRI’s too quickly). However, we want every woman who is on or thinking about taking an antidepressant to know what her choices are.
Depression includes a range of normal negative emotions. But clinical depression differs significantly from minor or situational depression or mood disorders, even though the symptoms can be the same. The difference is that in mild depression the symptoms ebb and flow and eventually lift, while in major depression they spiral down into a full-blown, entrenched mental health crisis.
Most forms of depression are characterized by overwhelming, persistent feelings of grief, anxiety, guilt or despair; a sense of numbness or hollowness; and a loss of interest or pleasure in activities that were once enjoyed, including sex. Dullness, decreased energy, difficulty concentrating or making decisions, and disrupted sleep patterns are also symptoms, as well as overeating and weight gain, or loss of appetite and weight loss. Suicidal thoughts or attempts and obsessing about death are serious warning signs that need to be addressed immediately.
If you’ve been feeling any of these symptoms consistently for over a month, you should immediately seek out medical advice, preferably from a trained psychiatrist, psychologist, or social worker.
Chronic physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and pain can be an indication of depression, but may be symptoms of an underlying physical condition that warrants further testing. Before taking antidepressants you should get a second opinion. Integrative medical practices (those that combine alternative and conventional medicine) are very successful at finding the true source of mysterious ailments. (For more information see our article on how to make alternative medicine work for you.)
The social stigma of depression
If you think you may have minor depression, you’re in good company! Everyone has normal, sometimes extended bouts of melancholy or grief, particularly after a trauma or loss. But pain and anguish aren’t often talked about. Our culture doesn’t like “downers,” so many of us put on a brave face and perhaps wonder why we can’t be happy like everyone else.
The truth is that sadness and grief are normal, and psychotropic drugs may interfere with our grieving or mental processing. Before going to the pharmacy, think about the possible reasons why you’re feeling blue. In many cases, you have good reason: death, health crises, financial woes, divorce, break-ups, moves, and other big transitions are common causes of situational depression. Even joyful events like weddings and births can bring on depression by resurfacing unresolved emotional experiences from your past.
Minor depression may stem from individual physical stresses such as jet lag, poor nutrition, illness, insomnia, low carbohydrate levels, carbohydrate addiction (more on that below), hormone imbalance, yeast or wheat sensitivity, allergies, and environmental pollutants. Many suffer from a downward cycle of poor health that creates life problems that in turn are depressing.
Then there’s the cast of well documented subcategories of depression that affect millions of people, such as post partum depression (PPD), post traumatic stress syndrome (PTSD), and seasonal affective disorder (SAD). They can be devastating while they last, making doctors quick to prescribe pharmacological solutions. Sometimes medications are needed and can be a useful bridge back to wellness, but it’s important to know that there are other, more natural options that work quickly, too.
And of course, there are those emotional issues we all grow up with. Sometimes we’re blissfully unaware of them until we run smack into them. I know a woman who at 47 had a sudden nervous breakdown. For a year she hid in her house, cried all the time, and stopped caring for her children. Today she’d be on antidepressants in a heartbeat. While they might have helped her get out of the house and to the therapist’s office (a good thing for sure), they would not have identified or resolved her underlying emotional issue: Her father had died tragically when he was 46. By outliving him, she fell unwittingly into a deep well of unconscious guilt and grief. With time she was able to work that through and her depression resolved.
The good news is that most forms of mild to moderate depression will respond very well to positive changes in diet, exercise and lifestyle habits and nutrient support. Why? The key is the connection between serotonin and cortisol levels, which are directly influenced by diet and stress.
Serotonin, melatonin, cortisol, and depression
While all of your neurotransmitters are important, serotonin is the star when it comes to your mood. When your serotonin receptors are in sync, you feel good: you sleep and eat well, and you awake refreshed and energized. Contrast this to an abnormal serotonin state in which you suffer all the symptoms of depression.
Serotonin is synthesized in the brain and the digestive tract, which is also the source of its precursors. This is yet another reason why what you eat and how well you digest are crucial to how you feel! L–tryptophan, an essential amino acid found in food and supplements, is converted in your body into 5–hydroxytryptophan (5–HTP), and then into 5–hydroxytryptamine ( 5–HT), which is the chemical name for serotonin.
Importantly, serotonin is the “parent” for the hormone melatonin, which regulates our circadian rhythm, or sleep cycles. If you have insufficient serotonin, your melatonin levels become imbalanced and your sleep gets disrupted. This can be a downward spiral, leading to further disruption of serotonin function.
Sudden changes in serotonin levels cause irritability, fuzzy thinking, and anxiety. Stimulants like coffee, sugar, simple carbohydrates, nicotine, and recreational drugs can release a flood of serotonin for a few hours, creating a pleasurable effect. When the stimulants wear off, serotonin levels plunge and we crave another “hit.” A reliance on stimulants puts your body and mind on a vicious up-and-down treadmill, resulting in chronic serotonin pathway dysfunction — not to mention weight gain.
Maybe you’ve heard the recommendation to eat a potato at night to help carbohydrate cravings and depression. This may sound silly, but potatoes and turkey contain L–tryptophan, that important building block of serotonin.
Stress is truly big here, too. When we are stressed, our body releases the hormone cortisol. A surge in cortisol is always accompanied by a surge in serotonin — and the inevitable dip a few hours later. Women who suffer from fatigue and cravings for carbohydrates in the late afternoon are probably on the high-cortisol/low-serotonin rollercoaster. And guess what? They usually feel depressed.
So what can you do?
Once you see the connection between nutrition, stress, and serotonin levels, it gets easier to understand how simple lifestyle and diet changes will make huge improvements in your mood — and overall health — without resorting to drugs. What you eat affects your brain chemistry. I can’t say it any more simply.
Many women with mild to moderate depression don’t feel they have the energy to make dietary or other changes in their health habits. They’re discouraged and tired. I tell them, just give it two weeks: you can do that for yourself. And the lift you’ll feel in your energy will be remarkable. You’ll have the strength to keep going with other changes. Here’s how to get started:
Limit consumption of carbohydrates, especially simple carbohydrates, including alcohol. Don’t eliminate all complex carbohydrates, however. Too few carbs will cause serotonin levels to plummet because the brain is not being fed properly.
Eat a balanced diet and take a rich nutritional supplement. Many factors that contribute to low serotonin production are created by nutritional deficiencies. Similarly, if you suffer from digestive problems, find an alternative practitioner to help you. (You may also want to consider digestive testing.) We put all our patients on a pharmaceutical-grade nutritional supplement, like those we offer in our Personal Program, to help cover any gaps in their diets. Optimal omega-3 fatty acid levels, for instance, are known to support mood and outlook. (Click here to read more about Essential Nutrients.)
Reduce stimulant use and known physical stressors to help balance out serotonin levels. See our article on reducing caffeine, as well as our full-length article on healing stress, for guidance.)
Exercise is a good way to reduce stress and enhance mood. It releases endorphins, which create a natural euphoria, and reduces stress. You don’t have to join a gym, even a daily walk of 15 or 20 minutes is a good place to start. Experts recommend beginning slowly, working up to 30 minutes, six times a week. Or just start with burst training — one minute four times a day, three times weekly. Combining some weight-bearing exercise with aerobic activity (like walking or biking) provides the most relief.
Get moderate sun or full-spectrum light exposure year-round. A real connection exists between vitamin D deficiency and depression. It’s commonly known that full-spectrum light exposure, especially natural sunlight (which stimulates vitamin D production), is a very effective treatment for SAD. Same with supplements of vitamin D. Future research will tell us more about this link (as well as low vitamin E levels). I am now testing my patients regularly for vitamin D deficiency. For people with symptoms of depression, this is one of the first places I look. Even if you decide not to undergo testing, supplementing your diet with 2000 IU vitamin D daily is an easy, safe, inexpensive, and extremely beneficial measure.
If these steps don’t help, don’t lose hope. Continue to care for yourself using above steps, but consider finding a practitioner who’s experienced with neuroendocrine testing and have your neurotransmitter and amino acid levels checked. While this is controversial, we have found it helpful to gain a picture of your levels at a moment in time.
At Women to Women I provide a customized combination of either 5–HTP or St. John’s wort, plus tyrosine, other amino acids, vitamins, and minerals for such patients, based on their test results and response over time. St. John’s wort works by inhibiting the reuptake of not only serotonin, but also dopamine and norepinephrine. Supplemental 5–HTP, which is more easily converted into serotonin than L–tryptophan, can be especially effective. It should be used with caution, however, as it can cause increased anxiety in patients with high cortisol levels. In addition, it should not be used in conjunction with St. John’s wort except as prescribed and followed by a qualified healthcare practitioner.
But whether or not you are using a form of targeted neurotransmitter support or taking an antidepressant, all the measures listed in the above box can help you. Many of my patients use our protocol to help wean slowly off their meds. Remember, it’s wise to seek guidance from an experienced professional when it comes to weaning off antidepressant medications.
Last, but definitely not least...
The natural remedies outlined above are remarkably effective, but won’t work for long without dealing with the emotional experience that lies behind depression. That requires work on the emotional factors that affect you: childhood trauma, relationships, work, memories, and fears.
Patterns of behavior and negative reactions that trigger bouts of depression are usually so deeply engrained — and hidden — that it takes professional help to dissolve them. We always recommend that our patients talk about their emotional issues and combine any physical treatment with counseling. We’ve found Gestalt-type therapy to be especially effective in connecting your current emotional state to past experience and thereby getting at a fundamental cure. So much depends on the skill of the therapist, so we recommend you keep looking until you find a therapy and therapist that are effective for you.
If this sounds more involved than popping a pill — it is! But taking a pill involves complications, too. You will find our approach requires greater self-care, and it may take some time, as well, but the healing benefits are profound and lifelong. It is my hope that you can use this knowledge and perspective to rediscover and sustain your capacity for joy safely, effectively, and without a lifetime of powerful drugs.
WHAT DO YOU THINK, PLEASE POSTS COMMENTS.
Labels: Antidepressants and natural alternatives
How to Grow Your Marriage
How to Grow Your Marriage
The idea that you need to work on your marriage every single day is a tough one for many people to understand. They often think that it should be easy and just come naturally, and that if they do need to work on it, then there must be something wrong with their marriage mate or with the entire concept in the first place. In reality, this is far from the truth.
Think of a good marriage as being like having a good career. There may be many things you do in your job or career that come easily and naturally, and certain tasks or requirements that aren't that difficult for you, but you probably work very hard every day to learn new things and to apply yourself to your job. Did you go to college or a trade school? Did you ever need to take evening classes to further your education, or sit through seminars that your employer offered? All of this means work and effort, and it's the same with marriage. You need to constantly be applying yourself, taking on new tasks, and learning new ways of doing things in order for it to work.
Your career has probably changed much over the years as well. Think back to when you started this particular job or line of work. Are you doing the exact same thing in the exact same way? Probably not. There are few careers and jobs that stay the same; even fast food preparation is always upgrading to new machines or procedures. Your marriage is much the same. It changes over the years as your life just naturally changes. Children arrive and then eventually move out, you may need to move yourself physically to a new city or state, and you face different problems over the years as well. Just as you've had to adapt to new circumstances in your career, you need to adapt to new circumstances in your marriage as well. This takes work and effort.
Adapting to your spouse takes work on the marriage as well. We all change over the years, especially as our bodies get older and we face new problems and our likes and dislikes and values change as well. Some think that a person should never change from the first day of marriage, but this too is unrealistic. That person who used to love going out and dancing until dawn may now find that he or she is tired after a long day at work and taking care of the children and prefers to stay in. Those friends that you used to find amusing now just annoy you as being childish and immature. Things you used to love doing together have now gotten boring. Working on a marriage means adapting to these changes in your spouse as well. This might include finding new things to do together, finding new friends you both enjoy being with, and adjusting our own preferences to accommodate him or her. Again, this all takes work, but of course it's worth it!
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Mommy, Do You Remember All Four Times You Had Sex?
By Amy Tuteur, MD (View Profile)
Mothering is marked by transcendent moments. I’ve had those moments while nursing my infants, watching my children in school plays and sports, and looking on proudly as they crossed the stage for graduations. This, however, is not about those moments. This is about teaching children the facts of life.
As a gynecologist, I always vowed that I would not subject my children to agricultural theories of human reproduction. None of that “daddy plants a seed” stuff for us. I planned on anatomically correct, age appropriate, completely truthful answers to any questions about sex. Each of my children learned where babies come from as soon as they asked, and each child got some version of “the talk.”
There were occasional complications; one child received his “talk” in a car at highway speeds. He was so embarrassed by the entire issue of sex that he always ran away when I attempted to discuss it. Only by giving him no option of escape could I make sure he learned the basics.
I was also motivated by my experiences as a practicing gynecologist. I have seen firsthand the results of the mistruths, half truths, and outright lies that pass for “information” among teens. The staggering toll of this misinformation is measured in unplanned pregnancy and sexually transmitted disease. Often teens lack basic information because no one ever bothered to tell them the truth about sex, about birth control, or about protecting themselves.
Whenever I talked about sex with my young children, I had the best of intentions. So why did I often end up answering completely unanticipated questions while struggling desperately not to laugh?
While cooking dinner one evening, I was approached by the youngest of my four children. She asked, “Mommy, do you remember all four times you had sex?” I tried to look thoughtful while biting the inside of my cheek in an effort to avoid laughing.
“Actually,” I said, “I’ve had sex more than four times.”
Her eyes widened. “Why would anyone do that?”
“Sex is not only for making a baby,” I explained. “Most of the time people have sex because they enjoy sex itself.”
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Labels: Do You Remember All Four Times You Had Sex?, Mommy
Depression: Psychotherapy to Treat Depression
Psychotherapy is often the first form of treatment recommended for depression. Called "therapy" for short, the word psychotherapy actually involves a variety of treatment techniques. During psychotherapy, a person with depression talks to a licensed and trained mental healthcare professional who helps him or her identify and work through the factors that may be causing their depression.
Sometimes these factors work in combination with heredity or chemical imbalances in the brain to trigger depression. Taking care of the psychological and psychosocial aspects of depression is important.
How Does Psychotherapy Help Depression?
Psychotherapy helps people with depression:
Understand the behaviors, emotions, and ideas that contribute to his or her depression.
Understand and identify the life problems or events -- like a major illness, a death in the family, a loss of a job or a divorce -- that contribute to their depression and help them understand which aspects of those problems they may be able to solve or improve.
Regain a sense of control and pleasure in life.
Learn coping techniques and problem-solving skills.
Types of Therapy
Therapy can be given in a variety of formats, including:
Individual -- This therapy involves only the patient and the therapist.
Group -- Two or more patients may participate in therapy at the same time. Patients are able to share experiences and learn that others feel the same way, and have had the same experiences.
Marital/couples -- This type of therapy helps spouses and partners understand why their loved one has depression, what changes in communication and behaviors can help, and what they can do to cope.
Family -- Because family is a key part of the team that helps people with depression get better, it is sometimes helpful for family members to understand what their loved one is going through, how they themselves can cope, and what they can do to help.
Approaches to Therapy
While therapy can be done in different formats -- like family, group, and individual -- there are also several different approaches that mental health professionals can take to provide therapy. After talking with the patient about their depression, the therapist will decide which approach to use based on the suspected underlying factors contributing to the depression.
Psychodynamic Therapy
Psychodynamic therapy is based on the assumption that a person is depressed because of unresolved, generally unconscious conflicts, often stemming from childhood. The goal of this type of therapy is for the patient to understand and cope better with these feelings by talking about the experiences. Psychodynamic therapy is administered over a period of weeks to months to years.
Interpersonal Therapy
Interpersonal therapy focuses on the behaviors and interactions a depressed patient has with family and friends. The primary goal of this therapy is to improve communication skills and increase self-esteem during a short period of time. It usually lasts three to four months and works well for depression caused by mourning, relationship conflicts, major life events, and social isolation.
Psychodynamic and interpersonal therapies help patients resolve depression caused by:
Loss (grief)
Relationship conflicts
Role transitions (such as becoming a mother or a caregiver)
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Labels: Depression: Psychotherapy to Treat Depression
Effects of child physical abuse
Home: Family & Friends: About Child Abuse: Child physical abuse
Child physical abuse damages children both physically and emotionally. The longer physical abuse of a child continues, the more serious the consequences. The initial effects of physical abuse are painful and emotionally traumatic for the child. The long-term consequences of physical abuse impact on the child in their adult life, on their family and on the community.
In the most extreme cases, physical abuse results in the death of the child.
Studies of physically abused children and their families indicate that a significant number of physical and psychological problems are associated with child physical abuse. Abused children compared with non-abused children may have more difficulty with academic performance, self-control, self-image and social relationships.
A recent US study comparing physically abused and non-abused children provided considerable evidence of the negative and lasting consequences of physical abuse. The physically abused children in the study experienced far greater problems at home, at school, amongst peers and in the community.12
Initial Effects of Child Physical Abuse
Immediate pain, suffering and medical problems in some cases death caused by physical injury.
Emotional problems such as anger, hostility, fear, anxiety, humiliation, lowered self-esteem and inability to express feelings.
Behavioural problems such as aggression by the child towards others or self-destructive behaviour, hyperactivity, truancy, inability to form friendships with peers and poor social skills. Poorer cognitive and language skills than non-abused children.
Long Term Consequences Of Child Physical Abuse
Long term physical disabilities, for example, brain damage or eye damage.
Disordered interpersonal relationships, for example, difficulty trusting others within adult relationships or violent relationships.
A predisposition to emotional disturbance.
Feelings of low self esteem.
Depression.
An increased potential for child abuse as a parent.
Drug or alcohol abuse.
The Social Cost Of Child Physical Abuse
The social and economic costs to our community of child physical abuse, whilst not always immediately obvious, are enormous. They include the financial costs of social welfare payments and services as well as the social cost to our community of problems such as mental illness, homelessness, crime and unemployment, which may occur in the adolescent or adult lives of physically abused children.
Failure to appreciate the costs may be an important reason why society lacks the will to aggressively deal with the problem.13
Early identification and effective intervention can ameliorate some initial effects and long term effects of child physical abuse and promote the recovery of victims.
Labels: Effects of child physical abuse
Spanking Raises Risk of Later Sexual Problems
By PSYCH CENTRAL NEWS EDITOR
Reviewed by John M. Grohol, Psy.D. on February 29, 2008
Children who are spanked are more likely to develop sexual problems as adults, according to new research presented yesterday.
A meta-analysis of spanking studies found 93 percent agreement among studies that spanking can lead to such problems as delinquent and anti-social behavior in childhood along with aggression, criminal and anti-social behavior and spousal or child abuse as an adult.
The researchers suggested that children whose parents spanked, slapped, hit or threw objects at them may have a greater chance of physically or verbally coercing a sexual partner, engaging in risky sexual behavior or engaging in masochistic sex, including sexual arousal by spanking. The researchers warned, however, that this is not a one-to-one or causal relationship.
The study also found that 90 percent of U.S. parents spank toddlers.
After 30 years of studying corporal punishment, Murray Straus, a spanking expert, concluded, “parents should never, ever spank because, although it does work, it’s no better than non-hitting methods that don’t have harmful side effects. If there was an FDA for spanking, they’d say use an alternative that doesn’t have harmful side effects.”
This analysis appears to be the first to link spanking with sexual problems, said Elizabeth Gershoff, an assistant professor of social work at the University of Michigan-Ann Arbor, who reviewed 80 years of spanking research in 2002 in the APA’s Psychological Bulletin. However, Gershoff wanted to add that even though many parents spank their children, future problems often depend on how the children process the experience and whether they ultimately equate love with physical pain.
The data was presented on Thursday at the American Psychological Association’s Summit on Violence and Abuse in Relationships in Bethesda, Maryland.
Source: American Psychological Association
Labels: Spanking Raises Risk of Later Sexual Problems
Couples Therapy
First, it is important to realize that couples therapy, marriage counseling and marital therapy are all the same. These different names have been used to describe the same process, with the difference often based on which psychotherapy theory is favored by the psychologist using the term, or whether an insurance company requires a specific name for reimbursement.
Couples therapy is often seen as different from psychotherapy because a relationship is the focus of attention, instead of one individual diagnosed with a specific psychological problem. This difference only arises if you consider psychological problems to be similar to medical illnesses, and therefore confined to a "sick" individual who needs treatment. That medical model of psychological diagnosis and treatment is common, but is really inadequate to describe and resolve psychological problems. All psychological problems, and all psychological changes, involve both individual symptoms (behavior, emotions, conflicts, thought processes) and changes in interpersonal relationships.
Couples therapy focuses on the problems existing in the relationship between two people. But, these relationship problems always involve individual symptoms and problems, as well as the relationship conflicts. For example, if you are constantly arguing with your spouse, you will probably also be chronically anxious, angry or depressed (or all three). Or, if you have difficulty controlling your temper, you will have more arguments with your partner.
In couples therapy, the psychologist will help you and your partner identify the conflict issues within your relationship, and will help you decide what changes are needed, in the relationship and in the behavior of each partner, for both of you to feel satisfied with the relationship.
These changes may be different ways of interacting within the relationship, or they may be individual changes related to personal psychological problems. Couples therapy involves learning how to communicate more effectively, and how to listen more closely. Couples must learn how to avoid competing with each other, and need to identify common life goals and how to share responsibilities within their relationship. Sometimes the process is very similar to individual psychotherapy, sometimes it is more like mediation, and sometimes it is educational. The combination of the these three components is what makes it effective.
Labels: Couples Therapy
Buzz up!
What is this?
What Fighting About Money Will Cost You
Couples who argue most about spending often end up with the smallest savings. How to kiss and make up — and grow your cash.
By Lisa Goff
Here's a bit of advice you won't find on the financial pages: Money isn't worth fighting over. Those squabbles are not only bad for your marriage, they're bad for your bank balance. The more you fight, the less likely you will be to decide on goals and pursue them as a team. Check out the common husband-wife scenarios below — any of them sound like your house? If so, read on to understand what you're really trying to tell each other — and the best ways to stop bickering and start building your net worth.
He says: "At the end of the month, there's never any money left over. Can't you spend less on groceries?"
She says: "You're so out of date on prices — the last time you shopped, Bush senior was in the White House."
At almost 8 percent of overall household spending, groceries do bite a big chunk out of the monthly budget. But unless you're indulging a secret passion for exotic vinegars or imported prosciutto, there's probably not a lot of slack in your bill.
Get-rich scheme: "Invite" your spouse to come along on your next grocery grab. Once he's staggered by seeing that a half gallon of orange juice costs $3.49 and boneless chicken breasts are "on sale" for $3.99 a pound, brainstorm better ideas for saving on food purchases. Some possibilities: Pack your lunch, limit the lattes, whip up scrambled eggs one night instead of ordering pizza. Even occasional acts of takeout restraint will add up to big savings.
He says: "How could you buy a new coffee table without consulting me? Send it back immediately!"
She says: "I don't have to get your permission every time I want to buy something for the house."
Couples who make substantial purchases on their own are playing power games — and the big loser is their wallet.
Get-rich scheme: Set a limit on how much either of you can spend without consulting the other. Then establish a formal process for considering large purchases. Suggested first step: reaching agreement on whether the item is necessary. That means you buy a new coffee table only when you have both decided it's time to fix up the living room, not when you happen to see one you like.
He says:"I can't believe you spent $60 on a haircut!"
She says: "And how is that adjustable-speed drill press working out, dear? I hope it was worth the $70!"
Subjecting all personal purchases to scrutiny isn't the way to save money either. "Each partner thinks that he or she only buys what's reasonable, while what the other buys is frivolous," says personal finance expert Deborah Knuckey. The result is that you both keep spending while continuing to get mad at your partner for doing the same.
Get-rich scheme: Establish a "luxury" fund with a monthly limit, maybe $50 or $100, that is the exclusive preserve of each spouse — no questions asked. If one wants to spend it on gumballs and the other on new china, fine. The pleasure of exercising absolute control over a certain amount of money makes it easier for spouses to compromise with each other on big expenditures.
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Labels: What Fighting About Money Will Cost You
Do AntiDepressants Work?
A Sober Look at the Happy Pills
With so many people in our pill-crazed culture taking antidepressants . . . we just have to ask:
Are they actually working?
Have we solved the problem of human suffering? Are we any happier? Is this the best solution we have?
So we went looking for answers,
and so far have found . . .
This excerpt from
The Wall Street Journal, June 12th, 2002:
First there was Prozac. Then came Zoloft, Paxil, Effexor and Celexa. Now the FDA is poised to approve what could be the next blockbuster in the enormous antidepressant market . . .
The arrival of Lexapro, made by Forest Laboratories Inc., is expected as early as this month, and many patients and doctors are eagerly waiting. "Everyone's going to want to try it on some patient," says Philip Muskin, a Columbia University psychiatrist. He explains: "You keep hoping that the next one is going to solve all of the problems."
But both science and past experience suggest that many people are bound to be disappointed . . .
Though demand for antidepressants is huge and growing - they are now the second-most prescribed drugs after anti-infectives, such as antibiotics - the frustrating reality for many patients and physicians is that they either don't work very well or have intolerable side effects.
Few patients realize that half of the people who go on antidepressants stop taking them after three months. Add that to the fact that Lexapro is, in part, a marketing maneuver. It is nearly identical in its chemical make-up to Celexa, which Forest also makes. And Celexa works very similarly to the other top-selling antidepressants. But doctors and analysts expect demand for the new drug to be huge, partly because so many patients cycle through antidepressants . . .
Sibyl Shalo, 32 years old, ran through four different antidepressants between 1994 and 2000. They either didn't work well or lost their benefits over time. Now she's on Celexa, which improves her depression but also causes constipation, diarrhea and fatigue. "If this is the best I'm going to get, that's not such a good thing," says Ms. Shalo. So she's awaiting Lexapro. "Now there's something else for me to try," she says.
Even the most popular antidepressants on the market work on only about half of the people who try them. Though the medicines have been life saviors for some patients, as many as 30% of those who are clinically depressed aren't helped by any existing drug, according to Datamonitor PLC, a London market-analysis company. Moreover, all antidepressants can cause troubling side effects - for example, 37% of patients on antidepressants experience sexual dysfunction, according to a recent study by Anita Clayton, a University of Virginia psychiatry professor.
The National Institute of Mental Health estimates about 19 million Americans - 1 in 10 adults - suffer from depression at some point each year. About half of them, eight million people used antidepressants last year, according to Datamonitor. If you count those who used the drugs to treat anxiety, such as panic disorder, as many as 10 million Americans may have taken the medications in 2001."
John Williams, a Honda salesman living in Seattle, enrolled in a Lexapro Trial after finding he couldn't tolerate the loss of sexual appetite he suffered taking Paxil. On Lexapro, the sexual side effects almost entirely disappeared and he felt he could handle the others - ringing in his ears and a spacey feeling in the morning.
When the clinical trial ended in April, he had to go off Lexapro, but began taking the closest thing on the market, Celexa. "They seem to be identical," he says. But while the drugs diminish his depression and anxiety, his symptoms aren't gone.
And so Mr. Williams is already wondering what new treatment is coming. His doctor just told him about a trial for yet another antidepressant starting soon, and he says he's thinking about enrolling."
- excerpt from The Wall Street Journal,
"Approval Is Near On a New Drug for Depression," June 12th, 2002
. . . and this excerpt from WebMD:
The latest scientific study to weigh in on the subject finds that the antidepressants worked only marginally better than placebos in a group of studies submitted to the FDA. Study participants taking the dummy pills had approximately 80% of the response seen in patients taking one of the six most widely prescribed antidepressants.
Lead researcher Irving Kirsch, PhD, tells WebMD that in many of the studies, while the difference between drug and placebo was significant from a statistical standpoint, it did not represent a significant difference for patients. His study appears July 15 in the American Psychological Association's electronic publication, Prevention and Treatment.
"We are not saying that people don't respond to these medications," says Kirsch, who is a psychology professor at the University of Connecticut. "On the contrary, the response is very large, and that is why there has been this so-called revolution in the treatment of depression. The catch is that the response to placebo is almost as large" . . .
"People may be better off exploring other treatment options such as psychotherapy or exercise, which has been shown to reduce depression. And the side effect of physical exercise is better health. That is much better than the loss of sexual function, tremors, agitation, diarrhea, and nausea that are side effects of SSRIs."
Psychologist Roger P. Greenberg, PhD, says it is understandable that the SSRIs have become so popular in such a short time, despite the lack of data showing them to be effective. Both patients and their physicians, he adds, have adopted a "fast-mood mentality," where the quick fix is expected for the treatment of depression. Greenberg heads the psychology division at SUNY Upstate Medical University and has written two books on the limits of treating depression with drugs.
"The notion that depression is caused by a biochemical imbalance that is easily treated with drugs has taken hold in recent years because it provides this easy solution," he tells WebMD. "Biochemical imbalance is a handy catch phrase, but there is not a lot of evidence that there is such a thing."
- excerpts from "Are Antidepressants Effective?
They're Just Slightly More Effective
Than Dummy Pills,
Research Shows"
by Salynn Boyles, WebMD
. . . and this excerpt from USAToday, January 22nd, 2004:
(LiveReal Editor's Summary of the Article:
Could antidepressants - those very things that have so often been hailed as the cure for depression . . . cause suicide?
"We don't know," experts say. "Maybe.")
Could antidepressants prescribed for more than 1 million U.S. children and teenagers cause some of them to attempt suicide?
The Food and Drug Administration's first public hearing on this question Feb. 2 is expected to draw polarized and emotional testimony. But the evidence needed for an answer won't be in for several months, says Russell Katz, director of the FDA's neuropharmacological division.
The FDA is re-examining 20 studies of eight antidepressants used in children. The studies didn't document a single drug-related suicide. But preliminary findings suggested that suicidal thoughts and attempts, though rare, were more common in kids taking the drugs than those on sugar pills. . .
. . . The FDA has asked drug companies for more information . . .
(Editor's Note:
Is there something wrong with this scenario?
Is the best way to gather real "information"
really to ask the folks whose very livelhood depend on the answers?)
. . . in December, Britain's equivalent of the FDA advised giving none of the SSRIs to children except for Prozac, saying it's the only one whose benefits outweigh risks . . .
. . . There's relatively little controlled research on SSRIs in school-age children "and zippo on kids under 5," says John March, chief of child and adolescent psychiatry at Duke University Medical Center in Durham, N.C. . .
. . . "The lack of supporting data, considering their widespread use, is surprising and disturbing," says Lawrence Diller, a behavioral pediatrician in Walnut Creek, Calif., and author of Should I Medicate My Child? . . .
. . . However, prescribing patterns and medical economics work against the eagle-eye monitoring needed, some say. General practitioners and pediatricians, often not experts in the field, write the majority of SSRI prescriptions for kids. Also, HMOs may restrict access to busy specialists and pay for pills but not therapy . . . says David Fassler, a child psychiatrist in Burlington, VT . . .
. . . Mark Miller, 54, of Overland Park, Kan., believes antidepressants cost the life of his 13-year-old son, Matthew. He'll testify at the FDA hearing.
After a family move in 1996, Matthew had trouble adjusting at his new school. On the advice of school counselors, the Millers took him to a psychiatrist the next summer, though he seemed happier.
The doctor gave Mark antidepressants, and he began to act fidgety, Miller says. The morning after Mark took his seventh pill, Mark's mom found him hanging by a belt from a laundry hook in his closet.
"We have no family history of depression and didn't even have a package insert because he gave us samples," Miller says. An autopsy showed his son's body had SSRI levels suitable for a 250-pound body, though the boy weighed less than 100 pounds, he says.
But other parents will tell the FDA that SSRIs saved their kids' lives.
Sherri Walton, 45, of Paradise Valley, Ariz., says major depression runs in her family. Walton's daughters, Jordan, 14, and Katie, 12, started Prozac in the past 18 months after episodes of severe depression.
"They didn't even want to dance anymore, even though they're avid dancers; they didn't want to live, and now they're normal kids," Walton says. "I'm going to tell the FDA, 'Don't take away what gave my kids their lives back.' "
The agency expects to have enough evidence to answer the questions on suicide risk by summer, the FDA's Katz says. Another hearing is likely then, and at that time the FDA might issue a new recommendation on SSRIs and children.
Parents who want their kids off the antidepressants now should consult doctors on how to do it gradually because stopping abruptly can be harmful, he adds.
For undecided parents, new interim guidance might come Feb. 2, Katz says. "All we can say right now is, use with caution."
- excerpt from USA TODAY, January 22nd, 2004
"Antidepressants and Suicide"
by Marilyn Elias
Appendix I: Does it all come down to "brain chemistry"?
It's very fashionable nowadays for modern psychologists to explain everything in terms of biology - every feeling, thought, impulse, perception - essentially everything you and I experience, says many psychologists - can eventually be reduced down to neurochemistry, synapses, hormones, and essentially, biology.
And there are many advantages to this approach. It's easy, it's blame-free, it let's almost everyone (except maybe God) off the hook, and when doctors start talking synapses and hormones and such, it's easy to sound intelligent and like you know what you're talking about.
But is it true?
Well, it does seem clear that there is a profound "connection," in a way, between what is normally called "mind" and "body." This is a huge topic, but we'll leave it there for now.
At the same time, this get totally, totally blown out of proportion nowadays.
This is further explored in our article on therapy - but to briefly summarize some points:
* In general, many folks who call themselves "psychologists" nowadays - apart from clinicians - are actually biologists. They don't study the human "mind" or "soul," they study bodily fluids and chemistry.
* It's much easier to be a biologist (and study body fluids) than it is to be a true psychologist (and study human beings).
* To say that all human emotions, feelings, thoughts, disorders etc are "caused by" various brain chemicals is like saying that all car crashes are caused by gasoline; that symphonies are "caused by" brass (horns, trumpets, etc), that the plays of Shakespeare are "caused by" letters/black marks on white pieces of paper. Sure - in a warped, twisted, academic way it's "true," but it's definitely not the whole picture.
At the same time, it's an easy solution to a complex problem, it's completely blame-free, and it lets psychologists who talk this way sound intelligent . . . so really, we don't expect this mindset to go away anytime soon.
Appendix II: Modern PsychoTheology
A LiveReal Agent Opinion:
When we once confronted the question "Why do we suffer?", theologians and ministers in old times used to talk about "man's fallen state." While this has generally become unfashionable to speak about (due in no small part to the science-religion debate - and a general in trend where science is generally gaining ground on religion) it has actually merely been replaced by a new, "scientific" version.
Meaning, instead of saying the "you were born into a fallen state," the experts (now doctors instead of priests or theologians) now say "you were born with "defective brain chemistry."
And instead of offering salvation through prayers, scripture, and sermons, they offer "salvation" through selling prescriptions and pills.
But they often fail to mention that, in addition to the possibility of "defective brain chemistry," there are many other possible reason why we suffer. And then, when certain problems come around that make us suffer, there are many other things to do to alleviate that suffering . . .
So, then
- if this is the case . . . then, what's a person to do?
Well, we believe the whole question of mental health is a bigger issue than is generally spoken about in polite society.
For example, there's the issue that our modern culture itself may be a little insane, and living in this culture can become a battle for your own mind . . .
Well, many folks suggest therapy, which brings up many other questions - primarily, Does Therapy Work?)
We strongly suggest a do-it-yourself approach (after all, you're really doing-it-yourself even if you do see and trust many doctors and experts) - an approach which does have its hazards as well . . . but then again, you have LiveReal, and our immensely valuable LiveReal Products as well . . .
And ultimately, the issue of mental clarity and emotional strength - the very "goals" of the LiveReal Psychology Arena, and especially our section on What's the Problem - but ultimately has what could be called a "spiritual" component.
But modern spirituality is a whole other furry animal - and one that we, your trusty LiveReal Agents delve into in the LiveReal Spiritual Arena . . .
Labels: Do AntiDepressants Work?
