Here's some depressing recent medical news: Antidepressants don't work. What's even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they DO work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.
The study I'm talking about was published in The New England Journal of Medicine. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit -- but almost none of the studies that show these drugs are ineffective. (1)
That warps our view of antidepressants, leading us to think that they do work. And it has fueled the tremendous growth in the use of psychiatric medications, which are now the second leading class of drugs sold, after cholesterol-lowering drugs.
The problem is even worse than it sounds, because the positive studies hardly showed benefit in the first place. For example, 40 percent of people taking a placebo (sugar pill) got better, while only 60 percent taking the actual drug had improvement in their symptoms. Looking at it another way, 80 percent of people get better with just a placebo.
That leaves us with a big problem -- millions of depressed people with no effective treatments being offered by most conventional practitioners. However, there are treatments available. Functional medicine provides a unique and effective way to treat depression and other psychological problems. Today I will review seven steps you can take to work through your depression without drugs. But before we get to that, let's take a closer look at depression.
What's in a Name?
"Depression" is simply a label we give to people who have a depressed mood most of the time, have lost interest or pleasure in most activities, are fatigued, can't sleep, have no interest in sex, feel hopeless and helpless, can't think clearly, or can't make decisions.
But that label tells us NOTHING about the cause of those symptoms. In fact, there are dozens of causes of depression -- each one needing a different approach to treatment. Depression is not one-size-fits-all, but it is very common.
Women have a 10 to 25 percent risk and men a five to 12 percent risk of developing severe major depression in their lifetime. (2) One in ten Americans takes an antidepressant. The use of these drugs has tripled in the last decade, according to a report by the federal government. In 2006, spending on antidepressants soared by 130 percent.
But just because antidepressants are popular doesn't mean they're helpful. Unfortunately, as we now see from this report in The New England Journal of Medicine, they don't work and have significant side effects. Most patients taking antidepressants either don't respond or have only partial response. In fact, success is considered just a 50 percent improvement in half of depressive symptoms. And this minimal result is achieved in less than half the patients taking antidepressants.
That's a pretty dismal record. It's only made worse by the fact that 86 percent of people taking antidepressants have one or more side effects, including sexual dysfunction, fatigue, insomnia, loss of mental abilities, nausea, and weight gain.
No wonder half the people who try antidepressants quit after four months.
Now I want to talk to you about the reasons why doctors and patients have been deceived by the "antidepressant hoax." Despite what we have been brainwashed to believe, depression is not a Prozac deficiency!
How We have Been Deceived by the Antidepressant Hoax
Drug companies are not forced to publish all the results of their studies. They only publish those they want to. The team of researchers that reported their findings in The New England Journal of Medicine took a critical look at all the studies done on antidepressants, both published and unpublished. They dug up some serious dirt ...
The unpublished studies were not easy to find. The researchers had to search the FDA databases, call researchers, and hunt down hidden data under the Freedom of Information Act. What they found was stunning.
After looking at 74 studies involving 12 drugs and over 12,000 people, they discovered that 37 of 38 trials with positive results were published, while only 14 of 36 negative studies were published. Those that showed negative results were, in the words of the researchers, "published in a way that conveyed a positive outcome."
That means the results were twisted to imply the drugs worked when they didn't.
This isn't just a problem with antidepressants. It's a problem with scientific research. Some drug companies even pay or threaten scientists to not publish negative results on their drugs. So much for "evidence-based" medicine! I recently had dinner with a step-uncle who runs a company that designs research for drug companies. He designs the study, hires the researcher from an esteemed institution, directs the study, writes up the study and the scientist just signs his or her name after reviewing it.
Most of the time, we only have the evidence that the drug companies want us to have. Both doctors and patients are deceived into putting billions of dollars into drug companies' pockets, while leaving millions with the same health problems but less money.
The scientific trust is broken. What can we do? Unfortunately, there is no easy answer. But I do think functional medicine, on which my approach of UltraWellness is based, provides a more intelligent way of understanding the research. Rather than using drugs to suppress symptoms, Functional Medicine helps us find the true causes of problems, including depression.
I see this in so many of the patients I have treated over the years. Just as the same things that make us sick also make us fat, the same things that make us sick also make us depressed. Fix the causes of sickness -- and the depression takes care of itself.
Consider a few cases from my practice ...
A 23-year-old had been anxious and depressed most of her life and spent her childhood and adolescence on various cocktails of antidepressants. Turns out, she suffered from food allergies that made her depressed.
Food allergies cause inflammation, and studies now show inflammation in the brains of depressed people. In fact, researchers are studying powerful anti-inflammatory drugs used in autoimmune disease such as Enbrel for the treatment of depression.
After she eliminated her IgG or delayed food allergies, her depression went away, she got off her medication -- and she lost 30 pounds as a side effect!
Here's another story ... A 37-year-old executive woman struggled for more than a decade with treatment-resistant depression (meaning that drugs didn't work), fatigue, and a 40-pound weight gain. We found she had very high levels of mercury. Getting the mercury out of her body left her happy, thin, and full of energy.
Or consider the 49-year-old man with severe lifelong depression who had been on a cocktail of antidepressants and psychiatric medication for years but still lived under a dark cloud every day, without relief. We found he had severe deficiencies of vitamin B12, B6, and folate. After we gave him back those essential brain nutrients, he called me to thank me. Last year was the first year he could remember feeling happy and free of depression.
These are just a few of the dozens of things that can cause depression.
The roots of depression are found in the 7 keys to UltraWelless and the 7 fundamental underlying imbalances that trigger the body to malfunction. Taking antidepressants is not the answer to our looming mental health epidemic. The real cure lies in rebalancing the underlying systems in your body that are at the root of all healthy and illness.
Here are a few things you can do to start treating your depression today.
7 Steps to Treat Depression without Drugs
1. Try an anti-inflammatory elimination diet that gets rid of common food allergens. As I mentioned above, food allergies and the resultant inflammation have been connected with depression and other mood disorders.
2. Check for hypothyroidism. This unrecognized epidemic is a leading cause of depression. Make sure to have thorough thyroid exam if you are depressed.
3. Take vitamin D. Deficiency in this essential vitamin can lead to depression. Supplement with at least 2,000 to 5,000 IU of vitamin D3 a day.
4. Take omega-3 fats. Your brain is made of up this fat, and deficiency can lead to a host of problems. Supplement with 1,000 to 2,000 mg of purified fish oil a day.
5. Take adequate B12 (1,000 micrograms, or mcg, a day), B6 (25 mg) and folic acid (800 mcg). These vitamins are critical for metabolizing homocysteine, which can play a factor in depression.
6. Get checked for mercury. Heavy metal toxicity has been correlated with depression and other mood and neurological problems.
7. Exercise vigorously five times a week for 30 minutes. This increases levels of BDNF, a natural antidepressant in your brain.
Overcoming depression is an important step toward lifelong vibrant health. These are just of few of the easiest and most effective things you can do to treat depression. But there are even more, which you can address by simply working through the 7 Keys to UltraWellness.
Now I'd like to hear from you...
Have you been diagnosed with depression?
How have antidepressants worked for you?
Do you plan to try any of the approaches mentioned here?
Please let me know your thoughts by leaving a comment below.
To your good health,
Mark Hyman, M.D.
References
(1) Turner EH et al. 2007. Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine. 358: 252-260.
(2) Eaton WW, Kalaydjian A, Scharfstein DO, Mezuk B, Ding Y. 2007. Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981-2004. Acta Psychiatr Scand. 116(3):182-188.
Mark Hyman, M.D. practicing physician and founder of The UltraWellness Center is a pioneer in functional medicine. Dr. Hyman is now sharing the 7 ways to tap into your body's natural ability to heal itself. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on Youtube and become a fan on Facebook.
Follow Mark Hyman, MD on Twitter: www.twitter.com/markhymanmd
Annie B. Bond: Why the Green Movement Should Include Environmental Health Issues
Antidepressant - Wikipedia, the free encyclopedia
Depression Medications (Antidepressants)
Antidepressants: Selecting one that's right for you - MayoClinic.com
Antidepressants - Health - The New York Times
Antidepressants, pills cause low libido in women
http://jeffreydach.com/2010/01/21/jama-says-ssri-antidepressants-are-placebos-by-jeffrey-dach-md.aspx
http://www.healthhabits.ca/2010/04/06/an-exercise-prescription-to-cure-depression/
The best diagnostics are done at the Amen Clinic with a full evaluation and SPECT scan of the brain.
Whether or not the effect is purely psychological does not bother me at all. It's a psychological disorder, and if it is helped by a psychological effect that is fabricated by the brain and our subjective perception of the benefits, then so be it.
However, I have been meaning to start taking multi-vitamins that include all of what you listed above (with the exception of the fish oil). Perhaps I'll start doing that to boost the legitimacy of my "safety net." And, again, even if I only get a placebo effect, who cares? It's still an effect nonetheless.
Your choice.
"Not by giving the body a drug that is promising "artifical happines," with side effects. "
Most people with major depression who take anti-depressant state that they more like themselves again. Nothing "artificial" from recovering from a very debilitating disorder.
The pills eventually made me try to kill myself. obviously something was wrong. I went too the psychiatrist and they put me on more pills! Im not suicidal anymore, but I am gonna get off my pills. Ive been feeling much better since I started following these steps.
All the drugs did was make me feel happy, but once again it wasn't real happiness. Any happiness by drugs is artificial wether its good or not. Real happiness can come from this artificial happiness though.
Drugs can't make you happy, they can make you feel it for a while. However they can help build you up to real happiness.
2) I've learned more about this topic from the informative comments than I did when reading the article, which is clearly a biased and self-serving effort for Dr. Hyman to promote his practice of "functional medicine". (side-note: I don't mean to sound petty, but his website looks like a subway ad for a weight loss scheme, plus the "institute for functional medicine" has been sued for making false claims. The following link has more information about the Institute for Functional Medicine, http://www.quackwatch.org/04ConsumerEducation/bland.html)
3) Although Jeffrey Hyman and other pioneers of functional medicine may believe in their work, when it comes to chronic illnesses, they often do more harm than anything else. They encourage sick individuals to give up on scientific and logical medical practices and persuade them to pursue "cures" that frequently prolong their suffering. Modern medicine does not ignore cures. If natural or "functional" medicine actually cured diseases, it would certainly be acknowledge by scientists and doctors. Even if pharmaceutical companies engage in unethical practices, that doesn't mean everyone should abandon scientific medical practices. The rational solution is to reform our laws that monitor pharmaceutical practices.
Depression is a complex illness and there are a lot of contributing factors/causes. I think the treatments for depression are generally equally complex for each individual case and should probably be a combination of medication, therapy and nutritional therapy to be really effective long term.
As someone already pointed out, the best way to better mind and body is through healthy eating habits, regular daily exercise and a solid support system of friends and family. A lot of my female friends in their late 20s to early 30s are now figuring this out, after also being given antidepressants by their doctors. I have one friend in particular who has switched meds more than I did - and I did it quite often - yet never felt any better. Finally I was able to convince her to come off the drugs and find a more natural way to cope.
Don't take my word for it, do your research, but I've worked on so many drug labels that knowing what I know now, I would find it hard to encourage anyone - even my enemies - to take antidepressants.
Studies show that the drugs DO have some response for more severe depression, and I can attest that I immediately started to show improvement after being placed on antidepressants. It wasn't a cure, but it was the first thing that made me feel able to cope. I have had better response since being moved to mood stabilizers instead, however, but I'd say that just because antidepressants aren't the BEST drug treatment for depression doesn't mean that ANY drug treatment for depression is a bad idea.