I Trust When Dark My Road

I am just now starting to digest this article. Anyone read it yet? What are your thoughts?

Why Antidepressants Are No Better Than Placebos – Newsweek.com: “”

(Via Ken Kelly.)

Below you will find a link to an article that indicates anti-depressant use has doubled in the US:

Reuters AlertNet – Antidepressant use doubles in US, study finds

Here’s the quotation I found most interesting:

“The survey did not look at why, but the researchers made some educated guesses. It may be more socially acceptable to be diagnosed with and treated for depression, they said. The availability of new drugs may also have been a factor.”

What do you think? How taboo is it to be diagnosed with depression? Is it more or less so if you are a pastor or some other type of church worker?

Here’s an article a friend passed along that highlights a new study on the challenges of tracking down the cause of different types of mental illnesses. A 2003 study linked a gene mutation that interrupted the neurochemical seratonin increased the risk of depression. The new study seems to refute that claim, or at least temper it quite a bit. Here’s one quotation:

Study Refutes Depression Gene Finding – Yahoo! News: “Scientists have had an unusually tough time linking specific genes with different psychiatric illnesses, such as depression, bipolar disorder and schizophrenia. The likely reason: The genetic and environmental interactions are both more subtle and more complex than in many other diseases, said Keith A. Young, vice chair of research at the Texas A&M Health Science Center College of Medicine Department of Psychiatry and Behavioral Science.”

The “cause” of depression is elusive and tricky. Biochemical, situational, and spiritual elements can all come into play. How to unravel the mystery? We, of course, may never be able to completely unravel it. As Lutherans, though, we are blessed with an understanding of God’s world that takes into consideration all of these factors, and does not see them as contradictory. I can look at mental illness, recognize the physiological causes, but also see how my life affects it, and how my spiritual life impacts and is impacted by it.

One thing is for sure. It’s not as clear as a broken leg.

Todd Peperkorn
aka DMR

One of the questions that regularly come up to me has to do with the ons and offs of medication. When and why do you go on medication, and when and why do you go off of them? While the two are related, they are not the same.

Why go on medication?

We go on medication simply put because we need it. There may be many factors which go into that decision. It may involve mood, basic functionality, self-image, the ability to handle situations or stress, being able to interact with other people, to keep us safe from ourselves or others. You know your own list. For myself, I knew I had to go on medication when I found myself hating the things that I love: my family, my wife, my vocation as pastor, even my hobbies and the things that I enjoy became a burden. I couldn’t handle living any longer, and so something had to change. While one can go the route of simply counseling or natural remedies, in my view and after much reading on the topic, I simply haven’t found any cure or natural remedy or counseling method that is more effective than anti-depressants. Can you go other routes? Yes. Can they be effective? Yes. But I don’t believe that they will work as quickly or as well as modern anti-depressants or anti-anxiety medication, and the body of research seems to continue to support that view.

That’s why I went on medication, both initially and that’s why I went on them the second time.

Why go off medication?

The reason we go off medication should be fairly simple: we go off medication because we no longer need it. Now that sounds very simple, but we often invest massive amounts of emotion and other negative energy into the decision to go off of medication. Here are a few that I see and hear pretty regularly:

1. I don’t want to become addicted.
2. I don’t want to be on medication for the rest of my life.
3. Taking medication makes me feel weak or out of control of my own body.
4. I don’t like the side effects.
5. I can’t afford to take them anymore (iow, money or insurance problems).
6. I have found a better alternative way of treatment.

Now out of that list (and I look forward to hearing yours), four of them are basically emotional responses to medicine (wants and likes and feelings), one is money based, the the final one is experimenting with others ways of treatment.

But remember that initial reason on why we go off medication: we go off medication because we no longer need it. Unless you are a doctor, it is very unlikely that you will be able to determine when you no longer need it, since the medicine working is what makes you have a normal, functional life in the first place.

So how do you know when you don’t need the medication? Here’s a tip: you can’t know by yourself. You’re not a doctor, you’re not a pharmacist, you’re not God. It takes outside evidence. It takes some level of expertise that most of us do not have. It’s why God gives us doctors and nurses and medication in the first place.

If you think you want to try going off your medication, I would suggest the following steps:

1. Wait a month.
2. Talk to your doctor about the possibility of going off medication.
3. Wait another month.
4. Talk to your spouse about it, and anyone else whom you trust that may have some wisdom on the subject.
5. Wait another month.
6. Talk to your doctor about it AGAIN.
7. Then come up with a reasonable timetable and a way of evaluating what changes happen as a result of going off the medication.

One thing is for sure. Don’t willy nilly try to do this. Don’t just decide you are going to “see how you feel” by stopping to take it for a while. That is just not wise.

If you are desperate, send me an email and we’ll talk about it directly. I’m happy to pool my wisdom/foolishness with yours.

Be at peace,
-DMR

I’ve been back on zoloft for a month, and finally I can breathe again. It took about three weeks for things to sort of stabilize. But my mood is better, I am not feeling overwhelmed, I can read, I’m generally being more productive and (dare I say it?) happy. This is all good.

It couldn’t come at a better time. There’s a lot of stress at the congregation right now, mostly about money. Plus with Holy Week and everything else coming up quickly, it is really good to feel like I am on top of things a little better.

The hardest part about anti-depressants in my view are 1) Starting. I have such a fear of medication of any sort, that getting the gumption to actually start really terrifies me. And 2) Waiting to see if it actually will work. I want things to change quickly, but anti-depressants take time to get into your system and do their work. It requires some patience, which really stinks.

But God is good, and things are working again. Now, it’s time to get back to sermon writing, bulletins, calls, and all the other things that make up the season.

-DMR