Why Antidepressants Don’t Treat Depression

Mark Hyman, M.D. by Mark Hyman, M.D. | July 7th, 2010 | 19 Comments
topic: Health & Wellness

Thoughtful woman near foggy window with hearts

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.

A study published in The New England Journal of Medicine 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.

That warps our view of antidepressants, leading us to think that they do work. 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. However, there are treatments available. Functional medicine provides a unique and effective way to treat depression and other psychological problems. 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 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. 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 5 to 12 percent risk of developing severe major depression in their lifetime. One in 10 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.

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. This minimal result is achieved in less than half the patients taking antidepressants. 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.

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 researchers who 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!

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.

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.

7 steps to treat depression without drugs

  1. Try an anti-inflammatory elimination diet that gets rid of common food allergens. 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 a 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.

To your good health,

Mark Hyman, M.D.

This article originally appeared on The Huffington Post.

Comments

  1. This article treats depression like it’s a joke. Clinical depression is a real and potentially serious ailment. It’s not self-inflicted and it’s not a product of being ungrateful or lazy. I’ve been sick since I was 13 with fibromyalgia, CFS, and depression. If antidepressants do not work, then how come I get severe depression if I accidentally skip my dose of Abilify for one day? If the author is trying to say that antidepressants do not work for everyone, that’s completely different and entirely valid. However, using a statement like “Antidepressants don’t treat depression” is irresponsible. There is already so much stigma surrounding mental illness. We do not need to spread lies about antidepressants not treating clinical depression. Furthermore, we do not need doctors becoming scared of prescribing antidepressants to patients who truly need them.

    Ricky | July 7th, 2010 | Comment Permalink
  2. I also agree with the preceding article
    This article is insulting, I come from a family that depression has run in for generations. The “shame and embarassment” that hid this disease is now starting to be talked about and accepted as a dilibating disease.
    I also follow all the suggestions but they are not a cure all but a huge help.
    The authur of the article did not mention sun and SAD light

    Dian A | July 8th, 2010 | Comment Permalink
  3. I’m with Ricky on this. Having suffered bouts of depression over the past 20 years and treating them only with natural steps such as the ones described above as well as “talk therapy”, I finally got a medical opinion this year. Having ruled out nutrient deficiencies and thyroid issues, I reluctantly filled a prescription for Prozac and can unequivocally say it’s made a HUGE difference in getting me out of the psychological black hole must more quickly. I can’t tell you if a placebo would have worked for me, of course, but I can say I wish I’d tried antidepressents sooner. It’s not helpful to discourage people from considering pharmaceuticals as an option to help them feel better.

    Catherine Kexum | July 8th, 2010 | Comment Permalink
  4. I think the manipulation of statistics misleading, and probably down right incorrect!!

    Tracy | July 8th, 2010 | Comment Permalink
  5. This is a dangerous and disturbing “article” (advertisement!!?!) For those for whom anti-depressants are life saving, this is a reckless slap in the face.

    Mary Glynn | July 8th, 2010 | Comment Permalink
  6. I am writing because your email and article describing anti depressants as fake and a money making front for pharmaceutical companies concerned me greatly. Your dismissal of the medications and smearing of the medical community that help people with emotional distress is profoundly irresponsible. By printing this untrue “sound bite” and article, you could discourage people who could benefit from them. Without proper treatment, people with serious depression will become non-functional and ultimately suicidal. Exercise and other measures can be helpful for melancholia and mild depression, but major depression does respond to anti-depressants and they are a miracle for those who are hopeless.

    ozzie | July 8th, 2010 | Comment Permalink
  7. I was treated for major depressive disorder with antidepressants for the last 16 years. I got tired of being dependent on the meds, not to mention the side effects and all the times that the meds quit working, so I took my life back! Coincidently, I’ve been successfully managing my depression with the same recommendations that this article gave. I was severely Vitamin D deficient and with the supervision of my Dr. have been supplementing not only with Vitamin D and Omega 3, but have also eliminated red meat , most dairy, and processed foods from my diet. Exercise is key too – I’ve even been able to lose weight. I have my personality back and I feel amazing!

    Shannon | July 8th, 2010 | Comment Permalink
  8. Gr8 news and story ….. and my experience is also more or less same !

    Exercises (aerobics) with little meditation etc. also helps …

    name vish ... | July 9th, 2010 | Comment Permalink
  9. I don’t think the author meant to imply that depression is a joke. Like a lot of chronic conditions, medication can alleviate symptoms but not necessarily elminate the underlying problem. Missing a daily dose of meds means the symptoms return – a cure implies that, after a course of treatment, the condition is gone.

    Diet and exercise sound like simplistic prescriptions but, honestly, I am beginning to believe that the body can heal itself in a lot of cases if only it is treated well.

    Fiona | July 9th, 2010 | Comment Permalink
  10. I guess there are some ways to avoid deppressions.It depends on ourselves,we are the one who make deppression.Because we think too much.Why not looking at the positve side of life than buying those anti-deppressant capsule?

    shawnmaullin | July 16th, 2010 | Comment Permalink
  11. Supposedly the information in this article is quoted from The New England Journal of Medicine: a creditiable source. As someone who has taken antidepressants for 4 years, I found that one did ok, but seemed to quit working. I was prescribed Lexapro and not only did I not feel better, I felt that life wasn’t worth living. There’s no doubt that some of the drugs work for some people…. lucky them.
    Frankly, it bothers me more that the FDA would lie to us than the fact that some drugs aren’t very effective. If you’ve been interested in healthly living, you can’t have missed quite a few drugs being yanked off the market when a few years after they fabulous debut, they are found to be harmful, even deadly. It’s one thing to find out years after the fact by study and research that a product is bad but the fact that the FDA knowingly approved the sale of some worthless and possibly dangerous products is a crime.

    Ann | July 19th, 2010 | Comment Permalink
  12. I completely disagree with the main idea of this article, that antidepressants are ineffective in the treatment of depression. I have lots of examples of people who taking antidepressants have almost got rid of this disease or are completely safe now.
    Simply there different forms of depression. If it’s a simple seasonal depression then i agree that those tips how to get rid of it are effective. Seasonal depression is very common and almost every person has gone through it at least once. But if it’s clinical depression or panic disorder – it’s much more serious thing and only these tips will not help for sure. Only antidepressants in combination with other drugs will lead to a positive result. It’s my opinion and i believe i am right.

    Milena | June 15th, 2011 | Comment Permalink
  13. Many have blasted this article saying that it tells lies or is dangerous. I have heard multiple opinions in the comments but no really debunking of what was said in the article. And we must remember the person that wrote the article is supposedly a medical professional.
    Personally I have taken Anti-depressants before (a maximum Dose actually), but I learned what was causing my problems and what was the real cause of depression, thus learning how to cure the problems instead of treating the symptoms. This I believe is an underlying topic of the article and has been being fought over in the medical community for the last couple of decades, that you need to treat the problem not the symptom. Unfortunately with the 5 to 10 minute doctors visits now, they only really have time to figure out the symptoms not the underlying cause of what ever is ailing you.
    The End of the article is a good start to balancing your bodies functions but it does seem to take more.

    Fuzzy | June 19th, 2011 | Comment Permalink
  14. I don’t know how much of this is true… I don’t have any real ability to debunk anything stated. All I do know is that 3 years ago, I gave birth to a baby daughter that I prayed for years to have, and was elated to carry for 8.5 months. However, when she arrived, I was hammered with what was later diagnosed as post partum depression. Thank goodness what I was prescribed wasn’t a placebo or I don’t know if either one of us would be here today….
    Do what you need to do to take good care of yourself and those you love, and treat yourself with kindness and compassion. Have no regrets.

    Kiki | June 21st, 2011 | Comment Permalink
  15. I have struggled with depression since 1980 and finally had to step into the pharmaceutical realm about 5 years ago. At the time it looked like the whole world was viewed in shades of gray to black. I also had so much physical pain from it that I thought that might have fibromyalgia. Very grateful that I don’t. My meds have been very helpful to get me to a place where I can function reasonably well so I agree that saying they are ineffective is irresponsible.

    However, I believe that his alternatives, which I’ve picked up on in the last year have been more helpful and I don’t have to deal with addiction and withdrawal. My meds also have an irritating habit of not working after a year or so. I suspect that most people who deal with depression would be well served by putting in the legwork with the vitamins, sunlight, D3, etc.

    I’m disappointed the author didn’t mention meditation and prayer as additional helps with depression. People who have a faith in something beyond themselves are far more likely to recover from ANYTHING than those who don’t. Meditation helps to cut through the bull-crap thoughts that go through a person’s head. I’ve found in my own experience that both prayer and meditation dovetail into each other very well and each makes the other more effective.

    But, back to my first point, I don’t think when I went in for the meds that I had either the physical or mental strength to work on the health regimen outlined so I needed them to get back on track. I believe there’s a balancing act to be done with health and alternative health professionals and neither should be completely discounted.

    Sker | June 28th, 2011 | Comment Permalink
  16. As far as I am concerned, anti depressants really works. The reason why anti depressants doesn’t doesn’t work is because of our body cells, hormones or some other process. Sometimes, the ingredients present in the anti depressant failed to cope up with our internal hormones. However, selecting a right anti depressant is such a tough task. Physician’s consultancy is needed.

    Zebulon | September 18th, 2012 | Comment Permalink
  17. What an insightful article. You guys are amazing, i like the way you describe every single point so carefully. This can help people and i must come again and again to read such an informational articles.

    Tejwinder | April 4th, 2013 | Comment Permalink
  18. this article contains lots of information about the depression. Thank you for this information. Also, I want to add that the depression can be happened due to the hereditary.

    Chapman | January 1st, 2014 | Comment Permalink
  19. Why is it always antidepressants that get such a bad rap? Are you talking from your own personal experience or just quoting statistics? Have you yourself suffered the debilitating effects of severe depression? Of course not, because then you’d actually have a clear perspective of the effectiveness of these drugs and realise why they are prescribed to millions of people.
    But then again, I’m no Doctor, so this probably won’t get published….

    Mark | January 31st, 2014 | Comment Permalink

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