In a past post I asked the question, “Is Depression an Illness?” Many expressed strong feelings on this subject. Some argued that it is indeed an illness; others made the case that it was an experience that most of us go through, some more than others for sure, but classifying it as an illness leads one down a path toward taking unhealthy drugs that in the long run cause more harm than good.

In another post, I described Ms. Laren Stover’s story, who, rather than pathologizing her experiences of deep melancholy, she avoided taking psychiatric drugs to deal with it, and defended her experience as having artistic value.

“Whatever happened to experiencing the grace of melancholy, which requires reflection: a sort of mental steeping, like tea?….It visits you like a mist, a vapor, a fog. It is generally uninvited. And as some people are born into royalty, wealth and prestige, others inherit a disposition for sadness.”

Shortly after writing my article, I came upon another one published in the AARP Magazine titled, “The True Story of My Life on Antidepressants.” Today I thought I would summarize this story and then provide my personal comments.

A Summary of Meg Grant’s Story

Meg Grant, tells us that the first 25 years of her life was “pretty darn good.” She had a good marriage, wonderful friends, and both she and her husband had excellent jobs–she a journalist and he a clinical psychologist.

Then, after a major move to another city and taking on a new job, one morning she woke up very disoriented and fearful. She describes this incident as follows:

“My ears buzzed, my leg muscles spasmed, and my throat closed. What was worse: I did not know where — not even who — I was.”

After about five minutes, she started to become less confused. And then, as she tells us:

I shook my husband awake, paced the living room floor, then finally ran out into the street, where I doubled over, struggling to catch my breath.

“Take me to the hospital!” I demanded. Instead, Greg [her husband] walked me back into the house and calmed me down, telling me I’d probably just had a disorienting dream. “We’re in a new place,” he said, donning his therapist hat. “It’s normal that you might at times feel scared.” He managed to coax me, still shaking, back into bed, where he held me tight. With him at my side, I tossed and turned until dawn.

We then learn that over the course of the next three weeks Ms. Grant was concerned about her hands trembling, lack of sleep and appetite. According to her, she “was in panic mode 24/7.”

Ms. Grant as a young reporter.

To help her through these experiences, she conferred with her internist, increased her exercise, and went to counseling. When none of this led to feeling as well as she would have liked, she decided to go to a psychiatrist. He or she explained to Ms. Grant that she was suffering from a serious depression, along with panic disorder, and then convinced her to take one of the drugs that the pharmaceutical industry refers to as “antidepressants.” She felt that this drug tamped down her anxiety enough to allow her to sleep. Nevertheless her problems continued.

For months my symptoms swept in and out like pernicious tides. One day I’d be able to savor a meal or talk to my sister on the phone without crying; the next, nothing would seem real, including me. I’d be lost in a fog — numb and dull. Travel, meeting new people and unstructured time all made me uneasy, which quickly morphed into a vague feeling of free-falling, then anxiety, then hopelessness about ever feeling normal again. Indeed, merely anticipating what I saw as the next inevitable bout of panic seemed to bring one on.

Her second psychiatrist, a Dr. Verhulst, at one point, upped her “antidepressant” dosage, which gave her dry mouth, constipation, and fatigue but quelled her panic. She felt that to live without all the angst was worth the side effects.

At about the time that she decided to have children, she was feeling well enough to see if she could withdraw from the drug that she was taking. There are some good reasons to consider getting off such drugs before a woman does become pregnant. Research studies suggest that there may be a number of very serious negative effects on the developing fetus and newborns when a mother takes these types of drugs during her pregnancy.

Ms. Grant’s efforts to get off the drug that she was taking at that time, Prozac, was not easy. She first tried cutting her dose in half. She learned that these types of drugs can lead to a very uncomfortable withdrawal syndrome. She experienced muscle cramps in her thighs, trembling hands, a dry lump in her throat, obsessive thoughts about going crazy and being locked away in a mental hospital.

By tapering off the Prozac in much smaller increments, she found that she was able to wean herself off entirely after six months. Now, med-free, she and Greg welcomed the birth of a baby girl. How did she fare off the drug?

My unmedicated life was kind of a beautiful thing. Yes, I was better. And yes, it felt liberating to no longer rely on a chemical crutch. But most important was my fading sense of alienation. I could now count myself among the normal masses, a healthy woman who, with my husband, had just started a family — something, in the throes of my illness, I feared would be closed off to me.

I remember those four years free of antidepressants as a cheerful but busy blur of baby-raising — decorating a nursery, changing diapers, hiring a nanny — while balancing my career. But after the birth of our second child, a strapping son, signs of a relapse appeared.

Ms. Grant quickly scheduled an appointment with a new psychiatrist. Without hesitating, he put her back on Prozac. Three months went by with no relief. She then tried Zoloft, again with no success. Finally, a colleague of Greg’s recommended Effexor. This seemed to help. As Ms. Grant tells it, the “crashing waves of fear and hopelessness began sliding out to sea.” It had taken her two years to regain what she referred to as “a sense of stability.”

Since then, she has decided to stay on her drug for the rest of her life. In making this decision, she conferred with a number of experts. Kenneth Duckworth, M.D., medical director of the National Alliance on Mental Illness, told her that there was not enough research on the long term safety of these types of drugs to offer any assurances that down the line she might have to pay a serious negative health consequence. “Medicines are tested for weeks or months, not years, to get FDA approval,” Dr. Duckworth said. “Once things are on the market, we rely on voluntary reporting for side effects.”

A researcher at NIMH, a Dr. Rudorfer told her, “It took many years to figure out that the older antipsychotics could cause tardive dyskinesia — a terrible, permanent neurological disorder. There does not seem to be anything that drastic with these antidepressants, but we’re talking about medications we are intentionally getting into the brain — and that should be taken very seriously.”

Dr. Rudorfer, did offer Ms. Grant some words of encouragement. In his opinion, “The risk of untreated depression is greater than the risk of any adverse effect of antidepressants.” Toward the end of her story, Ms. Grant states that she recognizes there are more ways to treat depression and panic experiences than with the drug that she was taking, but she came to believe that she could never have recovered without it.

My Comments

Jeff Rubin

First of all, I wish Ms. Grant well, and I fully support her right to choose how she wants to deal with her challenging experiences. She has far more expertise in what has been going on in her life than I do. I mean her no disrespect because of my disagreement with her drug approach for dealing with the type of experiences that so troubled her. Moreover, I have met people who chose to take drugs to deal with these kinds of experiences and they struck me as intelligent, decent folks.

That said, I wish to point out that in 30 plus years of providing counseling, I have met many people who struggled with panic experiences that sound very similar to what Ms. Grant described. As Ms. Grant mentioned, there are other ways to deal with panic and depression than drugs, and it just so happens I have experience using one such method. I taught people expressing concerns about their personal panic experiences that they can easily get through them by finding a quiet place, sitting in a comfortable position, and then practicing a type of meditation which involves observing the physical sensations they are experiencing in a nonjudgmental manner, as if they were tasting for the first time, fresh island mountain water. I encourage them to learn to befriend these experiences. I then taught them how to meditate on a regular schedule (twenty minutes in the morning and twenty minutes before the evening meal) even when they were not experiencing a panic episode.

Some found that after a while they stopped having these experiences. The others continued to have panic episodes from time to time after learning these skills, but they became less intense, occurred less frequently and lasted for much shorter periods of time. All my counseling cases got on with their lives without having to deal with the side effects of the drugs and being concerned about their long term health risks. None were ever hospitalized or committed suicide as a result of such experiences.

Besides the panic attacks, how would I handle the other sad and fearful experiences that accompanied Ms. Grant’s concerns? In an earlier post, I discussed three ways to deal with emotional pain that does not cost any money (see HERE). I refer you to that article. For those who find that they can use some additional help getting through these challenging experiences, counseling can be very helpful.

There was one particular part of Ms. Grant’s story that irked me. It occurred when Dr. Rudorfer told her that in his opinion, “The risk of untreated depression is greater than the risk of any adverse effect of antidepressants.” As someone who has participated in a number of debates on the use of psychiatric drugs, I have heard a number of physicians make the same claim. Whenever I asked these doctors what risks they were referring to regarding untreated depression, the answer has always been an increased risk of suicide. The doctors’ statements about this imply that if treated with “antidepressants” this can decrease the risk of suicide enough so that the depressed patient, by taking the drug, is better off than facing the risk of any adverse effects of the drug. But the doctors don’t know what the long term effects of taking the drugs are. What’s more, the scientific evidence currently available indicates that these drugs do not reduce the risk of suicide; for some, they may actually increase it. So, I did want to clarify this issue a bit.

Okay then, that’s my “From Insults to Respect” post for this week. I hope you have found in it some ideas worth thinking about.

My Best to You All,

Jeff

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.

antidepressantsDepressionpanic attacksProzac