Prescription drugs ease effects of depression for many
Dec. 27, 2002

By MORGAN LYLE
Special to the Observer-Dispatch

Twenty years ago depression meant being sad about something, and psychiatric care was a stigmatized last resort.

Today, society acknowledges depression as a legitimate health problem, and powerful prescription drugs to treat it are advertised on TV just like pickup trucks and fast food.

You don’t even need a psychiatrist anymore. Your family doctor can dash off a prescription for Paxil or Prozac, Wellbutrin or Zoloft.

Millions of Americans have embraced modern anti-depressant drugs. Increasingly, they’re being prescribed for children. The trend has its critics, some of whom worry about the safety of the medicines, others who suspect the pharmaceutical industry of inventing mental illnesses so it can sell the drugs to cure them.

But local mental health professionals and advocates agreed that, all in all, the easy availability and public acceptance of anti-depressants have made life better for a great many people.

“I would say almost 99 percent of the people that come to a meeting, or that call to get information, will say that the drugs really helped them. They had no idea they were as bad off as they were before they started taking the medication,” said Deborah Morgan, president of the local chapter of the National Alliance for the Mentally Ill.

“My opinion is that we are actually addressing a long-standing need,” said Dr. Celeste Johns, chief of psychiatry at Bassett Healthcare in Cooperstown. “While there may be a little overuse, I think until 1989 we were under-treating extremely widespread problems.”

1989 was the year of Prozac, the debut of the most popular mental-health drug in history. Prozac was the first of a new generation of depression-fighting medicines called SSRIs, or select serotonin re-uptake inhibitors.

They didn’t work much better than the previous generation of anti-depressants, but were much safer and had fewer side effects.

Prozac and the other SSRIs cause an increase in serotonin, one of the substances known as neurotransmitters that convey information between nerve cells in the brain. Their side effects are mostly minor, although the best-known, impaired sex drive, can be a significant problem.

The SSRIs revolutionized care for depression. They do not make a person high (or low), and are considered non-habit-forming, though some critics disagree.

They are not meant for people who are temporarily depressed because of circumstances, such as the death of a loved one or a divorce.

They are for people who have the symptoms of depression — persistent sadness or anxiety, loss of interest in sex or other once-pleasurable activity, low energy, trouble concentrating, decreased or increased sleeping or eating, or thoughts of suicide on a long-term basis.

At any given time, close to 10 percent of the U.S. population is suffering from some kind of depressive disorder, according to the National Institute of Mental Health.

Major depression consists of symptoms that interfere with the ability to eat, sleep, work and enjoy life. It can become disabling. A less severe form, called dysthymia, involves similar symptoms but is not disabling.

Far less prevalent, but potentially more serious, is bipolar disorder – formerly called manic-depressive illness, and characterized by mood swings between very high and very low. It can develop into psychosis.

“We’re seeing more depression, and that’s the scary thing. It’s increasing in prevalence, and the onset of depression is getting younger,” said Dr. Brad Bennett, a psychologist and director of the Clinton Therapy and Learning Center. “We’re now seeing more kids that are legitimately depressed at age 12.”

“Are we over-diagnosing kids? Yes. Are we under-diagnosing kids? Yes,” Bennett said. “There are still people that are falling through the cracks. ... But similarly we’re too quick, because we have these great medications out there, to assign a label to a child and prescribe medicine for them.”

“A lot of people don’t want a label on a child, and I don’t want to label a child either,” said Morgan, from the Alliance for the Mentally Ill, who is also a certified occupational therapy assistant for Madison-Oneida BOCES. “But the bottom line is that if there isn’t some kind of classification, they don’t get the help they need.”

Far less prevalent, but potentially more serious, is bipolar disorder — formerly called manic-depressive illness, and characterized by mood swings between very high and very low. It can develop into psychosis.

“We’re seeing more depression, and that’s the scary thing. It’s increasing in prevalence, and the onset of depression is getting younger,” said Dr. Brad Bennett, a psychologist and director of the Clinton Therapy and Learning Center. “We’re now seeing more kids that are legitimately depressed at age 12.”

“Are we over-diagnosing kids? Yes. Are we under-diagnosing kids? Yes,” Bennett said. “There are still people that are falling through the cracks. ... But similarly we’re too quick, because we have these great medications out there, to assign a label to a child and prescribe medicine for them.”

“A lot of people don’t want a label on a child, and I don’t want to label a child either,” said Morgan, from the Alliance for the Mentally Ill, who is also a certified occupational therapy assistant for Madison-Oneida BOCES. “But the bottom line is that if there isn’t some kind of classification, they don’t get the help they need.”