The authors discuss how depression may have served a purpose at some point, but the nature and intensity of today’s modern-day triggers may be leaving more of us depressed (up to 41 percent of us!) more of the time than seems reasonable. This perspective encompasses the inflammatory model of depression, which posits that both psychological stress and bodily inflammation result in brain-based changes that would serve us if they were brief, but may kill us if they are persistent (something like that).
The researchers of the review go on to explain how antidepressants are missing the mark, and why their prescription should be reconsidered, citing side effects including:
. . . headache, nausea, insomnia, sexual dysfunction, agitation, sedation, hyponatremia, stroke, cardiac conduction defects, and increased risk of mortality. The long-term use of antidepressants may be associated with additional adverse effects. For instance, some antidepressants may be weakly carcinogenic or cause osteoporosis. Antidepressants have also been associated with an increased acute risk of suicide in younger patients while they may decrease the risk of suicide in older patients or with longer-term use. Also, all major classes of antidepressants have been associated with unpleasant (and sometimes dangerous) symptoms when they are discontinued abruptly. Discontinuation of antidepressants is associated with relapse and recurrence of MDD (Major Depressive Disorder). In a meta-analysis, this risk was shown to be higher for antidepressants that cause greater disruption to neurotransmitter systems . . . [And] there is a growing body of research suggesting that when they are used in the long term as a maintenance treatment, antidepressants can lose efficacy, and may even result in chronic and treatment-resistant depression. Such reactions may be due to the brain’s attempt to maintain homeostasis and a functioning adaptation in spite of the medication.
For someone like me, this is a profound summary of the perspectives I have curated since my departure from conventional practice. The call to action is to view depression as the vague descriptive term that it is. Put simply, depression is a sign for us to stop and figure out what’s causing our imbalance. Another way to appreciate this perspective is to say depression is an opportunity.
Many of my patients are initially surprised to experience my wrath about the prescribing that’s going on all around me. I don’t think New York is any different from Anytown USA in how heavy-handed the average practitioner, whether it’s a family practice doctor or an internist or psychiatrist, is with prescriptions. In my opinion, it has become reckless. Their patients have never consented to the long-term effects of these medications because pharmaceutical research is, by nature, short term.32 There’s no incentive on the part of the pharmaceutical companies to take a good look at what happens to the average individual when she takes a medication for a decade or so. That said, in recent years there’s been a spat of studies linking antidepressants to an increased risk of aggression, homicide, and suicide, as well as fingers pointed at these drugs for their involvement in school shootings, airplane crashes, and other unfortunate events often blamed on terrorists, gun access, or lack of treatment.33
In one particularly alarming paper published in 2015 in no less an authority than the British Medical Journal, researchers from the Nordic Cochrane Centre, an independent drug safety analysis group based in Denmark, found that more than half a million people aged sixty-five and older in the West die every year from psych meds.34 Using an impressive meta-analysis of placebo-controlled trials, these researchers discovered that more patients die from taking FDA-approved antidepressants than do patients who take no drugs or who use other unconventional treatment methods. Similarly, the all-cause mortality rate (translation: dying from any cause) was found to be 3.6 percent higher among patients who take newly approved antidepressants compared to patients who take no antidepressants. The study’s scientists highlighted the fact most industry-funded studies favoring psych meds tend to skew the sample groups and test data so much that the results end up becoming meaningless. Underreporting of deaths, according to the study’s authors, is another major problem in the clinical trial process. The Nordic group estimates that the suicide rate among antidepressant users is some fifteen times higher than what the Food and Drug Administration (FDA) reports publicly.
Studies like this that uncover our modern medical assault on humanity are just the tip of the proverbial iceberg. I could write a whole book on the high-profile research demonstrating that patients are held hostage by psychiatric medications, made sicker, and convinced that neither is true. They are more likely to experience a worsening of their depression, as these drugs have been proven in rigorous studies to be mood destabilizers (contrary to what conventional wisdom says).35 I should also add that they’ve recently been labeled as carcinogens.36 In a major review published by the Australian and New Zealand Journal of Psychiatry, a group of researchers from a variety of institutions including Tufts University, Harvard University, and the University of Parma in Italy reported that the vast majority of psychotropic drugs can cause cancer in animals.37 Although the animal-based results are not enough to draw definitive conclusions in humans, these same animal studies are often used to justify drug and chemical safety, and therefore they are enough to warrant caution and appropriate informed consent. Unfortunately, these conversations are not happening.
Don’t panic if you’re taking an antidepressant now.
The information in this book will help you take control of this symptom once and for all, and if tapering is right for you, I’ll be sharing my personal guide for doing just that in Chapter 10. For now, accept the fact that we are all designed for depression as humans. It can be a warning sign that something isn’t right within. And just as we are designed to feel glum, we are also designed to self-heal and feel great.
DEPRESSION ISN’T GENETIC, IT’S EPIGENETIC
One of my favorite practice-changing papers was a 2003 case report of a lifelong vegetarian who experienced a month and a half of progressively worsening depression.38 Eventually she began to hear voices and feel paranoid. The fifty-two-year-old postmenopausal woman ultimately became what’s called catatonic, which meant she was awake and alive but nonresponsive, and largely in an otherwise vegetative state. One would automatically assume this was a serious case of severe pathology. She was treated with electroconvulsive therapy and antipsychotics to no avail. And then she was transferred to another hospital, where they happened to test her levels of vitamin B12. They found that she was a tad on the low side, and after receiving a vitamin B12 injection, she fully recovered. Coincidence? I think not. While it may be one of the more extreme cases, it’s emblematic of how a simple but critical deficiency can be at the causal root of psychiatric manifestations. Later on, we’ll see how vitamin B12 deficiency has long been implicated in the development of depression. It’s a classic example of how we are not just puppets at the mercy of our encoded DNA, but rather products of the complex interactions between our genes and our environment. And it’s now well established that our health outcomes are dominated more by our environment than our inheritance. As I like to remind my patients, depression is epigenetic, not genetic.
Even though genes encoded by DNA are more or less static (barring the occurrence of mutation), the expression of those genes can be highly dynamic in response to environmental influences. This field of study, called epigenetics, is now one of the hottest areas of research. Epigenetics, defined more technically, is the study of sections of your DNA (called “marks,” or “markers”) that essentially tell your genes when and how strongly to express themselves. Like conductors of an orchestra, these epigenetic marks control not only your health and longevity, but also how you pass your genes on to future generations. Indeed, the forces acting on the expression of your DNA today can be passed on to your future biological children, affecting how their genes behave in their lives and whether or not their children will face a higher risk of certain diseases and disorders, depression included. But, by the same token, these