Mental Health Series #1: Prozac Nation: A Miracle or a Crutch

Hello folks. About a week ago, a thread in the Basement took an interesting spin. It morphed into a discussion of eating disorders. The debate was quite interesting and spirited and it got me thinking; every time I've seen a debate around a mental health issue occur, the debate has been stimulating and very active. Knowing what I do for a living, this subject certainly interests me, so I thought starting a series on mental health subjects might be interesting. I enlisted the assistance of another poster, also involved in this field. Lightdemon. He and I have come up with some interesting topics that we will present for your discussion/debate. We would like to see what the general public thinks of some of these issues. Our participation in each thread may be minimal...at first, wanting to see interest peek before we interject information. We do not want to be the focus here; we want the topic to be. So, with out further ado, CC and LD present our first topic in this series: Prozac Nation: A Miracle or a Crutch

IN 1987, the FDA approved the anti-depressant, Prozac, produced by Eli Lily. Prozac was different than other anti-depressants, both in how it worked, and in it's efficacy. It, also, produced fewer side effects than previous anti-depressants. Because of these factors, Prozac became one of the most widely prescribed medications in history, and, SSRI anti-depressants (of which Prozac, Zoloft, Paxil, and Celexa are types), have become some of the most prescribed medications in the US, each year. These medications have also been used for anxiety, OCD, and other mood related issues.

This leads to some questions, though. Are medications like these, miracles for those suffering from severe depression? Or are these medications over used, and prescribed when someone is just "a little blue"? Are doctors too quick to dole out these medication, contributing to the "whimpifying" of America, or are these medications allowing people suffering from depression to function in ways that they would not be able to, without them?

Your thoughts around these questions or any issues around anti-depressant medication is appreciated.

CaptainCourtesy and Lightdemon appreciate your participation.

I just want to depart some useful information about SSRIs to jump start discussion. It's an acronym for Selective Serotonin Reuptake Inhibitor. The main function of SSRI's is to keep Seratonin abundant in the synaptic cleft. Reuptake is the re-absorption of used neurotransmitters; To put it simply, it's a recycling process. However, if the neurons are "inhibited" this process of recycling transmitters is stopped, and so the synaptic cleft is saturated with Serotonin.

The saturation manifests in constant action potential, which means the firing and activation of the neuron. Serotonin is associated with the feeling of happiness, and is used to combat major depression.

One major problem that arises from the constant saturation of Serotonin is that those synaptic clefts develop extra receptors, which means that firing off that neuron will now take more Serotonin. In other words, we build up a tolerance for the drug, which may mean higher dosage or higher reliance on SSRIs.

If you didn't want to read all that psychological mumbo jumbo....... Anti-Depressants can be very addictive, but I'm sure everyone already knew that. :mrgreen:

One important clarification. Anti-depressants are not addictive, at least not classically. The withdrawal symptoms that some suffer when coming off of them is a reaction to the discontinuation of the effects of the medication, and possible re-emergence of prior symptoms, and the urge to continue the medication for gratification, as we see with many street drugs, does not occur. Nor do people purchase these drugs on the street or "doctor hop" to get more. SSRI Discontinuation Syndrome is real, though, and, as Lightdemon said, the psychiatric/biological mumbo jumbo is pretty intense. However, the concerns about how to come off SSRIs is real, even if there is no addiction.

CaptainCourtesy said:

Are medications like these, miracles for those suffering from severe depression? Or are these medications over used, and prescribed when someone is just "a little blue"?

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I think it is both. I have seen peoples' lives improved by anti-depressants, and I've seen people who were disabled by depression made functional again.

But they are also over-prescribed. Every time I have seen a doctor for mental health issues, they have tried to prescribe me an SSRI immediately-- despite the fact that I meet few of the clinical criteria for depression. This wouldn't normally concern me, except for the fact that the first time I was prescribed an SSRI, I started having dissociative fits and I wasn't allowed to discontinue the medication until someone else was injured as a result.

CaptainCourtesy said:

Are doctors too quick to dole out these medication, contributing to the "whimpifying" of America...

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I think this could be used to describe the entire field of medicine, not just anti-depressants. The money in the pharmaceutical industry is not made in curing the sick, but in treating the worried well-- people take antibiotics for every kind of infection, no matter how minor. They take pills to sleep instead of getting more sunlight and exercise during the day. They take pills to lose weight instead of eating less and working more. For every petty ailment, there are a dozen medications designed to make the patient "feel better" instead of taking the steps to stay healthy.

It isn't a matter of "whimpifying" America, but an issue of mistaking feeling good for health-- and the demand for a simple, instant, and effortless solution to every problem.

Korimyr the Rat said:

It isn't a matter of "whimpifying" America, but an issue of mistaking feeling good for health-- and the demand for a simple, instant, and effortless solution to every problem.

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Except, and you alluded to it in the prior paragraph, that there really aren't "solutions". Nothing gets solved, only buried. Nothing is cured, only treated. In my limited experience with others who have had mental issues(depression, ADD/ADHD etc...) taking the drugs created an illusion of being better. In fact, I would argue that is all any drug ever does. Create sensations that are not in line with the reality of the situation. Sometimes, with regards to serious accidents/ or surgeries, its necessary. But thats what drugs do, IMO.

This leads to some questions, though. Are medications like these, miracles for those suffering from severe depression? Or are these medications over used, and prescribed when someone is just "a little blue"? Are doctors too quick to dole out these medication, contributing to the "whimpifying" of America, or are these medications allowing people suffering from depression to function in ways that they would not be able to, without them?

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I feel the role of psychotherapist in modern times has largely transormed into one of an enabler. By classifying and categorizing personality "types" and "disorders" they are essentially lending credence to their patient's problems by externalizing them. Prescribing medication compounds this problem further by suggesting that a patient cannot get better on their own. Psychology needs to shift its focus away from medication and classifcation and move towards individual empowerment. My current view on psychiatry in general is very dim.

I'm sure some people get a degree of relief, so SSRIs, like all drugs, they have some usefulness.

Personally, I have been prescribed SSRIs and I didn't like them. I have high highs and low lows and these drugs leveled things right out. Sounds great? I didn't think so. I like to experience life in full color, not shades of grey. I wouldn't give up the good to get rid of the bad, not worth it to me.

I'm pretty sure most of you know I have control issues. I've been diagnosed with eating disorders and flirted with cutting for a while (but I wasn't much more than a tourist). I'd probably be considered an alcohlic and/or drug addict if I talked to a professional about it. My point? I'm not sorry for any of it. I'm glad I've experienced all of it. I had a tough lesson in how fast it can all be taken away and I don't want to miss anything.

I think a lot of people go looking for an easy way out, and I guess they are willing to sacrifice actually experiencing life for comfort. That's their choice, I won't say they are wrong, I just can't choose it for myself.

I believe that teh overprescription of these drugs coupled with them being used as teh "sole" form of therapy is more of a problem than just using them as a tool in extreme cases.

Without CBT, these drugs are beign used to mask the peoblem by remoiving th esymptoms, instead of treating the problem.

Obviously, those who require these drugs, truly require them, should be getting them to alleviate their suffering, but if the doctor who prescribes these drugs does so without setting up a therapy designed to treat the problem as well, they are doing the patient a disservice, IMO.

Oh and I meant to add but forgot... my post isn't an invitation to help me. Please don't make this one of "those" threads.

Hmm... I think I agree with Korimyr's sentiments. I think said drugs are a "miracle" for some people but are terribly over-prescribed. I think far too many people rely on them instead of just dealing with ****.

My mother has had mood disorders and the like most of her life. Then again, so has my grandmother, great grandmother, aunt, and uncle. (Seems it runs a bit in our family *cough*) She tried prozac and hated it. She said it made her "numb", "zombie-like". She's tried a few antidepressants and I think she's finally found one that works for her, though I can't remember what it is offhand. But I do remember that she distinctly disliked Prozac.

Personally, I have only tried Zoloft and that was for a short period of time where my suicide risk was extremely high for a number of reasons. I think it helped me for what I needed it for during that month or two, and then I stopped taking it. (Actually, I think Ambien did more to help me than anything else)

But regardless, I think it's both. I think that some people desperately do need such medication and cannot function normally without it, but others merely seek some "easy way" to deal with **** and/or want to avoid responsibility for their actions by pretending to be the victim of some "disorder". They tell someone they're taking Prozac and assume then that some behavior is disregarded since they're "damaged". It's bull****, IMO, and I think far too many doctors prescribe it for all the wrong reasons.

Myself I don’t like relying on any drug, not even an aspirin; that said if your body gets used to the Prozac’s it will get lazy and not produce any …whatever it was in short supply of that caused the problem in the first place.

Kinda like anabolic steroids, yes they work but after a while your body shuts down on the natural production of testosterone. Same with sleeping pills, they work for a while then the body/mind says hey why bother, this dummy will slip me a pill and knock me out pretty soon.

Ethereal said:

I feel the role of psychotherapist in modern times has largely transormed into one of an enabler. By classifying and categorizing personality "types" and "disorders" they are essentially lending credence to their patient's problems by externalizing them. Prescribing medication compounds this problem further by suggesting that a patient cannot get better on their own. Psychology needs to shift its focus away from medication and classifcation and move towards individual empowerment. My current view on psychiatry in general is very dim.

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You should read information on "Positive Psychology" by Martin Seligman, or information by Maslow. The former, especially, focuses more on individual empowerment.

Kayleigh Katz said:

Oh and I meant to add but forgot... my post isn't an invitation to help me. Please don't make this one of "those" threads.

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I agree. This thread is for discussion of general issues surrounding medication and depression. It is not group therapy.

The thought that these medications eliminate the highs and lows is a fallacy. What these medications do is allow one to function in spite of the highs and lows, or, make the highs and lows manageable.

I like what Kori said. Often these medications are prescribed for the "worried well". These are people, often, looking for the quick fix, rather than addressing the issue.

But, here's a question for y'all. If you found out that a co-worker was on Prozac, would that alter your opinion of that person? And if so, how?

Or, we can bring it to DP. A few posters, on this thread, have admitted to taking an SSRI at one time or another, with a variety of responses. How does that impact your perception of that poster?

Tucker Case said:

I believe that teh overprescription of these drugs coupled with them being used as teh "sole" form of therapy is more of a problem than just using them as a tool in extreme cases.

Without CBT, these drugs are beign used to mask the peoblem by remoiving th esymptoms, instead of treating the problem.

Obviously, those who require these drugs, truly require them, should be getting them to alleviate their suffering, but if the doctor who prescribes these drugs does so without setting up a therapy designed to treat the problem as well, they are doing the patient a disservice, IMO.

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There has been a ton of research on this. It all comes to the same conclusion. There is a specific order that gives a higher probability of success to someone with some sort of psychological issue:

1) Therapy and medication.
2) Therapy alone.
3) Medication alone.
4) Nothing.

CaptainCourtesy said:

I like what Kori said. Often these medications are prescribed for the "worried well". These are people, often, looking for the quick fix, rather than addressing the issue.

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I have little room to speak here, but if we practiced good mental health practices before we became sick, we would have less need for the medicines we use-- and if our first response when we became sick was to improve our practices, we would often become well before actual treatment became an issue.

CaptainCourtesy said:

But, here's a question for y'all. If you found out that a co-worker was on Prozac, would that alter your opinion of that person? And if so, how?

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Almost my entire social circle has been treated for depression, bipolar disorder, or some other mood disorder at one point or another-- mostly as teenagers but frequently as adults as well. It is something I view as merely a matter of course.

CaptainCourtesy said:

There has been a ton of research on this. It all comes to the same conclusion. There is a specific order that gives a higher probability of success to someone with some sort of psychological issue:

1) Therapy and medication.
2) Therapy alone.
3) Medication alone.
4) Nothing.

Click to expand...

Exactly. Its because the medication is addresing the symptoms (by making them managable) whereas therapy addresses the actual problem. Common sense says it would be more effective. The research only confirms common sense.

For 90% a crutch, for 10% a miracle drug.


This applies to most substances, hell most things.

Reverend_Hellh0und said:

For 90% a crutch, for 10% a miracle drug.


This applies to most substances, hell most things.

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Especially crutches.

CaptainCourtesy said:

But, here's a question for y'all. If you found out that a co-worker was on Prozac, would that alter your opinion of that person? And if so, how?

Or, we can bring it to DP. A few posters, on this thread, have admitted to taking an SSRI at one time or another, with a variety of responses. How does that impact your perception of that poster?

Click to expand...

My step-father is on some kind of "mood pill" as I like to refer to them by their scientific name. He had/has anger problems. The drug, whatever it is, allows him to work with others better and not drive clients away. But conversely, it is very easy to tell when he doesn't take them. I don't know if he seeks counseling or not, as I tend to stay out of peoples business unless I am asked to participate, even family.

I guess knowing somebody is on some kind of mood pill doesn't really affect how I view them. Depending on whether they are on them, or not, will probably affect how I react to them, because I'm not going to simply sit there and take **** from people, disorder or not. But I don't view them as lesser people than myself. We all struggle with certain aspects of our lives.

while the drugs have a very important use, they are way over prescribed

took along time for me to figure it out, and maybe i am wrong

but when **** goes wrong, people get depressed, IMO, there is no need to medicate a normal reaction, unless they do not come out of it in a reasonable amount of time

but when everything is going fine, and one is still depressed, than there is a need to medicate

Kayleigh Katz said:

I'm sure some people get a degree of relief, so SSRIs, like all drugs, they have some usefulness.

Personally, I have been prescribed SSRIs and I didn't like them. I have high highs and low lows and these drugs leveled things right out. Sounds great? I didn't think so. I like to experience life in full color, not shades of grey. I wouldn't give up the good to get rid of the bad, not worth it to me.

I'm pretty sure most of you know I have control issues. I've been diagnosed with eating disorders and flirted with cutting for a while (but I wasn't much more than a tourist). I'd probably be considered an alcohlic and/or drug addict if I talked to a professional about it. My point? I'm not sorry for any of it. I'm glad I've experienced all of it. I had a tough lesson in how fast it can all be taken away and I don't want to miss anything.

I think a lot of people go looking for an easy way out, and I guess they are willing to sacrifice actually experiencing life for comfort. That's their choice, I won't say they are wrong, I just can't choose it for myself.

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you sound exactly like the closing of 'Gia' starring Anjelina Jolie
if you haven't seen it, i highly recommend it

Tucker Case said:

Exactly. Its because the medication is addresing the symptoms (by making them managable) whereas therapy addresses the actual problem. Common sense says it would be more effective. The research only confirms common sense.

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how does therapy help a chemical problem in the brain?

and now that i have read the thread, after my initial response to the OP, i too agree with the Rat's assessment

DeeJayH said:

how does therapy help a chemical problem in the brain?

and now that i have read the thread, after my initial response to the OP, i too agree with the Rat's assessment

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Therapy can change the way a person reacts to the stressors and alter their behavoirs so that they do not inadvertently cause a snowball effect.

For example, if someone is chemically depressed, and they dwell on the fact that they are depressed, their depression will worsen. Guaranteed. But with Cognitive behavioral therapy that person can recognize the detrimental behaviors that are congtributing to their disorders and alter them.

CBT has done wonders for panic disorder patients etc. There is a cognitive aspect in almost ll psychological disorders, especially mood disorders, that is totally ignored by medication only approach.

The coping strategies given through therapy can be amazing in inceasing the overall quality of life for those who suffer from these disorders.

Simply masking the issue with more chemicals never attempts to cure the issue.

Even peope with chemical depression can be taught how to cope with their disorder, much like a deaf person can be taught how to speak.

I'm quite surprised that Bonnie1988 isn't heavily into this thread, because she seems to be quite into this subject.