The use of antidepressants has been controversial for quite some time. And with good reason, altering the brain’s chemistry can yield unpredictable results. Regardless, drug companies and the media have done an extraordinary job at marketing these products and forcing them into our market. Who hasn’t heard of Prozac? If you’ve seen the recent commercials, you can finish this sentence, “Depression hurts, Cymbalta can…”
The use of antidepressants is very common. Between 2005-2008, the CDC estimated 11% of Americans age 12 and older took antidepressants . Over 60% of these people had taken antidepressants for 2 years or longer, and unfortunately less than a third had seen a mental health professional in the last year.
With such high consumption of antidepressants, you’d think depression would be as solved like polio, right? Wrong. A recent United Kingdom meta-analysis of 47 clinical trials found that antidepressant drugs provide almost no benefit to the people taking them .
Professor Irving Kirsch of the University of Hull led the study, which was published in the online journal Public Library of Science (PLoS) Medicine. He said the analyzed data showed the drugs produced a “very small” improvement compared with placebo of two points on the 51-point Hamilton depression scale.
Furthermore, Professor Kirsch was quoted as saying, “Given these results, there seems to be little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit.”
The alternatives he mentions include exercise, talk therapy, interpersonal therapies, and counseling. In other words, activities that naturally stimulate and invigorate the body and mind are increasingly being seen as the first line of defense against depression. Antidepressants are beginning to take a back seat.
How we ended up in this position may be explained by a line within the pages of a 1994 publication entitled, “Listening to Prozac,” by Peter Kramer. Kramer suggested that anyone who is lacking “joy juice” might give themselves a dose of the “mood brightener” Prozac.
Depression isn’t something to be maligned, either. It’s a very serious clinical condition that affects and really debilitates a number of people. Suggesting a “run around the block” will fix their ailment is ignorant at best.
However, given the results of the study, it is only reasonable to infer that some people who were prescribed antidepressants for depression were perhaps dealing with life’s ups and downs, daily routine, and other non-clinical stressors. If depression is caused by situational unhappiness, antidepressants alone will absolutely not help.
As a result of the study, Alan Johnson, the United Kingdom’s Health Secretary said, “Talking therapies can have dramatic effects. We have put a lot of emphasis on medication in the past and it is about time we redressed the balance and put more emphasis on talking treatments.”
Alternative approaches to depression, specifically exercise, have been of interest for quite some time and shown promise. A 2004 meta-analysis entitled, The Benefits of Exercise for the Clinically Depressed stated;
Lynette L. Craft Ph.D. and Frank M. Perna Ph.D. :“The efficacy of exercise in decreasing symptoms of depression has been well established. Data regarding the positive mood effects of exercise involvement, independent of fitness gains, suggest that the focus should be on frequency of exercise rather than duration or intensity until the behavior has been well established.” 
I find it interesting that frequent exercise, not necessarily the most intense, is what positively impacted symptoms of depression.
Most achievements in life are the result of following a plan and process. It’s hard to finish a book without reading the first page. Nobody gets to the top of the staircase without climbing all the stairs. Battling depression is the same thing, and the evidence shows that those who add exercise, and other non-drug therapies, to their routine, may have the best success.
by Dr. Edward Group DC, NP, DACBN, DCBCN, DABFM
- Laura A. Pratt PhD, Debra J. Brody, MPH, Qiuping Gu MD PhD. Antidepressant use in persons aged 12 and over: United States, 2005-2008. National Center for Health Statistics. 2011 October. Number 76.
- Jeremy Lawrence. Antidepressant drugs dont work – official study. The Independent. 2008 February 26.
- Craft LL, Perna FM. The Benefits of Exercise for the Clinically Depressed. Prim Care Companion J Clin Psychiatry. 2004;6(3):104-111.