Thursday, April 17, 2014

The Antidepressant Generation By Doris Iarovici, M.D.

NY Times    Read the comments to the article to get a clearer picture of the issues

Antidepressants are an excellent treatment for depression and anxiety. I’ve seen them improve — and sometimes save — many young lives. But a growing number of young adults are taking psychiatric medicines for longer and longer periods, at the very age when they are also consolidating their identities, making plans for the future and navigating adult relationships.
Are we using good scientific evidence to make decisions about keeping these young people on antidepressants? Or are we inadvertently teaching future generations to view themselves as too fragile to cope with the adversity that life invariably brings?[...]

Children and adolescents increasingly take antidepressants. In 2009, a large trial called the Treatment for Adolescents With Depression Study showed that those who took an antidepressant in conjunction with therapy for nine months were much less depressed, and less suicidal, in the year after stopping treatment than those without treatment — so clearly treatment is critical. But for how long? And is medicine on its own, without therapy, sufficient?
More students arrive on campus already on antidepressants. From 1994 to 2006, the percentage of students treated at college counseling centers who were using antidepressants nearly tripled, from 9 percent to over 23 percent. In part this reflects the introduction of S.S.R.I. antidepressants, a new class of drugs thought to be safer and have fewer side effects than their predecessors. 

At the same time, direct-to-consumer advertising of prescription drugs also became commonplace. Some of this very helpfully reduces stigma, allowing people who are suffering from depression to get much-needed relief. But it also creates demand where genuine need may be less clear.[...]

We walk a thinning line between diagnosing illness and teaching our youth to view any emotional upset as pathological. We need a greater focus on building resilience in emerging adults. We need more scientific studies — spanning years, not months — on the risks and benefits of maintenance treatment in emerging adults. Maybe someday, treating people like this young graduate student, I won’t have to feel like we’re conducting an experiment of one. 


  1. " Read the comments to the article to get a clearer ..."
    what comments???

    1. the comments to the NY Times article that appear at the bottom of the Times article.

  2. As with children, i feel it is important that ' medication' should not be viewed as a long term solution and a holistic appraoch to the problem be taken. The psychiatrist , Thomas Szasz unenthusiastic about the term “mental illness” preferred a different term: problems in living. The problem is maybe not all talk therapy helps. The collaborative problem solving model although originally designed for challenging kids and teenagers focuses on finding solutions to very specific problems which need to be defined and put into a real life context. Medication does not teach life skills or find solutions to problems . It may help people cope or learn these skills. A lot of success depends on a shinui rosh - changing one's thinking and life style and that means moving away from solutions that just ' compensate ' for problems rather than solve problems

    1. But aren't there also medical conditions (chemical?) that require medication as a long term solution? Or were you not talking about those cases?

    2. good point - with mental illness things are pretty individual and one cannot rule out any outcome. Even if one is in medication, a holistic approach could help by allowing the patient to benefit from less powerful and so less dangerous medication


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