Many People Taking Antidepressants Don’t Have Any Mental Disorders

Rob Wipond
28
597

The majority of people taking antidepressant medications have never had major depressive disorder, and 38% have never met criteria for having any mental disorder, according to a study in Baltimore published in the Journal of Clinical Psychiatry.

Johns Hopkins Bloomberg School of Public Health researchers reviewed data from the Baltimore Epidemiologic Catchment Area from 1981 to 2005. They then assessed lifetime prevalence of mood and anxiety disorders among participants who reported current antidepressant use.

From 1,071 people, 13% in 2004-5 reported currently using antidepressant medications. “Among antidepressant users, 69% never met criteria for major depressive disorder (MDD),” stated the researchers. “And 38% never met criteria for MDD, obsessive-compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder in their lifetime.”

“Many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders,” they concluded. “Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.”

Takayanagi, Yoichiro, Adam P. Spira, O. Joseph Bienvenu, Rebecca S. Hock, Michelle C. Carras, William W. Eaton, and Ramin Mojtabai. “Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample: Results From the Baltimore Epidemiologic Catchment Area Study.” The Journal of Clinical Psychiatry, January 28, 2015, 40–44. doi:10.4088/JCP.13m08824. (Abstract)

28 COMMENTS

  1. Unfortunately this title is misleading because it assumes that there is such a thing as “mental disorders.” In reality, most of that which doctors diagnose as “mental disorders” is the direct result of pyschotropic drugging. Anyone who disagrees with me is suffering from anosognosia and should see himself (if he is a psychiatrist) immediately.

      • Well GPs shouldn’t prescribe psychiatric medication in the first place, their is a reason there is a specialty for it. Antidepressants are defiantly over prescribed, no one is doubting that, especially people going through trauma ext. But I do think some people need it for the longer term, like people born with obsessive-compulsive disorder.

        • Just to clarify: not saying that some people don’t find these helpful. The scam is the idea you can diagnose someone with a “mental disorder” based on a checklist of inconvenient behaviors or emotions. And believe me, lots of psychiatrists prescribe promiscuously for people who don’t qualify for any diagnosis – I work with foster kids and I see it all the time. You’re right about the ignoring of trauma – it is systematic and very troubling.

          These drugs have their (in my view very limited) applications, but they should be a last resort, and we should not lie to people about what we’re doing – we’re medicating away symptoms, not treating a disease. And the millions of people now taking them for normal reactions to difficult life conditions or even just unreasonable expectations (see the “ADHD” epidemic for an example), well, it’s a travesty.

          — Steve

        • LoganBerman:

          Antidepressants (and all other psychoactive substances) should be banned for children, period. For anyone else, I would mandate a meaningful disclosure—e.g., all potential side effects; the fact that antidepressants are not appreciably better than placebos; the basis upon which the drug was approved by the FDA (including the fact that drug companies are not required to conduct longitudinal studies or submit all data), and the fact that nutrient therapies deliver superior results.

          • I agree with you GetItRight.. Stimulants are a different story though, as you said with children, which I agree with their are healthier alternatives. But again, for severe depression, SSRIs are better than placebo at reducing symptoms, that is pretty clear, not so much mild to moderate though as you stated. Medications are defiantly a last resort option for sure, but for some people, I believe they are necessary. Antidepressants might cause Mania in some people, Antipsychotics can give you diabetes and shrink your brain, however given someones circumstances, it could very well be worth it.

    • Unfortunately this title is misleading because it assumes that there is such a thing as “mental disorders.”

      Exactly. “Mental disorder” may be ok to describe a general state of mind, but it’s a subjective description, not a scientific or medical determination. Often people use it to get around the controversy engendered by the term “mental iullness.”

      So, there is much of value in this article but as you say the title implies that there are people who do have these purported disorders who do need antidepressants.

  2. As a formerly healthy person, I was put on an antidepressant with no prior personal or family mental health problems, but was lied to and told it was a “safe smoking cessation med,” not a mind altering drug. The withdrawal symptoms – brains zaps, odd dreams and thoughts, flu-like symptoms, increase libido (Wellbutrin was being illegally marketed as the “happy, horny, sexy drug” at the time), weight loss – were then misdiagnosed, according to the DSM-IV-TR, as “depression caused by self,” “paranoid schizophrenia,” “bipolar,” “schizoaffective disorder,” and finally, after the doctors realized I was allergic to ALL the neuroleptics, “adjustment disorder.”

    Medically unnecessarily putting that many people on antidepressants is very profitable for the medical community, but not in the best interest of humanity as a whole, especially the patients.

    And it’s really weird, the psychosis caused by the neuroleptic drugs, “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.” Resulted in a weird story of Jesus calling judgement day, then saying all the doctors would go to hell.

    After researching medicine for ten years, I will say I am adjusting to the reality that Jesus could have been right that the US medical community has completely run amok.

    • we’re medicating away symptoms, not treating a disease

      Well that is kind of how medicine works though. It isn’t an infection but it is an “illness” for some people, who have it chronic for the rest of their lives, it doesn’t go away, to say it does is kind of insulting. There are literally hundreds of different kinds of chemotherapy for people who have cancer that are individualized based on genetics and so forth. Just because there isn’t a test for it, does it mean it doesn’t exist.

      • And it is extremely insulting to tell someone they have a lifetime depression that will never get better and needs medication when many times, it is simply due to life stinking to high heaven big time. It is also insulting to tell someone they have a chemical imbalance which has been proven to be false.

          • You don’t know that their lives are necessarily better because of drugs or because of other things they’ve done to change their lives. But we do know this. We know that psych drugs cause a lot of havoc in a lot of lives. The facts are out there and the evidence grows.

            I am very suspicious of people who defend psych meds. You are either a patient suffering from spellbinding or a doctor or drug rep. Or just someone influenced by mass media. Regardless, do your homework. These drugs harm more than help.

          • Tell that to Brian Williams and countless others who not only were not made better but often committed suicide despite or even due to these drugs.

      • Actually, if we’re actually being scientific, the lack of a test for it essentially does mean it doesn’t exist – the concept, not the condition. If your hypothesis for the explanation for depression doesn’t test out, your hypothesis is scientifically wrong. Science is predicated on the ability to predict a particular result and test for the presence/absence of that result. Anything less is “professional opinion.”

        You say “it is an illness for some people, who have it chronic for the rest of their lives.” This is where the problem comes in scientifically. You are relying entirely on anecdotal evidence. There is no proof that depression needs to be chronic in general or for a specific person (even if they report that it is), mostly because there is no way to distinguish “clinical depression” from a normal reaction to adverse life events. For instance, a person may be chronically depressed because his/her mother abandoned him/her at a young age, or because s/he was bullied in school and never fit in, or because s/he is gay and has experienced and continues to experience ongoing discrimination and abuse, just to name a few examples. S/he may also be chronically depressed due to low iron, thyroid dysfunction, metabolic problems, sleep apnea, or chronic pain. And there may be things that can be done for any of those situations that will vary widely from person to person and condition to condition.

        There is no effort whatsoever in the DSM to actually distinguish any cause for depression – if you fit the criteria, you’re in, regardless of why. Scientists should be working to distinguish between real situations that cause depressed feelings, and devising specific responses to those situations, some of which would be medical and some of which would not, rather than trying to “treat” the feelings as a disease and provide a one-size-fits-all solution that really doesn’t work very well for any of the above conditions.

        Sure, some people are depressed chronically, and there are always some people who will view antidepressants as helpful to them. Scientifically, that is almost useless information. Lacking any systematic way to distinguish potential causes and the effect of possible treatment options on different circumstances, we are basically throwing painkillers at a broken leg. It may feel better, but the damned leg is still broken!

        And just to address your example, cancer can be tested for biologically, and we can objectively observe whether or not a particular treatment works. It’s a completely non-analogous situation. A better analogy would be “chronic fatigue syndrome” – yes, it happens, but no one really knows why, and different things seem to help different people. Of course, CFS sufferers have often been routed to psychiatrists and told it’s “all in your head” and prescribed drugs for it. Which maybe some of them find helpful, but it’s not a scientific approach at all.

        My last comment: a lot of people suffering job stress go down to the bar after work and heft a few brewskis to relax. It is a chronic condition (they feel this way every day), there are clear symptoms (tension, anxiety, depression), and the alcohol in the beer has a remarkable and direct positive effect on the symptoms. Does this mean that chronic disenchantment with work is a mental disorder, and that beer is an effective treatment for it?

        Just because something makes you feel better doesn’t make it a medical treatment.

        —- Steve

        • Well when your a child, of course, your brain is very plastic, and if you went through trauma your brain will be prone to trauma in the future. That in turn I believe can alter brain chemicals and set someone up for a reaction of some kind down the line. But what if someone, and I know a few, who have had terrific childhoods, who were still horribly depressed and anxious as a child.

          For instance, they did a study in Israel in the 90s showing people with OCD and Anxiety have much lower levels of Inositol in their cerbrospinal fluid. Inositol interacts with Serotonin neurotransmission in a way we are not sure yet, but yet, there was technically a chemical imbalance that was found in these people. So saying there is no chemical basis for depression and anxiety is kind of untrue for some people. Measuring actual neurotransmitters is a lot more difficult to achieve.

          Some of the psychiatric medication are loosely based on street drugs, that is kind of why they work in the first place. The bar analogy only makes sense because it eases you after a hard work day FROM stress. But if you have a great day of work, and are still depressed, suicidal, for no reason, and have been cleared of other tests, thyroid ext, that is real mental illness. If that scares people about modern medicine were it is as of now, well, I am not sure what to tell you.

          • If it’s a medical problem (like say low iron or thyroid dysfunction) – there are real medicines for it (or at least for some of them). If they are psychological they are not medical.

            Psychiatry is actually hindering the treatment of “real” mental problems caused by illnesses – instead of looking for a reason for low mood they throw anti-depressants on everyone.

          • First off, nobody does all those tests, or almost nobody. Second, the vast majority of psychiatrists don’t even screen for current or past stresses in my experience. I read an article very recently where they interviewed kids in a residential treatment home and discovered that some ridiculously high percent, 90% or more, had been traumatized in the past. This was not surprising to me or probably most people. The surprising part was that only 22% of these situations were actually noted by the staff!! How can you have a residence full of “mentally ill” children and not even bother to ask them what’s going on in their lives? Why does it take an outside researcher asking a set of questions to bring out this information?

            That is what happens when people take the current system too seriously. They forget that the main reason most people are “mentally ill” is because shitty things have happened to them. DSM diagnoses let the professionals off the hook from having to ask these difficult but obvious questions.

            —- Steve

          • You don’t know what caused the so-called imbalance in the first place or whether it has anything to do with depression. Correlation is not causation.

      • a) none of these drugs has been shown to have a positive effect long-term – in fact there’s some evidence that they prevent spontaneous recovery hence making the problems chronic

        b) traditional chemotherapy is not to be taken forever – there are short courses of it which are meant to kill off or reduce tumour burden and it’s well understood that putting people on them for longer would be lethal and would not increase chances of killing of cancer cells

        c) no one would give you chemotherapy without having a test for you actually having cancer

        and

        d) no one is claiming that psychological distress does not exist but labelling it a medical problem is a different beast altogether

  3. “Tell that to Brian Williams and countless others who not only were not made better but often committed suicide despite or even due to these drugs.”

    I assume you mean Robin Williams? He was really depressed and probably suffered from Bi-Polar disorder way before he took ANY psychiatric drugs dude. He talked about it on countless podcasts and so forth. Do really think he just committed suicide because of just taking medication, be serious. He was diagnosed with Parkisons and suffered from pretty bad addiction.

    “none of these drugs has been shown to have a positive effect long-term – in fact there’s some evidence that they prevent spontaneous recovery hence making the problems chronic”

    The point is it is already chronic in some people though before medication.

    • Yeah, I meant Robin Williams, my bad.

      He was “treated” for his whatever supposed mental illness and it didn’t do him any good – that’s my point. If these drugs were so awesome, shouldn’t they prevent suicide? Oh, wait, they actually INCREASE the risk of suicide and violence. Wonderful when you give them to people who are already suffering from distress.

      Btw, addiction is also a serious problem and recent rise in heroin addiction is closely linked to prescription drugs.

      Some people may be very well not happy about their lives but psych drugs don’t make it better any more than booze and a heroin shot.

          • Sorry, lost my cool. I think comparing SSRIs to heroin or booze or something is counterproductive.

            To Steve McCrea,

            I agree with pretty much everything you say, you make a lot of great points. A lot of psychiatrists, especially working in mental hospitals, just throw pills without getting past history and so forth. I was in a mental hospital for a while, being a mental patient myself, most of the people there were abused by their parents or were abandoned, and the doctors would just prescribe medications to help them cope.

            I’ll give you some background. I was born with severe anxiety and OCD. I was raised in a pretty wealthy family with not really a history of mental illness. Ever since I can remember, I have had terrible separation anxiety from my mother, horrible panic at pre school, anxiety from pretty much everything (loud noises, ext). I was in therapy since the age of 3 and continued until 13, with no real progress until my mother threw up here hands and we decided to see a psychiatrist, this is when the SSRIs were really picking up steam. I have tried a couple, most of which did nothing, until I found one that completely changed my life. I am able to live on my own and go to university, and what have you. The difference in my anxiety is so profound I cannot even begin to tell you.

            Maybe I can get off these medications one day, but regardless of the consequences down the road, I really could care less honestly, it is a risk benefit, especially with psychiatric medications. Do I have a chemical imbalance, I think so. Why do they work so well if not? Therapy really didn’t do much, but it helped a little.

            These meditations aren’t for people who went through a break up or something. It seems a lot of people have horrible experiences with medication because they went through some trauma and went to a GP or something, then go around and say SSRIS are mass murder pills or something.

            Mental illness is a comprehensive treatment plan. Like for diabetes, you wouldn’t just take Insulin and continue to eat horrible food, then blame the Insulin is bad medicine. Medication should be used to were you can get to therapy and start that process. Some people can go to therapy and get over their depression or anxiety, some people can’t, it just is that way sometimes I think.

  4. LoganBerman,

    Thank you for explaining your background and that you are currently using SSRI medication.

    Now, I want to address something you said in your last comment: “It seems a lot of people have horrible experiences with medication because they went through some trauma and went to a GP or something, then go around and say SSRIS are mass murder pills or something.”

    Like you, for years I was convinced that my medication combo (Celexa and Xanax) were a godsend and that my life was so much better for them. Mind you they were prescribed by a Board-certified psychiatrist who is still in practice, not a GP. I took those pills for over a decade. My initial diagnosis was garden-variety depression and anxiety. He offered no talk therapy nor would he refer me to a therapist and I thought at the time that this was the normal method of treatment..

    What really happened over the years was that I lost any real interest in life and just went through the motions. My emotions were generally blunted, so I was not really depressed anymore, but I was not happy either. Toward the end I was getting angrier and more anxious, on the same dosages. I found myself drinking a lot of alcohol (SSRIs can tickle the alcohol receptors) at times. I gave up almost all of my hobbies and interests. My family members knew something was wrong but nobody suspected the pills until later on.

    Eventually became more hostile and angry, and did things totally out of character for me. Stalking, vandalism, assault, relationships with sketchy people. Very lucky not to have been arrested or worse. Had constant obsessive thoughts of suicide and like the Germanwings pilot, researched them on the internet. It was after an attempted suicide and trip to the emergency room (swallowed all the Celexa, (20, 20 mg pills) and a handful of Xanax with a bottle of booze) that I realized something was very wrong. It was like waking from a bad dream..angry, I went back to the psych..

    The psych wanted to raise my dosages. He blamed the “disease” because there was no way, in his opinion, that the drugs could cause such wild behavior. Mind you this behavior was out of character for me…I was a very mild mannered person generally. I fired him and never went back. I began the very hard work of weaning myself off of these drugs. It took the better part of a year to even begin to feel better again. No doctor, not even my family doctor, offered advice. If you look at some of my earliest posts here, you’ll notice I come off quite a bit irritable. I used tapering info found on the web. The first few months were sheer misery and I had to take time off from work. Today, drug free going on 3 years since I made the decision to come off. My life is so much better today.

    I will never tell you to stop taking your drugs. I will however advise you to read your product literature and anything else you can, including SSRI stories.com, and educate yourself about them. I hope they never betray you like they did to me and so many other people. It’s good that you are in therapy as well. The practice of drugging people without concurrent therapy, in my opinion, is nothing short of criminal.

    Be well.