According to a new study, about half of those who take antidepressants have tried at least two drugs without success. About a third have tried four drugs without success. The study illuminates the frustrating experience of these people, who are euphemistically labeled “treatment resistant” because multiple antidepressant drugs have failed to work for them.
“Qualitative findings revealed severe emotional distress and frustration with existing treatments, as well as organisational and illness-related barriers to effective care,” the researchers write.
The study was led by Kiranpreet Gill and Danielle Hett at the University of Birmingham, and published in The British Journal of Psychiatry.
According to the CDC, 13.8% of American adults had an antidepressant prescription in 2018 (18.6% of women; 8.7% of men; 24.3% of older women). This has likely only increased since the treatment boom during the Covid-19 pandemic.
This means that tens of millions of Americans every year are experiencing the side effects of antidepressant drugs without improvement, trying multiple drugs, and becoming labeled as “treatment resistant” when the drugs don’t work.
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Hmmmm…. So 85% of “untreated” depressed people recover spontaneously. But half of those “treated” with antidepressants DON’T recover. How about we stop using the term “treatment resistant depressant” and start using the term “ineffective drug treatment?” Seems the average depressed person is far better off staying far away from “antidepressants!”
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“According to the researchers, those with TRD had cardiovascular problems, functional decline, substance abuse, anxiety, and were labeled with personality disorders.” And then they got tardive dysphoria, while probably being surrounded by clinicians who act like programmed robots promoting yet another drug for treatment rather than looking at their (the patient’s) life and seeing that these people need something else besides acting like a pill (or shock therapy) is going to change your history. How oblivious do these clinicians have to be to what’s really going on with a human being to facilitate all of this? And I’m not surprised given what so many people believe. What they think will give them entrance to heaven for example because someone or some book told them that’s how it works. Well just hand them a pill and get a bunch of brainwashed people to repeat the superstition….
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But did they really recover or are they self medicating with other things?
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Sorry, not a relevant question. The AD’s did not work, whatever other means they may be using to cope. That’s the point. If you are more likely to recover without antidepressants than with them, then it’s not that they are “resisting treatment.” It means the “treatment” does not work!
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Why stop at questioning whether they self-medicated? Why not have the premise that then they’ve learned not to see sadness as a disease simply accepted it and it went away, as if there’s something wrong with that? Why not have the premise that a situation that is labeled as good for them like going to church or always believing what the teacher says all the time or the boss that they have stopped with such and there is something wrong with that? Clearly I’m being sarcastic. Furthermore antidepressants mess around with neurotransmitters the same as street drugs or what you call self medicating. There’s no proof that they treat any serotonin deficiency in fact in the end they cause serotonin deficiency because the body stops making as much when the re-uptake is inhibited. And you have the same problems with withdrawal symptoms and with antidepressants that can be extremely difficult as well as having to deal with clinicians that instead of helping with withdrawal symptoms or being at all educated in how to relate that as a recurrence of a disease they label as a chemical imbalance. There is no real substantive proof that depression comes from a chemical imbalance, however there is substantive to proof that the medications used to treat depression which is labeled as a chemical imbalance do not treat a chemical imbalance but cause one that did not exist before. Again there is no real substantive proof that depression comes from a chemical imbalance. That is science.
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Irrelevant question.
But for the sake of argument, what’s wrong with self-medicating? Psychoactive drugs are psychoactive drugs, period. Why are they any more “moral” or “healthy” if a doctor is prescribing them vs if a person is self-selecting & self-administering? They have the same effects on the brain & body regardless. Of course, different drugs have different effects on the brain/body depending on the drug, but drugs in general have the same effect. The body doesn’t care which kind is societally condoned or not. In fact, even calling them “medications” is misleading; they are simply drugs. There is nothing medicinal about them; there is no “chemical imbalance” or otherwise irregularity that they are “fixing.” If a person desires the psychoactive effects of these drugs (legal or not, prescribed or not) to help cope with their distress, that is their choice, and only they know themselves best. One may rebuke, “but only a doctor can diagnose and prescribe these medications, because they are a professional! A person cannot simply take that into their own hands!!” The doctor is not running any biomedical tests. They are simply asking a series of questions and then using their own subjective judgment. What gives their subjective judgment any more weight than the patient’s? The doctor simply serves as an authority figure and a gatekeeper. They are the “cop”– of the mind, body, and heart.
Second of all, there is no rule that people who are taking medications may not also be “self-medicating” at the same time. Why do you suspect that those who are unmedicated are more likely to “self-medicate” than those who are medicated? Why are you so quick to be more suspicious of unmedicated Mad people than medicated ones? Sounds like some sanism you might need to unpack there…
Third of all, if you are implying that they are not “really recovering” if they are “self-medicating,” then if in both cases recovery is chemically induced, then why is a prescribed medication-induced recovery any more valid than a “self-medication”-induced recovery? Or on the flip side, what makes a recovery due to “self-medication” invalid if you see a recovery due to prescribed medication as valid?
And last of all, why do you seem so eager to scrounge for reasons why a Mad person could not *possibly* be genuinely recovered & happy without medication? That it *must* be because they are doing something else (implied to be “improper” in your eyes) in order to cope, and that’s the *only* possible explanation for better outcomes? Just some food for self-reflective thought…
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One more thing I just thought of: Fifth of all, even if they are “self-medicating with other things,” you’re literally admitting that self-medicating is just as effective — no, actually, MORE effective! — than prescribed medication.
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That was my point. If doing whatever they do gives them better outcomes than the ADs, it stands to reason that on the average, the AD’s are not helping. Which really calls into question the euphemistic use of the term “treatment resistant.” The actual term should be “treatment failure” or “ineffective treatments.” The client isn’t resisting. Their drugs just aren’t doing what they claimed to do!
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What do MDs with depression who have been treated say? Well, I am one. Depression and anxiety, as well as bleeding, always stops.
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What are you saying? Are you saying that when you take antidepressants depression and anxiety for you always stops? As you can see this isn’t always the case at all for everyone at all. What does this have to do with bleeding? Are you trying to say that for you as an MD when antidepressants stop your anxiety or depression, and this always happens, then this is different than self-medicating? Are you trying to say that antidepressants stop depression the same as when you physically stop bleeding? And thus it always stops it. It doesn’t even work to say that depression comes from a deficiency of serotonin because in the end antidepressants cause a deficiency of serotonin; after the body has gotten used to the antidepressant it stops making as much serotonin because of the reuptake inhibition. This is hardly in any way comparable to actually stopping bleeding. I think when you stop bleeding it actually stops, it doesn’t cause a body to start making more and more blood until it pops up all over the place from the pressure. Are there any more comparisons you’d like to make? If that’s what you’re trying to do? I mean, you could say it’s like building a building and antidepressants are the bricks you need. Then here we go again if there’s not enough bricks then all of a sudden for a while you have somehow more bricks, maybe it’s because they don’t go someplace else. But then after a while, the source of bricks starts lessening because this is found out, integration or re-uptake then is inhibited, so in the end you can’t finish the building because in the end this is exactly the problem that you said you began with, but hey you need bricks for a building so it’s like antidepressants. And what was trying to be built, it might be that the sadness needs to be understood also and that suppressed even simply with being labeled as a disease necessary insight and natural intelligence has never been given the place to express itself. There’s a difference between making crude comparisons that don’t really hold up to logic and reality…. There’s also actually no proof that a lack of serotonin is a physical symptom of depression, when they looked at it there was normal levels, too much, too little. I’m just using your analogy, that even as analogy doesn’t add up. To begin with, you need proof that there’s a lack of serotonin, not just some mental construct that makes it sound like you’re doing something. And stating how you are causing more serotonin to be there as being the solution to the problem, and then leaving out oh yeah but after 4 weeks or so then there’s less serotonin because the body stops making as much when reuptake it’s inhibited. And then also leave out that you don’t really have proof that a lack of serotonin was a problem to begin with, which if it was the case isn’t even what the end result is at all. And if with certain individuals, which in this case is not a majority at all, for them their depression was a real problem and antidepressants stopped it, this does not mean it’s as simple as stopping somebody from bleeding because that sounds like you’re doing something medical. Stopping somebody from bleeding is not interfering with natural functions of the brain, and neither is this something that only works for a minority of the cases would one really look at the statistics beyond the promotion of that this is the solution…… And it’s not honest
that when anyone believes this is a solution they can take on all sorts of examples because they need to let everyone know that they found the solution. True responsibility is something else. Would you truly want to help people you need to go further than just making such statements. Wanting to help people is something different than doing something to help people. To help people, what you’re doing actually has to have that affect, and not just in certain cases which given articulate cognition are a minority. The ideology that it’s treating founded chemical and balance has to have scientific proof and that doesn’t exist. When the treatment shows to cause a chemical imbalance that needs to be shared with informed consent. And when there’s a certain group of people that treatment seems to help you cannot push science to the side and start making comparisons with other treatments that do work for the majority and in general. I don’t think for example that stopping bleeding causes 50% of the people to be listed as treatment resistant. I also don’t think that when someone is bleeding and it really needs to stop that when they don’t seek treatment 85% of the time they get better. Being a medical doctor that truly heals people is more than just repeating indoctrination from the drug companies. And it certainly is more than offering well this works for me so it works all the time same as whatever else can be warped into a comparison…. No matter how strongly you feel you need to do something this does not mean you’re making things better when following an ideology that says you are.
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Sorry, about my rather florid attempt at trying to respond, but I can summarize what I was trying to say while using autodetect and having so many thing to have to juggle regarding the plethora of misrepresentation regarding the topic, that it was difficult to organize to say the least! I do feel this isn’t completely unrelated to confusion technique where you get a person so dizzy that they give up for anything else than being indoctrinated…….
1) I order to say a treatment is treating a chemical imbalance, there has to be proof that it is treating a chemical imbalance, no causing one. Scientifically antidepressants correlate with causing chemical imbalance, they disable natural functions of the mind.
2) To talk about treating a serotonin deficiency, the treatment would have to increase serotonin, this isn’t the case with antidepressants. In the first few weeks, with the serotonin re-uptake inhibited there is more serotonin, because the re-uptake has been inhibited, but after that period the body has noticed it and adjusted, and you end up with the body making less serotonin. This means that after the initial period, the medications have cause exactly what they are said to be treating.
3) In order to say that depression is linked to a deficiency in serotonin, you have to have proof that that is the case regarding depression, that hasn’t shown to be the case, there was more serotonin, less serotonin, or normal levels when this was looked at, and there was no clinical difference. When people on antidepressants have lower serotonin levels because of the medications, this also doesn’t show that depression and low serotonin are linked, this shows the medications and low serotonin are linked.
Then there are the clinical trials, beyond these distortions of scientific truth. How many trials were done were the data wasn’t shared before they got the marginal results they wanted. And how long did they suppress the data showing that antidepressants caused suicidal ideation and homicidal thoughts? In the original trials already suicides occurred. Also they had to take people out of the counting when they got better without the antidepressant, which then is called the control group. I don’t see how that’s truly honest. And then in many trials people had to leave the non control group when the antidepressants they were taking cause severe side effects. This wasn’t counted as the antidepressant not working. Then they had to give the people in the trial a sedative as well, because of side effects, so this wasn’t a trial for antidepressants anymore, it was for two drugs. Then they had to get people into the trials that already were used to psychiatric drugs, people that were used to having the normal brain functions disabled by medications, or even people that had to agree with treatment of other psychiatric drugs or they would be found noncompliant.
Can one add that the trials consisted of people that found sadness or depression so disruptive that they felt it to be a disease? Was there any attention given to the effect of allowing a person to see the depression as a normal part of life, which might have an intelligence behind: which might end up promoting empathy for people who are suffering and thus make connections, which might show a person what situation they were in that was causing the emotional response, and then tend to that (get out of the situation, put something straight with someone etc.
To make comparisons with the body being able to cause clotting to stop bleeding from a wound, or how one helps the body to stop bleeding and antidepressants, this is quite……..
What would happen if 50 percent of people getting treatment for bleeding were considered treatment resistant, meaning the bleeding didn’t stop? And then were administered more treatments that again correlated with more relapsing!? And NO, this doesn’t mean that when 85% of people who don’t get treated for depression get better, that then we loose 15% (because they would bleed to death) because they needed to try antidepressants and stand that chance of going round the treatment wheel (no intention to insult axles). Or that the 15% had no other option when no treatment worked, or they couldn’t then opt for anything but suicide or homicide and thus needed treatment initially rather than no treatment, even though 85% would get better without it, despite the warning labels saying they could become suicidal or homicidal, which is what the medicines contained in the vessel with the warning label are supposed to be preventing with such necessary treatment, although the warning labels say you have to watch out that what they are meant to prevent isn’t the result.
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For a sizable portion of patients it is clear that antidepressants are very helpful and integral to their recovery. I am one of them. These medications saved my life. To date I have taken them for forty years.
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They don’t help everyone.
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I’m sorry but “a sizable portion” is not a scientific term, nor is it objective. The statistics HERE in this article shared ARE objective and scientific. As well as that in the long term antidepressants correlate with MORE relapsing: https://pmc.ncbi.nlm.nih.gov/articles/PMC4970636/#:~:text=Furthermore%2C%20a%20study%20of%20antidepressant,using%20adequate%20dosages%20of%20antidepressants.&text=Patients%20not%20treated%20with%20antidepressants,lowest%20recurrence%20rate%20(26%25). How they can cause sexual dysfunction: https://www.madinamerica.com/2024/10/antidepressants-linked-to-lasting-sexual-dysfunction-study-finds/ https://www.health.harvard.edu/womens-health/when-an-ssri-medication-impacts-your-sex-life How they barely show to work more than placebo, while there are numerous questionable things going on with the trials that show thus https://www.medicalnewstoday.com/articles/325767 https://www.madinamerica.com/2022/08/antidepressants-placebo-caution/ https://www.madinamerica.com/2022/08/antidepressants-no-better-placebo-85-people/ When in clinical trials, people have to be put on more than just the antidepressant but also on a sedative because of akathisia this isn’t a trial for antidepressants anymore it’s a trial for two medications; when anyone getting better in the initial period or a few weeks, from the control, group is taken out of the reckoning; when often those in the non control group (those GETTING the medication being tested), have to be taken out of the reckoning because they left the experiment because of severe side effects, when the weeks after the experiment when those in the non control group had to get off of the medications and had SEVERE side effects isn’t reported; when there were who knows how many trials and ANY trial not showing the results wanted were discarded; when then given all of that STILL there was only a marginal efficacy which often isn’t even considered therapeutic, then we really DO have problems.
And when simple data is shared, and this is questioned by someone like Silvia Price trying to stereotype the people that got better without treatment as self medicating, as if the general public that simply doesn’t go for an antidepressants suddenly is full of self medicating people when 85% get better without any treatment such, or the use of the term “sizable portion” to avoid looking at the real statistics and what happens to people that DO NOT get helped, this starts to show that there is a lack of perspective, as well as bias.
When antidepressants work for you, or anyone else, this DOES NOT change the statistics regarding the general public nor does it excuse it. Nor is it objective, or science!
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How is this relevant to the article? Congrats, I guess? For already falling in line with the mainstream narrative…? I mean, I’m genuinely glad you found something that helped you… I just don’t understand the need to announce it here.
A platform like Mad in America is meant to center the voices/perspectives/experiences of those *outside* the mainstream narrative, i.e. those who are marginalized by the mental health system… So you are welcome to be here if you’d like, but don’t be disappointed when you find out that this space is not *for* you or will cater to/align with your personal experience. Your experiences are not being invalidated by the fact that others may not share the same experiences and yours are being validated by the mainstream constantly, yet our experiences have been systematically invalidated & devalued. Let us have a space, too.
Side Note: Also, how can you ever really know that it was the medication that “saved” someone’s life? Maybe there were other factors that changed in their life that happened to coincide with when they started taking medication. Maybe the medication simply provided hope, or a placebo effect, and that itself was enough for a person to keep going or to relieve them of their distress. And furthermore, how can you know with 100% certainty that they would’ve died (presumably by suicide) if they hadn’t started taking medication? Furthermore, if we want to be completely fair, we must account for all the deaths that *do* happen due to the medications themselves. Many, if not all, psychiatric medications come with a black box warning of increased risk of suicide and self-harm. Perhaps there are people who find that their suicidal inclinaitons dissipate after starting antidepressants, but there are others (statistically more, read here: https://www.madinamerica.com/2025/02/observational-studies-confirm-trial-results-that-antidepressants-double-suicides/ ) who become *more suicidal* after starting antidepressants. The latter may come in two forms: 1) pre-existing suicidal inclinations may intensify, OR 2) in the absence of pre-existing suicidality, patients may begin experiencing suicidal inclinations for the first time. Of course, many will rebuke this with, “well isn’t that just their underlying mental illness?” and if I answer with, “well then why would they begin experiencing symptoms that they never had before?” then I’ll usually get hit with a “well because that must just be the natural progression of their illness,” and some will even say, “well maybe those who are prescribed medication had more severe depression in the first place.” While it does seem like a plausible explanation & difficult to separate what’s caused by the “illness” vs what’s caused by the meds themselves, multiple studies using comparisons of medicated vs non-medicated patients with the same diagnoses and equally matched degrees of severity have concluded that medicated patients experience *more* decline over the same amount of time than their non-medicated counterparts, and have a *higher* risk of suicide overall. Meaning that not only do their suicidal thoughts & feelings increase, but their rates of attempting suicide & dying by suicide increase as well. Of course, these are *averages*, they won’t be reflected in the experiences of every single *individual.* But those who claim to benefit from meds are actually just a loud minority (whose voices are amplified even louded by psychiatry itself as “success stories” and “proof”). Aligning with the mainstream narrative doesn’t necessarily mean you’re in the majority, just as being marginalized doesn’t necessarily mean you are a minority. Women make up half of the population, and yet we’ve been marginalized by society for centuries. It has way less to do with numbers & way more to do with who’s given a voice & a seat at the table. Unfortunately, with the “mentally ill” (or as we like to say, Mad), anything we say, think, or feel that doesn’t align with the mainstream mental health narrative can be attributed to our “underlying mental illness” and therefore dismissed as invalid. Quite clever, really– in a warped, twisted way.
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Nicely articulated! I will add that in Antidepressant trials, those with preexisting suicidal ideation are almost always excluded. So finding an increase in suicidality can’t be explained by the client already being suicidal and his/her “disease” worsening. In any case, it is clear that on the average, there is certainly no argument that ADs REDUCE suicidality. At best, they have no effect, but it is likely that the overall effect is to increase the average risk, whatever individuals themselves may experience.
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So 50% isn’t a large enough statistic to break the false dichotomy for these fact-and-figure-driven docs?
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Why don’t doctors ever question themselves and their treatments? If they suspect a treatment isn’t working, why not question the treatment itself instead of throwing shade at the patient?
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This inability of doctors to see that it an AD prescription may be ineffective is the main reason my son was killed. Ineffective, so the dosage was raised 10, 20, 30, 40 mg fluoxetine. At 15, he felt sad over friend issues. A clinical counsellor said you need AD, and “not telling my dad is a good option”, he texted a friend. A “family” MD put him on fluoxetine immediately and raised the dosage over and over. A child psychiatrist saw him over Zoom and labelled feeling sad as “mental illness”. Dexter’s last message to a friend, as he was handed a 40 mg prescription, said he was told “stronger” would “cure”. No need to tell your dad. “I would tell my dad but it’s gone on too long and it’s embarrassing.”, he texted. Then days later, without a word, note, or symptom anyone could see, he killed himself at 15, in the room next to me. Medical authorities deemed it acceptable. I’ve now written over a hundred pages of complaints. Meanwhile, other patients are told they need a higher dosage or a different AD, but the negative effects increase in response to dose even though positive results do not. So it happens again. Dexter was destined for both music and medical school, ironically, and planning his rich life. Ramping up ineffective AD kills.
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I wish I knew what to say, I just cry reading this…..
Who is really mentally ill, the patient or the rest of them…..(!?)
They can’t see what they are doing to another person, to society!????
They can’t even read the warning labels?
They can’t see what the negative effects are?
They say they are helping a person, but they don’t even have the ability to actually
provide the space for that person to unburden himself?
I don’t know what to say about it. Their “ideology” is more non reality based, than the people they decide are “mentally ill.”
And they make someone feel there’s something wrong with them, as if when their treatment doesn’t work there’s something wrong with the patient, not the “cure,” and it becomes so embarrassing for their “patient” that…..
I don’t know what to say, I’m at a loss for words…..
I guess I don’t see how with the warning labels that are in place, although the drug companies tried to prevent it, how they can get away with supporting not telling a family member, when it’s known that these “medications” can cause suicidal ideation, and it says numerous places that that should be monitored (one would think they are responsible then to tell the family where the child lives, given the warning labels), yet they said it was a good option to not tell the family. The people they live with and thus who they then could relate to regarding what the effects are of drugs that are known to cause such!? Clearly it was not monitored by the professionals, the professionals themselves didn’t monitor it, and they prevented the child from telling his family, so the family could monitor the effects, neither did they tell the family themselves……
Isn’t that what they are required to do?
Neither do I see that failing to provide proper monitoring can be excused because it makes the drugs look bad, that then someone won’t keep trying treatment. There are already the warning labels in place.
Or if they actually take proper measures, and it’s known a person should be monitored that suicidal ideation can occur, then people not taking the drug, because it looks bad, might cause them to not heal from depression. Given looking at real statistics I don’t see that you can really back that up when being articulate and reality based……
Awhile back, someone heralding antidepressants mentioned how she couldn’t feel till she was on them. Then there was further discussion. And when I simply mentioned allowing the feeling some space to do what it does naturally, that emotions can be amazingly multidimensional. That they might just have a natural intelligence. And added more, because all art might be expressing this. And then she went on about “just a human emotion….” It’s like, did she want to feel or not, she said the antidepressants had helped her feel, but then feeling or just a human emotion…. or feeling……
It’s like people promoting avoiding a human response, because that’s just not accepted, rather than allowing it and making room for it……and it’s success to………
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