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Mindy

@msy1168

IL Katılım Mayıs 2011
263 Takip Edilen78 Takipçiler
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Dr. Josef
Dr. Josef@DrJosefWD·
Here are 5 reasons you might want to avoid long-term use of antidepressants that your doctor never discussed with you. Before I launch into this, I want to emphasize that this post specifically addresses reasons to consider avoiding long-term antidepressant use. I say that because I believe that antidepressants are safer for short durations. If you stick around until the end, I'll share when I think it makes sense to use them both in the short and long term 1) They likely don't get to the root cause. To understand why they don't address the underlying cause, we first need to discuss what the causes of depression are. Currently, there is no evidence of any underlying abnormalities in people who have depression. Researchers have been looking for a long time and haven't found any chemical imbalances. However, there is a large amount of evidence showing that life stressors, when compounded, push people into depressive states. For instance, severe stressors (like the death of a loved one, divorce, the loss of a child), prior trauma, abusive relationships, poverty, feeling trapped in employment you dislike, etc. In addition, even medical conditions and dietary problems are known to impact depression and anxiety. Having worked in this field for nearly ten years, I can say I hardly ever meet someone who doesn't have a compelling reason for their depression after I've spent a significant amount of time getting to know them. Unfortunately, most people today experience a conveyor belt-like process in doctors' offices, where they meet for 25 minutes, fill out a questionnaire, and then are offered an antidepressant. Most people are aware that their doctors haven't really tried to get to the cause of their depression; they simply identify the symptoms and then offer to "treat" them with medication. The problem with this approach is that if you have genuine issues causing your depression, you've essentially turned off the smoke detector. Instead of using your emotions to inform you to search for and fix the problems, you might end up never working on maladaptive traits that aren't serving you. You might stay in a job or relationships that aren't right for you. You might be ignoring signs that your diet is insufficient and not nourishing your brain properly. You might be missing that caffeine or nicotine use is impairing your mood and disrupting your sleep. So, it's like putting a piece of tape over the check engine light, which can be detrimental to long-term emotional health 2) You never get used to handling your full range of emotions. Another reason you might want to be wary of long-term use of antidepressants is that they mute your full range of emotions. This is, in fact, their primary therapeutic effect. Having spoken to thousands of people on antidepressants, and having taken them myself, the clearest way I can describe their effect is by inducing emotional constriction. That is, you don't feel your full range of emotions; it constricts the highs and lows. While this can be helpful, especially when someone is severely anxious and unable to function due to the anxiety, it becomes problematic in the long term. These drugs are not selective in how they blunt your emotions. For example, many people report disliking the global blunting of these medications. Some say they cannot cry in sad movies or at funerals. Many artistic people say they begin to struggle to access the same level of artistic creativity they had previously. Others say they feel less motivated to do things like exercise or socialize, even though they "know" they should want to. Some people, dislike how the medications reduce their level of emotional attunement to others. They find themselves less sensitive to the emotional states of those around them, like their partners or children, and sometimes struggle to manage their relationships effectively. Because the truth is that antidepressants act like a cast for a broken arm. They can be beneficial at the start if you are so anxious and overwhelmed that you need something to restrict your emotions range. But just like a cast, if you leave it on long term, it's bad for you. Like how when you leave a cast on too long the muscles in your arm begin to atrophy and weaken. And this is exactly what happens with long-term antidepressant use: you start to lose your ability to function with your full emotional and cognitive abilities. If you take antidepressants long-term to mute your anxiety, the collateral effect is a muting of your other cognitive and emotional systems. This can be detrimental because your cognitive and emotional functioning is there to help you navigate the world as effectively as possible. 3) The tolerance problem The next reason you may want to consider not taking antidepressant medication long-term is the tolerance problem. Antidepressants work primarily by disrupting our neurotransmitter systems. That's how they produce their unique drug effect of emotional constriction However, what is often forgotten is that these neurotransmitter systems are not just involved in the functioning of our mood but are also involved in the global regulation and functioning of multiple systems, such as the digestive and cardiovascular systems. When you take these medications, these systems don't appreciate being thrown out of balance. As a result, something called homeostasis kicks in. Homeostasis refers to the adaptive changes in the body designed to counteract the effects of the drugs. So, what happens with antidepressants is that the brain changes to counteract the effect of the drugs on the body. This is why many people find that they work well for a short period of time and then later only partially work, or they even start to struggle to identify what they're really doing. Consequently, for some people who really needed the potent acute effect of the medication, they begin to feel like the drug isn't working anymore, and then they start to gradually increase the dose. However, with each increase, further tolerance develops, and they get used to the higher dose. Eventually, they cannot increase the dose anymore, and then they need to add on another drug. This is how some people start with one drug and before long, they end up on 3 or 4 different medications. Unfortunately, once they're on 3-4 medications and their body has adapted to them, they will still feel depressed or anxious. But now, they may have multiple side effects, or might even feel worse due to the unpredictable effects of having 3-4 different medications fluctuating at different levels through their bloodstream throughout the day. In many cases, I see people in this situation get diagnosed with treatment-resistant depression and then start on increasingly risky treatments such as TMS, Ketamine therapy, or even ECT. In addition, Clearly, once you're on this many medications, it is also very challenging to get off them safely. 4) Side Effects The next reason why you might want to avoid long-term antidepressant use is the side effect profile. This video is too short to discuss them all, but I will touch on a few that tend to be most important for people. First, there are the sexual side effects. Many people struggle to enjoy intimacy in the same way as before they got on the medications. This can impact someone's self-esteem, but also their relationship. In uncommon instances, the sexual dysfunction does not resolve when people come off the medication and can cause enduring dysfunction for years. Second, there are the metabolic side effects of antidepressants which include weight gain, higher lipid levels, and higher blood glucose. This is especially problematic with the antipsychotic medications typically used as antidepressants. Given these side effects, which may impair quality of life and also duration of life, you should have very strong reasons for taking these medications long term. 5) Long-term Discontinuation Challenges And finally, the last reason you might want to avoid taking antidepressants long-term (this is especially relevant if you've only been on them for less than a year) is that they can take a really long time to come off safely. Unfortunately, this has only been recently acknowledged by mainstream psychiatric groups. For the longest time, the medical community was told these drugs could be stopped relatively quickly and that the withdrawal would be time-limited and mild. However, over the last two decades, we have seen a dramatic increase in the number of people who are having great difficulty coming off these medications. It's not clear why some people are able to come off quickly, while others have a much harder time. However, it might be due to individual differences in the ability of the brain to readapt quickly after the medications have been removed. Individuals who are less adaptable to coming off the medication find they develop severe withdrawal symptoms that can go on for months. And unfortunately, some of these people go on to develop a brain injury caused by protracted withdrawal, where they continue to experience withdrawal-type symptoms for several years, which don't go away when they get back on the medications. So avoiding long term use is the best way to avoid dealing with a tricky withdrawal or the risk of a protracted withdrawal injury. So, those are my top reasons why people should avoid long-term antidepressant use. As I mentioned at the beginning, given these considerations, where do these medications fit in psychiatry? For the vast majority of people, they should be avoided if the person will improve with time or with non-drug supports or therapy. If their symptoms are so severe that they're paralyzing, these medications could be used short-term to help them break out of these paralyzing mood states. Immediately after this, they should engage with healthcare, dietary, and counseling professionals to have a comprehensive plan put in place to identify the actual cause of the problem and address it, so the person can come off the medications as soon as possible. If no cause for the symptoms can be found after a comprehensive assessment of stressors, medical problems, and dietary issues, long-term use could be an acceptable treatment choice. So, there you have it: my top reasons for why you should consider not taking antidepressants long-term and where I think they could fit in psychiatric treatment.
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Mindy
Mindy@msy1168·
@botanical_farms scammed my elderly mother. She’s on a fixed income and they charged her $199 for a second order she never placed. Customer service didn’t gaf when she called to complain. Stay away from this company. @bbb_us @KwameRaoul @ILAttyGeneral
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Doryatthelake
Doryatthelake@doryatthelake·
@botanical_farms Scammed! Do not buy from these people. Ordered 39$ package and was charged 199.98 and 54.
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Mindy
Mindy@msy1168·
@enterprisecares Maybe don't confirm an online reservation if you can't actually provide the vehicle.
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Mindy
Mindy@msy1168·
@garthbrooks @garthbrooks Loved you since the beginning but disappointed in you now. Hard to say we have to take care of each other in one sentence and not require masks at your concerts in the next.
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Mindy
Mindy@msy1168·
@CNN Now that the presidency and impeachments are over can you go back to covering the whole country and maybe some of the world again?
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Mindy
Mindy@msy1168·
I've tried @FedExHelp but my packages are still being delivered incorrectly. Today it was at a house 2.5 miles away. @Walmart @Chewy @TGW_tweets I don't have this problem with @UPS, maybe you want to try them.
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