It's not some earth shattering revelation that "SSRIs don't work for many people". This has been known since SSRIs first appeared on the scene. This is also true of any other treatment you can think of. The reason they became the first choice as far as antidepressants go is they were a lot safer and better tolerated than the older alternatives. Besides, there's a lot more to psychiatry than just SSRIs. But with people like you it's always about SSRIs. Can't shut up about the SSRIs. If you hadn't noticed, this new drug is not an SSRI!
Psychiatrists recommend therapy, they recommend changes in diet and they recommend exercise. Clinical psychology, though technically a separate discipline from psychiatry, not being under the umbrella of medicine, is very much developed, researched and practiced in tandem and cooperation psychiatry, and vice versa.
You're constructing an elaborate strawman here, where the only reason for using drugs is some evil financial motive. It's just not that simple. There bad apples, and perverse incentives, but not only bad apples. Most doctors do in fact care about helping their patients.
Therapy can't fix everything. Therapy alone is not always sufficient and can be just as hit and miss as medication. Not everything is some deep personal issue that needs to be analysed and resolved. Mental disorder is often genetic, even neurological in nature. All the therapy in the world won't stop a bipolar person from cycling between mood disturbances, or someone with ADHD from being unable to concentrate.
We can't throw the baby out with the bathwater. Medication, therapy, meditation, diet, exercise, sleep hygiene are all part of the psychiatric toolbox.
Looking at how many people are medicating for mental health issues in the west (or world), I find it extremely unlikely this is because all these people have gone through therapy, exercise and diet and they have to take medication.
No. It’s the easy route to some sort of medicated happiness, and it’s profitable, so everyone does it.
But this many people shouldn’t be doing it. They shouldn’t be taking the easy route, because it’s not dealing with many issues we should be dealing with, as society and as individuals.
Saying it's "medicated happiness" is ridiculous fearmongering. Antidepressants do not make you happy. They do not change how you think or how you act. They can't. If you think they do, you do not know what you're talking about.
You know why my wife had PPD? Because being a mother is hard, and she also had a lot of unresolved anger and issues towards her own mother, and she was reminding herself of her own mother and causing quite a bit of anxiety. We were also at an extremely difficult part of our relationship, we basically hated each other for a year.
What did we do? We both went to therapy, and asked the hard questions about why this was happening, and how to resolve them. My wife spent 6 months in therapy and resolved the issues with her mother, and now she is happy with her own performance as a mother. We went to couples therapy, which was extremely hard, but after over a year, we are basically in love again, and we are STARTING to understand what patterns are causing our issues, and how to deal with them.
We took no medication. But we were on the road to depression, but decided to actually look behind WHY this was happening.
Popping pills of course is much easier. You don't need to face your demons, or your parent's demons.
The trouble is it is at crucial times in life like childbirth when these demons emerge. Yet hardly anyone wants to face them anymore. This is not mentally healthy. And what's even worse, you are very likely to pass on many of these issues to your children if they remain unresolved.
I know this is counter to 70% of what americans believe in, but it's the hard truth, and I think many people deep down know this is the truth, but it's just much easier to take pills and bury the fact that EVERYONE has mental issues that need resolving, without taking medication.
I'm not talking about the extreme cases btw. I know in some instances medication is necessary. But it is WAY overused, to get out of making hard choices.
To further illustrate the accessibility point when I lived in Canada therapy was not covered by the public health system and is entirely out of pocket.
In the US it obviously depends on the highly variable coinsurance/copay and assumes you can either take time off work or find a provider that works outside of business hours.
A 30-day supply of Lexapro is $4.50 and also has evidence that it works.
You and your spouse have had your experiences which are completely valid and true. Your truth does not invalidate others' truth. This medicine is for them, not you.
However your experience seems to prevent you from seeing the bigger picture.
"Popping pills" is probably chosen not because people don't want to solve problems and change their lives. It is probably because it is only available solution at that time to actually function as a person and member of the society.
It is great that you had money and event time to go to therapy for 6 months as new parents. A lot of parents of newborns will simply not be able to afford it both financially and because of time constrains. Did you bring your new born to the therapy? How much did it cost? Would every single mother be able to afford 6 months of therapy? Some middle-lower class family? Some family in very rural area? Please try to see a bigger picture here and befriend more people from different paths of life.
People take pain medication for back pain not because they don't want to fix their backs. If anybody could fix their back today instead of taking pills they would do it.
Initial treatment recommendations:
For mild to moderate postpartum unipolar major depression, we suggest psychotherapy as initial treatment. This approach is consistent with multiple practice guidelines, and is especially useful for lactating patients who do not want to expose their infants to antidepressants.
However, antidepressants (eg, selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors, bupropion, and mirtazapine) are a reasonable alternative if psychotherapy is not available, not successful, or is declined, or if the patient has previously responded to antidepressants.
In addition, combination treatment with pharmacotherapy plus psychotherapy is useful for some patients.
Source: UpToDate.
> And you don’t even know if it works.
While evidence for SSRIs is weak in meta-analyses this is not one of them. I will also agree that a single trial (i.e. the original post and what led to approval) is not definitive but does in fact suggest it works and will continue to be assessed in post-market studies.
If you only found out 2-3 years ago that SSRIs don't work for many people that's decidedly a you-problem. Psychiatry has known this for ages, which is one of the reasons that depression treatment is still tricky. You have to try what works for each person individually. And usually it's a combination of things.
SSRIs don’t work for many people and we only found out 2-3 years ago.
Opioids were prescribed to half of America for back pain.
That gives scope for healthy scepticisms at least. Just because you might have some anecdotal evidence of some chemicals working, doesn’t mean it works for others or that it leads to a good place.
Lastly - there are clearly lifestyle and even moral choices that people make or don’t make that can lead to mental health issues. Just from a common sense perspective it seems much healthier to try and deal with these first, with therapy, than just medicating. And not just therapy. Exercise, diet. We know these affect mental health, yet pills are easy, and they make doctors money.
medicating is much easier than searching, finding and healing the cause. Therapy takes years, if not decades. I can understand why people pick the easier route, but easier is not always better. Also, are you just permanently going to be on pills then? I mean it’s a great subscription business, I can see that.