Depression, Anti-Depressants & Mental Health - Do The Tablets Actually Work?

It's a debate that has gone on as long as anti-depressants have been available: Do they actually work or is it all down to the placebo effect? In my professional circles, social media has long been littered with those who are advocates of anti-depressants in the treatment of depression (often those who are or who have found personal benefits from them) and those who can only be described as opponents of them (often from a philosophical or anti-big-pharma standpoint). 

I've worked with hundreds of people with depression (and anxiety). Some chose not to start taking anti-depressants; of course they are entirely within their rights to make this decision and to pursue other sources of effective help. Some people who come to me are taking anti-depressants and noticing no change from taking them or report they are finding them only partially helping to ease their symptoms and so are seeking additional support. And of course there will be others who are prescribed anti-depressants and who find them completely helpful and so don't require any other therapeutic help.

My view, which I can state upfront, is that it is up to each individual to make the decision that suits them best. When someone comes to work with me, they may or may not be taking anti-depressants, yet either way we work with their individual situation, thoughts and feelings to make progress. Following this progress, my client can then go back to their doctor to discuss the possibility of gradually coming off the tablets if they wish to do so (and with the full co-operation, advice and review of their doctor). 

Sadly there are also still too many therapists (of many types) who seek to impose their own views upon clients and who, despite not being doctors or knowing the person's medical history, still suggest to them they should stop taking the tablets (usually with the advice to seek treatment from that therapist). In my view, this is both unprofessional and unethical and should be a big, bright waving red flag if you ever hear such assertions.

Anyway, I digress slightly as the main focus of this article is the recent study that has found that anti-depressants are more effective than placebos at reducing symptoms of acute depression in adults.

Anti-Depressants & Depression Symptoms

The study, which was published in the Lancet, looked at data from 522 studies, which included 116,477 patients who were taking one of 21 anti-depressant drugs or placebo.  The report found that 'all anti-depressants included in the meta-analysis were more efficacious than the placebo in adults with major depressive disorder.' The report also compared findings for different anti-depressants and found that some were more effective at reducing depressive symptoms than others.

So in summary, the reports says that the drugs are doing something more than just a placebo effect with regards to adults with major depressive disorder. And of course this is good news for those who are taking anti-depressants for depression and finding them beneficial as it gives solid evidence that they do have an effect. In fact, there were many stories published around the time of the report findings suggesting that millions more people should be given anti-depressants. 

However, this report is by no means the end of the story or the final word on depression and anti-depressants.

As the report itself states, there are a number of limitations when looking at the data. For example, the report only looked at results after eight weeks of treatment and so we don't know if they are the same after long term use of anti-depressants. 

The researchers only analysed average treatment effects and weren't able to investigate possible differences in results at an individual level, for example, based on age, sex, severity of symptoms or duration of illness. They also weren't able to look at specific side effects or withdrawal symptoms or how the results compare to the results achieved with other forms of therapy (in combination or as an alternative). 

So the net effect is that those who find anti-depressants helpful can potentially cite the study as supporting the fact that the medication does do something (and is not just placebo as some previous research had suggested). Yet those who are against taking medication can just as readily point to the limitations of the research.

Of course we could also debate whether all of this is just looking at the end results of depression and perhaps we should be researching and taking action to reduce the likelihood of it occurring in the first place.

All of which leads to the same conclusion, that is, if you do not wish to take medication for depression or the anti-depressants are only partially helping with depressive symptoms, then the most effective action for you, as an individual, may well be to seek additional therapeutic support that will help you to feel better.  

To your happiness and success,

Dan Regan

Hypnotherapy Ely, Newmarket, Skype