POZ Community Forums
Meds, Mind, Body & Benefits => Mental Health & HIV => Topic started by: OneTampa on December 27, 2012, 12:15:28 pm
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Interesting article in The Washington Post noting move to use anti-depressants to treat grief, a departure from previous psychiatric guidelines...
Excerpt:
"...It was a simple experiment in healing the bereaved: Twenty-two patients who had recently lost a spouse were given a widely used antidepressant.
The drug, marketed as Wellbutrin, improved “major depressive symptoms occurring shortly after the loss of a loved one,” the report in the Journal of Clinical Psychiatry concluded.
When, though, should the bereaved be medicated? For years, the official handbook of psychiatry, issued by the American Psychiatric Association, advised against diagnosing major depression when the distress is “better accounted for by bereavement.” Such grief, experts said, was better left to nature.
But that may be changing..."
http://www.washingtonpost.com/business/economy/antidepressants-to-treat-grief-psychiatry-panelists-with-ties-to-drug-industry-say-yes/2012/12/26/ca09cde6-3d60-11e2-ae43-cf491b837f7b_story.html
Again, as I noted here on a Boards before, the mental health assistance trend appears to go toward less talk and more pills.
::) ::)
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My reaction was a resounding hell no when I read the title of the topic , and after reading the link I'm even more dumbfounded that anyone can think normal grieving is something to be avoided and numbed . I think people rushing to the doc when a loved one dies so they can numb and stuff the feelings of loss some where to be forgotten and not fully expressed and dealt with could lead to problems down the road . I'm certainly not qualified to make the distinction but that's how I feel .
I'm on an antidepressant to help stabilize my mood and to help with my chronic pain condition , so I'm all for people seeking help and even using medications when needed .
When I was in my 20's I sought help for depression and was lucky enough to find a psychologist who wasn't pill happy , after listening to me for an hour he gave me some advice that has served me well for the rest of my life . He looked me right in the eye and told me that you are depressed because your life sucks , stop living a sucky life and I bet your depression will lift .
He then helped me sort out the things that were making my life a challenge and causing the stress and my depression did ease up once I , with his help improved my life . I'm fortunate I didn't find myself being treated by a doc that wasn't interested in working through my feelings instead of just numbing them .
I want to feel grief for the people I may lose in life just as surely as I want times of happiness and peace . I think that article stinks ... not to mention the drug company's pushing for it just to make a buck . I don't like it .
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My reaction was a resounding hell no when I read the title of the topic , and after reading the link I'm even more dumbfounded that anyone can think normal grieving is something to be avoided and numbed . I think people rushing to the doc when a loved one dies so they can numb and stuff the feelings of loss some where to be forgotten and not fully expressed and dealt with could lead to problems down the road . I'm certainly not qualified to make the distinction but that's how I feel .
I agree 100% with you Jeff, and I believe it can lead to problems down the track if people are medicated in order to suppress their grieve for lost loved ones, to be able to grieve and shed tears, IMHO, is all part of the healing process.
Aroha
Jan :-*
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I am actually on Wellbutrin, have been for some years. It never covered up the grief I felt for my parents' deaths. It may have kept me from going over the edge from the depth of the grief.
I'm not for covering up feelings and believe psychiatric medication used for depression should be coupled with therapy. I did find it suspicious that the doctors pushing for the use of Wellbutrin have benefitted from the drug company. But one hand washes the other.
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totally agree too that suppressing this kind of grief with pills is not the way to go
anyone that has lost a spouse knows that the "healing process" portion of grieving continues on throughout the rest of the surviving spouse's life. Quite simply, losing a spouse is something you never "get over". It's a hurt that never completely heals. It's very different from the grief of losing parents or friends. (although it may be similar to the grief over losing a child). To numb that kind of grief, a person would have to remain highly medicated for the rest of their lives (because one never knows when grief and depression over a lost spouse can hit).
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I think anti-depressants definately have a role for certain people who have severe, underlying problems and they can serve to stabilize them and keep them from doing something bad to themselves. I have dealt with anxiety for years, but I'd rather deal with it day by day myself than be medicated and have a ton of nasty side effects on pills. I have also had bouts of depression before, as I'm sure many have. That being said, I think grief is a natural process and people shouldn't run away from it. You have to face up to it, be strong, and deal with it so you can move on. You can't let yourself get consumed by it. I've found that such things are taking a nice quiet walk, or hanging out with friends, or going to the zoo, or art show, always lifts me up if I am in a down mood. And it doesn't come in a bottle!
I think doctors shouldn't be so quick to shove pills in our faces after a 5 minute visit instead of talking to the person and possibly discovering the root of their depression. We have become a pill-hungry culture, doctors no longer get to know their patients, it seems like they just want to throw pills at them and rush on to the next patient, like it's musical chairs. I guess everyone is different, but I think complex, difficult emotions are natural and can make someone stronger if you can overcome them. I know someone who took Valium way back in the day for depression, and now she regrets it and says it made her totally numb and she felt like a zombie. So I think anti-depressants can be a good thing for some people if used correctly, but doctors need to take more time assessing their patients' particular needs & concerns and not just throw pills at everyone. My doc wanted to start me on zoloft, but I sure as hell am not going to take it because I'd rather cope on my own than pop a pill. I think people should learn more coping skills and learn how to deal with their emotions and if that doesn't work medication can be a viable alternative. But pills shouldn't be a go-to stand-alone option for depression.
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I'm with Jeff, Jan and Betty on this.
Especially this...
I'm not for covering up feelings and believe psychiatric medication used for depression should be coupled with therapy.
Why aren't they recommending therapy for grief? Popping a pill is only pushing "dealing with it" down the road. Several times I've thought about seeking therapy to help me with the grief of my moms death...I would laugh in any doctors face if he said a pill would take care of it.
This is simply a money grab by Big Pharma, and this makes me sick...Drug companies have shown an interest in treating patients who have recently lost a loved one, having sponsored and published the results of at least three trials in which the bereaved were treated with antidepressants, including the Wellbutrin study.
Granted, in some case Medication may be warranted, but overall I think Talk Therapy would be better for Grief.
-W
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I am actually on Wellbutrin, have been for some years. It never covered up the grief I felt for my parents' deaths. It may have kept me from going over the edge from the depth of the grief.
I'm not for covering up feelings and believe psychiatric medication used for depression should be coupled with therapy. I did find it suspicious that the doctors pushing for the use of Wellbutrin have benefitted from the drug company. But one hand washes the other.
That article is mostly about the shady and unfortunate connections between companies, the APA, and research. That article does NOT explain what the research found - what the benefits and experience might be of using antidepressants for deeply depressed people in mourning.
I agree with BT65. People should be careful not to apply romantic and/or value laden judgements to criticize the use of antidepressants, to judge the drugs themselves.
Who is to say that leveling out or alleviating a depression is a counterproductive to successful grieving? The effect of the drugs may actually help certain people grieve, and get it together again. If someone is in a black hole, seeing nothing clearly. Overcome with sadness or loss, or loss of hope and interest for the future of living. The drugs might actually help to feel.
Its quite metaphysical as a question.
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I'm with Jeff, Jan and Betty on this.
Especially this...
Why aren't they recommending therapy for grief? Popping a pill is only pushing "dealing with it" down the road. Several times I've thought about seeking therapy to help me with the grief of my moms death...I would laugh in any doctors face if he said a pill would take care of it.
This is a frequent global judgement and misconception about antidepressants. In fact many people benefit from antidepressants because they ENABLE the person to deal and feel in the here and now. And NOT avoid, not be deluded, not be overcome by darkness, pain, anxiety, etc etc etc.
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This is a frequent global judgement and misconception about antidepressants. In fact many people benefit from antidepressants because they ENABLE the person to deal and feel in the here and now. And NOT avoid, not be deluded, not be overcome by darkness, pain, anxiety, etc etc etc.
If this is what you got out of my thoughts on the article then I think you may be twisting my words . I thought It was clear enough this article was suggesting treating a person that is grieving with antidepressants because they are anticipating depression that has yet to be seen . It sounded to me like they were saying normal grief and depression are one in the same ... and that sounds a bit to convenient for the ones who would profit from that assumption .
I take antidepressants so believe me when I tell you I know they a a necessity in some cases . My comments were about the article and how the drug company's are actually trying to make a case for antidepressants in situations that doctors have been traditionally reluctant to use antidepressants for ... all for increased sales .
If a doctor and a patient thinks that depression is something other than situational depression , that's a different story .
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The quote is from Willy, not you. ::)
Sounds like we can all agree that pharma is out for a profit.
I read the article and it was pretty much about the business and ethics. Not about the use of drugs to treat depression.
I wouldn't think routinely handing out antidepressants to people in mourning is a good idea. But in special cases, why not.
My qustion about the quote from willy stands. I do think that people have this belief that antidepressants "put off" problems.
Whereas you, BT, and I can attest that the drugs can in fact help people deal with both depression and getting on with life. So if a doc thinks someone is too far gone in grief, so what if they give drugs a try.
People commenting at the beginning of this thread seemed to be poo pooing that idea.
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anyone that has lost a spouse knows that the "healing process" portion of grieving continues on throughout the rest of the surviving spouse's life. Quite simply, losing a spouse is something you never "get over". It's a hurt that never completely heals. It's very different from the grief of losing parents or friends.
Well, not quite. Sometimes people never get over parents deaths, or even friends. It's been a few years since my parents deaths but I still cry from time to time and frequently at the holiday season. It depends on the person's experiences with the person who has passed. In my case, my parents were always there for me no matter how rotten I was during being strung out. I will never forget that, nor the extra miles they went for me. I will never get over that. So to say losing a spouse is "different" than parents because a person never gets over the spouse, is inaccurate.
I can honestly say I do not miss my first husband. I have more grief for my parents than for him. Every person's situation is different and you cannot apply your own feelings to all persons. We all need to be very careful when thinking our own feelings apply to everyone.
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So to say losing a spouse is "different" than parents because a person never gets over the spouse, is inaccurate.
losing a spouse is incredibly different. While losing any other relative or friend may be emotionally devastating, it is in no way comparable - especially when those people live in another home of their own. The person paying the other half of the bills, doing the other half of the chores, sitting across from you at the dinner table, and lying in bed with you every night is gone. (many elderly people often die soon after their spouse) Even if you don't particularly like your spouse at the time of their death, their absence from the house will change how your daily life is lived and handled. A person's life is never MORE changed than when the other half of a couple passes away.
I can understand giving someone drugs to assist them through a rough time; but with so many radical changes happening when a spouse dies (eating habits changes. People often have to move to another home. etc) putting someone onto anti-depressants just because their spouse dies seems like a cop-out to helping that survivor learn to cope with their new daily existence.
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losing a spouse is incredibly different.
No two bereavements are exactly alike, they're ALL incredibly different. This isn't a contest of who grieves the most for whom. I still miss my father more than forty years after his death and while it may be different from your own experience, you cannot fathom the depth of my grief or say that losing a life-partner is worse.
It's all subjective and very, very personal. So please don't try to imply that losing a parent is lesser than losing any other loved one in your life. That's what it felt like you were saying - if I got you wrong, so be it.
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I can understand giving someone drugs to assist them through a rough time; but with so many radical changes happening when a spouse dies (eating habits changes. People often have to move to another home. etc) putting someone onto anti-depressants just because their spouse dies seems like a cop-out to helping that survivor learn to cope with their new daily existence.
Who is advocating that? The article doesn't go into the details. Sound like we can all agree that its preferable if someone can manage a loss without drugs but the whole point of therapeutic use of drugs is that a prefessional makes a judgement that a patient isn't managing very well at all, so give the drugs. So lets make this clear - if a doctor sees that someone isn't managing, why is it a "cop-out" to provide medicine??
It sounds like some people really have a value judgement about anti-depressants. I say, over prescription of lots of kinds of medicine is a problem, not just anti-depressants. But that doesn't mean that the medicine doesn't work. Anti-depressants work, in my book, in my doctors books. And some people need anti-depresants. So big deal.
Get mad at the money angle, or get mad at doctors who prescribe wrongly or don't followup, etc. etc.
This misunderstanding about anti-depressants and these value judgements really seems odd in this forum. It sounds a little puritanical to me.
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So lets make this clear - if a doctor sees that someone isn't managing, why is it a "cop-out" to provide medicine??
It isn't a Cop Out, as you stated some people do need help in getting over a lost loved one. I have counselled quite a few young parents over the loss of a child in my time, and a fair few, after a period of time, and when it's obvious they are not coping with their grief have been put on antidepressants, and it has helped them get over their loss.
I say, over prescription of lots of kinds of medicine is a problem, not just antidepressants. But that doesn't mean that the medicine doesn't work. Antidepressants work,. And some people need antidepressants.
I totally agree, at the right time and in the right situation they do work.
Aroha
Jan
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In treating depression, medication does not discriminate in regards to etiology. In other words, in clinical practice the loss of a loved one is seen as a "legitimate" cause for depression, mourning, loss of interest, and so on, whereas a non-traumatic, every day trigger (such as gaining a pound) may not be.
The medication being used here treats the symptoms of depression, regardless as to the cause. It's not really clinically surprising (although it is clinically significant) that this would be the case.
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losing a spouse is incredibly different. While losing any other relative or friend may be emotionally devastating, it is in no way comparable - especially when those people live in another home of their own. The person paying the other half of the bills, doing the other half of the chores, sitting across from you at the dinner table, and lying in bed with you every night is gone. (many elderly people often die soon after their spouse) Even if you don't particularly like your spouse at the time of their death, their absence from the house will change how your daily life is lived and handled. A person's life is never MORE changed than when the other half of a couple passes away.
I have found that there are few absolutes in life and that nobody can claim to have cornered the market on bereavement. I find it condescending to suggest that your loss is somehow "superior" or more worthy, to a loss of any person, other than a spouse. This is why I find you so tiresome. Over the years, you have constantly professed your superiority over others because of the loss of a spouse. Try suggesting that to a parent, who has buried their child.
As much empathy as I have for you, over losing partners, I am tired beyond words at your using those losses as some sign of moral superiority. You are no better, nor worse, than any of us because of your losses. All losses are relative to the parties involved, not to those un-involved. Stop telling the rest of us, how inferior our losses are to yours.
Joe
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This isn't a contest of who grieves the most for whom.
Sure seems to be...