Inner Critics, Antidepressants, and the Medicalization of Emotions - Part One

8.01.19

By Adam Zwig, PhD

Everybody Must Get Stoned
Diagnoses of depression have skyrocketed since 2013. New statistics released by Blue Cross Blue Shield state that diagnosis rates have risen 47 percent for millennials and 63 percent for adolescents. Depression is the second most impactful condition affecting Americans, putting it right behind high blood pressure. It’s already being predicted to become the leading cause of loss of longevity or life by the year 2030.

As of 2017, 54 million Americans were on psychiatric drugs, mostly antidepressants. That’s 1 in 6! Tweet: As of 2017, 54 million Americans were on psychiatric drugs, mostly antidepressants. That’s 1 in 6! - Dr. Zwig https://drzwig.com/blog/detail/inner_critics_antidepressants_and_the_medicalization_of_emotionsTweet This Of these, 8.4 million were children, including infants and toddlers. From 1988-1994 and 2005-2008 the rate of consumption increased by almost 400%. Twenty-three percent of women in their 40s and 50s take antidepressants, a higher percentage than any other group (by age or sex).

Move Over Opiate Crisis—Here Comes the Antidepressant Crisis
Most people who take antidepressants do so for many years despite the growing list of long-term adverse effects. Researchers have identified increased risk of brain, cerebrovascular, cardiac, gastrointestinal, sexual and reproductive disorders, increased risk of Type 2 diabetes, and, paradoxically, psychiatric problems, including increased risk of suicide in teens.

In 2017 there was a major meta-study done in Canada that analyzed sixteen studies which included 375,000 participants. The results were scary. The analysis found that in the general population, people taking antidepressants had a thirty-three percent higher risk of dying prematurely than people who weren’t taking the drugs. In addition, antidepressant users were fourteen percent more likely to have a stroke or a heart attack.

Antidepressants disrupt your serotonin and dopamine levels which have important functions not only in the brain, but all over the body. For example, serotonin affects growth, reproduction, digestion, immune function, and lots of other things; it’s found in almost every major organ. So, while these drugs alter your brain chemistry they also have unintended effects on your body in a way that can increase your risk of death.

False Prophets
One of the causes of this antidepressant mania is the fact that anyone with a medical degree can prescribe these powerful drugs; no training in mental health is required. Primary care physicians and pediatricians routinely write prescriptions without having any idea of what’s going on with the patient. Writing a prescription makes everyone feel like the problem is being taken care of; the physician makes a diagnosis and the patient gets the “cure.” But does this meteoric rise in pill popping really mean depression is now being successfully treated? Or does it mean the pharmaceutical industry has given doctors enough financial incentive to convince the public that a pill which numbs out their problems is the correct and healthy way to go?

Peering into the Hidden Psych Lab
In 2008 a research study led by Dr. Irving Kirsch of Harvard Medical School analyzed the results of thirty-five drug trials submitted to the FDA to get approval for antidepressants. They were testing Paxil, Prozac, Effexor, and Serzone - really popular meds. Kirsch used the Freedom of Information Act to gain access to everything that was in the studies. What he discovered was shocking.

For patients with mild to moderate depression, which is most people who take antidepressants, the results were basically the same as placebos. Sugar pills! Those with severe depression felt only a bit better, and only the totally out-of-it folks noticed some improvement. In 2010 the Journal of the American Medical Association reported the same thing. The statistical results of these double-blind clinical trials (where people don’t know if they’re being given a drug or a placebo) showed that almost the entire effect of antidepressants is placebo. But the FDA still approved the drugs for marketing.

Serotonin’s Fake News
The painful experience of depression makes the intuition that you have a “chemical imbalance” seem reasonable. But it’s a wrong intuition. Unconscious psychological processes can produce the most severely messed up states of mind you can imagine—no chemical imbalance required. Antidepressants are supposed to work by increasing serotonin in the brain. Only problem is there are no studies demonstrating that depression is actually caused by a serotonin deficiency nor that antidepressants fix it. Tweet: Antidepressants are supposed to work by increasing serotonin in the brain. Only problem is there are no studies demonstrating that depression is actually caused by a serotonin deficiency nor that antidepressants fix it. - Dr. Zwig https://drzwig.com/blog/detail/inner_critics_antidepressants_and_the_medicalization_of_emotionsTweet This It’s an idea that’s never been proven. But this doesn’t stop doctors from prescribing drugs that alter serotonin levels.

The depression-serotonin idea has become so commonplace that people have stopped questioning it. They believe it to be a proven theory when, in fact, it’s still just a hypothesis. There’s a profound disconnect between the true status of the research and the public’s understanding. Drug companies amplify this confusion by doing advertising campaigns that reframe negative states of mind as “symptoms” which the drugs are designed to cure. The ads frame your emotions in terms of two choices: Either you have a mental illness or you don’t. They don’t provide a third option that perhaps feeling sad and hopeless isn’t an illness at all. If you’re depressed, feel vulnerable, or don’t happen to be a rigorous scientist, it’s easy to buy into these deceptive messages.

Symptom-Free or Self Aware
Now, don’t get me wrong. Many people claim they can function better when they’re on these drugs. For mild to moderate depression, however, an increasing number of studies show that people could achieve the same results just with changes in diet, sleep, and exercise. In my own practice I have helped hundreds of depressed clients completely turn their lives around, and we did it by processing their experiences, not by numbing them with medications. I've done this with many severely depressed clients, as well.

So, the real question is: Is our goal merely to be “functional” at all times?” The pharmaceutical industry has succeeded in convincing us to settle for “symptom-free” living instead of getting to the root of what’s really going on in our psyches. Many people have given up the pursuit of true self-awareness, understanding, and happiness in exchange for not having to deal with their processes. They've opted for the medicalization of their emotions over participation in the conscious evolution of their lives. They've bought into the false message that they should always be happy, and that normal states of sadness and pain are caused by a chemical imbalance of the brain.

We're embarking upon the same kind of dangerous path we entered when opioids became widely prescribed without warnings of harm and addiction. This time we're attempting to erase selfhood in people in order to get rid of their psychological symptoms; it will take a few decades for a new crisis to emerge. Tweet: We're embarking upon the same kind of dangerous path we entered when opioids became widely prescribed without warnings of harm and addiction. This time we're attempting to erase selfhood in people in order to get rid of their psychological symptoms; it will take a few decades for a new crisis to emerge. -Dr. Zwig https://drzwig.com/blog/detail/inner_critics_antidepressants_and_the_medicalization_of_emotionsTweet This

Bad Brain Science
The claim that depression is caused by a "brain disorder” sounds compelling but there is simply no scientific evidence for it. Brain imaging of depressed people shows correlation, not causation. Every emotion has a correlative brain state but this tells us nothing about whether the psychological process causes the brain state or vice-versa. The mere observation of two things happening at the same time gives no data on what causes what to happen. Otherwise you could say eating ice cream causes crime since the incidence of both rise when the weather is hot. There has never been a biochemical study that even remotely demonstrates the cause of depression.

The fact that a drug can numb your mental anguish says nothing about why you’re depressed. The same is true of someone who manages their so-called Social Anxiety Disorder by using alcohol; it would be illogical to claim that their anxiety was caused by a chemical imbalance which the alcohol cured. This confused notion of causality puts psychiatrists in a dilemma: They want to promote the disease / medication model but their official definition of mental illness says it's cluster of symptoms without any specific underlying cause. Since they they don’t know the cause they focus solely on masking the symptoms.

A powerful example of this confusion is psychiatrists’ dilemma over how to treat grief. The second most recent version of the psychology manual had a grieving clause that said you were allowed to grieve for loss of a loved one for two weeks and after that you have clinical depression. However, the newest manual took this out because it went against the chemical imbalance theory by saying depression can be caused by psycho-social factors. Think about it: Someone close to you dies and your grieving is considered a mental illness. The cure? Drugs. Now that’s some bad science!

To Repress with Pills or to Process
Buying into the chemical imbalance idea dissociates you from your process and encourages you to ignore it. Covering over your symptoms with drugs is a superficial, short-term fix. It misses the fact that behind depression, even severe cases, is a meaningful psychological process sounding the alarm for change and growth.

Taking meds is okay in an extreme crisis but you absolutely need to work on the problem. Long-term use of pills, while helping you function better, turns a blind eye and a deaf ear to the underlying problem, and the more you ignore what’s going on in your psychology the more you plant the seeds for future mental and physical health issues. Processing your depression takes you far beyond merely being functional; it makes you feel whole again and transforms your life in ways you never thought possible. Tweet: Processing your depression takes you far beyond merely being functional; it makes you feel whole again and transforms your life in ways you never thought possible. -Dr. Zwig https://drzwig.com/blog/detail/inner_critics_antidepressants_and_the_medicalization_of_emotionsTweet This It also frees you from having to deal with the all-too-common side effects of downing antidepressants.

Bob’s Mysterious Depression*
A client of mine, Bob, a thirty-nine year-old waiter, complained of chronic depressed moods despite the fact that nothing particularly depressing had occurred in his life. He couldn’t figure out why he always felt down since everything seemed to be in order—he had a good marriage, a decent job, and great friends. He claimed he was depressed “for no reason” and told me he had a chemical imbalance in his brain. Find out how I helped him transform his problem in Part Two of this Blog post.

*Client names have been changed

©2019 Dr. Adam Zwig

Dr. Zwig - psychotherapist, singer-songwriter, and author - is an internationally renowned workshop leader and lecturer, has had 9 Top Ten hit singles on the U.S Adult Contemporary charts, and has over 70 million views on YouTube. He has been featured in Billboard, Huffington Post, CNBC, MSNBC, ABC, CBS, Forbes, and Gibson. Dr Zwig has released 7 albums and his songs can regularly be heard on NBC, Fox, and Fuel TV. His forthcoming book, Music in the Mayhem: Tales of Total Transformation from a Rock n Roll Psychotherapist, arrives soon.