Contributors

Monday, June 18, 2018

Depressing Drugs

Recently there's been a spate of high-profile celebrity suicides. Anthony Bourdain and Kate Spade drew particular attention to the media's coverage of suicide.

But this is nothing new. In 2014 there was a similar fire drill when Robin Williams and Philip Seymour Hoffman committed suicide. That was when people started taking the opioid epidemic seriously.

This time, however, there's a different vibe: an article was just published in JAMA with the following statistic:
More than a third of Americans are estimated to be taking at least one prescription medication that carries the risk of depression, including suicidal symptoms, as a possible adverse effect—and they may have no idea—according to a study published this week in JAMA. 
The study is an observational one, meaning it can only identify associations and not whether common drugs are causing depression or suicide in people. Still, the researchers found some worrying links between the use of common medications and the potential for depression. Most notably, the researchers found that those taking three or more medications with depression risks had a greater chance of self-reporting depressive symptoms on a nine-question survey. Their rate of self-reported depressive symptoms was 15.3 percent, about double the rate reported by those taking just one drug with a risk of depression and about triple the rate of those taking no medications with risk of depression.
I can't say whether those drugs caused suicides and depression, but if you're taking three or more different drugs, you've got problems. When you add to those real problems the inevitable side effects and interactions between these often toxic drug cocktails, you are going to be miserable.

I've got some limited experience with this. About 20 years ago I was hurting. I'd been playing volleyball heavily for about 10 years, was hitting 40, and everything ached all the time due to overuse injuries. I stopped playing volleyball, but didn't get any better: everything still hurt.

So I went to the doctor and told him my story, and asked if there was some kind of physical therapy that could alleviate my aches and pain. In all seriousness he said, "You're suffering from clinical depression. I'm going to write you a prescription for Prozac."

I was skeptical, so I went home and thought about it for a while. I was unhappy because I couldn't do what I wanted to due to physical ailments, not because I had some underlying mental defect. "Screw it," I told myself. "I'm just going to do what I want." I threw out the prescription and just played volleyball. A little at first, and then more.

I endured the pain, sucked it up. Eventually it got better (endorphins, maybe?). Since then I've suffered through several injuries and surgeries, and now I'm getting arthritis and other afflictions of old age, but I keep soldiering on. I might be cranky because my hand always hurts, but I'm not depressed because I'm still doing what I want to do.

I do limit my playing time to four or five hours a week, and avoid overexertion: I've given up tournaments and leagues so that I don't have to play if I'm not feeling up to it. At some point I'll have to give up volleyball completely, and then I'll switch to biking or something less jarring.

I am sure that some drugs actually do cause depression. They often make people feel nauseated, prevent them from thinking clearly and have countless bad side effects like gas, lowered sex drive and the entire litany of disgusting ailments recited in those annoying drug commercials.

But the real problem with most drugs is that drugs do not cure the underlying problem. They just mask the symptoms. If you've got a strained rotator cuff or serious gastric reflux, Aleve and Prilosec will not fix your shoulder or eliminate your heartburn. The problems will just recur when you stop taking the drug.

Worse, taking the drug may hide real problems and eventually result in much more serious injury (a blown shoulder or esophageal rupture), which could have been avoided had the real problem been dealt with instead of brushed aside by doctors who are urged by management to crank through as many patients as quickly and cheaply as possible.

So, if eating pizza gives you heartburn, you should stop eating pizza instead of taking a drug to eliminate the heartburn eating pizza gives you. If playing volleyball four hours straight makes your knees hurt, only play for two hours.

People need to realize what's really going on with them and deal with the actual problem. If you have normal brain chemistry, no pill is going to fix all your problems and make you happier. Learn your limits.

Our national drug problem is an indictment of the health insurance industry, which always looks for the cheapest solution, and the pharmaceutical industry, which became drug pushers who steered people with normal aches and pains to highly addictive and extremely expensive opioids. It turns out boring old Advil and Tylenol are just as good as oxycodone for alleviating acute pain.

The sooner people understand that drugs do not cure your problems, the sooner this country will start healing. And stop committing suicide.

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