Antidepressants Often Slow to Counter Hopelessness
> 2/20/2008 11:40:19 AM

Individuals suffering from extended bouts of pessimism and a general lack of hope regarding the future often rely on personal faith, motivational speakers, or at-home self-help seminars for inspiration. Many also recognize their mood problems as diagnosable medical conditions and turn to professional treatment: therapy and, more often, medication. All affected individuals would like a pill or therapy session to miraculously grant them a 180-degree shift in mood. But their expectations may be unrealistically high as antidepressants, though effective for a majority of patients, often require a good deal of time to take full effect, and dramatic mood swings, even if they seem positive, are most likely not a good thing.

Depressed patients waiting for a sense of renewed hope may, unfortunately, need to accept the fact that instant chemical cures for long-term emotional lulls do not exist and try to have greater patience with their medications and therapies - new reports seem to confirm that the hopelessness so common to depression is quite often the last symptom to improve with treatment. Most antidepressants take at least 3-4 weeks to begin influencing thoughts and behaviors on a physiological level, and very deeply ingrained cases of depression take far longer to counteract. Even in severe depression cases, individuals are able to resume their work and social lives 1 to 3 months after beginning treatment, and loved ones will most likely also notice a positive shift in their moods. But they may still be plagued by a general sense of malaise and a grim view of future prospects, and this negative outlook can greatly influence the course of their recovery.

The latest published reports on this subject analyze an Eli Lilly-sponsored study progressively examining the treatment outcomes of 573 patients medicated with SSRI antidepressants such as Prozac, Paxil and Zoloft. After beginning their medications, patients answered surveys about their status at 1, 3, 6 and 9 months. These updates sought to gague the patients' depressive symptoms, work and social functions, emotional well-being and "hopefulness beliefs." A patient's sense of hopefulness should, at first, be distinguished from his or her current state of emotional satisfaction. One can reply positively to mood indicators, noting that he or she is back at work, conversing better with family members, and exercising regularly while still harboring a sense of impending gloom. Improvements in mood do not necessarily mean that the deeper influence of depression has passed.

The earliest symptoms to improve significantly in this study were somatic complaints relating to physical discomfort. Lest we forget: head, back, and stomach pains, as well as recurring insomnia and accelerated heart rate/shortness of breath are very commonly reported somatic symptoms of depression. These changes plateaued early, with most progress reported by the end of the first month of treatment. Mood issues also improved dramatically, with 66% of patients noting a decline in symptoms after 1 month and 88% reporting the same after 3 months. Self-described measures of hopefulness hardly decreased, but their improvement followed a more gradual trajectory, leading researchers to state that depression should increasingly be viewed as a multi-pronged disorder whose symptoms are distinct entities that respond to treatment in different ways.

Treatment of a condition cannot be considered successful unless it targets each major symptom of that condition. This study's importance becomes clearer when considering the fact that a sense of absolute desperation and a belief that one's lot will not improve in the foreseeable future are common to nearly every case of completed or attempted suicide. If a patient who has been taking antidepressant medications for 3 months cannot shake his or her underlying sense of desperation, discontinuing the meds will most likely not help in any way, and doctors should encourage their patients to allow for a longer period of recovery. If notable improvements in a patient's emotional outlook do not occur over time, alternate prescriptions or therapies may be in order.


All of us have different DNA and different metabolisms. Some herbs and vitamins work better than others. The first thing that is needed is proper nutrition and a good physical exam. As the director of Novus Medical Detox, I often see patients who are on alcohol or opioids, central nervous system depressants, also taking antidepressants. When they detox they find they don't need the antidepressants.This is good news because a Swedish study showed that 52% of the 2006 suicides by women on antidepressants. Since antidepressants work no better than placebos and are less effective than exercise in dealing with depression. There is a prescription drug epidemic and these are leaders in the list of terrible abuses.Steve Hayes
Posted by: steve hayes 3/2/2008 2:21:19 AM

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