In January, Erick Turner, a professor of psychiatry at Oregon Health & Science University and a clinician at the Portland VA Medical Center, shook up the medical community, provoked the pharmaceutical industry and, perhaps, disappointed millions of depressed Americans, Phil Dawdy writes in
The Willamette Week. That's because he published a paper in The New England Journal of Medicine that revealed antidepressants are not as effective as thought. For years, he implied, drugmakers exaggerated the performance of their pills. Turner calls it the “dirty little secret” of the psychiatric world.The study has given Turner not rock-star status, perhaps, but a level of notoriety in a profession where docs typically labor in anonymity. Since the publication, Turner has become a go-to source for reporters writing about depression and antidepressants. The great irony is that, for 18 months, Turner pimped for antidepressants. He wouldn’t put it that way, of course, as many docs do the same thing. But starting in 2004, Turner, who is the medical director of the Mood Disorders Program at the Portland VA and has worked at the FDA and NIH, became a speaker for Lilly, the paper writes.
Lilly approached Turner around the time the FDA was set to approve a new Lilly antidepressant named Cymbalta. He was an especially good catch because, in addition to his academic appointment at OHSU, Turner spent seven years as a researcher at the prestigious National Institute of Mental Health and another three years as a clinical trials reviewer at the FDA. “They’re using your reputation and political capital, as it were, as sort of a frontman for the drug,” Turner, 54, tells the weekly.
After training in Indianapolis in the summer of 2004, Lilly sent Turner out into the field in the Northwest, receiving anywhere from $500 to $750 per talk. He says he did about 12 talks for Lilly over the next 18 months, and that his motivation wasn’t so much the money - he netted less than $10,000 - but a desire to keep up his reputation as an expert on clinical trials. "In the beginning, I think I got narcissistic gratification,” he tells the paper. “They fly you somewhere else in the country and pick you up in a limo, and you stay in a nice hotel you could never afford otherwise.”
But Turner soon found he could say only what Lilly allowed him to say. He could use only Lilly’s overhead slides of results from clinical trials of the drug. And he couldn’t offer his own expertise as a researcher and former FDA reviewer to his fellow doctors. “I began to feel straitjacketed,” he says. But there was evidence in unpublished clinical trials that antidepressants didn't always perform very well, and Turnerk knew this. So he began to rebel - he stopped taking money from Lilly and started to tell the truth. “I guess you could say I bit the hand that fed,” Turner tells the weekly.
In November 2004, Turner wrote a paper that was published in PLoS Medicine, an influential, peer-reviewed medical journal. In the article, Turner argued that all clinical trials submitted to the FDA should be published online by the agency, so doctors could know the breadth of a particular drug’s research base before prescribing it to a patient. The paper made him an official critic of the pharmaceutical industry and its long-standing practice of hiding data from public view, the weekly writes. Hardly anyone in the medical-publishing world listened.
Feeling as if his hands were tied, Turner quit doing doctor talks for the pharmaceutical industry in 2005, convinced he needed to make his case more strongly by collecting reports of pre-approval clinical trials for antidepressants that had not been published, the weekly continues. He found some of them online, deep in the FDA’s website. Then he reached out to other researchers in the field, getting some records from a researcher at the University of Nevada at Las Vegas and other records from a researcher in Seattle, where Turner says, “I literally went down to a Kinko’s and photocopied them.”
Eventually, Turner amassed findings from 74 trials. Of those, 51 percent found that a drug had performed better than a placebo, while 49 percent were negative or had mixed results. The bulk of the negative trials had never been published anywhere. It was almost as if those trials, and the thousands of patients who participated in them, had never existed, the weekly notes. The implication - drugmakers had successfully overstated the power of antidepressants for two decades. Put another way, the weekly writes, the drugs were made to appear more beneficial than they really were.
Turner, however, still prescribes antidepressants but admits he is careful not to overplay their benefits to patients in order not to give them false hope after decades of hype around the drugs. “There are some people who seem to get a great response and a lot who don’t seem to get much response at all,” Turner tells the paper. And he says he probably won’t be asked by the industry to run clinical trials on antidepressants anytime soon.
"I don't think they would want to risk it after this paper,” he says. “They would not want to touch me with a 10-foot pole, unless it had a sharp end on it.”
This is only an excerpt, folks. Click here to read the full piece.
Source: The Willamette Weekly
Hat tip to Furious Seasons
28 Comments
Fascinating. Can anyone comment on or answer this: the report references Turner finding 74 trials, 51% of which showed the active better than placebo and 49% poorer than placebo. He refers to pre-approval trials. I'm assuming that the drugs in these trials were all ultimately approved. If that's not the case, and some of the drugs in the 49% were discontinued, wouldn't that alter the outcome? I'm sure they thought of that before publishing in NEJM but I'd be interested to learn more.
Chris, Good point. I don't know the answer. I had a long talk with one of my psychs today. He is over 70 years old (very sharp, just couldn't retire) and has worked in the state hospital, the VA, hospital stress clnics, private practice and community mental health centers. In short, he has vast experience and is old and wise. I asked him about this--does he think the anti-depressants work?
He said, "HC, you can take me to all the dinners you want, you could fly me to Paris, and if a drug didn't work, I wouldn't use it. You tell me about a new drug, and I try it a few times. If it works, I will keep using it. Otherwise, pffft!"
He went on to say that the SSRIs work about as well as the old tricyclics, but with better safety and side effects. He said that psychiatrists go by the rule of thirds: one-third of patients will do great; one-third will be better, but still symptomatic, and one-third will fail. He seemed pretty pragmatic about it.
Another thing one of my researchers pointed out is that the kind of patient who qualifies for a clinical trial is often very different from those in practice. They are often somewhat milder--and the milder the patient pool, the harder it is to differentiate from placebo. This same doc said (and I don't know how true it is), that trials get their share of borderline personality disorders--and nothing works in those patients.
In short, I think the trials accomplish about all we can expect them to. The true test of the drug comes in the real world. And despite what many on this blog seem to think, no matter how persuasive the rep, a doctor is not going to prescribe a drug that doesn't work.
Finally--to his point that he could only use Lilly-provided slides and not share his own experience. This is a pharma restriction implemented since the off-label debacles. It's too bad, because the programs are a lot less valuable, but pharma can't afford to have a doctor go off-label and have someone in the audience report it.
I think that guys like Turner come out with this stuff like they think it is some big revelation to the industry and doctors--and it isn't. He is really just playing to the press and his own ego (look at me!! I'm a "whistleblower!"), when doctors look at the data and yawn.
"He went on to say that the SSRIs work about as well as the old tricyclics, but with better safety and side effects."
If he truly believes this, then he isn't reading the current warnings and side effects. The warnings, side effects and adverse reactions on ssri's have bypassed tricyclics a long time ago.
"side effects and adverse reactions on ssri’s have bypassed tricyclics a long time ago."
The warnings on most new drugs have surpassed older drugs. But that doesn't mean that they are less safe. That just means that pharma companies are doing a better job of covering their butts.
Laurie, So....he should ignore 40 years of prescribing experience in deference to a written WARNING...
Let's see...swallow a few extra tablets of a tricyclic and die. Swallow scores of tablets of Zoloft and...throw up. Which would you rather have a depressed person exposed to?
Tricyclics: nausea, vomiting, orthostatic hypotensions, weight gain, heart arrhythmias, anxiety...also same suicide warning as SSRIs.
I have experienced both. I'll take my Zoloft any day.
BASTARD,.. No Explanation Needed.
HC,.. Dont,.. even,... think about it.....
When you sit down and look at all the information available, response rates to cognitive behavioral therapy and medication are pretty much equal. Some groups like children and adolescents respond better over the long term to therapy than to medication. Pills really can't teach you anything. Excess reliance on them may support the belief that you don't have the power to help yourself. There are not toxic effects from too much counselling either.
In children and adolescents, therapy alone or with fluoxetine appears protective against suicidal thoughts (see the last NIH TADS trial report). I suspect, this is probably also true in young adults where there are growing concerns on the same self-harm issues with SSRIs.
It may be true that any medication - SSRI or Tricyclic - has some association with acting on suicidal thoughts. This may just go hand in glove with the depression. Medication may improve motivation before it improves mood - a motivated person with suicidal thoughts may be worse than someone who hopes to die, but can't bring themselves to get out of bed. I am not being flippant here.
I've heard some reasonable speculation that these risks may be greater in a medicine with a short half life (like paroxetine. With short-half lives you may get the added burden of waxing and waning medicaiton effects.
Tricyclics have more acute toxicity, but that does not necessarily mean that SSRIs are a better treatment. Just that SSRIs are safer in overdose. This is all reductionist thinking, and not very helpful overall.
The question should be not what is the best medication for depression or anxiety, but how is depression or anxiety best treated, and how can the depressed or anxious person be best helped? Newer, shinier medications and placebo controlled trials don't help much to answer the important questions.
My opinion is that if you are "sick" enough to use a medicine, you are also "sick" enough to talk to a therapist, consider and address sources of stress/conflict (this may be family/marriage counselling), start/adhere to behavior modification (physical activity improves mood, sleep hygeine is important, too - please ignore my time stamp).
The big lie is that depression is merely a "chemical imbalance." I think there is reasonable experience that indicates it a connection to our modern/western/acheiving/ consuming/conforming lifestyle.
Sadly no one details phsyicians on the value of counselling, or a complete bio/psycho/social perspective on mental health. However, lots of folks are eager to talk about how Lexapro is so much better than Celexa since that pesky "r" isomer is out of the way. Soon, we will also learn how much better is Pristiq than Effexor XR. Sometimes I think physicians hear so much of this they forget simple truths.
An aside to Horus-Cat. Off-label PROMOTION as a corporate strategy or by individual reps is not legal. Sharing clinical inforomation about off-label uses from one professional to another - when it is acknowledged to be off-label - is not illegal. It is also perfectly legal for a PhRMA company to provide information to me about off-label uses through a clinical information department or scientific liason if I REQUEST it. Dr. Turner had to stick to the script not because of legal restraints, but because Marketing wanted the particular message delivered in a particular way. If you haven't read Dan Carlat's "Dr. Drug Rep" is worth a look.
An additional aside to Nathan - since the FDA user fees started last decade, there seems to be a higher rate of product withdrawals and medication problems surfacing after approval. Newer drugs which were approved according to the negotiated schedule may in fact be less safe. This story is covered elsewhere on Pharmalot
Oh Lisa, just shut up. You are living proof of what Neil Boortz says: you can't cure stupid.
Dr. Helm, You make an excellent point: I have laughed at the idea of Pristiq numerous times on this site--noting that the last thing we need to be spending our R&D on is me-too drugs (unless the existing drugs have tremendous nuisance side effects or dosing inconveniences, which is not true in the case of the SNRIs). I have said multiple times on this site that counseling and other non-medication techniques are essential to being "well"--this could include psychotherapy, prayer, meditation, physical exercise, yoga, CBT, etc. I have stated that children seem to respond well to therapy, including CBT. I have stated that my son (who is autistic) goes not only to a psychiatrist, but to a counselor and social groups. I have stated that the best physicians require some sort of counseling with their medication management. I have also stated that I believe that our lifestyle--lots of leisure time, no physical challenges (for most of us), plentiful nourishment, lack of community, loss of extended family--contribute most to our mental state. In a way, we have evolved technologically and industrially beyond our physiology. In other words, you jumped into a on-going discussion and assumed that the drug rep believes that only medication is needed, while I was simply responding to the context of the blurb and responses. Nonetheless, your point is well taken.
Furthermore, I did not state that one doctor may not provide off-label information to another (when sponsored by a company at a dinner program, he must be asked and he must clearly state it is off-label), nor that medical liaisons are not available for off-label discussion. What I clearly meant was that in the context in which Dr. Turner is referencing, i.e., a speaker program, off-label promotion is verboten (unless another physician were to ask him a question). It is true that he could use his own slides if they contained no data, simply disease state information. I suppose he could get up there and say that he doesn't think anti-depressants work, if that is what he believes, but I don't think that would be appropriate in that setting, nor do I think his audience would believe him. As I suggested above, in my experience, good physicians don't overestimate the efficacy of medication. They do know the limitations of clinical trials and they trust the years of experience they have in using the drugs.
Lisa Van S says: "BASTARD,.. No Explanation Needed. HC,.. Dont,.. even,… think about it….."
Yes, there is an explanation needed. HC didn't say anything offensive or misleading as far as I can tell. She was giving her own opinion and using her own experience as an example. If "BASTARD" is the best responce you have, then... well, I guess HC must be speaking truth. If you disagree with her, come up with a more coherant responce please.
Thanks, Nathan. Gosh, I feel like I am pretty even-handed in my understanding of pharma...yes I am pro-pharma, but I am also a patient, a parent, a daughter...I think I made it pretty clear that good doctors don't consider drugs to be miracle cures...but I do think that it is pretty foolish to tell a physician who has been practicing successfully for 40 years that his experience means nothing and the drugs he uses don't work (he is just too stupid to see it).
I became depressed while in high school. Much as Dr. Helm alluded to, I think it was a combination of social and family issues with a genetic predisposition. This was long before Prozac came on the market, and besides my dad is a surgeon and at least at the time, had nothing but contempt for psychiatry. I went untreated until college, when I developed an eating disorder and was hospitalized for suicidal ideation. Again, this was before SSRIs and unmedicated, so I don't think anyone could argue that pharmaceuticals were at fault!
I was put on three different tricyclics and could not tolerate any of them. I gained weight; I slept constantly; I had such severe orthostatic hypotension that I fainted several times. It was only a combination of CBT, counseling, group work (a 12-step type program) and yes, PROZAC, that I began to feel better, after more than a decade of feeling like s***. I firmly believe that the combination of treatments was necessary, including the Prozac.
In the interim, my younger brother became suicidal and self-mutilating. Once again, it was a combination of therapy and medication that gave him his life back. I used to be convinced that I would get one of those middle of the night calls (no, not for you, Hillary), where my mom or dad told me my brother had killed himself. He's not perfectly well now, but I don't worry about the phone call anymore.
That is why I am so adamant on this site that the SSRIs and other psychotropics are a useful and necessary adjunct to the treatment of depression and associated mood disorders. I know that there are physicians out there who do little more than write a scrip and say come back in 6 months. That is not practicing good medicine. But it not good medicine, either, to say get some counseling--you'll feel better.
I have lost patience with people on this site who have no perspective. I come at this not only with the experience of someone in the pharma business for over a decade who has spoken to thousands of doctors and patients, but someone who has "been there, done that." So thanks again, Nathan.
HC--you seem to think YOUR experience is the ONLY experience. I, too, have been there and done that. I was on trycyclics and SSRIs. My experience in no way mirrors yours. I, too, lose patience--with those who seek to elevate themselves and their views, stroke their own egos and play to the press. Pot . . . meet kettle.
"In short, I think the trials accomplish about all we can expect them to. The true test of the drug comes in the real world. And despite what many on this blog seem to think, no matter how persuasive the rep, a doctor is not going to prescribe a drug that doesn’t work" Says Horus Cat ..
The true test of drug comes in the real world?
We... Is it not obvious HC that what patients are saying is the drugs are CRAP and the drugs are making them SICK and the drugs like SSRI's used on them in the real world are causing them problems!!! Do yourself a favour and google "Paxil" and other SSRI drugs, the sheer volume of complaints about these drugs surpasses nearly all other drugs .. That's the Real world Test.. And the real world test is not in favour of these drugs!..
If a doctor prescribes an SSRI drugs and he sees a patients mood improve somewhat , but only sees that patient every couple of months between prescriptions, the Doctor cannot make an accurate opinion on whether the drug is working or not.. in between those visits the patient will have all manner of side effects .. Also , the efficacy of SSRI drugs is extremely subjective and deceptive .. To simply say they "work" is too basic .. In what way do they "work" Patient is depressed , he is prescribed an SSRI .. The SSRI is designed to elevate mood not to deal with the psychological issues of depression or anxiety .. It is no different than prescribing a mild dose of MDMA or "E" .. They work on similar pathways, serotonin, dopamine and GABA Giving an emotionally upset and vulnerable patient a "pep" pill is hardly a suitable treatment .. Most doctors who use these drugs and advocate them are just lazy , they claim they don't have time to treat the patient properly, but really its that they don't have the knowledge and also they would prefer to make time to see more patients so that they can earn more money in that day..
The "pill" for every ill agenda in relation to mental health is an absolute disgrace and any doctor that ascribes to it is a "pill" pusher.. When health care boils down to a 5 minute diagnosis and dispensing of a prescription , then health care has lost its "care" and thats where it's at now unfortunately ..
Melody: One, I don't play to the press. Two, I don't seek to elevate--I am the only one on this site who says "balance." YOU and idiots like truthman are saying they NEVER work. You are obviously ILLITERATE and cannot read my posts, where I say we need balanced therapies that offer counseling, spiritual guidance, exercise, etc. You ignore me when I say good doctors don't just "write a scrip and give a 5 minute diagnosis." You are ignoring the literally millions of people in the world who benefit from these drugs. You frame your opinions only from your own experience and the vocal minority who haunt websites. You ignore any evidence that flies in the face of your prejudices. I will acknowledge that not everyone needs medication and that some people do not respond well to them. YOU assert that NO ONE benefits. Who sounds like a kook? YOU do. YOU sound like the scientologists spouting all sorts of hogwash while attempting to debase anyone who turns to modern medicine for help with a problem that is beyond their ability to solve on their own.
Your inability to see anyone else's point of view is stupefying.
HC, I think you embellished your story a little bit. Are you sure the good doctor didn't state "1/3 got no benefit whatsever from the drugs, 1/3 got worse on the drugs and 1/3 benefited from the placebo effect"? I believe if you go back and read the article above Turner does not believe this is a new relevalation as he has been stating this stuff for years but people weren't listening. Just like you now.
HC, you state: You ignore any evidence that flies in the face of your prejudices. I will acknowledge that not everyone needs medication and that some people do not respond well to them. YOU assert that NO ONE benefits. Who sounds like a kook? YOU do."
Exaggeration, and "kill the messenger" if you can't kill the message--nice strategy . . . predictable, but if works for you, you go, girl.
I don't think you can find anyplace on ANY of Ed's blogs where I have said that no one benefits from medicine. (Go ahead--take a look back through June 2007.) Likewise, the post to which you so 'eloquently' responded--did that escape YOUR literacy? I STATED that I had used both tricyclics and SSRIs . . . and that my experience did NOT mirror yours. I didn't say they didn't work; as a matter of fact, the tricyclic worked (for me) much better than the SSRI. All I am saying is that it appears that once YOU take a stance . . . all others readers here should either 'fall in line' or cease participating.
This study didn't really focus on whether or not SSRIs work. In fact, the meta-analysis from this study found that they all worked.
It focused on publication bias - where positive studies wind up in the published literature and negative studies don't. Why? Probably two reasons, although the study can only speculate about it. First, companies do most of the studies on their drug and they're less eager to publish negative or inconclusive results. Second, journals normally don't like to publish negative results, making it that much harder to get the study published. For the former reason, hopefully new guidelines will eliminate this. For the latter reason I doubt that will change.
HorusCat
I am not an Idiot .. Only Idiots would be as arrogant and conceited as you.. It takes intelligence to have insight.. And clearly this is something you lack.. Not to mention manners and civility..
Your incredulous claim that SSRI's "work" and "benefit millions" is text book Pharma PR speak .. No one is arguing that these drugs can be useful in severe depression and anxiety , but they must be given under strict supervision and the patient must be informed about all the possible dangers and have therapy to address the underlying issues.. In how many cases does this happen on average HC??? Close to ZERO , thats how many..
To imply that they work , implies that they are somehow fixing a problem.. You know damn well that they are chemical bandaids HC.. They FIX NOTHING.. they mask problems and they numb the user.. Just like all mind altering drugs, from alcohol, marijuana and SSRI's, they are a crutch.. They DO NOT CURE EMOTIONAL PROBLEMS!!! DONT YOU GET IT!! IF you cant see that then you really are an IDIOT..
Since the SSRIs are, fortunately, here to stay, this discussion is moot. And no, Jane, unlike many here, I don't prevaricate. The excellent doctor, like many I have spoken to, spoke just as I recounted.
Let's follow the bouncing ball: I had a conversation going with Nathan and others. Someone called me a bastard...that would appear to be the moment, Melody dear, when someone was communicating either go along or cease participating. Nathan pointed out that I was being balanced, and my reply back to Nathan was none of your business. YOU chose to jump in and accuse me of playing to the press. Since I am anonymous on here, and there is no press, exactly to whom am I playing? So it seems that following being called a bastard, you jumped in with both feet. Add to that Truthman, who needs to follow his own cures for mental derangement, and I think it is pretty clear what the prevailing theology on this site is. There are very few of us who dare to come on here and speak the truth in the face of emotional attacks by people like Jane and Lisa Van S.
You guys remind me of drug reps I know who won't admit that any other drug works and that sometimes theirs isn't the best--just at the opposite end of the spectrum. Neither end is credible. Fortunately, as I said, the SSRIs are here to stay and none of you will be able to change that.
HC..
You are a waste of space..
Horus Cat "Add to that Truthman, who needs to follow his own cures for mental derangement, and I think it is pretty clear what the prevailing theology on this site is. There are very few of us who dare to come on and speak the truth in the face of emotional attacks"
You have not even addressed any of the points I made in reference to SSRI's.. I have never debated with you on here before, yet you call me an idiot for no reason, you then call me deranged.. If you examine your own behavior and responses in this thread.. It is clear for anyone to see that you are the idiot ..
truthman30, I am not going to debate with someone who has a religious belief about medication and mental illness. It would be like trying to debate a right-to-lifer.
"No one is arguing that these drugs can be useful in severe depression and anxiety , but they must be given under strict supervision and the patient must be informed about all the possible dangers and have therapy to address the underlying issues.. In how many cases does this happen on average HC??? Close to ZERO , thats how many"
I will debate this point. In my experience, most physicians take the time to discuss safety, tolerability and efficacy with their patients. They do with me, they have done with me when my kids are involved, and I know that they do with their other patients. For one thing, tman, there are too many litigious people out there not to cover safety and tolerability. For another, they have to set patient expectations about efficacy, so they tell them not to expect miracles and to give the meds 4-6 weeks. Your assertion that this does not happen is not backed by any data, but rather an emotional belief that it never happens. Such irrational assertions are impossible to argue.
As for your belief that mental illness cannot be helped by medication, that's your belief. Welcome to it. Feel free not to take any medication. The rest of us, rational human beings, will use medication judiciously along with other approaches to maintain emotional wellness.
There's really nothing to debate. You and others like you continue to assert, in the face of the evidence of millions of people who have been helped by SSRIs, that they don't work and they are dangerous. That is irrational precisely because it is contradicted by real world experience. The failure of some to respond to SSRIs and/or the adverse events experienced by relatively few do not argue against their use in the general population. It is a risk-benefit analysis that doctors make in concert with their patients. Fortunately, your belief system is relevant only to your personal choice.
PS, I'm sorry I called you an idiot.
Truthman, Also deranged. I got a little energetic there. You are not only welcome to your opinion, but I do read it and listen to it. I just disagree totally. I think the brain is a mysterious combination of chemicals, electricity and something special that makes us "conscious". I do think that when genetics and experience and environment combine in the wrong way, some people have mental disease--just the way they can have liver disease or cancer or anything else. The brain is plastic, but after a time of experiencing something stressful (abuse, neglect, whatever), the synapses get set in an unhealthy and distressing way. Only hard work of whatever kind a person finds helpful (prayer? exercise? meditation? counseling? cognitive behavioral therapy?) and sometimes, medication, can remodel the connections to perform in a healthier fashion. Medication may be a sort of band-aid--it protects the connections while the person does the work to practice seeing and feeling things in a different way. It's a band-aid in a good way--the way a bandage on a deep wound protects it, but does not actually heal it.
You believe that doctors don't encourage patients to do the hard work of remodeling their brains. I disagree. There are many, many good doctors (I only work with psychiatrists) who encourage and even require counseling, CBT, journaling, group therapy, spiritual guidance, whatever particular form of "mental exercise" a patient may respond to in order to rework the broken synapses. Some psychiatrists offer psychotherapy themselves, but most don't--but they affiliate with social workers, psychologists and others who can offer support services.
Part of the problem lies with a reimbursement system that often does not reimburse ancillary services, and part lies with the patients themselves, who do not want to do the really hard work of learning to see the world and themselves differently. Things like cognitive behavioral therapy are really hard and require a lot of psychic energy. Sometimes, a patient remains in a situation where the harmful experiences keep happening (an abusive spouse or work environment for ex), and it requires tremendous energy either to leave the environment or fight back against the harmful effects. I think this is part of the reason medication doesn't always work--it can't work all by itself. The individual needs to pour fantastic amounts of energy into healing himself or herself. I think this is very hard for people--who can blame them for wanting a pill that will do the work for them? Especially when they are used to having a pill that works like a switch to lower blood pressure and cholesterol or kill bacteria.
I'd say that mental health is a totally different animal from bodily disease and wellness, except it really isn't when you think about it. It's ok to take an anti-hypertensive or a statin, but we really need to exercise, eat right, manage stress, find enjoyment and value in life, have good relationships--all those things lead to bodily wellness, as well. We don't live in a world that makes these things easy: we don't have to challenge ourselves physically for the most part, our food pretty much comes to us, our extended families are spread out, we work a lot and don't find a network of friends and support, we are told constantly that happiness can be found in a new car or a new Swiffer, TV fills our head with violence...
Medicine can only do so much. Individuals need to take responsibility for their own wellness.
I am sorry I was caustic with you. I do value your opinion and think about the things you say. At the same time, I know my life was saved by the combination of medication and hard work by myself and support from others. I want others to have the option to use all the tools they can to find the often elusive thing we call wellness.
Looks like some of you could use some Haldol.
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